Birth Centers - I need help!

[GoofItUp]

Hi, Dissers! It's been a while since I was on the boards, but I have a question that I can't discuss with anyone I actually know yet and I knew just the group to help me out!

DH and I found out just last week that I'm pregnant! We have been married almost 8 years and this is our first. We haven't told anyone yet since we're still trying to deal with the excitement (and shock!) ourselves.

I am not opposed to hospitals and medical doctors, but do feel somewhat nervous in that setting. So, I have called a birthing center about 45 minutes away. I think I would be much more relaxed and in control at a birthing center. We have an interview with them this Tuesday to find out if it's the right thing for us and I have a complete mental block on what I should ask them. So, if any of you have helpful thoughts or questions I could use, I'd love to hear them!

 

[EthansMom]

Personally, I would ask how close they are to a hospital and what the protocol would be if there was a problem with your labor/delivery. I didn't use a birthing center, but had minor problems with both labors (DS's heartrate dropped when he got stuck and DD's dropped due to the cord being wrapped around her) that could easily have led to requiring services that aren't available in a birthing center.

My aunt used a birthing center for her third labor and was very happy with it.

I'm not anti-birthing center, but I would recommend that you also take a look at the birthing facilities at the local hospitals. Both of my labor/deliveries were at very modern hospitals with Birthing Suites -- very non-hospital, but with all of the hospital services close in case of emergency.

 

[kristen821]

1st I want to say congratulations.

I agree with Ethansmom

 

[golfgal]

I am not anti-birthing center either but 45 minutes is a LONG way away from where you are going to have a baby. I would also ask how long you stay after you deliver, what medical care is available for the baby after birth, do they have a pediatrician on staff to monitor the newborns? What happens in the event you need a C-Section? If they aren't equipped to handle the C-Section you aren't going to want to have to be driven to a hospital.

 

[ceiligh1]

I didnt use a birth center we went with a hospital so keep that in mind with my answer. Find out the process for dealing with complications should they arise. How many visitors or family can be with you during/after the birth. What pain management they use most often. Ratio of nurses to moms. How they keep track of the child. If the child stays with you at night or goes someplace else. If they allow/ encourage the use of birthing positions other than on your back. If your doctor can deliver at that location or if you need to use one of their doctors. Will they encourage/support BF if you should choose to do it. THat is what I can think of off the top of my head. Congrats to you.

 

[Lisa loves Pooh]

1st I want to say congratulations.

I agree with Ethansmom

Ditto!

45 minutes is a long commute if there is a problem.

And while I am all for as natural as you can handle--having proper emergency back up is important.

I remember an episode of baby story where the mom had cord prolapse. All bets were off at that point and she had to leave the birthing center and go to the hospital quickly for a c-section. 45 minutes would be dangerously long in that situation.

I have a friend who has home birthed as well. So there are options.


Just make sure that "a close hospital commute in case of emergency" is part of the plan.

 

[jama]

Some hospitals have midwives who work at the hospital. So there is that option to explore.
Jama

 

[U2_rocks]

I had my first at a hospital and my second and third at a birthing center. My decision to switch was easy due to my circumstances - I was never worried.

The hospital wasn't a state of the art big city hospital (nothing like that near me), so the birthing center wasn't actually that different. They couldn't do C-sections there or any kind of surgery, and there was no medical doctor in attendance (though I could have chosen to have one there). But the birthing center wasn't far from the hospital, and if there had been a problem the midwife would have gotten on the phone immediately and set things up while we were transporting, and it wouldn't have taken any (or much) longer than if we were already in the hospital. You see, when there's an emergency several things need to be checked and sorted out - is there a free OR, is there an anesthesiologist available, is there an OR nurse free to assist? etc. These people don't stroll around our hospital at all hours of the day or night - sometimes they need to be called in, and it can take them longer to get to the hospital than it would have taken me! The birthing center had an incubator to keep/transport infants in if there was a problem, and the midwife was trained in infant resuscitation and had all the equipment. The only bad outcomes she's had (BAD meaning compromised babies, not deaths) were as a result of overly large babies whose shoulders were broken, or who had some brain damage as a result of a long and hard labour. However, in those cases the parents chose to continue to try at the birthing center when they could have transported to the hospital. At our birthing center the midwife and parents make decisions together every step of the way, and the parents must have a back-up OB that can be called in if needed, and this OB must have hospital privileges. So the parents in the "bad" cases decided to keep trying even when things got tough, and the outcome wasn't good - that cannot be blamed on the birthing center.

