SIL planning to use birthing center-should I say something or keep my mouth shut?

[goldenpig]

My SIL is newly pregnant with her first baby and is already blogging about it even before her first checkup (as in "hey, the pregnancy test is positive!"). No waiting for the 12-week mark to share the news--she's from the Gen Y Twitter crowd so everything is broadcast to the public in real time. She said that she is planning to give birth at a free-standing birthing center with midwives (she also looked at a hospital-based midwife practice). I think the reasons she listed was that it was cheaper, she got more personal attention during her tour, and that there is no option for an epidural so less chance for medical interventions. Her comments gave off somewhat of an anti-doctor vibe which as an MD is kind of offensive to me, but whatever. I think she said they do not do any fetal monitoring either. Frankly this is what has me a little worried. I know the chance of something going wrong is very low, but there is sometimes no way to predict when a problem is going to happen and sometimes you need to intervene fast and the potential for catastrophic outcomes (brain damage or death of baby or mom) is always there. Reading about sste's experience just drives that home for me. From their website it looks like less than 10% need to get transferred to the hospital but I don't know how far away that is. DD was a vacuum assist after not progressing past a 3 hour pushing phase and DS ended up having a double nuchal cord...he started to have some decels right at the end but came out quickly--if he had been my first I would probably have ended up needing a C. So I was very glad to be in a hospital setting, even though I am not a high risk mom. Plus I was happy to have my epidurals. I think every first time mom (myself included) thinks "Oh I don't need an epidural" until she's actually in labor. SIL could be in for a lot of pain from a long first labor...but that is a lesser issue to worry about. I'm mainly concerned about how they would know if there's a problem with the baby without any monitoring and how quickly can they get help if there is a sudden problem.

When my mom read her blog, she called me up begging me to convince SIL to change her mind and not go to the birthing center because she's worried about potential emergencies. I hate that my mom is asking me to talk to her...she also called me up when SIL posted on FB that she was planning to go skydiving. Thankfully she was OK and wasn't pregnant then! It's not my job to police SIL. My mom says "You're a doctor, she'll listen to you!" Yeah right...probably just the opposite. I feel like it's not really my business and she has the choice of what to do and is going to do whatever the hell she wants regardless of what I say. So I haven't said anything to her yet. But part of me feels like if I don't say anything and something bad happens, it'll be my fault for not warning her. I feel like if I do say something, I'll be seen as nosy/pushy and it may alienate her from me. OTOH, if I say my piece, at least whatever happens will be her responsibility. I don't think I will change her mind but at least I'll get it off my chest. WWYD--butt in or keep quiet?

BTW, as background to why this is bugging me so much--several years ago my mom's 2nd husband had some chronic medical problems and one Christmas everyone came over to our house and stepfather seemed a little shaky. DH and I told him to go to the ER and offered to take him but he refused saying he just needed to rest and would be fine. Later that day and the next I called him telling him to go to his doctor but he said he felt better. Then the next day he died suddenly at home. I felt guilty that I didn't try harder to force him go to the ER. Recently when my mom came to visit for DD's bday, she spent all weekend sleeping on the sofa instead of helping out or playing with the kids. I kept trying to get her to see a doctor but she said she was fine. Finally my sister and I gave her an ultimatum and said she could not get onto the plane to go back until she got checked out. Turns out she was dehydrated, hypotensive and had a kidney infection. So I feel like I have to intervene, and guilty when I don't.

[Canna]

Coming as someone who gave birth to #1 and #2 at home - I would say, sure talk to your SIL, but be sure to listen to what she has to say and be respectful of her. I had so many people tell me that I was either crazy or "brave" to have my kids at home. But I didn't feel that I was either. I knew what the research was about home birth, I knew that I would have not one but 2 very qualified nurse midwives with me at all times and I personally felt a lot more comfortable taking the risks associated with giving birth at home rather than the risks associated with giving birth in a hospital setting. Every birth involves risk. Everyone should have the opportunity to give birth in the setting and with the care givers that make that individual mom feel the most comfortable. Because being comfortable is going to allow her to relax and have a more successful birth experience.

Also, a birthing center is not as primitive as you may be imagining. Even my homebirth midwives arrived with IV set ups (in case they were needed, not a given), oxygen in case of emergency, pitocin in case of bleeding afterward, etc. Generally care givers in non-hospital setting are incredibly good at monitoring how their patients are doing. Even in the case of transfer to a hospital it is usually not due to an emergency, but just because the mom is tired and needs anesthesia, etc.

Your SIL will likely not be surprised to hear that you have reservations about her birth choices. She may be quite happy to address some of your concerns. If it seems that your conversation makes her uncomfortable or unhappy, just let it go. Understand that people make different choices and can legitimately want very different types of births.

ETA: You might be interested to know that my DH is a physician - though not an OB or anything close to that, he wanted no medical part in the birth, just a fatherly part :) - so it is very possible for someone from the medical community to feel comfortable with non-hospital birth.

[JBaxter]

I think you should stay out of it and keep your mouth shut. Its her body, baby and birth. Dont rain on HER parade because YOU have different views. I wish I would have had that option with my first.
I did have 4 hospital births but I think it is fantastic she has the mind set of a natural birth in a calmer setting

[JElaineB]

I would suggest that you get more information yourself about the birthing center before questioning your SIL's choice. Why don't you call yourself and ask the questions you have? You may be very satisfied with their answers and then you wouldn't need to create bad blood by interferring with your SIL's choices regarding her birth. I also don't think a male relative with a chronic illness should be compared to a healthy pregnant woman, so I do think your guilt over that is something you should not let affect the current situation.

ETA: I was high risk and had a very high intervention birth with DS, and I'm glad the technology was availalbe for him to arrive safely, but many many women do not need such services and a free standing birth center is an excellent choice for them. Also, to directly answer your question, I do think you should butt out and let your SIL make her own choices unless she asks you for advice directly.

[bcafe]

You need to be supportive of whatever decision she makes. It is her body, her baby, her birth. You have a medical background and honestly that does skew your viewpoint. Be happy for her!

[Beckylove]

I think that birth has turned into a political issue and some people need to insist on being "right" and everyone else is wrong. I get the feeling that this might be your SILs stance, so you are an establishment MD, thus your opinion can't be trusted. I think anything you say might make her inclined to do the opposite.

I would usually say to let her make her own choices. But your third paragraph has me second guessing myself. How is your relationship with your brother? Maybe talk to both of them. I guess I would approach it with an attitude that they need to choose what is right for them, but here is a list of questions that they should ask their midwife about. So, help them further educate themselves, and try as hard as you can not to push. The questions should include all the "what ifs"
how far to the hospital if needed?
How do they know if there are decels?
How do they handle a cord around the neck situation?
etc, etc.

Healthy babies and mommies happen everyday at birthing centers. I'd try to keep my personal thoughts out of it, and help provide them with the information and questions they need to make the healthiest decision for them. After that, you and your mom should butt out, as difficult as that can feel when you are genuinely concerned.

[♥ms.pacman♥]

When my mom read her blog, she called me up begging me to convince SIL to change her mind and not go to the birthing center because she's worried about potential emergencies. I hate that my mom is asking me to talk to her...she also called me up when SIL posted on FB that she was planning to go skydiving. Thankfully she was OK and wasn't pregnant then! It's not my job to police SIL. My mom says "You're a doctor, she'll listen to you!" Yeah right...probably just the opposite. I feel like it's not really my business and she has the choice of what to do and is going to do whatever the hell she wants regardless of what I say.

i think you said it yourself here. it's not your job to police her, and the fact that your mom is trying to get you to convince her on what type of birth to have seems extremely meddlesome. why is your mom more qualified than your SIL on what type of birth to have? i personally would feel really offended if family members kept questioning my choices on how i wanted to birth my own child and kept offering unsolicited advice. i think most of us here can agree that having a mother-in-law try to passive-aggressively butt in with unsolicited advice on parenting issues (birthing exp, breastfeeding vs. formula, etc) can make a pregnant/post-partum momma miserable.


You need to be supportive of whatever decision she makes. It is her body, her baby, her birth. You have a medical background and honestly that does skew your viewpoint. Be happy for her!

:yeahthat:

also, i don't see anything wrong with her announcing her pregnancy right away. the time when a pregnant woman decides to share the news with others is highly personal decision. i had a blog with pregnancy with DS in the early days after i found out, and i first shared it with only family then friends. i dont' see what's unusual about that. it's not like she doesn't know that miscarriage is a possibility at this stage.

[JBaxter]

:yeahthat:

also, i don't see anything wrong with her announcing her pregnancy right away. the time when a pregnant woman decides to share the news with others is highly personal decision. i had a blog with pregnancy with DS in the early days after i found out, and i first shared it with only family then friends. i dont' see what's unusual about that. it's not like she doesn't know that miscarriage is a possibility at this stage.

Im curious to why do you think its a bad thing to announce a pregnancy that early.

[Sillygirl]

Goldenpig, I'm sure as an MD you've learned to have selective deafness/ blindness outside of your professional life. If someone mentions the name of a prescription medication they're taking in passing, I then know their diagnosis - but I don't act on that and try my best to forget it, unless they discuss it with me explicitly. People relate medical stories and by reading between the lines, I can tell a lot more than they think they're expressing, but again, I just let run in one ear and out the other. When I see my patients in the grocery store and the cart loaded with chips and soda, I smile if they smile and don't mention the cart (although they often do!) After enough years at this job you develop some super-sensitive senses to things, and every MD I've known (that wasn't a total weirdo) has learned to tone those down in social settings.

So, if your SIL asks you, by all means give your reasoned opinion about birthing centers. Until then, I would keep quiet.

[wellyes]

I know it's hard to bite your tongue, but in this case, she's not doing anything wrong. Don't insert drama into a positive situation. Just be happy for her.

[nov04]

I think you have very good intentions and I hope I come across as just the same.

I planned on a midwife/birthing centre birth for dd1 from the beginning. Over the course of months, we realized that my pg was high risk and we preferred the care of an OB and a hospital that was close by.

The pressure I got from family and most from close family members, a nurse an OB themselves included was not pleasant at all. In fact, it still affects my relationship with them, although I don't think they know it. It felt like the judgments were being made before all the information was in. Once we knew the pg was high-risk, we made the appropriate choices, but when my pg was not, we evolved.

I still vividly remember pacing the floor in labour and being asked when we were going to fire our doula. when we politely declined between contractions, we were told that we had more money than brains. I'm not saying you would be so blunt, but that was the icing on the cake, so many other subtle things.

