{20 weeks pregnant with number 3}
~
A bit of background: my first babe, our son, was born after being induced in a big city hospital and my doctor was the chief of obstetrics. I was a number being shuffled through a factory system, and I didn’t know any different. This was before my introduction to anything even remotely natural in birthing issues, and though I said I’d “try” it without an epidural, I eventually ended up getting one. Thankfully I didn’t have any further interventions (other than the Pitocin they gave me, despite already being in labour), and he was born safely into our arms.
My second babe, our daughter, was attended by our family doctor in our small-town hospital with my awesome doula by my side. I was introduced to natural birthing by now, having read Ina May’s Guide to Childbirth, and watched The Business of Being Born. I gave labored and birthed her completely drug and intervention-free (other than being induced with Cervidil). I was empowered and amazed by the incredible power of my mind and body as a woman.
Now, we are blessed to be just past the halfway point in our third pregnancy. We live in the same small-town now, and there are no midwives here. Our small-town hospital is not equipped for c-sections, so those who are high-risk are sent out to the city. I am fortunate enough to have had complication-free labours and deliveries, however this time we decided we really wanted to go with a midwife. We have to drive almost an hour and a half to the city to get there for each and every appointment, as well as for the birth itself, but we feel that it is completely worth it. (The vast difference in care with a midwife is a separate post in and of itself.)
Now, here’s where my dilemma comes in. Our plan is to drive to the city as soon as labour begins, and check in to the bed & breakfast that we know welcomes laboring and birthing women. I will labour comfortably in a home-like environment (not my home, but the next best thing, since the midwives won’t travel all the way to our town), and have a water birth in the birthing pool we plan to rent. We will stay for a few days then travel home after our third-day check-up with the midwife.
But.
It will cost us…
– The home birth supplies (like renting the birthing pool, towels, etc).
– The B&B for 3-4 nights.
– Meals.
We were fine with this, and planning financially to save between now and then for the costs… until we found out that I could potentially have a midwife-attended water birth in the hospital. They have a room set up now for water births, and my midwives would still be my care providers. There would be no random doctors and nurses coming in and out while I’m laboring, no pressure to do anything I don’t want to do, the environment as I want it (dimmed lights, music, etc).
And since I live here, it would be free. After our 1-2 nights in the hospital, we may go to the B&B for a night, or we may go straight home and then come back on day 3 for our midwife appointment. We could decide at the time on that one.
So, I’m torn. I have no idea which one I want. If money were no object, I’d probably choose the B&B. However money is very tight for us these days, and I want to make a responsible decision. If there would be a big difference in the experience and the environment, then it’s worth it, but if it will be pretty well the same… then I just don’t know.
Thoughts? Advice? What would you choose?
Krista
Just curious what you decided. 🙂
Krista
Beth
I’ll post about it very soon! 🙂
Sarah Stogryn
Hi Beth!
I’m a friend of Mat & Naomi’s, and was their doula. I’ve just started reading your blog (& just started my own again – I’ve listed your blog on mine as one that I read. But if that’s not okay just let me know!).
Anyhow, I feel compelled to chime in on a couple things:
1 – Marci – you wrote clearly & eloquently on the brainwashing that happens re the “safety” of hospital vs home birth. Thank you!
2 – I think you might find my post on “birthing in place” (aka emergency childbirth) helpful in your planning:
http://www.herbalembrace.blogspot.com/2012/01/preparing-for-emergency-childbirth.html
3 – If you think there is a good chance that you might (accidentally or otherwise) birth somewhere other than your planned/intended birthing location, some extra time preparing for what to do in unexpected circumstances might be beneficial. “A Book For Midwives” by the Hesperian Foundation is great and can be downloaded as a PDF from their website:
http://hesperian.org/books-and-resources/
3 – Birth pools do not have to break the bank. In fact, you can have a DIY set up for under $60.
