What would you do?

[dappleton]

OK dilemma time -

I have 2 weeks to decide where to give birth, I have 2 main options and really don't know what to do :

Option 1) Pro's: Large, well equipped hospital, seems well prepared for all eventualities. Cons: Only male doctor available, the idea of which i'm not at all comfortable with and can take 1.5hrs to get to from my house.

Option 2) Pro's: Female doctor, i'm so much happier with this idea, close by - about 10min drive. Cons: Very small clinic delivering just a couple of babies a month, really not confident that they have all the facilities if complications.

What would you do?
Pregnancy is uncomplicated, baby in a good position (head down) - first baby though and don't know what I should expect and hence which of the above options to go for... all opinions very welcome.
P.S. not in UK

Personally I'd go for option 2). 1.5 hours is a helluva long way to travel by car when you're in labour! With DD I had to go 15 minutes and that was bad enough.

How fast can option 2 get you to a bigger/better-equipped facility if needed?

I went for a small hospital with DD and they said they were no more than 5-10 minutes by emergency ambulance from the larger hospital, but also had emergency facilities on-site if needed.

It really is a very personal choice though.

Have you/will you have a chance to talk to the Drs re. their personal attitudes towards birth?

Over and above whether a Dr's male or female I'd be interested in how interventionist they are - my preference would be for a Dr that is happy to sit back and let me get on with birthing my baby, keeping a watchful eye to make sure there aren't problems developing.

I DON'T want a Dr that will insist I give birth on my back, in stirrups, with VE's every 2 hours to check dilation, augmentation if I dare dilate slower than an arbitrary standard, etc, etc.

I'd also have a preference for a location that can give me 1-to-1 support during labour, preferable from an experienced MW - IMO that makes it far more likely that any potential complications will be picked up while there's plenty of time to go somewhere or do something (although things can and do go wrong very fast, true obstetric emergencies that require a highly medicalised environment to solve are pretty rare).

NSPM is completely right - its a very personal choice. (And I also wouldn't fancy being in a car for 90 minutes whilst in labour)

10 minutes in a car when in labour was plenty for me - I got a contraction every time we hit a bump. I would go for the closest one but ask, like Pukey says, how long it would take them to transfer you.

A quiet unit is more likely to give you good one to one care during labour.

Even if they only deliver a few babies a month they will have lots of ongoing training including what to do in emergency situations and should have a plan in place. Talk to them. Ask how many women they have to transfer during or after labour and under what circumstances they would do this.

I went to the local birthing centre for DD. They had a list of suggested questions for you to ask when deciding whether to go there. It was fab.

If you get to the stage of needing a doctor, you are unlikely to care if it's a man or a woman.

I agree that the man/woman issue wouldn't (and didn't) bother me but some people/cultures/countries might think it was an issue.

Where are you? Some assumptions are being made in previous posts that healthcare standards are high where you are.

Ask about transfers and neonatal care. If they can transfer you within 30 minutes to a hospital that be prepping a theatre during that time, that's considered okay for home births or MLUs in the UK (as it takes that long to prep theatre for a previously not high risk birth - if you're high risk they may have people on standby).

Male/female also doesn't bother me. Some of the best care I got in hospital was from men.

Hi all,
Thanks for all the replies. Sounds like the nearest hospital would be the best idea, I was thinking 90min in a car in labour sounded a bit much but as i've never been in that position before I just needed to hear it from those who have been. That automatically solves the male/female doctor issue anyway - which i'm sure wouldn't be an issue at the time but the thought of it now really panics me for some odd reason.
If I did have to be transferred to another hospital it would probably be the local state hospital which is about 30min away (prob less in an ambulance). From what i understand its well equipped for most eventualities but is hot, crowded and drab and I can't really think of a worse place to be but if the situation requires it i guess it is at least there!