Mothering Forum banner

1 - 13 of 13 Posts

·
Registered
Joined
·
395 Posts
Discussion Starter · #1 ·
I apologize in advance for this being super long... I wanted to provide enough info to try to give an idea of the situation. Thanks in advance if you make it through!<br><br>
Last night DH an I attended the first class of a series of birth classes geared towards those who are having a homebirth or giving birth at a birth center. When the doula/instructor found out where we were giving birth she let us know that we should consider switching over to the hospital birth class that she provides (not in affiliation with the hospital and taught by someone else other than her). After class she spoke with us a bit more and told us that the portion of the homebirth/birth center class that deals with transferring wouldn’t be necessary for us since we’re already in a hospital and transferring could simply just be someone else walking in the room to provide care. She also mentioned that the hospital birth class spends more time on breastfeeding with an LC visiting the class versus only a half of a class – not sure if I look like I can’t breastfeed or if this was supposed to be a plus to going to the other class.... (Note that on the classes’ website, it does say that people having births in a hospital-affiliated birth center should attend the hospital class – from what we had gathered, our birth center is separate from the hospital though the CNMs have a relationship with the physicians there and utilize the hospital rooms for births. I didn’t realize that our birth center was considered all that affiliated with the hospital – maybe pure oversight on my part, I don’t know.) One of the CNMs recommended this instructor and I’m thinking now I should have clarified which class she was recommending, and I may still do that as I have a few days before I have to get back to the instructor.<br><br>
Should I be worried about giving birth in a birth center located within a hospital? We chose this birth center because they have a good relationship with the doctors at the hospital should something happen that would need to be transferred to an OB (we will be pre-admitted to the hospital). From what we understood when looking for a birth center, another local birth center does not have that same relationship, so either you are admitted to the hospital via the emergency room or you are transferred to a different hospital through what can be very dense metro traffic at commute time. Birth Center/Hospital #1 is less than 5 miles from our house, Birth Center #2 is less than 5 miles from our house but Hospital #2 is 10 miles (can be 30+ minutes in traffic) from our house. Hospital #1 is a baby-friendly hospital should we end up in the care of an OB. So, after talking with the midwives at the in-hospital birth center, we felt that we wouldn’t have to worry as much about transferring and could still receive a really great birth experience (although the rooms are definitely not as homey as the out-of-hospital birth center) with very little if any interventions. The CNMs can administer an epidural but we are planning to not have one.<br><br>
Is having a birth in a birth center located within a hospital very different from a freestanding birth center? My initial thought was that the biggest difference is the potential for a transfer in a freestanding birth center means a physical move from one location to another, which definitely has a different emotional draw than not having to physically move. But, the emotions dealing with a transfer of care to an unfamiliar OB would be very similar correct?<br><br>
The hospital birth class outline (more generic than what I have for the homebirth/birth center outline) covers labor variations and interventions (incl. c-sections) as well as medication/anesthesia and c-sections as well as breastfeeding, newborn care, labor coping techniques, etc. The birth class we signed up for covers emotions of labor, things like perineal massage, transferring to the hospital, medication interventions, labor techniques, etc. (the hospital birth class is $50 more plus goes an addt’l two weeks longer than the homebirth/birth center class).<br><br>
So, the question DH and I have before us is where do we fit in? We chose a birth center and thus chose a birth class that specifically deals with homebirth/birth center births because we don’t want a hospital birth with the common medical interventions. Yet, I feel as though maybe we don’t fit in the birth center class and don’t fit into the hospital birth class. I don’t know if we should continue with the birth center class (where now I feel as though we are not in the same ‘calibur’ as those around us - the class is about 60/40 birth center to homebirth couples – with the birth center couples all going to out-of-hospital birth centers), attend the hospital class even though we don’t care to hear that much about pitocin and such, or just try to get our money back and focus on reading up on everything and using the internet to prepare on our own and work with our CNMs to develop a birth plan.<br><br>
If you made it this far, thank you! I am surprised by how emotional I have become over this. I hardly slept at all last night and am still in tears because I feel so awkward and embarrassed that apparently we don’t fit in anywhere. I’ve had such an easy pregnancy and this is the first bump in the road we’ve hit (since ttc for so long) and it’s completely thrown me. I thought maybe I could ask here and get some feedback before composing my thoughts and feelings to the instructor (which I have to do soon because I can’t handle only 2 hours of sleep and awful dreams about having a negative birth experience – first one of those I’ve had<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad">). Any thoughts? Am I overreacting and we should just stick with the birth center class with an instructor who is supposed to be very very good to learn what other birth center couples are learning or do we not fit in?
 