A kiddie pool like the one I linked to below is *more* than adequate for a single home use. And then your kids get to play in it over the summer too. If you go to the local hardware store, you can purchase a length of *drinking water quality” hose to fill & drain the tub. You can also buy the little bits needed to attached the hose to the tap. Then you can fill the tub straight from the tap, and drain the tub into the bathtub).
http://www.canadiantire.ca/AST/browse/2/OutdoorLiving/PoolsAccessories/Pools/PRDOVR~0813013P/Deluxe+Crystal+Inflatable+Pool.jsp?locale=en
4 – I would encourage you to not let money be the deciding factor. Your birth experience shapes who you are, and who your child is, for the rest of your lives. Although birth plans and birth reality don’t often cross paths, envisioning your ‘dream birth’ can help clarify your goals, and your fears, and can sometimes provide a helpful framework for decision making.
Hope all this helps.
Good luck!!
Sara L
This is tough. I sooo long for a home birth, not a birth center birth or a hospital birth. Just to be at *home*. Yet, since our lovely small town has no midwives, for me, it’s not an option. I get your struggle. I stuggled with the same and had soooo hoped that the birth center would be the next best thing. I hindsight, I think if I was happy with the hospital I’d maybe go with that. I didnt like having to leave right away (which wouldn’t be an issue at a b&b, but it was at the birth center). I also found it very noisy, street noise, etc. Which I had wanted to avoid. My hospital births were quieter… I like the RD hospital though. I had some complications with #4 and had to go there… the atmosphere was great, the nurses were very kind and the dr we saw was terrific. I would have had # 4 there if I could have… Anyways, blessings to you! Hopefully you’ll find great peace with one option. Have you taken a tour of both places?
Beth
Yup, a home birth is ultimately my dream as well. I hope that I’ll get that chance one day… we shall see! I really should take a tour of both place – great suggestion!
Marci
I’d like to just point out that some of the comments here reveal a concerning level of excessive social conditioning!!! To all of you who are suggesting some version of ‘I had an acquaintance who didn’t make it to the hospital in time to save the baby when complications arose’ —hold on here. How do you KNOW that the baby would’ve lived had he or she been in the hospital?!? We really need to stop airing the view that ‘the hospital is the safest place to deliver the baby.’ In Canada (we happen to be a world-leader in homebirth research), our research clearly shows – depending on which study you read – that homebirth for low-risk women is either 1) AS SAFE AS hospital birth; 2) SAFER than hospital birth. Why is it that – even when we ‘ve done rigorous studies on Canadian shores, we ignore all that research? None of the studies over here (done using our hospital system, and our midwifery system) show babies having worse outcomes than the hospital. In fact, the only recent study to claim that homebirth results in more baby deaths comes out of the States. And it’s not all done with their own hospitals and midwives – they mixed data from across the world, with varying levels of care and systems of care [And care in other places in the world is NOT equal in all cases]….and also drew over 60% of their data from birth certificates (meaning that you can’t actually tell the difference, in that data, between planned homebirth and a totally unplanned homebirth. Think that show “I didn’t know I was Pregnant” here). When you’re considering a homebirth, you need to know if it’s safe IN YOUR AREA. So a large metastudy? Does NOTHING towards helping a woman figure out what is safer in her given area.
So you know what this means, right :)? This means that there are HOSTS of babies dying in the hospital. And because we’ve been socially conditioned to believe that hospitals are safe and babies never die there; because we’ve been socially conditioned to watch Baby Story where each narrative is constructed to highlight emergent situations; because we are constantly told that we need the security of a doctor’s knife rather than a strong belief in the design of our own bodies….we forget that medicine has its place in certain emergencies. But ultimately, the way most births happen in hospitals these days does NOT do a better job of preserving the life of mom and baby.Babies dying in hospital almost never make the news – so we just assume that ‘no news is good news.’
