Back up hospitals for Cambridge homebirth - Mothering Forums

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#1 of 13 Old 06-18-2009, 06:57 PM - Thread Starter
 
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Hi ladies,
We're planning a home birth here in Cambridge this fall and are starting to research hospitals for our back up plan.

We've had the unfortunate pleasure of going to both the Cambridge and Mt Auburn emergency rooms this past year, but don't know much about their L&D departments. Does anyone have a strong impression either way? Which hospital would be the better choice for an emergency delivery or delivery with complications? Just a note - I hate hospitals and had a very unpleasant experience with the birth of my first child at a NY hospital - soooo - I'm looking for not only the best choice medically, but also the best choice regarding facilities and nursing care.

We're planning on visit the hospitals as well, but thought I'd get some opinions from you guys first.

My plan is to go to a Cambridge hospital if we run into trouble during the delivery, since they are the closest. If a medical issue arises with the baby post-birth then we were thinking in terms of going into Boston, possibly Childrens. I haven't done much research on this either. Does anyone have experiences with Children's, Brigham and Womens or one of the pediatrics and/or neonatal departments at and of the Boston hospital that you think would help us decide?

Thanks for any insights you can provide. So many hospitals in Boston/Cambridge, I feel like i need to narrow it down a bit before we actually venture out for some visits.
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#2 of 13 Old 06-19-2009, 03:30 PM
 
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As far as I know, Cambridge doesn't have a NICU so Mt. Auburn may be the better choice since if there are problems with the baby you might have to be transferred there anyway.

I stayed in the Cambridge hospital for a day after my son was born (which was at the birth center) and thought everyone was very friendly, considerate, and helpful. I had never been in hospital before in my life though so I have nothing to compare it to! They are very used to working with the birth center patients so there was no trouble about refusing every standard procedure.

Good luck with your homebirth -- it is a truly wonderful experience (my first was born at home!)
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#3 of 13 Old 06-20-2009, 03:02 PM
 
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Children's Hospital is fabulous (after you give birth).

Sorry, I don't have advice about L&D in that area.

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#4 of 13 Old 06-20-2009, 07:22 PM
 
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As far as a hospital for baby issues after birth, I'd vote for Boston Medical Center, as they are the only Baby Friendly hospital in the area.

I know nothing about Cambridge Hospital, but I know a few people personally who birthed at Mt. Auburn and really liked it.

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#5 of 13 Old 06-22-2009, 07:49 PM
 
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I'd like to know too. I'm homebirthing with my first this fall and hate hospitals too (bad experiences). I live really close to Cambridge Hospital and thought I would go there if something went wrong during the birth, but would like some thoughts on other options...

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#6 of 13 Old 06-22-2009, 10:01 PM
 
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Our family had a positive experience at Children's Hospital (outpatient) when my child was a newborn and we would definitely recommend that hospital for any unexpected issues that arise with a baby after birth. Hopefully you won't need it! :-)

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#7 of 13 Old 06-24-2009, 01:11 AM
 
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Our planned hb last year ended in a transfer to Brigham and though it wasn't what we were envisioning for the birth we were happy with our experience there and felt we were treated respectfully. I think whether your mw has any preferences/suggestions to where SHE has had good (or not good) transfer experiences should be a big part of your decision. Also although it sounds like you feel better having a single contingency plan in reality it may be more fluid depending on the situation--in a true emergency requiring transport by ambulance (rare!) you'll be taken to the closest ER regardless of your plan.
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#8 of 13 Old 06-24-2009, 10:47 AM
 
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I don't have any info on the Cambridge hospitals - but fyi re: BWH.

I was planning on a hypnobirth with my midwife, but it looked like my baby might have serious health complications so we choose to have the baby at Brighams since it has an excellent NICU (level 3- I was very impressed with the NICU and its staff when I toured the unit) and they are right across the street from Childrens. I found the staff to be wonderful and really very supportive of my birth plan and open to my doula (my midwife couldn't attend due to insurance issues . I had heard iffy things about hospital births so I was very pleased. Unfortunately, there were complications and my baby had to be born early. They were great about respecting my wishes as much as possible during the birth.

Luckily my baby was fine so I didn't have to use the NICU. We have gone to Children's a few times and they are wonderful. We've also used their satelites and the care there is also excellent (and sometimes quicker if you want an appointment with a specific doctor).
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#9 of 13 Old 06-24-2009, 11:48 AM - Thread Starter
 
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Thanks for all the input! It just occurred to me that we should probably take into account our pediatricians hospital affiliations. She has privileges at both MassGeneral and Children's. I've sent her an email asking her opinion.

