Question about Hospital?

Okay twin mommies. I need your advice. I LOVE my doctor to PIECES. He has been SO supportive of all we have been through. Well I also LOVE my local hospital, it is really small and you get ALOT of 1 on 1 attention. With my daughter I was in there for 3 days and was the only one that delivered, with my son I was also in there for 3 days and was 2 other deliveries ONLY. So I like the one on one and the nice quiet atmosphere. Well the problem is, is that there is no NICU in the hospital. My dr says as long as I deliver after 34 weeks that he can deliver me there, but if it is sooner than that I have to go to St Joes..(almost an hour away). Should I deliver in the bigger hospital to be safe...or do you think I will be okay in the smaller hospital. I dont want some stranger to deliver me. I am very close with my doctor and my hospital. I need your honest opinions ladies. Thanks so much for all your help. : )

 

I live in a smaller town, and our hospital has a Level 2 NICU, but not a Level 1. If I had delivered before 32 weeks, I would have had to go to a different hospital (7 hours away!). Once I passed the 32 week mark, I was confident that the hospital could handle my delivery. I also knew that the babies were growing well and it didn't look like they had any complicating issues. I think as you get closer to the time you will have a good sense for what you feel comfortable with. My babies were born at 36 weeks, and we didn't even need the NICU. I'm so glad that I didn't go to a bigger hospital, I got lots of individual attention and great care. Good luck!

 

I delivered at a small suburban hospital with no nicu, also because I loved my ob, felt very comfortable with her and was told if I delivered after 32 weeks I would deliver at the hospital, if not then I'd go to one of the larger hospitals here about 1/2 from my house. Because I never thought anything could go wrong and I'd need the nicu, we went right along with that plan. I delivered at 34w5d and Natalie had complications (not related to an early birth - but related to complications due to a syndrome we found out she had after she was born). The hospital that was 1/2 hr away was full, so she had to be transferred an hr away from our house. Even if I delivered at the 1/2 hr away hospital (if it was full, I'm not even sure they would have taken me), we would have still had to travel to go to the nicu. I think the biggest thing was that I had a vaginal birth, if I had had a c-section I would have still been in the hospital and not been able to see Natalie until I got out of the hospital. I had an uneventful pregnancy, minor placenta previa scare that resolved itself, but no early contractions - softening cervix, etc., but its a big gamble. If I had to do it again, I would probably go with the same plan we did for this birth, I was comfortable in the hospital and with my drs, they handled Natalie's care before she had to be transferred very well. Good Luck with your decision.

 

QUOTE(Durangomom @ Jun 16 2009, 04:38 PM) [snapback]1356975[/snapback]
I live in a smaller town, and our hospital has a Level 2 NICU, but not a Level 1. If I had delivered before 32 weeks, I would have had to go to a different hospital (7 hours away!). Once I passed the 32 week mark, I was confident that the hospital could handle my delivery. I also knew that the babies were growing well and it didn't look like they had any complicating issues. I think as you get closer to the time you will have a good sense for what you feel comfortable with. My babies were born at 36 weeks, and we didn't even need the NICU. I'm so glad that I didn't go to a bigger hospital, I got lots of individual attention and great care. Good luck!

GREAT! That makes me feel better, of course we will have to play it by ear as we go along. thank you for replying. I pray I have an uneventful pregnancy...but for me that is near impossible..lol.

 

QUOTE(kimr @ Jun 16 2009, 04:43 PM) [snapback]1356980[/snapback]
I delivered at a small suburban hospital with no nicu, also because I loved my ob, felt very comfortable with her and was told if I delivered after 32 weeks I would deliver at the hospital, if not then I'd go to one of the larger hospitals here about 1/2 from my house. Because I never thought anything could go wrong and I'd need the nicu, we went right along with that plan. I delivered at 34w5d and Natalie had complications (not related to an early birth - but related to complications due to a syndrome we found out she had after she was born). The hospital that was 1/2 hr away was full, so she had to be transferred an hr away from our house. Even if I delivered at the 1/2 hr away hospital (if it was full, I'm not even sure they would have taken me), we would have still had to travel to go to the nicu. I think the biggest thing was that I had a vaginal birth, if I had had a c-section I would have still been in the hospital and not been able to see Natalie until I got out of the hospital. I had an uneventful pregnancy, minor placenta previa scare that resolved itself, but no early contractions - softening cervix, etc., but its a big gamble. If I had to do it again, I would probably go with the same plan we did for this birth, I was comfortable in the hospital and with my drs, they handled Natalie's care before she had to be transferred very well. Good Luck with your decision.

