Scared to death about a hospital delivery

Oh with patient rights- Patients here have the right to full disclosure... So a nurse must be able to tell a patient what drugs they are administering and why, and any other treatments/therapies performed... the patient must be informed/educated, and give verbal consent. Documentation is a massive thing here too.

Do you have to pay for the private midwife service? and what are their insurances like? (I only ask because I'm trying to suss out australian home birthing now), and are there policies and guidelines that are policed? Because I think that's the main reason why there is a problem with getting insurance for homebirthing midwives in australia.

(Sorry, you are almost going to have to write an essay to answer all my crazy questions)

Excuse you? You are the one who rudely came in from lurking in a random thread to let us know that we should close it. No one was being rude to Al, everyone was just posting their opinions, stories, and other info. Which is exactly what she came here looking for. You should really take a deep breath, lol.

TTC7783:

Excuse me? You don't have to be so rude!!! I'm not blasting anyones opinion but some of the posts people were getting upset because it wasn't the same opinion as theirs!!! Whatever decision she makes is hers!! And last time I checked it was a free country I can post anywhere I want. There's pros and cons on a hb and a hospital birth. It's IMO a personal preference!!!

Excuse you? You are the one who rudely came in from lurking in a random thread to let us know that we should close it. No one was being rude to Al, everyone was just posting their opinions, stories, and other info. Which is exactly what she came here looking for. You should really take a deep breath, lol.

Al--you need to do what you are most comfortable, and what is most safe for you and your baby. I think you could homebirth safely with the medical expertise of a midwife. A medical professional has the ability to recognize if you are in trouble as they are able to monitor you and your baby objectively. A MW has this background, and will fit the bill nicely. I hope that you will progress easily, and have a wonderful birth. Given that you are very close to a hospital, where you could go if needed is an added cushion of help very quickly.

 I am very pro homebirth, but have had to have 2 hospital births with my midwife for medical reasons. I had very good births at the hospital, and although I still longed for a homebirth, they arrived safely and healthy. I had to put my desires for a homebirth under the needs of my babies to arrive safely. The only intervention I had with the twins was that I required an injection of oxytocin AFTER they were born, to help my wayyyyyy overstretched uterus to contract and expel the placentas, or I could have bled out significantly. Given I had no complications, I was cleared to go home after 6 hours.

I won't lie, but I loved my homebirths. Having my family at home, with me, when we added to the family. I am extremely grateful for the care and assistance of my midwife. Hospitals can also be good options, especially with early discharge. Whatever you choose will be the right decision for you.

You know I'm gonna be the adult here and walk away from this I'm not gonna sit and argue with someone I don't even know. To the original poster I wish you a happy and healthy pregnancy no matter where you decide to give birth.

tickleme:

Out of curiousity (as I know you are completely keen on birthing at home)... are there midwifery clinics in america? Where you birth at the clinic, but they have access to 'the gear, and the doctors' if something happens that's unforeseen? But other then that, they don't intervene other then with natural therapies (oils, lighting, massage etc)

And when you are talking about being hooked up to a monitor... do you mean the fetal monitor that straps around your belly to monitor for fetal distress and contractions? Cos I really quite like being on those... lol... but then I don't get stuck to them for ages, it's jsut for a short time.

And what sort of rights do you have as a patient to refuse interventions?

Do you have to pay for the private midwife service? and what are their insurances like? (I only ask because I'm trying to suss out australian home birthing now), and are there policies and guidelines that are policed? Because I think that's the main reason why there is a problem with getting insurance for homebirthing midwives in australia.

 

Most pregnant women here will see an OB/Gyn for their prenatal care and that doctor, or a member of the practice who is on-call, will deliver the baby at the hospital they have priveleges to deliver at.  So, you have to be both ok with the philosophy of the doctors in your group and also ok with the policies of the hospital they deliver.

Or, you can have a midwife care for you through your prenatal period and be delivered by that person at the hospital they deliver.

Or, you can have a midwife attend to your birth at a free standing birthing center which is either associated with a hospital or close by one.  We have 3 in my area but none accept VBAC patients. 

Yes, I mean fetal monitoring and I believe they also monitor contractions. The downside of continual monitoring is that you can't leave the room, go outside, walk the halls, etc.  You can push the monitor to the center of the room and get on the birthing ball and they are even submergable so you can use them in the labor tubs.  Doc says they re working on getting wireless ones but that will probably not happen by the time I give birth.  If you aren't a VBAC patient, you can do 20 minutes on and 40 minutes off but VBACers have to be on it the whole time.  Also, guess what?  Just found out this morning that my doctor has to be there the whole time - he has to meet me at the hospital and he can't leave until I give birth.  No wonder they had less than 5 VBACs there all last year!  (My doc just started over there a few months ago).

I suppose the patient can refuse most of the intervention unless it's an emergency situation - in which case you would probably have to sign a heap of paperwork, not sure.  You don't need to have pitocin, or an epidural and you certainly don't need to agree to have your membranes swept or ruptured.  Most people write out a birth plan and bring copies to distribute to the nursing staff and I assume, have a plan with their doctor or midwife.