Do you all think this is really an issue? If the baby is in need of critical care, s/he will have NICU doctors anyway... is it helpful for our family pediatrician to have access/input?
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#10 of 13 Old 06-24-2009, 12:34 PM
 
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BklynMama, I would want my family ped to have access, to be on record as our family doctor, to get DC's records forwarded to her, etc. I would want a doctor that *I* picked (one who at least understood my desires and philosophies) to be involved in my child's care. I'm not sure she'd need privileges at the hospital to have that though.

If I was transferring, I would def. want a Level III NICU on-site, so Mt. Auburn is out for that reason (as well as others, see below).

The OBs I spoke to at MGH were universally extremely negative about homebirth. I don't know how they are when patients transfer. The attending ped on the L&D recovery floor when I was there (two years ago) was pretty daffy, and their LC was awful. These things may have changed (among other things, when I was at MGH last winter, it appeared that they now partner with Isis Maternity for childbirth prep and lactation consultants), and I know nothing about the staff at BWH (which has been partnered with Isis for quite some time). My anti-MGH bias may not be entirely justified, especially if you'd only be transferring there in an emergency.

When I was talking to midwives, they all seemed to think that Brigham & Women's was the best choice for homebirth transfer if you needed it. They were not thrilled with Mt. Auburn (it's apparantly great if you plan to deliver there but doesn't deal with HB transfers so well).

My temptation would be to plan to transfer to BWH if necessary (because of the midwife opinions), and to request that NICU staff keep your ped informed, so you can ask his or her input. All of these hospitals (except for Children's) are part of the Partners network, and one thing that network does really well is share information. If your ped has access to MGH's patient records systems, those should be integrated with BWH's systems.

Finally: While Children's has a well-respected NICU, they don't offer any obstetrical services, so they are accustomed to transferring babies in. You might ask your ped what it takes to transfer a baby from BWH to Children's. They are, as you note, right across the street from each other.
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#11 of 13 Old 06-24-2009, 01:58 PM
 
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Quote:
Originally Posted by BklynMomma View Post
Do you all think this is really an issue? If the baby is in need of critical care, s/he will have NICU doctors anyway... is it helpful for our family pediatrician to have access/input?
My experience has been that, if the baby needs specialized care, it's very helpful for the family pediatrician to have access/input, especially for any follow up that's needed after the baby is out of the hospital and out of the care of the specialist.

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#12 of 13 Old 06-26-2009, 04:00 PM
 
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I'm an L&D nurse in NYC right now, but from Boston and I did my senior nursing practicum on L&D at BWH and while I am glad to hear others have had respectful, fine experiences with transferring from a homebirth, I want to make clear that during OB rounds on my shifts one of the attending OBs at BWH called a special meeting to NAME certain homebirth midwives in the area whom they were attempting to pursue legal action against, and were stealthily trying to collect data from past patients and nurses about these individuals. This man was VERY adamantly AGAINST home birth (and murmurs of support came from numerous staff members, while the CNM on shift at the time just stared at the wall).

Now, I know BWH does plenty of natural child birth, more than my current employer does certainly, so the nurses are definitely more used to it, but I just want to make clear that from the meeting I sat through, they are NOT in support of homebirth. I plan to homebirth in Cambridge, and will not be going to BWH unless it is truly emergently necessary. But that is just my experience with them. For others, they may work out wonderfully. And if I had a serious medical reason in pregnancy or labor like a baby with a heart condition or something, I would probably go there--they are great with super high risk stuff.

Just my 2 cents!
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#13 of 13 Old 06-27-2009, 09:58 PM
 
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I have given birth to both my girls at Boston Medical Center. However, I have to add that I also work for the medical school there. I can tell you that BMC is a very capable and accomplished hospital when it comes to patients arriving without any prior plan. And they do have a Level III NICU. I can say from direct experience that the staff will not be surprised by someone like yourself. At my girl's first pedi visit when she was a week old, I was comparing notes with a West African mama about how little time we were in L&D before we delivered. I was 40 minutes, she was 18 minutes .

OTOH, going to a place where your pedi has privileges would be very reassuring. However, keep in mind that even though your ped would have privileges, they may not be your babe's full time care provider at the hospital. At most Boston teaching hospitals, that is up to the residents (who then report to an attending physician).
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