Do You Really HAVE to Deliver in a Hospital Setting ??

Basically you can do whatever you want but you need to think about a few things.
1. You are 40. This puts you at a higher risk during delivery.
2. Complications can be fatal to you and your baby.
3. You are only poked and prodded while you are in labor because they staff needs to monitor your condition. Trust me, they'd rather be sitting behind the desk having a cup of coffee.
4. Your obstetrician is not going to do a C-section unless it is absolutely necessary. They are not more interested in golf than your baby.
5. You CHOSE your obstetrician. If you think he's going to be running off, change docs.
6. They don't scream at you to push if you listen to them and do what they tell you.
7. When things happen during labor, wouldn't you rather be in the hospital where they have all the tools to fix any issues??
8. My #1 was a meconium baby - he pooped before he delivered. This sounds benign, but if he breathed in the poo, he could have serious problems. There were more white coated staff in my room than you could shake a stick at. I was very happy to have all those docs there to make sure he was healthy and safe.
So - you may want to put up with all that knowledge and experience and that poking and prodding... I'm just sayin'.
YMMV
LBC

Congratulations K.. I had my only child at 43 (a son) who is now 4. I am so grateful I could have this child. It is a life changing miracle - so enjoy every second of your pregnancy. Getting pregnant at 42 after a long time trying - I had an "ideal" of what I wanted my pregnancy and delivery to be. I wanted to do it without meds. I wanted to be in control of every step with my husband an sctive participant and really be instumental in bringing this baby into the world my way. At 6 months I had gestational diabetes. I can't tell you how angry I was - I was doing everything right - how could this happen? Well - my age and the fact that I have PCOS pretty much guaranteed I would get it eventhough I was on a great food plan and exercise regime. I was fit and didn't gain alot - a very healthy weight for pregnancy. So we took our birthing classes, prepared fo things like how to avoid an episiotomy, wrote out a birth plan - met other Dr's in my Dr's group just in case. And THEN - because of the diabetes (though controled by diet)- my Dr INSISTED that I be induced. I fought her like crazy - I was so very bummed the day I was scheduled to check in. I wanted my son to come when HE was ready. And I just felt like they had the date wrong and I was 2 weeks from being due. So inducing was making me unhappy. But I figured she was the trained professional and for my son's health I just needed to suck it up and listen to her. I AM GLAD I DID !!! She was right. He was born over 9 lbs. And because I had listened to her - I was still able to have a vaginal birth. Because she listened to our birth plan we avoided an episiotomy and suction machines. And though I originally didn't want an epidural - I was glad I was in a hospital and asked for it in time for it to be administered. Ptosin makes for painful constractions so I was grateful for something to take off the edge. Then I was relaxed through the day so I'd have energy to do my job once the pushing part came.

So I look back and realize it was the right thing to let go of my "idealized" delvery plan for the health of my son. If I had not listened and waited he would have been so big that I have no doubt I'd have been into a C-section or some complication due to his size. And in restrospect - that day is not what I remember anyway - it's every moment since then since he was born and having him in our lives. I'm just glad he is healthy and was not traumatized during delivery. My 2 cents - hope it helps! Blessings, S.

There are so many responses already and I just don't have the patience to read through all of them. Your concerns are valid & legitimate. I can't promise that you're a candidate for a home birth, but it can't hurt to check.
http://www.RichmondMidwife.com the midwives here are excellent, there's Kim, Jo & Glenda. If you're not a candidate for a home birth they will recommend a wonderful, low tech OB they work with.
Best wished & congratulations :)

Having had two children, nothing in the world can prepare you for how much you will love your child. No matter how you feel now, it will intensify 100-fold. My opinion is that no matter how small the risk is, I would want the back-up of a hospital setting to protect my child.

I know some people believe that a home birth IS healther and safer. Complication rates often seem less because hospitals get women with a vast array of complicating issues. Home births are usually healthy mothers and normal pregnancies. This does not mean a there is not risk. In delivery, seconds matter, and an ambuilance ride may be too long.

I consider myself to be in charge of my child's welfate and my own body. And at the hosptial I called the shots. But I use the medical expertise of others I don't have. Yes, women have been delievering for thousands of years at home, and yes, we are gifted to be able to do so without anyone's assistence. But not without risk. And unless you never take a Tylenol or never have a pap smear, then I don't think you can claim that medical monitoring and intervention is unecessary or harmful.

What I think is critical is informing yourself about the labor and delivery process, and finding a doctor/midwife/hospital who is a partner with you in the process. Educate yourself on labor coaching, doulas and midwifery, infection, complication rates, etc. If you feel like your doctor will scream at you and cut you open, then you haven't picked the right doctor or midwife. Search for a birthing center and consider using a doula (a coach in addition to your partner), but I urge you to not dismiss medical care because it is trendy or sounds more natural. Anyway you deliver is natural because it is you who did all the work.

