Post # 1
- Wedding: October 2011 - Bed & Breakfast
So Mr. LK and I are trying to decide whether or not we will TTC. As part of my “homework” to humor my ever-so-cautious husband I am researching the birth options available to us. We live in a rural-ish area with 4 hospitals in a 40 minute driving radius. But they are all 40 minutes away in different directions. In addition, they all seem to be very much of the medical model. They are progressive, to a degree, but not as progressive as I would prefer them to be. (NOTE: These are just impressions from reading online, as we have not visited any of these hospitals in person.) One of these hospitals has a well-established midwife practice that has privledges and is conveniently located near Mr. LK’s new job, making it very easy for him to attend every appointment, but even the midwife practice strikes me as being more medically-oriented.
And then there is a birth center that is an hour away (assuming no traffic, which is a sketchy assumption). They are a midwife-only model complete with various alternative labor and birthing options. They have a very low c-section and transfer rate, but are also located very close to a hospital with a good NICU and their staff are all privledged at said hospital should a need to transfer arise. However, I would need to travel to their location (1 hour drive each way) for all of my regular appointments. And in the last month or so, when I am going to frequent appointments, I imagine that this could become a relatively significant issue when trying to horde as much of my paid leave time as possible for maternity leave.
There is also the home birth option. However, in MD it is illegal for a midwife to attend a home birth. I am not comfortable with going it on my own, so I am ruling out the home birth option.
What would you choose? A closer practice and hospital that does not fully reflect your desired approach? or a practice farther away that most closely reflects your pregnancy and delivery goals? Have you experienced traveling a significant distance for prenatal care? Did the travel become an issue?
Obviously this is theoretical for me right now, and we still have not made a TTC decision. But I’m trying to think ahead and be able to answer Mr. Lk’s inquiries when they arise. When dealing with his worries, it always helps to have at least a solid outline of a plan ahead of time.
Post # 3
I would go to the hospital near DH’s job! My hospital is also 40 minutes away, but I live in Boston, so EVERY hospital nearby is fairly prestigious.
Post # 4
I’d choose the practice closest to DH’s job.
Post # 5
@lovekiss: Where would you have your regular check-ups if you don’t choose the birthing center?
Post # 6
I would go with the birth center, hands down. I grew up in a rural area and my mom gave birth an hour away from home, preferring that hospital and her doctor over the local one; I’m also going to be traveling about an hour away to work with a midwife and birth center rather than settle for more medically-oriented care closer to home. I think that’s just mentally easier to deal with for people who live further west than for people on the East Coast, where everything is closer.
Really, if you have to travel at least 40 minutes in any direction for any prenatal care at all, I’d say it’s more than worth it to travel just a little farther in order to have the kind of care and birth experience you really want.
Post # 7
I would go with the birthing center, if the difference is 20 minutes of travel but how volitile is traffic in your area? You haven’t visited the other hospital yet so I wouldn’t write them off. You might end up getting a good vibe from them. I’d meet with the midwives at hospital #1 & see if you’re on the same page. If not, birthing center all the way.
Post # 8
I’m not TTC yet but there is a hospital 10 minutes away or a birthing center 40 minutes away and I would be seriously considering the birth center even if it was an hour!!! 🙂
Post # 9
@lovekiss: I would choose the one near your DH’s job. This is why.
Right now it is all theoretical but I have a feeling that if you went and talked to the midwives/doctors you would be able to find at least one who had the same ideas as yours when it came to your birth.
Secondly, I feel that traveling an hour each way as you get farther into your pregnancy is going to be exhausting. I don’t know what part of MD you are in but I know that the VA-MD traffic is hell and I would NOT want to deal with that more than I had too.
Third, it is most likely going to be important for you to have your DH at as many apts as possible!
Post # 10
I would most definitely choose the Birth center.. no question! Going through pregnancy & birth carries so much weight in our lives as women & moms & even wives that I wouldn’t ever risk giving up my needs for care because it was more convenient to go else where…. or I wouldn’t anymore any ways. (I had a hospital birth with my first that ended in cesarean)
Now, I plan homebirths (it’s legal here) and my MW is close to 2 hours away. She does usually travel to me, but I do travel her way periodically for labs, u/s, and to see an obgyn that is overseeing my thyroid meds. It’s worth it 100%. And FWIW I was willing to travel over 2 hours away to be able to vbac had I not found a MW that would come to me for an hbac
Also, I wouldn’t go for a hospital MW, b/c I’ve seen first hand that they are still bound by hospital policies (maybe not quite as bad as an obgyn) but definitely more than those in a free standing birth center. For me, I’ve just seen too many women regret not going for the care they really wanted & needed and seeing it affect so much of them for sometimes so long after the birth.
I would atleast interview the birth center before choosing something that is a more convenient location…. who knows the hospital MW or the hospital they’re at may still have a low cesarean & intervention rate, they may not though.
