American Mums - giving birth US style - what can I expect??

[AnnieLaurie]

I am shortly moving to Seattle and will be giving birth there to my second child.

I have spoken to a few American Mums over here and it seems that midwives do not feature in the States as they do here.

Can anyone tell me a bit about what the care is like in the States/any advice on what choices I may have etc regarding childbirth. Would love to hear some people's experiences.

Have visions of self strapped to a bed with feet in stirrups and lots of men in white coats...!! Do they let you move around as you wish? Do they leave you alone, or examine you all the time? Are they into natural childbirth??

Had quite a bad experience 1st time round with unsympathetic male midwife so am anxious to have nurturing, supportive female environment 2nd time round if poss.

Thanks!

Fair enough - but I think the risk of PPH in an uninterfered-with birth is negligible.

When I had my first one (the 22 year old) it was an 18 hour hard labour. I had 3 male doctors, one on vacation, second couldn't be reached...may have been off his shift and the third was on the golf course.
The third finally came in (I had a wonderful nurse with me named Pat though and she was the only saving grace). The cord was around my sons neck and I would push and he would move a half centimeter and then be pulled back a quarter. They finally did a episiotomy (not sure if that is the correct term...where they bring a huge shears and take a big snip) and out he came. He was 9 lbs exactly.
The nurse I begged not to make me wait for the doctor to show up and she agreed. I'm sure I would've birthed sooner but for the cord.
With the midwives, they did a lot of monitoring. Anything life threatening there was a doctor that was always within 5 minutes if needed. I had 3-5 of these wonderful women around me (and the hubby) comforting me, but I didn't really need it. The two births there were 30 minutes and 20 minutes of light pushing. My second two were a weight of 5lb 7 ounces and 6lb 2ounces. Good healthy weights. No pain killers, no need. I was very pleased. I was more confident with the second as the first midwife birth was 10 years difference from my first child. I was told it is like having a first baby when that much time is between.
You should be able to get a listing of midwiferies for your state. Just start making calls and use your best judgement. It should be fine. I know being in a different place is stressful but you will make friends easily, especially if you do a midwife birth. We met lots of other mums to be and their partners. Good luck on it!

do you guys really think the NHS is superior to private US care? i was pretty horrified by the standard of care in my UK pregnancy, compared to my American mates.
one midwife visit in first 18 weeks.
two scans - last one at 20 weeks.
in spite of two previous miscarriages.
birth plan out the window and delivery was highly medicalized, via syntocin, epidural, forceps and episiotomy.
us infant birth rates are mainly from teen pregnancies, which are higher risk.
the argument seems simplistic: midwives=good; doctors=bad.

You can choose to have a midwife as your primary care provider in the USA. The wards (USA) are staffed with registered nurses and the doctor (and his team of docs that he is partnered with) that you see throughout your pregnancy usually deliver the baby.

In the USA the midwives have master's degrees and can be used in place of a OBGYN if that is what you want. The registered nurses on the wards will then assist the midwife during your delivery rather than assist a doctor. The registered nurses will take orders from the midwife.

So basically when you fall pregnant you can choose to be seen by a practice of OBGYN's who always have one of their crew at the hospital in case one of their patients are delivering, or you can have a midwife (who may be affiliated with the obgyn practice) or may be independent and have her own business.

In the UK the midwives are bachelor's degree prepared and staff the ward as nurses. The doctors are called if there is a problem.

In the states you get your own room, telly, your own private bathroom with a toilet and shower and a private phone in your room over there so that is cool. There are better nurse ratios so hopefully someone will actually show up when you ring your callbell.

sorry for the grammar I am rushed this morning.

I watched this documentary by Riki Lake some time ago (note, I'm not in the US, just very interested in this sort of thing).

I found it fascinating.

the american way of birth - nancy mitford written a while ago but an interesting read nevertheless. my friend workied in a big jewish hospital in new york her stories were horrific

It's not the wallpaper, telephones, or tvs in rooms that count though.

There is simply a different approach to childbirth in the UK. Here it is more holistic and seen as a normal and natural event. In the US, it is seen as a medical problem. That's one of the reasons they need lots of nurses and monitoring - they do the same for cardiac surgery.

If you had the level of funding that is available in the US and the UK ethos, you would have a fantastic system.

