[1341]

I found out that I am most likely going to need to switch from the midwife assisted birth of my dreams, to a hospital birth. While I should be able to give birth, naturally and vaginally, with no problems, it's now necessary for me to be in a hospital in case of an emergency c-sec need. I don't trust doctors to allow me to have a natural birth, I don't have any friends in my community to ask for OB references from, and I just plain don't know what to do.

I was so excited about giving birth. Now I am terrified. I feel like I'm suddenly on a ride gone horribly awry. I'm petrified that a doctor is just going to push pitocin, make me labor and push on my back, and give me an episiotomy. I don't want those things, and I don't see how or why they would be necessary. Can you flat out refuse these things in a hospital? Can they kick you out if you do? The idea of pushing a person out of my vagina seems like the most normal thing in the world, but cutting it? I'm so afraid of that! I love to make love with my husband, what if some doctor ruins that forever so for their own convenience? I am so scared/frustrated/mad right now...

If you had to switch from very family friendly midwife care to care by a regular OB due to a medical complication, how did you go about finding the right one? What did they do so that you knew you could trust them? How did you get the hospital staff to respect your wishes? And most importantly, how did you deal with the sadness, and the fear?

I'm sorry if this is rambling. I'm at a loss.

 

[soxthecatrules]

First of all...slow down....take a deep breath. Going to the hospital and having an OB is not the end of the world. I actually really like my OB (open to natural remedies, has "hands out" policy, etc) and our hospital (was allowed to hold DD for over an hour to BF, hospital staff left us alone in mother/baby for 6+ hrs at a time). Are you open to sharing exactly why you have to make this change? The answer to this question may help others with their responses.

 

[DreamsInDigital]

I'm in a similar situation except I am having a cesarean birth due to placenta previa. My youngest two were born at home and I was planning my third homebirth but now I'm going to the complete opposite end of the spectrum. It's really weird for me. I still haven't found an OB I completely like but it's pretty irrelevant for me because I don't have to worry about the labor and birth part but I did write up a plan for the immediate postpartum and my hospital stay and talked with my OB about declining things for the baby and she was really pretty cool about it. You could try posting in your local tribal area for a good OB.

 

[1341]

I'm sorry I left that out. I've been diagnosed as having a velamentous cord insertion, which is where the cord doesn't connect directly to the placenta. If you google it you'll find a lot of information that mentions it along with a condition called vasa previa, which I do not have. Regardless, it means that the insertion point for the umbilical cord is weak. During pregnancy this isn't usually a problem, but if it snaps during labor or delivery (which is unlikely, but can still happen), an immediate C-sec is necessary to prevent the baby from bleeding to death in the womb.

Thanks for the suggestions, and keep them coming please!

 

[channelofpeace]

Breathe. It is going to be ok, and it is possible to have a gentle empowered birth in a hospital.

As far as finding an OB- post in your tribal section here. Is there a LLL group near you? There are often women there who can give you a recommendation off the record.

Contact local doulas. Hire one. Seriously worth their weight in gold if you are a natural birther in a hospital. She might have some recs on OB's also.

If you have a choice of hospitals, talk to these same people about their recommendations of birth place. The 2 hospitals I birthed at (2 sections and a vbac) were very awesome and aside from one grumpy PP nurse one of my stays, I have nothing but praise about them. Very respectful of my wishes, baby stayed with me all the time, great nurses.

And finally, read the happy, empowered hospital birth stories- they are out there. Good luck and I hope that your birth goes smoothly

 

[Defenestrator]

Midwifery care might be an option for you if you choose a hospital large enough to have an OB on site 24 hours a day. Maybe that would be a good compromise.

 

[DreamsInDigital]

Do you mind mentioning where in Oregon you are? I've never heard of being risked out of homebirth due to VCI alone.

 

[iemaja]

I'm so sorry you're having to face this decision during your pregnancy, mama!

