Provider vs. Birthing facility - Mothering Forums

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#1 of 22 Old 07-29-2009, 08:40 PM - Thread Starter
 
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So in your opinion which is more important?

We toured the hospital last night and I was so under impressed. I literally had an anxiety attack on the way home. One of my major issues is that I have 4 other children. This hospital only allows 4 people to visit, spouses and children count in that number. So basically my husband couldn't bring all 4 of the kids up at the same time. I asked about an exception and was told that it would depend on who was on and how busy the unit was at that time. Now I adore my midwife, and trust her completely, BUT there is no guarentee that she will be the one on call that day.
SO I talked to my husband and we are going to tour the birth center in Arnold. But now I am very anxious over the fact that I won't know these midwives as well.

Basically anyone who has made this decision, which is more important the place you birth or the person who catches?
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#2 of 22 Old 07-29-2009, 10:56 PM
 
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Well, I adore the midwives at Special Beginnings. I've had 3 kids there and been thrilled with them.
Have you had other births at AAMC? I was there a few times while pregnant and the care really depends on the person you get. Some of the nurses were great and some not so. I went to help my sister in law at her birth and took my infant with me. Some of the nurses were ok with him being there but then after the shift change, the next nurse made me leave. You wouldn't want an infant in the maternity ward, after all!

I vote for Spec Beg!!

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#3 of 22 Old 07-30-2009, 07:51 AM - Thread Starter
 
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I am sorry I don't know what aamc is.
My first 2 were born at Fransklin square, (before I knew better)
My 3rd was born at Union Memorial, I really miss that place, and my 4th at St. Agnes. My tour was of Mercy. Special Beginings is a drive for me, BUT, distance is fine, I just want my family there, and I want to "feel" no outside stress of worring about people.
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#4 of 22 Old 07-30-2009, 08:59 AM
 
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Being totally comfortable with your environment is so important to being able to allow your body to give birth the way it needs to. The way you describe your feelings after the hospital visit don't sound like they would be conducive to relaxing and letting your body work! The SB midwives get great reviews, and the setting is pretty comfortable and welcoming.
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#5 of 22 Old 07-30-2009, 01:23 PM
 
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How about a homebirth? Then you would have a relationship with ONE midwife, you would have time to really get to know her, you don't have to travel anywhere at all, and your whole family gets to participate as much/as little as *you* want.

There are a few fabulous homebirth midwives in Baltimore who could serve you. Just ask if you want recommendations.

Also, my apologies if you've already discussed this here and stated why a homebirth would not be possible for your circumstances.

Oh, also, to answer your question I think both are equally important - really and truly. Both need to line up in order to have the birth you want!
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#6 of 22 Old 07-30-2009, 05:37 PM - Thread Starter
 
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Thanks Ladies!
as much as I would love a homebirth, my husband adamently opposes it. He was considering it, but after interviewing a HB midwife he said no. He was so turned off my her that he won't even discuss it, and refused to even interview any other HB midwives. Honestly, I didn't click with her, but there wasn't anything that scared me in the interview. I need him to be ok with where we are too.
I have the interview set up at SB, so hopefully that will go well.
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#7 of 22 Old 07-30-2009, 06:05 PM
 
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I had a similar thing happen when I was pregnant with dd. At 28 weeks, I just knew that when it came down to it, I didn't want to go to the hospital. I ended up using the now-closed Baltimore Birth Center and had a wonderful experience.

With baby #3, I used Special Beginnings and was glad I chose them rather than a hospital close to home.

Midwife (CPM, LDM) and homeschooling mama to:
13yo ds   10yo dd  8yo ds and 6yo ds and 1yo ds  
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#8 of 22 Old 07-31-2009, 10:34 AM
 
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There is always the option of delivering and going home early (AMA? depending on what your midwife says).
That way your husband is comfortable with the hospital delivery and your kids would be able to see you afterwards and not miss you for 2 days.
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#9 of 22 Old 07-31-2009, 04:58 PM
 
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For the original Q - I agree with Awaken that it sounds as though you need to switch. I can't decide which I think is more important - facility or HCP, but if it's a hospital, I'm leaning towards facility being most important because:
1. They tend to have lots of policies that tie the hands of the HCP**
2. The HCPs will be attending other laboring mamas, and/or showing up later in your labor, so you'll be cared for by nurses throughout labor anyway, & Those nurses are very likely to be total strangers
3. Post-partum time, you are also cared for by nurses & baby by pedis, so your maternity care HCP is irrelevant here.
**Even if you can get your HCP to agree to exceptions to policy, nurses are likely to fight anyway and/or be nervous & uncomfortable with a big deviation from how they're used to caring for patients. & who needs that?