"In the USA the midwives have master's degrees"

"In the US, it [childbirth] is seen as a medical problem

Someone might put me straight here but my understanding is that in the US you have to qualify as a nurse before being allowed to practice as a midwife in most states. I've also been led to understand that there's a very strong antipathy and mistrust of midwives who haven't trained as nurses first who work as 'lay midwives'. I suppose this is an expression of the general belief that birth is a medical emergency - that even normal, low risk, midwife led births are seen to need a lead professional with nurse training.

I see nursing and midwifery as two related but separate callings. I personally would prefer to have someone at my birth who'd done 3 years training in midwifery than someone who'd done 3 years of nurse training and 18 months midwifery training.

Over here my feeling is the majority of really outstanding, innovative midwives now come through the 'direct entry' route (ie they don't do a nurse training first).

Certified Nurse Midwives were nurses first, often Labor & Delivery nurses. Their initial education and experience would have been in the medical model, but their subsequent midwifery training should turn them into proper midwives.

I know that my CNM was a very good midwife - she was not a OB wannabe.

Yes you have to be an RN..bachelors prepared first then go back for your masters to become a midwife. Must have at least 1-2 years experience as an OB nurse first. No they are not doctor wannabes. Nursing and medicine are two different sciences.

'In the states you get your own room, telly, your own private bathroom with a toilet and shower and a private phone in your room over there so that is cool. There are better nurse ratios so hopefully someone will actually show up when you ring your callbell. '

What insurance company is this?

Most people I know - my whole family is still there - only get coverage for a semi-private room.

Hell, even when I worked in a hospice, the Medicare patients - most of our patients - got semi-private.

You had to pay extra for private.

I have seen, studied, and worked in the labour, post partum wards of 3 US hospitals. Never saw a semi private room. All were private. One was a catholic hospital that took any patient, one was a non-profit, and one was part of a large corporation.

I honestly didn't see any semi-private rooms. One of my friends was uninsured and in -eligable for medicaid ( ahem slight criminal record way in the past) and even she had a private room. I mean this with all do respect ex-pat but are you from the south?

I have heard that the facilities are a bit shitty down that way.

Houston.

Worked at Denver Health Medical Centre for 2 years as well.

Was a Kaiser patient for 8 years, got semi-private rooms on surgical units every time.

Twice the other bed was empty.

'I have heard that the facilities are a bit shitty down that way.'

I've heard similar things about the people in the NorthEast.

that would be Center.

formerly known as 'DG', Denver General Hospital. County.

Yeah the Northeast corners the market on shit but it was my understanding that hospitals in the south struggle a bit more..i.e.more uninsured etc etc. There are more social programs operating in the northeast. Pennsylvania has all sorts for uninsured etc compared to the south. I think life is tougher in fire at will states.

So, if it's only the uninsured that get rubbish care, that's OK. As long as you are insured, you get a telly (with the usual crappy channels) but still have to hope the remote works for it.

Why anyone who is uninsured would decide to have a baby is beyond me. But medicaid usually covered unisured mums anyway. I looked after a 19 year old medicaid patien. Her care was no different than the others i.e. nice room, one to one nursing care etc...medicaid even provided her with a carseat.

Lots of the patients don't or can't pay.

I suppose the uninsured and underinsured want a family as much as anyone - that's why they do it. The levels of adequate insurance in the US are appalling.

Medicaid may cover uninsured but not many OBs accept it.

it's also incredibly hard to qualify for, SP.

if you're working poor, that is.

OK,

I live in NJ and it definitely isn't bad here. But then again I have a relatively small sub-urban/rural area. Sometimes I think the smaller the hospital, the better the services.

I was on medicaid (due to my job loss the previous year) while pregnant with ds2. It was really easy to qualify for. I just them my financial information, and got ds1 and I signed up. I now have insurance through my job but ds1 and ds2 still are on medicaid.

i tried to get it in the state of colorado when i was single, childless and out of work, i'd been laid off from one job, picked up another and then got laid off from that before i qualified for COBRA (dot.bomb).

i didn't qualify for it according to state guidelines and couldn't afford it on my own.

i was driving one of my boyfriend's cars and only able to afford liability insurance for myself when a drunk driver ran a red light and struck my car.

a repeat offender from Arizona driving a friend's car.

needless to say, no money came to pay my medical bills.

i was granted personal bankrupcy in 2001.

the health insurance issue is one on the majors i would never consider living there again.