The way I see it, this is the start of caregiving for your child. Your child has to come first, and you need to make this the beginning of being vocal and assertive with the medical community in having the birth you want. But I can't imagine risking my child and myself (my children's mother) when it could have been prevented because I wanted the experience to be a certain way. I had two vaginal deliveries in a hospital with epidurals (eventually) and I had a happy wonderful experience. One daughter had pressure on her cord at the end stages of pusing. My second daughter had heartrate fluctuationsearly in labor. Both were concerning, and I am thrilled they were monitoring, but no intervention occurred. They just knew what was going on and that was comforting.

Whatever way you choose, good luck. Motherhood is the greatest joy. In terms of getting ready, I found the "Grirlfriends Guides" really helpful. And later in your pregnancy, start reading "Healthy Sleep Habits of a Happy Child" and "Happiest Baby on the Block." Also, if you plan to breastfeed, start interviewing lactation consultants. Having a good LC on call in the weeks after birth is soooo helpful.

Congratulations, 40 is a great time to have a baby.

Although it is very hip to have your baby elsewhere, in the rare event that something went wrong, the hospital is the place to be. I my opinion, I would not be able to live with myself if something went wrong and I didn't do everything possible to ensure the safety of my child. If you don't want a drug, tell the hospital not to give you that drug. It may not be as sweet as a home birth, but your going to have this child forever. What's a day or two in the hospital?

I wanted a 100% natural childbirth with no meds at all, but because of my medical background and knowledge I decided to deliver in the hospital just in case, but still stick to my birthing plan. My first pregnancy was perfect from conception to delivery. However my second pregnancy was perfect until my son inhaled merconium (the first bowel movement) during delivery. Up until this point in time both the baby and myself were fine. Luckily my being in the hospital allowed the doctors to suction, give him oxygen and immediately place him in the incubator and give him antibiotics. He only had to reamian in the hospital for a week, which seemed like a month. This experience made me think about how lucky I was to be in the hospital so he could get the best immediate care. I was told that if I had delivered at home he would of had to be rushed to the hospital and possible had some mild brain damage due to oxygen deprivation. Everybody's experiences are different however even a healthy pregnancy can require medical care during and after delivery. Ask your doctor questions, do your research and decide what is best for you an your son.

Take Care,
F.

Someone below said, "If there are no foreseeable complications" you can deliver outside a hospital. But birth complications can happen in a second, even if the birth is wholly without epidural, c-section, etc. It's not just medical interventions that cause complications, as someone claimed. A cord can wrap around a baby's neck at the very last moment as the child's emerging, or the baby can inhale meconium as someone noted. And though some have said "don't assume you're high-risk because you're 40!" the fact is your pregnancy may be considered high risk based on your age no matter how terrifically healthy you are, and insurance may not cover anything but a hospital setting.

I think you could consider finding a doctor who has some choice of hospitals for you (not always doable) and hospitals that let you tour them first. I fortunately had a choice of hospitals and chose Alexandria Hospital over Fairfax because Alex. was smaller, more intimate, and felt less "clinical" in the delivery rooms. Write a detailed birth plan and ensure your doctor has it and that you carry it to the hospital; this covers things like your stated request not to have meds, to have the baby breastfeeding as soon as possible, etc. (But it's not some legally binding document -- If something goes wrong you may have to have last-second meds, be aware of that.) And it's very important if at all possible to have the same doctor through pregnancy and childbirth -- I had one friend who had to see SEVEN different docs at the practice through her pregnancy "just in case, because whichever one of us is on call will deliver the baby." I had one doctor during pregnancy and she delivered the baby, so it was much, much more encouraging than having some stranger doing it.

I know people have had great home-birth experiences but I personally wouldn't take the risk -- that's me. Also, recently on one of the news shows, I think on NBC's Today show or another NBC show, there was a report about a couple suing a prominent midwifery practice for letting the home-birth labor go on for four days. Needless to say the outcome was tragic. I'm not saying that's common but you might want to search NBC's web site for that report as it talked about midwifery versus hospital births and did seem to give opinions on both sides.

K.-
In direct answer to your question about having to deliver in a hospital, no you do not HAVE to. However, you need to think about what could be done outside of a hospital-setting if you have complications during delivery. As you are an older first-time mom, you have a higher chance of having complications. Also, you are still pretty early in your pregnancy; any one of a number of things could happen between now and D-Day that could make having the baby in a hospital setting much safer.

