Esposito vs. Kathy Sloane-Need help choosing between hospitals and Midwives in Maryland!!!!! - Mothering Forums

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#1 of 47 Old 07-17-2009, 09:14 AM - Thread Starter
 
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Hi There,
I am due in October and currently trying to decide where to have my 1st baby. I really want a natural, no interventions birth and I currently live in Howard County. I'm trying to decide between Esposito, Hogan & Mayer with Howard County Hospital and Kathy Sloane's Practice with Mercy Hospital. I've looked at both and am still in the fact gathering stage.

Some of my biggest concerns awith Mercy/Kathy Sloane are the lack of experience that the new midwives at Sloane's practice have -I've found very little information on experience or even the background of Katie and Bayla. I went to a consultation and was very impressed with Kathy's knowledge and presence. If I knew 100% that Kathy would be the attendent then it would be a no brainer. I'm also wary of Mercy hospital, although I have heard that they are family & Midwife friendly (I have a tour this week).

Some my concerns with HoCo and the Esposito practice is the number of midwives -they have. They are pretty large, I have 6 midwives to rotate through and I would like to have a comfort level with all of them. However, on paper all of them have great credentials and years of experience to match. The other common theme I hear is that Hoco is conservative and NOT midwife friendly and that I would be more likely to have an intervention there. I've only met with Stephanie Rhodes so far and I was impressed with the information and the manner in which she dealt with me.

Anyone that could share their personal experiences with either of these groups please let me know so I can make a decision soon. I think I'm starting to stress about the whole thing. Please help!! :
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#2 of 47 Old 07-17-2009, 09:59 AM
 
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Kathy's new midwives are not inexperienced, just new. She wouldn't have chosen people she didn't believe in. If you are going for a NCB, your best bet is certainly mercy, NOT hoco.

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#3 of 47 Old 07-17-2009, 12:53 PM
 
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congrats!!!

I have heard great things about Kathy and her group and agree with Trisha that she would select good midwives to serve with her. I would set up a time, if possible, to talk to the other midwives if that's your main reservation.

As for the Howard County group I've yet to hear a positive comment about them from people looking for a natural, intervention-free child birth. When someone is looking for a midwife, I never hear their group suggested while Kathy Sloan's group or Evelyn Muhlhan's are often reccomended for those looking for an in hospital birth.

You might also want to look at Special Beginnings birth center as well. I'm not sure where you're located but I know many women that make the hike down there to be able to have the birth they want.

Unfortunately, I can't offer first hand feedback on any of those options, just what I've heard from friends. Now, if you start considering a home birth, there I do have some experience I'm happy to share.

Karen happily partnered mother of 3 beautiful girls (teen/toddler/newborn).
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#4 of 47 Old 07-17-2009, 01:57 PM
 
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I'm biased, but who isn't?

I have met one woman who had a natural birth at HoCo within the last few years. She was with the Esposito group, and said she "lucked out" because the midwife on call when she went into labor was "one of the ones" who are supportive of natural birth. Also, that her doula was very helpful. Natural birth is not the norm at HoCo, but she said she had a wonderful experience.

I actually chose to deliver at Special Beginnings because I was not comfortable with HoCo. I was there when my SIL delivered (vaginally, with an epidural) and it was just so impersonal. Seriously, the nurses hooked up her IV fluids, ABX for GBS, epidural, catheter, and monitor, and then sat at the nurses station and watched her monitor feed on a computer screen.

FYI- last I heard, it is policy at HoCo that all babies (even healthy babies) are taken to the nursery (or wherever) for the newborn exam. That cemented my decision, as there was no way in hell anyone was going to take my baby out of my sight unless there was a true emergency.

I highly recommend Special Beginnings. If you need/prefer a hospital delivery, they do catch at Anne Arundel, not just the birth center. If you have any questions about travelling there from Ellicott City, feel free to PM me.

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#5 of 47 Old 07-17-2009, 02:57 PM
 
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Hi, just a reminder of our provider review policy here. Thanks so much and best wishes on a great birth

I have retired from administration work, so if you have a question about anything MDC-related, please contact Cynthia Mosher. Thanks!
 
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#6 of 47 Old 07-18-2009, 02:51 AM
 
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HoCo midwives have told clients of mine that they have a 95% epidural rate because "that is what women want." The nursery takes all babies healthy or not after just 90 minutes. A recent student of mine is leaving them because of the impersonal nature of her experience.

