To change, or not to change?

Sballerina · July 2015

For about a month now I have been toying with the idea of switching my OB practice so that I can deliver at a hospital 45 minutes away rather than in town. The reason is because I have heard only one person say they were happy with their delivery at it. She said that the midwives are great and support moms who want med-free births, but a nurse and the doctor were pushy about getting an epidural whwn she had her second chikd. She just had her third. She is friends with two of the midwives, and apparently by the time I am due in October, they will have both a doctor and a midwife on call at all times, so there will always be a midwife. The midwives and one doctor that I have seen at my clinic all seem nice enough during my brief checkups, but no one seems to rave about their delivery practice. I have at least three friends who are enthusiastic about their experience at other hospitals, with other OB practices, slightly further away. I also heard that several years ago the hospital in town had a high number of issues where babies had injuries or problems after birth. It seems to have resolved since but the reputation from that time lingers, I guess.

Also, the hospital in town, unlike the other 45 minutes away, doesn't have tubs to labor in. I know warm water with jets is very helpful to me to relax, so I think it might be helpful for labor. But I don't know if I should change OB practices at 27 weeks or so just in order to have a tub.
I have not yet toured either birthing center. I called the OB practice that delivers at the farther one, and they said to change practices they would need a release of records first. Not sure if I could just meet with a practitioner there to "interview" them. They are also a combined doctor and midwife practice.

So...I need opinions from BTDT moms on:
1) Switching OB practices around 27 weeks
2) How hard is it to handle a 45 minute car ride to the hospital in early labor
3) Helpfulness of laboring tubs
4) What you would do in my situation, given what I know, if you wanted a med-free birth? Do I have enough to go on to change? Or does the distance to checkups and the hospital (and therefore extra loss of pay to go to appointments) mean it's not worth pursuing?

LiveNLove44 · July 2015

I hear what you're saying and I can definitely understand your concerns. To address your specific questions:

1) Switching OB practices around 27 weeks wouldn't be terrible, but it will mean that you won't really "get to know" the other medical support people who will be on your care team as well as you know those with whom you're working now at your current practice.

2) I live about 10 minutes away from my birthing center/hospital. For that reason, I was able to labor at home for a long time before we got in the car to head to the hospital. I spent some of that time in my own tub

It was far more mentally relaxing for me to be at home during most of my labor.

3) I can't speak to a laboring tub as I didn't have this experience personally.

4) It sounds like you could have a few more serious conversations before making the move. I'd contact your hospital in town and ask if it would be possible to talk with some staff during a tour to have some more questions answered. Also, address these exact concerns with your midwife and other support people. They can all be great advocates for you throughout labor and delivery.

If I were to be in your position, I would be inclined to stay with my current practice given the information you've provided. It sounds like you're definitely apprehensive about what you have heard and/or read about your delivering hospital, but that doesn't mean that positive experiences aren't out there. You'll have to seek them out now if you want to make the best decision! I wish you the best of luck!

ameares721 · July 2015

It sounds like you already know what will make you happy (switching!) however, 45 minutes will feel like an eternity and you can plan all day long, but your baby may have a different plan! Good luck

Sballerina · July 2015

Thanks for such a thoughtful response, @LiveNLove44. I see what you mean. I also kind of feel like it might not be worth all the changes. I do not have a specific midwife assigned to me. I will have to deliver with whomever is on call. But the fact that apparently there will be a midwife on call at all times by October means I should have a natural birth advocate and I won't get stuck with just a doctor.

@ameares721, I think you are suggesting that if I make the switch the baby may "decide" to come at the hospital in town anyway. Thing is, these hospitals are close enough that apparently if you are scheduled to deliver at one, but come to the other, they will send you BACK to the one you are scheduled for. A friend told me about that hapoening to a woman sge knows. They took her vitals and detenined she hsd longer to go than the 45 minute druve to her scheduled hospital, and she had to drive herself (husband was away or something)! Gotta love the business aspect.

komorebi · July 2015

I'd go for it. For sure do some research on stats but i think it's so important to honor your concerns. Where you give birth matters and reputations get bad for a reason.

I had to travel 45 minutes to the birth center with my first baby. It was not comfortable but doable. You doing what you need to do to stay relaxed.

And laboring in water is amazing. Totally wonderful and it helps you relax. That'd be a huge bonus imo.

Good luck!

eheba · July 2015

I was in the same position as you. I had a doctor near me, and heard terrible terrible reviews about this hospital. at 19 weeks I switched doctors to one a little further but a better hospital. the hospital is 25-30 min away and I was worried at first but really I feel so much better after doing it! I recommend if you're hesitant now it won't go away. it's not a hassle, if rather do it sooner than later! Good luck mama!

Sballerina · July 2015

@komorebi: research on statistics? Of what? Where could I find them?

Also, is anyone aware of some reliable online resources that are objective about the differences between natural start to labor vs using Pitocin to induce? I had my checkup today and saw one of the doctors of the practice. I asked about their policy on induction after full term is reached. She said they follow the recommendations of the national college of OBs (whatever the name is!) to ensure delivery by 42 weeks. She said they let you go to 41 weeks, then monitor you closely for signs of fetal distress, in which case they induce, or if everything looks fine they wait, but induce before you actually hit 42. She did say they try to let your body start naturally because if the cervix isn't ready it's like 80% chance of C-section. I said I've heard Pitocin contractions are way worse. She said the contractions aren't different; women just say they are worse because the Pitocin causes them to start abruptly. The appointment was rushed because she was running late, so I didn't get into the specifics of what I've heard about the drug causing them to be so long and close together the mom can hardly catch her breath and ends up caving and getting am epidural. So I just didn't argue with her. She's the same doc that I believe contributed to the pressure my acquaintance felt to get an epidural.

Sballerina · July 2015

Ugh, forgot to add the issue of whether I can eat during labor. One in town prohibits it. If the one further away does allow, that could be another reason to switch. I may not want to eat much, but all I know is my body shuts down pretty fast after 4-6 hours without calories. I find it very hard to think or make decisions. I think I will need some energy in order to stick with natural birth.

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