Would your midwive be willing to attend your birth if you were in a hotel right next to the hospital? Just a thought...may or may not be possible.

If a hospital birth is truly in your future, please consider hiring a doula to guide you through the rest of your pregnancy and birth. A doula can help you process what you are going through, make decisions about your care, provide references for local care providers (doctors, hospitals, etc), craft an effective birth plan, "hold the space" for viewing birth as normal (especially important when giving birth in a place that doesn't hold this philosophy!), and much, much more.

Good luck to you on your path...I hope you have the birth of your dreams.

 

[meganmarie]

If I were in your situation I would be posting in the MDC "tribe" area for my state to ask for a rec. Other sources I would try: your local chapters of LLL, Attachment Parenting International, Holistic Moms Network, or ICAN. (All these organizations are full of crunchy mamas and have websites listing their local chapter leaders and meeting locations). Doesn't your midwife group also know who the better local OBs are? Have you asked for referrals?

Its ok - you can have a good hospital birth (I had two and one was with a big mainstream OB practice).

You already know what you need to ask so you can make sure your new care providers are as mother-friendly as possible.

And if you can get a doula, that's a really good idea - it will give you a lot of peace of mind and also provide you with the kind of continuous support that a midwife would have provided but is missing from traditional hospital care.

 

[MidwifeErika]

Absolutely look for a doula and ask for recommendations for a dr. in your area.

I had to switch from a planned UC with our last baby to a hospital birth induction at 43 weeks. It was not a horrible nightmare birth, it was just different than we had planned. I still labored in water, freely moved about, birthed without medication, had a dr and nurses who treated me like an intelligent human being, and was able to leave early to recover at home. In the end, I had a fine birth and a healthy baby. It didn't happen at home. It didn't happen unassisted. It still happened and I have no regrets over the way things went.

I hope you have a wonderful birth.

 

[pinksprklybarefoot]

I had to switch from a homebirth to a hospital birth at 34 weeks for PIH/pre-e. I used the CNM that my homebirth MW (a CPM) recommended. And I had a lovely birth.

Some things that I think contributed to the birth going the way I wanted it to:

-The CNM that my CPM recommended was awesome. She will be attending this birth. She knew that we were homebirth kind of people and understood what I wanted. She was good about respecting my birth plan and asking about any sort of interventions that she felt necessary for my and the baby's health. Before the birth, I went through my birth plan with her, point-by-point. I was very adamant about what I thought should happen. Luckily, she agreed with me on most everything.

-Since we had already paid my CPM, she was at the birth acting as labor support. She really didn't do much other than be there, but I felt so much more comfortable knowing that she was.

-I waited a long time to go to the hospital (not sure how that would work with your condition, though). I went in 2 hours before DS was born. I waited until I was sure that he was coming and there was no stopping it. The car ride was a little rough, but worth it.

I was very upset when I found out that a homebirth was not going to happen. I cried for a few days, but then I decided that I would just have to get over it. I tried to look at things as positively as I could and focus on making the birth as good as it could be with the parameters that I had.

 

[dogmom327]

Where in Oregon are you? There are a couple of us on here who can likely give you specific info/assistance.

 

[rixafreeze]

Hmmm, I had an (unknown) velamentous insertion and had a home birth, unassisted to be exact. In my case it was a good thing that I did it on my own, since my placenta took 2 1/2 hours to come out and, had I had an overly anxious midwife, I might have had a problem if she'd tried to get the placenta out earlier.

I've never before heard of that being the sole reason of risking out of a home birth, since you don't have vasa previa. Have you got second opinions on this from other home birth midwives?

 

[1341]

As of Monday, my midwife hadn't received the ultrasound results back yet. So I'm not sure how bad the insertion is, where the placenta lies, etc. It sounded like she would be totally willing to still move ahead as planned. She's a good lady, and I was so looking forward to having her catch our first baby.

