In Search of a Semi Crunchy Birth Experience

By that I mean I am torn between two worlds, the one of complete whole foods and hippiness in which I was raised, and the one of modern medicine that helped me get pregnant in the first place. Put more simply, between natural birth and epidural.

As an almost perfect analogy, I am a member of two distinctly different message boards, one is thenest.com where I feel too crunchy and the forums of mothering.com where I am not nearly crunchy enough.

My personal comfort level lies somewhere in between: The thought of a home birth scares the bezeejus out of me, but so does the typical medicalized hospital birth and all interventions and crap that they do that lead inevitably to c-sections.

My ideal birth would be in a hospital, with a doula and a midwife attending and me giving a natural childbirth my very best shot. But I am not totally commited to it, that is I can’t rule out the possiblity that will cave in and want an epidural – I just know my pain threshold and it’s not all that high.

But in the vulnerable state of giving birth, I don’t want to get pushed into inverventions that I may not need, so its extremely important to me that I find a hospital where a natural birth is the norm and NOT the exception.

This has proven to be more difficult than I thought it would be. The hospitals in the NY/NJ area where I live have notoriously high rates of c-section and other interventions such as episiotomies etc. And many of them have only a token midwife or two (if any) that have delivery rights.

I think I may have finally found it!

There is a hospital in Tarrytown NY (Westchester County) about 20 minutes from us called Phelps Memorial Hospital that seems to cover all the things that are important to me:

1) Over 50% of their deliveries are done by midwifes

2) Labor, delivery and recovery all done in the same room

3) Huge birthing Whirlpool tubs!

4) Accupuncture available for pain management!

5) Baby can room in

6) Breast feeding support within one hour of birth

7) Low(ish) rates of interventions (at least lower than most in the area)

This last one is actually quite hard to find research on, until I found this webpage that has a link to find out the intervention rates in some states including Alabama, Alaska, California, Florida, Maine, Massachusetts, New York, New Jersey, Oregon, Texas and Utah:
http://ourbodiesourblog.org/blog/2007/11/finding_and_comparing_csection_rates_by_hospi.php

So I was able to compare the internventions of several area hospitals for 2005, the most recent year the data is available for.

The results for Phelps shows:

Augmented Labor (pitocin) 10.7%
Episiotomy 9.2%
Epidural 21%. (that tells me women are getting the support they need to labor naturally.)

Compare that to the rates of Good Samiritan, the hospital I am currently slated to give birth at:

Augmented Labor: 16.4%
Episiotomy: 32.6% (!)
Epidural: 48.9%

Surprisingly, their c-section rates are similar in the 20-23% range.

All in all, I think Phelps will be a much improved experience over Good Sam. All that’s left now is to ditch my current OB who I actually quite like and find a midwife that I like who delivers at Phelps… I wish I had a personal recommendation to go on, but since I don’t I guess I’ll have to take a stab in the dark. Wish me luck!

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ariana says:

There have been some new comments on this old post as of late (Shawna, Michelle and Jessica!) so I just want to add an update: I had my first son Jasper at Phelps with the midwives at Open Door.

You can read Jasper’s “Birth story” here: http://www.becoming-mom.net/2008/08/25/jaspers-birth-story/

I LOVED everything about the midwives and the staff at Phelps on the labor and delivery floor. I have come to realize that Phelps is such a unique place in that all of the midwives and even the OBs that work there have a very similar philosophy of low intervention.. which means that it’s hard to go “wrong” choosing a provider at Phelps! (Dr. DiStefano and Mendelowitz are also amazing OBs!)

I chose to have my twins at a different hospital ONLY because Phelps does not have a high level NICU and with twins I didn’t want to risk it.

The only thing I did not have a good experience with at Phelps were the lactation consultants. One in particular refused to look at my latch and told me if it hurts I’m doing it wrong. I was so distraught! It wasn’t until a nurse told me that it hurts in the beginning no matter what that I relaxed and stopped freaking out that I was failing somehow!

I have two friends who have delivered there and had similar bad experiences with them, so I HIGHLY recommend anyone delivering there also have Julie Bouchet-Horwitz’s number in your back pocket: http://www.juliebouchet-horwitz.com/ she is in Irvington just a stone’s throw from Phelps.

The other thing I did not love about Phelps were the pediatricians who I think were overly aggressive in treating Jasper for very minor health concerns. A hands off natural labor and delivery philosophy does not necessarily mean that baby’s care will be similar, which I found out the hard way.

Still, I highly recommend Phelps to everyone I meet who is pregnant!

Shawna says:

I loved the midwives at Full Circle Women’s health! I can totally relate to the experience you’re looking for. I had a c-section with my first child, and I wanted a VBAC with the second. The midwives were great, and I am certain I would not have had a vaginal delivery with the second if I would not have had their support. I ended up needing/wanting some medical support, and it was great to know that I was supported no matter what. In the end, I am very happy with my experience and would recommend Full Circle to anyone!