Let me tell you a bit about myself. I found out I was pregnant last September, 3 days after my 35th birthday. My husband and I were thrilled and stunned. I had my first OB appt on October 6. I told her about my hypothyroidism. She was fine with that, it can be monitored and controlled during pregancy. I knew that I was still a high-risk patient, though, due to my age age and this condition. My pregnancy progressed beautifully, no complications, no nausea/morning sickness. At 28 weeks I was diagnosed w/gestational diabetes. This changed everything. I had to follow a strict diabetic diet and I ended up having to give myself insulin at dinner and before bed to control my sugar levels. BTW, I am not and was not diabetic in my "regular" life. GD can cause problems w/the mom and the baby if it is not strictly controlled. My OB decided to induce me at 39 weeks because of the GD. I was really excited about this; I was ready to not be pregnant anymore. The induction took 24 hours and I was not dialated at that time but I was contracting, so I was put on pitocin to induce labor. I also had an IV w/insulin and carbohydrates to keep my blood sugar level. I was on pitocin for 24 more hours before I was fully dialated to deliver. Then I pushed for 3 hours until my son was born. Turns out, the cord was wrapped around his neck. He was white as snow when he was born because oxygen had been cut off. And his blood sugar plummeted after the cord was cut. He did not cry for 7 minutes after birth because his lungs were filled w/fluid, then he needed to be given formula immediately to raise, and stabilize, his blood sugar.

I have a very happy and healthy 3.5 month old son, and to look at him you would never know that he was really traumatized when he was born. But if I had not had him in a hospital, I hate to think about what may have happened. You never know what assistance, expertise, you're going to need at delivery until you're in the midst of it. I had a very easy pregnancy, but for the diabetes, and the delivery was very difficult.

I understand fully your aversion to being poked and prodded by the doctors and nurses, but it really is a small price to pay in order to have a healthy baby. BTW, I was in the hospital for 4 days and couldn't wait to leave!

I know that this is a long entry, but I really hope that you will strongly reconsider having your baby at a hospital. I hope the best for you, baby's daddy and your baby.

K. in Maryland, USA

I am so glad you posted this question. Of course you have choices!

Let me begin by dispelling the myth that just because you are 40 that you are a "high risk". If you are a healthy woman, you can have a healthy pregnancy, and you also have the right to make a decision that is best for you and your baby when it comes to your pregnancy and birth.

Most births are simple and uncomplicated. Medical intervention is the NUMBER ONE cause of complications in birth (in other words, once your doctor "gets the ball rolling" with one intervention, others are bound to follow).

Our area is rich with options for birth center and home birth. We have a wonderful selection of professional, nurse and certified midwives at our disposal. I would highly recommend that you join the yahoo group http://health.groups.yahoo.com/group/NoVahomebirth/ to learn more about your options. Also, depending on your location, join a Birth Matters group (http://www.birthmattersva.org/). These two resources will be fantastic for you.

Best of luck and I hope you can join the ranks of those of us who have been profoundly changed by our amazing out of hospital births!

Hi K.-
I was also pregnant for the first time at forty. It was one of the best experiences of my life and it can be for you, too. The first thing I did was find a female obstetrician (OB) or you can find a midwife in your area. I did not use a midwife and I did not opt to deliver in a birthing center as opposed to a hospital because I was 40 and that is considered high risk.I just didn't want to take a chance. My OB was not like your description above, rather, she was a kind and caring person who really listened to me. I interviewed several before I picked her. That was the first step. The next step was to get CVI or Chorionic Villi Sampling. This is done much earlier that an amniocentesis and will let you know in the first trimester if there are any problems. Once I was given a clean bill of health, I first breathed a sigh of relief and then concentrated on nutrition and exercise and birthing classes. I got on a mommy blog so I could talk to other moms and get advice...etc. I ended up working until the due date. That morning, my water broke and I was off to the hospital. In the end, I gave birth to a beautiful little girl in a birthing room in the hospital which was very much like a regular private hospital room. My husband even had a place to sleep when he wasn't helping me breathe. I also documented my experience with a journal and pictures. My daughter, who just turned 16, often looks at it to this day. Best of Luck! D.

No, you don't! Here are some other books to read - just to give you some ideas about a different kind of birth experience:

Ina May's Guide to Childbirth by Ina May Gaskin (she's a midwife who runs a birthing center "the Farm" in Tennessee and she provides personal accounts of births and discusses natural childbirth vs. medicalized childbirth).

Natural Childbirth the Bradley Way, by Susan McCutcheon. While we didn't do Bradley because my husband didn't want to be my labor coach (and good thing, too, because he was a real emotional mess during our delivery - that was beautiful, but he was too busy having his own experience to help me). But, the book does a great job of explaining what to expect in pregnancy and childbirth and gives you a different perspective.

Gentle Birth Choices by Barbara Harper, R.N. who advocates water birth. I didn't do this either, but found it helpful to get a wide variety of perspectives and choices before making my own decision.

I also recommend What to Expect when you are Expecting. It's a general information book with lots of great info about pregnancy.

I also recommend you talk to and interview some doulas no matter what kind of birth you are considering. Doulas are non-medical assistants - there to support the mother, the father. Mine really helped a lot with pain management, focus, and helping me communicate with my midwife.

You might also check out information on Attachment Parenting. It's a gentle and natural way of parenting. Dr. William Sears and his wife MArtha have authored a book on the subject. There's also an organization Attachment Parenting International. You can find more info at their website: www.attachmentparenting.org. I think with your Native American roots and your desire to have an alternative to medicalized birth, you may also wish to have an alternative to mainstream parenting.

