Mapping Out Your Birth Plan: Close to Home or Close to Work?
I’ve just loved reading your blog for years, and enjoyed your weekly pregnancy calendar, Zero to Forty, even when I wasn’t pregnant! Now I am 15 weeks pregnant and really delighted to enjoy all this information all over again for myself!
I have a question you may be able to uniquely understand, because I live in the DMV. I currently live in DC (NW) and am currently seeing midwives that deliver downtown. My plan is to move out to the burbs (to your county, in fact! I swear I don’t stalk you too much, I’ve just seen you mention that you moved in the county I grew up in!) because my wonderful parents have offered to watch my baby, offering me !free! child care. I love living in the city, but it makes the most sense to live near them for pick up and drop offs.
Here’s where my question lies: I work in the city and plan on working up until my due date. Should I switch practices to one in the burbs because that’s where I’ll be living, or should I remain with my practice in the city? For ease of appointments, the city is best. But if I go into labor at home… and you know how DC traffic is. What would you suggest? I don’t feel particularly tied to the practice I’m currently being seen, but the hospital in the city is definitely a higher caliber than the general hospital in the ‘burbs.
This question is much trickier than it should be! For non-DC-metro-area readers, let’s start with some geography: I live in Howard County, Maryland now, so we’re talking about a move 45 minutes to an hour’s drive from DC under “normal” traffic circumstances. However, DC-metro-area traffic is rarely ever “normal.” It’s batshit insane, frankly, with three-hour rush “hours” morning and night and heavy volume pretty much all the time. We are perfectly used to random stop-and-go gridlock because of bad weather (or like, a drizzle), accidents, breakdowns, rubbernecking, or even because the sun is shining too bright and everybody on the Beltway forgot their sunglasses.
(Actual traffic report I heard on the regular.)
(The good news is that while getting to and from DC at peak times can still be hellish, driving around here in what the locals consider “traffic” is basically adorable.)
Like you, Urban Mama, I lived in in Northwest DC during my first pregnancy. I chose an OB/GYN closer to where I worked (in the Montgomery County burbs) for the ease of appointments, and because I planned to work right up to my due date. But that plan didn’t actually happen, as is very often the case in late pregnancy. I made it to about a week before my due date before the discomfort and swelling and exhaustion (and the lack of any maternity work clothes that could adequately cover my giant belly) won out and I opted to work from home. This meant a lot of extra driving out to the suburbs in those final days for cervix checks, and of course, once I went into labor we needed to be conscious of the time it would take to get to the hospital (about a 20-30 minute drive).
It all worked out just fine, obviously — I went into labor in the evening and by the time the contractions got into head-to-the-hospital territory it was super late at night and we coasted there on an completely empty highway. And the ease of getting to all my regular appointments and being close to my doctor and the hospital while at work was really nice!
As for the cons, well, it wasn’t always ideal for appointments where my husband wanted/needed to be there (he was usually down in the city or even Northern Virginia, aka the seventh circle of commuting hell), or whenever there was a preterm issue that required getting checked out in Labor & Delivery. (Spotting, false labor alarms, etc.) So in retrospect, yeah, maybe it would’ve been nicer to have gone with a practice closer to home, or with one that had admitting privileges to more than one local hospital.
But it was fine! And I think you’ll be fine, with whatever option you go with. Personally, I’d probably stay stick with your current practice, then reassess on a month-to-month basis. Once you make the actual move you may find that you’re working from home more and more and appointments down in the city aren’t as convenient after all. Or you might feel just great and keep working until your due date (or even past it), and can just spend the last couple days of your pregnancy at a hotel downtown to ease any worries about a long drive in active labor. (Also, room service and housekeeping! Yay!)
Or, if something completely unexpected happens (like super-fast labor that requires getting the nearest hospital ASAP, no matter which one it is) you might end up giving birth at a different location and with a different doctor or midwife than you planned on. That can happen, and guess what? It will also be fine! If that possibility feels super distressing (which I do understand), then yeah. I’d probably look for a close-to-home practice once you move — maybe you could even see midwives at two practices for awhile, just to make sure you have someone you’re comfortable with in both geographic areas. (Note that not every insurance or birthing practice will be down with that arrangement, but it might be a compromise worth looking into.)
I also understand — if we’re talking about the same DC hospital vs. local general hospital comparison that I think we’re talking about — your concerns about a possible quality disparity. While the ER doesn’t get the highest marks reputation-wise, I’ve heard almost universal praise for their Labor & Delivery unit, maternity ward and NICU. There are also quite a few private birthing centers up here, if you want to pursue a natural birth/experience. But again, I probably would stick with the current plan/practice until you’ve made the move and reassess your options then. There’s no shortage of great doctors/midwives up here so even a late-in-pregnancy switch won’t be too difficult, if that’s what you end up deciding.
Readers: What did you do, if you had a similar choice between close-to-work or close-to-home decision in regards to OB care and birth location? Or if you moved mid-pregnancy? Chime in with (NON-SCARY TO NEWLY PREGNANT LADIES ONLY PLEASE) stories in the comments, please!
Photo source: Depositphotos/jovannig
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