We NEED to stop assuming (as I’ m seeing in many of the comments here) that hospital birth is safe birth. That if that birthing mama had just chosen a hospital, baby would not have died. That’s modern brainwashing….and there are a host of other problems that come with it. I’ve read the raw research studies themselves (not an article that claims to be explaining what these studies are about) that I’ve mentioned above (a huge pile) and I’ll say with confidence: these studies prove that the woman’s body was designed to give birth….and that most of our use of modern medicine actually interferes with it (or else why is it that a doctor, who has 8+ years of medical education, gets ONLY THE SAME OR WORSE RESULTS, than a midwife, who trains for 4+ years? The difference is that [most often] the midwife tries to respect the mandates of intelligent design, whereas it is not uncommon for OBs to look at the woman’s body in labor as a problem waiting to happen)
That said – Both options here sound good. But have you had a conversation with your Midwives where you asked what hospital policies are if you have an extended labor? From what I’ve heard, this is where things can get dicey. If the hospital will be completely hands off and let you labor without unnecessary interventions should things go longer than planned, it might all pan out. But some hospitals actually have rules where, after a certain amount of hours in labor, care must be transferred to an OB or an OB must come in an assess you….so I would find this out before signing on . Your a third time mama, so in all likelyhood, you might be looking at a speedy delivery. But it would be good to make sure that, in the event this little one likes to take his/her time, you have the time you need.
I also answer pretty pro either option because you’ve given birth in hospitals twice before, so it’s unlikely that that environment stalls your labor. But if you were a first time mama, or had trouble dilating in a hospital in the past, I would’ve said still push for the B&B birth. A water birth in a hospital is hard to get these days in Ontario….so it might be nice to take advantage of that option in Alberta 🙂 [I checked in my area, and if you plan to give birth in a hospital, they won’t even let you bring in your own inflatable water tub. All they allow is ‘water labor’…not ‘water birth’.]
For now…that’s all 🙂
Crystal Walker
I believe I stated that it was my personal opinion. To clarify, it is the choice I would make based on experiences that (personal) acquaintances shared with me and other women during a similar (live) discussion. I do not believe I am in the practice of brainwashing.
I do appreciate your literacy on the subject. If and when I am making that decision, I will choose what I am most comfortable with, and will read up about the subject further.
Marci
Hi Crystal,
Sorry for not being clear! I was writing fast. I wasn’t suggesting that people who were suggesting that ‘baby is less likely to die in hospital/hospital =security/etc’ *were* brainwashing others; I was suggesting that *our culture* has been brainwashed by media treatment of this issue to believe that hospitals are ‘safe spaces’ for birth. So I wasn’t suggesting that you or anyone else is brainwashing others by your posts, etc….but that many of us have bought this idea of ‘hospital security’….and that’s it’s one peddled by mainstream media.
I hope that this response is clearer.
I am for women’s choices in this issue – so it’ doesn’t bother me if women decided they – for whatever reason – want to birth in a hospital. But as long as the research stands as it does, I will take issue with people who suggests – in some form or other – that a hospital birth is safer for a low risk woman *as long as the research in her area indicates that it is* :).
Marci
P.s. oops! Typo: last line should say:
“But as long as the research stands as it does, I will take issue with people who suggest – in some form or other – that a hospital birth is safer for a low risk woman. A homebirth is as safe as/safer than a hospital birth for a low risk woman *as long as the research in her area indicates that it is* 🙂 “
Beth
That’s another good question to ask – what happens in the case of extended labour. I am actually wondering if the environment would stall my labour (something I’ve been reading a ton about lately) because of all I know now, and what I know my birth *could* be like. I may be more nervous in a hospital and therefore have a negative reaction to that. (this is a complicated issue involving hormone production during labour, etc…).
Marci
Hey Beth,
If you’re wondering if the hospital setting might stall your labor, then I’d lean towards the B&B birth. The production of the hormones needed to dilate is a really complex and delicate process, and I’d lean towards nurturing an environment that will help this along in any way possible. And if you’re in a B&B, and labor slows for a bit, you can always use more natural methods of increasing Oxytocin (as they say: they same energy that got the baby in their in the first place can help get the baby out lol! 🙂 ). So there are other options at a B&B that you may or may not want to take advantage of in a sterile hospital environment.
Maybe you could do a mix of both options? Stay at the B&B until your 8-9 cm dilated; then go to the hospital and soak in the tub and give birth there? By that point labor will be so well established, the chances of a hospital environment interfering with anything are slim.
Good luck 🙂 It’s always a hard decision….