Depending on your location, have you considered Upper Chesapeake? They really are quite natural birth friendly! They have a practice of 3 CNMs. 1, I'm not so fond of, the other 2 are FABULOUS!

They said the prefer a max of 2 ppl in your room during labor, but the nurse giving the tour said they weren't strict about it. She joked that if some women really wanted a whole "team of people cheering them on" while birthing, they don't mind as long as your HCP is OK with it!

I was stuck in the hospital 48 hours after DS was born (GBS+ & got no ABTs, so that's the standard, I didn't bother to fight). No one even mentioned to me a max of visitors! As a matter of fact one afternoon I simultaneously had, Gmom, Mom, Dad, MIL, sister & neice, + DH. No one said a word & there was even nearly enough seating & space for everyone!

But, yeah, from all I've heard Special Beginnings is fabulous if you don't want to HB. I just couldn't do the drive - 50 min from home, but like 1hr 15 from work. Just too much for me for all those prenatal apts.

As for HB, I think it's worth mentioning to your DH that there is nothing in terms of medical/safety equipment that a birth center has that an HB MW doesn't bring with her. Nothing! When I read that here on MDC, I really was sold on HB for #2! Plus, that & the fact that Dr. Marsden Wagner, head of maternal & child health for the WHO for many years, advocates it & one-thrid of all births in The Netherlands are HB. It really isn't risky & not considered a crazy thing in other countries.

IMO, just doesn't make sense to be "vehemently opposed" to something without facts... & it's important to note that the studies AMA & ACOG point too that supposedly prove the danger of HB are fatally flawed. They lump together all HB - including accidental UC! Seriously?! It's comparing apples to oranges! It makes no sense to lump together unintentional, accidental, unplanned birth at home with those attended by an experienced MW - of course the former are more risky! OK... stepping down now
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#10 of 22 Old 07-31-2009, 05:02 PM
 
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Not being snarky at all, just wondering why you think unplanned home births are more risky than those attended by an experienced midwife. Or were you being sarcastic?

: mama to 4 boys
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#11 of 22 Old 07-31-2009, 05:03 PM
 
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Quote:
Originally Posted by iluvmy4girls View Post
I am sorry I don't know what aamc is.
AAMC is Anne Arundel Medical Center in Annapolis.

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#12 of 22 Old 08-01-2009, 03:10 PM
 
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I just delivered at Upper Chesapeake a couple weeks ago and had a wonderful natural birth with a fantastic midwife. They added two more midwives to their practice so it is 5 now, and my understanding is that the new ones are the most natural-birth friendly. I was really nervous about getting a midwife I didn't click with, but I lucked into getting the part timer (I had really hoped to get her, but it was unlikely since she only delivers 4 days a month) and she was SO amazing, I don't have words for how terrific she was and how much better my birth experience was between her and the great nurse I had. All of my nurses were great as well. Like MegBoz says, they are pretty lenient on their visitation policy and will even allow your kids to be there when you deliver, as long as there is a separate adult there with them (like your DH if you have a doula, but if your DH is your support person, you need another adult to be with the kids). I chose UC because the birth center was too far for me and my DH felt similar to yours about a homebirth, although that was what I had wanted. Plus we couldn't afford the homebirth costs when insurance would cover a hospital delivery. For me, the place is probably more important than who catches, in that it was really important to me to deliver somewhere that allowed you to keep the baby with you at all times. The major drawback UC had was the food - it was terrible, highly processed (loaded with HFCS, etc), and there wasn't really enough for a nursing mom to keep her energy up! Luckily, DH was able to bring me decent food, LOL. Anyway, I think it really comes down to whatever factors are most important to you. GL with your decision and your delivery!!
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#13 of 22 Old 08-01-2009, 03:59 PM
 
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Originally Posted by Pinky Tuscadero View Post
Not being snarky at all, just wondering why you think unplanned home births are more risky than those attended by an experienced midwife. Or were you being sarcastic?
They (unplanned) statistically have the worst outcomes.

hh2.gif

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#14 of 22 Old 08-01-2009, 06:16 PM
 
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Originally Posted by iluvmy4girls View Post
I literally had an anxiety attack on the way home.
I'm not sure I can answer your question but I am fairly sure the place that gives you an anxiety attack is not a good place for labor!