But since the ultrasound, I've been researching like crazy. I've never heard of this before. I was able to briefly speak to the ultrasound doc, who assured me that I did not have vasa previa, but beyond that he isn't my doctor, and I won't be meeting with my midwife until Friday (longest week of my life). I posted with questions about VCI in the pregnancy forums here. There are several women on the boards here who have had VCI with no problems. And then there is a woman who lost her baby when the weakened cord snapped off during labor. Her baby effectively bled to death in her womb. While it seems that 9 times out of 10 a VCI turns out just fine, with no problems, there is also that 1 time our of 10 where a woman should be in the hospital.

I place a great deal of stock in science. My husband is an engineer. And we chose to stay out of the hospital because hard data supports the fact that midwives have the same outcome (healthy baby) with a MUCH lower intervention rate when dealing with a healthy pregnancy. But that math changes when the pregnancy isn't healthy, and a VCI isn't healthy. It's a pretty rare anomaly. The idea of being in a hospital is terrifying to me. And in normal labor and delivery, the baby doesn't just crash. There are warning signs that give time to get to a hospital. But from my research, and from this nice lady on the boards who lost her child this way, it seems like a VCI baby can crash fast. Too fast to get to the hospital.

I don't want to give birth in a hospital. Period. But if it means having a healthy baby I will labor on my back, hell, I'll cut my son out myself. I just don't want to be that woman who knew that she had a dangerous condition and chose to ignore it, only to lose her child. I couldn't live with that.

 

[MegBoz]

Quote:

Originally Posted by channelofpeace Breathe. It is going to be ok, and it is possible to have a gentle empowered birth in a hospital. As far as finding an OB- post in your tribal section here. Is there a LLL group near you? Contact local doulas. Hire one.

:
I had a good hospital birth!

No, they can NOT kick you out if you refuse to do things like push on your back. It would be "patient abandonment" & they won't do it. So don't worry there. you can ALWAYS refuse anything!

Quote:

Originally Posted by pinksprklybarefoot I was very upset when I found out that a homebirth was not going to happen. I cried for a few days,

I was going to say it sounds like you need to mourn this loss. Accept the fact that you must mourn, so that you can try to heal & move on in order to build healthy, positive images in your mind of hospital birth.

I had a lot of anxiety about hospital birth as well. I realized I needed to "reframe it in my mind." I had such a great image of enjoying labor & birth (even though I expected it to be painful.) But I had trouble imaging good labor in a hospital. I KNEW I needed to resolve that. I posted around & got lots of great tips. In addition to having a doula & great birth plan reviewed by every OB in the practice, one of my fav tips was to "think of your hospital room as YOUR room" - like you are entertaining guests there. It's your territory - you are not a guest in the nurse's/ OB's territory.

You'll be fine.

 

[Rivka5]

I had a great hospital birth with a CNM, so it is possible.

Do you have a choice of hospitals available to you? It might be helpful to find out about various hospitals' policies, decide where you want to deliver, and then look at the list of OBs/CNMs for that hospital.

For example, there's one hospital in my area where continuous fetal monitoring is required for everyone, whatever their risk level, and mothers are required to stay in bed so the monitor doesn't fall off. Unsurprisingly, almost everyone winds up needing an epidural and they have a very high C-section rate (42%). Their L&D nurses don't even know what to do to support a natural birth, and the rooms aren't set up to accommodate them.

In contrast, my hospital has tubs, birthing balls, and squat bars available and the L&D nurses are used to caring for a significant percentage of women who aren't using pain meds. When you take the tour, they warn you to bring a robe and slippers "because your doctor or midwife will probably want you walking the halls" - there's no expectation whatsoever of staying in bed.

There may be good OBs who deliver at the other hospital, but they've got an uphill battle against the hospital status quo. Just looking at the baseline policies, you can tell that you'd have a better chance of a good birth at my hospital.