I had my baby naturally - vaginally, no epidural, no episiotomy, no induction, not even an IV. I was 41 years old. I had a midwife in attendance and a doula and my husband who understood what I wanted and helped make it happen. I had to deliver in a hospital because our insurance wouldn't pay otherwise and we didn't have the money. Also, there were no birthing centers nearby (and my husband was nervous about me delivering at home).

There are plenty of options as long as you have no serious medical issues. Do the research and go with your heart.

If there are no foreseeable complications, you can deliver your baby at home. There are about 6 billion people on the planet and a large percentage of them were not born in a hospital. I'm not sure what you'd do with the placenta/cord after a home birth but there must be ways of dealing with it. I'm also not sure you'll be able to get an epideral at home. Personally I considered the anesthesiologist my best friend during my 36 hour labor. Some people go in for the natural birth thing and that's fine. I figure a tooth ache is natural too and I don't know anyone who'd get a cavity filled without some kind of pain management. I get the impression you are panicking. I'd start with buying a book "What to Expect When You are Expecting". A very well thought out book which will answer a lot of questions. You've got the pregnancy and the birth to get through, but don't forget you'll be a Mommy when this is all over and a little life will be depending on you. It's wonderful and a bit scary all at the same time.

You do not have to deliver in a hospital setting. There are great birthing centers around here where a midwife takes care of your prenatal checkups and delivers the baby. Then a few hours later you can go home with your child. They are also associated iwth hospitals so that if anything does go wrong you can be quickly admitted and taken care of. THis is the web address of one birthing center that my friend used. http://www.birthcare.org/ she had a wonderful experience. I wish that I had had my frist at a birthing center instead of the hospital. I could have avoided a c section that way.

Hi K.,

Congratulations on your pregnancy! It's completely normal to be nervous now - pregnancy and childbirth are pretty major events and change life drastically. Don't WORRY though...millions of moms aren't lying when they say having a child is more wonderful than they could have imagined. Resting, relaxing, trusting your body and your intuition, and enjoying this time are probably some of the best things for you and the baby right now.

Educate yourself! It's not too early to take a childbirth class (or two!). They offer short sessions at hospitals and longer classes privately. If you want to try for a pain medication free birth (or just get a thorough overview of what to expect) you might want to look up Bradley method classes. They are 12 week courses that cover everything from where to give birth, what happens in labor, to breastfeeding, to what to eat during and after pregnancy, to preparing for the baby, and relaxation exercises. In most settings you'll be in a group of other expecting couples which also helps serve as a support group.

Education is key. You'll feel more relaxed, ready, and empowered if you know all the scenarios, options, and possibilities. Best wishes!

Dear K., I had a baby at age 38 in a birth center. I really wanted to be drug free. However, I did make sure a hospital was ten minutes away. My baby did need antibiotics (which means he was in the NICU for 7 days). So this meant I was at the hospital 24/7 after three days of labor, with no room, no rest, etc.

On the other hand, it is almost certain the hospital would have steered me toward a caesarean because of the long labor, etc.

If you go to the hospital, have a midwife attending and a doula (your boyfriend can't do it all). I was at a friend's birth at a birth center in a hospital and it was beautiful. And we were able to talk her out of the drugs when it got painful. A good friend and/or a doula will help you stick to your birth plan.

I see you are part Native American. You should have Blessing Way! I played the tape from my Blessing Way all during the birth (my friends are great singers), and my midwife loved it so much she asked for a copy. Good luck!

Hi K.,

No you don't have to deliver in a hospital setting, but you should consider all your options before making a decision. Plenty of people have had babies safely at home, in a birthing center, or in a hospital. I had my first in a hospital and did feel sort of poked and prodded, although I was able to have a successful natural, vaginal birth. I am planning on having my second baby at a free-standing birth center in Annapolis called Special Beginnings. I highly recommend them. They have 4 certified nurse-midwives and an OB/GYN on staff and you can deliver at the birthing center (assuming you are low risk) or at Anne Arundel Medical Center with them in attendance. Anyhow, I don't know where you live in MD, but if you decide to look into the birth center/midwife option there are at least 4 birthing centers in the MD/DC/VA area that I know of. Here are a list of them and their websites:

1.) Special Beginnings (Annapolis, MD): http://specialbeginnings.reachlocal.net/index.html

2.) Bay Area Midwives (Annapolis, MD):
http://www.bayareamidwifery.com/home

3.) DC Developing Families Center (Wash DC): http://www.developingfamilies.org/dcbc.html

4.) Birthcare & Women's Health (Alexandria, VA):
http://www.birthcare.org/

Good luck choosing!
M.

