Am I even a candidate for a midwife/birth center/home birth?

[HeatherlovesCDs]

Short version and question: I have a history of high BP in pregnancy, GD with my first, pre-term labor with my last set of twins (technically with both) and pre-e with my last set of twins. The monkey wrench is that my previous births were twins. That automatically raises your risk of the above issues. I already have high BP at 13wks, but the other things the risk is much lower, especially the pre-term labor/delivery.

Can someone tell me if a midwife/birthing center/home birth is even an option for me with my history?

Back story: This is my 4th pregnancy. With my first, I wanted to deliver at a Birthing Center and my husband wasn't on board. Also, the only center was over an hour away over a bridge that OFTEN had heavy and very unpredictable traffic. I didn't push it. I tried to go without pain meds. I made it 42 hrs and 9cms before ending up with the epi. It's still a sore spot with me, but that isn't the story for this thread. With my second and third, both times it was twins and I had regular hospital births with planned epi's.

Anyway, I know the risks of an epi and I know the benefits of going without. At this point, I'm scared, but I'm strongly leaning toward going without pain meds for this 4th and last delivery. My husband is much more on board this time. He is definitely willing to go with a birthing center and maybe even have a home birth.

The big problem with this is that I am having a very hard time finding a Birthing Center near me. The closest seems to be about 1.5 hrs away. It seems like if I'm going to go the midwife route I'm going to need to do a home birth. Of course, I have no idea how to find one of those or if I even will in my area.

So, before I go nuts looking for one, am I even a candidate??

ETA - There are definitely no midwives that deliver at the hospitals near here. There is only one that I know of and it's an hour away. Also, she is much more like an OB. I was with her practice prior to moving here. I LOVED the OB there. Her not as much. She wanted to induce me at 34wks with my twins and my OB said NO WAY! The hospital where I am currently planning to deliver, there is literally one OB practice that delivers. It has 3 OB's. Luckily, both the hospital and the OB's are very supportive of going med-free. The rooms even had large bath tubs in them for laboring in. My OB said the only way he won't deliver is in the water. I'm fine with that. So, if I have to go with them, I'm okay with it. But, I'm thinking if I want to go pain-med free, my best bet is not in a hospital where I have the option to cave.

[umphreysmommy]

I think it would depend on the midwives and if your issues can be controlled with diet/lifestyle changes, I don't think CPM's can prescribe meds. Also, something I recently found out was that unless the birth center is part of a hospital and on site it is no "safer" than a home birth. They have the same equipment that the vast majority of home birth midwives bring to the home with them and they also would need to transfer to a hospital should issues arise. Good luck and hope you get the birth you are looking for!!

[sillyutalktome]

When I spoke to the birth center here they were willing to take me as a patient even though dd was born premature as long as I saw someone concurrently if a problem occurred and of course if baby came before 37 weeks I'd have to deliver at the hospital.

[Hitchkids]

It is totally going to depend on the midwife. Some will look at each pregnancy individually and treat issues as they become a problem. Or perhaps give you ways now to prevent the concerning issues. Others will automatically say it's too much risk. I've dealt with midwives who have viewed things both ways. My current HB midwife treats each pregnancy individually while also giving suggestions on how to avoid issues that have cropped up in previous pregnancies. Of course, it may also depend on the rules in your state. If your midwife has to have patients approved by a supervising doc, that doc could override their decision. I had that happen in a previous state. It was quite annoying.

[tygr2410]

if you're being medicated now for the high BP, it may be hard to find one...and they will prob need to be backed by an OB that can prescribe meds if you're going to continue to need meds throughout pregnancy. At the birth center i am going to here, if you have GD and are diet controlled, you can continue care, but if meds are required you have to transfer out. Not sure the same would apply for other types of issues or for just GD

Since both twin deliveries were not c-sections, i'd think that it would make you a decent candidate for a birth center or home birth...but i'm not a midwife or anything.