Geez, I hope I walked that policy line alright. If you want more you will have to PM me.
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#7 of 47 Old 07-20-2009, 07:42 AM
 
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Just to chime in about Mercy - I had a lot of complaints about postpartum care and the lc there, but not once did they ever take my baby out of my sight - or even ask to - and I never had to remind anyone about my birth plan or requests regarding my baby. Everything was followed to the letter. The ped seemed irked that my ped ok'd an early discharge and I was following his advice, but other than that everyone was very pleasant about my requests. If I had to choose a hospital birth again, I would have no worries in choosing Mercy.

Mama to DS1 (2/08) and DS2 (9/10).
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#8 of 47 Old 07-20-2009, 01:11 PM
 
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I had a natural birth at HCGH with an Esposito midwife last August. I was very set in my decision to have a natural birth and extemely strong willed when it came to that decision. I stayed in my own clothes, did NOT have an IV, and was able to move around and labor in any position I wanted. I did have a doula and I had a very supportive nurse for the majority of my time there. My midwife was also very patient with me. Feel free to PM me for more info/details.
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#9 of 47 Old 07-20-2009, 11:41 PM - Thread Starter
 
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Thanks for the responses. I'm going on a tour of Mercy this week. Hopefully, that will shed some more light. I appreciate all of your information sharing.::
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#10 of 47 Old 07-21-2009, 04:10 PM
 
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I had a, mainly, intervention free delivery with the OB's of Esposito's practice. I can't comment on the midwives, because I was risked out of midwife care for a variety of reasons, so I was seen only by the OB's of the practice. That being said, I showed up at a 38 week appt dilated 5 cm and 80% effaced so I was sent directly from the office to the labor and delivery at HoCo. (It was 4:00 on a Friday afternonn) The OB on call immediately wanted to augment (though I was already in labor and didn't know it...so augmentation was beyond necessary)...but actually listened when I refused the intervention and didn't push for it again. I was able to labor and progress naturally, and wasn't pushed to do anything as long as it didn't cause complications (I had an incredibly high risk pregnancy but a miraculously and delightfully easy and uncomplicated labor and delivery...even at HoCo!!!) with the delivery.
But, I have no experience with their midwives...just wanted to share a positive birth experience at HoCo.
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#11 of 47 Old 07-21-2009, 06:23 PM
 
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Just another vote for checking out Special Beginnings in Arnold.
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#12 of 47 Old 07-22-2009, 10:02 PM
 
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Hate to be the voice of dissent, but I used the midwives at Esposito, Mayer, Hogan and Associates and loved them. I never felt that they were pushing me to do anything I didn't want to do, or tried to discourage me from anything I did want to do. I rotated through all of them and there was only one I didn't like. I was in the hospital for delivery through a shift change so the midwive present at check-in was not the one who delivered me. Both were so nice and comforting and encouraging. The L&D nurses were absolutely awesome as well- always there and helped by massaging, etc. Seriously.
Also, another important consideration if you're planning on breastfeeding: HoCo has a lactation consultant there at all times. My husband is a social worker and several months ago was working with a 17 yo foster girl who was pregnant and ended up delivering at Mercy. The poor thing, she really wanted to breastfeed but was having problems with positioning and latch. She was told that there wouldn't be a lactation consultant available for at least another day- I don't remember the exact amount of time it was, I just remember my husband being so upset and him and another worker spending all this time trying to find someone who could help this poor girl get her baby eating. I found HoCo to be pretty breastfeeding-friendly.
Oh, and I believe they'll take the baby away at Mercy too for their check up. I don't know of any hospital that doesn't. My baby stayed with me for 2-2.5 hours, and then left for about 30 minutes, and they let my husband go with her. They just cleaned her up and that sort of thing. But she stayed with me long enough to latch on a couple times and get her temperature and all of that stabilized. I'm thinking that as long as the baby is healthy, if s/he hasn't latched on yet or whatever the mother is waiting for, then they'll delay taking the baby away for the checkup.
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#13 of 47 Old 07-22-2009, 10:33 PM
 
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Oh, and I believe they'll take the baby away at Mercy too for their check up. I don't know of any hospital that doesn't. My baby stayed with me for z2-2.5 hours, and then left for about 30 minutes, and they let my husband go with her. They just cleaned her up and that sort of thing. But she stayed with me long enough to latch on a couple times and get her temperature and all of that stabilized. I'm thinking that as long as the baby is healthy, if s/he hasn't latched on yet or whatever the mother is waiting for, then they'll delay taking the baby away for the checkup.
No one at Mercy ever tried to take ds from my room.

