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back up hospital question.


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#1 mamaj180

Posted 09 July 2014 - 12:23 PM

Hi ladies! This forum seems quiet. I am 14 weeks pregnant with baby number 5. And planning my first home birth. Have had one c-section and three vbacs. I have my first booking in appointment with midwife comming up soon. She mentioned to me that she will be doing a referral for a back up hospital near me. Im just wondering is it necessary and if any of you ladies had booking back up hospital appointments how did they go? I'm very nervous about having to go in. I was hoping to avoid seeing an ob at all. And I've always given birth at one of the main hospitals in perth they wont accept this time unless I do all my care and birth through them. The one ill be going to be backed up in is swans and I havent heard many good things about it im afraid. :/

#2 deejie

Posted 09 July 2014 - 01:05 PM

Hi Mamaj! Yes it has been very quiet in here recently :)

We are having our third baby in September, which will be out second homebirth. Our two homebirths have been with two different midwives. I have not been "back-up booked" in to a hospital either time. If I need to transfer, then I need to transfer. The public hospital I am zoned to in Melbourne is not going to turn away a zoned-homebirth transfer, are they? Of course not. So I have not seen the need to be "booked in" as a backup at all. Neither have my midwives.

In my experience with women who have booked in, all it causes is an additional appointment at which (unless you score a sympathetic OB) your choice to have your baby at home will be questioned.

If you do need to transfer, your midwife will come with you and will notify the hospital by phone in advance. I really don't see what all the fuss is about.

Is the midwife providing your care a private midwife? Can you discuss this choice with her any further?

#3 mamaj180

Posted 09 July 2014 - 03:28 PM

Hi Deejie
             Thanks for getting back to me. I gave my midwife a call (she's a private midwife) and told her my concerns. Im not sure if its different over there in melbourne. But she said here she has to do a back up hospital referral it is up to me whether I go to that appointment or not but she did advise me too. She said when I get my appointment time in the mail we can try and organise it where she would be able to come in with me and that way if the Dr tries to bully me regarding my decision she will be there to shut them up lol. The hospital that I am booked into my midwife is actually teaching there this month as well. Im so new to how this process of home birth is. I am hoping everything will run smoothly. My previous hospital births haven't been a great experience. After my last births as well I now have a uterine prolapse. I do believe if I had another hospital birth it will get worse with all that yelling to push push! Hoping to breathe the baby out this time.

#4 deejie

Posted 09 July 2014 - 07:59 PM

View PostGlitterFeralFarts, on 09 July 2014 - 07:32 PM, said:


If she's a 'registered' midwife, conditions of keeping her reg is to insist on hospital care. Otherwise she could be stripped of her regs and investigated.


I don't know about this, Glitterfarts. The two private midwives for my births have not even mentioned any requirement for a back-up booking. I know of two women who have birthed in Melbourne with a third midwife where they also didn't have a back-up booking. I think there is some room for interpretation and some midwives (understandably given the current political climate) feel the need to "cover their a*se" with a formal hospital back-up booking.

I agree with you though that if she comes along, it will be an excellent chance to see how she advocates for the OP if she comes across an unsympathetic OB in the hospital appointments.

#5 apple702

Posted 09 July 2014 - 11:33 PM

My MW (in NSW) said its up to me if I want a back up booking or not, and that she could make it on my behalf and no visit would be necessary? Maybe I should check at my next appt to make sure I understood correctly. either way I don't have one made at 21 weeks.

Not very helpful sorry :)

#6 Benevolence

Posted 12 July 2014 - 12:25 AM

Hi mamaj180. I'm a few weeks away from my second home birth in Perth.  I'm going through the cmp again and I have to have a back up hospital as part of this program.  I'm going through joondalup.  Last time, nearly the years ago, joondalup were tricky and difficult about giving me a clearance to hb. This time, it is a different ob in charge and she is really supportive and has been a pleasure to deal with. Perhaps you could go through joondalup for back up?

#7 veggiepatchfamily

Posted 15 July 2014 - 12:57 PM

Hi,
I am pregnant with my third (will be second home birth).
I was booked in with my local hospital last time. That way they had my blood and ultrasound results and I was registered with them, for ease of the computer system (BOS- which I know most victorian hospitals use) and they had my paperwork (stickers etc) easily available if required.
I will again book in at the local hospital.
It is always recommended that our home birthing and free birthing women book in with the midwifery department. They do not require them to see the midwives clinic or obs, but they at least have access to their info, in case thing don't go as planned.

As a midwife (who works in my local hospital) I can only express how difficult it can be if someone who you know NOTHING about arrives on your door step in labour or even worse post birth birth with complications.

To check your midwife's registration head to
http://www.ahpra.gov...ctitioners.aspx
type in as much as you know, last name, state etc. You will be able to have a quick snap shot of their registration.
Good Luck!!

#8 tick

Posted 16 July 2014 - 08:20 AM

I had a VBAC at home in Melbourne and while my midwife didn't insist on a hospital backup booking, she kinda wanted me to have it.  She said she gets a bit more nervous about "doing the right thing" when attending VBACs because she's been reported a couple of times.

I did go to the appointment and apart from losing 2 hours of my life, it was completely uneventful.  The OB took my BP, asked me a couple of questions and told me he understood why I might want to avoid hospital, but that they were there if I changed my mind or if something went wrong.  He said that he hoped he didn't see me again (in a nice way).  It was surprisingly refreshing actually.  I didn't bring my midwife with me to the appointment but she would have come if I wanted her to......

