***I'm putting this in Homebirth because I don't want to have to argue the safety/merits of homebirth -- but I am open to a variety of responses.***
I'm 11 weeks pregnant and trying to settle on a care provider. My insurance will fully cover the local out-of-hospital birth center, and I'm currently lobbying for coverage of a CNM-attended homebirth. But...I'm not sure which one I really want.
My last birth was a planned homebirth that ended in a pretty frightening transfer (that was well warranted). We couldn't go to my midwife's hospital because it was too far -- had to go to the closest place, AND we had to drive ourselves because (get this) 9-1-1 DID NOT ANSWER. Once we got to the hospital, things went amazingly well -- L&D there was staffed by midwives, and the midwife on duty happened to know my own midwife, and basically let her do her thing.
The reason for transfer in a nutshell: I hadn't been progressing well, I tried a small push, there was an alarming amount of blood and then some meconium, baby's heart rate dropped. I was at 42 weeks, and had been trying to induce with castor oil -- finally I decided to do an amniotomy, because in NJ your other choice at that point is a hospital pit induction. (This was after a week of castor oil and prodromal labor. Once we did the amniotomy I went into serious back labor. LOP baby.) The fluid had been clear previously, and heart rate good, but after I gave that push, I watched the midwives' faces go white. They immediately put me on oxygen and got me ready to go.
Because of the adrenaline of the transfer, my labor shut down, and I got a very small dose of pitocin to get it going again. (And about 3 bags of IV fluid, since I'd been puking myself into dehydration.) Going back into labor and pretty quickly into transition at the hospital was incredibly stressful, and I was whining and begging for a c-section. I had to have oxygen the whole time; without it, heart rate dipped. Finally after a pep talk from my awesome midwife, and a hell of a lot of work on my part, I pushed out my daughter -- no pain meds. She had what the hospital midwife charted as shoulder dystocia, but my own midwife (a woman of 30 years' experience) charted as "sticky shoulders," and was covered in mec. She hadn't aspirated any, but had trouble breathing. I can't remember her apgars, but the first set wasn't so hot. She had a crazy-big conehead too.
So in some ways everything went right -- my midwives were amazing, and I am absolutely certain they helped spare me a cesarean, the hospital was really pretty good (although there was some stupid stuff, people yelling PUSH and postpartum take-the-baby-every-fifteen-minutes crap, but nobody forced any procedures on me or treated me with anything other than kindness), and I felt respected, well cared for, and honored the whole time.
On the other hand, the actual medical stuff that went down was pretty scary -- we didn't know if I was having an abruption, I thought I might be hemorrhaging or dying, and the psychological crappiness of the transfer itself (esp. with 911 not being there). It's hard to convey the terror, and then having to make the decision to let them turn on the pitocin so I could go back into labor -- it was really, really hard. (But I did it! Yay me!) On top of the difficulty of what I think was probably a particularly painful labor and birth. (At one point I had two midwife hands in my vagina along with my baby's head. It got her turned, but YOW.)
Now I'm pregnant again, and I'm really not sure what to do. I'm going to visit with that wonderful midwife on Thursday and see what she thinks about all of it -- but I also want to be more clear in my own head. On one hand, I absolutely believe in the safety and awesomeness of homebirth, and I love the one-on-one care you get from a small midwifery practice, how well you get to know each other. I hate the idea of having to go somewhere in labor. I'm okay with not having pain relief immediately accessible (shoot, if I can have THAT birth...) I love and respect the midwives I used last time, and have known them for years.
On the other hand, I wonder if I would be worrying the whole time about..."When will we transfer? Do we have to transfer for this? How about this?" I wonder if I wouldn't really settle into staying put and just being present. I also know that I'd be at least 45 minutes away from any homebirth midwife's privilege hospital, and that if there were a transfer from home, I'd be headed into a pretty intervention-happy hospital.
The birth center is midwife-run, and I'm not sure how many are on staff. They're across the street from a hospital where they have privileges, and while I'm not crazy about the hospital, it would likely be less awful than the closest one to my home. The birth center itself has a pretty good reputation; everyone I know who's used it has been pretty happy with it.
Sadly, it's not an option to plan a hospital birth w/ the previous midwives -- there's no chance insurance would cover it, and we really don't have the money to pay out of pocket for that.
I don't really know what I think about all this. I'm afraid I'll either talk myself into a homebirth that I'm not comfortable with, or talk myself out of a homebirth that could be really great.
