Thursday, February 08, 2007

Moving on to the next big decision

I've got another post up at Mommy Blogs Toronto. And it's quite timely--a plea for advice, particularly from those in the Toronto area, on birthing options. Go on over and have a read. I talk a bit about my previous experience (mostly good).

A few things I left out from that post, dealing with my insurance situation:
  • Technically, the insurance I have as an international student provides coverage equivalent to OHIP.
  • However, few hospitals will automatically provide services without requiring upfront payment and leaving me to navigate the paperwork for reimbursement.
  • So for the downtown area, I'm limited to Toronto General, Toronto Western, and St. Michael's.*
  • I will be going to a campus doctor next Friday to confirm the pregnancy and get a referral.
A few elaborations on my experience and expectations:
  • I had seriously considered using a midwife and birthing center for my first pregnancy, but decided not to because there is some history of difficult births in my family (even though I was convinced it wouldn't affect me).
  • I went into the birth not wanting to use any drugs or intervention. I ended up with pitocin, an epidural, and a forceps birth after my contractions failed to become regular and my progress stalled out.
  • I came very close to having a C-section. If I hadn't been at 10 cm at my last check (a couple hours after getting the epidural), they would have started prepping me.
  • I somewhat expect that I will broadly follow the same pattern: fairly regular pregnancy, all numbers good, difficult delivery. I'm headed into this thinking a C-section is about a 50% probability.
Since, as far as I understand, a midwife would be able to handle a straightforward pregnancy with an obstetrician taking over if I needed intervention, I'm leaning towards the midwife.

Thoughts? Advice? Stories about the hospitals listed above? Those of you outside of Toronto are welcome to weigh in about the broader issues.

*Toronto General is where I took Trillian when she had pneumonia. To say we were not impressed is a gross understatement. But we've only experienced the emergency ward. Similarly, Toronto Western seems OK (though parking is awful), but we've only been to internal medicine.


bubandpie said...

Everyone I know who has used a midwife has absolutely loved it, and would never do it any other way. (This is especially true of those who went the O.B. route the first time and had a midwife the second time.)

Trillian said...

What I find shocking is that we are paying almost 3 times as much for our health insurance up here and getting less for it (and I'm not including what I fork over in taxes for others to get OHIP). I still have my US health insurance for me and Scooter (Mouse can't be covered because we aren't married according to the state where my employer happens to be). The US insurer will pay for more, I get help more quickly and it covers prescriptions. I have to say, I would prefer paying for an individual plan for Mouse and going back to the US for the birth, rather than have to deliver at Toronto General where I waited 9 hours (!!) for assistance in the emergency room. It all makes me very nervous about the "care" we'll receive here.

Her Bad Mother said...

I left a response over at MBT, in which I said some stuff about Women's College... here I'll say this - we had an OB (our family doctor) AND a doula, and it was really, really great.

Laural Dawn said...

First of all, let me say that I never ever share my birth story (it haunts me) so the fact that I'll say this much says a lot for how much I like your blog :)
I had a midwife. The care leading up to the birth was fantastic. My son was a surprise. I was not ready. I would go to the midwife almost hysterical as I got closer and closer and panicked more and more they listened, calmed me down, took a ton of time. The added benefit was that they had midwifery students (closer to my age since I was 25) who I could talk with and ask all my questions.
At one point I had to see and OB and it sucked. I was rushed in and out - I remember thinking how much I was happy with my choice.
Besides the incredible medical care they provided the emotional support was amazing.
My pregnancy was normal and fine. The birth was horrible. I had my son in the hospital. We also had forceps. A doctor took over the care technically, but the midwives were there the entire time. The transfer of care worked really well because it was more a formality. They still took control of a lot of stuff - I asked them all the questions I had (I hated the doctor), they came to see me every day we were in the hospital (5 days). At the end I wanted to leave and I was fighting with the hospital about releasing my son and I. I was getting nowhere. The midwife stepped in and within an hour I was released.
If nothing else, I felt like they were my advocates. The doctors and nurses did their job, but the midwives went above and beyond.
This was not unique to my experience. I have found everyone has said this that had one. And, the transfer of care works really well.
Good luck with it. Sorry for the long comment :)

Naomi (Urban Mummy) said...

I left my input over at MBT. Should you want to know anything else, or just want to chat, drop me a note!

Lisa b said...

Wow I am appalled that your choice of hospital is being dictated by your coverage and not your care-giver. I can see why you and Trillian are not excited at the thought of going to TGH.

I'd agree with everything said about Midwives and I've heard (and experienced thorough my genetic counselling) much the same about transfer of care that Laural describes.

cinnamon gurl said...

I can't help you on the hospital situation, but I had midwives, and ended up with a transfer of care and c-section. What was great was that they stayed with us throughout, one of them talked to my huz before the surgery, and they stayed with us throughout the surgery, telling us what was going on, etc. One of the nicest things was how joyful they were about the birth, how much they love newborns and how excited they were to exclaim: "He's a redhead!" If I have another one, I'm not sure if I will try a vbac or a scheduled c-section. If I'm not going to try a vbac then I don't think it's fair to use the midwives when they have to turn people away sometimes. Otherwise I would totally 100% use the midwives again for sure.

All that said, there were times when they seemed more like "medwives" than the midwives I expected as far as choices leading up to the birth. Sometimes the hospital's and their college's regulations can get in the way, in my opinion.

Mouse said...

Still trying to get a definite answer out of the insurance administrators at school. I will be paying them a visit on Thursday.

But I have also been impressed by all of the midwife stories and am definitely trying to figure out if I can make that work. I was incredibly lucky to have a wonderful OB and great labor nurses. But a midwife sounds like the best way to make sure I have an advocate in the room--rather than relying on luck again.