Michael
We had a midwife in a hospital for both boys. Both times we were happy with that. As long as the midwife is taking the lead, it works very well.
Beth
Good to hear positive midwife-hospital combo stories – thanks for sharing!
Serena
I’d go with the water birth in the hospital for one reason. If there were any complications then you are already in the hospital. You still would have everything you wanted in a delivery, just you have a safety net as well. We unfortunately have friends who used a midwife outside of a hospital, and while many many women have completely safe deliveries doing home births, our friends did not, had complications and unfortunately did not make it to the hospital in time to save their baby. Soooo for me, I would rather have the medical care right outside the door, just in case =)
Beth
I hear this argument, and it’s hard not to be swayed by those kind of fears. Unfortunately I have the other side competing in my head… fearing the hospital dangers! So, I really need to examine the evidence and go with what seems to be safest/best, logically speaking (which, I think is an out-of-hospital birth, or at the very least a midwife-hospital birth).
Lola
Oh, and do you have a doula who would be comfortable delivering a baby in the car if need be? Or at least watching while you deliver in the car 🙂 I think that’s fairly vital in your situation.
Beth
Nothing for sure yet, but I am convinced it’s a good idea. I will definitely be researching “emergency” childbirth situations and what to do/prepare for, just in case we end up delivering on the side of the road. I’m not afraid of that, really, but I want to be prepared as much as I can just in case.
Lola
You may be surprised by my answer but I would totally go for the hospital birth if I were guaranteed a “midwife only” in attendance. If money is going to be a concern, I think the hospital would be just as pleasant. I would definitely bring my own blankets, pillow etc… Because the baby needs to be exposed to your own bacteria and NOT the hospitals at first. I do think you need to be extra assertive in any hospital situation but you are perfectly capable of that. I LOVED my rented condo birth with Gretta but it was a financial strain and I do think we could have achieved the same environment in the hospital with some good planning. And I’m all about an early release if you have a nice place to go. And really, is there anything better than the hospital mesh underwear? 🙂
Lola
And this may just be my overly active sense of freedom but it always makes me laugh when they think that they get to “release” me from anywhere. Ya right.
Marissa
I love the mesh underwear:) so comfy! I was thinking about it more, and I was thinking that although I am glad that we laboured at the B&B, I do feel that if I had the option of being with a midwife at the hospital where it wouldn’t cost more that I would go for it.
Beth
You probably wouldn’t have been able to do a water birth in the hospital though right? And then with an early release would you have just gone home? Or stayed in the area? C is even further away than RD… travel might be a bummer if you had to go back at day 3 to the midwives.
Kate
Hmmm. There’s nothing like a homebirth. I’m an advocate! However, in this case, a homebirth isn’t actually an option for you. Bummer. Since your midwife works in the hospital, she’ll be “in charge”, so if you want the lights dim, or people to stay out, or whatever, as long as she isn’t opposed, there’s no reason you can’t have those things in the hospital. Things that might sway me would be outbreaks in your hospital around the time you’ll be giving birth (ie: rsv was a huge problem up north during the winter months in the hospital), as well as how Isaac and Aliza will be treated/welcomed. Can Chris stay with you, in a bed, at the hospital (I mean, unless the ward is full to exploding)? I’m sorry that what you would really like isn’t an option for you, but I do think you can have an awesome, safe experience in either the B&B or the hospital.
Cost-wise, there’s not much to be done about the tub rental, but birth supplies don’t have to be pricey, especially if your midwife is willing to connect you with some clients who have leftovers. I know I had a package of blue pads and a bunch of other stuff sitting in a bag in my laundry room for almost a year after Nate was born. Chris is going to be buying his meals no matter where you are, and, let’s face it, he’ll probably be buying a few food items for you too. The hospital food doesn’t always cut it! If you’re thinking you might stay in the B&B after a hospital birth anyway, maybe the cost differential isn’t that great?
