Hospital birth or midwife/birthing center?

ConJos_love · April 2016

Hey! I'm on my third pregnancy and had both my babies at our hospital here. Both really great experiences but this time I'm kind of toying with the idea of a birthing center or maybe a midwife.
I'm interested in costs, benefits, downfalls.
My main concern with a midwife is what happens if something goes wrong? That is scary to me.
I might also be using all these terms wrong...sorry

I've never really looked into this before.

TIA for all your info!!

NatashaSprout · April 2016

My 3rd pregnancy as well. My midwife is actually out of the hospital and works hand in hand with my OB. We will have the baby at the hospital with a midwife and doula. If things go south the doctor will step in. I find its the best of both worlds. I get the least intervention and most laid back approach at a hospital. I like go home after the baby is born, I don't like staying the night so I don't do any meds/epidural.

shevaCC · April 2016

I'm in a somewhat similar situation in that my first two babies were born in the hospital, overseen by midwives (like @NatashaSproutdescribes -- but they still made me stay overnight both times, you're lucky!). However, this time the hospital that works with midwives is nearly 2 hours away from where I live and work so I'm considering delivering at a birth center with midwives. I asked a lot of questions about emergencies when I visited the birth center. For now I'm going with planning to deliver there and if my anxiety gets too high I can switch to a hospital. Unfortunately my only close-by hospital has some nurses that literally laugh at women for laboring med-free.

lin0442 · April 2016

Yes, a lot of hospitals have midwives that work there too. If you pick a midwife, make sure she is a certified nurse midwife- they have more thorough medical training. A midwife at a hospital is a great alternative!

I will always advocate for hospital births. I work in an area of the hospital that is involved in obstetric emergencies, and the time frame for a lot of emergency situations is very small. I would not trust an ambulance to arrive in time. Yes, these situations are thankfully uncommon, but they can be very serious for you and the baby. Many hospitals have improved dramatically in trying to make the birth experience better- if you don't like the one you delivered in, try checking out other ones in the area if that is an option for you.

shevaCC · April 2016

@Babydoll572011, if your other two labors were low risk and med-free, you'd be an excellent birth center candidate.

The total bill for the birth center will likely be much lower than the hospital, but your portion may be no different, depending on your insurance.

Low risk moms have statistically equivalent outcomes in a birth center or a hospital. But...birth has that non-zero risk of something going wrong. Things can obviously go wrong in a hospital too, but delivering out of a hospital introduces some small additional unknown of whether the hospital outcome might've been different. That's the thing I'm mentally grappling with now.

Thewizardofrhythm · April 2016

Like pp I see a combined OB/midwife practice that delivers at the local hospital. Either a midwife or MD may deliver the baby depending on who is on call but the OBs do any emergency c-sections or other interventions requiring certain training obviously. Because they are a combined practice many of the offices policies are "midwife style" meaning minimal interventions unless necessary, low c section rate, no unnecessary ultra sounds to minimize radiation unless you ask for more, etc. I love the practice and totally agree with pp that it's the best of both worlds.

muybueno · April 2016

If I wasn't doing a repeat VBAC, I would have a midwife at a birthing center in a heartbeat. My friends and family that have used this option have had wonderful, personalized experiences. In general, I don't make decisions based on extremely unlikely scenarios and I try to be realistic without letting "what if's" or fear drive the process.

My primary reason for wishing I could use a birthing center is that I would love to have a water birth. Again, I've had several friends/family use this option and it sounds absolutely fantastic for people (like me) who want to avoid medicinal methods of pain relief during labor.

shevaCC · April 2016

@muybueno, does your hospital allow you to labor in a tub for part of the time? I wasn't allowed to give birth in the tub, but was able to stay there for a while with both labors and it helped a ton. The first time they wanted to check progress so I got out. The second time I had to get out since I felt "pushy".

kms456 · April 2016

I had to have an emergency C with #1 due to cord prolapse so I'm all hospital, all the way. OB is on board for a VBAC so I'm comfortable with where we are at.

muybueno · April 2016

shevaCC
No, for the simple reason that they don't have tubs in the rooms. Only showers and a shower wasn't appealing to me last time.

TwandaFTG · April 2016

I had to be induced due to gd last time and had group step b so it was a hospital birth. And then I spiked a 104 degree temp in delivery so I earned another 48 hours on iv antibiotics.

I found the hospital stay so draining and invasive. If you have the option to stay out of the hospital then look into it! Our local free standing birth center is near a hospital that also has l & d so it is a less "scary" option.

Also, if you care able to labor as much as possible at home that helps too!

elsie2014 · April 2016

I did all my prenatal care at the birth center here for my first. They are supervised by an OB, and are three minutes from the hospital in case of emergency. All those things made me feel safe with a birth center. However, at 38 weeks DD1 was still breech and wouldn't turn, so they transferred my care to the supervising OB for a vaginal breech birth. THEN, my baby ended up being footling breech when I arrived to the hospital mid-labor and I had a c-section at the hospital (to avoid cord prolapse).

Many midwives have agreements with local hospitals, and can deliver there if you feel more comfortable at a hospital. If you really want a birth center birth (more personal, relaxed, hot tubs, etc) just ask what their procedures are if something goes wrong with a birth or if you decide you want pain relief, etc.

Because I will be doing a VBAC, their policy is that I have to birth at the hospital instead of the birthing center for safety reasons, but I'll still be working with the same midwives.

Oh, and a birthing center is usually much cheaper, and it was still covered by my insurance.

rspalding001 · April 2016

I did a birthing center with my first. A couple things to keep in mind is that birthing centers will only take you if you are full term, if you deliver early they will tell you to go to a hospital so you can have a NICU unit available. If your birthing center is popular (like mine was) they may have to send you to the hospital anyway if they are full when you go into labor. Luckily mine was not so I was able to deliver there, but I just mention it so that you know to stay flexible with your plan and be prepared to have last minute changes.
As far as midwives go its been my experience that most hospital and birthing centers are open to having midwives present during the labor and delivery.

FallenLeaves1990 · April 2016

Hospital because I have to have another c-section.
Super jealous of those beautiful, water birthing mamas.

rooftop · April 2016

I did a birth center with my first and plan to again with this one. Loved that tje midwife was present for most of my labor and they provide a doula as well. Whole thing cost about 5000 dollars but some of that was covered by insurance and it included all prenatal visits the delivery with anything needed included so we werent nickel and dimed and several postpartum visits including an in home visit the day after delivery. Most places have a transfer policy in case something goes wrong and because the midwife is around for most of it they tend to spot potential problems faster than if your at the hospital.

zrain · April 2016

I'm going with a birth center. I'll have a team of a midwife and her apprentice and student and they'll be with me the entire time. They have a culture there of early transfer to hospital if needed and my midwife has over ten years of experience so I trust her to notice before it gets to the point of an emergency. I'm going with birth center rather than home because it's a little closer to the hospital and there are more people there to be available if something goes wrong. Also they have nitrous oxide to help with pain/exhaustion which I may need since I have an arrhythmia that makes my heart rate speed way up sometimes. They have beautiful rooms with big tubs and lots of plants. Oh, and with my insurance it's only $1750 for all prenatal care, birth center birth, and 6 weeks postpartum care!

ashleymercado · April 2016

I had my second pregnancy (and will have the third) at our local birthing center. I saved thousands of dollars by having my baby at the birth center, plus it was a lot more homey, less invasive, and more personalized. Our center (and I assume all centers) has admitting privileges with three local hospitals. I spent less time there than in a hospital and did not have as much depression/had more energy after leaving the hospital with the first one (but maybe that was because it was the first and not the second).

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