First relax! At your age and this being your first delivery you should be at the hospital. So many things can go wrong so quickly that it is better to be safe. Have faith in your doctor and discuss a birth plan. Be willing to change that birth plan should the need arrive. Not all doctors will do a c-section for convenience they will do one ONLY IF NECESSARY. You don't get poked the whole time either. With the sounds of anxiety level two days in the hospital could be a good thing so you can get comfortable with your baby BEFORE going home.

Not to scare you but just to show you how important a hospital can be. I recently had a friend, 28yo, first child who last minute decided to deliver at the hospital (she was going to try a home birth). Well that decision saved her and her sons life. Her placenta ruptured during the delivery and she almost bled to death in a matter of 2 minutes. If not for hospital, iv, and blood products her son would be motherless. Good luck.

Hi K.,

I had three awesome hospital births with incredible labor and delivery nurses, including a real sweet lady from Australia! I was given lots of caring, attention and given quiet time to rest and labor in a peaceful dim room. Two of my deliveries too a LONG time but the doctors were incredibly patient and did everything in their power to allow for a regular delivery and not go the c-section route. For me, I wouldn't change a thing. I know others who have had a birthing center birth and been happy too, so I wouldn't criticize that. I did however have a friend who was delivering for the first time (twins) at home with a mid-wife. Unexpected problems occured (and there are often "unexpected" problems with babies) and one of the twins died in childbirth. She had received very frequent prenatal care and there was nothing to predict this occuring. In her case, the baby could have been saved if they were in the hospital and had access to an operating room. But, again, I do know that is not the typical case.

NO you absolutely do not have to deliver in a hospital, but if you go to a doctor for your prenatal care (as opposed to a midwife, e.g.), s/he will probably insist on a hospital. Contact BirthCare Midwives in Alexandria, you can deliver at their birthing center or even at home (but contact them SOON- their dates fill up quickly!) I delivered both my babies in a hospital totally naturally with no interventions but if i had it to do over again i would do it at home. Also read The Thinking Woman's guide to a Better Birth by Henci Goer or anything by Ina Mae Gaskin. And take Bradley birthing classes to prepare yourself. Good luck!

Depending on your health insurance, it may be mandatory. A friend of mine was considering home birth but her insurance refused to cover any prenatal care and any possible complications with the birth if she didn't have the baby in the hospital. Of course, my question was "what if the baby is born in the car on the way, would nothing be covered then".

Hospital births are definitely the "preferred" method for many reasons. For one, many women don't realize they have other options. Also because it tends to be the safest way. Not to scare you, there can be complications that arise during labor and delivery or immediately following delivery that simply cannot be handled at home and that trip to the hospital could be the difference of life and death.

I educated myself by reading as many books and websites as I could. I also talked to anyone who was willing to talk in detail about their experience. Once in the hospital, I called the shots. If I didn't want things done a certain way, I let my wishes be known.

You can "shop around" to different hospitals, get experiences from others who have recently had babies. This may mean going to a different doctor, but that's a decision only you can make. Different hospitals offer different things. Some even have jacuzzi tubs in the rooms!

There are wonderful homebirth midwives in this area and a few birth centers that offer out of hospital options.
Please do not let the advanced maternal age myth dissuade you from having the birth of your dreams.
You can check out the Birth Options Alliance (BOA) yahoo group to find out all sorts of related info.
Not sure of what area you live near. I can provide referrals to midwives in your area.
L. M

try a midwife or a birthing clinic. although with being 40 many places may not take you but i'm sure someone will. many are even resorting to having their babies at home with or without help. i myself feel more comfortble having a baby in the hospital "just in case" and just make sure that i know what i do and dont want and read up or learn the facts so i know what i dont have to and can do bfore and after or during delivery even though they wont tell you.

Hi K.,
When did you have your sonogram? Was it just now at 13 weeks? If so, that is way way way too early to determine the sex of the baby. All babies look like boys at 13 weeks. This is why most physicians do the "determination of gender" at 18-20 weeks. I would suggest you get another sonogram a little later just confirm that it is a boy.

Sometimes Americans forget that having a baby is not an illness. I'm all for healthy prenatal care, but I think that in many circumstances, a stay of two days in the hospital after giving birth is not necessary for a normal vaginal delivery, a healthy baby and a mom who would rather be at home and has plenty of help.

I'm pregnant with my third child. For my first, I stayed 24 hours and got sick because... hospitals are full of germs. For my second, I stayed about 8 hours, and would have left earlier if the doctors and nurses hadn't been actively trying to scare me into staying.

This time around, as long as the baby and I are perfectly healthy, I'll probably stay about four hours. Long enough to rest a bit, and make sure I'm walking ok and that everything's working as it should with me, and long enough to have a pediatrician check out the baby.

The thing is, I've been taking care of infants my whole life, am surrounded by family who wants to help, and I have no qualms about going back to the hospital if anything I'm concerned about crops up.

The most important thing is your health and the health of your baby. Understanding that, it is up to you when you leave the hospital. Realize, however, that if you leave before your expected time is up, you will be leaving "against medical advice," and will have to sign yourself and your baby out. This is mainly because hospitals have to be cautious for insurance reasons.

