How far would you travel to deliver?

AmandaD30 · August 2014

We live very far from what I would consider adequate medical care. The closest town is 8 miles away and it's only 1200 people! The closest OB office and hospital is an hour away and they do not get good reviews. People say awful things about the service and even the local ambulance service doesn't recommend them. The main OB who has been there also left after nearly 20 years and I don't really like her replacement. The closest place with a NICU is 180 miles which takes about 3.5 hours to get there. There is a smaller hospital about 2.5 hours away that does come highly recommended. I just don't know how far is too far. I can't imagine being in labor and having a 3 hour car ride on twisty mountain roads. Plus there will be the monthly (and more often later on) trips during the winter which can be pretty extreme around here. Anyone else had to deal with this before or any recommendations?

[Deleted User] · August 2014

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inawe07 · August 2014

I wouldn't be comfortable with a 2.5hr trip to the hospital in labor. I'm assuming this is your first, there is a lot of unknowns with firsts. You could have a fast labor being one of them. I was only 15 minutes away from my hospital last time and that 15 minutes was the car ride from hell.

I guess you could go and see the dr and hospital 2.5hrs away and talk to them about it. It's not totally unheard of.

AmandaD30 · August 2014

The local birth center was just shut down on August 12th so that is no longer an option. The level of care at the hospital is not good. They typically have to transfer via helicopter for even minor medical emergencies. My good friend almost died there. His tonsils were infected and the hospital held him for 5 days for insurance reasons before they airlifted him out. Also they deliver very few babies (1 new OB in the entire county) and you share a recovery room with other ER patients not just new moms. To me it just sounds like a nightmare.

AmandaD30 · August 2014

dragonmom35 said:

I'm curious why you're factoring in where the nearest NICU is? I'm not trying to be nasty but unless you have a history (and if you do I'm sorry, I don't read intros) I wouldn't worry about it and would go to the smaller one. BUT, I would try desperately to find somewhere near by first. And rest assured if baby does need NICU time they WILL get baby there in time, my friend's 29wkr had to be airlifted to the NICU. She lives, and delivered, almost 3 hours away. Once again, I'm basing all of this off of not really knowing your medical history.

This is my first and I'm honestly not sure what I should be looking for. I have just been reading other posts on selecting an OB and hospital and I see NICU mentioned a lot. My ignorance just lead me to believe it was an important factor in the selection process. The hospital with the NICU is honestly not really an option though because it is so far away.

Hummingbirdbaby3 · August 2014

Yikes!!! Hmmm well that's a tough one. We are making a 45 minute drive but that's just because I prefer a certain hospital. It isn't necessarily better than the ones closer to me, I just love the staff and worked there for years. That's really hard to imagine making a drive any more than an hour. I would be too worried about that personally. My only advice is to be careful of reviews. You need to do your own research. Maybe go to the closer hospitals and get some info/meet some staff...

AmandaD30 · August 2014

inawe07 said:

I wouldn't be comfortable with a 2.5hr trip to the hospital in labor. I'm assuming this is your first, there is a lot of unknowns with firsts. You could have a fast labor being one of them. I was only 15 minutes away from my hospital last time and that 15 minutes was the car ride from hell.

I guess you could go and see the dr and hospital 2.5hrs away and talk to them about it. It's not totally unheard of.

We have been talking about going to some of the smaller closer hospitals over the next few weeks to see how we feel about them. My local girlfriends who have had children around here either schedule a c section in the city, which I do not want to do, or go stay with family in a larger city. 15 minutes of labor hell in the car doesn't sound appealing let alone hours.

[Deleted User] · August 2014

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AmandaD30 · August 2014

GrailSeeker14 said:

I don't know how you feel about birthing at home, but if it's something you're open to, perhaps there are midwives in the area who can come to you rather than you having to take a multi-hour drive while you're in labor ???

This is something we have discussed and I think if my pregnancy progresses normally and healthy it may be an option. I just wonder what we could do if there were complications.

HeavensAngel20x · August 2014

I am a nurse practitioner and I would choose the hospital with a higher level of care. NICU is important because you (the mother) do not want to be recovering in the hospital while your baby is being airlifted away. The mother does not go with the baby. My OB actually has been delivering in a hospital outside of our town because it has a level 2 NICU, (level 3 is the highest level of care) the older hospital in our town is a level 1. Fortunately just a couple months ago a new hospital was built in our town and it has a level 3 NICU. The OB will be delivering there in a couple months. I'm very excited and glad it's in my town

and will be closer to my husbands job as well. I personally would choose the higher level of care. Better doctors and if you have an emergency they can treat you as well. Now 2.5-3 hours away is a long time away. But if your water doesn't break super early, I would get a hotel close to the hospital a few days before due date

hope this helps!

hello_im_tash · August 2014

I am just a lurker but do you have a family member or friend you would be comfortable staying with close to your due date to deliver in the hospital you would be more comfortable with?

I am not entirely sure how the OB system works in the United States but in Canada (or Ontario at least) we have the doctor we chose for our care and then deliver with whichever OB is on call at the hospital.

So you could do your routine care with someone in your area and then move to a larger centre as your due date draws near and deliver there?

HeavensAngel20x · August 2014

No I do not, but know many people that have an actually have taken care of some pregnant women in the cardiac ICU and also have taken care of a mom that almost died during pregnancy from a clotting disorder.. The baby was ok, mom was intubated and she eventually recovered slowly: they actually allowed the baby to have short visits with the mom once a day to have mother baby bonding.