I can understand there are some underlying issues as a result of your stepfather's death. But I think there's no connection at all between the two situations.

[egoldber]

I think you should keep your mouth shut.

Birth centers, in general, are if anything too cautious in the patients they will accept. They have very strict guidelines about the types of patients they will see and are quick to risk a patient out when problems arise.

And there are simply no guarantees in birth or in life. Terrible things sometimes happen. Being in a hospital in no guarantee of a safe birth and a happy outcome.

[goldenpig]

Im curious to why do you think its a bad thing to announce a pregnancy that early.

I don't think it's necessarily bad (I announced mine to family at 8 weeks both times, over the objection of DH who wanted to keep things quiet till 12 weeks). Just providing some background as to the way she communicates and why I know so much about her choices so early on (she lives in another state and we rarely talk--the only reason I know what's happening in her life is from Facebook and this blog).

I totally get that this is her pregnancy and her body. That's why I haven't said anything to her and I'm not looking to change her mind at all. But I feel like if I don't say anything I'm going to be worrying this whole time about what's going to happen during delivery, and if I at least talk with her about it that I'll feel better that I said something, and relax and enjoy her pregnancy with her.

[sunshine873]

I think that birth has turned into a political issue and some people need to insist on being "right" and everyone else is wrong. I get the feeling that this might be your SILs stance, so you are an establishment MD, thus your opinion can't be trusted. I think anything you say might make her inclined to do the opposite.

I would usually say to let her make her own choices. But your third paragraph has me second guessing myself. How is your relationship with your brother? Maybe talk to both of them. I guess I would approach it with an attitude that they need to choose what is right for them, but here is a list of questions that they should ask their midwife about. So, help them further educate themselves, and try as hard as you can not to push. The questions should include all the "what ifs"
how far to the hospital if needed?
How do they know if there are decels?
How do they handle a cord around the neck situation?
etc, etc.

Healthy babies and mommies happen everyday at birthing centers. I'd try to keep my personal thoughts out of it, and help provide them with the information and questions they need to make the healthiest decision for them. After that, you and your mom should butt out, as difficult as that can feel when you are genuinely concerned.

:yeahthat: I'm all for a hospital birth, but it really is a personal decision. I like this idea of letting them know that you support whatever decision they make, but here are some good questions to ask, just so they can make sure the center they've chosen is well-qualified to handle any situation that may arise. You can be super-supportive of them, while saying your MD background, and your past experiences demand that you at least give them a little guidance. Beyond that, it's a perfectly acceptable way to have a baby and the only people that have to be comfortable with their choice is them. :)

[Lolabee]

My SIL is newly pregnant with her first baby and is already blogging about it even before her first checkup (as in "hey, the pregnancy test is positive!"). No waiting for the 12-week mark to share the news--she's from the Gen Y Twitter crowd so everything is broadcast to the public in real time. She said that she is planning to give birth at a free-standing birthing center with midwives (she also looked at a hospital-based midwife practice). I think the reasons she listed was that it was cheaper, she got more personal attention during her tour, and that there is no option for an epidural so less chance for medical interventions. Her comments gave off somewhat of an anti-doctor vibe which as an MD is kind of offensive to me, but whatever. I think she said they do not do any fetal monitoring either. Frankly this is what has me a little worried. I know the chance of something going wrong is very low, but there is sometimes no way to predict when a problem is going to happen and sometimes you need to intervene fast and the potential for catastrophic outcomes (brain damage or death of baby or mom) is always there. Reading about sste's experience just drives that home for me. From their website it looks like less than 10% need to get transferred to the hospital but I don't know how far away that is. DD was a vacuum assist after not progressing past a 3 hour pushing phase and DS ended up having a double nuchal cord...he started to have some decels right at the end but came out quickly--if he had been my first I would probably have ended up needing a C. So I was very glad to be in a hospital setting, even though I am not a high risk mom. Plus I was happy to have my epidurals. I think every first time mom (myself included) thinks "Oh I don't need an epidural" until she's actually in labor. SIL could be in for a lot of pain from a long first labor...but that is a lesser issue to worry about. I'm mainly concerned about how they would know if there's a problem with the baby without any monitoring and how quickly can they get help if there is a sudden problem.

Please take this in the kind manner in which it is intended, but I really think you need to butt out and let your SIL make her own decisions. I agree with the PP who pointed out that it's her body, her baby and thus her own personal birth experience.

I understand that many doctors have a positive opinion of the increasing medicalization of the birth experience. My own OB used to be much more like this when I first met him 10 years ago, thankfully he has since softened on this stance and was wonderfully supportive of my opting to go epi free during my most recent VBAC birth experience. If I had listened to the naysayers I would have unnecessarily subjected myself to another C-section, and I am so thankful that I stuck to my guns and had the birth experience I wanted. It's not necessarily anti-MD to eschew medical technology during the birth experience, it's simply a matter of weighing the pros and cons and making one's own medical decisions accordingly.

It's great that you loved your epi, I and many others I know hated our own experiences with them. (I had one during my first childbirth experience and I loathed everything about it. From the immobilizing effect of it, to the fact that it only worked on one side, and the length of time it took to wear off post delivery, oh and the fact that it is well documented that the placement of an epi can cause labor to stall in a small but still significant portion of the patient population who receive them. It certainly did in my own experience.) I also feel compelled to point out that the evidence in the current medical literature is still out on whether CFM has any positive effect on fetal demise outcomes during labor and delivery.

I agree generally with the medical community that the continuing advancement of technology is good for doctor and patient, but I don't necessarily agree that it's always a good thing during labor and delivery. Our nation's current C-section rate is generally acknowledged to be far too high these days, but I think it goes hand in hand with the movement away from trusting a woman's body to birth without a whole lot of medical interventions. I understand why you are concerned for your SIL, and why you might feel personally affronted by her current stance on how she wants to birth her baby. But I would really encourage you to step back a bit and leave her alone on this, and tell your Mom to back way off too or she's just going to cause a huge problem with her DIL in the process that may very well linger long after SIL delivers her baby.

[JBaxter]

I don't think it's necessarily bad (I announced mine to family at 8 weeks both times, over the objection of DH who wanted to keep things quiet till 12 weeks). Just providing some background as to the way she communicates and why I know so much about her choices so early on (she lives in another state and we rarely talk--the only reason I know what's happening in her life is from Facebook and this blog).

I totally get that this is her pregnancy and her body. That's why I haven't said anything to her and I'm not looking to change her mind at all. But I feel like if I don't say anything I'm going to be worrying this whole time about what's going to happen during delivery, and if I at least talk with her about it that I'll feel better that I said something, and relax and enjoy her pregnancy with her.

Women who choose birth centers and midwives do do research. Its kind of like when someone questions my vaccination choices. I know whats best for my family /body. Are you an OB/GYN?

[JElaineB]

I totally get that this is her pregnancy and her body. That's why I haven't said anything to her and I'm not looking to change her mind at all. But I feel like if I don't say anything I'm going to be worrying this whole time about what's going to happen during delivery, and if I at least talk with her about it that I'll feel better that I said something, and relax and enjoy her pregnancy with her.

Honestly this seems like a selfish statement - you want to risk pissing off your SIL just so you can relax while she is pregnant.

[Momof3Labs]

But I feel like if I don't say anything I'm going to be worrying this whole time about what's going to happen during delivery, and if I at least talk with her about it that I'll feel better that I said something, and relax and enjoy her pregnancy with her.

Huh? You need to talk to her about the awful things that could happen during her birth so that YOU can relax and enjoy her pregnancy with her? When you rarely see or speak to her? Why not let her handle her birth preparation in her own way so that SHE can relax and enjoy her pregnancy, and look forward to the birth of her first baby?

And BTW, I had an epidural with my first and HATED it. So much that I chose to have DS2 with no pain meds. And after experiencing it both ways, I really, really, really wanted to have my twin girls without any pain meds. But alas, baby A was breech and a vaginal birth was not an option.

[Smillow]

The pressure I got from family and most from close family members, a nurse an OB themselves included was not pleasant at all. In fact, it still affects my relationship with them, although I don't think they know it. It felt like the judgments were being made before all the information was in.

I think the bolded portion of nov04's post is important. Respecting someone's choices is important & comes up over & over & over in pregnancy & child rearing! I think it is more important to have a positive relationship with your SIL & future nieces & nephews than to micro-analyze the very personal choices she makes in her medical care. That way, she may feel comfortable coming to you with questions & concerns. I think it is important for people to seek their own influence & it doesn't work to force influence upon them.

[WolfpackMom]

I dont have any btdt, as many responding seem to, but I wanted to stick up for OP a little. I don't think she was posting in an effort to bash birthing centers or anyone on here's personal choice. I think she is concerned for her SIL's health, and that yes, her medical background does make her biased, but that doesnt mean she has a mean or bad intentions in her thinking or is trying to say doing things in any particular way is wrong.

I would not say anything to SIL, if she approaches you, then I would outline some of the questions she should ask the birthing center (how far is hospital, what rate the transfer, what emergency precautions do they take). Otherwise your feelings are just something you will have to deal with on your own because, in all honesty, what you say probably won't change her mind anyways if this is what she wants and its not worth harming your relationship with your SIL and brother. I understand why you are concerned though.

[niccig]

i think you said it yourself here. it's not your job to police her, and the fact that your mom is trying to get you to convince her on what type of birth to have seems extremely meddlesome. why is your mom more qualified than your SIL on what type of birth to have? i personally would feel really offended if family members kept questioning my choices on how i wanted to birth my own child and kept offering unsolicited advice. i think most of us here can agree that having a mother-in-law try to passive-aggressively butt in with unsolicited advice on parenting issues (birthing exp, breastfeeding vs. formula, etc) can make a pregnant/post-partum momma miserable.



:yeahthat:


It's her life, her body, her baby - she gets to decide and frankly other family membes who are not her spouse, should butt out - unless she asks for advice. My mother is b$tching about my cousins wife and choices they made during their pregnancy. My repsonse - it's their baby, they get to choose and why is my mother more suited to make that decision???

I do understand that you are concerned, but you need to tread very carefully here. Your concern could be taken as you knowing better than they do - and that is quickest way to alienate your SIL and brother. If your mother brings it up again, I would suggest you tell her the same - their choice and everyone else in the family needs to shut up, as they have no say in what antoher person does for their medical care or personal choices

[goldenpig]

Women who choose birth centers and midwives do do research. Its kind of like when someone questions my vaccination choices. I know whats best for my family /body. Are you an OB/GYN?