Mama to DS1 (2/08) and DS2 (9/10).
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#14 of 47 Old 07-23-2009, 08:49 AM
 
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Mercy definately does NOT take baby away from mama for routine checks. I had that in my birth plan and no one made a peep about taking baby.They do the pedi check in-room and if you don't want them to give the baby his first bath, they respect that, no problems.

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#15 of 47 Old 07-23-2009, 09:00 AM
 
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Mercy definately does NOT take baby away from mama for routine checks. I had that in my birth plan and no one made a peep about taking baby.They do the pedi check in-room and if you don't want them to give the baby his first bath, they respect that, no problems.
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#16 of 47 Old 07-23-2009, 10:47 AM
 
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Mercy definately does NOT take baby away from mama for routine checks. I had that in my birth plan and no one made a peep about taking baby.They do the pedi check in-room and if you don't want them to give the baby his first bath, they respect that, no problems.
ok, i was wrong about that aspect of delivering at mercy! but i didn't have anything about that in my birth plan, so maybe HoCo wouldn't have taken my baby for the bath if i had stated a preference? i can't say, because all that i asked for was that my husband be allowed to go with her, and they did allow that.
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#17 of 47 Old 07-23-2009, 02:28 PM
 
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Hate to be the voice of dissent, but I used the midwives at Esposito, Mayer, Hogan and Associates and loved them. I never felt that they were pushing me to do anything I didn't want to do, or tried to discourage me from anything I did want to do. I rotated through all of them and there was only one I didn't like. I was in the hospital for delivery through a shift change so the midwive present at check-in was not the one who delivered me. Both were so nice and comforting and encouraging. The L&D nurses were absolutely awesome as well- always there and helped by massaging, etc. Seriously.
Also, another important consideration if you're planning on breastfeeding: HoCo has a lactation consultant there at all times. My husband is a social worker and several months ago was working with a 17 yo foster girl who was pregnant and ended up delivering at Mercy. The poor thing, she really wanted to breastfeed but was having problems with positioning and latch. She was told that there wouldn't be a lactation consultant available for at least another day- I don't remember the exact amount of time it was, I just remember my husband being so upset and him and another worker spending all this time trying to find someone who could help this poor girl get her baby eating. I found HoCo to be pretty breastfeeding-friendly.
Oh, and I believe they'll take the baby away at Mercy too for their check up. I don't know of any hospital that doesn't. My baby stayed with me for 2-2.5 hours, and then left for about 30 minutes, and they let my husband go with her. They just cleaned her up and that sort of thing. But she stayed with me long enough to latch on a couple times and get her temperature and all of that stabilized. I'm thinking that as long as the baby is healthy, if s/he hasn't latched on yet or whatever the mother is waiting for, then they'll delay taking the baby away for the checkup.
As I sated previously, I also had a sucessful natural birth at HCGH with an Esposito midwife. I also had one great nurse and one not so great nurse (luckily it was the great nurse that was there for the majority of my labor and the delivery).

I wanted to chime in about the LC. I def took advantage of the LC while in recovery at the hospital. I don't think they are there 24/7, but they were very helpful.

I also wanted to add to the discussion of taking the baby away. This is my biggest issue looking back. My son was 9lbs 2oz and 23.5 inches long. I didn't know before entering the hospital in labor that if your baby is below or above a certain weight range that they take them 30 minutes after delivery for glucose testing (I even remember seeing the chart on the wall while I was in labor and thinking I had nothing to worry about because my baby would DEFINITELY not be that big). I think if I was aware of this ahead of time I would have thought about it and probably tried to refuse but at the time I had just delivered after a long and pretty excruciating labor (24 hours of back labor, ugh) and was on an extreme endorphin high. I let them take him thinking that he would be back with me before I knew it (and made Dad go with). He was born at 1:50AM, so they prob took him around 2AM and I didn't see him again until almost 6AM!! I was very frustrated by that point and if I had known when they took him that he would be gone for so long I probably would have fought to keep him with me. Hindsight, it's always 20/20 They also gave him a pacifier when they did the hearing test even though I had in my birth plan no bottles or pacifiers. He never would take a pacifier (to my delight) so I guess it didn't do much harm in the long run. I guess if I were to do it again in the hospital these are things that I would remember to remind the nurses about. But hopefully I won't be in a hospital next time
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#18 of 47 Old 07-27-2009, 11:11 AM
 
