expansion on Q re: hospital or MW

potbellypig

Intro: Hi, I posted once before about whether or not I should stick with my midwife who is 90 minutes away or go to the hospital in town which is 3 minutes away. I had a water birth with the midwife 2 years ago. I have one daughter and am expecting a son in February. Winter driving out where I am. I know this has been asked but I'm curious what people think is important...

The hospital is town that is 3 minutes away is very hit-and-miss. There are some great Dr's and there are some who just clamp the cord, tug the placenta etc. I've heard a handful of great stories from women who mostly laboured at home (which is my plan)...(none of the women had a MW birth to compare to) and I've heard stories of nurses telling mom not to push (despite body wanting to push) because the dr wasn't there, of tugging at the placenta (and getting infected because some was left behind), huge episiotomies, vacuum deliveries, a few women saying they hemorraged due to placenta issues etc.

I'm not worried about not having a natural birth (they don't use pit or do epi's in town) but I want a respectful birth which I know I'll get with the midwife. At the same time, I would like to labour at home this time and would rather not do the hotel-room thing we did last time. I have a doula which I know can make a difference.

So if you were me, and it was a "hit-and-miss" hospital 3 minutes away but you could labour at home or a "guaranteed" respectful-birth midwife 90 minutes away with winter driving involved, WWYD?

ncbelle

That's a tough one.  Personally I can't imagine having to drive 90 minutes in labor (30 was more than enough for me!), particularly in winter weather (although I've never personally experienced winter weather - ha!).  One factor to consider is that you are an informed mother who knows what she wants and sounds willing to advocate for what you want.  That works in your favor even with a less than fabulous provider.  That said, it sounds like things could potentially be rather awful at that hospital.

One possibility is to stick with the midwife and if things move quickly or if the weather is awful, head to the hospital instead.  They can't turn you away in labor even if you aren't a patient of anyone there.

aylafsu88

For me 90 minutes is to far. In labor the last thing I wanted to deal with was a long drive.  I would probably stick with the hospital as it is closer. I agree with the PP, if you have a doula, you are informed on procedures and you have an idea of what to expect then things would probably go well at the hospital.  I know that I used this approach for myself when I delivered LO.  I was prepared and educated which helped things immensely. The on call OB from the practice who I had never met delivered my LO. He was great and probably more NB friendly than the main OB I saw.

AmyRI

With the local hospital, can you see a specific doctor and they will be there to deliver you, or do you always get whoever is on call?

Assuming you can pre-screen doctors now and find one that will be hands-off, I would absolutely stay local. You have a doula and your DH to back you up on your decisions and remind the doctor of specific requests.

If you're at the mercy of the on-call doc, I'd consider driving the 90 minutes. Although that's 80 minutes farther than I can imagine driving while laboring.

potbellypig

AmyRI said:

With the local hospital, can you see a specific doctor and they will be there to deliver you, or do you always get whoever is on call?

Assuming you can pre-screen doctors now and find one that will be hands-off, I would absolutely stay local. You have a doula and your DH to back you up on your decisions and remind the doctor of specific requests.

If you're at the mercy of the on-call doc, I'd consider driving the 90 minutes. Although that's 80 minutes farther than I can imagine driving while laboring.

I work in health-care in town so I can see who's on schedule for call ahead of time, although to an extent it's whoever is available to show up first.

sschwege

It wouldn't be worth it IMO, 90 minutes just seems too far.  

You seem really worried about this hospital, have you considered a HB?

potbellypig

sschwege said:

It wouldn't be worth it IMO, 90 minutes just seems too far.  

You seem really worried about this hospital, have you considered a HB?

I am worried about the hospital

HB isn't an option because of the lack of midwifes. If it were, I'd be in L&D heaven!

sschwege

potbellypig said:

sschwege said:

It wouldn't be worth it IMO, 90 minutes just seems too far.  

You seem really worried about this hospital, have you considered a HB?

I am worried about the hospital

HB isn't an option because of the lack of midwifes. If it were, I'd be in L&D heaven!

Too bad about that!  You have strong advocates in your corner which will carry you far.

I don't want to scare you, but want to make sure you are really considering everything, what if you get discharged and baby has to stay in the hospital?  A 90 minute drive particularly in the winter could be really tough.  With DS we weren't sure he would be discharged until the 48 hour mark, at which point I would have to go home regardless.  All the while I was so relieved that our hospital was only 15 minutes away, when I thought about going back and forth to see him and nurse him, all the while having a two year old at home, I was pretty relieved we lived as close as we did.  He did go home with us thankfully, but it was a load off my mind knowing we wouldn't be far.

MississippiCatfish

A 90 minutes drive in MN winter weather can EASILY turn into 2.5-3 hours. That honestly seems really far to me in February. It's usually a 90 minute drive from where I live (minneapolis) to my hometown (eau claire, wi) and I would't consider it even in the summer. Good luck with whatever you choose!

ETA: I'm guessing you have, but have you done lots of calling and internet searching to find out if any of the docs in town are NB friendly? Some have to be more than others and it might help to try to get to know them.

pdilly2b

How long will the hospital require you to stay afterwards? Are they baby/mama friendly? If they do such horrible things in L&D, I'd worry about post-partum too. 

FWIW, my baby/mama friendly hospital for DS still wasn't all that great for postpartum (interventionist pediatrian on call ordered unnecessary tests on DS that I didn't know better to decline, nurses wouldn't take out my heplock, made me stay more than 48 hrs because GBS+ even though I had 3 rounds of antibiotics in labor, etc.). Though if they did that to me there, I really wouldn't want to experience a place where I also had to fight for rooming in, respecting BFing wishes etc.

Is there another hospital that's >3 min and < 90?

potbellypig

pdilly2b said:

How long will the hospital require you to stay afterwards? Two days I think? I don't mind staying longer as I go back to a 2 y/o. Are they baby/mama friendly? If they do such horrible things in L&D, I'd worry about post-partum too. 

FWIW, my baby/mama friendly hospital for DS still wasn't all that great for postpartum (interventionist pediatrian on call ordered unnecessary tests on DS that I didn't know better to decline, nurses wouldn't take out my heplock, made me stay more than 48 hrs because GBS+ even though I had 3 rounds of antibiotics in labor, etc.). Though if they did that to me there, I really wouldn't want to experience a place where I also had to fight for rooming in, respecting BFing wishes etc for some reason this part doesn't bother me. I guess I know I'll be able to fight for what I want after the birth. I'm just worried about what might happen when I'm in the throes of L&D.

Is there another hospital that's >3 min and < 90? Sadly no.

wintersong

I'd vote the closer hospital--easier variables to manage. With a doula and an educated dh and educated mom/other family to support you in labor and post partum. 90 minute drive would make me way nervous, especially in winter.

Birth centers in my area, at least the ones not attached to hospitals, will really only let you stay a few hours after delivery...once you pee and get a little rest, they want you to go home. Is that true of your center? Would you want to drive home an hour and a half so soon after having the baby?