Hi Ariana,
I hope you did have the birth you hoped for. Just an update about Full Circle Women’s Health midwives… we do take some insurances and we work with you to figure out exactly what your insurance covers and what remaining costs there are. Please know we try to make our care accessible to all, while also bringing in enough revenue to cover expenses and keep our doors open! We often speak of Phelps as a “hidden gem” of a secret along the Hudson River and hope more people who are looking for a positive birth experience will reach out!
Thanks for your post.
Best, Michelle Chiafulio (one of the midwives at Full Circle) 914-421-1500

Jessica says:

Do you have an update on your experience and who you ended up with at Phelps? I’m in the same position that you were in and would love some guidance!

Carolyn says:

Ariana,

Can you give an update regarding your experience at Phelps? We’re about to move to Rockland County and I’m pregnant with baby #2–my first was delivered in a Brooklyn hospital by a midwife and I did end up requesting an epidural. So, I would like a midwife again and all options for pain management in case I need them. Did you have a good experience with Phelps and can you recommend a midwife/OB?

Elizabeth says:

Thank you for writing this! I feel exactly the same way as you do. Right now I am slated to give birth at Stamford Hospital-I love my OB and she has a midwife, but there is no guarantee that I will get either one. I could end up with someone from the hospital I have never met! As that is totally unacceptable, i think I am looking for a new place to deliver, and it sounds like Phelps may be it!

ariana says:

Kate, thank you for sharing your experience! I agree about being flexible. I think that is what I am hoping for, a hospital that will be supportive of me whatever I decide in the moment.

Kate says:

I had a very similar plan when I had my son two years ago. I had a doula and the intention of avoiding an epidural. I didn’t want to slow down my labor and risk a C-section. Ironically, my labor ended up going way too fast – piggy backing contractions (no break) a minute apart within just a couple hours. I ended up getting the epidural specifically to slow down my labor, and I am so glad I did! It was more important to me to be mentally present than doing it without medication. And I didn’t know that until I was in the situation.

My point is that it’s impossible to plan your labor, anything can happen. I think the most successful moms are flexible and allow themselves to do what they need to do in the moment without judging themselves.

But a great tip, if you want to be super sure about the epidural, is to make a deal with your husband that you need to ask three times. Just a little mechanism to help you deal with it after the fact if you’re worried that you might “cave” in a moment of “weakness.”

One more thing about interventions…after the epidural the contractions did slow down (thank g-d!) and they wanted to rupture my water. But I opted for a VERY low level of pitocin instead. The bag of water protects the baby, cushioning him as he moves into position. I didn’t want to take that away and, ironically, using pitocin seemed the more natural choice. Six hours after the pitocin began, my water broke on its own and my son was born about 1.5 hours later.

I was very happy with my birth experience and I hope you will be able to say the same!

ariana says:

Leyla, this does help TREMENDOUSLY. Thank you so much for delurking and posting your experience.. I am going to call her office and see if they take my insurance!

Leyla says:

I delivered my son (first-born) at Phelps about two and a half years ago, and I had a wonderful experience there. I had a very difficult time nursing my son at first (latching issues) and if not for one of the lactation specialists at Phelps I don’t know what I would have done. She helped me through those first few weeks and even let me call her at home when I needed guidance. I ended up nursing my son well after his first birthday, but could have easily given up on it early on.

I don’t know if this will help you, but I go to Sleepy Hollow Medical Group- which is an OB/Gyn practice of 4 OB’s (I think) and 1 midwife. The midwife, Ingrid Deler-Garcia is so sweet and wonderful, but there is no guarantee who will be on call when you are ready to deliver.

At the time I joined the group, I was actually hesitant to see her because I thought I would prefer to have an actual doctor to deliver my baby and had no prior experience/knowledge of midwives. But after meeting her, I quickly changed my mind. By the end of my pregnancy, I had met everyone in the practice and was confident in and comfortable with whomever would be available when I was ready to deliver.

My plan was to try to use Lamaze techniques for as long as possible until I felt that I could no longer handle the pain. I ended up having a normal vaginal birth, with an epidural (when I was ready for it which was sooner than I thought), and no episiotomy, but I tore a little. Oh, and a beautiful 7.1 lb baby boy!

Sorry, I don’t usually comment, and here I’ve written a book. Hope this helps a little.

ariana says:

Hi Katherine!
Yes, its really close, only about 10 miles tops, its actually closer than where I got all my infertility treatments!

Mary, I would love to work with Kathy or Robin, but they both don’t take insurance :( I actually went to their office to work with Angela Le for my infertility accupuncture.. its a great place, I wish they took insurance!

Hi, I was happy to see that you “found” Phelps! I can recommend two midwives, if you’d like:
Kathy Heron and Robin Bradley phone # 914-421-1500

Katherine says:

Is the hospital a far drive from your house? I live in LA, so getting across town can take up to 2 hours sometimes. :) Hopefully you’ll like this hospital. I say take a visit and go with your gut. For me, a big deciding factor was getting an OBGYN who took my HMO and was in my neighborhood. The plan is to give birth at St Josephs across the street from the doc’s office. Perhaps I’m too lazy to do any more shopping around than that!

Katherine

PS~ I’m on thenestbaby.com too.

Ariella says:

That is exactly what I want for a birth exsperance. To be able to chose an epidural but not have it forced on me. I hope your hospital gives you the birth exsperance you want.

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