Natural Birth

Free standing birth center - getting comfortable

MH and I toured a local birth center and LOVED it.  Our preference would be to have the baby there.  I had an OB appt today and an ultrasound and told him that we had decided to go with the birth center and my worst fear happened...he completely tried to change my mind.  I was kind of expecting it, but not to the extent that he went to the extremes.  There's a group of midwives in my OB practice that he was trying to push us towards, but there's still the issue of hospital protocol, being on a time table, etc., and I just love the postpartum practices at the birth center - no separation from baby, etc. 

I have of course thought of the "what if's" at a birth center.  I'm not worried about the issues that can slowly develop because I feel confident the midwives at the birth center would catch those early enough and their transfer, c-section, and mortality stats are great, but it's more the unpredictable things that can happen in an instant that are now on my mind again.  How did you ultimately get comfortable with this?  Was it enough for you that these unpredictable things happen in such a small percentage of cases?

If you got this far...thanks!  I hate that my OB put some doubt in my mind because I was feeling so confident.  Thanks for your insight.



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BFP #1 6.17.10 - natural M/C 5w2d
BFP #2 8.4.10 - missed M/C, D&C 8w
BFP #3 1.18.11 - natural M/C 5w1d
BFP #4 5.6.11 - 13dpo: hcg 68, p 16.3; 16dpo: hcg 211,
p16.6; 18dpo: hcg 416, p 15.6; 25dpo: hcg 6,007
DS born 1/30/12
BFP #5 4.28.13 - LO due 1/4/14

Re: Free standing birth center - getting comfortable

  • Well, I always knew I would want to birth at a birth center, but the low incidence of actual emergencies certainly reinforced that desire. That said, I've never HAD an OB. The midwives at your bc should be able to handle all of your prenatal care, and if so, I would drop the OB and just deal with them. You don't need someone trying to change your mind your whole pregnancy. I think it would help you feel much more confident.

  • We looked at one my first pregnancy but i was so far along that we just decided to do a hospital birth.  This time i was dead set i was doing a birth center and so we are doing it and i love it and since i've been going there have been many babies born there and i love my midwife too and i have complete confidence in her that if something should go wrong she will transfer me and my baby to a hospital.  Here in the state of NC/SC i have to see and OB twice within my pregnancy and i see one that is in complete support of the birth center and i like her too.  I will recommend the birth center to everyone now even if my delivery goes wrong since i have had an amazing experience and wouldn't change my mind for the world! Good luck in your decision.
  • I had a home birth and I think having a period of doubt is totally normal, especially in our society where birthing outside the hospital is so unusual.  I started worrying about the what if's and all that, but talking to my midwife really helped.  She was able to go over a lot of different scenarios with me and that helped.

    Plus, when I started really thinking about it, things go wrong in hospitals too.  While I was pregnant I heard of two different babies dying during hospital births, so there is risk no matter which way you go.  I knew I'd be more comfortable at home and ended up having an amazing birth experience.  I'm glad I didn't let my doubts get in the way, but we all have to reach our own conclusions and ultimately do what is best for us.

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  • Studies have shown that infant mortality for a low-risk mother is the same at a hospital and a birth center, somewhere around 2 percent, I think? Maybe someone knows more specifics. Typical birth center transfer rater is higher than that, around 10 percent, because they want to be extra careful. But the "death rate" is going to be pretty similar no matter where you are, if you're seeing professional care providers. But think about all the other risks that go UP at a hospital (risks of interventions, c-secs, etc). You have to factor in how healthy it is to be at a birth center for a low-risk, normal birth.
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  • One thing that eased my mind was asking about the birth center's process for getting to a hospital if necessary. I purposely chose a birth center within a block from a hospital (basically across the street). They could get you into an OR in minutes if they had to. Their back-up OB and her partner were very supportive of the BC MWs- there was mutual respect and trust, not an attitude of "well you should have been in the hospital in the first place." If an ambulance had to be called, the hospital would send an OB and a NICU nurse, NOT EMTs. Those were really the only conditions under which I would be comfortable with an out of hospital birth.

    I needed to know that, even though it was statistically unlikely, if something adverse DID happen that there was a plan for a seamless and quick transition to a higher level of care.

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  • Thanks for your insight ladies.  I'm going to set up an appointment with a midwife at the birth center to talk through my concerns.  I really think the birth center is the right choice for us and I'm hopeful that I'll get fully comfortable.  Thanks again.


    Baby Birthday Ticker Ticker
    BabyFruit Ticker

    BFP #1 6.17.10 - natural M/C 5w2d
    BFP #2 8.4.10 - missed M/C, D&C 8w
    BFP #3 1.18.11 - natural M/C 5w1d
    BFP #4 5.6.11 - 13dpo: hcg 68, p 16.3; 16dpo: hcg 211,
    p16.6; 18dpo: hcg 416, p 15.6; 25dpo: hcg 6,007
    DS born 1/30/12
    BFP #5 4.28.13 - LO due 1/4/14

  • I had an OB give me a hard time as well, funny enough it was the OB my birthing center sent me too in order to get cleared for a low risk birth! They trusted that he would be supportive, but he tried to talk me out of it even though I was an excellent candidate for home/birthing center birth

    I guess it's not uncommon for this to happen. I ended up having a water birth at a birthing center and it was an amazing experience. I was so glad i didn't have to fight for what I wanted to happen in my birth, they just let me take the reins. I don't regret it and am planning on repeating the experience with baby #2

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  • It sounds like it's time to cut the cord with your OB and move to that Birth Center. We recently did just that. We feel in love with a Birth Center and midwives and I let my doctor know we were switching (I will go back to her for my own care and paps afterwards). She wasn't too excited about it, but that's what I expected of an OB practice.

    Just get all the info you need on how your center will handle emergency situations or under what circumstances they'd recommend a hospital birth for you. Then you have the answers for all the doubters. Best of all, if you switch now you'll be around people who are supporting your decision.

    Best of luck!!!

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  • It's sad that your OB wasn't supportive of your decisions. Based on my experience, when I labored with DD at the birthing center, the labor was natural, med-free and absolutely amazing. I had the freedom to labor how I wanted and it was exactly how I envisioned it. But after 22 hours, DD eventually went into distress and things took a turn. The midwives were so quick to pick up on the problem, so supportive of me and all the hard work I did. They recommended a transfer and never made me feel bad about the situation. They were so quick and had all my files ready to transfer to an OB on call. Within the next hour, I had an emergency C-section and everything went so smoothly. The Birth Center statistics for that year was a 9% transfer rate with about half-of those needing c-sections. Even though I belonged to that small percentage that needed the emergency transfer, it was reassuring to know they knew exactly what to do and I never felt my our care was compromised. At all. Hopefully that brings you a little comfort. I'm trying for VBAC this time and completely trust my midwives to do the best for me as they did before. Good luck!
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  • Most of the "what ifs" at the birth center are easily dealt with by the trained competent midwives that are on staff.  :) 

    I was comfortable with the idea of my birth center because I had already had a child in a hospital and knew I didn't want to do that again.  I discussed home birth (didn't know about the birth center at the time) with my OB.  Mistake.  She went into a tirade about dead babies and blah blah blah.  OBs are trained for the worst case scenarios.  Some of the pregnancies that they see are high risk.  Midwives at birth centers are trained in normal pregnancy and birth, they don't see high risk pregnancies.  They are also trained for the emergencies that might come up, but most of the births they see are totally normal.  I think that's why OBs can't fathom delivering outside of a hospital because they are seeing the worst cases on a regular basis. 

     

    Mama to Lucy (7/06), Lexi (5/09), and Max (11/11) M/C 12/17/10
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