Am I too far?
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Thread: Am I too far?

  1. #1
    Prolific Poster tanismom's Avatar
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    Default Am I too far?

    So I'm still struggling with my options for prenatal/birth care.

    I live 35 minutes from the hospital. Some MWs won't take me because of that. there's a dr who will attend the birth, but he doesn't really do prenatal care.

    I'd really like to get some thoughts on how far is really too far from a hospital for a safe home birth - or possibly an unassisted birth (let's just throw that out there for a possibility, even though it's my last choice.) I don't expect any complications, but I don't want to be stupid either, there are a couple of emergencies that have no warning signs and a few minutes can make all the difference.

    do any of you know of specific stabilizing procedures/supplies that should be prepared for those rare cases?
    ~Ayelet & Yoram
    Tani 7/6/04
    Odeliya 3/8/07
    NJ, USA to Israel 12/29/08
    Yitzchak, 22.6.09
    Asa'el, 14.10.11
    Welcome baby boy!! 26.7.13

    Rambling on at http://milkandhoneymomma.blogspot.com
    facebook and twitterID: ayeletschwell

  2. #2
    Super Poster shiregirl's Avatar
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    I am about 25 to 30 minutes from the hospital, and am planning a homebirth. My midwife is a CNM, and she brings certain supplies with her to deal with emergencies, should we need them while in the process of a transfer. She doesn't seem to have a problem with my distance from the hospital. Would your Dr. be willing to partner with a midwife for prenatal care?






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  3. #3
    Prolific Poster tanismom's Avatar
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    continuity of care is something that israelis just don't know about. you go to your health clinic for prenatal care and then you arrive at the hospital and are attended by the mw's on shift. there is a dr that I see when i go the clinic, but she's not "my" dr. I don't feel that way about her, and I don't think she feels that way either.

    if I have the mw and that hb dr that I mentioned both care for me, that means I would have to pay them both (there is no insurance coverage for any alternative birthing options. it's hospital or pay for it yourself.) so that is a little out of my range.
    ~Ayelet & Yoram
    Tani 7/6/04
    Odeliya 3/8/07
    NJ, USA to Israel 12/29/08
    Yitzchak, 22.6.09
    Asa'el, 14.10.11
    Welcome baby boy!! 26.7.13

    Rambling on at http://milkandhoneymomma.blogspot.com
    facebook and twitterID: ayeletschwell

  4. #4
    Super Poster shiregirl's Avatar
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    Hmmm, that is a bit difficult. If I had a midwife who I felt confident in, and who had some supplies to deal with certain emergencies that might arise, I would probably be ok personally with a 35 minute drive to the hospital. What about ambulances? Is there a rescue station close by who could get to you quicker than that and then transport you if need be?






    My June 2011 Space <<-- Updated 06/11/11

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  5. #5
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    When you are in hospital the "decision to incision" time is often quoted at roughly 30 minutes (by the time the team is gathered, OR prepped, etc). So, personally, that would be my time line for a home birth as well. The mw could call ahead, they could get ready, and the c/s would happen in basically the same time frame whether you were at home or an in-patient.

    As for supplies, they should carry oxygen, bag and mask, suction, meconium aspirator, intubation supplies, IV fluids, oxytocin, etc. Those are all required supplies for mw here to carry.

  6. #6
    Posting Addict gardenbug's Avatar
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    My DD lives 5-10 minutes from the hospital. She was told that it takes 20 minutes to prepare the room for a patient. So calling ahead is important. Fortunately, she never needed a transfer. Her midwife is VERY competent and experienced. DSIL is very comfortable with the MW as well.
    Leo (3 1/2) with Malcolm the cat

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    Posting Addict Spacers's Avatar
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    Do you live 35 minutes from THE hospital or from ANY hospital? If it's an emergency, you go to the closest hospital even if it's not "your" hospital. But you know that. I think if I had a well-equipped midwife who carries oxygen, pitocin and/or methergine, terbutaline, vitamin K, and an IV, I would feel fine being 35 minutes from a hospital. Unassisted, for me it would depend on ambulance response time, can they respond & have you to the hospital within 30 minutes? If they have a 10-minute drive to you or if the road to the hospital is so twisty that it would take just as long, then I probably wouldn't consider unassisted.