Either way, just be smart and open and listen to everything the doctors and nurses tell you about your and your baby's condition. If there's any question in your mind, just wait. No level of homey comfort is worth endangering your family's health.

You don't HAVE too. Check out the home birthing midwives or birth centers. They will send someone to your home to deliver the baby if you are not a high risk pregnancy. I would highly recommend having a back up plan though, know where the closest hospital is and don't hesitate to go there if needed.

I really wanted to have a natural childbirth but things don't always go as planned. I can tell you that I was 23 when I delivered my first and I had a perfectly normal, healthy pregnancy. When I went into labor I spent 30 hours in labor and the baby went into distress at the end. His heart rate kept dropping with my contractions and they did an emergency c-section. As it turned out my son had the cord wrapped around his neck twice and he wasn't far enough into the birth canal for them to see what was going on or to unwrap the cord. At the moment when a staff of 8 came rushing in and and said, "we need to do this now" I was frightened and was so glad that I was in a place that they could get my son out within seconds and he was fine.

It is a very personal choice and I would encourage you to check out all of your options with all the details, in the end for me it just made more sense to have all the neccessary equipment and I am soooo glad they did.

NO!!! What area do you live in. You can have a wonderful homebirth or use a birthing center. My dd has homebirths. E-mail me and I can help you find a midwife in your area. Congratulations!!! : ) I am also native american (Choctaw) and Irish descent
L.
www.JennifersClothDiaperBoutique.com

Hi K.

You have a lot of responses and it's a topic many people feel strongly about. I thought I would share my experience since I have had 4 kids, the first 2 by more "conventional" methods, the most recent 2 by more "traditional" methods. I am a low risk pregnancy and am in good health. Babies born when I was 23, 26, 38 and 40.

The first baby was born in a hospital. Not a terrible experience, but not one I wanted to repeat. Episiotomy, hooked to IV, only ice allowed by mouth, no moving from bed during birth, dictated birthing position, baby was "delivered" (not caught), then baby was washed, tended and given shots by nurses and kept in a nursery until I requested him, lots of light, lots of noise, surrounded by strangers, photographed with a flash for a "keepsake." The whole business (and it IS a business) was not me and not comfortable.

Second baby was born in a birthing center. Labor started and progressed so quickly that the baby would have been born in the car since we arrived at the birth center well before the midwife, who then insisted I run up two flights of outside stairs half naked in the middle of the night (it was early March and very cold) to get to the birthing room which was unheated because it was the middle of the night. Midwife was ok, but a bit brusque and tended to all the details (generously allowed husband to cut the cord). Not so many interventions, baby still got eye drops and a vit k shot I didn't want (research has shown this can lead to excessive jaundice, which our baby DID have) Better birth but still not comfortable and not one I wanted to repeat.

Third baby we had prenatal care by a midwife and told her we wanted a husband-only assisted homebirth. MUCH, MUCH better birth. At home, in bedroom, very peaceful, very intimate, very joyous, husband helped prepare and did all the clean up. Uneventful birth although we were somewhat nervous.

Fourth baby was breech that did not turn. Local obstetrican offered to "turn" the baby but my instincts told me this was how the baby was meant to be. Turns out she had a very short umbilical cord and manually turning her would have been dangerous. Our prenatal midwife agreed to attend a home birth but I knew she would transfer us to hospital because of the liability issues she was facing. I labored in water in the dark bathroom alone (I prefer to be alone during labor so I didn't wake my husband). My husband woke up as the baby was emerging, got panicky and insisted I get out of the tub and turned on the lights. The contractions then slowed (think how hard it is to pee if someone were to burst in the bathroom) and the baby was half in/half out for a a couple minutes before being born. For breeches the danger in being partially born is that it puts pressure on the cord which limits oxygen transfer to the baby. This is why almost no obstetricians will allow a vaginal breech birth and very few even know how to attend one. Breech vaginal babies tend to have lower APGARs immediately after birth, but then APGAR normalize and the babies are fine. Our baby was born, breathed immediately and was fine. This may sound like an unacceptable risk, but you need to weigh it against the risks of C-section and hospital birth, which are not trivial. I know of at least 2 individuals who were severely harmed by hospital birthing/interventions. One mom (my stepsister) died, the other is a child who acquired a hospital-associated infection and was mentally disabled.

Bottom line is that the home births were preferable for me. We had ample time to make a decision about where to birth our breech baby. We did not encounter any sudden emergencies that we would have been unable to handle outside a hospital. The reality is that most emergencies occur with higher risk pregnancies which can be screened ahead of time. Other complications that develop during delivery are usually accompanied by warning signs that would indicate a hospital transfer. Examine how other countries (the Netherlands, for example) handle birth. Do your homework and learn as much as you can, but trust your instincts and respect your body and its ability to birth your child.

