Pediatrician is telling me a birth center birth is irresponsible and reckless! - Mothering Forums
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#1 of 16 Old 09-20-2013, 11:04 AM - Thread Starter
 
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Hello all, 

 

Long time lurker, first time poster.  

 

Anyhoo, I'm 30 weeks pregnant with my second child, a boy, and this go around I'm using a birthing center run by midwives here in town instead of my standard OB/GYN.  There are numerous reasons for this (wasn't too thrilled with my hospital treatment, Doc was "this" close to doing a c-section if I hadn't pushed my daughter out in another 30 min even though my total labor was about 6 hours long,  was put on general ward when they ran out of room in the birthing ward next to some very ill patients, being induced, and lastly the cost which was about $8,000.00 with insurance!)  

 

Anyway, this midwife practice/birthing center has been in my area since 1985.  The founding midwife is still in practice and has been delivering babies since 1980.  They have a staff of fully qualified LM.  I've found my care to be quite nice thus far.  They are a lot more laid back than my OB/GYN who was rather test happy even after I declined many of the tests they suggested. It's a lovely location next to the ocean and I've liked it a lot.  I understand emergencies happen (one of my acquaintances from church was transferred to the hospital from this birthing center because she was just simply exhausted and was having a rough time of it.) but I feel good about their close proximity to emergent care in case there was problem.  

 

I took my older daughter in for a slight bout of foot and mouth disease and while I was there (this was a few months ago) I asked my pediatrician what their policy was for babies getting checked out after they had been born in a birth center.  He gave me this look of absolute disgust and said "I won't even touch a child who has been born in a birthing center for the first two months, the outcomes for those places are horrible!"  I was shocked (and also partly sleep deprived since my daughter had been up with a fever for most of the night) and I couldn't think of a thing to say except "duly noted".  

 

At this point I was really questioning my judgment, maybe I was crazy to go this alternative route?  Maybe my baby or myself would come to harm as a result of this decision?  I finally decided that no, I would just get another pediatrician for when my son is born and see if I liked them and eventually transfer my daughter over.  I have since found a practice to take my son to when he is born and feel pretty good about it. 

 

Fast forward to this past Monday when I had my daughter's 2 year appointment and I didn't bring anything up about this pregnancy, just stuck to my daughter's exam but he brought it up again!   "So where are you going to be delivering this pregnancy?"  Even though he knows full well where I'm delivering!  Again I tell him I'm going to a birthing center and again I get the speech about how many babies suffer needlessly at the hands of these free-standing birth centers and that many neonatalogists have told him horror stories about things going vastly wrong for the baby.  

 

Now I'm having my doubts again.  I looked to see if any charges of negligence or lawsuits had been brought up against my midwife group and could find none so really it's a case of he said, she said.  I like the model of care I'm receiving but there is this doubt that's in the back of my mind that what if I'm the first one for something to go wrong?  Law of averages and all that.  

 

I don't really have any close friends who have gone this route and I tend to keep to myself about since people in our circle of friends would think I'm nuts for even doing this.  I guess my question is, have you had a good birth center experience?  Do you feel it was better than hospital if you went that route beforehand?     

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#2 of 16 Old 09-20-2013, 11:19 AM
 
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I had my first in a FSBC and it was lovely - i had the next two at home - never delivered in a hospital so i cant comment - but why dont you talk to the MW on staff at the BC about your fears ?- find out their transfer rate and find out the top reasons for transfers - also sometimes the BC will have a mothers meeting or a 'ask the MW night"  or something like that which will allow you to get to know them other women who have actually birthed there.


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#3 of 16 Old 09-20-2013, 11:51 AM
 
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My question is, if something goes wrong how far would you go to the hospital?  That made a big difference in my comfort.  I gave birth at a birth center across from the hospital, so it really wasn't much riskier than the hospital.  A good midwife will transfer you if anything starts to go wrong.  Also, it is good to know that the midwife has some doctor's at the hospital to back them up in emergencies.  I know emergencies can happen in an instant but birth centers are usually equipped with oxygen and other basic emergency necessities.  If it makes you feel better take a look at the midwifes statistics and record.  Overall, for a normal pregnancy it is just as safe if not safer to give birth with a midwife.