#9 ikealover

Posted 16 July 2014 - 12:06 PM

With my hb (5th) I did all the hospital apps but just didnt tell them of my plans for hb, that way I was in the system and played along with them. I then had all my midwife app at home.
Showed me the polar opposites of both systems-waiting 2hrs for my app and have to correct the drs when they had the wrong records to drinking tea with my midwife who certainly knew who she was talking to.

#10 deejie

Posted 16 July 2014 - 01:43 PM

View Postveggiepatchfamily, on 15 July 2014 - 12:57 PM, said:

As a midwife (who works in my local hospital) I can only express how difficult it can be if someone who you know NOTHING about arrives on your door step in labour or even worse post birth birth with complications.

See I'm really not sure how having access to my FBE/ferritin etc result at 28 weeks, or my ultrasound result at 20 weeks really helps you out here. They will have absolutely no bearing on the WHY or HOW I am presenting in the event of a transfer (emergency or not) during labour or after birth.

In the event of an emergency transfer, my midwife would notify the hospital over the phone in advance. There would be a verbal history given. My vitals and further communication would be exchanged at handover-- much more relevant than my BP at a booking visit weeks earlier.

I understand some midwives cover themselves by arranging a backup hospital booking appointment. In terms of practicality though, they serve very little actual purpose.

ETA-- I agree glitterfarts that the "hospitals" (being very general here) are doing themselves a disservice by being difficult. If only we were all guaranteed an appointment as friendly as tick's! The increasing incidence of DOCs notifications and the like by hospitals is becoming frightening.

Edited by deejie, 16 July 2014 - 01:51 PM.


#11 CountryBumpkin

Posted 20 July 2014 - 07:31 PM

I booked into back up hospital and regretted it. The pressure from the hospital, even the appointment i went to they went on about the dangers of HBing. The OB even pulled the dead baby card! he got a copy of my amazing birth story ;)

If you can avoid it, i would. my midwife had great notes, which is all the hospital is going to have when you arrive anyway, so if the midwife hands them over if you need to transfer, then they should be able to treat you sufficiently.

#12 Raincloud

Posted 20 July 2014 - 08:46 PM

I'm going through the CMP here in Perth. I only made the decision recently and had already had one appointment at the hospital and have another booked next week. When I rang to cancel next week's appointment they said that if I'm on the CMP they recommend I go for an appointment with a GPOB at some point anyway as they are my back up hospital. So I  going to the appointment, although I don't really see the point.

#13 Danny Doo

Posted 22 July 2014 - 01:57 PM

Hi,

As a homebirther and MW myself (who works in a public hospital in NSW), registered midwives can work as independent midwifes attending women in their home without risk of losing their registration. Insurance is a personal matter however I believe all MW's working in private practice would be a little crazy not to have insurance. Best for them and their clients.

I book homebirthers in at my hospital regularly, it is their choice and one I personally fully support. What I'm trying to say is they never see an OB, just a midwife, who records information we may need if they come in under an emergency situation. Blood group, rubella status, GBS and GDM results if she has had those tests, U/S results etc. All MW's I work with are respectful of women's choices and never make disrespectful comments to home birthing women.

I booked into my local hospital myself when having my homebirths as it made me comfortable to know there would be a seamless transfer if needed (which of course it wasn't).

All public hospitals that I know of, have MW's do the booking in appointment so you should never have to answer to an OB. Good luck with your pregnancy and birth - it will be the time of your life!

#14 mamaj180

Posted 24 August 2014 - 12:51 PM

Hi ladies thank you all for your replies. I went back to my gp after I did my anatomy scan and she did the back up hospital referral.for me she sent them all my notes and put in the referral that I shouldn't need to go in as they have my notes and im planning a home birth with a midwife. Its been a couple of weeks now and I havent heard anything from the hospital not to sure if thats a good thing or bad.

#15 suline

Posted 25 August 2014 - 11:42 PM

I went through the CMP in Perth did the backup appointment (which I was happy to do) the OB cleared me no problem but did say that if I transferred in not to think of it as a failure.

I DID transfer in for failure to progress, and initially it was a smooth transfer- the CMP midwives went ahead and met me in labour ward, had me all set up and got my paperwork sorted so I didn't have to check in with the ward clerk. they had worked over their hours so had to hand over to a hospital midwife, -and this is where I believe the whole booking thing is a waste of time

The midwife clearly never read my notes or listened properly to handover, she really had no idea what had happened to me. I ended up going for a Caeser so I still needed to have a cross match and HB check. They scanned me to check the position of the baby. She wasn't happy that I had been in labour so long and kept asking me why the doctor hadn't documented in the notes, I kept having to explain myself, explain what had happened, what I wanted to happen and that I had in fact had antenatal care and so on. the doctors seemed to cope much better with the transfer in than she did. That 2hrs sitting in clinics for someone to check my BP and make me sign a hep B and newborn screening consent was the biggest waste of time if the midwife can't be bothered to read your notes.

#16 renjul

Posted 29 August 2014 - 04:07 PM

Im also a midwife and planning a home birth. Im in two minds myself about whether I book in to my local hospital. My midwife said in her experience it makes no difference, and apparently she can send them through a letter in pregnancy that they apparently stick in a file. I also agree with the other midwife here, that having someone transfer without having any booking-in paper work can make for a grumpy midwife at 2am. But really thats not the concern of the labouring woman. Thats just me knowing what its like to be the midwife on the other end.

Ive moved to a new area so I have no idea what the staff are like at my local hospital and that makes me nervous. Ive just come from a hospital where home birth is a common occurrence and transfers are always received warmly and without judgement. But I also know this is not the norm. As Ive heard some horrible tales.  And if I was back living in the area that I previously worked I wouldn't hesitate to book in. I do think its important to keep the lines of communication open, and that hospitals need to come on board with home birth being a rightful birth choice for women. So its tricky




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