Pros and Cons of Birth Center Birth & Logistics post birth

[Anonymous]

If it helps to convince him, Kaiser (the mainstream HMO) was a happy to pay for my birth center birth a few years back, and our Kaiser pediatrician had no problem with the baby having been born outside the hospital. So it's not as if it's a radically out-of-the-mainstream choice, even if some people frame it that way.

[Anonymous]

Great point about Kaiser! Several women in my birth class delivered at BirthCare in Alexandria and had Kaiser. I had a hospital birth the first time around but am planning to switch to BirthCare the next time around. Hope your husband is supportive of your decision!

[Anonymous]

Agreed re the insurace -- MDIPA paid for my birth center birth, and our peds were very supportive of it (Capitol Medical Group, which has 2 lactation consultants on staff -- having a ped in the same building as the Breastfeeding Center also sounds like a good plan!)

I think *very* few pediatricians would have a problem with a birth center birth or early-check-out hospital birth, once you are seeing them in their office for visits. However, if you want an early check out at the hospital, (this is addressed to a PP, who may know this already), you need to find a pediatrician who has privileges at the hospital where you'll deliver and who is willing to come to the hospital promptly to do the "early" discharge. My sense is this is rare, and most peds leave post-birth hospital discharge to the hospital's staff pediatricians. I'm not sure how to find one of those that would be interested in doing an early discharge of the baby for you... it probably goes against their economic interest and is a professional risk (no matter how slight) they may be unwilling to take with a patient they have no connection to... CYA, you know?

[Anonymous]

Besides the BoBB, Orgasmic Birth is a fantastic movie to watch about the safety and simplicity of natural birth and it's available on Netflix. It is not graphic at all (no vaginas even) and although the title is a little wild, the movie is very down-to-earth and accessible. Seeing the 11 families' positive natural birth stories makes you believe more and more that you can have one, too.

If I were to recommend only one book for pregnant parents, it would be Pushed, by Jennifer Block. The book is basically like a huge research paper with a ridiculously extensive bibliography, but somehow it's very interesting and readable with anecdotes and interviews from professionals on all sides of each issue.

[Anonymous]

This is PP wanting an early check out from the hospital. Yes, that is exactly the problem I am facing -- any pediatrician I've talked to now has said she doesn't mind an early check out at all, but that they get flack from the pediatricians at Sibley (where she has priveleges) for not deferring to the staff pediatricians -- I guess even when your own pediatrician comes to care for baby.

I'm not sure how to get around this. Perhaps I should start a new post about it to see if anyone else has answers...

[Anonymous]

I chose to go with a midwife in a hospital because A) I was unaware of the DC Birth Center B)My Insurance. I went with MCA at Shady Grove.

As far as your husband, just watch The Business of Being Born with him.

The delivery went just fine, the midwives were great, the hospital staff were great and maintained a good distance. In fact my husband and I were alone most of the time (which was good), and the support we had stepped in at the right times.

However, I did not like being at the hospital after the baby was born. The midwife took good care of me and the baby right after the birth but in the hours and days after it was the regular hospital routine. I would consider the DC Birth Center because of this. I would have loved to have a peaceful, low tech time with our baby afterwards (without the hospital photographer barging in and pressuring us for photos when we were trying to get some rest)...

[Anonymous]

New poster here. BirthCare in Alexandria appeals to me, but I'm in Bethesda, and the distance to travel for prenatal visits, not to mention while in labor, concerns me. I'm not pregnant yet, but we're planning ahead, and I'm going to have to make a decision on insurance soon. If I go with Kaiser, I'm set for BirthCare, and if I go with the PPO, I can go with MCA. My only concern regarding MCA is what the PP said - it would be the hospital routine for the baby after the first few hours of his or her life.

Has anyone on the board gone with BirthCare despite living somewhat far away? If so, I'd love to hear about your experience with this. In the end, we may end up going with MCA because my husband is more comfortable with delivery in a facility that has a high-level NICU.

