Homebirths & Hospital distance - how far away is too far?

Question

We are TTC and will have the baby in a homebirth setting with a certified nurse-midwife. However our home is an hour away from the nearest hospital. My best friend lives closer to town, about a half hour away from the hospital. So I'm not sure if we should have the birth at home or at my friend's house (she has offered). Naturally I would prefer to do it at our home so the baby and I don't have to go anywhere afterwards, especially since we are doing Lotus Birth (umbilical nonseverance) and will still have the placenta to deal with when we drive home if we opt for my friend's house.

For those of you unfamiliar with midwifery, even "emergency" c-sections are not immediate, it typically takes 30 min. to get you into the ER once the decision to do one is made even when you are already in the hospital, and midwives are well trained to recognize the signs that a c-section might be necessary well before things get to that point.

Of course I will ask the midwife this when we actually get pregnant, her input will strongly influence the final decision, just wondering what the general consensus is on here tonight.

Answer 1

I used to live in a rural area, and I know a midwife who is comfortable attending births over an hour from a hospital.  However, she is rather quick to transfer at the first sign of a problem.  Midwives who practice in areas nearer hospitals are more likely to wait longer before considering a transfer because they know it isn't difficult to get to a hospital if a potential problem doesn't resolve itself.  

I once met a couple who had intentionally moved closer to a hospital for their last two planned home births.  However, they had their house paid off so it wasn't hard for them to afford renting a small apartment in the city for the last couple of months of her pregnancy.

I didn't have a lotus birth, but from what I understand, doesn't the umbilical cord detach on its own within the first few days?  Would your friend be willing to allow you to stay just a few days, or do you believe that would intrude on her?  I don't know how difficult transporting the baby would be if still attached to the placenta, but as long as you can get the baby into the car seat, you're only planning one drive under those circumstances...

Answer 2

Good luck on TTC.  As far as how far is too far-I would say go ahead and plan to be at home.  As your pregnancy progresses the midwife will have a better idea of how things look, assuming you are not in a high risk group.  Do you have a doctor in mind to use if you do end up in an emergency situation, or will you just go to the ER and get whoever is on call?

Answer 3

An hour away from the nearest hospital, imo, is too far. Have you considered a birthing center. It's not home but some can have a homey feel to them. At least that way, you would be closer to a hospital.

When having an emergency c-section, usually they wheel you down the hall to an operating room on the labor and delivery floor. With mine, once they figured they couldn't stop the distress, by me changing positions, I was wheel immediately into the OR, less than 5 minutes. However, once we got there the baby was fine, so I was wheeled back to the delivery room. Then later, my labor wasn't progressing, so I was prepped, then wheeled to the OR. Basically, it depends on the degree of the situation, in my experience when dealing with a c-section.