·
Registered
Joined
·
1,928 Posts
Sounds to me like your birth plan fits with the class you're currently in. I would tell the instructor just that - you WANT to get as much information as you can on natural labour and delivery. I suspect the increased length of time spent on bf-ing in the "hospital" class is because they spend longer on "why it's a good thing". I think you likely have that covered <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/wink1.gif" style="border:0px solid;" title="wink1">
 

·
Registered
Joined
·
339 Posts
I'm not sure - it does seem like you are probably in the right class, but since the same program offers a class geared towards hospital birth center classes it might be a little more applicable? The class we are taking (haven't started yet) is not hospital affiliated but does have us meet separately for hospital/homebirth night (I assume that is when they cover transfers, etc. so they gear the class to what is appropriate). I was the person that got dumped by my HB midwife and had lingering emotional issues over that - for that reason the birth instructor said I could attend both sessions if they don't conflict so I can get as much out of it as possible.<br><br>
All that said - I know that my "friendly birthcenter" at the hospital is going to be nothing like a homebirth. We will try our hardest and seem to have a supportive duo of midwives who have told me their patients are respected and the labor staff on call are really good about trying to ensure I get the type of birth I want, but there will be labor nurses to contend with - and you don't get to preselect those... so I am glad that I will be getting the "hospital" perspective of the class - as taught by a a very pro-natural birth instructor that has experience with other couples that have delivered at my very hospital. So that is something to think about... Ex: she has been a doula for deliveries at my hospital, so even in our phone conversations she has been a great resource for my questions regarding the most common interventions and how to prepare to decline things - facts to back yourself up, etc. in case I do encounter a bad egg in the labor nurse department.<br><br>
As for the breastfeeding class portion - no idea on that. PP is probably right - they will spend extra time discussion the pros? And maybe give some tips and things to put in a birth plan/make known to the support staff that might not be intuitive in some hospital settings (skin to skin contact, etc).
 

·
Registered
Joined
·
395 Posts
Discussion Starter · #4 ·
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>OlyR</strong> <a href="/community/forum/post/14747302"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">...but there will be labor nurses to contend with - and you don't get to preselect those... so I am glad that I will be getting the "hospital" perspective of the class - as taught by a a very pro-natural birth instructor that has experience with other couples that have delivered at my very hospital. So that is something to think about...</div>
</td>
</tr></table></div>
This is a good point, I'll have to see how many other staff members end up in the room from time to time. I know that the midwives are with you the whole time (though they may switch after their shifts - I have met all of them at my appts. for this reason as well as who is on call is who helps you).<br><br>
I did cross post this in the birth professionals board so I'm getting feedback from that viewpoint as well. Thanks for your feedback so far ladies!
 

·
Registered
Joined
·
1,853 Posts
Oh, you sound so stressed! Hugs to you!!!!<br><br>
My feeling is, try to clarify what *you* want to get out of your birth classes, then approach the instructor with your wish list and have her help you decide which class best fits your needs. This is about YOU and your needs, it's not a competition or a judgment on your choice, or it shouldn't be, anyway.<br><br>
I think the previous posters have good points about why the hospital class might have more breastfeeding coverage, and getting tips on dealing with labor nurses can be really helpful.<br><br>
But whichever class you choose, this is about getting the information you need. There are certainly things in both classes that could be helpful to you.<br><br>
Good luck!
 