Here’s a list of questions I used for my homebirth MW.. of course not all are relevant but it’s still a great comprehensive list for a MW model of care. For the hospital MW I would add questions about what requires them to transfer to an overseeing obgyn, what their cesarean transfer rates are & why they often need to transfer (is it ftp, fetal distress, maternal exhaustion, etc)… and here is a list I made for some of the ftm in my month group to ask their obgyns at their first visit.. I’m sure between the two you could have a really great list for a birthing center mw & in hospital mw.
Post # 11
I’m in MD too. I have a feeling the birth center I’m planning to birth at is the same one you are talking about. I’m about 40-50 minutes drive from that birthing center. The midwives near your husband’s job, do they all deliver at the hospital? Or do they have a separate facility? What is the c-section rate for patients of those midwives specifically?
Post # 12
Place near your husband’s job. You’re basing your opinions on hospital websites, which all try to seem modern and official. At least meet with a midwife in that practice, explain what you feel, and ask if it’s possible. I wouldn’t pre-emptively avoid it based on such little information. And if your midwife is on board, you can have a very mellow non-interventional birth in a hospital. I’d at least check it out.
Post # 13
Have you looked at the different hospitals cesarean rates? You can find those online rather easily even before you go in… yea they won’t necesarily reflect the practices rates BUT will still give you an idea if you’re looking at an acceptable one of not!
Post # 14
I’d visit these places but ultimately od probably go with the one near yout dh job. I’d never go an hour. My max is 40minutes & that’s pushing it. Buf I’m use to having lots of hospitals nearby.
Post # 15
But keep in mind a birthing center or home birth would never be an option for us.
Post # 16
- Wedding: October 2011 - Bed & Breakfast
@peachacid: If I chose the hospital option, the midwife practice associated with my current front runner hospital is a 35 minute drive from my home and is literally 1/4 mile away from DH’s office.
@KCKnd2: I am still getting used to not living in the city and having everything super close. LOL We’ve only lived here for a year. We love the area, but it can be inconvenient at times.
@MrsRugbee: Traffic sucks here. The first 30 minutes of the ride to the birthing center is all windy back roads, which would only suck in the snow. But the last 30 minutes would take me on 3 highways, one of which has bad rush hour traffic issues, one of which is a disaster on certain days of the week during the summer (basically don’t try to use it Friday-Sunday in the summer time and during certain events throughout the year), and one of which seems to be excessively accident-prone. My 1 hour drive could easily take 90 minutes or more in traffic.
@harperlynn: You make some really good points. I know how tired and uncomfortable I was in the last 7ish weeks of my first pregnancy, and how much I was not interested in driving there at the very end, and how I could barely fit behind the steering wheel. With that pregnancy my OB practice was only 15 minutes away, and that was enough for me.
@runsyellowlites: Thanks for sharing that list. I would definitely meet with the birthing center prior to making any decisions. Two friends have delivered there and both gave glowing reviews of their experience. I know what it’s like to have a less-than-stellar birth experience because my first was just horrid. It was so bad that I swore I never wanted to experience birth again. But here I am, 15 years later, eating my own words. Go figure. That’s why I am thinking hard about this. I don’t want to go through another bad experience, but I also want to keep in mind my own exhaustion at the end of pregnancy and my husband’s work schedule since I have more work flexibility than he does. The “frunt runner” hospital with the midwife practice near my husband’s office has a c-section rate of 35.5%, and the 3 other hospitals within my 40 minute range are 32.1%, 32.1%, and 39.5%. The numbers are not encouraging.
@CuriousOne: The midwife practice near my husband’s office only delivers at a specific hospital. I have no doubt that it’s good… for a hospital. I am just struggling with the idea of delivering in a hospital since I had such a crappy hospital experience the first time (though the crappy experience was at a different hospital). I don’t know the c-section rate for the practice near DH’s office. If the time comes, that will definitely be a question to ask. But beyond that, it’s the hospital’s policies and such that give me the greatest pause. I want skin-to-skin contact immediately after birth instead of having my baby whisked to a bassinet for poking and prodding while I call out from across the room “What is it?” True story, everyone else in the gd delivery room got to see my son and know that it was a boy before I did. Is that not ridiculous? I want to not be stuck in bed for continuous fetal monitoring because the hospital is afraid of liability issues. I want to eat more than ice chips (I vomited them anyway, so might as well have had something with a bit more flavor while in labor. Not like that will change the outcome). I want to be made to feel normal instead of being on display like a zoo animal for 5 med students. Hey kids, wanna see my vagina?! I just… I’m not a hospital person. But the ability for my husband to attend all of my appointments is tempting. And the long drive to the birth center, even without traffic, is a serious downer. There’s time. Lots of time. My brain is just churning over the options.