How far from hopital?

[Mary-Beth]

How far from a hospital do you live?

I am considering a home birth and looking into my various issues/concerns.
One issue is that I live at least 25 minutes (going FAST) from the nearest hospital.

What about you? And, how much did this factor into your decision for a homebirth? How much consideration would you give to the distance of emergency care?

[indigolilybear]

For our first, we were like a couple minutes from a hospital. W/no. two, we were about 25 and it was a freebirth.

We figured that that would be plenty of time and if not, we'd call the ambulence. Most complications, your MW (if you have one) should be able to diagnose early enough......and I think the amount of complications and stuff you'd be able to avoid makes it worth the chance!!!! Just MHO. Really, there is risk either way.....

[owensmom]

30-40 minutes, plus it was january so if weather was awful longer....

[Defenestrator]

I'll preface this reply by saying that the majority of homebirth transports are non-emergencies, and that in many cases, if you call ahead to L&D, the amount of time between emergency and action can be as short as if you were in the hospital itself, especially if we are talking about a small hospital.

For example, if you need an emergency c-section, you need to be moved to the operating room (assuming it is ready to go). They have to find the anesthesiologist and he/she needs not to already be in surgery. The docs and nurses need to scrub up and get dressed. Your anesthesia needs to be prepared. Most hospitals try to accomplish all of these things within 30 minutes. If you live 25 minutes away, and call ahead, the team can be ready to go by the time you get there and there really isn't a big time difference.

Some things to think about:

How well is your midwife trained to handle emergencies? Is she trained in neonatal resuscitation? Does she carry oxygen (this perhaps is less important) or pitocin?

Is your local EMS professional or volunteer? What is their response time? (there are ambulance services I would NEVER call for a client)

What is the hospital like that you would choose to transfer to? Do they have a NICU, or good emergency facilities?

How has your midwife handled transports in the past? What kind of things has she transported for?

For me, personally, 25 minutes doesn't seem very long, as long as the hospital you are going to is a decent one and EMS is readily available. I just started working in a homebirth practice, but in talking to the midwives about their transports and how they worked, it really is a very rare occurance that there would be an emergency transport, and extremely rare that there would be a transport where distance were a factor. We are in a rural/suburban county, with SOME hospital within about a 5-30 min. drive for most of our clients.

Good luck!

[candiland]

Assuming that the pregnancy is a healthy one and the babe is head down, I wouldn't worry about it. *They* say you should live within a half hour of a hospital. So, think about it... various scenarios that would require transport are:
a.) prolapsed cord, when the cord goes down into the birth canal and gets squished by the baby's presenting part... the midwife would hold the baby's presenting part off of the cord, allowing adequate oxygen to flow to the baby while transporting. This is very rare, and if the baby's engaged, it's nearly impossible for this to happen;
b.) postpartum hemmorhage... does your midwife carry Pitocin and Methargin? If so, the need to transfer in the event of a hemmorhage - which is also very rare - makes it rarer still;
c.) baby not responding... as long as the midwife has oxygen with her and knows neonatal resuscitation, the babe would probably be okay until paramedics arrived;
d.) baby's heartrate deccelerates, and oxygen and changes of position does not help... this is an early warning sign, allowing ample time for transport;
e.) very long labor, leading to dehydration, exhaustion, etc etc., or broken waters and fever.... again, plenty plenty of time to transport.
Can you think of any other emergency scenarios? I think this covers those very rare instances which may call for transport, and in my opinion, these complications are much less likely to happen outside of the hospital, because you will be in a familiar environment and your body and baby will not be stressing out during labor.

[Mary-Beth]

Thanks for all your replies. I will need to ask the midwife some of these questions although I know she does carry oxygen, pitocin and some other medication which I cannot remember by name right now for hemmorage issues.

[Kirsten]

You have gotten lots of good advice already.

We just had our first homebirth (baby 1 in hospital, baby 2 in freestanding birth center which was two minutes from hospital, baby 3 at home - about 25 minutes from hospital).

I was very comfortable with that distance to the hospital. The midwives had taken care of us all through pregnancy and I trusted them to know if something was going wrong - before or during labor. They brought oxygen, pitocin, etc. with them to the house.

It was also our third baby and the first two went smoothly so that made me feel comfortable too (although this baby was posterior and that was a whole other ball game....)

Homebirth is pretty cool.
Kirsten

[BirthTender]

I am a homebirth midwife in NC & I have done births for folks who were even 50 min. from the nearest hospital. I think it's up to you to decide your comfort level. You have already been very well informed from the previous posts as to what emergenices can happen & what is usually done at home to handle them & how long the hospital actully takes to set up for a c-sec, so i won't rehash all that.
I do the birth wherever the client/couple chooses it. I carry the standard meds & herbs for hemmorrahging. I also carry an IV set-up & fluids to folks homes who are more than 1/2 hour from the closest hospital. They are aware from reading the Informed Choice Document that I have these items available in that situation & they decide (either prior to labor of during) if they want to move in closer to a hospital, such as motel, family or friends' homes, my home, travel trailers, etc. Blessings, karen of BirthTender

[bloodrayne]

What indigolilybear said.

We live about 5 minutes from the hospital.

[Yooper]

I live 40 minutes from the nearest hospital. I live 1.5 hours from the nearest hospital with a NICU. There is a professional EMS unit 15 minutes from my home. This is my first. To be honest, I did not even think about the distance. My MW has transported from my area before and did not seem worried. However she does not carry any meds, IV, or oxygen. I think the distance will be a factor in any decisions I might make should anything funny happen between now and b-day. I might be more likely to cave to a hospital birth than I would be if I lived down the street. But it would still have to be significant for me to consider it. I guess I take the attitude that women have been doing this since the beginning of time.

Yooper

[Willow Tree]

60 minutes

we live on an organic farm way out in the country 60 minutes from the nearest hospital 30 of which are on a dirt road. Something we have chosen as a back up is to join CALSTAR, a rescue helicopter agencey it only costs 50$ a year for the whole famly to join and they will give you a free helicopter ride to the hospital if you need it, although in the case of just a non emergencey transfer we would have a very uncomfortable ride ahead of us! But i really feel confident # 2 will have no problems being born at home!
good luck