No, just a concerned relative. Seriously guys, if I said anything it would not be to attack her choices or try to get her to change her mind. I am doing my best to be supportive of her and my brother. I just want to discuss what would happen in case of emergency and how they would even know if there was a problem. Just as you can't guarantee a good outcome in a hospital and that medical intervention is not the be all and end all (yes I get that there can be complications from medical interventions), you cannot also guarantee that a low risk pregnancy is not going to have problems that arise at the last minute. I guess my anxiety over this is, I would feel so bad if the baby ended up dying or having brain damage from lack of oxygen from some undetected problem at delivery. Heck, I worried about this even though I was giving birth at a hospital. So I want to find out more about this birthing setup and hopefully that will put my mind at ease. Maybe you're right, I should just call the center myself.

[JBaxter]

No, just a concerned relative. Seriously guys, if I said anything it would not be to attack her choices or try to get her to change her mind. I am doing my best to be supportive of her and my brother. I just want to discuss what would happen in case of emergency and how they would even know if there was a problem. Just as you can't guarantee a good outcome in a hospital and that medical intervention is not the be all and end all (yes I get that there can be complications from medical interventions), you cannot also guarantee that a low risk pregnancy is not going to have problems that arise at the last minute. I guess my anxiety over this is, I would feel so bad if the baby ended up dying or having brain damage from lack of oxygen from some undetected problem at delivery. Heck, I worried about this even though I was giving birth at a hospital. So I want to find out more about this birthing setup and hopefully that will put my mind at ease. Maybe you're right, I should just call the center myself.

You can be quietly worried its just something YOU will have to deal with. But really it isnt any of your business unless she invites you into the discussion. Finding out about the birth center SHE chose isn't something you should do and would really tick me off and it may be a HIPPA violation if its done in concern for SIL and WOULD be over stepping YOUR bounds as a relative. Again .. her body her baby her life HER choice.

[BabyMine]

I don't think the problems stems from where your SIL gives birth but your guilt over your mom's 2nd DH. You asked him to go and he refused. You can not make someone do something against their will. Stop carrying the guilt around that if you had just forced him the outcome would be different. When M coded in the PICU I learned just how little power I have over situations. You are not responsible for his death and stop thinking "what if". You cannot stop bad things from happening to people becasue you might also stop good things. Please stop carrying the guilt :hug:. Yes you are an MD but you are also human.

[LBW]

I know you mean well, but I really do think you should stay out of it. I know that I would have been really annoyed, and possibly creeped out, if I found out a family member called the hospital or birthing center I was planning to use.

FWIW, I've given birth in a hospital with OB, in a hospital with a midwife, and at home with midwives. How a woman chooses to "manage" her pregnancy and birth is a very, very personal choice. Feel free to share your own personal experiences with her, but please don't tell her what YOU think about HER choices.

[liamsmom]

Birth centers, in general, are if anything too cautious in the patients they will accept. They have very strict guidelines about the types of patients they will see and are quick to risk a patient out when problems arise.

:yeahthat: Your SIL will most likely get all of the typical prenatal tests and if her labor is stalled or facing complications she will most likely be transferred to a hospital.

It sounds like you assume that she just nonchalantly decided to use a birthing center. I'm willing to bet that she has been doing her research for a while now, before she learned she was pregnant. Why are you assuming that she is ignorant of the risks of pregnancy and labor?

I can tell from your OP that you are struggling not to be judgmental, but you are judging her birthing choice and her choice to tell others about her pregnancy via her blog. Her decision to use a midwife, not an OB/GYN, is not about you! She is seeking the best care for herself. I'm sorry about your mother's husband, but you can't hold yourself responsible for the health/medical choices of your entire family. You will drive yourself crazy every time an issue comes up.

And consider this: How would you feel if your MIL and SIL told you when you were pregnant that they disagreed with your birth philosophy? If they had told you an epidural would lead to complications and you'd be better off with less interventions at a birthing center or birthing at home. No matter their good intentions, you'd find it intrusive and non-supportive.

[niccig]

No, just a concerned relative. Seriously guys, if I said anything it would not be to attack her choices or try to get her to change her mind. I am doing my best to be supportive of her and my brother. I just want to discuss what would happen in case of emergency and how they would even know if there was a problem. Just as you can't guarantee a good outcome in a hospital and that medical intervention is not the be all and end all (yes I get that there can be complications from medical interventions), you cannot also guarantee that a low risk pregnancy is not going to have problems that arise at the last minute. I guess my anxiety over this is, I would feel so bad if the baby ended up dying or having brain damage from lack of oxygen from some undetected problem at delivery. Heck, I worried about this even though I was giving birth at a hospital. So I want to find out more about this birthing setup and hopefully that will put my mind at ease. Maybe you're right, I should just call the center myself.


You're assuming that THEY have not done any of this. I get that you're concerned, but still if you were my SIL and called my birthing center, I wouldn't talk to you again for a LONG time.

I understand you feel guilty about not making your FIL go to the hospital - but this is not the same situation, your SIL is no presenting with any medical emergency - she's pregnant and she has decided to have a birth in a setting that is different to how you would do it.

Respect her decision. If you dont' like her decision, then that is YOUR issue and you need to deal with it without stepping all over her rights to make choices for herself.

[TwinFoxes]

OP, I understand that you're posting because you're concerned, not because you are bashing your SIL.

That being said, I think you need to not get involved at all. I think calling the birth center is a terrible idea frankly. I would be really insulted if I found you out you went behind my back to check up on my choices. It's like a sneak attack mommy drive by!

I'm someone who never considered giving birth outside of a hospital because I was high risk. But I think women should be allowed to make their own decisions without being second guessed.

[goldenpig]

I don't think the problems stems from where your SIL gives birth but your guilt over your mom's 2nd DH. You asked him to go and he refused. You can not make someone do something against their will. Stop carrying the guilt around that if you had just forced him the outcome would be different. When M coded in the PICU I learned just how little power I have over situations. You are not responsible for his death and stop thinking "what if". You cannot stop bad things from happening to people becasue you might also stop good things. Please stop carrying the guilt :hug:.

Thanks BabyMine & Wolfpack Mom for your kind words of support! And I appreciate everyone's input--but I am not bashing birthing centers or the people that choose them.

[egoldber]

I really do think this is about the guilt you are feeling and your general level of anxiety. I truly do mean this kindly. I would consider talking to someone about these feelings.

I don't think there is anything wrong with calling the birthing center and asking about their general policies. I would NOT say anything about SIL, just pretending to be a potential new patient with questions.

[Indianamom2]

I dont have any btdt, as many responding seem to, but I wanted to stick up for OP a little. I don't think she was posting in an effort to bash birthing centers or anyone on here's personal choice. I think she is concerned for her SIL's health, and that yes, her medical background does make her biased, but that doesnt mean she has a mean or bad intentions in her thinking or is trying to say doing things in any particular way is wrong.

I would not say anything to SIL, if she approaches you, then I would outline some of the questions she should ask the birthing center (how far is hospital, what rate the transfer, what emergency precautions do they take). Otherwise your feelings are just something you will have to deal with on your own because, in all honesty, what you say probably won't change her mind anyways if this is what she wants and its not worth harming your relationship with your SIL and brother. I understand why you are concerned though.


:yeahthat:


It must be hard to be a medical professional and know the "what ifs" and still maintain a balance of respect for the other person. I'm not sure I would be good at that. It's also really hard not to judge a situation based on how our own experiences color it.

I wouldn't question her choice or speak up. It's not your fault AT ALL if something happens, and the reality is that something equally bad could happen in a hospital setting. And that wouldn't be your fault either, but you'd probably feel just as guilty, kwim?

The "what ifs" can eat us alive, if we let them. :hug:

[goldenpig]

I can tell from your OP that you are struggling not to be judgmental, but you are judging her birthing choice and her choice to tell others about her pregnancy via her blog. Her decision to use a midwife, not an OB/GYN, is not about you! She is seeking the best care for herself. I'm sorry about your mother's husband, but you can't hold yourself responsible for the health/medical choices of your entire family. You will drive yourself crazy every time an issue comes up.

And consider this: How would you feel if your MIL and SIL told you when you were pregnant that they disagreed with your birth philosophy? If they had told you an epidural would lead to complications and you'd be better off with less interventions at a birthing center or birthing at home. No matter their good intentions, you'd find it intrusive and non-supportive.

I'm not judging her announcing her pregnancy by blog. I'm just saying that that's the only reason I know about any of this so early. My main form of communication with her & my brother and my youngest brother is via Facebook, that's just they way they work. Calling people is so last century to them. :ROTFLMAO:

OK, I agree that calling the birth center feels kind of weird to me so I probably won't do that. And personally, I don't care if she doesn't use an MD to give birth but I do want it to be as safe as possible.

[TwinFoxes]

Women who choose birth centers and midwives do do research. Its kind of like when someone questions my vaccination choices. I know whats best for my family /body.

This actually really hits home for me. I have a good relationship with MIL and SILs, except they always question decisions I've/we've made. Like I pull these decisions out of thin air without taking time to think/do research. This is everything from "still" rear facing DDs, to why I didn't let them watch TV until age 2. It really, really bugs me that they think their advise (which really is being pulled from thin air) should trump my research. OP, I know your advise is based on a medical background, but I have a feeling it will have the same effect on your SIL.

[niccig]

And personally, I don't care if she doesn't use an MD to give birth but I do want it to be as safe as possible.

And of course, she wants the same thing. No mother doesnt' want a safe birth!

It's is very arrogant for other family members to question another adult's choices. SIL/brother aren't children, they can decide for themselves. And it's time for your mother to let them do exactly that and not try to drag you into telling them what they should and shouldn't be doing.

I deal with this with my mother thinking she knows better than anyone else - her relationship with me and DS has suffered as she does not respect my decisions.

The best thing you could do for SIL/brother is to tell your mother that they are adults and can make their own decisions.

[brittone2]

I had a midwife attended hospital birth for my oldest, and actually I think that was likely a "riskier" birth in a few ways than my next two births. That particular midwife was on the more intervention happy side of things and it would not have surprised me to end up with unnecessary intervention that in itself carried risks.

My 2nd child was born at a freestanding birth center (after careful research of course. DH is a PhD chemist, I have my masters in physical therapy so it isn't like we aren't able to research and weigh it out for ourselves). 5 mins from a large university hospital with a high level NICU. The midwife staff was trained in neonatal resuscitation and they carry a large amount of equip that would be available in a hospital. There was also a team that could be sent via ambulance that was child/newborn specific. I knew their history, what they would transfer for, etc. They've been around a looooong time and have a long history of good outcomes.

