back up medical staff?

[mamamoogs]

I am curently under the care of my homebirht midwife only, i was reading on certain other boards that it is up to me to have a back up plan with a medical doctor and facilty. I sthis necessary ? what do you think? I didnt think it was necessary.

[megviolet]

Maybe it's different for US and Canada, but here it isn't necessary. If i need to go to a hospital to deliver i can just show up unannounced... the on-call doctor would deal with me.

[Kitten]

I suppose you can if you want to, but don't feel like you have to. A hospital cannot turn away a woman in labor. That is federal law, called EMTALA. If you end up transferring the odds are pretty good that you will end up with whoever is on duty at the hospital, even if you have been seeing a backup doctor. I've seen a lot of people say that the backup doctor often tries to scare them into doing the hospital birth no matter what.

You could try bringing this up with your midwife and see what she says. Often they can recommend homebirth-friendly docs (almost always family practice docs) if a situation comes up where you might want a consult.

When it is time for our next we are planning on a homebirth. I don't intend to specifically see a backup doc at any point unless the midwife wants a consult. The clinic we go to has a family practice doc who does obstetrics and is very homebirth-friendly. We see this clinic for our regular health care so I don't see any need to set up a special backup arrangement. They already know us, KWIM?

Anyway, the short answer is, I don't see any need to have a special backup plan. The hospital legally can't turn you away or refuse to treat you.

[SublimeBirthGirl]

I thought it was totally unnecessary for me (and it was).

[reillys_mom]

I have had OB backup for both pregnancies. With #1, I didn't decide to have a homebirth until 4 mo and had an HMO with free pre-natal so did all tests there. My MW also recommended maintaining a reduced schedule of visits with the OB, just in case we had to transfer. For this pregnancy, I've seen the OB that Mw has a relationship with. So far I've seen him 3 times -- initial meeting, 20 wk ultrasound, and when I got pneumonia. Basically, I think that it's useful to know that you have access to medicine and treatments that your MW can't order. If your GP will do that, great.

You also want to be sure that you do have a plan of where you will transfer if you need to go to a hospital. A place that views your prenatal care with MW as valid and will allow her to conitnue to participate is important. You hope you don't need it, but it's better to think about it early.

[crunchy_mama]

I think a lot depends on your area and your thoughts on things.

Where I live dem's are illegal. Therefore I cannot be under the care of my mw if I transfer. Also, I live in a fairly small town. In the rare case of transfer I do not want to leave it up to fate what dr is on call. Of ALL the dr's in town there is only one I trust to come within 10 feet of my vagina. Also, I want to keep my ob for other well-women care as my mw only does pregnancies and lives 1.5 hrs away at that. Another thing for me is that I am RH-, my mw says she could likely get it, but it would be very expensive, so I like to keep the relationship for that reason. I have gotten my bloodwork through him as well.

[AugustLia23]

For me personally I feel it is smart to have a relationship with a hospital and hospital based midwife/OB should the need arise for a transport. Of course I could just show up at the hospital and I know they would treat me, but with the advance knowledge of who a doctor/practice is, I would be able to transfer to a hospital confident that they know and are respectful of my original wishes. I don't want to transport to a hospital and have them treat me like sh*t because I was a crazy homebirther.

I will also be having my bloodwork and U/S done through my back-up practice.

I don't plan on using it, but I feel like it could make a difference if I do end up needing it.

[krismarie]

Originally Posted by megviolet

Maybe it's different for US and Canada, but here it isn't necessary. If i need to go to a hospital to deliver i can just show up unannounced... the on-call doctor would deal with me.

nope, it's the same here for me... i know of some hb mw who have back-up obs but mine doesn't...so we'd just show up at the hospital. i didn't really want to either b/c i thought i'd think about a hospital scenario more then and i wanted to focus my energy on visualizing my hb

[Snork]

No I dont think you need it. I've only ever had my midwife and her backup midwife (who comes when the woman is pushing). I dont even book into a hospital - if needs be I'd just turn up.

[firefly mama]

It really depends on your hospital situation. For me, the OBs work on a rotation, so if you develop a relationship with one particular OB, your chances of that person being available for your birth are really small. So it would be a huge waste of time for me to make arrangements with a back-up OB, given that she would only have a 1 in 6 chance of being my OB for the birth (should I need to transfer). My MW has been practicing in my town for more than 20 years - MUCH longer than any of the OBs have. They all know her, and they respect her profession and know that when a transfer comes in from her, it should be treated with respect.

So we make no back-up arrangements. Come to think of it, no OB has ever seen my vagina in my entire life.