·
Registered
Joined
·
240 Posts
It seems from your post that the issue you are having is not so much just feeling like you are in the wrong class, but questioning whether you have selected the right birth setting, and the issue with the class is bringing up questions and doubts for you.<br><br>
My suggestion is that this is what you really need to look at--because you were going with a birth center b/c you wanted a more birth-center-y experience without the hospital "stuff" but may now be questioning whether the in-hospital birth center is going to provide an experience similar to either an out-of-hospital birth center or homebirth, based on the fact that the childbirth instructor seems to think you need the hospital/hospital-based-birth-center class. You seem a little unsure as to what exactly the affiliation/relationship is between the birth center and the hospital. I think this is important for you to clarify, so you know exactly what you are dealing with. If it is IN a hospital, I am pretty sure that it is most likely affiliated with/part of that hospital. How independent/separate they are may vary--some hospitals will have something that's truly more of a birth center with its own practices and protocols--and others simply rename the maternity ward "the birthing center at XYZ hospital" and hang some nicer curtains and hire a couple of CNMs who practice similarly to doctors! I mean--really find out what it is that differentiates them from the hospital, and if that suits your needs/desires.<br><br>
So I would approach it from that angle and research it more/again. Why do you want a birth center birth instead of a hospital birth--specifically, what elements of a birth center birth are important to you? What is it about a hospital setting that you want to avoid? I would clarify your intentions and values about that. And then determine if you have chosen the right setting given your intentions. After that--the choice of which class you should take should become apparent I think.<br><br>
I would very specifically ask the birth center you are going to and the midwives there some very specific questions. If they are CNM's working under/in relationship with the hospital/an OB practice, they will have written protocols that determine how they practice, what they can and can't do at the birth center, when they have to transfer care/transport. You can ask to see their practice protocols and parameters. I would also ask what percentage of women intending to birth at the birth center, actually end up having their babies there, and what percentage risk out, both before labor and in labor. Some of those things will be inevitable (like anybody, homebirth midwife or hospital birth center midwife, will tell you to go to the hospital if you start labor at 33 weeks, for example.) But, for example--how long can waters be ruptured before they will want to transfer you to the hospital? At what point would they decide that your labor is not progressing fast enough and want to start pitocin augmentation in the hospital? These things may very well vary widely between this birth center, and the out of hospital birth center, and a homebirth midwife. (I used to live in a city with a birth center that was out of hospital but very close to a hospital and got backup from that perinatal group in the hospital--their rules were strict enough that at least 40% of the people intending to birth there ended up actually in the hospital.)<br><br>
You could also just point-blank ask the childbirth educator/doula what her experience is with the in-hospital birth center you have chosen, and see if that fits with how you thought things were going to be. For example--she may have attended births there and knows stuff that you don't yet about that setting. If transferring is indeed as easy as an on-call OB walking into the room--it may be much more likely/prevalent than you believe. Definitely check up on that stuff. And then if you still decide to stay with the same setting, I would still prob. take her recommendation to do the hospital/in-hospital-birth-center class.
 

·
Registered
Joined
·
395 Posts
Discussion Starter · #7 ·
I agree that my concern goes beyond what class I belong in to wondering if the birth center we chose is what we believe it is. With all of the knowledge that we have of it, it does seem like it is a good fit. However, the instructor suggesting that we might be better in attending her hospital birthing class caught us by surprise and wondering why that class would better suite us. I have a new list of questions for the midwives at the practice including what protocols they are bound to by being located in the hospital (the birth center is separate from the general maternity practice, though the midwives have rights to utilizing the maternity floor for their patients), what, if any consultation happens with any OBs, how many other people will be coming in and out of our room, etc. (Thanks for the questions you offered, they are good specific questions I can ask.) I'm not as concerned about being pushed into an epidural (I've read reviews of a few births, including some here on MDC) I know they have helped mothers follow their birth plan and have talked people out of epidurals and the birth center and hospital itself are very pro-breastfeeding so I'm not concerned about anything related to that either.<br><br>
I also sent an email to the birth educator describing what birth experience we're hoping to have along with why we chose the birth center we did. I asked her for her insight as to why she thinks the hospital class might better suit us and if we should have any concerns regarding birthing there. She has been a doula for more years than I've been alive so I'm assuming she may be able to be pretty honest and helpful about this particular facility. Hopefully with her input and with the questions of the midwives we can either be content and happy with our decision or we can figure out how we can best accomplish what we're hoping to.
 