WIth my 3rd I made the (researched!) choice to homebirth with a CNM who had done homebirths in a previous practice, then worked in a university hospital for a number of years, and then went back into solo practice. I was 30 mins from a hospital. I'm low risk, I read the studies, and it was well within my comfort level.

If asked, feel free to offer your opinion, but please realize she has likely done her own homework and feels this is an appropriate choice. She likely has plenty of research supporting her decision to back her up.

Not choosing to birth in a hospital doesn't mean she hasn't educated herself about her options/choices.

[Ceepa]

I think four pages of the same opinion gets the point across. I'll just say that I know you are concerned for your family members and mean well. You posted here first because you sense that your first instinct would carry you over the line of appropriate involvement.

It'll be OK.

[goldenpig]

And yeah, it sucks sometimes being in medicine. Knowing everything that could go wrong made me anxious about my own pregnancies. And whenever something health-related comes up in the family you feel like it's your responsibility to deal with it. When I was in medical school my father had back pain for several months and his DO (not that an MD would have done anything different necessarily) kept blowing him off and sending him to physical therapy. When he eventually had trouble walking, he finally got an Xray and it was metastatic cancer causing a vertebral fracture. We never figured out where the original cancer came from. He went through two years of treatment and eventually died. Many years after the fact it's hard to let go of the feeling that I should have been able to do more for him, even knowing there was not much that would have changed if we had picked it up earlier. I know it's not my fault but sometimes still feels like it is a little.

[niccig]

.
Many years after the fact it's hard to let go of the feeling that I should have been able to do more for him, even knowing there was not much that would have changed if we had picked it up earlier. I know it's not my fault but sometimes still feels like it is a little.

:hug: That's a heavy burden to carry. Is there someone YOU can speak with to discuss this. I think your SIL's situation is bringing all this up again. I hope you can find a way to deal with how you feel.

[Katigre]

Everyone else has made great points, I just wanted to address this:


I think she said they do not do any fetal monitoring either. Frankly this is what has me a little worried.
What your SIL likely meant was that the FSBC does not require *continues external fetal monitoring* (meaning you are attached to belts throughout your labor which has many con's for the mother laboring). Instead, they will check the baby's heartrate intermittently instead - most likely using a hand-held monitor. This means that the mother can be in any position and her baby's HR can be checked by the midwife instead of her having to climb into bed or remain in a fixed position so the belts don't slide. There is not compelling evidence that continuous monitoring saves lives - and there is quite a bit of evidence that it leads to higher rates of surgery and interventions for the mother and baby. It is not inherently riskier to to intermittent monitoring (and I believe doing so has many benefits for the laboring mother and baby). But obviously in certain circumstances of higher risk you need to do it (having an epidural is one such circumstance because the medication can affect mother's blood pressure and baby's heart rate). How/When to monitor heart rate in labor should be evaluated on a case-by-case basis which her midwives are well-trained in.

Here is one medical study that compared fetal outcomes with continuous vs. intermittent monitoring: http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1994.tb13181.x/abstract

Explanation of different monitoring pro's and con's: http://www.childbirth.org/articles/efmfaq.html

ACOG's statement on Continuous Fetal Monitoring: http://www.ourbodiesourblog.org/blog/2009/07/acog-issues-new-practice-bulletin-on-continuous-electronic-fetal-monitoring

If you are curious about the birth center you could google it and see what they say - most birth places have websites now. That might help set your mind at ease :).

[KrisM]

Women who choose birth centers and midwives do do research. Its kind of like when someone questions my vaccination choices. I know whats best for my family /body. Are you an OB/GYN?

I think a lot of women who choose a birth center with midwives actually do more research than average. The standard is to go to an OB, get an epidural, and take that 25% chance of a c-section. It's just "how it's done". I did a lot of research when choosing a midwife for my first birth. I did end up with a c-section, but I am confident that it was necessary and that I did all that I could to avoid it.

[liamsmom]

:hug: That's a heavy burden to carry. Is there someone YOU can speak with to discuss this. I think your SIL's situation is bringing all this up again. I hope you can find a way to deal with how you feel.

:yeahthat::yeahthat:I'm sorry, goldenpig. Pregnancies seem to have tendencies to remind people of their own trauma/issues. If you're reminded of your own deceased father and step-father, that's got to be terrible. I'm sure it doesn't help that your mother asks you to intervene.

I hope you find someone to talk to or a way on your own to deal with this problem. Because, your SIL's pregnancy aside, there will probably be many other occasions where you feel conflicted about speaking up. It never occurred to me that MDs are always MDs even when they are not at work. That has to be hard; you have my respect. :hug:

[goldenpig]

Everyone else has made great points, I just wanted to address this:


What your SIL likely meant was that the FSBC does not require *continues external fetal monitoring* (meaning you are attached to belts throughout your labor which has many con's for the mother laboring). Instead, they will check the baby's heartrate intermittently instead - most likely using a hand-held monitor. This means that the mother can be in any position and her baby's HR can be checked by the midwife instead of her having to climb into bed or remain in a fixed position so the belts don't slide. There is not compelling evidence that continuous monitoring saves lives - and there is quite a bit of evidence that it leads to higher rates of surgery and interventions for the mother and baby. It is not inherently riskier to to intermittent monitoring (and I believe doing so has many benefits for the laboring mother and baby). But obviously in certain circumstances of higher risk you need to do it (having an epidural is one such circumstance because the medication can affect mother's blood pressure and baby's heart rate). How/When to monitor heart rate in labor should be evaluated on a case-by-case basis which her midwives are well-trained in.

Here is one medical study that compared fetal outcomes with continuous vs. intermittent monitoring: http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1994.tb13181.x/abstract

Explanation of different monitoring pro's and con's: http://www.childbirth.org/articles/efmfaq.html

ACOG's statement on Continuous Fetal Monitoring: http://www.ourbodiesourblog.org/blog/2009/07/acog-issues-new-practice-bulletin-on-continuous-electronic-fetal-monitoring

If you are curious about the birth center you could google it and see what they say - most birth places have websites now. That might help set your mind at ease :).

Thank you, this is the info I needed and very helpful. Intermittent monitoring sounds very reasonable to me. I thought she meant they did no HR monitoring at all. And it does look like they have the option of requesting IV pain medication so that is good. Since we mainly keep in touch by email/FB it would be weird for me to suddenly call her up and grill her about the birthing center (on the rare occasions my brother calls me, my first instinct is to ask "What's wrong?" because it must be some family emergency if he actually calls :ROTFLMAO:). So I think I will just say nothing and wait for the next installment of her blog. :D Thanks everyone!

[SnuggleBuggles]

I got halfway through the posts, sorry f this is a duplicate.

I had ds2 in a free standing birth center. I highly recommend, if possible, that *you* go and tour it. See the medical supplies they have tucked in there, see how professional and cautious the staff is and get your questions answered. My mom was very nervous about the birth center thing but she understood that I really researched and understood the safety choices and options available. They did not do monitoring the way hospitals do with the belts but they listened in via doppler regularly and a great deal at the end of labor. They were also present 100% of the time, I was the only birth going on. No one was just chilling at the desk in the hall reading a screen to see how my labor was doing. The full time, continuous availability of the staff has been shown to really have a bearing on labor safety. I think you can here "no monitoring" and decide that they aren't responsible or using good safety guidelines but I am willing to bet that she is going to be monitored and attended to.

I think that when you come at birth (or life) with the medical mindset it's hard to understand choosing to go away from that model. if inclined, the book "Pushed" by Jennifer Block is a great book about the current status of birth in the US. Unlike a lot of books of the ilk it is not angry, OB bashing. It's just a good read.

eta- see if her birth center has a website. the one I used posted all there stats on there- all the outcomes and safety information was on there. it could help. They should basic FAQs and such that could help ease your mind. :)
Beth

[brittone2]

Piggy backing off Katigre's posts, no birth center could possibly get accredited without doing at least intermittent fetal monitoring. I mean, there's obviously no way they would be able to be insured, etc. if they weren't following evidence based medicine and developing appropriate guidelines.

The midwives at the birth center I used work with an OB they consult with (he doesn't provide regular care there, but they consult with him on more complex cases). They have strict guidelines about scenarios that risk out a woman from their care, or guidelines that risk them out of birth at the birth center (they will attend births at the hospital in that situation if appropriate).


I also got great postpartum care. I had staff calling to check up on me at 1 and 2 days postpartum, and they sent a NP out on day 3 which is when the metabolic screening was completed, and baby and I were checked. Baby was given a regular newborn examination, weighed, talked about how BFing was going, etc. It was so, so nice to not have to rush out the ped right away (and obviously heading out to the ped at 2 days postpartum potentially exposes baby to nasty stuff anyway.). I always felt the care I received was thorough, competent, etc. and I'm very, very picky about practitioners ;)

Typing in a rush, but yes, they most definitely provide intermittent fetal monitoring, etc. There's no way they could retain their individual licenses, the birth center accreditation, insurance, etc. if they weren't following guidelines. They clearly want a safe delivery for mother and baby as well.

eta: in terms of pain meds, the FSBC I used always said their #1 reason for transfer was moms wanting an epidural. So they have a "transfer rate" (meaning mom and support person drive to hospital in their regular car from the birth center, and the midwife hops in her car and follows them there, they aren't going by ambulance w/ lots of drama) and then an "emergency" transfer rate, kwim? The emergency transfer rate is extremely, extremely low. And they obviously (like any good practitioner) err on the side of caution and if things start seeming a little off, a little funky...they err on the side of having mom transfer (but stay in their care if no emergency is arising) and having her at the hospital. I also agree with the PP who said if anything, birth centers are very much on the side of risking out anyone even potentially high risk. They tend to be pretty conservative with what patients can birth in their facility.

[sewarsh]

I get your point...I don't think there's anything wrong with asking them questions about the center and just dropping a couple minor points, but DEFINATELY be cautious and be respectful, because if you p*ss her off, it could permantently affect your relationship with SIL and brother.

I see no wrongdoing in just mentioning things in a discussion but in the end you have to know when to back-off.