[Anonymous]

Years ago I delivered at Maternity Center in Bethesda, sadly they are no longer around. At 35, I was considered an older mom, but with a low-risk pregnancy. After delivering in Columbia Hospital's so-called birthing center years prior, there was just no way that I was willing to birth in a hospital again, unless, it was deemed medically necessary.

The nurse midwives at the Maternity Center empowered me with the knowledge that child birth was the most natural thing in the world. Prenatal care was topnotch, they explained every test that was administered and various elements of my ultrasounds in specifics instead of generalities. The entire team really got to know our family. I delivered my son there 11 minutes after I crawled up into my suite and it never crossed my mind once that I needed meds. I laughed and chatted during push out and reached down and touched my son as I pushed him into the world. I actually felt the change in the room as a new life entered it. It was an incredibly, beautiful, and powerful experience for us. Also younger siblings could be in your suite or elsewhere playing nearby in the center. If I hadn't delivered so quickly after arrival, I could have labored a bit in the jacuzzi. We took our son home 5 hours later. I felt strong and alert and didn't experience the agony that I had of soreness, dehydration or the residual effects of an epidural or other drugs.

If I had experienced complications during labor, I would have been transported to Suburban Hospital.

[Anonymous]

Anonymous wrote:Has anyone on the board gone with BirthCare despite living somewhat far away? If so, I'd love to hear about your experience with this. In the end, we may end up going with MCA because my husband is more comfortable with delivery in a facility that has a high-level NICU.

I'm going with Birthcare and live near downtown Silver Spring - Bethesda is actually closer to Alexandria if you take the beltway/GW parkway! Getting to/from the appointments can be a drag if they are too close to rush hour, but I really prefer the idea of the birth center vs. the hospital (we'd go to Shady Grove with the midwives if we weren't doing Birthcare). I think for a first birth, we're comfortable with the distance/time it'll take to get there, because we're assuming things will progress slowly...

[Anonymous]

Has anyone on the board gone with BirthCare despite living somewhat far away? If so, I'd love to hear about your experience with this. In the end, we may end up going with MCA because my husband is more comfortable with delivery in a facility that has a high-level NICU.

I live about 45 minutes from Birthcare and have had 2 homebirths with them and continue to go there for my GYN care. They are worth the drive, hands down. Having been in the reproductive chapter of my life for a decade now, I've relied on the Birthcare midwives for some big experiences... miscarriages, pregnancies, births, postpartum, birth control decisions, various GYN issues that have arisen.... Marsha and Alice have so many years of experience. Mothering Magazine profiled Marsha as a "living treasure" back in 2007 and she was the subject of a Smithsonian exhibit about black midwives. About choosing to birth at home rather than the birthcenter, Alice likes to ask "Would you like to come to our house or shall we come to yours?" As long as your home has some space and quiet, and you live within 30 minutes of a backup hospital and you are healthy, there is little difference between the birthcenter and home. I don't want to get in the car when I am in labor.

If I were to have another baby now, I would try to hire Erin and Mairi of MAMAS just because they are closer to home and they work with the same professionalism and spirit as Birthcare. http://www.mamasmidwives.com Erin worked at Birthcare and Mairi worked at the DC Birth Center.

About wanting your newborn to be near a NICU... if your baby is healthy, there is no need. The odds are so very slim that you will need it and you can get there if needed. Being in-hospital increases the poking and prodding that your baby experiences, as well as multiple strangers caring for your baby. What a baby needs is peaceful connection to mama and papa, and undisturbed time at the breast. Skin to skin, gazing up at your eyes, with a mama who is well-rested, well-fed and taken care of. That will help your baby's blood pressure, heart rate and body temp more than medical observation.

My children love to climb into bed between my husband and me and hear the stories of their births in that bed. We all hug just as we did in the first moments after they were born.

I know on this board that few people birth their babies this way. But I wanted to share that it’s been a very good experience for me.

