Cross-posted in FyT for local recommendations, but I figure I'd look here for general advice, too.
With my first I was planning a home birth, but ended up at transferring when I developed pre-e at 38 weeks. I got all my pre-natal care from my DE midwife, so when I got sick I didn't have a pre-existing relationship with an OB and I just got whoever was on call. The nurses at the hospital were great, but the OBs I saw (all four during my 3 day labor) were indifferent at best and preachy at worst.
This time I'm planning a home birth again, but considering parallel care in order to establish a relationship with a practice, in case I need to go in again for something. I just don't know where to begin. I got kind of burned last time: my GP told me that she would be my back-up, but when my blood pressure went up she freaked out and lectured me then sent me to the hospital. Also, one of the big reasons I'm planning a hb is because I plan to decline a lot of the standard testing, and I don't like the idea of spending a ton of time/energy/money on prenatal appointments where I only see the OB for 6 minutes. But it'd be nice to have some support and sympathy if I do need to transfer.
So, what do you all think? What have you homebirthing mamas done in the past? Is shadow care worth it? Any recommendations for OBs or practices (in the Twin Cities, MN) would be appreciated...
Mama to Lauren Philippa Elethea (3) and expecting a little Jay bird March 2012!
I think a lot of what you need to figure out is what the situation is where you live. With my last birth, I put together a back-up plan with my midwives, and they if something happened, they would come to the hospital with me to act in a doula's capacity and would be able to know and ask for my wishes in case I'm not in a position to do so. There is one hospital in town that allows home birth transfers to transfer directly into CNM care, and they are a group of midwives that operates in a way that they have shifts and whoever is scheduled is the one caring for whoever comes in, so I basically would be like one of their patients coming in if I had to transfer care. I know a few of the midwives in the practice, and one even gave birth at home with my same midwife, so I have less fear of being judged by them if I needed to transfer. If I needed an OB, I'm not quite as confident that I would be as pleased with the situation since I would be left with whatever OB was on call, but I would hope for the best, and I would have my husband and my midwife with me, and if things got serious enough that I was asking for help from an OB, I would probably be in a position that I appreciated her expertise. The hospital in question is also "baby-friendly," so many of my wishes would already come automatically.
My midwife requires a back-up doctor in case of emergency, but not parallel care. The doctor she recommends, Dr. Jason Rothbart, is very home birth friendly, open to your ideas and very progressive. When we had our visit he said, "thank you for coming, I hope you never have to see me again." Maybe you should ask your midwife if she knows of any more natural minded home birth friendly doctors. If she has been practicing a while I'm sure she at least knows who to avoid.
Mama to Madelynn 8/16/2009 and awaiting buggy #2 March/2011 , partner to DH
I'm fortunate enough to have scored the only homebirth midwife in my state. She is a CNM in her own homebirth practice, but she also works with two OB/GYNs in a traditional practice. Should the need for a transfer arise, I would be going to the hospital she already has privileges at and would have access to one of those physicians - and I have heard nothing but wonderful things about them both. Fortunately this hospital is also very mother-baby friendly, offers birth tubs and is generally very hands off and respectful of the birth process. And the docs that my midwife works with are pioneering the gentle Cesarean technique in this state, which also makes me feel better about their views on birth. Not that a transfer would mean a C-section by any means, but it is good to know.
I had originally planned to have a CPM from a bordering state attend my birth and she did recommend a couple of dual care visits (with the docs mentioned above!) but she is no longer allowed to attend births in this state.
I hope you are able to find the support you need!
“He allowed himself to be swayed by his conviction that human beings are not born once and for all on the day their mothers give birth to them, but that life obliges them over and over again to give birth to themselves.”
- Gabriel García Márquez