This started out as a "would you UC if..." post but in the process of writing down my thoughts I realized I already new my answer-yes. I've left it intact though and just added this little opening. Here we go. WARNING: very long.
Need advice! Would you UC if making that decision meant that you wouldn't be able to transfer in an emergency?
Ok I've been lurking on this board well basically since Mothering started it (got the email they sent out saying they started it went to check it out and was like "you can do that?")
This style of birthing really speaks to me. It's what I was looking for for in my first birth, My midwife wanted me to write out a birth plan and when I objected to the idea saying that I just wanted to go with it, approach it as a very intense meditation... she must have decided I was a flake. I got nothing but hostility from her from then on out. When a few months after giving birth I read that article about the hormonal blueprint of labor I got so mad. I realized how much she hindered my birth. After about 8 hours of labor I was definitely going into transition. DD's head was down on my pubic bone and I was starting to get the urge to bear down when she came in and freaked out because my water was going to break and make a mess. (she wanted me to put on a diaper!) We got into a huge argument and my labor stopped. DD receded back up into my belly and I didn't have another contraction for an hour and a half. That's when the pestering about not progressing and possible hospital transfer started...
OK. I'll stop rambling and start talking about my current situation. I'm RH-. The Japanese are all RH+ (including my husband). Most hospitals do not stock RH- blood (where are they going to get it from?) Also the hospitals tend to be very exclusivist (just like the rest of Japanese society) if you come in during a medical emergency they may chose not to treat you if they don't already have a relationship with you. (A good friend of mine's FIL is now a vegetable because 4 hospitals refused to treat him while he was having a stroke. only by pulling strings with a connection were they able to finally get treatment-too late). So if I don't have a previous relationship with the hospital it's quite likely that if I were to have an emergency the hospital might not be willing or able to help me.
Plan WAS to give birth at my husband's childhood home (his grandmother's house) with the assistance of a different midwife. We've been going to fairly regular appointments at a nearby hospital so that 1. they'll be willing to give me rhogam after the delivery 2. will accept a transfer in the case of an emergency. Then grandmother and FIL (who also lives there-japanese style) decided they didn't like that idea. OK so we give birth here in our current 2 room apartment (not bedrooms- rooms). But the idea of that never appealed to us (that's how we ended up with the first horrible midwife-only one with a birthing center who would take an RH- mother). the walls are extremely thin. The house next door is about 10 feet away and the people who live there are very loud and obviously unhappy. In the summer, when we can open up the windows and get some air in we've got their unhappy vibes floating in (I'm due in mid-august). The only outdoor space, between the apartment and their house, is one third concrete, one third weeds, and one third big ajisai bushes. And affords absolutely no privacy. I was going to deal with it. was working on making it a little bit nicer place to give birth deweeding etc., when my husband came home from work one day and suggested that we go find some natural setting and give birth there, just the three of us. Yes! But the particulars. I'm not sure if it's legal in Japan (though I don't really care that much-we'll be moving to the states shortly after the birth) but I'm also not sure if I can get a birth certificate without an official birth attendant's stamp on the report of birth. (that is a big deal don't want anything to hold up getting out of this place) And last but not least--Where?
Up till now I've mainly been researching the two factors that have been making me pause. First Not being able to get Rhogam after the birth. But after all of the research I've done I've come completely to terms with this (we're not even planning on having more than 2 children, thus the shot would be a "just in case I accidentally get pregnant again" thing and now that I know how little research they actually did on it before recommending it for all RH- moms and the actual statistics that they do have I'm not sure it would be worth it anyway--especially for a "just in case scenario") Second no hospital transfer. So I've been researching birthing complications like crazy and come to the conclusion that there are only 3 situations in which access to medical treatment could positively affect the outcome of the birth. 1. transverse lie 2. placenta previa and 3. cord prolapse. With the first 2 I'd have an indication that something was wrong before going into labor and would probably be able to get treatment at the hospital I've been going to (even if I stop now). as for cord prolapse. extremely rare in the first place, and for my last birth my water didn't break until one contraction before birthing the baby (all in one contraction). If it does happen time is of the essence. Because hospitals don't stock RH- blood, if I needed to transfer they'd have to get their hands on compatible blood before they could treat me. So even if I compromised on what I really want to have the possibility of a hospital transfer most likely they wouldn't be able to treat me fast enough for it to make a difference.
So I've decided to go with my heart on this one. still looking for a nice place that we can rent for a few weeks to a month. We've had a few leads on a couple of places but none have panned out yet. But I have faith that we'll find just the right place to welcome this baby.