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Natural Birth
nodito
member
talk me through this hospital idea - crazy?
nodito
member
I think we're going to have to nix the doula idea - it's just too expensive. I've been fretting about this on and off for the last week and a random idea struck me that may be crazy but I wanted additional perspective.
The c-section rate at our local hospital, where my OB has privileges, is 36% (!). It would take me 10 minutes to get there. In nearby cities the c-section rates are lower. There's a hospital 40 minutes from us, for example, that has a 22% rate, and a hospital even further that has an 18% rate. So basically, I can halve my risk of getting a c-section if I deliver at one of these other hospitals, right?
So here was my thought. Suppose I keep my current provider for prenatal appts who I like, and who delivers at the local hospital, but when I go into labor I drive the half hour or hour or wherever to deliver at the low c-section rate hospital with a provider I don't know. Is that crazy? My OB wouldn't be there, but since he's in practice by himself, there's a 4 in 5 chance I won't get him anyway if I go into labor over the weekend or at night (I would just see the on-call doctor, who I don't get a chance to meet). I know I'd have to check whether the new hospital is covered by insurance. What other things should I be thinking about? If this is insane, please tell me so.
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Re: talk me through this hospital idea - crazy?
Have you considered the type of patients that deliver at these hospitals which can contribute to the higher C/S rates? I know that some hospitals are better equipped to deal with high risk pregnancies which can increase their overall C/S rate. Honestly, 36% is high but is really not that bad as the national average is 30%. Plus the hospital does not push a C/S, your provider does. IMO I would not drive to another hospital just because it has a lower overall rate. Your provider and the type of care they give really determines what could happen to you. If your provider is anti-natural birth then you should switch providers. I think you should discuss C/S with your OB and when he feels they are appropriate.
ETA: Just a thought but what if you end up with a on-call OB at the further away hospitals that is not supportive of a natural birth and pushes a C/S? It really is rolling the dice to show up at another hospital and deal with the resident OB.
I know it's risky delivering with a provider I'm not familiar with. But the way it works with my current OB is that if I go into labor after 5pm or on the weekend, it might be my OB delivering me (if it's his on-call night) or it might be one of 4 other doctors I never get the chance to meet. They back each other up. So I'm thinking there's a high probability I won't know the OB delivering me anyway.
It was this article that got me thinking about it. https://www.hsph.harvard.edu/news/press-releases/pregnant-womens-likelihood-of-cesarean-delivery-in-massachusetts-linked-to-choice-of-hospitals/ It's basically a new study finding that c-section rates have more to do with the characteristics of the hospital than characteristics of the patients. I'm just worried I'm going to look back on the birth and berate myself, "What did you expect, nodito, you picked a hospital that c-sections more than a third of all patients!"
I would also labour at home, and try to find another labour support person even if you can't afford a doula. Continuous support is what lowers c-section rates. A friend or family member that has had a natural birth could be a lot of help to you. If you know anyone that has done Bradley classes, they'd probably be willing to be "on call" for you.
I arrived at my hospital fully dilated. At that point in my labour, it was pretty easy to not worry about hospital policies or pressures. I would focus on making sure my partner was really educated on what I wanted and why and on not arriving at the hospital too soon.
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The other hospitals are going k need your prenatal records if you go there in labor. Can you start seeing a provider who works out of either if them? That would be easier in the long run.
ETA: Is this your second kid? If so, I wouldn't be super worried about the hospital rate. Just make sure your OB's whole practice is aware of your requests/plan for med free birth.
DS2 - Oct 2010 (my VBAC baby!)
I understand your concern. I went to a large practice with 8 OBs. I saw 1 main OB but depending on who was on call when I went into labor I could deliver with any of the OBs from the practice. I question my OB and the other 3 I meet during my visits. I found out that the whole practice was pretty natural birth friendly so I hoped that in the end it would work out OK. I stayed home as long as possible before going to the hospital so there was not much time to push interventions. The OB on call was one I had never met. He was amazing and probably more natural birth friendly than the main OB I saw. I had a wonderful birth experience. Could you talk with your OB to see how natural birth friendly the other doctors are? He should be able to give you an idea of their general practices which may help ease your worries.
B born 7/15/13, C born 3/2/15, #3 on the way May '17
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Have you looked into a volunteer doula group? I live in Chicago and found a group by googling it. The group I found asks for donations (you decide $) in lieu of a fee. For $250 we were able to have a great doula, which would normally charge 3-4 times that.
Since you asked... yeah, I think your plan is pretty crazy.
The c-section rate of your particular provider is more relevant, IMO, than the c-section rate of the hospital you deliver at. It sounds like you are not happy with the low chance that your OB will actually attend your birth AND with the hospital's c-section rate. Those are two separate issues.I'd start looking for a new practice that has a low c-section rate as a whole, personally.
pretty much.
I had another post but I'm on mobile and it deleted so I'll try again. Basically, I think you may end up hurting your chances of a natural birth by going to a new hospital. They won't know you or your preferences/records so they probably won't take any risks with your LD if things go long. Its one thing to have an emergency land you at a new hospital, another to purposely plan on going somewhere new for such a big thing. Maybe your hospital has a high rate because it has an excellent NICU that draws high risk ladies there or maybe they allow elective Csections.
My OB knew I wanted to avoid a CS, so even when the nurses were talking about me having one, he told them we'd do whatever else we could do first. That resulted in a vacuum delivery, but no CS!
Just wanted to add also that I think OBs really get paid for all of their work with you when you have the baby with them. They don't really charge per prenatal appt, or not that much, but get a big bolus of money from the birth. So you're kinda screwing over the doctor, who you like, by doing this.
If it were me, I'd switch providers now to a practice that does birth in a way you like (you can meet all drs, at the different hospital if that's what you want) and then go back to your current OB for your normal woman stuff next year or whenever after the baby is here.
Do any of the hospitals have tubs in labor or birth balls, things like that? I would not have survived med free without the jacuzzi tub at the hospital where I gave birth. I rank these characteristics of a hospital as much or more than I do their c-section rate, but above all else want a provider that is on board with my med free desires.
DS, May 2011
This.