·
Registered
Joined
·
362 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>mompy</strong> <a href="/community/forum/post/14751053"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">You could also just point-blank ask the childbirth educator/doula what her experience is with the in-hospital birth center you have chosen, and see if that fits with how you thought things were going to be. For example--she may have attended births there and knows stuff that you don't yet about that setting. If transferring is indeed as easy as an on-call OB walking into the room--it may be much more likely/prevalent than you believe. Definitely check up on that stuff. And then if you still decide to stay with the same setting, I would still prob. take her recommendation to do the hospital/in-hospital-birth-center class.</div>
</td>
</tr></table></div>
I was thinking along these lines, too. The childbirth educator may know something you (OP) don't know about this birth center. I know in my metro area everyone who has an interest in birth trades stories about different providers and hospitals (we don't have birth centers) and you hear the good, the bad, and the ugly, especially from people like doulas and childbirth educators. It's not to say anything bad about the place that you've chosen to give birth, but it may be that they have a significantly higher transfer rate than the unaffiliated birth center, in which case it may be more likely you are subject to interventions. And even if you know you don't want interventions, if there is a chance you may end up in a hospital (sometimes even really minor things can "risk you out" of certain situations) you want to know the facts beyond "I don't want it." I don't know; I hope the CBE was trying to be helpful and not just giving you a hard time. I would think that if she was truly passionate about birth she would want you to get the best education you could for your situation and that is why she would steer you in one direction as opposed to another, but you never know. Also, about the breastfeeding thing, again it may not be anything personal, but it may be that the CNMs at your practice don't have as much follow-up breastfeeding care as a homebirth midwife and she wants to make sure you have the best start possible. I don't think that it would hurt to spend extra time on one thing you could quite possibly benefit greatly from (breastfeeding) and spend less on something you wouldn't need (transferring from a homebirth). YMMV. Good luck! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

·
Registered
Joined
·
395 Posts
Discussion Starter · #9 ·
The CBE emailed me back and has offered to have a phone call with us or visit her at her home office to talk more about making a decision. She said we made a good birth center choice, there are just some differences in her language in the out-of-hospital birth center class. Although bummed this ever became an issue, we are actually thankful it happened because we have a bit of a different view of where we'll be giving birth - not bad, just different. We also have a list of questions to ask our midwife group, as well as some specific items for our birth plan that we may not have had otherwise (though probably covered in our birth class so we may have eventually came up with them). We may switch classes just due to the environment difference, we just want to make sure all of the same natural techniques are covered in the hospital/in-hospital birth center are taught - we assume they are.<br><br>
Thanks again for your feedback!
 

·
Registered
Joined
·
252 Posts
As someone who has pushed out a human in many many different situations ...I would say that a birthcenter in a hospital is like birthing in a hospital. Its sort of like why OBGyns have a few medwives on staff these days.<br>
I have had perfectly fine birth experiences in all locations but the truth is that there is practically zero diff between a birth center in a hosptial and a regular hospital birth.<br>
That doesn't mean you can't have the birth you want.... it just means they tell you its different...like there could be a birthball floating around or a jacuzzi tub...but the birth , itself will most likely be the same.<br>
Tricia
 

·
Registered
Joined
·
395 Posts
Discussion Starter · #11 ·
Update...<br><br>
The birth educator invited us to her house to chat about which class to be in and the birth environment. It was so nice of her to spend time with us, helping couples have a great birth is definitely her passion. We have definitely come to the conclusion that we are birthing in the right place for us. There are many differences between the out-of-hospital birth center and the in-hospital birth center we're going to be in. However, the group of midwives we have are highly regarded and they work hard to help women have natural births and stick to the birth plan, especially where epidurals come into play. There are some hospital protocols that we may encounter on certain aspects of the birth, but with the help of our birth instructor we'll be prepared for those protocols (plus the conversations we'll have with the midwives). The midwives work independently from OB's until we hit a bump where a protocol is mandated. I know we're on the same floor as the 'regular' L&D patients, but I'm not sure yet if we are in a different wing - though that doesn't matter all that much to me. I have also heard nothing but good things about the L&D nurses so that's positive.<br><br>
The biggest difference between the classes she teaches is that the hospital/in-hospital birth center class spends a lot more time on developing a birth plan (covered in the other class but only from the point at which a transfer is necessary) and she has an entire class devoted to breastfeeding (something she just couldn't fit in as much in the out-of-hospital class). She also spends more time during class discussing how to be firm in what is wanted should interventions end up being necessary.<br><br>
So, we are definitely very comfortable taking her in-hospital birth center class as well as the birth center option we chose - of course, it goes without saying that we are definitely more confident in our ability to have a natural birth at this center as well.
 

·
Registered
Joined
·
240 Posts
Great! I'm glad that it all seems to be working out for you and that you are feeling comfortable with both the birth location AND the class situation! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up">
 

·
Registered
Joined
·
362 Posts
Glad you got it straightened out!
 
1 - 13 of 13 Posts
Top