Medstar WHC vs GW vs Sibley vs other?
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Anonymous
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Hi,
I'm 27 weeks pregnant and so far have been at Medstar Washington Hospital Center (the ob-gyns, not the midwives) because it's near my house in Takoma Park. Every mom I ask around here, though, says she went to GW. Can anyone inform me of the differences between the various hospitals (Medstar WHC vs GW vs Sibley vs any others)? Thanks so much!! |
Anonymous
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At 27 weeks it’s getting later in your pregnancy so switching practices is probably becoming less of an option, if not an impossibility. What are your concerns specifically?
WHC and GW are very similar urban teaching hospitals with similar patient demographics, facilities, and same level NICUs. I believe both are level 1 trauma centers. Main reason that is good is in case you need a blood transfusion or your delivery goes terribly—they are best prepared to care for you. Both have hospital based midwife practices that have positively influenced OB practices. At WHC they offer nitrous for pain relief in labor. At GW they do not. GW has more liberal policies for eating and drinking in labor than WHC. They use and teach forceps at GW, and are in of a very small number of teaching hospitals still doing that (forceps come with greater risks to the mother than vacuum and many hospitals favor vacuum over them for operative delivery). I am not sure about forceps use at WHC. The facilities at both are not cushy. There will be a broad range of women on the flooor in labor and delivery and postpartum—different races, ethnicities, income levels. Sibley is a community non-teaching hospital known for a more cushy experience, a higher c section rate (largely due to patient demographics), and more older/affluent/whiter clientele. They redid their rooms a few years ago and they are supposed to be very nice. People joke about their smoothie cart. They have a lower grade NICU and are not a level 1 trauma center. They are not a teaching hospital so residents and student will not be involved in your care. Search past posts for specifics—plenty of feedback on all places. General feeling on DCUM is that Sibley offers a cushier experience but the downside is that they may not be fully able to care for you or your baby in the event that things go very, very badly during your birth. Though that is very very unlikely, it’s not impossible. This doula also offers a helpful overview to all hospitals. http://www.tarabetholson.com/hospitals |
Anonymous
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GW has a reputation for being very evidence-based and more supportive of natural birth than other hospitals. Their protocols are woman and baby-centered, for instance letting women have intermittent monitoring, deliver in any position they want, recommend doulas, have birthing tubs available, let you eat and drink during labor, etc.
Everyone I know who has delivered at Sibley was wealthy and white. People rave about the "spa-like" experience of their postpartum. They have a higher c-section rate. I've heard varying things about how welcome doulas are (my doula practice 4 years ago avoided it like the plague). WHC doesn't seem to have much reputation either way. It's a very large city hospital. They have hospital midwives. They offer nitrous for pain relief (which studies show isn't very effective). I don't think it's as convenient to get to for a lot of people since it's not on the metro. |
Anonymous
That feeling is kinda wrong and misleading. Sibley's NICU can care for babies from 34 weeks gestation on. Any NICU can care for the vast majority of problems a baby could be born with. What they may not be equipped to deal with are extremely rare congenital defects and extreme prematurity. But even so, worst case scenario, they would be able to stabilize the baby and transport them to children's. It's so odd how people on this forum constantly perpetuate this myth on here, both about the NICU and this anxiety that something catastrophic could happen to the baby. The risk is low for a high-risk pregnancy; for a low-risk pregnancy it's minuscule. |
Anonymous
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I’m the PP you are referring to. It’s not misleading to point out that Sibley is a level 2 NICU, which is less than GW, Georgetown, Children’s, and WHC. According to the website they are prepared to care for babies 32 weeks and older. So if you had early preterm labor before 32 weeks, for instance, and delivered a micropreemie, they would not be the hospital you’d want to be at. That’s not likely but does it happen? Absolutely.
It’s all about a woman’s comfort with risk. Some people would prefer to be at the hospital most equipped to deal with a catastrophic situation—even if it is highly, extraordinarily unlikely for their pregnancy. Others might not be concerned or prioritize that as much—it all comes down to what degree of risk you are comfortable with and what your priorities are. The reason NICUs have different designations is because they offer different degrees of care. It’s not perpetuating anxiety to acknowledge that something catastrophic could happen and that in that case NICUs with higher levels have the potential to be better able to care for the baby. Transferring a critically ill infant can be a frightening and risky experience—if it gives an expectant mom peace of mind to deliver in a hospital where they would not have to worry about that, that’s their choice to make. Furthermore, women have anxiety because terrible things do happen in birth, even if rarely. It is often said that the most dangerous day of a baby’s life is the day it is born, and childbirth has historically been the most dangerous day of a woman’s life. Pretending that the possibility for bad things to happen is so minuscule it is not worth worrying about is a dismissive attitude that is disrespectful of women’s preferences, priorities, and tolerance for risk—and the current state of maternal mortality in our country. https://www.marchofdimes.org/baby/levels-of-medical-care-for-your-newborn.aspx https://www.hopkinsmedicine.org/sibley-memorial-hospital/patient-care/specialty/maternity-services/special-care-nursery.html |
Anonymous
Loved Sibley generally. It was really nice and the food was actually decent - didn’t really want a teaching hospital and c section rate is going to be dependent on your OB but yes generally the clientele is older and wealthier. At almost 31 I felt like I was definitely on the younger side. My doc was telling me how one of his other patients had a mom who flew in from the west coast as soon as she found out she was in labor, naturally on her own plane, so you know, totally normal  i do think the higher c section rate is related to older clientele and i think we saw at least one person coming in for a scheduled one.
