Under what circumstances would you transfer to a hospital? - Mothering Forums
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#1 of 15 Old 07-12-2011, 06:05 AM - Thread Starter
 
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I think the title says it all. I don't anticipate having to transfer. This will be my 2nd homebirth. I haven't really thought of this because I've just been going along assuming everything will be fine like it was before.

Something came up recently that started me wondering. Under what circumstances do you decide it's time to transfer to a hospital, other than very obvious emergency? Prolonged labor or only if there are other signs of distress? Extreme pain? Exhaustion?

I want to be better informed so that I'm not completely relying on my MWs to make that decision for me.

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#2 of 15 Old 07-12-2011, 12:39 PM
 
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You probably have a way better understanding of this than me, since you have already had one hb and I'm about to have my first next month. But for me, it was really important to choose a mw who I felt comfortable with, who really understands me, and who is not afraid to transfer if need be. This is important because I decided that I have to be willing to 'let go' of having to make that decision for myself, since I know my fear might be driving the decision-making for me when I'm actually in labor, and I won't be able to distinguish fear from intuition.

 

 


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#3 of 15 Old 07-12-2011, 01:08 PM
 
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IMHO, if I am contemplating whether or not I need to transfer... that is a good indication that I probably need to transfer.

 

I had a marathon home birth last summer - long labor, long pushing stage.  Ended up with a swollen cervical lip and had to STOP PUSHING for maybe an hour?  And at no point during all that did a transfer even cross my mind.  I knew a) what was happening, b) how it happened (pushing when there was still a little cervix in the way), c) how to make it go away (stop pushing until the swelling went down) and d) that it didn't necessarily present a danger to the baby.  Had I not had that knowledge I might have demanded an ambulance as soon as the midwives told me what was going on.  And even knowing it all turned out okay, that desire to go to the hospital would still have been totally justified because I think women should birth where they feel safe.  At baseline, I am more comfortable and feel more safe at home but if I'm worried that there's something wrong, I am going to feel waaaay more safe in the hospital with their OR's and NICU's right there.

 

Put another way, as soon as the idea of transfer popped into my head I don't think I'd be able to banish it and focus on labor.  I think I'd have to just go.


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#4 of 15 Old 07-12-2011, 01:21 PM - Thread Starter
 
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I read a lot about listening to your intuition. I'm a strong believer in that and go with my gut on most things. I do trust my MW but I don't like to ever rely completely on another person for anything. That's part of the reason I choose home birth. I don't want to give up my decision making to a doctor or hospital protocol.

I certainly don't feel at this point that there's any reason to be worried about my home birth. My intuition is telling me it's all good.

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#5 of 15 Old 07-16-2011, 03:38 PM
 
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I plan on transferring if my gut tells me to. Also I have a great CNM who I used last time for my transfer. I need to know that I have competent people around who can help me make decisions and I know she wouldn't steer me wrong.

 

If this works out, it will be my first home birth. I would be ecstatic if I didn't have to transfer, but I won't be too disappointed if I do.


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#6 of 15 Old 11-17-2011, 05:24 PM
 
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Just thought I'd update. I did end up transferring from home to a hospital. Labor started and progressed at a good speed, I was doing fine with pain management, but ended up pushing for 6+ hours without much progress. I got to a point where I was so absolutely exhausted and lost faith in myself, so I asked my mw what I could do if I transferred. She didn't judge me at all, but laid out my options. I ended up transferring (getting a 1.5 hour bumpy ride laying in the back of the car to jostle DS into a better position) to get a shot of fetanyl that cleared my head and gave me the confidence to keep going.  There is part of me that is sad I didn't get to birth DS at home, but I know I made the right decision to transfer.


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#7 of 15 Old 11-17-2011, 06:55 PM
 
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Great job, mama! You did what it takes to birth your healthy baby. And you didn't end up with a C! Congrats!


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#8 of 15 Old 11-17-2011, 08:02 PM
 
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Thanks BonnieNova!


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#9 of 15 Old 11-18-2011, 05:38 AM
 
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Jumping in late....It might be good for you, the OP, to ask your midwife what things she would look for to transfer.  I remember reading a story here of a baby lost at a homebirth and mom had a fever during labor.  It triggered me to remember my mw saying that any time mom has a fever during labor, that's a transfer.  So she may have some ideas of why you'd transfer and that can help you remember at the time what things might be abnormal in addition to your intuition.


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#10 of 15 Old 11-18-2011, 09:12 AM
 
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hug.gif  I'm sorry to hear things didn't go as planned, but it sounds like you made the right choice (and picked a good midwife!).   Hope you and the baby are doing well!

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#11 of 15 Old 11-19-2011, 02:07 PM
 
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Congratulations cat13!! 

 

OP its a good question. I think if things were very different from my previous experience, then i would get worried. With both my ds', one in the hospital, one born at home, i was pushing for 20 minutes. If it started to go too much longer than that, i might want a transfer. 