Oh wow...so your Natalie had to be transfered while you were still in the hospital? was it like right away after she was born? Sorry I have question...I just want to know all the what-ifs. You also said you were able to deliver then vaginally...how did that go for you? And if you dont mind me asking what did Natalie have, and could it have been diagnosed through ultrasound? My daughter had Triploidy and my son had Anencephaly...so I am curious about these things..
i am scared something will be wrong that my ultrasounds dont pick up. I appreciate your help and your story! Thanks so much!!! : )

 

I see all the issues that you had in the past. For my peace of mind, I personally would deliver at the bigger hospital, even if it meant that I didn't get to see my OB.

My condolences on the losses.

OMG! You're a local! What hospital are you thinking of deliving at? I had my two at St. Joe's and I cannot say enough good things about the women's hospital.

 

I delivered at a hospital 15 min from my house that also did not have a NICU.My dr told me that if it looked as though I would deliver too soon etc or if I did go into labor he would send me to a bigger hospital which is only 35 miles away.I liked the smaller one though.I had my two oldest ones there and loved it.You have a room that you labor,deliver and recover in the whole time.There is only 10 L&D rooms there and you get a lot of 1 on 1 also.I did end up delivering there with the twins and had no problems.The only difference was I didnt deliver in the room I had to deliver in the OR incase on Emer.CS but everything went well and at the time they were full but I think I still got the most attention from everyone because of the twins.A lady and her husband in the room 2 doors down even went out and bought the girls an outfit(it was 2 weeks before christmas).It was really sweet.If you are comfortable with it and your dr is then I would.

oh and I delivered at 36 weeks and 5 days after bedrest from 30weeks and being on procardia every 6 then 4 hours from 30 weeks also.I was dilated to a 3 when I was induced.So I didn't have the easiest pregnancy but everything turned out fine

 

I live in a place 2 1/2 hours away from any NICU, the good ones are 4 hours away. There wasn't even one infant respirator in the town when I had my girls. The doctor was very conservative about my care and we talked about how and who would be transported if there were any problems. As it turns out there weren't any.

 

QUOTE(Angel_Mommy @ Jun 16 2009, 08:54 PM) [snapback]1357002[/snapback]
Oh wow...so your Natalie had to be transfered while you were still in the hospital? was it like right away after she was born? Sorry I have question...I just want to know all the what-ifs. You also said you were able to deliver then vaginally...how did that go for you? And if you dont mind me asking what did Natalie have, and could it have been diagnosed through ultrasound? My daughter had Triploidy and my son had Anencephaly...so I am curious about these things..
i am scared something will be wrong that my ultrasounds dont pick up. I appreciate your help and your story! Thanks so much!!! : )


I was still in the hospital, but released later that day. If I had a c-section I wouldn't have gotten out for a few more days. She was transferred when she was 36hrs old on a Saturday and Brooke was released on Sunday. My birthing story on the vaginal part is not good so please don't think this is normal. I was given the choice of going c/s or vaginal - up to that point because of the position of the girls (both transverse) we were always told we'd go c/s - but when I was admitted after my water broke they were "in position" to go vaginal so we chose that route. I had pitocin and an epidural placed, I wasn't dilated . My ob turned off the epidural when we got into the OR (I didn't even realize that, I just thought it was that painful even with the epidural). I pushed for about 2 hours with Natalie and then unfortunately Brooke liked having me all to myself and it took 3 1/2 hrs to push her out - all of this without the epidural b/c my ob wanted me to be able to feel the contractions for pushing. Like I said totally not what most vaginal twin births is like. Natalie has something called beckwith wiedemann syndrome and sometimes it is picked up by ultrasound - it is a very rare syndrome.