[goldenpig]

I just remembered another reason this midwife/birth center thing had me worried. My sister used a midwife practice for her second child, and for the last week before she gave birth she was kind of shaky (why is it all my family members get shaky!) and drinking tons of OJ and not feeling well, really tired. She talked to the midwife over the phone, but she didn't have her come in to get checked. And then after delivering my sister left the hospital a day early. She was still not feeling well a few days afterward and the midwife did nothing, so I ended up taking her to the ER in the middle of the night. She was feverish and sick with a kidney infection, her platelets were low, her blood pressure was way up, etc. She ended up staying in the hospital for some weird atypical pre-eclampsia and getting IV antibiotics for the infection. Man, I hate being seen as/having to act like the family doctor. It's a responsibility that I just do not want or should have to have. It's this pattern in my family of everyone asking me for medical advice about themselves or other family members/friends (which I dislike too) or ignoring my advice and then my having to convince them to seek medical attention. Despite my nagging I can't even get my DH in for a checkup (which I know he needs) or convince my mom to have a colonoscopy. So yes, experience this colors how I think because I have either had bad things happen when I didn't act or serious things wrong when I finally did convince them to go in.

Thanks everyone for letting me know what it's like at a birthing center. It sounds like they have more monitoring & medical equipment available than I thought. It sounds like it should be OK and I feel much better about it now.

[Indianamom2]

You know, I was just thinking about Ds#2's birth in a traditional hospital, with an induction, and it occurs to me that I wasn't continuously monitored there either. I was with DD#1 6 years ago, but with Ds#2, the nurse would just pop in every once in a while and use a handheld heart monitor wherever I happened to be at the time. I was able to walk around the hallways, the room, sit, stand, whatever the whole time.

Maybe that will ease your mind a bit, as not even all hospitals do continous monitoring for routine pregnancies.

[alirebco]

I know most people have already chimed in and while I agree with them, please remember that she will be using certified nurse midwives who do births all the time. Also keep in mind, that in other countries, like the UK, low-risk pregnant women are seen and delivered by midwives not OBs unless they are high risk or have pregnancy complications.

And finally, if you haven't seen it yet, you might want to watch The Business of Being Born. You can watch it instantly on Netflix. It talks more about home births but definitely talks about the medicalization of birth and how it has gotten out of hand.

FYI - this is coming from someone who had a hospital birth with an epidural for my first and is planning on a birth center with CNM's for my 2nd.

[hellokitty]

GP, not to be disrespectful, but just b/c you are a MD, it doesn't give you authority over everything medical. FTR, both my brother and sil are MDs, they are expecting their first child and they are planning to give birth at a birth center. They do not want a very medicalized birth. In just about every country other than the US, the vast majority of births ARE attended to by midwives, YET our c-section rate in this country is extraordinarily high. More medical intervention doesn't automatically equal better outcome.

I understand that you had some difficulties during your labor, but that doesn't automatically mean that your sister will too. I know that you care about her and feel that everything should be done in case something goes wrong. Birth centers are very careful about sending mothers (not patients, b/c since when is giving birth a disease????) to the hospital if they feel that things are not going well. Those midwives that you are so suspicious of also have their license to protect, just as MDs have their own license to protect, so they are not going to purposely do something risky to endanger the mother/child or their license.

I know it is probably bugging you really bad to see that your sister has made this decision. Most ppl who decide to go with a BC have already researched their options, so I would not automatically assume that she has just very naively made this decision. I think that while it's nice that you are a MD, you are your sister's sister first and you need to show her some support for her decision. If she should have some pregnancy related issues arise, by all means, give her your medical opinion that maybe she should have her baby at a hospital. However, if she has a healthy, non-eventful pregnancy, there is no reason to assume that just b/c she is going to give birth at a BC that the outcome will be bad.

[SnuggleBuggles]

I just remembered another reason this midwife/birth center thing had me worried. My sister used a midwife practice for her second child, and for the last week before she gave birth she was kind of shaky (why is it all my family members get shaky!) and drinking tons of OJ and not feeling well, really tired. She talked to the midwife over the phone, but she didn't have her come in to get checked. And then after delivering my sister left the hospital a day early. She was still not feeling well a few days afterward and the midwife did nothing, so I ended up taking her to the ER in the middle of the night. She was feverish and sick with a kidney infection, her platelets were low, her blood pressure was way up, etc. She ended up staying in the hospital for some weird atypical pre-eclampsia and getting IV antibiotics for the infection. Man, I hate being seen as/having to act like the family doctor. It's a responsibility that I just do not want.

Thanks everyone for letting me know what it's like at a birthing center. It sounds like they have more monitoring & medical equipment available than I thought. It sounds like it should be OK and I feel much better about it now.

Bad things like that happen with OBs too. I never label the person by title but rather by their actions. There are terrible OBs and terrible midwives. You can't paint any with the same brush. In that case, your sister really should have been more pro-active- you don't need to have the burden.

Beth

[StantonHyde]

I think the real issue here is that your family is expecting that you will bail them out of medical situations and, as an MD, you buy into that expectation. I am saying this as the daughter of an oncologist and wife of an ER MD--and the expectations were always very heavy that dad and now DH would "save" every family member and friend, and second cousin twice removed who had a medical issue. The stories I can recall are absolutely crazy when you consider the severe medical issues at hand and the expectation that while no other MD has been able to help--somehow *you* will be expected to save the day. Other PPs need to realize the burden this presents and that MDs attract medical trainwrecks from family and friends. Seriously, it comes out of the woodwork and is so much worse than what people in non medical families face!

GP--you are going to keep facing this issue over and over throughout your life. I understand that you want, want, want to help people--otherwise you wouldn't have given up 10 years of your life for yor profession! It is hard to establish boundaries and I don't know very many people who do it well. But let's start with your mom--I realize it looks to her like she has lost 2 husbands because of you. But its not your fault. And secondly, your mother (not you because you know this already) needs to know that SILs choices are her own to make. Maybe you should put your mom on Facebook so she can't make anxious phone calls. ;)

Boundaries and staying out of family business is hard for every family and even more so if someone in the family is a medical expert. Good luck!!!

[goldenpig]

Bad things like that happen with OBs too. I never label the person by title but rather by their actions. There are terrible OBs and terrible midwives. You can't paint any with the same brush. In that case, your sister really should have been more pro-active- you don't need to have the burden.

Beth

Agreed, totally.

It's just hard when it's your family member and you know they need help, to not feel responsible for them.

[goldenpig]

And secondly, your mother (not you because you know this already) needs to know that SILs choices are her own to make. Maybe you should put your mom on Facebook so she can't make anxious phone calls. ;)


Ha ha ha, this is what got SIL in trouble with her MIL in the first place with the skydiving...my mom is FB friends with her so she sees everything that SIL posts (and SIL posts about EVERYTHING). Then my mom comes to me and my sisters to try to "talk sense to her". I think the solution to all this is SIL should de-friend my mom. :hysterical:

[[email protected]]

Goldenpig:

I am sympathetic. I'm not a doctor, but DD2 was born with her umbilical cord around her neck and it was the scariest few minutes of my life when she was born and a team of doctors took her away from me. That experience will forever make me leery of having a birth outside a hospital. However, they knew well before I started pushing that she was in trouble--so if the birthing center is near a top hospital with a NICU and if they offer at least some form of fetal monitoring, in your position I'd keep my mouth shut unless asked. Even then, I'd frame it as concerns rising from my (rare) experience rather than as a doctor.

I agree about googling the birthing center's website. Its a non-invasive way to reassure your self.

Christine

[lmwbasye]

You're assuming that THEY have not done any of this. I get that you're concerned, but still if you were my SIL and called my birthing center, I wouldn't talk to you again for a LONG time.

I understand you feel guilty about not making your FIL go to the hospital - but this is not the same situation, your SIL is no presenting with any medical emergency - she's pregnant and she has decided to have a birth in a setting that is different to how you would do it.

Respect her decision. If you dont' like her decision, then that is YOUR issue and you need to deal with it without stepping all over her rights to make choices for herself.

This...totally. I don't understand why any of this is your concern at all. Your job as a relative is to say congratulations and be happy. Period.

[goldenpig]

I think the real issue here is that your family is expecting that you will bail them out of medical situations and, as an MD, you buy into that expectation. I am saying this as the daughter of an oncologist and wife of an ER MD--and the expectations were always very heavy that dad and now DH would "save" every family member and friend, and second cousin twice removed who had a medical issue. The stories I can recall are absolutely crazy when you consider the severe medical issues at hand and the expectation that while no other MD has been able to help--somehow *you* will be expected to save the day. Other PPs need to realize the burden this presents and that MDs attract medical trainwrecks from family and friends. Seriously, it comes out of the woodwork and is so much worse than what people in non medical families face!


So true. DH's aunts are always asking us for recommendations to the "best" doctors for uncle's prostate problem or cousin's skin condition and to write a referral or call up their doctor. DH's uncle was in the hospital and his aunt was calling DH (who is also a doctor) asking us to talk to his doctors to convince them to transfer him to the university hospital because they felt like he would get better care there. Ugh. Awkward. You have to draw the line somewhere. Sometimes you have to stop yourself from trying to help out and sometimes it's the family members who don't get the boundary issues. It works both ways. Oh yeah, and no matter what type of doctor you are or how long ago you went to medical school, you are expected to be the expert in everything...cancer, OB, pediatrics, derm (what's this rash?) etc. It's crazy.

[mousemom]

I guess my anxiety over this is, I would feel so bad if the baby ended up dying or having brain damage from lack of oxygen from some undetected problem at delivery.

I think this is the heart of the problem. There can be bad outcomes in hospitals and bad outcomes in birth centers. But if such a thing should happen, as terrible as you might feel as a member of the family, it would in no way be your fault. It does sound like you have a lot of guilt/anxiety over trying to help various family members and that this situation is stirring up those feelings again. But your family members are responsible for their own health care and, unless, they've specifically asked for your medical opinion (and you feel qualified to give it in their situation), you should stay out of it.

[DietCokeLover]

Goldenpig,

I think the most appropriate response for you is to say "Congrats and hey, if you ever want to talk through anything, I'm available. So, what are you craving these days?"

[WolfpackMom]

Goldenpig,

I think the most appropriate response for you is to say "Congrats and hey, if you ever want to talk through anything, I'm available. So, what are you craving these days?"

I think this is very good advice. :thumbsup:

[Kindra178]

Like others said, there is little you can do to change your sister in law's mind. If she asks, give your opinion on birthing centers and delivering a baby away from a hospital setting. I had a similar situation happen a few years ago. My mil knows I am chemical nut, and she was really upset when my sil and bil registered for a whole set of pots and pans with teflon. She tried to talk to my bil, and wanted me to talk to my sil. It was a really weird situation. But my solution was a little easier: I bought three cast iron skillets of varying sizes. She told me she uses them all the time. She is an excellent cook.

Just wanted to clarify a few thoughts cited above. An epidural DOES NOT increase the chance of c-section. Check out a 2005 study out of Northwestern. Indeed, a secondary finding of that study was that an epidural may hasten labor. That was my experience twice as well. But don't get me started on pitocin!

