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Old 01-13-2012, 08:33 AM   #11
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So, am I understanding that sometimes the ob's do the epidurals? I have never heard of that.
At our hospital, yes. At the time there were 3 OBs. One lady in her 30s (awesome doctor who delivered my kids) and two male doctors who are easily in their 70s. They've been around long enough that they know how to do an epi, and at least one of them does because he did mine on a Thursday morning around 9. Since their practice is right behind the hospital, it was quicker to get him than the anesthesiologist. And I must say, the ob was good at it. He was fast and didn't have patience for the contraction I was in the middle of, but he did a good job.

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Old 01-13-2012, 08:35 AM   #12
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Re: If you gave birth in a small hosptital....

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Originally Posted by crunch!910 View Post
I delivered DS1 in a small hospital. There were only 8-10 "birthing suites".
I had to wait a couple hours or more for epidural because they had to call the anesthesiologist in (which makes no sense to me because I got my epidural around 5pm? Why wasn't he already working?
If he or she had worked a night shift or had a day off etc. they would need to be called in. In our hospital, they have to call the anesthesiologist in, so you may have to wait a bit. Anethesiologists are in short supply in our neck of the woods.
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Old 01-13-2012, 12:59 PM   #13
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Re: If you gave birth in a small hosptital....

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Can laboring moms get an epidural waiting a wait at that hospital? Do women in your area talk/complain/plan around a wait for an epidural?

I am so curious about this because I've never heard women in the US talk as though they'd want an epidural but not be able to get one fast. But it seems that in a hospital without an on-site anesthesiologist, laboring women would have to wait.
I've never once heard of a complaint about waiting for an epidural. Generally they seem to be induced so they would be laboring during the day while anesthesia is already there. However, a large number of moms I talk to are more "naturally minded" and are rarely induced and do not receive epidurals. I do know of a few moms who had emergency c/s and anesthesia was able to get there on time. In my case, I didn't have an epidural as I didn't labor before my c/s (had severe pre-e). I really don't know how long it would take to get an anesthesiologist there in an emergency but I'm guessing they live close by.

*edited to add - There are 3 total hospitals in our area so the majority of moms go to the slightly larger hospitals (still relatively small). Have not heard of any difference between wait time for epidurals between the 3.

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Old 01-13-2012, 01:39 PM   #14
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my hospital is very small 25 beds 4 ob rooms I have never had a epidural so don't know about that
with my first 2 my midwife was with me at the hospital most of my labor with my 3rd my midwife was out of town so I my family Dr came in to see me he than left and didn't make it back in time and my favorite Ob nurse delivered my baby
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Old 01-13-2012, 03:36 PM   #15
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Re: If you gave birth in a small hosptital....

Doctors don't work typical 9-5 shifts, so its very possible that they would have to call someone in during "regular" working hours, especially depending on staffing. For instance, dh worked 3:30 pm until 8 am last night, but today he's home.

The hospital where I had my youngest was a small hospital. They averaged about 30 deliveries a month, sometimes way less, sometimes way more. They did not have Peds or anesthesia in house, Peds did at home call, and we were required to live no more than 20 minutes from the hospital. The OB's could also do in home call, but were required to be in the hospital the entire time a patient was laboring and do all of the post birth check ups on their patients themselves, even if it was their day off.

The nurses were STABLE certified, my dh happened to be the one who taught them since he was an instructor. That teaches nurses how to stabilize newborns and get them ready for transport. The closest NICU was an hour away, so there were a lot of nights dh stayed at the hospital all night transporting and bagging babies.

I wouldn't say that dh was forced to do more than docs at large hospitals, mostly because the population he saw was low risk. Now that he is in a major medical center and doing intensivist stuff, he is doing way more than he did then. There were so few deliveries, and the population was low risk that he wasn't seeing the genetic syndromes, heart problems, 23 weekers and so on and so forth. They were almost all healthy newborns and if they had trouble they could be stabilized enough for transport to the NICU.

As far as waiting for an epidural, once again, they couldn't live more than 20 minutes from the hospital. If they did, they had to do call in house.
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Old 01-13-2012, 04:45 PM   #16
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Re: If you gave birth in a small hosptital....

According to that site, my hospital has a total of 215 beds(between two locations). There is no nursery or NICU. When I delivered DD, I did have to wait about an hour to get my epidural. It was in the middle of the night, but the doctor was super nice. My epidural didn't work, but the doctor was cool and really tried to get it working.
My family practice doctor delivered her, so she was called when I went in and she made the call to admit me. They consulted with her over the phone until maybe three hours before I delivered and then she came in. If I had needed a c-section, she had a back up OB that would have been called.
With DS, I had a new dr, an OB this time, since my dr stopped doing OB. She is in a practice of 5 OB's, so I would get the on call dr(from the office of my dr) if I went in after hours or on a weekend. I happened to go into labor on my dr's day off, so I got the on call, which was fine. I had met her before. There is no full time OB at this hospital.
For the epidural, the birth center now uses nurse anesthetists instead of doctors, so there is always one on the floor. He.was.awesome.
As for peds, there is no full time doctor there. Most patients have already chosen a doctor for the baby and that doctor will come to the hospital 12-24hrs after birth. They will also discharge the baby. There is a ped that is called if there is no doctor chosen prior to birth. If there is an emergency, they can keep baby stable until an ambulance or Life Flight can take them to the bigger hospital 30 minutes away.
I absolutely loved my births at this hospital. IF we have another, it will be there. The birth center(they don't call it L & D at all anymore) is so calm and peaceful. The birthing suites are huge, with jacuzzi tubs in all of them. The nurses are amazing. Every one of mine(only three, but still) was an LC. If it weren't for them, I would have given up BF before we even left. I did FF with DD, just because I wasn't sure on breastfeeding, but with DS, I really wanted to. We had issues at first, but my nurses were just amazing. They never ONCE suggested formula. DS had jaundice pretty bad and went home on a bili blanket. I was instructed to nurse, nurse, nurse. Never a word about supplementing. Yet, they are supportive of FF moms, too. Neither of my sisters wanted to bf and they brought them formula with no questions asked. If you are a bit unsure, they can have a LC come see you, but they do not push anything on you.
Anyway, my small town hospital experience was amazing! I love the personal care you get.
Also, my labors progressed very slowly, like a cm every 3-4hrs. We were basically left alone, with the lights turned down so we could sleep for the majority of the time. I actually had to ask to be checked four or so hours after we got there because I wanted to know if I had made progress. They would check, tell me I was doing great and leave. The dr came in once, told me I was a 5 and she would be back after office hours. Then she came back to deliver. The dr and nurses actually told me that if everything was going well, there was no need to rush things.

ETA: This hospital doesn't deliver before 35wks. You would be sent by ambulance to the bigger hospital if you went into labor before then and they couldn't stop it. My sister went into labor at 31wks and they managed to stop it with terb. Otherwise, off to the big city she would have gone.
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Old 01-13-2012, 08:03 PM   #17
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Re: If you gave birth in a small hosptital....

Our hospital is an hour away - there are 2 obs that work there (they usually rotate shifts) and one anesthesiologist. He does not work at night. The only way they will call in the anesthesiologist is if an emergency c-section is required, he will not do an epidural at night without a VERY good reason.

There is no nicu.

Dp doesn't seem to understand why I don't want to drive an hour to get to the hospital and would prefer a hb. We have another even smaller hospital within 5 minutes from our house that would airlift us to a big hospital if required (essentially the same thing the hospital an hr away would do).
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