On another note, wasn’t your labour with Aliza pretty quick? How on earth are you going to sit in a car for 1.5 hours while you’re in active labour. I mean, you’re going to wait until you’re sure you’re actually in labour, and then you’re going to get in a car just as things are getting going? This does not seem like a sustainable activity to me! (am I missing something? is the hospital at a midway point or something?) I’m not being critical of anything, just wondering if you’re a little nutty. In a very lovable way. You might want to have a few birth supplies around anyway, just in case 😉 I’m eager to see what you decide, and what sort of genitalia this child has, and what you name him/her, and how it all goes, and, and…
Beth
Hmm, yeah I doubt that Chris would be able to have a bed to sleep in (in the hospital). And that’s a big factor, since we won’t be close to home, and he definitely needs all the rest he can get too. The food is worrisome too – I remember being starving after giving birth to Aliza- she was born at 10:16pm, and the hospital didn’t have food until breakfast. I was famished, there was nothing open in the entire town except the gas station, so I had a sandwich from the get n’ go. Ugh. I really need to plan better this time (and I’m sure it would be easier in a B&B).
Yeah, I would probably go for an early release (like a couple hours after birth) and head to a B&B, so cost-wise, you’re probably right – it’s probably not as significant as if I stayed for a day or two in the hospital.
Labour with Aliza wasn’t all that quick – 8-10 hours or so (no pushing – she came out in about 10 seconds)… but that was with cervidil. So I am a little worried that a naturally started labour will be way faster, but when I told Chris this, he said “meh, I could catch the baby, I’m not worried” 🙂 Haha! So, yeah. Oh, and if we were doing the B&B thing we’d have all the home birth supplies with us. Is it totally nutty that I’m not *that* worried about that? (The drive is one hour fifteen minutes, and I’m guessing Chris will be driving a little faster than normal 😉
Dea
With K’, we had booked a B&B and planned to be there with our midwife. But in the last weeks we realized that it was getting too tricky to keep a reservation when we’re dealing with an unknown date, and that we couldn’t afford more than one night.
We switched to “midwife in the hospital” and it was AWESOME. I would definitely do that again. For sure. Absolutely. The hospital was amazing, the experience was incredible, and given that K was sent to NICU for his first night, we were thankful that we were right there. I really think it’s the best of both worlds as it offers so much freedom and support, while still being financially feasible and offering certain securities/comforts. (I’m just baffled that there are no midwives in our town!)
Beth
That’s another potential wrinkle in the plan: we won’t be making a reservation, and if the B&B is full when I’m in labour, then plan B is the hospital. I’m mentally ok with that though.
It’s good to hear that you had such a positive experience with the midwife/hospital combo!
Crystal Walker
And I agree with Kelly – gorgeous photo!!!
Beth
Thanks 🙂 I had to edit the heck out of it, but I think it turned out nicely 🙂
Crystal Walker
Option two is the option I had wanted when Aliyah was born, but we didn’t get a midwife in time (apparently they need to know “before” you get pregnant or as soon after as possible, and we just had no idea when that would happen – and didn’t know it actually HAD happened until 6 weeks in!). Personally, I would choose option two – for two reasons. An acquaintance of mine had a home birth in which there was an issue that caused the baby permanent damage, and another acquaintance had a hospital birth that turned out extremely high risk with no previous knowledge whereby mom and/or baby would have died if not at the hospital within 5 minutes of birth. I realize the technology and skills of a midwife are extremely high and I’m probably not even aware of how they would deal with such situations, but I (personally) would feel like I was taking an unnecessary risk (again, that’s personally and I am not making any kind of judgement on any other parents’ decisions!). Also, It’s cheaper and is a very similar experience to a home birth, but with the additional support just in case.
But that’s just me! (: I’m so excited that you get these choices to make – that we live in a time where this is possible.
Now here’s a different topic entirely, one I’d love your opinion on. With Aliyah’s condition, we are seeing major advances in treatment due to stem cell research – a highly controversial topic. I wish I had explored the idea of donating cord blood for research purposes, but I did not. Is that something you would consider doing?
Beth
Crys, I think it’s pretty difficult to get in with the midwives in Calgary. There just aren’t enough in Alberta, period. It’s sad, and it doesn’t even make sense – midwife/home births are way cheaper for the government – you’d think they’d be funding midwifery programs like crazy, but they’re doing the exact opposite! Anyway, that was a bit of a tangent!