Ncountrygal · August 2014

Ugh! I'd be right there with you. A couple thoughts:

1. as long as you are low risk, birth really isn't a complicated medical event. You would be absolutely fine in a small town. That being said, I believe that being comfortable and relaxed during labor is the best thing you can do for a smooth birth.

2. If you need to go farther for peace of mind, do it! Talk to your doc and have a contingency plan if labor goes fast.

3. Consider taking Bradley classes or getting a doula. It's invaluable to be able to tell how far into to labor you are by your symptoms (more accurate than timing contractions), and invaluable to have good relaxing skills. Either way, you'd have a birth attendant to help you relax and gauge progress (your hubby or the doula).

emb518 · August 2014

We are delivering at the hospital that I had my son at. At the time we were living in the same town as the hospital, so it was the obvious choice. They did an incredible job and saved my sons life. Since we have moved 25 miles away from that hospital but I am still insisting on delivering there, even though there is one hospital closer.

heatherwhite1984 · August 2014

I will be traveling over an hour and a half for the hospital. There are few stop lights, and its high speed limits, so not like we will be driving through small towns or a city in traffic.

AmandaD30 · August 2014

@KateRN08 Did you have any signs that you were going to be going into labor the days leading up to it? Even if we end up 2 hours away I think we would just go stay in a hotel once it seems to be getting close.

ally3242 · August 2014

Visit all of your options and get a feel for them to figure out what is best for you. We certainly can't make this decision for you on a message board. A commute over an hour by choice would give me anxiety. I planned to deliver DS at a hospital 35 minutes away from our home and that was enough to make me chew my fingernails down.

AmandaD30 · August 2014

@ally3242 sadly an hour is the close one, lol! We love living remotely but it isn't ideal for this situation.

ScarletOflaherty · August 2014

AmandaD30 said:

inawe07 said:

I wouldn't be comfortable with a 2.5hr trip to the hospital in labor. I'm assuming this is your first, there is a lot of unknowns with firsts. You could have a fast labor being one of them. I was only 15 minutes away from my hospital last time and that 15 minutes was the car ride from hell.

I guess you could go and see the dr and hospital 2.5hrs away and talk to them about it. It's not totally unheard of.

We have been talking about going to some of the smaller closer hospitals over the next few weeks to see how we feel about them. My local girlfriends who have had children around here either schedule a c section in the city, which I do not want to do, or go stay with family in a larger city. 15 minutes of labor hell in the car doesn't sound appealing let alone hours.

The hell?? Please tell me they had previous c-sections and that's why they did it. I can't for the life of me fathom opting for a c-section when there is an actual choice involved. They could just as easily schedule an induction if it's their first.

ally3242 · August 2014

AmandaD30 said:
@ally3242 sadly an hour is the close one, lol! We love living remotely but it isn't ideal for this situation.

Well then that would probably be my anxiety ridden self's first choice lol

Sharon&Paul · August 2014

I agree that I would look for a hospital with a NICU. I work as a physician assistant in pediatrics and our last DD was a NICU baby. It was a normal pregnancy and delivery, but went downhill really fast when our DD stopped breathing. She was born at 37w 2 d, but she was 7lbs 10 oz. No one expected anything to go wrong until it did. We are grateful for the care she received so promptly and so grateful to have our DD here today.

My first DD was an induction. My second DD I went into labor and driving in the car during contractions was awful. You have a tough situation. I think you can get your best advise from people in the area. Talk with friends and family. Also go visit the hospitals. Just always be prepared for the unexpected.

Lyndsey13 · August 2014

Normal, healthy pregnancies result in babies going to the NICU all the time. If you had a choice of NICU vs. no NICU, I would say its a complete no-brainer which hospital to choose. I will be driving about 1 1/2 hours to deliver. The local hospital is a joke and has no NICU. I will definitely choose the hospital with the best care, over worrying about a crappy drive...and no this is not my first baby. I would figure out a way to be at the further hospital, whether you stay in a hotel for a week, have an early induction, etc. It would be too scary for me to deliver somewhere that doesn't have the best care and I also think a 3 hour drive would be too far. So I would find a way around it.

FitMom3510 · August 2014

That sucks I would for sure make sure you are somewhere that you are comfortable but within a safe distance too.

HeavensAngel20x · August 2014

dragonmom35 said:

HeavensAngel20x said:
No I do not, but know many people that have an actually have taken care of some pregnant women in the cardiac ICU and also have taken care of a mom that almost died during pregnancy from a clotting disorder.. The baby was ok, mom was intubated and she eventually recovered slowly: they actually allowed the baby to have short visits with the mom once a day to have mother baby bonding.
Ok, so you have basically no experience in the NICU whatsoever. Taking care of pregnant women =/= NICU experience. Allow me to introduce myself, hi, I'm a NICU mom. I fully understand the importance of having a NICU in the hospital. And I also fully understand how ridiculous it is to base where you give birth on the worst possible things happening. FFS do you get into the car and go "I'm going to pre-dial 911 because there's a small chance I'm going to crash"?

The number of newborns who require NICU time are far, FAR outnumbered by the number of Infants who are born perfectly healthy, aside from jaundice which occurs in 60% of newborns (usually occurring at or after the 24hr mark) but usually needs no treatment.

You have your own opinion. I am a medical professional and maybe that makes me more cautious. But obviously this person asking about a NICU and hospital for birth does not have access to good care because they are in a rural area. Maybe they would feel more assured birthing in an area/hospital that has more access medical care. I live in Texas and access to good medical care in rural areas is not easy to come by. You obviously have your own opinion, but you do not need to judge my opinion like I have not judged yours.

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