[arivecchi]

OP, I think you mean well, but I agree with sillygirl's advice. Just wait until your SIL asks for your advice and then give your 2 cents without harping on it.

[ThreeofUs]

I totally get that this is her pregnancy and her body. That's why I haven't said anything to her and I'm not looking to change her mind at all. But I feel like if I don't say anything I'm going to be worrying this whole time about what's going to happen during delivery, and if I at least talk with her about it that I'll feel better that I said something, and relax and enjoy her pregnancy with her.


I think you're trying your best. I wouldn't say much, honestly, but I'd probably call the birthing center and ask my questions. You might be surprised with the answers you get.

The one thing I would say is to offer services and expertise if she needs it. I've offered this to family and it's made a world of difference. Just a "call me if you need *anything*, and I'll be there for you" can be a big help, even if they don't use it.

JMHO. GL and best wishes to your SIL.

[edurnemk]

Finding out about the birth center SHE chose isn't something you should do and would really tick me off and it may be a HIPPA violation if its done in concern for SIL and WOULD be over stepping YOUR bounds as a relative.


You're assuming that THEY have not done any of this. I get that you're concerned, but still if you were my SIL and called my birthing center, I wouldn't talk to you again for a LONG time.



I think calling the birth center is a terrible idea frankly. I would be really insulted if I found you out you went behind my back to check up on my choices. It's like a sneak attack mommy drive by!


:yeahthat: ten times over. After we announced I was pregnant with DS my MIL went and found out who my OB/GYN was and scheduled an appointment with him for some lame made up reason, just to meet him and see what kind of doctor he was, and maybe try to get some info about me and the pregnancy. I'm not kidding, this is a true story. DS is almost 3 and I still haven't forgiven her for this. I no longer share much information with her, BTW and I switched OB's partly because of this. It's a terrible invasion of privacy. And I'm sure your SIL would be very, very offended and your relationship would be permanently ruined, so I would not take this suggestion. You'll just have to trust that they've done their research and chose this option for a reason. And as other PP's have said the birthing center will be the first to refer her elsewhere if she has any risk.



I don't think there is anything wrong with calling the birthing center and asking about their general policies. I would NOT say anything about SIL, just pretending to be a potential new patient with questions.

Even if she doesn't find out, IMO, it's not very respectful to do this.

I also understand that our mother's generation tends to freak out at the mention of home births, and birthing centers, because they're not familiar with it. Maybe if your mom read some info about it she'd relax a bit. But I would really advise to not mention anything to SIL or your brother. It will simply be taken as meddling and cause serious problems.

OP, I understand as and MD you feel responsible, but remember you can't force others to choose something and they are responsible for their own choices. Your stepfather's death was NOT your fault.

[sunnyside]

My father is an MD and I have a lot of respect for the years of education and experience he and other MDs have.

That said, the litigious society in which we live today has created an atmosphere of fear in the medical community. This has caused the doctors to make decisions that help them avoid lawsuits. With that, most commonly, they will make decisions or recommend courses of action that lead to a live baby even at risk of it not being as healthy for the mom and baby as another course of action might have been. It's just the nature of avoiding a malpractice suit. And those courses of action are now becoming the "norm", even though ultimately in many cases they are not the best decision.

My trust in my OB was shaky because I knew all of this. I was pressured to induce and refused. My OB told me that I was risking a still born baby. I was only a few days past my due date. I asked if something was wrong with the baby. He did a non stress test and we were both perfect. I went into labor the following day.

I didn't have the baby fast enough, so I was pressured to hurry up or have a C section. Luckily she was born soon after. Then the OB didnt mention delivering the placenta until a half hour had gone by while he stitched me up (2nd degree tear). So then he said it was too late and it would have to be removed surgically. I had to ask if i could just try to push it out. I did so just fine.

Then at my 6 week post partum visit, my OB said that exercise doesn't really help you lose weight. That only really dieting helps because think about how many calories are in food and think about how long you have to be on the treadmill to burn 300 calories.

I had a 30 hour labor and was glad to be in the hospital for it, but was ever so glad for my doula/midwife who was there to help me make informed decisions. I do not trust my OBs to have steered me in the best decision. I would trust them in a true emergency, but not for a normal birth.


Also, My doula said that at the community near us, the anesthesiologists are not at the hospital all hours. They are on call instead. So while you could give birth in the hospital there, if there was an emergency, you would have to wait for the on call anesthesiologist to be called in to work and drive to get there. They could live 20 miles away. So would it be better to be in that hospital or would it be better to be in a Birth Center or at home and have a 5 mile drive to the hospital? I'd rather be 5 miles and at home myself...

[rkold]

Agreed, totally.

It's just hard when it's your family member and you know they need help, to not feel responsible for them.

But your SiL does not need help. ^^;;;

Maybe your mother needs help learning its not her place to interfere

Maybe you need help letting your guilt go

But your SiL does not need help.

I'm 35 1/2 wks pregnant and planning to give birth in a free standing birth center. My Mom was really nervous about it, so I took her on a tour, along with my sister who is training to be a RN. Mine happens to literally be across the street from the hospital and the midwives all have privileges so can help there should you need a transfer.

[Jo..]

I wouldn't say anything. Childbirth can and should be a natural beautiful thing. Although I have the utmost respect for doctors and medicine, I agree that many doctors have an intervention mindset when it comes to childbirth. They want to DO something, and more often than not they just get in the way and complicate the experience.

With my #1 child Adam, I was told I was high risk due to a clotting disorder. I was induced with Pitocin just shy of 37 weeks. 24 hours of PIT labor, a doctor who tried to bully me into an epidural or a c-section due to failure to progress, soured me on doctors for childbirth. I think it is essential to have ACCESS to them in an emergency, but 90% of the time they hopefully won't be needed. I wound up kicking the doctor out of the delivery room and having DS in my own time.

With Leah (child #2), my new OB had a more laid back approach. Mom is healthy, baby looks good, no need to induce. I went into labor naturally and labored at home for a couple of hours in our whirlpool tub. Got to the hospital JUST in time to pop her out. Within 15 minutes. #2 was a much better, less painful, and more beautiful experience.

I think doctors are amazing, and they saved my husband's life...but I don't think they know how to step back and let nature take its course with something like childbirth. They want to do something to make it better, and usually they make it worse. Again, sometimes in emergencies it is crucial to have access to expert medical care, so not disrespecting the profession or the expertise at all...just the need to get in there and "do stuff", when most of the time they just need to watch and wait.

[goldenpig]

But your SiL does not need help. ^^;;;


Sorry to be confusing. I don't think I was referring to my SIL in that specific quote. That was a tangent about my other family members who needed prodding to seek medical attention when they were sick, not about SIL.

Let me be perfectly clear. I am not anti-birth center or anti-midwife. And I think SIL has a right to make her own choices and I don't think it's wrong what she's doing at all. I had some specific concerns/misconceptions about birthing centers from what she said--I thought there was no fetal monitoring at all and no options for pain relief but apparently that is not true. I was concerned from a standpoint of the safety/health of SIL and the baby, not because I felt personally affronted that she (or any of you all) would choose a non-MD birth. It makes no difference to me. I was worried initially, but from what several of you have said about what goes on in birthing centers, I now feel comfortable that she will be OK and that I don't need to call up the birth center or ask her my questions anymore because you all have answered them. I am not planning to discuss it with her unless she wants to, other than to offer my support.

Hope that clears things up and thank you all for your help!

[Hawkeyewife]

Good to hear you are planning on staying our of it. Your SIL doesn't need you to interfere with her birth choice yada, yada, yada. As she won't if she choses to exclusively breastfeed or vaccinate on an adjusted schedule (or not at all) or home school etc. Different strokes for different folks.

As a mother who has had a wide experience with birth I find it interesting how many people still view natural birth in a birth center or home as somehow being irresponsible, selfish, or even child abuse. It is so nice to read that there are so many enlightened woman on this board that have educated themselves on birth and are sharing it. I think it's ironic that women that birth in a hospital utilizing all the modern interventions (many without prior knowledge of what might happen to them there) are not questioned at all, but woman who choose natural birth are questioned about the safety of their choice all the time.

Would you have written this email had your SIL chosen any OB in any hospital anywhere. Would you have been compelled to "research" the facility etc? Hospital C-section and intervention rates do vary from region to region and do have an affect on Moms and Babies.

So she skydives? So what, she is experiencing life her way, does she question the way you experience your life?

[luckytwenty]

As a mother who has had a wide experience with birth I find it interesting how many people still view natural birth in a birth center or home as somehow being irresponsible, selfish, or even child abuse.

Oh, I find that judgment runs both ways. I'm in a prenatal yoga class and the only one who's totally cool with not trying VBAC (for this baby or the one before him) and when I first made that clear among so many women going alternative birthing routes, after the crickets stopped chirping I got some very judgy questions and comments. And the birth is just where it all begins. You'll find all kinds of self-rightegeousness on just about every baby parenting call, from cosleeping to vaccinations to formula to sleep training. And it definitely runs BOTH ways. We're all mama-bears and we care so much about doing right by our babies and anyone who suggests we're doing it the wrong way is going to get growled at (and "suggests" can be an openly critical comment or to some people, simply choosing the opposite route than what you chose.)

To the OP, I understand your concern completely but like just about every other choice you've made so far as a been there/done that mom, you really need to hold your tongue or your SIL will frankly resent you. And don't be surprised if your SIL, once she's got a few months of motherhood under her belt, questions choices YOU made. Because again, this undercurrent runs both ways. I think the best thing to do is just trust that you made the right choices for you and that there are many many right choices.

[poohbear]

I dont have any btdt, as many responding seem to, but I wanted to stick up for OP a little. I don't think she was posting in an effort to bash birthing centers or anyone on here's personal choice. I think she is concerned for her SIL's health, and that yes, her medical background does make her biased, but that doesnt mean she has a mean or bad intentions in her thinking or is trying to say doing things in any particular way is wrong.

I would not say anything to SIL, if she approaches you, then I would outline some of the questions she should ask the birthing center (how far is hospital, what rate the transfer, what emergency precautions do they take). Otherwise your feelings are just something you will have to deal with on your own because, in all honesty, what you say probably won't change her mind anyways if this is what she wants and its not worth harming your relationship with your SIL and brother. I understand why you are concerned though.

:yeahthat:
A few things. First of all, OP came here for support and advice. No reason to be rude or nasty to her or judge her. And just because she comes from a medical background does not mean that her feelings or beliefs are not founded on this subject or she should be shamed for being a doctor and/or believing in hospital births.