We have private insurance here and the rules regarding what must be covered by law is governed by each state.  In California, where I live, midwife care is to be covered the same as doctor care and homebirths should be covered by all insurance.  They don't make it easy though.  It's much more difficult to get reimbursed by your insurance company and in most if not all cases, the midwife charges up-front and has a part time billing person try to get the money back for the patient from the insurance company after the fact.  I have a $2950 dedudtible through my insurance so no matter what, I am going to pay that in any given year before my insurance will pick up 70% of the allowed cost for any services that are covered.  The midwife I hired the last time charged $4200 - broken up in payment plans - so, after the yearly deductible would be met, I would try to get 70% back of what ever was left.  The hospital birth, if all goes well, should be around $2200.... last time, with the surgery and the NICU stay, it was around $9k out of pocket total.  This is not to mention that my insurance premiums are $400+ a month for me and my son.  DH has his own cheaper policy.

My personal fears have to do with timing and being restrained on the car ride over because as I recall, that ride was excrutiating and before I got in the car, I was doing pretty well.  Had breakfast, took a shower, curled my hair.  Got in the car and AHHHHHHH!!!!!!  Got to the hospital and I was ok again, parked, went up the elevator.  Than had to be monitored in a bed for 20 minutes before admittance and AHHHHHHHHH!!!!  Worst thing ever was being in one place without being able to move.  When we moved to labor and delivery, they immediately had me filling out paperwork - I had pre-registered so I don't know why there was another 1/2 hour's worth of paperwork - and they inserted an IV.  So, along with the monitor cords, I also had a fluid line and was pretty much stuck on the bed.

Don't want to get to the hospital too early. Don't want to get there too late!  Don't want to be stuck in traffic. 

The rest, I can handle.  My doc will make sure I don't have an unneccesary c-section because he doesn't believe in them.  And he will be there the whole time.

I'm going to have a hospital birth.  There I made up my mind.

Thanks for your post, CharlieCats.  That was nice.

Alsestis- thanks for answering my questions, because I'm sure in the future there will be a wider availability of homebirthing in Australia. it's just interesting to hear the positives, negatives, and the obstacles associated with it.

If you don't mind me asking, as you don't need to answer... what has made you change your mind?

Best wishes to you n your family on this journey.

tickleme:

Alsestis- thanks for answering my questions, because I'm sure in the future there will be a wider availability of homebirthing in Australia. it's just interesting to hear the positives, negatives, and the obstacles associated with it.

If you don't mind me asking, as you don't need to answer... what has made you change your mind?

Best wishes to you n your family on this journey.

 

I'm not sure. 

I guess I realized that my fears were getting in the way and that this time, I will be able to cope better.  I will take the hypnobirthing course.  I will know what to expect.  I will have a very supportive doctor there the whole time.  I will have a caring nursing staff to help get the nursing off the ground - it's been a while since I nursed anyone.  I can leave the hospital after 24 hours and be back with my little buddy who will probably enjoy the sleepover at his grandparents house as it's an opportunity to wear his backpack.   My mother can relax a little. My husband can relax a lot.

Pretty much the same reasons I decided to do it there in the first place. 

 

Alsestis, I think you are going for the right decision. I'm doing the same thing. I will probably attempt VBAC at the hospital. It is just too early to make any decisions. If I carry to term, it will only be 15 month after the c-section. So, there is a lot of factors we have to look at, including the size of the baby. I'm a very petite girl, but I have huge babies. Our poor baby boy boy was born at over 3 pounds at 27 weeks.

I just wanna wish everyone on here happy and healthy babies regardless of where they choose to give birth.

Al - I'm glad you've come to a decision and that you feel good  about your choice! 

I'm not sure what your hospital policies are, but I fill out a big packet of paperwork and mail it to the hospital before my delivery.  I honestly maybe sign my name twice when I get there?  I think it's considered "pre-registration" or something?  You might want to ask about that.

Also - my hospital has a lactacion consultant - these ladies tend to be die-hard supportive, and you can likely contact her before your delivery and let her know you'd appreciate a visit while you are at the hospital.  Mine - bless her heart, has come to see me all three times even though I only nursed my first.  This service can be a real benefit.

I know I already mentioned the home nurse - it's covered by my insurance - but I know policies are different...can't hurt to ask about it.  The nurse will come to your house the next day and weigh your baby, check for jaundice, ask YOU how you are feeling etc.  It's just reassuring and comforting and totally relaxed and on your terms while she is there.

I would try to take full advantage of the benefits that do come with utilizing the hospital for your birth - hopefully, it will make the experience a great one for you and your family!