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If you haven't already, please email me over at ICANofBaltimore @ comcast.net so that I can email you my "Spectrum of Caregiver Choices" that illustrates the range of birth location and caregiver options available to birthing women. I created the spectrum after learning the hard way that not all midwives are created equally. I suggest that all moms look at the spectrum and weigh in their own desires and values and decide where they land. Then, if you are further towards the right (midwife attached to an OB practice or a plain old OB) then know that you need to be particularly strong in your advocacy and, like all moms, very much need a back up plan in case you get to your due date and don't like what is going on (pressure to do testing such as amniotic fluid levels, orders to induce at 41 weeks for no medical reason, etc.) A strong doula is also a must as is having you and your partner memorize the phrase "We do not consent" and plan on using it during labor.

If you have already emailed me for the spectrum and I haven't gotten back to you I apologize. I'm a bit backed up but hoping to get through my inbox today. I can also send you the Maryland hospital cesarean rates.

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#19 of 47 Old 07-27-2009, 01:10 PM
 
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HoCo has a lactation consultant there at all times.
My DS was born at Upper Chesapeake & they had LCs available 7 days a week. Unfortunately, in my experience they were awful & definitely made it worse. So I personally wouldn't consider the mere presence of LC's all the time to be a bonus. Get in touch with your local LLL leader for help & recommendations for good LCs.
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#20 of 47 Old 07-27-2009, 02:03 PM
 
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I started my pre-natal care with DD#2 at Esposito in Sept 2007, so this information may be a little dated. After my first m/w visit, my main concern wasn't the care I would get at the group as much as HoCo hospital policies that I wasn't interested in having to fight. (I hope these policies have changed since!)

My m/w told me she was fully supportive of my desire for an intervention-free birth, but that she had no control over me or the baby after the birth. According to her, taking the baby to the nursery for bath, weighing, shots, etc, and yes, automatic blood tests for low blood sugar if the baby were "large for gestational age" (which usually meant anywhere near 9 lbs.) was standard procedure. From her experiences, the neonatologist in charge of the nursery procedures was VERY concerned about ANY low blood sugar, and his procedures involved IMMEDIATELY giving formula, NOT sending the baby back to mom to nurse, nurse, nurse.

The m/w said that even though she, other m/w, and doctors had shown him the research about colostrum being better at raising blood sugar than formula (not to mention the risks in giving formula that routinely), he stubbornly refused to listen to them and continued in his formula-happy ways. Also, she said, nursery procedures routinely take HOURS there, and those who try to fight sending baby there were often treated extremely rudely. After my first birth (OB, vacuum extraction, fluid in DD#1's lungs and her being in the incubator on oxygen for 2 days), I wasn't at all interested in anyone taking my baby!!

I ended up switching to Bay Area Midwifery, had a lovely natural birth at AAMC, and baby didn't leave my sight!
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#21 of 47 Old 07-28-2009, 11:22 AM
 
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I gave birth last week at Mercy with Kathy Slone (it was actually Kathy who delivered her). I can't say enough good things about my experience there. I birthed in the pool, and my post-partum care was great. Lucky for us, everything went exactly as it should.

I was 9 cm and +2 when I arrived, and pretty anti-intervention.

These are the things I would look into...

I was only allowed to birth in the pool if I had completely clear amniotic fluid. So they had to break my waters to check that. I was ready to deliver pretty much on arrival, but if I had spent first stage in the pool, maybe I would have had to get out to have a cervical check and have my waters broken?

My husband took the baby to the warmer and rubbed her vernix in while they got me out of the tub and into the bed. That was fine with me - I wouldn't have wanted to carry her, but maybe others would prefer something else?

I had in my birth plan - no bath, Vit K if bruising, no Hep B, delayed eye drops, complete rooming in, no artificial nipples. We decided against the eye drops, and nothing was said. No-one commented once on the Hep B, I was strongly advised to have the Vit K, which we had in the end, due to bruising, but I wish I had bought drops.