 

My experience with a birth center was fantastic.  It was so calm and peaceful.  I never had to wait long for an appointment and had a great labor.

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#4 of 16 Old 09-20-2013, 01:25 PM
 
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Your pediatrician is poorly informed.  Birth centers are at least as safe and healthy as hospitals.  It's simply not true that "the outcomes for those places are horrible."  He's probably thinking of just a few specific babies he's seen who were born in a birth center and later had some health problems.

 

I think your instinct to switch pediatricians, as well as switch to the birth center, is a good one!

 

My son was born with a midwife but in a hospital.  That midwife has since moved away, so I'm now going to a freestanding birth center for care, and God willing I will deliver my second child there.  I have a friend who gave birth there and was thrilled with the whole experience, and I'm feeling very confident about it.


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#5 of 16 Old 09-20-2013, 01:34 PM
 
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The birth center where I had both of my babies gave us a list of local birth center-friendly pediatricians - and it was several pages long. This is because they had a policy that required babies to have their first pediatrician check-up before discharge, so they kept track of which doctors were willing to do rounds there. They also were very open about publishing their statistics on hospital transfers for both mothers and babies, and the reasons why.

Does your pediatrician know his numbers regarding the safety of your birth center, or is he using his degree as means to add validity to anecdotal scare stories going around? There is a difference. However, it is always wise to do your own research and try to learn about the birth center from multiple sources. Your ped isn't the only voice out there.
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#6 of 16 Old 09-20-2013, 01:35 PM
 
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It's possible that your doctor is alarmist and misinformed, but it's also possible that he's trying to clue you in to something about the birth center.  Forget the stats for birth centers overall - what are the stats for THAT birth center?  What kind of outcomes are they getting?  If you ask around, going beyond the clients that the birth center will give you as references, what experiences have their patients had with emergency transfer? 

 

The studies that praise the safety of birth centers are often talking about certified, licensed, insured, centers run near or in hospitals by CNMs.  Not all birth centers fit this criteria - it can be a lot like having a home birth at someone else's house.  There's a lot of variability in safety.

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#7 of 16 Old 09-20-2013, 02:09 PM
 
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I've done the research and the stats are pretty clear, if your first pregnancy was without complications then your second is very likely to be the same. There are risks, some that a rush to the hospital will not help, but they are very rare. So really, you have to weigh the cost. If you had a baby already and it was pathologically uneventful, then your risk of complication is very low. If you had problems the first time around, better to have it in the hospital. If you are a person that sweats the !% risk, don't have birth in a birthing center. If you're a person who doesn't worry about the small chance of risk, then the birthing center is for you. The only problem I see is, there is very little regulation of birthing centers. So there isn't much oversight going on to make sure things are the way they should be. The Greenhouse Birthing Center in Michigan has been fighting a couple of lawsuits brought by parents of babies that died under their care, and their neonatal death rate is higher than the national average. That is really scary when you consider that all the moms that go to the birthing center are healthy, educated and mostly middle or upper class, and the average neonatal death rate in that demographic is WAY lower than the national average. So, clearly something was wrong there.

 

Do your research, ask the center for their stats. What is their neonatal death rate? Find out if anyone has lodged complaints against the birthing center you chose. Check with the hospital that serves them and ask the folks there how often they get people in crisis from the birthing center. If the hospital has glowing things to say about them, then that would be a really good indicator that they are doing a good job. But take what they say with grain of salt, after all they are in competition with the birthing center.

 

The bottom line is, most births go off without a hitch. So it makes sense that most people will have wonderful things to say about a birthing center that has been in business a long time (indicating they have repeat customers who are satisfied). The problem lies in that that tiny percentage that will have complications. Just make sure that the birthing center does a good job in those circumstances and you'll be fine. Just keep in mind that the goal here, the real goal, is a healthy baby - not a great birthing story. If you can have both, though, why not?

