Some birth center questions
Long story short, I'm due in August, we may be moving, and I'm looking at a birth center in our potential new town.
1. What's the latest that you think a birth center (there is ONE in the metro area, my "next best" choice is a hospital with a 40+% Ceserean rate) would take a new patient?
2. If I'm in my early 30s and healthy, but had a miscarriage a few years before my first child (car accident), but there are no other issues with the pregnancy, am I still considered "low risk" enough for a birth center? I had an freakishly easy labor with my first birth; she came out with an APGAR of 9. Do you think I could make my current OB forget to put the miscarriage on my records when she sends them over?
3. The birth center's website talks very much about "it's an experience for the whole family, we welcome guests, etc..." I'm looking at a birth center ONLY because I don't want unnecessary interventions. Due to certain past experiences I've had and family dynamics, I'm very adamantly opposed to having anyone but my DH or necessary medical personnel there (as would be any OB/MW with a brain if they knew the whole situation). It's not by any means a decision anyone supported with my first child; there is a pretty strong possibility someone might try to crash the delivery room.
Are birth centers bound to the same privacy/HIPPA regualtions as hospitals, or do I lose my right to privacy when I go to one? Do birth centers even have the same security as hospitals? If I spoke to the OB/MW in charge beforehand, do you think they would they be able/willing to keep my ILs/Family OUT of the delivery room?
Re: Some birth center questions
The birth center is also bound by HIPPA. Their primary concern will be your comfort and if you don't want someone there they certainly will not allow them in. You absolutely don't lose your privacy. Having you be stressed about people trying to get in is the opposite of what they want (a stres free gentle birth). Just discuss this with the mw. They will advocate for you.
As far as taking you later in pregnancy, I would contact them now and be in touch throughout your pregnancy. GL!
eta: typo
This.
I transferred my care to my midwife at 30 weeks. She has taken in patients as late as 38 weeks in the past (my midwife delivers at homes or at the birth center, depending on what you choose.)
1. I think that's just going to depend on the birth center. The freestanding birth center where I had Eleanor probably wouldn't take you because they already have too many patients. The hospital based midwifery practice I delivered Callum with took me at 35+ weeks.
2. I don't think that a miscarriage would matter at all as it doesn't have any bearing on your labor and delivery.
3. Yes on HIPPA - no one was at my birth but DH, the midwife, a student midwife (I was asked well in advance if I was ok with that and again when I came in in labor), and a nurse. There was no "security" at my birth center - but I think that's something that will vary by location. Just don't tell anyone you are in labor or where you plan to deliver ;-)
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These are all great questions for the center itself, but here is my best guess...
1. They will want a relationship with you, so early is better, but that said--if they still have space in your birth month, they may take you quite late. With DS, we had until 34 weeks to make the call. Because relationship is si important, they did not offer any discount for the short period of care. We ended up choosing hospital for financial reasons. Perhaps you could start a telephone relationship even before you move?
2. Miscarriage does not generally make someone high risk. It was not considered as a factor for me beyond having progesterone at the beginning with DS.
3. I think the point of statements like the family ones is that they go with what the parents want, not what abritrary rules say--like in a hospital. One question on the forms of a birth center near me is about who I want there, who I don't want there, any concerns they should be aware of, people they need to prevent from entering, etc. Midwives treat the emotional side of patients and pregnancy as well as the physical, so I would expect sensitivity.
Also, I'm going to make a leap here based on my own past (don't feel any need to respond this this as to your own story), but if you have a history of abuse, that is something that you should discuss with your delivery team no matter which way you go so they can be aware. The emotions and stress of labor can bring up old issues in weird ways and as a team you can prepare. Making sure your delivery team is an emotional fit for you can be a very helpful thing. If you end up doing hospital, try to find a doula who is an emotional fit.
4. The birth centers near me are bound by HIPPA. Midwives are regulated differently in different states, though. I don't think your request to privacy/security is uncommon. Many, many people have similar concerns for various reasons. I cannot imagine a practice staying in business if they bandied personal information about. Also remember that sharing details of delivery place with family is your choice. You also do not have to tell your family when you go into labor.
I know that these things are stressful to imagine, but I think any reputable place will have your back on this. Asking the right questions, processing with your team/other professionals early in the pregnancy, and then putting this to rest emotionally (as much as possible) may benefit you. During labor, your focus will need to be on relaxation, the task at hand, and your bright future!
More Green For Less Green
what everyone else said, plus one thing. From what I remember, as long as you've had some kind of prenatal care throughout your pregnancy they'll take you whenever.
If you don't have prenatal care before 20 weeks, you're considered high risk.