P.S. - my last ridiculous tip that I tell all my friends - hospital food can be pretty gross.  Go for a grilled cheese.  No one can mess that up, and it's wonderful comfort food after delivery ;)

Something to consider discussing is epidurals. They may insist you have one as this is a vbac. I was told I must have one with the twins, just in case B got stuck and they needed to do an Emerg section. If I did not have one, they would have to knock me out if I needed the emerg section. Which meant I wouldn't see B be born. I was willing to take that risk, and was fortunate to have an easy birth. My choices are not for everyone. Just food for thought, so you can form your own choices before they come up. Hope that is helpful.

There are too many controversial opinions about epidural during VBAC. I heard that they prefer you not having them, because if your uterus raptured the only way to tell is by burning pain, which you won't feel with an epidural. I think it makes sense. If I am to have a VBAC, I won't take an epudural. I had my DD without one and I am alive and well.

I completely agree that you should go the hospital.  With my 4th baby everything was going along perfect, and when the doctor broke my water the cord prolasped.  I had a crash c-sec and even though he spent 4 days in the NICU at least he was alive.  Every seconds counts and no matter well your pregnancy is going, there is always the chance that something could happen.  I am completely against home birth for this reason.  And the funny part is a friend of mine tried to convince me to have a home birth and I am so thankful I did not, otherwise my sone would not be alive.

Take care :)

 

alsestis:

Thanks in advance for reading this looooong post...

A bit of history on me and birthing.  I had an easy and complication free pregnancy with DS.  DH and I had seen all the birthing documentaries and even before then, I liked the idea of a homebirth.  I have no idea why but I stuck with my current OB/Gyn and proceeded through the normal path of labor and delivery at the hospital.  I didn't think anything bad would happen to me.

Arrived at the hospital at 3cm dialated and 100% effaced.  Immediately was offered an epidural and I took it.  Within 20 minutes of that, the doctor entered and broke my water to move things along.

All hell breaks loose.  Baby's heart rate tanks along with my blood pressure and an emergency c-section is ordered.  To this day, I am not sure what went wrong and whether or not the emergency was caused by the interventions that took place that morning.

It was a relatively painless surgery and my recovery was not bad.  Baby spent 2 days in the NICU being monitored for respritory issues - not uncommon for c-section babies.  I had the blues pretty bad and I felt like crap that my perfect birth had been ruined.

I get pregnant again last year and DH and I decide that the best way to ensure a natural birth after c-section is a midwife attended homebirth.  Well, he isn't gung-ho at this point but he went along with it.  We interviewed 3 midwifes (all wonderfull - midwifes are like English teachers) and we pick the one we like best which was hard to do.

Then, the baby dies at 14 weeks.  :(

Get pregnant this time.  DH has made a 180 degree turn away from homebirth.  The combination of my son's c-section along with the loss of baby#2 has shaken his confidence.  He wants to be ensured that everything is going to be ok.  The rest of the family - our moms - agree.  Everyone (but me) feels the hospital is the safest place to deliver.

I change care to a team of very pro-VBAC, pro-natural-birth,  hospital delivery doctors.  They assure me that they will do everything to get me the natural birth of my dreams.  All is well and we proceed with our care with the intention of delivering at a very good hospital about 32 minutes from home with labor tubs.

But as the time grows closer, I am suddenly growing anxious about my choice.  I have reached out to the midwifes that we interviewed last year and one has responded that she would be happy to co-manage my care along with the doctor and attend my homebirth.  The doctors both are on-board with a homebirth attended by midwife.  She and I haven't discussed the particulars or the fees.

DH told me this morning, and this was really mean but really not how he normally is, "if we have a homebirth and anything goes wrong, I will never forgive you."

Well, fantastic.  I know part of him blames me or wonders if I had anything to do with the miscarriage because I had a sip of beer here and there and drank a cup of coffee every day.  Here he is putting me in this position.  

My mother says that she will support my decision but she also feels like the hospital is the safest place to deliver in case there is another "emergency."  They both admit that they think the interventions caused the emergency in the first place and that it probably wouldn't have happened if we weren't at the hospital.

I really don't want to have my baby anywhere but my own nest.  Sorry.  The idea of timing the whole thing bothers me.  The idea of the long car trip in labor bothers me.  The idea of being constantly monitored bothers me.  Staying overnight, being away from my son, not being able to eat and drink, hospital gowns and uncomfortable hospital beds  - all bother me.  

I am planning to take a hypnobirthing class and both DH and DM are saying, "maybe you can hypnotize yourself to not be scared of the hospital?"  Yeah, or maybe I can not go to the freakin' hospital in the first place.

HELP!  What would you guys do?  I could put my foot down and say, "tough luck, my body and my choice," but I don't want DH and DM to be worried about the birth just like I don't want to be worried.  

Oh, and I should mention, that as a VBAC patient, there are no birthing centers in my area that will allow me to birth.

 

 

Hi Tiffany,

Why did your doctor break your water?  Mine did so at 3cm dialated to "move things along."  I think my son may have also had a prolapsed cord as a result although that wasn't indicated on any of the records.  Everything was cool until the membrane was ruptured. 

AL :)