 

I was wondering about this too. The hospital I work for doesn't have a NICU, but there is one at the hospital only 9 blocks away. But, I have only had bad experiences at the NICU hospital and really want to deliver where I work. I know a lot of the nurses and L&D is much quieter. I just have to make it to 34 weeks. After that, we can always ambulance down the street if we have to.

 

I just had this discussion with my OB the other day because the private hospital where I'm delivering in London has a NICU but it only handles births 34 weeks and beyond. He explained to me (that at least in urban areas), it does not necessarily matter whether you deliver your babies at a hospital with a NICU. The reality is that given the capacity and or capabilities of the NICU in question, chances are that your baby could still end up being moved anyway. He says that upon birth, the babies would be stabalized and if the hospital in question was not equipped to handle the needs of those particular babies, or did not have room, then the babies could still be moved. What he told me is that if there's a problem, they try to move the mother first (or have you go to a hospital with the appropriate NICU level for the needs of your babies). So, I would say that there's probably not a reason for you to not plan on having your babies at your chosen hospital so long as you can make it to the other hospital in case of an emergency (which I'm sure your doctor would tell you to do anyway).

 

We have the same situation with our hospital, only i have to make it to 35 weeks to be able to deliver there. I absolutely love my ob, as well as the hospital and pray i make that long. The hospital i would be sent to before 35 weeks is about 15 minutes further away. I have every intention of delivering at my smaller hospital, but understand if things change.

 

Given your past obstetrical history (two stillbirths), it is probably advisable that you see a perinatologist/specialist at a larger referral center, they might even want you to deliver with a specialist. I am fortunate to live in a city with several level 3 NICUs (the highest level), but I wouldn't consider delivering at a hospital without a NICU with twins and a past history of stillbirth. My views may be skewed as I am a physician (not obgyn) in a large city where specialty care is highly available and the standard of care.

 

with my first 2, I used my awesome family doc and delivered in a great small local hospital. I had n complications or any reason to believe I would have any complications. With the twins, I wanted to go to a place with a NICU just in case.

My cousin had her twin boys full term (I think it was 38 weeks ) and 1 still needed NICU time. It would be unbearable to me to be in a different hospital than my babies. I went to a peri I got a recommendation form my family doc) with my twins. WE didn't need any NICU and the doc I used was great but we went right back to my other doc as soon as I had the babies.
I talked to my doc about it and got my peri's name form him because it meant a lot to me that no feelings were hurt. It worked out great.n Looking back, iwouldn't change a thing and would do it the same way all over again. It was totally worth the piece of mind.

good luck.

 

I delivered at a hospital with No NICU also but my ob told me if i went early to just go to the bigger hospital.
i would wait and see how far you get and trust your gut when it comes to where you should deliver.

 

Yeah, mine were born at 36w3d and needed 12 hours of "observation" in the NICU. I specifically choose my hospital because it had a Level III NICU (which is the highest level). I just didn't want to take any chances ... I was lucky that that was the hospital my doc worked out of anyway.

I just feel like SO many people on this site had their twins at 34 or even later and still required NICU time. I would hate for my babies to be moved to a different hospital than me.

 

I delivered as an emergency right at 36w - the very conservative OB called the peri at the hospital with the NICU which was about 45 mi away and she told him IF there were issues that's what the medivac was for! so I delivered with no NICU which I really didn't have any issues with since they had a special care nursery in our hospital so I knew that stabilizing was no problem should there be issues...

furthermore it appears that the stillbirth's have nothing to do with OB care but more to do genetically - if the testing done on the twins you're having is coming out normal and you're OB is comfortable I'd put the "what if's" aside...but thats just me...

 

QUOTE(KristenLee @ Jun 16 2009, 03:51 PM) [snapback]1357134[/snapback]
I was wondering about this too. The hospital I work for doesn't have a NICU, but there is one at the hospital only 9 blocks away. But, I have only had bad experiences at the NICU hospital and really want to deliver where I work. I know a lot of the nurses and L&D is much quieter. I just have to make it to 34 weeks. After that, we can always ambulance down the street if we have to.

I am hoping to pursue a similar option...I want to deliver at the smaller hospital with a Level II NICU...but there is a Level III NICU on the other side of town that we can be transported to if necessary...that is, if I make it to 36weeks...the smaller hospital won't take me before then...