Also, in terms of announcing pregnancies, I, personally did not announce my pregnancy until I was 12 weeks pregnant and was fairly confident that I had a healthy (for 12 weeks) growing fetus. I have had a few friends who announced when the stick turned blue only to either miscarry or find that their fetus had no heartbeat. It was terrible for them to then have to tell everyone this. And I was with one friend who four weeks after had someone come up to her and ask "how's the pregnancy? are you going to find out if it's a boy or a girl?" after she had miscarried. She had told everyone that she was pregnant, but didn't have the heart to tell everyone she had miscarried. That's a rough spot to be in, so that's why many people do not tell others before they have at least heard the heartbeat. It is a personal preference, but understandable when people are surprised when someone announces at 3 weeks. Also, 9 months is a long time to wait for someone else to have a baby...

OP, as for your concerns: I think some of it depends on your relationship with SIL. She may ask you for your opinion, in which case you may want to say your concerns, and she may tell you "oh, they have this this and this." I have a friend who had her baby at a birthing center, but it was in a hospital, so some of the concerns were less of an issue. Or she may listen and take your concerns into consideration.
As to your mom, I think that's a conversation that's easier to have. I think you say that you're not comfortable talking to SIL unless she approaches you, and that as SIL's MIL and the future child's future grandmother, she might want to take the same stance...
HTH!

[chlobo]

No, just a concerned relative. Seriously guys, if I said anything it would not be to attack her choices or try to get her to change her mind. I am doing my best to be supportive of her and my brother. I just want to discuss what would happen in case of emergency and how they would even know if there was a problem. Just as you can't guarantee a good outcome in a hospital and that medical intervention is not the be all and end all (yes I get that there can be complications from medical interventions), you cannot also guarantee that a low risk pregnancy is not going to have problems that arise at the last minute. I guess my anxiety over this is, I would feel so bad if the baby ended up dying or having brain damage from lack of oxygen from some undetected problem at delivery. Heck, I worried about this even though I was giving birth at a hospital. So I want to find out more about this birthing setup and hopefully that will put my mind at ease. Maybe you're right, I should just call the center myself.

This whole thing makes me thing that you think the hospital is the only safe place to give birth. I'm sure the birth center has experience in monitoring fetal distress. Why do you assume that she hasn't researched these issues? Just because she didn't blog about the center's ability to get you to the hospital in 6 seconds doesn't mean they can't.

[AnnieW625]

I would keep your opinions to your self. I am sure she has done her research. I gave birth twice at a regular hospital and it was fine, but I would have loved some of things that they have at birthing centers like a water tub, esp. for DD1.

[goldenpig]

As a mother who has had a wide experience with birth I find it interesting how many people still view natural birth in a birth center or home as somehow being irresponsible, selfish, or even child abuse.
This is not what I am saying at all.



Would you have written this email had your SIL chosen any OB in any hospital anywhere. Would you have been compelled to "research" the facility etc?
No that was not my original intention. Calling the facility was something someone suggested as an alternative to calling my SIL with my questions, which might be seen as attacking her choices. It didn't feel right to me though and I decided not to after I had my questions answered here.


So she skydives? So what, she is experiencing life her way, does she question the way you experience your life?
If you read my posts carefully, it was not me that had a problem with her skydiving, it was my mother. I have never told her what to do about anything. My mom is the one that likes to meddle.


:yeahthat:
A few things. First of all, OP came here for support and advice. No reason to be rude or nasty to her or judge her. And just because she comes from a medical background does not mean that her feelings or beliefs are not founded on this subject or she should be shamed for being a doctor and/or believing in hospital births.


:signthankspin:

Thanks! I feel the need to defend myself because I am starting to feel personally attacked by some of you. I admit I did not know much about birthing centers, and from what SIL posted on her blog about no monitoring, no epidural, etc. it sounded kind of scary to me. Like she would be laboring away in pain and because they cannot get epidurals without being transferred to the hospital she would feel pressured to suffer through even if it was more painful than she originally thought. Even with low risk moms, problems can come up suddenly during birth (nuchal cord, failure to descend, hemorrhage etc). I misunderstood and thought that they did no fetal monitoring at all, so I was worried that they would not be able to tell if there was a problem with the baby until it was too late. And I was worried that if there was a problem that came up suddenly, there would be an additional delay for her to be transferred to the hospital, which might be far away, and that the baby might suffer oxygen deprivation because of this. So you can understand why I was concerned.

Unlike my mother, I am very hands-off and I normally do not get involved at all in my family members' decision-making. But I have had several family members get sick or die when they didn't seek medical attention, so I wanted to make sure that this wasn't something that would put her at unnecessary health risk. I came to you all for support and advice and it was helpful because I learned that indeed, birth centers do have intermittent fetal monitoring, IV pain meds, oxygen, and other things that will make it safer for her. I am not judging or attacking her choices (or any of yours) so please keep that in mind and please do not assume anything negative about my questions or motivations. Thanks for enlightening me.

And yes, I have decided not to say anything to SIL any more because my concerns have been adequately addressed here, so I do not need any more advice on that aspect.

[MamaSnoo]

I saw this one really late, and boy! has it been a hot topic.

I do not think that the OP intends to bash birthing centers or the women and families who choose more natural birth experiences.

I think the OP is in a really tough position, and that in part, she is contributing emotionally to herself being in that position.

To goldenpig: it sounds like you have had a lot of really sad and difficult medical things happen in your family. This is hard for anyone. I think it is especially hard for physicians because as much as we feel guilty when a patient has a bad outcome, we feel that much worse when a family member has a bad outcome. Just because you are an MD, does not mean that you can remove yourself from the emotional aspects of having an ill relative (your dad or your mom's 2nd husband) or a relative in a situation with physical risks (your SIL). ITA with PP that the experiences you have had with your other family members do not bring to bear on the likelihood of the safety of your SILs pregnancy and birth.

I also totally understand that if your SIL gives birth in a center (and lets face it, it could be a hospital, not all of them are great either! or would you feel better if she had an MD, but one with a so-so reputation?) that you do not know much about, and if there is a bad outcome, you are going to beat yourself up for not checking it out. I think it is not a bad idea to either review the center's website (all public info) or call them and ask general questions about their services. Someone suggested that this is a HIPPA violation. I do not think that it is, and to my reading of HIPPA, it would only be a violation if you called and asked for information about your SIL (or another patient). I do not think you need to tell your SIL that you did this, and I think the purpose of this is not to butt in, but to give yourself piece of mind.

Frankly, I think it is unfair of your mom to ask you to butt in with SIL. She is putting you in an unfair position because you an MD. Families do this a lot, and it is not fair. No one should have to carry the burden of being the doctor for the whole family (unless they really are the non-related, impartial, non-emotionally involved doctor for the family.) This is why we do not treat our kids and our loved ones. I think it really hard to understand this burden unless you have carried it yourself.

I would really recommend that you try to meet with a counselor about this. There should be people available through your hospital (if you work in one) who could help you with this, and they should be experienced in dealing with emotional issues that arise around the practice of medicine. They may be able to help you deal effectively with your mom too.

All in all, I do not think you should weigh in with your SIL about her birth plan. But I can see why you might be feeling anxious and why the situation is hard for you, given the things you have chosen to share here.

[poohbear]

duplicate post.

[poohbear]

I saw this one really late, and boy! has it been a hot topic.

I do not think that the OP intends to bash birthing centers or the women and families who choose more natural birth experiences.


I also totally understand that if your SIL gives birth in a center (and lets face it, it could be a hospital, not all of them are great either! or would you feel better if she had an MD, but one with a so-so reputation?) that you do not know much about, and if there is a bad outcome, you are going to beat yourself up for not checking it out. I think it is not a bad idea to either review the center's website (all public info) or call them and ask general questions about their services. Someone suggested that this is a HIPPA violation. I do not think that it is, and to my reading of HIPPA, it would only be a violation if you called and asked for information about your SIL (or another patient). I do not think you need to tell your SIL that you did this, and I think the purpose of this is not to butt in, but to give yourself piece of mind.

Frankly, I think it is unfair of your mom to ask you to butt in with SIL. She is putting you in an unfair position because you an MD. Families do this a lot, and it is not fair. No one should have to carry the burden of being the doctor for the whole family (unless they really are the non-related, impartial, non-emotionally involved doctor for the family.) This is why we do not treat our kids and our loved ones. I think it really hard to understand this burden unless you have carried it yourself.

I would really recommend that you try to meet with a counselor about this. There should be people available through your hospital (if you work in one) who could help you with this, and they should be experienced in dealing with emotional issues that arise around the practice of medicine. They may be able to help you deal effectively with your mom too.

All in all, I do not think you should weigh in with your SIL about her birth plan. But I can see why you might be feeling anxious and why the situation is hard for you, given the things you have chosen to share here.

:yeahthat:

Wow, I just have to comment again here. Not about the birthing center issue, but about the fact that some members of the community here are being so judgmental towards one of our own members for their perception of her being judgmental of her SIL. It's really appalling and upsetting to me. I understand that this is a heated topic but OP was not asking to be judged and I never got the impression that she was judging SIL. I'm assuming that none of us know Goldenpig's SIL. I personally don't know goldenpig at all, and I definitely don't know her SIL. What I do know is that she, as the OP, wanted people's opinions on what she should do, not people's opinions or judgments or harsh criticisms on her own thoughts or beliefs. Goldenpig, hopefully you feel more comfortable about what you need to do.

Also, there is nothing wrong with finding out more about the birthing center. That is not a violation of HIPPA laws in any way (You are not asking about any particular patient, nor exchanging any information about any particular patient). I would have no issues with any medical professionals in my family checking out anywhere I was having any medical procedures, etc performed.

[1964pandora]

I think that if you play the scenario of having a conversation with your SIL out in your mind, the answer to your question will be very clear. Imagine what you are going to say. Imagine what she is likely to say. Are you happy about where you ended up? Did you accomplish what you wanted to accomplish? Is your relationship with your SIL better or worse? I approach these situations very practically.

[goldenpig]

Update--I did call SIL to find out how she is doing. She is feeling well, not having morning sickness yet, and is still waiting for her first prenatal appointment at the birthing center when she will be 10 weeks along. We talked for a while about how she is doing, and I did end up asking her a few questions about the center...but not in a confrontational way. It is 1 mile from the hospital and if she does need to transfer there for an epidural, the midwife will continue to follow her but if she needs a C section she'll get one from the OB on call there. I do feel better now about the whole situation and I am no longer worried or anxious about her delivering at the birthing center now that I know more about what is involved. She gave me her cell phone number so we can talk more frequently, so I think she was not offended at all. I am happy for her and hope that our shared experience of being moms will bring us closer together since we will have more to talk about. Plus my DC will have a new cousin to play with soon! Just wanted to let you all know that this situation has been resolved in a positive way...thanks again for your support.