    The two emergencies that I prepared for when considering an unassisted birth with Tiven were cord prolapse and breech. You have a "proven pelvis" so breech shouldn't be a concern, just remember to not pull on baby, and put warm towels on baby's body because cool air triggers breathing & you don't want that to happen with the head still inside. For cord prolapse, you get your butt up in the air, as high over your head as you can manage, so you have gravity helping. Have your DH hold the head gently but firmly to keep it from putting pressure on the cord. If it's possible to move the cord back past the baby's body, do it; if it's not possible, then he just keeps holding until baby comes out one way or the other.
    70% of the U.S. population now lives in a state where same-sex marriage is legal. At 36 and counting!

  8. #8
    Posting Addict Spacers's Avatar
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    I think you'd be fine with the doctor who will attend the birth but doesn't do prenatal care. Get yourself some protein & sugar strips to check your urine, and a BP monitor. Your instincts will guide you beyond that.
    70% of the U.S. population now lives in a state where same-sex marriage is legal. At 36 and counting!

  9. #9
    Prolific Poster tanismom's Avatar
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    Thanks Stacey! Yeah, it's 35 min from any hospital, unfortunately. There are something like 40,000 humans (Israeli and Druze) living in the golan and 20,000 cows - the animals definitely have more services here than we do!

    The ambulance response time here is record - and they could probably get me to the hospital actually in 20 minutes. (both hospitals are about a 35 minute drive, but one is a less mountainous drive) i wouldn't trust yoram to do it with me in labor, but the ambulance could do it in 20/25 for sure.

    I met with a doula today, I actually went to her for acupuncture for this crazy congestion/allergic type feelings that I just can't shake. She was great! She speaks some English and fully understands it. I asked her a few "doula" questions and felt very comfortable with her answers. She's going to send me a list of a couple of MW's in the area, including a new one! Who knows! I am also going to call the dr guy and at least talk to him and meet with him. And I spoke to Yoram today about designating our small internet savings account to be the "birth fund" this way we can build it up over the next 5 months and hopefully have enough to not have to worry about any eventuality (i.e. needing to pay for DNA testing to prove the baby's mine if I decide not to have a certified attendant) That will also give me peace of mind.

    I think right now there's enough in there to just cover a MW's fee (it's about a 1/4 of what US mw's charge!) So if we add some to it over the next few months, I think I would feel like I have more options.

    I'm definitely feeling better today, and speaking to Einat (the doula) really helped me feel more comfortable. I like her style a lot and her philosophy. I think if we decided to hire her, everything else would go more smoothly.
    ~Ayelet & Yoram
    Tani 7/6/04
    Odeliya 3/8/07
    NJ, USA to Israel 12/29/08
    Yitzchak, 22.6.09
    Asa'el, 14.10.11
    Welcome baby boy!! 26.7.13

    Rambling on at http://milkandhoneymomma.blogspot.com
    facebook and twitterID: ayeletschwell

  10. #10
    Posting Addict Illiana's Avatar
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    In all of my research on breech birth, the biggest thing about having a successful one is not to touch at all until baby's arms are out and you need someone to support the body. Touching either the mother or baby can cause movement and tensing which in turn will prevent baby from coming out. Having the baby's head in there too long is the issue not them breathing since that causes cord prolapse. And the main concern with having a breech presentation (why everyone sees it as dangerous) is that the cervix isn't dilated enough when you start pushing and end up with the head getting stuck because the feet/butt can pass through a space smaller than 10 where the head wont. This causes problems in hospitals (and some MWs too) is that they don't trust the birth process and breech birth should be hands off.

    There are places online that have copies of emergency childbirth by gregory white. its worth a read for anyone pregnant since you never know when you will end up on the side of the road or at home alone when you go into labor.

    Look into TRUE emergencies of childbirth not just the fear of it put on us by doctors who want to control everything and everyone on their schedules.

    I had a UC dbl footling breech birth to a big baby (11.2lbs). I also live 40ish minutes from my backup hospital. (and yes there's a closer one but i'd have to be dying to go there)

    pm me if you need to talk or want any info since i only lurk here occasionally now.

    I would go with that doc and homebirth regardless of prenatal care. unless its something that YOU aren't comfortable with.
    Jade, momma to Ariana 5/23/06 and Trystan 9/28/10
    http://www.teambeachbody.com/member/sn/illianaraska

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