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#8 of 16 Old 09-20-2013, 03:08 PM
 
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I agree with Meepycat, I would want more specifics about THIS birth center. Not all are created equal. Neither are all midwives. I LOVE the care of the midwifery practice I am working with now, but for the first half of my pregnancy I was with another midwife who was just awful. I don't look at it in categories of midwife vs. OB, hospital vs. BC. Find it whatever you can about the outcomes at this BC with this midwife.
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#9 of 16 Old 09-26-2013, 03:13 PM
 
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From your description, personally, I’d be looking for a new pediatrician rather than a different birthing option.

What it sounds like to me is that you have practiced due diligence and have evaluated the safety of the individual birthing center you have chosen, already. And from your description, it seems to me that you’ve made a solid choice and a birthing center that sounds safe.

Your pediatrician is giving you a highly-opinionated evaluation seemingly based on national outcomes (which include a variety of centers that range from highly-regulated, professional centers to unregulated centers where a lay-midwife with questionable credentials delivers in a setting that is really no different than giving unassisted birth in a hotel room); rather than providing you with any specific opinion on the safety of your own particular choice. And if this particular birthing center is near enough to your pediatrician’s practice that you know that your pediatrician should be familiar with the birthing center you plan to use, I’d highly question any doctor who made such broad-reaching generalizations when he could as easily see the specific, local outcomes. Not to say that I necessarily question his right to believe in a medical birth as a better option, as a doctor, but simply to say that he shouldn’t be using generalizations that empirical evidence show to be different in the individual case in order to create fear. And fear-mongering is what he is doing in this scenario. If he had seen/heard of specific information to the area to prove either any of the area birthing centers or even the particular one you intend to use as unsafe, he could and should have directed you on how to find out about the safety of your midwives and center, rather than making broad generalizations. Also, it sounds to me like he’s saying that he’s refusing to see the child before 2 months because “the child might be too sick.” So in essence, he’s saying that he’s refusing to see infants who are MORE in need of care (by his opinion) after birth than his regular patient base, simply because of the location where they were born, and that seems to send out a screeching alarm, to me.

With that said, if you really do like your pediatrician otherwise and have reason to trust and stay with him, I might add that since we’d chosen not to do the hepatitis vaccination at birth, would not have circumcised if we had a boy, and had no medical issues arise in the first two months, we had absolutely no reason to see a pediatrician with our little girl in the first two months. She was born in a birthing center after I had researched three possibilities in the area and chose the one that I felt had the best to offer – the most experience and the most options in terms of emergency services. She consistently had APGARs of 10, and it was not just based on a “loose” interpretation of the ratings – everyone has told me that they cannot believe that the pictures they’ve seen of her from the birth were from a baby just minutes old because her coloring was perfect.

But personally, I’d ask the midwives if there’s a pediatrician they would recommend.

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#10 of 16 Old 09-30-2013, 02:38 AM
 
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I'd worried about taking a child to a doctor who say that he "won't even touch a child who has been born in a birthing center for the first two months". Excuse me? Did he not take an oath when they gave him his degree? Even if he believes birth centers are horrible, that is a messed up thing  to say.

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#11 of 16 Old 11-22-2013, 07:13 PM
 
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I read the thread and then reread what the OP said. As described, it is a case of scare tactics.

Intern46, you looked into this birth center fully, and felt good about it, right? Then the doctor told you that birth centers were scary and you started to worry. Like a PP said, it doesn't sound like he had any actual information to give you. So... if it were me, I'd just find a new doctor, perhaps a gp or family doctor and take the baby in whenever you want to.