What say you, internet?
I'm 11 weeks pregnant and trying to settle on a care provider. My insurance will fully cover the local out-of-hospital birth center, and I'm currently lobbying for coverage of a CNM-attended homebirth. But...I'm not sure which one I really want.
My last birth was a planned homebirth that ended in a pretty frightening transfer (that was well warranted). We couldn't go to my midwife's hospital because it was too far -- had to go to the closest place, AND we had to drive ourselves because (get this) 9-1-1 DID NOT ANSWER. Once we got to the hospital, things went amazingly well -- L&D there was staffed by midwives, and the midwife on duty happened to know my own midwife, and basically let her do her thing.
The reason for transfer in a nutshell: I hadn't been progressing well, I tried a small push, there was an alarming amount of blood and then some meconium, baby's heart rate dropped. I was at 42 weeks, and had been trying to induce with castor oil -- finally I decided to do an amniotomy, because in NJ your other choice at that point is a hospital pit induction. (This was after a week of castor oil and prodromal labor. Once we did the amniotomy I went into serious back labor. LOP baby.) The fluid had been clear previously, and heart rate good, but after I gave that push, I watched the midwives' faces go white. They immediately put me on oxygen and got me ready to go.
Because of the adrenaline of the transfer, my labor shut down, and I got a very small dose of pitocin to get it going again. (And about 3 bags of IV fluid, since I'd been puking myself into dehydration.) Going back into labor and pretty quickly into transition at the hospital was incredibly stressful, and I was whining and begging for a c-section. I had to have oxygen the whole time; without it, heart rate dipped. Finally after a pep talk from my awesome midwife, and a hell of a lot of work on my part, I pushed out my daughter -- no pain meds. She had what the hospital midwife charted as shoulder dystocia, but my own midwife (a woman of 30 years' experience) charted as "sticky shoulders," and was covered in mec. She hadn't aspirated any, but had trouble breathing. I can't remember her apgars, but the first set wasn't so hot. She had a crazy-big conehead too.
So in some ways everything went right -- my midwives were amazing, and I am absolutely certain they helped spare me a cesarean, the hospital was really pretty good (although there was some stupid stuff, people yelling PUSH and postpartum take-the-baby-every-fifteen-minutes crap, but nobody forced any procedures on me or treated me with anything other than kindness), and I felt respected, well cared for, and honored the whole time.
On the other hand, the actual medical stuff that went down was pretty scary -- we didn't know if I was having an abruption, I thought I might be hemorrhaging or dying, and the psychological crappiness of the transfer itself (esp. with 911 not being there). It's hard to convey the terror, and then having to make the decision to let them turn on the pitocin so I could go back into labor -- it was really, really hard. (But I did it! Yay me!) On top of the difficulty of what I think was probably a particularly painful labor and birth. (At one point I had two midwife hands in my vagina along with my baby's head. It got her turned, but YOW.)
Now I'm pregnant again, and I'm really not sure what to do. I'm going to visit with that wonderful midwife on Thursday and see what she thinks about all of it -- but I also want to be more clear in my own head. On one hand, I absolutely believe in the safety and awesomeness of homebirth, and I love the one-on-one care you get from a small midwifery practice, how well you get to know each other. I hate the idea of having to go somewhere in labor. I'm okay with not having pain relief immediately accessible (shoot, if I can have THAT birth...) I love and respect the midwives I used last time, and have known them for years.
On the other hand, I wonder if I would be worrying the whole time about..."When will we transfer? Do we have to transfer for this? How about this?" I wonder if I wouldn't really settle into staying put and just being present. I also know that I'd be at least 45 minutes away from any homebirth midwife's privilege hospital, and that if there were a transfer from home, I'd be headed into a pretty intervention-happy hospital.
The birth center is midwife-run, and I'm not sure how many are on staff. They're across the street from a hospital where they have privileges, and while I'm not crazy about the hospital, it would likely be less awful than the closest one to my home. The birth center itself has a pretty good reputation; everyone I know who's used it has been pretty happy with it.
Sadly, it's not an option to plan a hospital birth w/ the previous midwives -- there's no chance insurance would cover it, and we really don't have the money to pay out of pocket for that.
I don't really know what I think about all this. I'm afraid I'll either talk myself into a homebirth that I'm not comfortable with, or talk myself out of a homebirth that could be really great.
What say you, internet?