I've had three children at SB and love them as well. I felt very comfortable there & there is plenty of room for your support people, children, family, neighbors, etc etc. I hope you enjoy your tour and get a good feeling about the providers AND the facility.

IBCLC, LLLL, Mom to 3, obsessive baker, where's my coffee
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#15 of 22 Old 08-03-2009, 07:07 AM
 
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Talk to your midwife about this. The tour at Mercy really put me off, too, until I asked Kathy about each point that bothered me. She really put me at ease, as she has a lot of leeway at Mercy. I was not bound to all of the hospital's policies while I was there.

Mama to DS1 (2/08) and DS2 (9/10).
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#16 of 22 Old 08-03-2009, 11:04 AM
 
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Originally Posted by iluvmy4girls View Post
Thanks Ladies!
as much as I would love a homebirth, my husband adamently opposes it. He was considering it, but after interviewing a HB midwife he said no. He was so turned off my her that he won't even discuss it, and refused to even interview any other HB midwives. Honestly, I didn't click with her, but there wasn't anything that scared me in the interview. I need him to be ok with where we are too.
I have the interview set up at SB, so hopefully that will go well.
I always say no vagina, no vote. Birth where you want. When the men learn how to give birth they can have a say. Seriously makes me nuts! We did this without them for thousands of years. Fifty years ago we invited them into the birth room and now some of them thinks that means they get to decide how it happens. NOT! I love my husband!!
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#17 of 22 Old 08-03-2009, 11:10 AM
 
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I agree! My body, my choice!
Being surrounded by strangers, in a strange setting, and being subjected to painful, invasive procedures will slow down the labor process. This is a large part of the reason why so many women are diagnosed "failure to progress". How can you possibly relax and let your body prepare to give birth with stranger spoking their fingers in you and threatening to cut open your belly if you don't hurry up?

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#18 of 22 Old 08-03-2009, 12:39 PM
 
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Originally Posted by Pinky Tuscadero View Post
Not being snarky at all, just wondering why you think unplanned home births are more risky than those attended by an experienced midwife. Or were you being sarcastic?
No, that was sincere. Because an unplanned HB has NO medical equipment & probably not much knowledge either. (Knowledge on what warning signs to look out for & how to handle problems). Just a few items off the top of my head:
  • No oxygen for infant resusitation
  • no Pit (or methergine or cytotec) to help control a post-partum hemmorage
  • no doppler or fetoscope to check on FHT (fetal heart tones) to see how baby is doing
  • No way to take Mom's blood pressure (the device that measures BP is a long strange word that I forget)

as Mysticmomma already noted, they do have the worst outcomes.
(Although I fully, 100% support a mama's right to UC - "UC" around here generally refers to PLANNED - which generally includes a lot of work & preparation! Again, it is 'apples to oranges' to compare planned UC to unplanned, unintentional, accidentally UC HB.)
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#19 of 22 Old 08-03-2009, 12:51 PM
 
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Does anyone have staistics to back this? I have never read that unplanned "out of hospital" births have poor outcomes.
Just looking for research for when I debate others, y'know! It's helpful to have all the info at hand.

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#20 of 22 Old 08-03-2009, 01:47 PM
 
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I'll look around. I couldn't find any. You may try over in the birth prof's forum. they don't have POOR outcomes. Just statistically poorEST.

hh2.gif

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#21 of 22 Old 08-03-2009, 02:15 PM
 
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Originally Posted by mysticmomma View Post
I'll look around. I couldn't find any. You may try over in the birth prof's forum. they don't have POOR outcomes. Just statistically poorEST.
Agreed. Generally speaking, births that happen very fast (and hence, unplanned homebirths ) usually are complication free because the body and baby didn't stall or anything but there still is a higher incidence of postpartum hemmorhage not being noticed/stopped because of lack of medical access. Usually everything is fine. Usually mothers and babies do fine in birth. But when you do encounter that rare complication that wasn't researched and learned how to deal with in a planned homebirth -- that's when trouble might occur. But, again, on the whole, everyone does fine.

(Just like most mothers don't have life-long problems when having an epidural that doesn't mean the chance of danger is higher than not...so too while unplanned homebirth usually works out fine, that doesn't mean it's just as safe as a planned homebirth.)
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#22 of 22 Old 08-03-2009, 04:43 PM
 
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The book "Born in the USA" by Dr. Marsden Wagner probably has them in there somewhere - as a comparison between MW-attended HB.
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