Honestly, before I had my third child I never thought that giving birth in a teaching hospital would be part of my birthing plan. I loved the hospital where I had given birth to my second baby and I had built a trusting relationship with my nurse midwife after nearly three years. So when I did find out I was pregnant with my third baby, it made complete sense to stick with the same hospital where I delivered my second daughter. But everything changed when, shortly after I found out I was pregnant, my husband lost his job and my growing family lost our insurance.
I immediately knew that my birthing plans would have to change as a result of everything going on around us. The hospital where I'd planned to deliver didn’t accept uninsured patients or patients insured through Medicaid, so until my husband got a new job, I wouldn’t be able to deliver there. In fact, without insurance my only options were to choose from two hospitals who accepted self-pay patients or deliver at home. Since a home birth wasn't an option my husband and I felt completely comfortable with, we too settled on a teaching hospital in the core of our city, one that had a reputation for working with patients in difficult financial situations.
Once the initial shock of my husband's job loss wore off, I started the process of signing up for Medicaid. The whole process made me anxious: I needed to submit income records, tax returns, and proof of my pregnancy, and thankfully everyone I talked to helped guide me through the process. The most nerve-wracking part was the wait, because it took several weeks of phone calls and paperwork before we finally got the news that both my kids and I were approved for full-coverage care through Medicaid. My husband was able to sign up for a high-deductible plan through the Healthcare Marketplace and we were able to breathe easier knowing our whole family was insured again. Mostly, I was so thrilled to know I wouldn’t be paying cash for my delivery since Missouri offers great coverage for expecting women and children.
As a patient covered through Medicaid, I was still limited to choosing from a handful of hospitals in our area for prenatal care. I decided to stick with the original hospital I'd chosen, which also happened to be a teaching hospital. In a teaching hospital, most of the doctors on the floor are residents who report to an attending physician. The residents are also shadowed by medical students. To be honest, I didn’t really know what to expect from my prenatal care and delivery at a teaching hospital. The only framework I had was from binge-watching Grey’s Anatomy during my freshman year of college, and truthfully, I think I expected to deal with inexperienced doctors who relied on textbook knowledge during my delivery or who were more nervous about my childbirth than I was.
During my last two deliveries, my doctors were great, but it was obvious that delivering babies had become an old hat to them, something they'd done everyday for years. But at the teaching hospital, my doctors were so excited to be a part of my birth, to talk through what my body was doing and how they were helping me prepare to deliver, that their excitement and passion was infectious.
But I couldn’t have been more wrong. For the most part, delivering in a teaching hospital was a great experience. As a patient in a teaching hospital, I had the pleasure of seeing doctors who were young in their career and passionate about their jobs. The doctors I saw chose labor and delivery because they loved it, because they wanted to learn more, and you could tell that was true, even at 3 in the morning. During my last two deliveries, my doctors were great, but it was obvious that delivering babies had become an old hat to them, something they'd done everyday for years. But at the teaching hospital, my doctors were so excited to be a part of my birth, to talk through what my body was doing and how they were helping me prepare to deliver, that their excitement and passion was infectious.
I had a cheering squad in the delivery room. I had three doctors talking me through each contraction, encouraging me through my exhaustion, and telling me how great I was doing.
Don’t get me wrong, delivering at a teaching hospital wasn’t all perfect. I literally had an audience in my delivery room and had to let go of my discomfort with being on display for so many eyes. I also had to learn to speak up for myself because I felt uncomfortable with students doing my cervical checks because it was way more painful than when a more-experienced doctor performed them. Once during delivery, I had to ask a student to stop touching me because I could tell he felt like he knew what was best for me better than I did, and he was being a little pushy towards me. I had to repeat myself more than once, but eventually he understood and backed away and gave me the space I needed to relax between contractions so I could refocus in time to push.
But when the time came to push, I had a cheering squad in the delivery room. I had three doctors talking me through each contraction, encouraging me through my exhaustion, and telling me how great I was doing. While at first I was overwhelmed by the number of people in the room, when it came time to deliver I was grateful to have the extra support. I was exhausted after being awake nearly 36 hours and I truly needed the room full of people who were there to respond to my needs and coach me while I brought my son into the world. After my son arrived, I had pediatric residents excitedly telling my about my baby and his health.
All in all, I had a great experience giving birth in a teaching hospital. It wasn’t perfect, but I've yet to meet a woman whose birth was absolutely perfect in every way. Looking back on it, it felt like my family and I were guests of honor instead of just another pregnant woman in a long list of patients. In the teaching hospital where I delivered, I felt like we were all learning from each other.