You probably DO have a choice.

I hear it a lot. "I HAVE TO have this, that, and the other thing during labor, or I'll DIE! My doctor told me so! I can't have anything but hospital births!" Fear mongering at its finest, if you ask me. Do you know, I found out recently that a certain stupid OB slapped a high risk label on me because of "a history of macrosomia", meaning I have big babies. High risk because I have big hearty babies? Really? Every midwife I've ever spoken to has been happy to hear the size of my babies, and saw it as a positive thing because large babies are usually strong, and mine were no exceptions.

The point is, you can't take a doctor's word for whether or not you're really high risk, and need to birth in a hospital. Do you have any idea how much money doctors make for each hospital birth? Like tens of thousands of dollars. They WANT you to think you don't have a choice because if they scare you into thinking that, you'll just keep coming back, and they'll just keep getting richer. Not all doctors are evil, but a lot are very profit driven, and most are kind of scary. They look for stuff to be wrong even when it's not. That's what they're trained to do. If they look hard enough, and twist things enough, they'll find something. It never fails. If a doctor tells you you're high risk, get a second opinion, and make sure it's from a midwife.

With that said, according to the World Health Organization, 15% of women will actually have some medical necessity to birth in a hospital. You know what that means, though? 85% have a choice! Those are amazing odds! Also, just because you had to birth in a hospital once doesn't mean you always will. Maybe you had to do a hospital birth because you had triplets last time (in TX, twins can be delivered at home or in birth centers, but not triplets or higher), but you're having a singleton or twins this time. You're probably a candidate for any type of birth you want. Say you had severe anemia last time and had to do a hospital birth. Get some tincture of Yellow Dock, a lot of spinach and broccoli, and beef if you eat it, and of course you'll also need an understanding midwife, and you can probably do whatever kind of birth you want next time. Were preeclamptic last time? You might not be this time. Talk to a midwife about how to decrease your odds of it. Most risk factors are transient, but the doctors don't tell you that. They want you to keep coming back. They love your money. If you don't want to be there, at least ask if there's some other options, and ask someone who's actually in a position to give you that option, not a doctor. Obviously 99% of doctors are going to tell you homebirth or birth center birth is a horrible idea. When is the last time a doctor attended a birth anywhere but a hospital? 1930 or thereabout? You get the idea. Doctors aren't going to encourage you to do anything that would make them less money. Remember that when talking with them.

Also, be informed. You required several IV's during labor, so you have to birth in a hospital? What? I don't think there's a midwife on the planet who doesn't do IV's. Find a CNM so she can prescribe your medication, then deliver wherever she assists births. It will probably be a birth center in most states, although in some states, CNM's do homebirths, too, so ask around. Anything that can be done in a level 1 hospital (minus surgery) can be done at a birth center or home. Don't act like it isn't an option for you just because you needed some oxygen or something. They bring that stuff.

If you know these things and still don't choose it, that's cool, but if you consciously choose hospital birth over other options, with the full knowledge that you had options, you lose all your credibility when it comes to jumping on those of us who advocate birth center and home birth as viable options for women who are not happy with the way their hospital does things. Realize that when we propose that, there's an 85% shot that the woman in question would be well served by finding another route. I'm not going to stop advocating for something because of a 15% chance I'm talking with someone who couldn't do that. I also think it's important to remember that just like you hospital birthers are coming from what you know, so are we. I was a transfer once, but I have never planned a hospital birth, and find that prospect absolutely horrifying. When people have a problem with something on the forms (like not having a "no" option for the question "Would you like your son circumcised?") our answer to that is always going to be, "That doesn't sound like a safe place to bring a baby into the world. I would not give birth in a place like that. Can't you find a nice birth center or a homebirth midwife to assist you?" It is never too late to transfer. I've seen girls transfer to the birth center at 37 weeks, and have great normal births after their OB's told them they were nothing but c-section candidates, or had to be induced. I advocate it because I know it works.

With that said, I feel sorry for the 15% who don't have a viable option. However, I really do believe that there are a lot of people walking around thinking they don't have options, when they really do. Step out of the OB's office.