I've delivered twice at a hospital and never felt poked and prodded. Yes, I was hooked up to IV's and I was checked for progress, but other than that I was left to do my thing unless I asked for other assistance (pain meds, epidural, etc.). While pregnancy and giving birth are not illnesses (as stated by another responder) there is a very clear reason why infant and mother mortality rates have severely decreased since women started having babies in hospitals.

If your pregnancy goes along smoothly and there is no reason to believe that there would be any issues, have a midwife (if you can find one) take care of you. I have yet to meet a doctor who would cut you open to make a tee time. The assumption that doctors just do what's convenient for them when delivering your baby is one that is more lore than fact. I had two high risk pregnancies and for the first was induced and for the second, he came five days before I was scheduled to be induced. Neither time was to be convenient for the doctor. Both times were because my health and the baby's health was at risk if I continued due to blood clot issues, gestational diabetes, rapidly rising blood pressure.

Quite honestly, I had only one birthing plan: Go have a healthy baby and hopefully he came out the way he was "put in". :) Other than that, I knew I wanted meds (I know my own pain threshold) and that was it. Heck, for my second delivery, the doctor didn't even make it to the room in time. That's the other thing. While I know there are women who will labor for days on end, there are still others who will go into labor at noon and be napping with the baby before dinner time. You just don't know how it's going to be. Every woman is different, every pregnancy is different, every baby is different.

Where do you start? Talk to your doctor. Sit down with him or her and discuss your concerns. Let him or her know exactly how you'd like it to be. If you really think your doctor would do as you have stated, find another doctor. My doctor for my second child was pretty down to earth and asked me when I wanted to have my baby. I told him the date and he said, "Well, make sure you talk to God." :) Well, I did, and He and my son were the only ones who listened when I said he'd be born when he was born. :) The date I chose!

You can start with Calling the Midwifery @ depaul Hospital...THey are FABULOUS.....I had my 5th daughter there and it was such a wonderful experience....it's just like the comforts of home but you have the staff of the hospital there when needed....they will give you a tour of everything and answer your EVERY question...Blair and Nell are the greatest...my friend is set to deliver there next month with her 5th....I wish you the best and all with be fine just relax and enjoy your pregnancy....

Hi!
You definitely don't have to deliver in a hospital setting! I had both of my children at a birthing center (Special Beginnings in Annapolis). I'm not sure where you are coming from but there are two birthing centers in Annapolis, Special Beginnings and Bay Area Midwifery. I had a wonderful experience both times at Special Beginnings and know many people who have enjoyed Bay Area Midwifery. The fall back hospital (should you have a problem) for both is Anne Arundel Medical Center which has a great mom/ baby facilities and NICU.
If you are too far away from a birthing center to make that practical, you should consider using a midwife for your hospital delivery. It varies, but typically if you find a free-standing midwifery practice (as opposed to a OB/GYN that has a midwife or two) you'll find they will allow you to be the decision maker in what you want your birth to be like, even in a hospital setting.
If you have more detailed questions about my birthing center experience, please feel free to email me. Good luck!

Hi K.!

Congrats on your pregnancy! What an exciting time for you. As to answer your question, no, you don't have to deliver in a hospital but depending on the nature of your pregnancy, it may be the best option. Your doctor, or midwife, will help you to choose the best possible setting for the birth of your baby. You will be considered "high-risk" due to your age (I was too but I also had some other factors that determined I be monitored extremely close during my entire pregnacy and delivery) and a doctor would probably advocate for a hospital delivery. Some women have chosen to use midwives or birthing centers for a more relaxed approach that may appeal to you. As a side note, if you decide to use a traditional obstetrician, be choosy. I absolutely love my ob - he kept me relaxed during the birth of both my children - there was no yelling, only encouragement. My body was in charge of how things happened, not the doctor and I never felt he was put out when things were taking a while. There really are some great doctors out there who do put the needs of their patients first. Good luck in whatever you decide and may you have a smooth pregnancy!

K.

No, you do NOT have to birth your baby in a hospital, so long as you and your baby are healthy. I birthed my first son in a hospital, and it was only because I didn't know better. My second son was born here at home, and it was a beautiful, wonderful experience.

Please watch this short 'movie': http://vimeo.com/6182741

And check out this wonderful study that was published just last month: http://www.cmaj.ca/cgi/rapidpdf/cmaj.081869v1

Good luck to you with your decision!
M.

No you don't have to deliver your child at a hospital. There are still midwives around who will come to your home.