If you decide to go with a birthing center you are taking responsibility for your own birth. The midwives (and OB if you have one) are there to offer their expert advice and support, but the ultimate responsibility rests on YOU - it is YOUR birth (and that's what I loved about it). Make sure you are ready to accept that. Think about what makes a "good" birthing center, and think about what risks you are willing to assume, and structure your discussion around whether the birthing center fits this idea you have. You have to be completely confident there, and have to trust them and the process - if something does go wrong, you are the one who will have to live with your decision. Things go wrong in hospitals as well, don't forget - with all that equipment and experts, babies and moms are still lost occasionally, and babies do still get "damaged" by forceps, vacuums, surgical births and lack of oxygen. Moms still bleed to death, have epidural complications and other health issues. Being in a hospital is no guarantee. If you feel strongly about having a natural birth without all the medical equipment, the hospital might be a difficult option unless you are very lucky to have a natural-minded OB who smooths the way for you (a doula can also help champion your cause). I know that the things they did to me in the hospital with baby #1 were directly responsible for making his birth more difficult, and necessitating an hour in the warmer for him as he was shivering and miserable when he was born (I have analysed his birth, discussed it with my midwife, researched it, and I KNOW what lead to what). The births of my DDs in the center were so dramatically different it was unreal! I could never go back to the hospital to have a baby unless there was a real medical need!

Good luck - I hope you find the perfect place for you!

 

[Tigger&Belle]

I read that the birthing center is 45 minutes away from her, not 45 minutes away from the hospital. Or did I read it wrong?

Our first 2 babies were born in a hospital (in Texas, BTW) and our next 2 in a freestanding birth center. Our hospital was great and we didn't have any major issues, but when we moved to Maryland we couldn't find hospital experience that we'd had in Houston. We were very happy with the birth center.

As far as the questions, I don't remember. Maybe try doing a search to see what you can come up with and I'll let you know what I remember. The birth center will probably give you information to read and think about, which will generate questions.

 

[canwegosoon]

For me...trying to get pregnant for 6 years, and then finally pregnant with twins, I knew I wanted to be in a hospital (we have 6 within 20 minutes of me) so I picked a home(like) place, that had a lot of private rooms...and I was very happy. I also had to have a c-section due to a prolapsed cord on baby A. SO I wish you the best...look over all your options, and weigh your risks. It is your decision. Wishing you a Happy Healthy Pregnancy.

 

[transparant]

I do lots of deliveries at birth centers - and I believe it is the law for them to be within a certain amount of minutes from a hospital in case of an emergency. I can tell you that every single one of my clients that have delivered at a birth center had amazing births! Thankfully none had any problems whatsoever. Discharge time is usually within 6 - 12 hours after delivery.

Let us know what you think after your interview! GOOD LUCK AND CONGRATULATIONS!

 

[GoofItUp]

Thanks for all the responses and well wishes! The birthing center is 45 minutes from where I live, but there is a medium-size hospital in the same town and a big hospital with neo-natal care and all about 15 minutes away in the next town over.

I guess the birthing center and the hospital make me nervous to some extent. My cousin's wife had a baby a few months ago in the hospital I would go to if I chose that route. The doctor induced her, she had two contractions, and the doctor decided it would take too long to have this baby and there might be problems, so she had a c-section. Then she was doped up for many hours and really doesn't remember anything about the birth, who came to the hospital, etc. That kind of situation scares me since I am one who does things naturally. (I had allergies for two years after moving to where we are but didn't want to take allergy medicine so that I could build up my own immune system. And now I don't have allergy problems any more!) On the flip side, though, I would not do anything to jeopardize the baby's health or well-being. The birth center does have 2 NARM Certified Professional Midwives.

I know I have a lot to learn......I was almost offended when one of the posters above said something about finding out if the birth center would encourage/support BF. I though "he's not my BF, he's my DH!"

 

[Tigger&Belle]

I know I have a lot to learn......I was almost offended when one of the posters above said something about finding out if the birth center would encourage/support BF. I though "he's not my BF, he's my DH!"

I'd like to tell you that the hormones will improve, but, uh, they won't.

 

[U2_rocks]

Thanks for all the responses and well wishes! The birthing center is 45 minutes from where I live, but there is a medium-size hospital in the same town and a big hospital with neo-natal care and all about 15 minutes away in the next town over.