[brittone2]

Sounds like it went well. :cheerleader1:

:hug:

[hellokitty]

Update--I did call SIL to find out how she is doing. She is feeling well, not having morning sickness yet, and is still waiting for her first prenatal appointment at the birthing center when she will be 10 weeks along. We talked for a while about how she is doing, and I did end up asking her a few questions about the center...but not in a confrontational way. It is 1 mile from the hospital and if she does need to transfer there for an epidural, the midwife will continue to follow her but if she needs a C section she'll get one from the OB on call there. I do feel better now about the whole situation and I am no longer worried or anxious about her delivering at the birthing center now that I know more about what is involved. She gave me her cell phone number so we can talk more frequently, so I think she was not offended at all. I am happy for her and hope that our shared experience of being moms will bring us closer together since we will have more to talk about. Plus my DC will have a new cousin to play with soon! Just wanted to let you all know that this situation has been resolved in a positive way...thanks again for your support.

I'm glad that you two had a chance to talk things over and you got to find out some of the info about the birthing center to ease your mind. Your sister is lucky that you care so much about her.

[vonfirmath]

My SIL is newly pregnant with her first baby and is already blogging about it even before her first checkup (as in "hey, the pregnancy test is positive!"). No waiting for the 12-week mark to share the news--she's from the Gen Y Twitter crowd so everything is broadcast to the public in real time.

Eh. I'm not "Gen Y Twitter crowd" and I didn't wait until 12 weeks to share the news. I couldn't even wait past the night we got the positive to call my parents (my husband And I discussed it for... maybe 20 minutes?)

I'm just not one that can keep that kind of news quiet.

[Uno-Mom]

I didn't read through all the back and forth replies. I can guess how they went, given the topic. And I bet some were heated.

I have empathy for any of you who are MDs, midwives, nurses, etc. It is extra-hard to have all that knowledge when loved ones are having babies. Or are experiencing any medical event.

For me, DH and I work with folks who have severe developmental disabilities - many (espeically the older folks) from birth injuries. We had to work very hard to keep perspective when Sprog was on her way. The examples we've seen for so many years are so dramatic and it can feel like complications are super-common when you are surrounded by people who had them. I know it's the same for friends in the medical field.

Our priest had a similar experience. He told us about being a NICU chaplain while his eldest was expected and an infant. How he didn't realize for months how his work had him on edge and panicky for his perfectly healthy son.

On another note: like most issues, the extremes of all the birth arguments make me gag. It always ends in demonizing the other side. (I didn't read this thread, so I don't know if that happened here.) As a granola-munching, doula-using hippie mom ... I had a terrific hospital birth experience!

[nov04]

I'm glad you had a chance to chat with your sister.

[indigo99]

I wasn't high risk, and my doctor and I decided to induce a week early at the hospital. I ended up with a c-section after 2 hours of pushing plus suction didn't work. His head was just too big so it would have really been bad to be in a birthing center at that point. The cord was wrapped around his neck when they pulled him out so if he had somehow made it further down and THEN been stuck there while I was transferred to a hospital...

I'm just the type who likes to have insurance. I'd never plan an outdoor wedding without a backup plan either, but there are a lot more sunny days than rainy.

[SunCB]

I would stay out of it! I planned a OOH VBA2C (birth center close to a hospital) but my MW got scared (nothing medically changed) and so I was left going to a place where I did NOT feel comfortable (a hospital w/a male OB) bc of how later my pregnancy was and my "medical condition" (VBA2C). Guess what, in less than 3 hrs being there and only 19 mins of pushing with her head coming out looking at my left thigh and her arm up by her head and being over 8 lbs I had my DD.

I had family (extended as most close members understood as I explained) and friends (obviously they were not good friends) say I was not thinking about my baby or myself for planning an OOH birth which was very hurtful but I was actually bc there would be less things being done to us that would create a situation for me to turn CBAC again. My CSs were bc of a induction gone bad (cannot tell you all the stuff they had me hooked up to) and #2 was bc OB could not wait any longer (wanted to go home by dinner time).

If you would like some clarification on stuff about the monitoring and how close a hospital is then ask but that is it! All the MWs I have spoken with said they monitor (portable doppler or fetoscope) just not with the machine that you have to be strapped to like in a hospital.

I see nothing wrong with telling everyone so early though I get why people wait as that is what we do. My brother is 1 to tell everyone right away. So was a friend until she had her 1st MC several wks after the announcement and saw/felt why we waited 12 or more wks to tell people 3 times.

[TwinFoxes]

Update--I did call SIL to find out how she is doing. She is feeling well, not having morning sickness yet, and is still waiting for her first prenatal appointment at the birthing center when she will be 10 weeks along. We talked for a while about how she is doing, and I did end up asking her a few questions about the center...but not in a confrontational way. It is 1 mile from the hospital and if she does need to transfer there for an epidural, the midwife will continue to follow her but if she needs a C section she'll get one from the OB on call there. I do feel better now about the whole situation and I am no longer worried or anxious about her delivering at the birthing center now that I know more about what is involved. She gave me her cell phone number so we can talk more frequently, so I think she was not offended at all. I am happy for her and hope that our shared experience of being moms will bring us closer together since we will have more to talk about. Plus my DC will have a new cousin to play with soon! Just wanted to let you all know that this situation has been resolved in a positive way...thanks again for your support.

I'm glad it all worked out. And I'm glad you're still coming back here. :)

[SnuggleBuggles]

I wasn't high risk, and my doctor and I decided to induce a week early at the hospital. I ended up with a c-section after 2 hours of pushing plus suction didn't work. His head was just too big so it would have really been bad to be in a birthing center at that point. The cord was wrapped around his neck when they pulled him out so if he had somehow made it further down and THEN been stuck there while I was transferred to a hospital...

I'm just the type who likes to have insurance. I'd never plan an outdoor wedding without a backup plan either, but there are a lot more sunny days than rainy.

I had a birth center birth and we had a good hunch that he was going to be on the big side. So, during labor my midwife discussed with me how in an instant she may tell me during pushing to change positions, like onto all fours. She said that if there was any indication that baby was having trouble descending that hands and knees open your pelvis up so much more that it has made a huge difference in successful deliveries. But, she also made me aware that if there were indications of trouble more than that that we would transfer. They don't want anything bad to happen (though that is not always avoidable) but as posters have mentioned, birth center staffs tend to be really cautious. 30% of births have the cord around the neck and most of the time it's pretty easy to slip it up and over. Usually there are signs that it is a problem and the staff can best decide how to handle it though. I completely understand not being a person that was comfortable with an out of hospital birth- that is a very personal decision. I did just want to share how being out of the hospital in some situations that are maybe really scary outside of the hospital are handled. I was never worried and felt confident that the common complications could be handled.

Beth

[Katigre]

:yeahthat: Snugglebuggles.

[kellyd]

My suggestion would be to consider if you weren't an MD. If you were by chance a home birth midwife, and your SIL had decided to birth in the hospital. Would you challenge her decision to give birth in a hospital? I would stay out of it, if you're really concerned I would do as a PP suggested and contact the birthcenter directly to address your concerns.

[brgnmom]

:yeahthat:

Wow, I just have to comment again here. Not about the birthing center issue, but about the fact that some members of the community here are being so judgmental towards one of our own members for their perception of her being judgmental of her SIL. It's really appalling and upsetting to me. I understand that this is a heated topic but OP was not asking to be judged and I never got the impression that she was judging SIL. I'm assuming that none of us know Goldenpig's SIL. I personally don't know goldenpig at all, and I definitely don't know her SIL. What I do know is that she, as the OP, wanted people's opinions on what she should do, not people's opinions or judgments or harsh criticisms on her own thoughts or beliefs. Goldenpig, hopefully you feel more comfortable about what you need to do.

Also, there is nothing wrong with finding out more about the birthing center. That is not a violation of HIPPA laws in any way (You are not asking about any particular patient, nor exchanging any information about any particular patient). I would have no issues with any medical professionals in my family checking out anywhere I was having any medical procedures, etc performed.

:yeahthat: I'm really late in this discussion, and I'd like to help support the OP. I'm glad that the OP and her SIL were able to speak, and the OP was able to learn more about the birthing center and how it's very close to a hospital in case a medical emergency arises during the L&D process. It's very sweet how the OP is concerned and cares enough to speak with her SIL about her medical choices and options. I wish my SIL cared enough to talk with me about how my pregnancy is going, etc! ;)

[purpelina]

There are too many schools of thought, besides, it's a very personal (as well as highly emotional) issue, so your best bet is let it take its own course. Your SIL contacted professionals, she does not want to go to a forest and follow rituals of old tribes she read about in a book, you know. She seeks medical assistance, that's important. She blogs about it, that's OK. I think it might be alienating "making her" do this or not do that...

On a side note, we all love to share our opinion on emotional issues, especially on our past experiences. See, I'm a real estate agent, and I see it all the time when someone decides to sell or buy a house. EVERYONE has his/her own advice on what to do, what not to do, what type of home to buy and for how much, whom to trust, what mortgage rates and conditions are appropriate... Even though the last time that person bought a property was 20 years ago, and things have changed CONSIDERABLY now, everybody wants to do the job of say a mortgage broker...

To me, pregnancy is similar to this. Of course, pregnancy per se is the same as it was 2000 years ago, but THE ENVIRONMENT where one can deliver a baby, medical assistance and life in general changed. Medical issues were the prime reason for all superstitions (not to tell before 12 weeks etc) Miscarriage happens now as well, but there are more ways to help now.

Also, in Eastern Europe, you are not supposed to buy ANYTHING for the baby until after it's born! (day 1 is fine), so some people are not buying strollers, cribs and other expensive things (that they could have gotten on sale at a good discount at the right time), because of superstition.

Let everybody make own decisions, mistakes if you wish... We all have good intentions, we want to warn a person, prevent something "bad" from happening, so we give advice. But in reality we shouldn't UNLESS ASKED FOR...

To sum it up, I was actually glad that when I was pregnant and giving birth my family was in different country. I went to wonderful Hospital (Brigham & Women's in Boston). I had amazing doctors and nurses, and I felt I can trust them with health and well being of me and my baby. I also felt incredibly at peace, because I personally don't like unsolicited advice and comments.

Everybody is different of course...