They did the hearing test in our room, as well as the newborn exam, which was done by a nurse practitioner. She put her finger in the baby's mouth to pacify her, else she would have had to come back later when baby was sleeping. Emmeline was 8 lb 2.8 oz, at 39 weeks 5 days, which was considered big for dates. (Cut off for 39 weeks is 8 lb 2.5 oz I was told, and she was closer to 40 weeks anyway). The L & D nurse said apologetically that she was supposed to do heel pricks for blood sugar every two hours, but I could refuse, so I did. We checked at 24 hours instead, at the same time as the PKU, and she was fine.

We pushed for "early" discharge, which is 24 hours after vaginal birth, rather than the normal 48 hours. She was born at 4 am, we left at midday the following day.

Hope that helps, and good luck with your decision!
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#22 of 47 Old 07-29-2009, 07:22 PM
 
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I was only allowed to birth in the pool if I had completely clear amniotic fluid. So they had to break my waters to check that. I was ready to deliver pretty much on arrival, but if I had spent first stage in the pool, maybe I would have had to get out to have a cervical check and have my waters broken?
Well I'd like to say that I'm not a fan of artificially rupturing membranes as part of any kind of routine just to check for clear fluid. I wonder if this is part of a new protocol since she sold her pratice to the hospital?

-Barbara
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#23 of 47 Old 07-30-2009, 12:18 AM
 
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Well I'd like to say that I'm not a fan of artificially rupturing membranes as part of any kind of routine just to check for clear fluid. I wonder if this is part of a new protocol since she sold her pratice to the hospital?

-Barbara
Nah, she has been doing this for years and it never made sense to me ever.
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#24 of 47 Old 07-31-2009, 10:30 AM
 
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That makes no sense. If there is meconium in the fluid, it would be visible in the water (my first birth my waters broke over the toilet well into labor and I could easily see meconium), and until the waters are broken, the chance of infection when sitting in water is basically nil. Once broken, it increases (not much, but why take that risk). If there is meconium, and she doesn't want to deliver in the pool, she can always ask the mom to come out. :
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#25 of 47 Old 07-31-2009, 05:05 PM
 
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Well I'd like to say that I'm not a fan of artificially rupturing membranes as part of any kind of routine just to check for clear fluid.
My thoughts exactly. I mean, you're doing something that CAN potentially increase stress to the baby... in order to check to see if the baby is stressed?

Upper Chesapeake has a tub & I remember looking over the looong list of stipulations to use it. I don't remember this being in there.
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#26 of 47 Old 08-01-2009, 02:42 PM
 
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Does upper chesapeake do water birth or is it just for labor?
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#27 of 47 Old 08-01-2009, 10:51 PM
 
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Kathy said it was hospital policy to check for meconium before birthing in the pool. I wasn't sure about it, but I spoke to my doula, and I was 9 cm and +2 station, so there wasn't much risk...


I'm pretty sure Upper Chesapeake will only let you labor in the pool, not birth.
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#28 of 47 Old 08-03-2009, 12:58 PM
 
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Does upper chesapeake do water birth or is it just for labor?
Yes, only for labor. As of a year ago when I had my DS.

At the time, they had JUST opened the tub! So I don't know if they are sometimes lenient about "allowing" you to birth there anyway - or if they will physically lift you out of the tub if need be.
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#29 of 47 Old 08-03-2009, 01:48 PM
 
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They drain the water if you don't move.

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#30 of 47 Old 08-09-2009, 05:08 PM
 
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Not sure which provider you chose, but I have gone to Kathy Slone's practice for both of my deliveries. I loved Mercy and as a doula have seen other hospitals now and their practices. I can honestly say that Mercy is very 'low-intervention' when compared with other hospitals. If they know you are a midwife patient and that your choice is go to natural, I think they leave you alone as much as possible.
That being said, I think the same goes for the midwives. If you make it clear that you don't want any interventions, and you clearly don't 'need' any of them, they will leave you alone. If you are 'so-so' with your decision, they may step in and help things out. I was on the fence about not having pain medication, and Kathy told me that I probably should have it because I was clearly out of control.

As for pre-natal visits, I loved the fact that I had alot of time to ask questions, I never felt rushed and I never felt pushed to do any type of testing, etc. I had GD and I was never treated like I was a specialty case.

Thumbs Up for Kathy's practice. I have met the newer midwives. I think my first impression was 'holy crap, they are young'. I am not sure whether that is because I am getting old! I have watched both 'in action' now and would be confident in having them deliver one of my children.

Good luck and hope all works out!
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