Choosing the hospital re epidural transfer - Mothering Forums
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#1 of 10 Old 08-13-2005, 01:28 PM - Thread Starter
 
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I just found out that I can choose to deliver at the hospital in my town which is a 5 minute drive as opposed to one 30 minutes away which I though was the case.

Originally when I signed on with my midwifery practise they were in the middle of becoming certified at the far away hospital and in order to have practise at overseeing the epidural they were only delivering at the far away hospital since there are so few epidural births in the practise, they wanted to be at the one they were getting certified for all births, in case any epidurals were required. Now that they're certified they are back to birthing at both places.

The major difference other than proximity is that at the further hospital, if I for some reason do need an epidural, the midwives are certified to continue as my care providers, whereas at the nearby hospital, if I need an epidural they have to transfer my care to the OB on call. As I don't PLAN to get an epidural, it seems that the close hospital is a better choice since that way I will feel more comfortable labouring longer at home which is what I want to do, but then again I'm not crazy about having to transfer care in case I need an epidural for some reason. The nearby hospital is also a lot newer and nicer apparently.

I've booked tours at both hospitals. Right now I'm leaning towards the close one.

Any thoughts? which option would you choose?
A) Nearby, newer hospital but chance of transferal of care in event of epidural.
B) 30 minute away hospital, stay in midwifery care in event of epidural.

Mom to DD(2005), SD(2004), DS(2013) and expecting another boy June 2014!
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#2 of 10 Old 08-13-2005, 03:52 PM
 
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I'd stick with the further hospital if what you really want is a midwifery model of care birth. Once your care is transferred to OBs, all bets are off as far as your birth plan and interventions.
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#3 of 10 Old 08-13-2005, 04:24 PM
 
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Originally Posted by RachelGS
I'd stick with the further hospital if what you really want is a midwifery model of care birth. Once your care is transferred to OBs, all bets are off as far as your birth plan and interventions.
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#4 of 10 Old 08-13-2005, 07:13 PM
 
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I agree with the rest. It depends on what you wish for your birth. Don't make your decisions based on whether or not you can get an epidural. Make you plans based on whether or not you want a managed rest of your pregnancy and a managed delivery.
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#5 of 10 Old 08-13-2005, 10:15 PM - Thread Starter
 
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I can get an epidural at either place and I DO NOT WANT one, but if I do end up needing one, at the close place an OB will step in.

I've been thinking that if I do have an epidural, it will be because something else is wrong in which case care will most likely already be transferred. (If it is transferred, at least one of my midwives will stay, if not both).

In either case, my midwife is the same person, it just depends where we go when it's time to go to the hospital, and really, how soon we will have to leave. If we choose the close hospital I'm going to feel more comfortable labouring for longer at home which is something I really want to do. If it's going to be a 30 minute drive I have a feeling both me and DH will be a little bit leery of waiting too long just in case.

I'm going to ask my midwife at my next appointment what would cause them to suggest an epidural.

Mom to DD(2005), SD(2004), DS(2013) and expecting another boy June 2014!
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#6 of 10 Old 08-14-2005, 08:23 AM
 
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Quote:
Originally Posted by akemi
I can get an epidural at either place and I DO NOT WANT one, but if I do end up needing one, at the close place an OB will step in.
IMO, there's never a case when you NEED an epidural, you just WANT it!
I still can't believe a MIDWIFE would et you have one...
Anyway, whatever you end up doing, good luck!
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#7 of 10 Old 08-14-2005, 02:18 PM
 
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i think the only time you might absolutely need one is if you were having an emergency c-section - in which case, the OBs would be taking over your care anyhow. If you don't want one, my suggestion would to be at the place that would make it the most difficult for you to decide in the middle of transition that you want one. For example, I'll be delivering at a Birth Center with midwives. They can administer things like stadol, but not epidurals. I won't take stadol, because I've had it in previous births and I hated it - so, if I want medication, I can have it - but i would have to transfer to the nearby hospital to get it. I figure that even if i'm screaming for an epi, there's no way I'd get transfered in time to actually have one, so I'll just have to stay put.
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#8 of 10 Old 08-14-2005, 02:23 PM - Thread Starter
 
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Thanks for the comments. A friend of mine went to the same midwifery practise as I did, and the midwives suggested an epidural after a bunch of hours of pushing (not sure how many of pushing but she was in active labour for something like 30 hours) that weren't doing anything because the baby's head was tilted sideways and mom was getting exhausted. They wanted her to rest on her one side in hopes that gravity would lower the baby's head into the right position and thought that an epidural would facilitate that. It didn't work and she ended up having a vaccum assisted birth but was able to avoid a c-section.

Mom to DD(2005), SD(2004), DS(2013) and expecting another boy June 2014!
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#9 of 10 Old 08-14-2005, 06:07 PM
 
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There are some indications that a compassionate and well-timed epidural can help an otherwise dystocia-ed labor along. That said, a lot of the dystocia that might happen is often caused by actually being at the hospital--stress, anxiety, being in bed reclining, the NPO order, IVs, etc.--so the best medicine in that case would be not getting there too early. (Or not going at all ) Also, an epidural might be useful when the mama is exhausted by labor, and is running out of steam. But, I agree, the epidural is NEVER necessary. But it can be helpful.

I've only seen one birth where I wished the mama would have gotten an epidural, and that was after 54 hours of transition-like contractions.

I've not ever heard of an epidural while pushing. Sounds to me like perhaps they were prepping her for a forceps-assisted birth or a cesarean birth. That would make sense if the mama had been pushing for a long time. But, an epidural acutally hinders pushing.

Good luck to you as you decide. Perhaps you might look at other reasons for choosing. What is the newborn protocol? Things like that might help you make your decision, too.
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#10 of 10 Old 08-14-2005, 07:00 PM - Thread Starter
 
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Good point onlyboys. I will have to definately consider the rest of the stuff. I have tours booked at both places so I'll be able to decide better after that.

My DH thinks that the distance shouldn't be an issue. He's pretty laid back and doesn't think that 25 minute extra drive will make much difference. I'm so glad that he lets me decide these kinds of things

Mom to DD(2005), SD(2004), DS(2013) and expecting another boy June 2014!
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