Anonymous
Post 05/07/2019 11:38     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:
What sibley cannot do is care for a neonate who requires mechanical ventilation- for instance, if a baby had a bad meconium aspiration and had to be intubated and put on a ventilator, they would need to be transferred to a level 3 or level 4 NICU that can handle ventilator support.


Emphasis on "care" - Sibley can definitely intubate and initiate MV; in practice, CPAP/BIPAP (which Sibley can maintain indefinitely) is done with the very same machine on a different setting. It's just that if MV is expected to be needed for more than 24 hours, Sibley will transfer to Georgetown for staffing (i.e., RT availability, nursing ratios), likely co-morbidity, and ultimately licensing reasons.
Anonymous
Post 05/01/2019 11:55     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:A quick Google search says 10 percent incidence of meconium aspiration, not 1 percent. Let’s not minimize this as “exceedingly rare.”

The percentage of babies who need respiratory support for this is less than 1%.

https://www.dovepress.com/meconium-aspiration-syndrome-challenges-and-solutions-peer-reviewed-fulltext-article-RRN
Anonymous
Post 04/30/2019 21:38     Subject: Medstar WHC vs GW vs Sibley vs other?

I had no risk factors at all and ended up with HELLP syndrome out of nowhere at FT. I was a private patient of a doctor at a hospital where she had privileges (Inova Fairfax) and felt like there was absolutely no one looking out for me when my doctor was not at the hospital. It was horrible and, if not for some very high quality nurses who leaned wY forward for me, I could have had a catastrophic outcome. Knew for future kids that I wanted an academic medics center where continuity of care was a given. Had 2 kids at GW and was SO much happier. Not the hospital per se, but the academic model.
Anonymous
Post 04/30/2019 21:01     Subject: Medstar WHC vs GW vs Sibley vs other?

A quick Google search says 10 percent incidence of meconium aspiration, not 1 percent. Let’s not minimize this as “exceedingly rare.”
Anonymous
Post 04/30/2019 13:35     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote: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



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.


NICU level isn't just about preterm care. Many of the 34-weekers who end up in the NICU are feeders and growers, and just need to be monitored for a bit for growth. Sibley can do that. What sibley cannot do is care for a neonate who requires mechanical ventilation- for instance, if a baby had a bad meconium aspiration and had to be intubated and put on a ventilator, they would need to be transferred to a level 3 or level 4 NICU that can handle ventilator support.

Again...an exceedingly rare complication unless there was some other risk factor.


Actually, meconium aspiration is not something that is exceedingly rare or only seen in a high risk pregnancy. It is seen more in patients who go past their due date, but can happen to anyone. I'm a 32 year old physician with no health problems and no complications in pregnancy and my DS came out blue and not breathing due to meconium aspiration. He was born at 40 weeks 2 days. While not common these things do happen

Meconium aspiration requiring treatment occurs in <1% of babies and less than half are severe enough to require intubation and mechanical ventilation. There are factors that increase the risk.. the point is for most people the fear of their baby needing high level NICU care is unfounded.
Anonymous
Post 04/30/2019 09:44     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote: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



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.


NICU level isn't just about preterm care. Many of the 34-weekers who end up in the NICU are feeders and growers, and just need to be monitored for a bit for growth. Sibley can do that. What sibley cannot do is care for a neonate who requires mechanical ventilation- for instance, if a baby had a bad meconium aspiration and had to be intubated and put on a ventilator, they would need to be transferred to a level 3 or level 4 NICU that can handle ventilator support.

Again...an exceedingly rare complication unless there was some other risk factor.


Actually, meconium aspiration is not something that is exceedingly rare or only seen in a high risk pregnancy. It is seen more in patients who go past their due date, but can happen to anyone. I'm a 32 year old physician with no health problems and no complications in pregnancy and my DS came out blue and not breathing due to meconium aspiration. He was born at 40 weeks 2 days. While not common these things do happen
Anonymous
Post 04/30/2019 09:12     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:
Anonymous wrote:
Anonymous wrote: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



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.


NICU level isn't just about preterm care. Many of the 34-weekers who end up in the NICU are feeders and growers, and just need to be monitored for a bit for growth. Sibley can do that. What sibley cannot do is care for a neonate who requires mechanical ventilation- for instance, if a baby had a bad meconium aspiration and had to be intubated and put on a ventilator, they would need to be transferred to a level 3 or level 4 NICU that can handle ventilator support.

Again...an exceedingly rare complication unless there was some other risk factor.
Anonymous
Post 04/30/2019 08:49     Subject: Re:Medstar WHC vs GW vs Sibley vs other?

PP here. And to clarify for anyone wondering, the difference between level 3 (GW/WHC) and level 4 NICU (Children's/GT) is level 4 can do ECMO. If your baby would potentially need ECMO for something like a heart defect, you would in most cases find out about this during your prenatal appointments (or anatomy scan at 20 weeks)
Anonymous
Post 04/30/2019 08:43     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:
Anonymous wrote: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



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.


NICU level isn't just about preterm care. Many of the 34-weekers who end up in the NICU are feeders and growers, and just need to be monitored for a bit for growth. Sibley can do that. What sibley cannot do is care for a neonate who requires mechanical ventilation- for instance, if a baby had a bad meconium aspiration and had to be intubated and put on a ventilator, they would need to be transferred to a level 3 or level 4 NICU that can handle ventilator support.
Anonymous
Post 04/29/2019 19:51     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:My friend is an OB at WHC and I live a mile from VHC, but I delivered twice at GW to be with the midwives there. In my circle, delivering at GW is code for “I have a doula, I am hoping for a vaginal birth without pain meds but I’m not crunchy enough to home birth”.


Chuckling at this because it does partly apply to me. I have a doula, I am hoping for a vaginal birth but WITH an epidural, and i'm definitely not crunchy enough for a home birth. Had my first at GW and was happy.
Anonymous
Post 04/29/2019 15:31     Subject: Medstar WHC vs GW vs Sibley vs other?

My friend is an OB at WHC and I live a mile from VHC, but I delivered twice at GW to be with the midwives there. In my circle, delivering at GW is code for “I have a doula, I am hoping for a vaginal birth without pain meds but I’m not crunchy enough to home birth”.
Anonymous
Post 04/29/2019 15:01     Subject: Medstar WHC vs GW vs Sibley vs other?

Thanks for the updated info ladies!! I wanted to figure that out before deciding to haul my nausea-ridden self across town for the tour
Anonymous
Post 04/29/2019 14:15     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:Question about Sibley (new poster here)--some older posts indicated that you have to share a recovery room with another mom and baby, or pay $200/night for a private room. Is that still the case? I thought I'd read that all Sibley recovery rooms were private now but maybe I misunderstood?


I delivered at Sibley a month ago. All rooms are private now. Room sharing was from before they built the new building. It is pretty nice.
Anonymous
Post 04/29/2019 14:14     Subject: Medstar WHC vs GW vs Sibley vs other?

Anonymous wrote:Question about Sibley (new poster here)--some older posts indicated that you have to share a recovery room with another mom and baby, or pay $200/night for a private room. Is that still the case? I thought I'd read that all Sibley recovery rooms were private now but maybe I misunderstood?


That’s old info. All rooms are private (and beautiful...I had a two room suite).
Anonymous
Post 04/29/2019 13:46     Subject: Medstar WHC vs GW vs Sibley vs other?

Question about Sibley (new poster here)--some older posts indicated that you have to share a recovery room with another mom and baby, or pay $200/night for a private room. Is that still the case? I thought I'd read that all Sibley recovery rooms were private now but maybe I misunderstood?