Ask Yo Mama- Where should I give birth?

askyomama Dear Yo Mama,

 As you know, our baby catcher’s practice just closed. We were thinking of another hospital based midwifery practice, but discovered that the hospital has a higher C-section rate than we are comfortable with.

 You come across as an expert in this area, and we would like to ask you what you would do if you were in our place. We’re considering a Freestanding Birth Center, but it’s expensive and may not be covered by our insurance — however, we may look into insurance options if it seems like the right path. Home birth feelss scary to us, but making a decision based on fear isn’t always the best one.

Would you mind providing us with advice? We’re just lost on what to do.

Sincerely,

Belly without a Baby Catcher

 

Dear Belly,

I’m so glad you reached out to me!

It’s a hot topic right now, with so many feeling ‘lost’.  And midwives and doctors are human- sometimes something changes that forces them to not be able to carry out their original commitment to ‘catch’ your baby.  Choosing a care provider (and birth place) is tricky– it’s a little like dating- which is not very fun-  but if you use the same feelings of ‘chemistry’ along with some good research, you can find your way to a choice that fits your family.

I think the first thing to consider is where both you and your partner will feel the most safe.  With choices like whether or not to use an epidural- you, as mama, get 100% of that vote.  With birth place, I would say it’s 60% (mama)/40% partner.  both of you need to feel that it is a safe place for you and baby.  Since you have to push a baby out that day, you get an extra 10% of the vote.

Safety can be found in different ways.  For some, it is knowing that every possible medical intervention is at your fingertips.  For others, it could be knowing that the medical interventions are as far away as possible, or at least used as a last resort.  For many, it can be knowing that they feel at home with the environment- smells, sight, and feel of the place.  Looking at cesarean birth rates is one important factor for sure.  Most hospitals, nationwide are around 33%, which is shocking, but true.  So you want to look at individual practices within each hospital (Nurse midwife practices tend to be more like 10-20%).  Out of hospital birth centers tend to be 6% or even lower (Ina May’s center is 1.5%- but that’s a long drive to Tennessee).  You are in a good birth class, and preparing yourself with good tools, so you should be in a good position to avoid a Cesarean birth (see my post:  3 most important things you can do to Have a Great birth)

It’s also super important to consider the care provider or team you’d be working with.

And I tend to go both for the letters by their name as well as the ‘gut instinct’   I would ask yourself the following two questions after you meet with a care provider:

  1. would I go on a road trip with this person?
  2. would I go into a one-stall bathroom with this person?

Birth is long and winding like a road trip, and as intimate as any bathroom event you’ve had so far.  If you couldn’t imagine taking your pants off in front of someone- they might not be the right fit for your birth.

Freestanding Birth Centers can be a wonderful option.  You have Certified Nurse Midwives, and a beautiful facility, and medical interventions are truly a last resort.  Home birth can also be great, but is not for everyone.  I think some of the pluses are:  not having to drive while in labor, the postpartum care is extraordinary, and you’re in your ‘own space.’  And for any higher-risk pregnancies, or those that feel the ‘safety net’ of medical intervention should be close by for any reason, a Hospital based midwife or OB practice is usually the best way to go.

I would meet with individual care providers and feel into how you could imagine your birth experience with each of them.  Ask all the questions you want, listen to the answers.  And then listen to your inner answer.  Your belly will know.

Thanks again for reaching out!

All the best,

Yo Mama

 

ASK YO MAMA welcomes your letters and questions- please email katie@yomamayoga.com with ASK YO MAMA in the subject line.  We will edit your letters and respond on the blog.  We respond to as many as we can.

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