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Natural Birth
Showing up at a hospital where my OB doesn't deliver?
I like my provider (an OB) a lot, but 1) he delivers at two hospitals in our area, neither of which is known for being especially friendly to natural birth. This bums me out. Especially because he's one of 5 providers in his practice and so I only have a 1/5 chance of getting him anyway. So more than ever it truly is going to be about the nurses and the hospital, which makes me want to switch...
However, I looked into transferring care to a different OB or midwifery practice that has delivering privileges at one of the more natural birth friendly hospitals, and honestly, that bums me out, too. For example, I called the clinic of midwives that delivers at a pro-NB hospital in my area and found that there are 20 (!!!) midwives in that practices, and there's absolutely no knowing who I'll get. They recommend that I see as many as possible between now and delivery so at least I have a chance it won't be a stranger (I'm 32 weeks). That just seems silly to me, when it's likely I'll end up with a stranger anyway. Why not at least have continuity during the pregnancy, with a provider that I like?
So today it occurred to me: What if I were to keep up care with my OB during pregnancy, but then when I go into labor, just show up at the hospital that's more pro-NB and use whichever doctor or midwife is the attending that day? Because honestly, isn't that likely to be what I'd get anyway--whether I went to one of my doctor's hospitals or switched care? And if that's the case, shouldn't I go to wherever the nurses are friendlier to NB?
Please just tell me if this idea is dumb...
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Re: Showing up at a hospital where my OB doesn't deliver?
1. I would go with the pro NB hospital
2. So important for you to have support ppl doula or family members that are familiar and on board with your birth an to be your advocate with the hospital personnel
My main thought is cost/health-ins related. Most states require OBs/midwives to charge prenatal care with the cost of delivery under global-billing. If you intend to be with one caregiver until 40 weeks during appts, but then just deliver with a random caregiver at a different hospital, what does that do to your billing/costs? I really don't know.
Plus, IMO as long as your honest with your current caregiver that you don't intend to use them for delivery, but instead intend to go to a more NB friendly hospital, I think it's reasonable. Basically, I would want, as the caregiver, to direct you to someone else if that prenatal care with one and delivery with another caregiver wasn't "appropriate" (not sure if that's the right word).
Oh and I switched caregivers at 32-34 weeks and still have been able to get to know and bond with them, so it's not really too late to just switch and be honest with your caregiver that you're switching b/c of the hospital and not them personally.
...baby #3 is here...
is the nb friendly hosp closer to you? you could always just go there, and say, "I don' think i'm going to make it to my hospital" They can NOT turn you down. My friend had her son in a completely diff hospital than planned, because there was a blizzard, and she just couldn't make it there, so she ended up at my hospital, which happen to be very NB friendly, so she got the birth she wanted even without her OB there. So, yes, I think it's a fine idea
) You need to go wherever you think you will be most comfortable birthing! Keep us updated, I'd love to see what you decide! 
)
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TTD pics taken by knottie jen&louie
Obviously this is something that everyone is going to feel a little bit differently about.
Have you seen any of the other doctors in your current practice? Do you know what their philosophies are like? If not, I'd be hesitant to go to a hospital you don't like with a 4/5 chance that you'll end up with a provider for labor that you don't know anything about. Now, if you know the other providers in the practice and are comfortable with them/they're in line with your philosophies and will be a good support for your natural birth, then I would stick with the current practice.
As far as staying with them then heading to the NB friendly hospital and taking the person on duty, I would feel less comfortable with that than I would switching to another practice that I would be able to get to know in the next few weeks, provided that the practice I'm switching to is a good one. Obviously a huge practice like the one you are looking into isn't exactly optimal BUT if you are able to meet with several different people and you like the practice/trust that everyone there is going to be good support for you then that's worlds better than just taking what you're given at the hospital IMO just because you have NO idea what you're going to end up with.
But I agree with PP, since you're really not sure who you're going to end up with (even if you stay with your current practice and hospital) I think it's probably important for you to have a strong support person or persons there. I think a doula could be super helpful in your situation.
