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Discussion Starter #1
Hi! I'm pregnant with my first and my husband and I have decided to use a midwife and, hopefully, birth center for prenatal care and delivery. We are scheduled for their informational this Thursday. Did anyone use a birth center or know maybe what to look for? Questions to ask? Etc. Any info is welcome and appreciated!
 

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If you can, just go with your gut and look for a midwife who you really, really trust on a personality level. I know insurance and other things can limit provider choice, but if at all possible don't settle. I settled with my first midwife, and felt like our personalities clashed in the delivery room. I think this contributed to my having a c-section. I wish I had worked with someone with whom I could better communicate, didn't realize how important that would be.
 

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I am working with a birth center and midwives currently that my boss went through last October. When I went to their informational meeting, they basically laid out everything I needed to know and sat and talked with me for about 30 minutes through all the "silly" questions I had (this is my first). Before the birth center, I was actually meeting with hospital midwives and had started the process there but I didn't feel as comfortable there as I do with this birthing center. The birthing center gave me a lot of hand outs about what they do specifically in different situations and typically how things go. Really, the question I had for them that they didn't answer right off the bat was "What kind of interventions do you use here?" and they were very open and listened very well.

I would just think about how you want your birth to go and base your questions around that. What's important to you. Go with your feelings because it's your experience :)

Edit: Sorry for DDC hopping, just thought I'd chime in :)
 

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There are good lists of questions if you look around online. I'd ask what can risk you out of the birth center, what rules and regs they (and you) have to follow, when they would transfer, what is their transfer rate, where do they usually transfer to, do they have a backup OB, etc. Perhaps also what they can do that a homebirth midwife cannot.
 

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One question I think is useful to ask of any provider or location is, "How does a birth here usually go?" That way you can see what kind of things they are used to doing without giving them an idea of your own desires. Of course you'll want to get into that later, but at first I'd want to hear the answer without worrying they'd tailor their answer to me.
 

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Discussion Starter #6
Thank you for all the suggestions! I definitely didn't think to ask about some of these like what interventions they use or what would make me risk out. I will largely look at how our personalities mix, that's a good point. I would love to just find one midwife and work with her but we're renting right now and I do not want to have a home birth here. I go tonight so I'll bring my notes!
 

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For what it's worth, with my first I really wanted one midwife that I knew really well. With my second and third, I've felt that I'd rather have a team of good midwives, and one doula that I completely trust (even in a homebirth setting!). The midwife can be a good support person, but she has a lot of things to think about - particularly making sure you and baby are safe. It is SO nice to have someone who is focusing just on helping you with breathing, rub your back, positioning, etc.

The nice thing about having a team of midwives is that you know that they aren't coming off of three consecutive births and are exhausted. With a call schedule, you don't necessarily love the person you get, but at least you know they are in a good place to make decisions and can get help when needed.
 

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As I do more research I'm finding a doula would make sense. I hope I can afford one or qualify for assistance. I think if I labor a significant time at home, which will probably happen, I'd like that support. Any suggestions on how to find one?
 

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You could start by asking at the birth center, they always have a list. :) Locally we have an active birth related facebook group that makes it easy to find reduced or in training doulas. Go to your local LLL group and ask there.
 

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My 3rd birth was at a birth center. I learned a lot through the process.

Ask if they have OB backup. This OB would write an open order for pitocin, cytotec, oxygen, vit K shot for your newborn, etc. Depending on your preferences, you may appreciate the OB's open orders, or dislike them. I feel like the birth center I used relied too heavily on these things, making it a much more medical birth that I wanted. It also means that an RN is required to be at your birth. And that's often an extra cost to you, not included in the birth center's contract and cost.

Ask where the midwives live in relation to the birth center. How long will it take each of them to get to the birth center, when you are heading there in labor? You don't want to get there, and have to labor in your car, in the parking, while you wait for the mw to arrive.

Ask how many births the midwives have missed. It's less likely for them to miss your birth if you're a first time mom, but it happens. Much more likely to happen if you're a multip.

Ask what classes they do throughout the pregnancy. I.e., is there a third trimester kick off? At the birth center I used, all moms entering their third trimester came to this. We all had a quick measurement and heartbeat check, then all did the 1hr glucose test together, and they talked about some things about getting ready for the birth. Also had a birth month meeting somewhere around 32-34w. They talked about packing your bag, what to do if baby came before you made it to the birth center, etc.

Do they welcome/encourage families to take childbirth prep classes? Are families restricted to their classes, or can you take Bradley/Hypnobirthing/etc with an instructor that you click with?

Can they write scripts for some things, like diabetes testing supplies, if you end up testing positive for GDM? Does GDM risk you out entirely?

Do they offer homebirth services, too? Can you switch to homebirth, if you change your mind during the pregnancy? If so, how much is the birth kit?

Will the mw do the newborn screenings, including blood and hearing, or do you need to take your newborn to the ped to get this done? If you have to take your newborn to the ped, figure out your insurance coverage for this.

Will your mw give you a birth/newborn report to take to the first ped visit?

Is the birth center open to alternative therapies for pregnancy discomfort, such as chiropractic care?
 

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I would make sure you are super clear on the cost and how and what they bill. I hear from clients who used birth centers previously that they were surprised or confused about certain hidden costs, network issues, deductibles, etc. Talk to their billing person and do a VOB early in care so you know what to expect.
 
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