How did you decide where to deliver?

mom2be0912 · April 2012

Hello! It is my goal to have a completely natural childbirth (I'm a FTM). As of now, I have an OB that I love and am set to deliver at a hospital near me. It is a nice facility but I have heard many rumors that it is not a very natural birth friendly atmosphere and I should expect a "factory birth." This upsets me, obviously!

There is another hospital about 35-45 minutes away which I believe have whirlpool tubs in their birthing suites. I hear they are much more natural birth friendly and even offer hypnobirthing classes (something I'm very interested in). The distance is the biggest concern of mine here.

Then there is my favorite option.. the birthing center. This is very close to the nearest hospital to me and has beautiful birthing suites equipped with amazing birth tubs and has such a serene atmosphere. Obviously my biggest concern is what if something happens and I'm not in an immediate medical facility that could meet my needs? I want a no-intervention birth but it still frightens me to think that if I needed ANY interventions, I would HAVE to be transferred to the hospital.

I will be touring the birth center today and plan on touring the other hospital in the near future. I just wanted to see if anyone has had similar decision making they've had to do.

So my question to you ladies is, how did you decide on what type of facility to deliver in? How important was it to you to deliver in a birth center vs. hospital setting? TIA!

princessyetz · April 2012

Out of your options you listed I would go with the birthing center. Free standing birth centers are supposed to be very close to a hospital (by law) in case a transfer is needed. I know the birth center here has you pre-register at the hospital just in case you need surgical intervention. So don't let the thought of being away from surgical help scare you away from this option. Midwives are extremely skilled at what they do. Most OBs are not really trained in natural birth, but are trained for what to do when something goes wrong. Midwives are trained in natural birth and how to spot if/when their patient needs surgical intervention. If you want a natural birth go with the birth center.

mom2be0912 · April 2012

princessyetz:
Out of your options you listed I would go with the birthing center. Free standing birth centers are supposed to be very close to a hospital (by law) in case a transfer is needed. I know the birth center here has you pre-register at the hospital just in case you need surgical intervention. So don't let the thought of being away from surgical help scare you away from this option. Midwives are extremely skilled at what they do. Most OBs are not really trained in natural birth, but are trained for what to do when something goes wrong. Midwives are trained in natural birth and how to spot if/when their patient needs surgical intervention. If you want a natural birth go with the birth center.

Thank you so much for your input. I'm very excited about the possibility of delivering at a birth center as opposed to a hospital. I hope that once I actually visit it today I will have a lot of my questions answered and feel better about making that decision.

laurny · April 2012

I chose to go naturally in a hospital setting, and I have many friends who have successfully delivered at home. It really comes down to where you are most comfortable. If you have a complication free L&D a birthing center is a great option, but sometimes problems arise. A close family member of mine recently went through a tragic experience at a birthing center when her midwife did not transfer her when she should have...I hate being told negative stories, but her experience has made me even more aware how important it is to be educated!

nosoup4u · April 2012

Midwives are trained in normal labor, they can tell if your labor isn't progressing the way it should, and they will know when it's time to transfer if you need to go. Part of freestanding birth center rules is that they are x distance from a hospital, so women can be transferred in a timely manner.

InfinityDreamer · April 2012

I would choose the birth center. It will likely be a much more comfortable atmosphere, and since there will be less other woman birthing there you'll reduce your potential exposure to pathogens and birth centers usually have a more consistent staff so you will receive more individualized care.

When you tour you can ask them about their transfer rates. Most have <1% emergency transfer rate, non emergency transfer rates will be higher (6-8% usually), but they most commonly occur when the laboring woman decides she wants pain medication beyond the scope of what the birth center can provide or due to an excessively long labor (think 36+hours) where progression has slowed or ceased despite natural interventions to aid or restart progression.

I delivered my first at the hospital, my second at home, and will be having another home birth in August.

annabelle.27 · April 2012

For me, it was a choice between home or hospital- there's only one hospital in my city and no birth centres. I chose home.

Clearly I'm comfortable with an out-of-hospital birth, but in your situation I would choose the birth centre. It's closer than the other hospital, and the "bad" hospital is there in case of emergency. There are very few true you-need-a-c-section-right-this-moment emergencies- if something was going wrong, your midwives would be able to get you to the hospital in enough time to have a surgical birth. I would prefer the low-intervention mindset of the birth centre. But, if you find yourself leaning towards a hospital birth for your own peace of mind, 35 minutes isn't that far when you get right down to it- I personally would choose the birth-friendly hospital over the high-intervention hospital closer to home.