My advice is to talk to your midwife about this. I bet you'll feel better.
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#12 of 16 Old 11-23-2013, 11:52 AM
 
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I was lucky enough to find  a fabulous midwife practice inside our University Hospital.  My labor came on really fast and I almost delivered our baby in the car and I was still not totally sure what was happening when I arrived at the hospital and felt terrified.  I also had a lot of bleeding after the birth and there was meconiam when my water broke, and I just ended up feeling very reassured that whatever happened, the team there could handle it within seconds, since in an emergency every second counts.  I am sure that it is true that it depends a lot on the birth center as not all are equal.  I know this is a minority opinion on this forum, but I would really look at both sides before making your decision.  For that reason I'm posting this video from Huffington Post about home birth:

http://live.huffingtonpost.com/r/segment/home-birth-statistics-fetal-deaths-injuries/51479633fe344411590004ba

 

It is a hard decision to make, because I know it is true, there are also a lot of problems with hospital birth.

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#13 of 16 Old 11-24-2013, 01:15 AM
 
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I have a hard time taking any video seriously that has "Dr" Amy on as their expert. And that's not to take away from the experiences of the moms in the interview. People have bad experiences in all settings, not just at the hospital.

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#14 of 16 Old 11-25-2013, 09:33 AM
 
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I didn't click the link but I do want to say that there are ways of looking at information and making a decision as a pregnant mom that don't have to include putting yourself in a position to hear personal stories about worst case outcomes. When I was pregnant I would not have been able to emotionally handle that.

OP, do whatever you need to feel comfortable. I believe that is one of the most important things involved in birth. For me, that means being in my own home. You'll make the best decision for you. We don't get to decide, the ped doesn't get to decide, etc. If you're interested in how I would feel if a doctor said that to me, I'd be angry that someone disturbed my peace in a well thought out decision if already made. After I make my decisions with regard to birth, I like to listen to my hypnobabies CDs and keep away from negativity. Not because I'm ignoring safety, but because I believe that's the safest thing to do and I've already considered my options.
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#15 of 16 Old 12-07-2013, 01:03 PM
 
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My DS2 & DD1 were both birth center babies, everything went SO peacefully and we were all healthy. This birth center was 1/2 block from the hospital in case of emergency, and they have an EXCELLENT record for safe outcomes.

 

OTOH, DS1 was a hospital birth, and they did everything @$$-backwards...he is nearly 8yo and still struggling with the effects of birth trauma from unnecessary interventions and the Hep B vax.

 

I am possibly expecting #4, and going back to the same birth center. :) Do what makes you comfortable, and don't be scared by doctors who treat pregnancy and birth as a "medical condition" instead of a normal, healthy part of life! Good luck!


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#16 of 16 Old 01-12-2014, 11:13 AM
 
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I like that your acquaintance was transferred for 'exhaustion and having a rough time' - this suggests that the midwives in the practice are pragmatic and sensible (not 'natural birth at all costs' zealots!)

Everything you have said about the centre sounds good - longstanding, licensed midwives and close to hospital if the need arises.

 

I would echo others who say, if in doubt, ask! Talk to the midwives about this, ask for their transfer records or any other info they can give you.

What they have to say about it all / how they cope with your questions  will give you a good indication of what their ethos is and how they are likely to approach any problems later on.

 

It is worth remembering that, when things go wrong in hospital, women are not generally transferred instantly to theatre. There is usually a wait period while theatre is vacated/readied, during which time you may be distracted with 'prepping' - but time passes.

If a birth centre phones in an 'emergency'  much of this prep can be done whilst you are being transferred, so there is a chance you might be whisked directly to theatre on arrival!

 

That said, in most instances transfer will occur before things reach critical point (your friend's story bears that out) and birth centres will be equipped to deal with the most likely problems (bleeding in mom, breathing in infant)  Homebirth midwives also carry this gear, and if they can cope with these events, then there is no reason for a birthing centre not to.

 

I have not used a birthing centre myself (all homebirths for me) but my sister-in-law used one for all 3 of hers and was well cared for.

 

Also remember to listen to your gut! I discovered especially with my last pregnancy how right my instincts about stuff were - it may sound crazy, but intuition seems to abound in pregnancy, especially if we let it.

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