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Any experience with a hospital birthafter no prenatal care in last few months of preg

5K views 10 replies 8 participants last post by  Yaliina 
#1 ·
I am likely going to be breaking up with my midwife practice at 32 weeks pregnant (with my 3rd baby). I cannot afford to pay the up front costs of a home birth midwife, and i'm not interested in trying to find an ob last minute and likely hitting the same differences of opinion (over who is the authority on my body and who has the final say) as i'm dealing with at the moment from my hospital-based midwives/birth center. So i'm looking at simply forgoing care for the last 2 months. I know how to check my own weight, bp, and what to watch for that would warrant an e.r. trip. I have a healthy pregnancy, and on the 3rd one i'm very comfortable with what to watch for. My main concern is that if i simply show up at the e.r. once labor gets going, i might end up with a lot of resistance, extra paperwork, etc because of the 2 months without prenatal care. If i'm in for a fight i want to be prepared ahead of time. Does anyone have experience with this? Also i'm not interested in unassisted birth, so i can't avoid the hospital. I'm in CA, if that makes a difference.
 
#2 ·
I'm paranoid and would probably go to a clinic or OB just to cover my butt for prenatal care. I've heard way too many stories about CPS taking kids (even infants) for all sorts of absurd reasons.

Usually with a planned hospital birth, you're supposed to pre-register. Can you still do that without a practice? I can't remember but even with my homebirths, I think I'm supposed to have some sort of pre-registration, jic? Maybe I'm mis-remembering about that part...

it might make it easier just to be pre-registered. I'd just say you're in between care right now as you weren't happy with/couldn't afford your midwife.
 
#3 ·
I don't know if they would give you trouble because of not having prenatal care, but they would probably want to know who your doctor or midwife was. If you were in their system, they might be able to look up your records or contact your HCP. As a doula, I went into a hospital where the woman was not planning on going. Her hospital was too far away at the time. There were a lot more questions in triage because they had no information on her in their systems, so you should expect to have to answer more questions and give them your insurance info. Is there a clinic you could go to for prenatal care? Could you somehow find an OB so you can do the pre-admittance process and be in the system? With my insurance, my OB wasn't going to be at the birth anyway so it didn't really matter what she thought. I went to the hospital that had CNM's and got whoever was there.
 
#7 ·
I don't think it's true that she would have zero choices about her birth. You always have choices. She may have no choice who attends her birth, but that may or may not be a problem. Some OB's are really laid back and some are more aggressive, same goes for midwives.
 
#8 ·
Thanks for the replies! I would be going to the hospital that my curent midwives are attached to, so all my records and labs are already in the system/i'm already pre-registered. And its a big practice so already could be anyone at the birth (difference now will be random doctor rather than random midwife). But really i don't care who catches the baby, and i'm confident in my ability to decline any treatment i'm not ok with. I know my rights as a patient, and it is a "baby friendly" hospital so already even the o.bs routinely delay cord clamping and do imediate skin to skin and all that. My main concern is with whether they'd want to do extra tests or want to keep my baby extra days for observation.
 
#9 ·
I've read about some issues with certain tests not being on file. For example, the GTT test. If you don't have a regular CNM/OB who is supportive of your choice to not have the GTT or some type of alternative, the attending pediatrician may want to do heel sticks to monitor blood sugars. I know about this first hand, because I always decline the GTT, and my OB doesn't even ask anymore. I went into labor early with my 7th baby (way early for me-38 weeks) and got his partner because mine was on vacation until the next day. Well, when I delivered my standard large for gestational age baby, the OB didn't know anything about my declining the GTT and that my OB knows I follow a good healthy diet anyway, therefore the ped and nursing staff wanted to test my baby for sugars..it was my only fight.

The other things I have heard about are not having a GBS swab on file can cause issue with prophylactic antibiotic pressures, and if you or the baby has any sort of elevated temperatures, they often push for a longer stay for observation and/or spinal tap.

All in all I wouldn't be too concerned. I'd have a birth plan written up, and an explanation for the lapse in care. Best case would be to have an OB and go to a few prenatals in between.

Best wishes for you!
 
#10 ·
I was a homebirth transfer. The hospital was upset that my GB strep was expired. I was 41+3 and my midwife hadn't been concerned. The hospital really pushed for iv and because of this. Mehta else could they want to test you for? If you show up in active labor, how many tests can they even have time to do???
 
#11 ·
I was a homebirth transfer for my last one, too, and we didn't have any problems. I had seen the OB that ended up delivering DS, and he was snotty because he knew I was an attempted HB & he'd told me he "wouldn't" be my bakcup. He didn't have any choice when I showed up in labor, though. And your choices will be about the same whether you stick with a practice that is pushing interventions you don't want or if you show up to a place you've never been, in my experience/opinion. And if you are concerned about the tests, just go have a test run- you can make an appointment for just lab work- that's what my direct-entry midwife told us to do. GBS would be the thing that I would think would cause the most trouble with pushing for abx. I refused the glucose test with my last 2 & nobody said squat about testing baby's bloodsugar or anything. But, they were average-sized babies, born 2 weeks late, so maybe that made the difference.

I think you're fine doing it the way you want, but I would think it might be easier/less stressful to switch to the OBs- sounds like it's one of those practices with 2 "sides".
 
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