Under those conditions I would absolutely go for the birthing center! I just find it so hard these days to have a natural birth in a hospital. Yes, some people manage it, but it's not easy - you have to have a like-minded OB on your side, a doula never hurts, and you have to have nurses who will also support what you want. It can really add stress to an already-stressful time to have to argue about every little thing that the hospital wants you to do to cover their *** (CYA). Of course I am not talking about medically necessary things - I am talking about the many CYA things that happen in a hospital. If these CYA things didn't affect births negatively I wouldn't care about them so much (I'd put up with being uncomfortable for the baby's sake), but there are too many instances of these things leading to issues which require more intervention, which lead to more issues, and of course my own situation is a prime example of it. Unless you are lucky, it seems that you either have to go the completely natural way (birthing center, home birth etc.), or you go the completely managed way i.e. the docs and nurses control the whole process (meaning they decide when the water should break, how long things should take, when you should push etc. - it's their birth, not yours). It seems rare to find births that are allowed to proceed normally and naturally in the hospital, where intervention is reserved for true medical need only.

I'm trying hard not to make a blanket judgment about which way is the right one, since I only know what was right for ME. Some women are happy to have their births managed, and if that's what they want then the hospital is absolutely the right place for them! I didn't, hence I sought alternatives when birth #1 was a fiasco!

 

[Tigger&Belle]

When we had our two "successful" natural hospital births, we'd done all our research, picked a dr who would support us, and hired a montrice (a private duty nurse).

 

[crz4mm2]

Don't forget you can have a midwife Most of us support natural childbirth.

 

[Tigger&Belle]

Here's the website of the birth center where I had my last 2 babies, just in case anyone is interested in taking a look at what a birthing center is like. http://www.maternitycenter.com/

 

[Lisa loves Pooh]

Thanks for all the responses and well wishes! The birthing center is 45 minutes from where I live, but there is a medium-size hospital in the same town and a big hospital with neo-natal care and all about 15 minutes away in the next town over.

I guess the birthing center and the hospital make me nervous to some extent. My cousin's wife had a baby a few months ago in the hospital I would go to if I chose that route. The doctor induced her, she had two contractions, and the doctor decided it would take too long to have this baby and there might be problems, so she had a c-section. Then she was doped up for many hours and really doesn't remember anything about the birth, who came to the hospital, etc. That kind of situation scares me since I am one who does things naturally. (I had allergies for two years after moving to where we are but didn't want to take allergy medicine so that I could build up my own immune system. And now I don't have allergy problems any more!) On the flip side, though, I would not do anything to jeopardize the baby's health or well-being. The birth center does have 2 NARM Certified Professional Midwives.

I know I have a lot to learn......I was almost offended when one of the posters above said something about finding out if the birth center would encourage/support BF. I though "he's not my BF, he's my DH!"

I had a rushed doctor my first baby--but not that rushed. WE used a midwife for our second. For future babies--at the present there are no longer any midwives who deliver at our hospital. But my midwife recommended a doc who would meet my needs when the time comes.


Sounds like she had a bad doc. not a bad hospital.

In general--your questions should pertain to how you want your birth experience to be--what you wish to avoid--what is really necessary--and what procedures can you do without unless medically necessary.

Think about the "basic" things...

IV's
stirrups
noise
laboring options (hot tub, moving around, et cetera)
birthing options (yes there are different ways to push that baby out--I did have a friend who with her last baby-delivered standing b/c that was what was comfortable at the time)

Also consider looking into hiring a doula. All the fears you have--they will help with and they can help you construct your birthplan.

 

[roliepolieoliefan]

I know I have a lot to learn......I was almost offended when one of the posters above said something about finding out if the birth center would encourage/support BF. I though "he's not my BF, he's my DH!"

Nothing really to add. But that comment cracked me up. I had both kids at the hospital. Even being a former OB nurse, I was still too paranoid to deliver anywhere but a hospital.

Good Luck!

 

[mamacatnv]

First, congratulations!

Second, no matter what anyone tells you, only you and your DH can truly know what you want for yourselves and your baby.
Don't be talked into or out of something unless it is wholly your decision or that of your health provider (don't be afraid to get a 2nd opinion).
This includes all relatives, friends, neighbors, co-workers and little old ladies in the grocery store. Everyone will have an opinion that they will feel the intense need to share with you.

The hospitals here have "family birthing suites" it was not an option for me, I wanted drugs and lots of them

Should have done it tho, DD was born in less than an hour, no time for drugs, I could have been in the room that looked like a hotel suite complete with a jacuzzi tub, king size bed and room service. Oh well........

These birthing suites were IMHO the best of both worlds, the easy quick access to ER medical care if needed, with the "do it yourself" birth style.

Good luck on whatever you choose, and congratulations again....