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#12 of 15 Old 11-21-2011, 06:09 PM
 
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My midwife and I have a deal - she says we transfer, and we transfer.  I hired her to make that decision for me.

 

Of course, this being my first unmedicated, un-induced birth, I may end up freaking out over every little thing, but in the end, if she even has the slightest inkling that something may be going wrong, we get in the car and go.


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#13 of 15 Old 11-22-2011, 06:26 AM
 
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You know, this being my third birth, I have a much better idea of when I would transfer:

 

When I ask myself if I should or, if the words "if xyz doesn't happen/does happen in the next 'whatever' minutes, we should transfer" come out of my mouth.

 

I don't want a "close call"....I don't want to realize thirty minutes after I think about it, that "if I had been in the car thirty minutes ago, I'd be at the hospital NOW instead of in my house, scared as shit, trying to get into the car" - you know?

 

At no point during my last two births did transferring enter into my mind. So I know that's not something I do when I'm in moments of extreme intensity or in transition or whatever...so if I DID have that thought, if things were really intense and I thought to myself "I wonder if this is really okay, I wonder if I should be getting in the car" - I'd just rather get in the car. Hell, I can always birth in the car outside the hospital or in the bushes behind the emergency room if everything is "okay" by the time I actually get there! I've been trying to have an outdoor birth since my fist one, anyway! haha. Can you imagine, giving birth behind the hospital and then going home without ever checking in? Geez luoise would that be nuts. But I have been called crazy. ROTFLMAO.gifnut.gif

 

There are certain things I'd straight up call 911 about....fetal distress, certain kinds of blood loss or symptoms of abruption, etc. It always kills me when I read a birth story where abruption causes/almost causes really terrible things to happen and leading up to the "bad part" I'm reading the story and I'm like "this sounds like abruption, why isn't the MW saying that!!!" - so that is stuff I've spoken with my MW about at length. She knows that I don't need her to be "transfer happy" but she also knows that there are certain things that if she even THINKS symptoms are "adding up" to something nasty we need to go...it's also the reason I like the way my MWs work. I tend to be a lone birther, I want them here "just in case" (well, my DH insists on it!) but I like them to hang back. So I have one MW who is more present, but hanging back....and then one (very experienced, many years in the field) MW who is hanging back observing, not in any way hands on. I like it that, because I feel like one MW can get swept up in the whole thing and be very "in it"....but another is observing from a more objective standpoint and I think that lends a better sense of clarity and that the midwife hanging back is the one who is truly able to judge time, intensity, etc. I believe that the MW who is more hands on attending, goes into a "laborland" of sorts right along with the mother and that it can prevent her from realizing until after the fact how things were really going at certain points.

 

Just my opinion!

 

I'd rather give birth in a hospital and end up having had nothing wrong....than stay at home because "it's probably just a more intense birth this time, with more bleeding...and more pain...and ummmm, hhmmmm, maybe we should have transferred an hour ago". You know?

 

OP I'm sorry things didn't go super as planned....but the overall plan was to snuggle a baby, right? So I guess things did kind of go as planned, after all, huh?? Good job listening to your gut, that's what it is there for. ;)

 

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#14 of 15 Old 11-22-2011, 07:19 AM
 
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Originally Posted by cat13 View Post

Just thought I'd update. I did end up transferring from home to a hospital. Labor started and progressed at a good speed, I was doing fine with pain management, but ended up pushing for 6+ hours without much progress. I got to a point where I was so absolutely exhausted and lost faith in myself, so I asked my mw what I could do if I transferred. She didn't judge me at all, but laid out my options. I ended up transferring (getting a 1.5 hour bumpy ride laying in the back of the car to jostle DS into a better position) to get a shot of fetanyl that cleared my head and gave me the confidence to keep going.  There is part of me that is sad I didn't get to birth DS at home, but I know I made the right decision to transfer.


I think this is a good mental place to besmile.gif.

 

My homebirth babe is 5yo nowbawling.gif , but back when we were planning the birth I asked my mw what she had transferred for previously and what were the outcomes. Though I don't remember the specifics her transfer rate was pretty low, no lights and sirens emergencies just "signs are adding up to a potential problem"; sometimes the problem materialized and sometimes not.

 

My first birth was induced for pre-e and I was pushing (medicated) for 3hrs--by the end of that third hour I really felt that I couldn't do it anymore. They broke my waters and ds corked in crooked; he had a left side conehead for a month.

 


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#15 of 15 Old 11-23-2011, 12:44 PM
 
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Congratulations on your birth! We decided to transfer at about forty hours, stalled labor due to asynclitic head position (midwife didn't remind me to pee). I think I should have transferred when I started begging for my husband to take me for a c-section. Next time for my homebirth I will research my midwife better and have clearer perimeters for transfer with my husband.

 

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