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I was going to do this when I was pg with #1. I even asked my OB at the time if it was ok that I just show up to the other hospital. She said no because they wouldn't have any information about me, or my prenatal care. If you deliver at your current hospital the OB that delivers your child may not even be your OB but at least they can see all of your health information and know of any problems from the past (they have your file).
If you just show up to a new hospital you are basically a stranger to them, they don't know anything about your prenatal care. My OB told me they consider doing this very rude.
That is why I actually switched OB's at 36 week, and I'm very glad I did.
I think it is more important that your OB and his partners at your practice are NB friendly than anything else. Honestly, I think your own doctor is probably going to have as much or more sway on how your birth goes than nurses or "hospital policy." My ob has admitting privileges at two hospitals. Both hospitals have c-section rates over 30%. However, I toured both hospitals and asked about things like doulas (they both said "Great! Doulas are awesome!") and getting a heplock instead of an IV, laboring in water, intermittent fetal monitoring so you can be mobile and walk around, etc. and they were both groovy with all those things. So I think it is absolutely possible to enjoy a natural birth in a hospital with an OB--if you have the right OB and are willing to stand up for yourself (perhaps with some assistance from the doula if needed). You always have the right to refuse treatments you don't want.
I will probably be older than most of my L&D nurses and I am not going to take any crap from them. It is MY birth and I WILL be a partner in the process, not some doll to be pushed around.
Over-40 parents...what we lack in vigor, we make up for with cunning.
This is what I was thinking, too. You'd have a really long list of questions that they would ask you.
I'm not understanding why showing up at the hospital with a ton of MW is okay - you won't know who you get in labor - but going with them for the rest of your pre-natal care sucks - because you won't know who you get in labor. Isn't that the same thing either way?
I know everyone is different, but both my pregnancies were with very large MW groups. I saw 1-2 that I liked a lot for appointments, and knew that my chances of them being with me in labor were low. Doctors and MWs pretty much only show up at the end during a hospital birth anyway, unless you have one person dedicated to your care.
It sounds like having a doula (even if it's a friend or relative for constant support) might be a good idea for you.
DS2 - Oct 2010 (my VBAC baby!)
Do what you need to do, but be warned that showing up "no doc," on purpose, in labor when you could easily get to your correct hospital will NOT help your L&D process start out smoothly.
Think about it from an OB/MW/nurses perspective- if you just show up they know NOTHING about you at all. You could be the highest of high risk, no prenatal care, HIV+, GD, whatever. Not really someone they will be excited to have off the monitor, no IV, walking around, no internals, etc, kwim? Yeah, they have to accept you, but they don't have to be happy about it. You don't want to start out with everyone pissed for a totally avoidable (and legit, IMO) reason.
I'd stick with the OB that you like rather than roll the dice with whats-her/his-name at a hospital that doesn't know you.
At the end of the day it is YOU who will be delivering the baby. Have folks around you that you have a decent chance of knowing if you can.
(this coming from a person who had an ER doc 'deliver' her second kid. At least the on-call dude showed up for the stitching, lol!)
Just to clarify, I definitely would have gotten my chart there ahead of time, and I would have talked with my ob about the the best way to do that. But I'm pretty convinced that this is a stupid idea either way, so... never mind!
Definitely planning to hire a doula, so that part is covered.
I was thinking the same thing.
I would switch to the midwife practice and try to see as many as you can. If you like the first midwife you see then tell her about your need to know the delivery person and ask if there is anyway to see the on-call schedule or if she would agree to take your call when you're in labor.
Based on my experience, the support of the hospital is far more important than the support of the doctor/midwife. I barely saw my doctors/midwife during labor and delivery but I saw my nurses a lot. The first nurse was begrudgingly supportive of my plan but the second nurse was 100% on board with me and made the last part of labor so much easier on me. No matter what, try to go to the hospital that supports NB, you'll have a much easier time and not have to fight for your desires.
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