[HeatherlovesCDs]

I'm not currently on meds for the BP, nor have I ever been. I had a very high BP at my OB appt when I found out I lost one. Based on that reading, my previous OB wanted me to go on them. I knew it was a fluke and that my pressures were not normally high enough for meds. So, I waited to start. My husband took it at home and when I saw the new OB I showed him my chart with all of them. He agrees with me. I don't need them. Although, it is possible I'll need them later, but I don't think I will. The issue is it turning into pre-e. The day I was to be induced with my last set of twins, it had progressed to pre-e because I was suddenly spilling protein in my urine. I asked if we really needed to induce that day (no one thought I was going to make it that long since I was dilated to 5cm's for 2wks prior and had been contracting every 10 minutes for well over a month.) I was willing to continue to suffer through the horrible swelling, but he told me my BP was going up (it was) and I was now spilling enough protein to diagnose pre-e and that I needed to deliver. (I know he wouldn't have delivered me if it wasn't time. He had already told the midwife no once.)

As for the GD, it was diet controlled...easily. It wasn't diagnosed till about 34wks. It was very mild. It was also my first pregnancy, followed by 2 twin pregnancies with no GD. But, it was my only singleton pregnancy and so is this. I hope I don't get it again.

I feel like without the high BP and GD, I am a good candidate. I've delivered 5 babies, 2 sets of twins without any issues during labor (except with the epis. ). I know I could do it. But, now I'm wondering if it is even worth it. I think I'll end up having to drive a good distance. The OB that would work with the MW would probably be up there too. If I transferred, I'd still be far away. I think the chance of me needing to transfer is good. Maybe I'll just get a doula. The hospital here does have a very nice set up including a tub and birthing balls and such for laboring without meds. Maybe I should take a tour. LOL!

[HeatherlovesCDs]

I'm not currently on meds for the BP, nor have I ever been. I had a very high BP at my OB appt when I found out I lost one. Based on that reading, my previous OB wanted me to go on them. I knew it was a fluke and that my pressures were not normally high enough for meds. So, I waited to start. My husband took it at home and when I saw the new OB I showed him my chart with all of them. He agrees with me, but they are on the high side. I don't need them. It is possible I'll need them later, but I don't think I will. The issue is it turning into pre-e. The day I was to be induced with my last set of twins, it had progressed to pre-e because I was suddenly spilling protein in my urine. I asked if we really needed to induce that day (no one thought I was going to make it that long since I was dilated to 5cm's for 2wks prior and had been contracting every 10 minutes for well over a month.) I was willing to continue to suffer through the horrible swelling (I swelled so much, I lost 50lbs in 10 days after delivery!), but he told me my BP was going up (it was) and I was now spilling enough protein to diagnose pre-e and that I needed to deliver. (I know he wouldn't have delivered me if it wasn't time. He had already told the midwife no once.)

As for the GD, it was diet controlled...easily. It wasn't diagnosed till about 34wks. It was very mild. It was also my first pregnancy, followed by 2 twin pregnancies with no GD. But, it was my only singleton pregnancy and so is this. I hope I don't get it again.

I feel like without the high BP and GD, I am a good candidate. I've delivered 5 babies, 2 sets of twins without any issues during labor (except with the epis. ). I know I could do it. But, now I'm wondering if it is even worth it. I think I'll end up having to drive a good distance. The OB that would work with the MW would probably be up there too. If I transferred, I'd still be far away. I think the chance of me needing to transfer is good. Maybe I'll just get a doula. The hospital here does have a very nice set up including a tub and birthing balls and such for laboring without meds. Maybe I should take a tour. LOL!

[lindsey.leanne]

Hi Heather, I am not sure if you remember me but we both live in the Chicago area if I am correct. I might have info on a midwife or practice but remind me which area of Chicago you are located (pm if you prefer). I think you would be a candidate as long as you are willing to see an OB if issues arise.

[lindsey.leanne]

Sorry...DP

[HeatherlovesCDs]

Lindsey, thanks for the offer, but you might be thinking of someone else. I am a little outside of DC. I know DC of course would have options. Closer in there are. I live too far out to take advantage of the many options there. It's about an hour and a half away now. I grew up much closer (20 min) and I miss having so many options for everything. Thank you though!!