I understand the fears and what-if’s – I mean, it’s your baby… you don’t want to do taking unnecessary risks. The thing is (as Marci mentions below) there is statistically no extra risk to giving birth outside of a hospital. You don’t hear of the babies that die in hospital due to unnecessary interventions/medical mistakes because they’re never on the news. Also – hospitals carry their own risks like disease outbreak, tons of germs, etc. So, logically, I think a very strong argument can be made that it’s actually less risky to give birth at home/outside the hospital.
As for the cord blood thing – that’s a fascinating topic. I would definitely be interested in banking cord blood, but it costs several hundred dollars. Do you think that if you’d banked Aliyah’s cord blood they could have used it somehow to help her? I would be interested in donating it if it were affordable/free. Do you know if it costs? (Stem cell research is controversial when it involves aborted fetal tissue, which I definitely opposed to, but when it comes from cord blood, I see no ethical issue).
Crystal Walker
I do appreciate the strong argument for home births.
Banking cord blood for your own child costs a ton of money and it wouldn’t have helped Aliyah anyway, as there isn’t a cure yet for cystinosis. But donating it is, I believe, free. I know that currently “they” have reversed cystinosis in mice using stem cell research, and I also know that a lot of (if not most of) stem cell research comes from aborted fetal tissue, which I am so strongly opposed to. If it comes from cord blood, I think that’s a beautiful way of contributing to medical advances.
I’ll be looking into it. When I first heard about the stem cell research advances for Ali, I was so excited – and then when I realized the extent to which abortion contributes to that research, I felt like I’d been sucker-punched. How do I rejoice over potential cures at the cost of so many little lives? It’s been a hard issue.
Marci
Ok, so here’s the thing about cord blood: when I see those commercials, they suggest that this could be helpful for the child or other children later on should an illness/disease arise, etc. But this cord blood being banked? Wasn’t it designed by God for your baby in the minutes immediately following birth? That cord blood is supposed to flood your baby with it’s last dose of nutrients and other goodies and strengthen it immediately following delivery.
Here’s my other question: if they are going to bank cord blood, do they have to clamp the cord? Or can they wait till the cord has stopped pulsating, at which point (I’ve been told) the cord has done its work. [I recognize that some women opt for a Lotus birth, but I’m not referring to that situation here]. If they have to clamp the cord before it’s stopped pulsating….I’d avoid banking cord blood. Because it was designed for the little one after birth, and the little one should not get robbed of his or her benefits :). But if cord blood can be taken after the cord has stopped pulsating, I’d be interested.
Does anyone know which is the case?
kelly
All my five babies have been born in hospital. The last 3 babies were born completely naturally. I have had great hospital experiences and felt very well cared for. I was never pressured to have any interventions I didn’t want (except by my obgyn before the birth of the twins because epidurals are “standard”in twin deliveries…but I firmly said no and that was the end of it…it was never even mentioned in the delivery room). I feel like “the business of being born” did not at all reflect my hospital experiences. I think next time I have a baby I will choose a midwife but will give birth in the hospital. I guess what I’m saying is that hospitals aren’t all bad! I’ve got nothing bad to say about the one I gave birth in! But what ever you choose it’s going to be incredible! And that photo above is beautiful! I’m kinda jealous of your prenant-ness….lol!
Beth
I’m glad you enjoyed your experiences, and didn’t have any interventions that you did not want. Unfortunately I think you’re in the minority. There are other factors about the hospital that I dislike, which I will perhaps write more about to elaborate.
Marissa
How would it work if there was someone else needing the water birth room as well? First come first serve?
For me I loved being at the b&b but I also didn’t have a midwife which makes a huge difference at the hospital in my experience. The only problem for us was that we were on a tight budget and so when labor went longer and we stayed longer, the b&b bill was quite a hit financially. Still worth it though. That’s my two cents!
Beth
Hmm, I’m not totally sure. I’m going to add this to my list of questions for my midwives for next appointment. Thanks for your thoughts!