I personally feel that, when other options are available, and in a low-risk pregnancy, I would not want to birth in a hospital. But that's just my opinion, you have to decide for yourself what you are comfortable with.

skyejo · April 2012

My choice was basically made for me. I wanted something my insurance would cover and that left me with an OB/MW practice that delivers at a hosptial. I saw the MWs and had a med-free birth with zero interventions (not even a hep lock/IV).

If you love your OB and he/she can deliver at any one of the options you listed, I would go with the birth center. If you do need to be transferred to a hospital it sounds like one is close by that you will be fine.

Good luck with whatever you decide!

*LrCg* · April 2012

I have had homebirths. My CNM offers her birthing center or a homebirth. She brings the same equipment to your home that she has at her birth center (oxygen, etc.). For me, I felt safer at home then a hospital. After a lot of research I came to the conclusion that a lot of the "what ifs" happened due to medical intervention (notice I did not say all). The CNM we use is highly trained and very much respected in the hospitals. She is trained to expect and watch for the unexpected. And if there was an issue arising, she would be on the phone with the hospital during transport so they would be completely apprised to what situation she was transfering to the hospital and be prepared to deal with it upon arrival. And even though my home is 25 min from the hospital I still had no reservations about a homebirth. I've never regreted my homebirths- they were amazing!

amber323 · April 2012

I'm having a home birth, but if there was birthing centers in my province then I would definitely go to one, I definitely am not ok with going to the hospital, they terrify me to no end and smell funny, I know I wouldn't be relaxed in there and would definitely end up with interventions, so naturally a home birth was more appealing

mom2be0912 · April 2012

Thanks for all of the advice, everyone! I just got back from my meeting with the MW at the birth center and it was amazing. She completely put me at ease and addressed all of my questions and fears. I think this is definitely the best choice for us.

Bonidiebabe · April 2012

I switched from an OB that would deliver in a hospital to a BC with MW's at 25 weeks. I wasn't comfortable with the way they (ob's) were responding to my questions. Plus, I took a baby basics class at the hospital and I just had the shivers thinking about birthing my child there.

DH was highly concerned at first about transfering to the center. The orientation session I think really put his mind at ease. I think you'll eventually come to find out that birthing at the center isn't that scary afterall.

The main reasons I chose to move my care to the center.... I felt more like an expecting mom rather than a number or just another patient. I hated that at my OB office they make it seem like something is wrong with you. If its not now then there will eventually be. KWIM?

I felt like with my OB I would have to fight for the things that I wanted (no interventions, a relaxed atmosphere, laboring in the tub, skin to skin, letting the cord pulsate, delayed shots and eye goop, no pressure to circ., not removing the baby from my sight, ect) All of these things I wanted are standard practice at the BC. Makes my birth plan pretty dang easy.

You stated that if you need ANY intervention you will HAVE to be transfered. That may not be the case. MW's have some meds just like the OB's do. It is actually standard practice at the BC to have a little PIT right after birth the stop hemmorage and get the placenta out with no issues. I am fine with this for all else I get in return.

GL with your decision making!!

SWBs Wifey · April 2012

I'm not sure what I'd do in your position. I know I'd want to ask questions at all of those locations and feel secure and reassured that I wouldn't have an intervention laden delivery if it wasn't necessary. Another NB mama recommended the birth center I'm delivering at. It's attached to a hospital... You pass through the "regular" L&D to get get to the Midwifery Suites. And they pointed out today (they require a third trimester class I went to), the operating room is actually more easily accessible from the Suites than from the other L&D rooms in case there is an emergency.

BostonGayGal · April 2012

I am lucky that there are a number of hospitals close to where we live. One has an excellent reputation for natural birth support (no its unless indicated, tubs, eating allowed) so I chose a midwifery practice at the hospital and had the birth I had hoped and planned.

StefandTodd · April 2012

If I were you, I believe I'd probably pick the birth center.

We had two hospital options...similar to yours (although, not that the other was considered "factory birth"...just, they're the more high risk of the two, higher c-section rate (largely in part b/c they handle all local high risk), and their midwifery program was newer and not as established as the other). I picked the one that was more NB friendly, less high risk, no NICU, longer and well established midwifery program, 12% c-section rate. Was very happy with my hospital birth, although I would still love a home birth, or even birth center birth next time if I had those options (at a reasonable $$).

GL to you.

Lou&Beth · April 2012

I chose the birth center that is 2.5 hours away as opposed to the hospital that is 20 minutes away. I value having a caregiver who I can trust to stay on course with a natural birth and only push an intervention when it's completely necessary. I know I wouldn't get that in a hospital and I would hate doubting everything my doctor tells me during labor. I think the atmosphere of a birth center is the absolute right place for me to have a natural birth, and I am fine with being transferred to a hospital if the need arises. I just think it will be far more comfortable to labor in a birth center that is not restricted by "hospital policy".

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