[Anonymous]

to 10:11 - how did you decide to home birth, and did you have any issues convincing your husband?

I'm leaning towards the DC Birth Center because my husband currently acts like he would be more comfortable with a hospital birth and they give me that option. But I haven't ruled anything out at this point.

And birth location options aside, does anyone have opinions on the midwives at the DC Birth Center v. Birthcare? or is this really a question of whether you're looking for a home birth or not?

FWIW we live about 1 mile from Georgetown Hospital, which makes me at least open to considering the homebirth option.

[Anonymous]

Anonymous wrote:to 10:11 - how did you decide to home birth, and did you have any issues convincing your husband?

My husband came with me to a few OB visits in hospital and then to my midwife visits at Birthcare. That convinced him more than anything else. And talking to the midwives usually seals the deal. The Birthcare midwives have had coversations with nervous fathers about hospital vs birthcenter vs homebirth many times. They know what the common concerns are and know how to listen and answer those concerns. Watching the BOBB is also a great tool. The message isn't new but it's so well made compared to other pro-midwife documentaries.

About choosing between Birthcare and DC BC, you have to meet the midwives, ask questions about their practice, and get a feel for the place. Ask about how they handle common issues, like high BP during pregnancy, Gestational Diabetes, Group B Strep, going past your due date, breech presentation, posterior presentation, using a birth tub, birthing in water, checking fetal heart tones during labor, meconium in the waters, etc. Hearing those answers will give you a feel for the practice and hopefully know which one fits you best.

[Anonymous]

Tried to have my first at the birth center in Bethesda (the one that no longer exists) and wound up at Shady Grove. Hated the postpartum nurses, really terrible experience for me. Had my second at that same birth center and it was wonderful. Really great, positive experience. My pediatricians in Silver Spring were very supportive.

[Anonymous]

And birth location options aside, does anyone have opinions on the midwives at the DC Birth Center v. Birthcare? or is this really a question of whether you're looking for a home birth or not?

In my opinion, the Birthcare midwives are much more experienced than those at the DC Birth Center. Birthcare has been in operation for ... I don't know ... 20 years now? Those women have seen it all. DCBC has much younger, newer midwives. Now, I really LOVE the DCBC because they provide a unique service in this area -- they allow women the option of waterbirth at their birth center, yet they can continue the woman's care should she need a hospital (ie, pitocin or epidural). That is really fabulous because no place else in DC can offer that flexibility (except Special Beginnings, which is kind of far away). Yet they do not have that long-term experience, and it is really important for them to maintain their relationship with the hospital so sometimes they might come from a slightly more medical model than Birthcare.

Regarding birthcenter vs. homebirth, the truth is that the biggest difference is psychological; ie you feel safer because you are going somewhere "legitimate" to have your baby. And it seems this applies mostly to scared husbands! Somehow they miss the fact that literally every piece of medical equipment present at the birth center would also be present at your homebirth (because the midwives would bring it). The one benefit of a birth center is that if a transfer were to be necessary, there is a system in place that has been tested before (ie, ambulance knows where to come, they know exactly how long it will take to get to the hospital). However, if you are with an experienced, skilled, homebirth midwife and you live within 20 minutes of a hospital (which almost all of us do here in WDC) then it can be equally as smooth should you need to transfer. In the end, it comes down to YOUR comfort. Is you home comfortable enough for you to birth in? Do you have a/c? Do you have thin walls and you'll be worried your neighbor might hear? Those are the sorts of things you would want to consider. The biggest thing for me was: driving in labor sucks. Why do it if you don't have to?

If you want to get your husband on board, bring some homebirth midwives to your house to interview them. Make sure you husband grills them with every question he can think of. Midwives have done this hundreds of times, and usually in the end the dad is sold.

[Anonymous]

Thank you to everyone who posted with such great information here! I am a PP who is considering BirthCare for a second birth and this reaffirms my thoughts about the decision. I hope to have a positive story to share sometime in the future.