 

[Girlprof]

You're getting good advice here. I also had two very positive hospital births both with CNMs backed up by OBs I felt really good about. My second birth was higher risk so I was kicked out of the birth center.

Whether or not some women with your issues give birth at home isn't really relevant anymore. You are not comfortable with that option. Hospitals are not all evil places that torture birthing women for fun. Sometimes they are places that save the lives of birthing women and their babies.

If you have a midwife you really like right now, I would start with figuring out how much of a role she can still play. What OBs can she work with? Can you get some advice from local doulas? Even if you don't hire someone, you might be able to find someone to guide you in deciding whatever decision you have to make.

It is hard to give up that birth of your dreams, I know. I had a really fantastic first birth and I was ready to change just a few things to make my second birth "perfect". That didn't happen and I had more intervention the second time around. This is a pretty significant deal and you have every right to mourn the loss of the birth you thought you were heading for.

It's pretty important to find care providers that you feel really good about in this situation. Not all doctors are going to make you give birth with pitocin flat on your back with an episiotomy, etc. But, as you say, if it means having a healthy baby, you will labor on your back, etc. So, you need to find care providers that you really really trust. So that when they say, I recommend intervention X now, you can believe that it is for a good reason. I actually did have pitocin and I pushed flat on my back AND I think this was the healthiest option for me and my baby. But man, did it take a lot of talking with and trust in my midwife for this to happen. The problem with most of the possible interventions is not that they are ever used; it's that they are used too much. But most interventions are appropriate sometimes.

Sending hugs and good thoughts. You will get through this.

 

[MeepyCat]

Wow. That is a lot to deal with, mama. Can your midwife recommend an OB that she's worked with before? Can she act as a doula for you, or refer you to one?

They cannot kick a laboring woman out of a hospital, no matter how stubborn and uncooperative she is. You need to plan, and you need support people, but you can be as obnoxious to the staff as necessary. There are some issues with pregnant women and the right to refuse treatment, but you are (I believe) on pretty safe ground in refusing pitocin, choosing your own labor position, and doing everything possible to avoid episiotomy. I strongly recommend that you check out as many local maternity wards as it takes to find one where the notion of a woman *not* laboring flat on her back isn't a shock to anyone.

 

[JosieAK]

Definitely ask your midwife for recommendations. She probably works with a back up doctor and may know of others who are pro-natural birth.

Also, if I need to transfer late in pregnancy (very early in pregnancy it may not be finacially workable), my midwife said she would act as my doula ("a glorified doula" is actually what she said) unless she has another birth to attend. So if you've developed a good relationship with your midwife through this pregnancy, that might be a connection for you.

A nurse I was talking to recently (she was working hard to convince me that I was a nut for planning a home birth) told me that hospitals "have to follow birth plans." This was somewhat reasuring to me, so if I were you, I'd create the most concise, clearly worded, friendliest birth plan you can muster and make sure everyone in the world reads it.

Also, I have no idea how much time you have before you are due, but you might consider taking a Bradley Birthing class. My husband, also an engineer, loves the classes. He really woke up to his role at the birth, and I've heard him talk to people about how he will be "protecting" me from bad attitude nurses, etc. I think the classes are probably even MORE effective for natural hospital births. If you don't have that much time, I would at least encourage you to pick up "Natural Childbirth the Bradley Way" and go through it with your husband.

Anyway, those are some things that came immediately to mind. I wish I could give you a big hug! I know this must be hard, but I also believe that you will have the strength you need to have a beautiful and courageous birth.

 

[Shelsi]

You've gotten great advice. Also realize there is power in your words. This is not your worst nightmare and if this is the worst thing that ever happens to you then you are a very lucky and fortunate person.

If I had planned a homebirth and it turned into a hospital birth I would grieve a bit. I would probably even panic for a day or so because I'm just that type. But then it would be time to settle down and think about the positives because there ARE positives and the most positive thing will be your baby at the end of it all whether it's a home birth or a c-section.