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Anonymous
NP here. Agree it's totally fair to distinguish between levels of NICUs and that babies do unexpectedly need a NICU. I do think the idea that people like Sibley because it is "cushy" and whiter is a little misleading. My OB recommended Sibley over Holy Cross because it is less hectic, something we witnessed for ourselves during the tours (he said both are fine hospitals, so this is not intended to bash Holy Cross). And yes it sucks that this is a function of the fact that this is because Sibley is in a whiter, wealthier area that is not transit accessible, no question. That being said, there are tangible benefits to you and your baby to being in a place where your doctor is less busy. With a low-risk pregnancy, I'd guess that the odds of a less than ideal outcome because your hospital is overwhelmed are much higher than the odds of your baby needing the NICU, so there is a risk to choosing the higher-level hospital. It's just a different kind of risk than going somewhere with a lower-level NICU. |
Anonymous
In my anecdotal experience, women choose GW either because of the midwifery practice or because it's close to where they work, making prenatal appointments easier, or some combination of those reasons. The people I know who have chosen WHC have done so because they wanted to deliver with a midwifery practice and GW was too far from where they live and/or work. The people I know who have delivered at Sibley (myself included) largely did so because our OB practice delivered there. I was initially reluctant to deliver at Sibley. I had my first baby without pain medication in a birth center with midwives, and Sibley just seemed so different from that experience. I was worried about the lack of flexibility in various hospital protocols (monitoring, IVs, etc.). I wasn't particularly concerned with the level of NICU at Sibley, but I know there are people who worry about that. In the end, I was induced, and I did that without pain meds for about 6 hours before getting an epidural because induction drugs are no joke painful. I never felt pressured to get the epidural earlier than I did and no one ever discussed a c-section with me. I found the L&D staff to be wonderful, the environment to be calm and non-stressful, and the postpartum care to be stellar. I have heard that GW's postpartum care is pretty bare bones and not on the same level as the L&D care. I have heard good but non-specific things about WHC as I only know one person who has delivered there and we are not super close. FWIW, I also never saw the smoothie cart at Sibley, though the cafeteria food was pretty decent. |
Anonymous
| I’ve delivered twice at WHC (2nd and 3rd babies, 1st in another state) and have had a great experience in L&D! Both were inductions, but I was able to use the wireless monitors and move around throughout my very long inductions. During my most recent delivery I used nitrous and it was a game changer for me. Definitely takes the edge off the pain -especially with Pitocin - and was able to deliver a very large baby without an epidural. I also suffered a large hemorrhage with my last and am very thankful for the quick and efficient response from all of the nurses, midwives and doctors! It might not have the fanciest facade, but it makes up for it with expert care! |
Anonymous
Ok, fine. I’m not going to argue with someone who advocates in favor of letting extreme anxiety guide their decisions over where they give birth. Women know how to talk to their doctors about what their individual risks are that might warrant preparing for micropreemie care or whatever other issues there are. |
Anonymous
| My wife had both of our kids at WHC and we had great experiences. Our first child ended up in the NICU, so I was glad we were there. We got very good care from both nurses and doctors. They do not have a nursery, but that is what we wanted. |
Anonymous
You seem to be under the misunderstanding that a low risk pregnancy cannot become catastrophic, and that somehow knowing individual risks ahead of tome can guarantee a good outcome. Plenty of “healthy, low-risk” women can become very ill very fast. Two in my own circle were very healthy and one developed HELLP syndrome and had to deliver a premature infant and another had a severe postpartum hemhorrage. Women are only low risk until they are not. That’s not promoting extreme anxiety, it’s acknowledging reality that while most times things can and do go well, when they do not it may be preferable to some women to deliver somewhere they have a blood bank and high grade NICU, for instance. |
Anonymous
NP here. PP, it sounds like you do not think there is ever a situation in which a woman could responsibly give birth at a hospital without the highest grade of NICU. To me, that sounds like extreme anxiety, in that it would imply that any hospital that does not have a level 4 NICU should close to maternity services, since anything else would be irresponsible and potentially catastrophic. If that is not what you are saying, then please explain what you ARE saying. Are you suggesting that women should not deliver at Sibley at all because their NICU is not as highly capable as GW's? |
Anonymous
| “Everyone” in your peer group goes to GW these days because it’s metro accessible and convenient, and because folks in these peer groups, esp first time mothers, tend to mimic what their friends and peers have done already. If WHC is working for you then I would not switch. Agree with the PP who noted that WHC serves a wide cross section of the city, whereas Sibley is a private practice hospital that serves wealthier, whiter patients. |
Anonymous
| No I am saying they any woman choosing Sibley over GW or WHC should just be aware that in the very minor likelihood of extreme catastrophe, they or their infant might not be able to get the full level of care they need and may need to be transferred. If they are comfortable with that very minor risk, fine. It’s about being informed. Just like someone delivering at home should know the risks of homebirth and that urgent medical care would require a transfer and delay of treatment and accepts that risk, women choosing to deliver in a hospital need to understand that all hospitals are not equivalent. I think many women assume they are all and do not understand the different designations, levels of care, access, etc. unless they are physicians, work in health or health care, or are really informed patients. |