Of course not. Like others responded, though, it's sometimes reassuring to know you're in a hospital, just in case. Others recommended midwives. I know that's a great option, I just never had one with any of my 3 kids. I did, however, have a doula all three times. I wanted drug-free births, but was going to be delivering at Fairfax Hospital. From what I'd heard, FH didn't really do many natural births and the reputation was that it was a baby factory. But that was the closest hospital that my insurance covered. I was really concerned with having an epidural and then falling down that slippery slope towards a c-section - epidural slows labor, then they want to induce to pick-up the pace, then they go to c-section... With my first, I did have an epidural, and all of the poking, dropped-heart-beat-drama that comes with it. Still, it was a great experience. With my second two, I did it drug-free. My daughter came so quickly that I was barely in the bed - no IV, no fetal monitor, not even a hospital bracelet yet. With the third, I did have an IV for GBS and a fetal monitor on my stomach. They weren't really in the way, but I noticed them. It was an amazing birth - most of the 2-3 hours was just me and my doula (DH was walking the halls with the kids, too much for them!) working. No poking, no prodding. I knew when it was time and asked (OK, demanded!) for the doctor.

I agree that picking your doctor is key. I have Kaiser for insurance and each time just got the Kaiser OB on call at the hospital, I didn't know either of them before seeing them in the delivery room. It was great the 3rd time around - when I told the Dr that I wanted drug-free, she was really excited - said she really doesn't get to see that. She spent about 20 minutes in the room with me and the doula talking about what a doula does, how accupuncture can be used to start labor (my son was 4 day overdue and I'd gone in for accupunture about 36 hours earlier).

So, even with a litle intervention, a little poking, a hospital birth can still be a great one. I specifically DID NOT look into a birthing center for my 2nd or 3rd because I wanted the 48 hours of nursing/breastfeeding care that the hospital gives. I really relaxed and slept after my 3rd was born - kept him in the nursery at night, had nurses limit visitors.

K.-

Step 1- Relax and breathe! You and the baby need that. Pamper yourself a bit and enjoy being extra-special for a while.

I understand the extra stresses of being an older first-time mom. The options seem more limited for us because everyone wants to tell us about the higher risks (as if we needed to be reminded!).

If you and the baby are both healthy, try looking for a mid-wife who can deliver the baby in a birthing center or other calming location that would still give you quick access to a hospital if there is a problem. Consider a doula, too. I had my hubby and best friend both train as birthing coaches, but when the situation got complicated they both stood around looking helpless. I wish I had hired someone to take care of me while the medical staff focused on the baby.

Enjoy this little surprise :) He was just meant to be, and your concern for him already shows what a great mom you will be!

I had pretty typical hospital births--- however, I had a good friend who had a home birth. The midwife came to her house and had a couple of assistants pregnant. I think you just have to decide if you have any risk factors to consider in case you want a hospital--- my friend lived 5 minutes from our local hospital so it was nice knowing, if she needed it, she'd just have a short drive to get to a hospital.

I am an Land D nurse for over 20 years and I understand exactly what you are saying. Depending on where you live there may be a birthing center. Alos many people deliver at home. Just be sure to be near to a hospital in case an emergency develops(shoulder dystocia, hemorrhage, baby not responding well) I wish you all the best!!! I too am a widow who had a baby later in life(45)

I gave birth at home with an excellent midwife. I too didn't want to be poked and prodded. I wanted to give birth in a peaceful atmosphere without all the interventions - and I got it - at home! Research has shown that, unless you are high risk, it is just as safe and sometimes more so do birth at home. The more there is intervention in the birth process the more likely you are to end up with a C-section. I know many people who gave birth at home. Or there are birthing centers (I know of one in DC and one in VA) that you can go to. I know some people who birthed there and had wonderful experiences. There are alternatives to the hospital. By they way, my husband is a doctor and some doctor friends of mine also recommended that I birth at home (based upon my wishes for a natural, peaceful birth. They knew I couldn't get that at the hospital). You just have to do what is right for you and your baby regardless of what others may think.

You sure as heck don't. I had my last 2 babies at home. The 1st was a beautiful 3.5 hour labor from start to finish I was laughing singing dancing cleaning my kitchen putting my other kids to bed reading stories then having quiet time to myself. I really will say with that one I was soi tune with myself it really was free of pain. The secnd I was too wrapped up I think I. Trying to recreate that that itwas longer and different nt bad just more intense

I would never go the hospital route ever again unless I had a transverse baby that wouldn't turn etc. I did all my own prenatal work never felt that there was anything wrong with myself or my baby and just listened to him and my innervoice for reassurance on my path. If you want more info please contactme. I will say that 2 pregnancies free of poking and prodding were beautiful.

Hi K.,

First off...congratulations!!! I had my first at 36 and my second at 41 so welcome to the club of us 'advanced maternal age' moms :)

No, you absolutely do NOT have to deliver at a hospital. Many folks are choosing homebirths. Not sure where you are located but here in the Tidewater area we have some GREAT options. There is a Birthing Center at Depaul hospital where you can have the most AMAZING midwives attend your birth, their number is ###-###-####. just ask for an appt with a midwife. If you want a homebirth I would recommend Seven Cities Midwifery care, www.sevencitiesmidwifery.com. I am totally into birth, pregnancy, etc. If you want more info feel free to email me at ____@____.com.

Congrats again!
S.