Here in Kitsap County we enjoy many options for low-risk, healthy clients who are looking into venues where they might like to give birth. This post is applicable to clients with every health situation; hospital birth is where most people will give birth and it’s the safest place for high risk clients. I hope you find this information helpful!

When we work with clients who are trying to figure out their options, our first question is, “Beyond safety,  what are your birth goals?”

Knowing the ultimate destination in which you are headed helps us to ascertain what options might be most helpful to you. Do you want to have an epidural at a certain point of labor? A hospital is the place for you. Would you like to have more control over your experience but don’t want to deal with having people in your home? The birth center would be a great option for you. Feel most safe and comfortable birthing at home? Midwifery led homebirth might be the option for you!

Let’s break down what those options look like here in Kitsap County.

Hospital Options

We have two hospitals serving Kitsap County, Harrison Memorial Hospital for civilians and Naval Hospital Bremerton (NHB) for military families.

Clients birthing at Harrison will choose from The Doctor’s Clinic, Women & Children,  right inside the hospital, or Kitsap OB/GYN just a few blocks away. As a patient in one of these practices you will choose the provider you wish to work with and they will attend most, if not all of your prenatal visits. The physician that is on-call during the time you deliver will be the one to attend your birth. Some of the providers will make an effort to come to your birth even if they are not on call, but you aren’t guaranteed to have your provider at your birth. Harrison does not (yet!) support midwifery care but we are crossing our fingers that this will change!

Clients birthing at NHB will choose a provider and generally, work with that provider and their team throughout their pregnancy. When the time comes to deliver, your provider will make an effort to attend your birth, or the provider who is on call. This could be a certified nurse midwife, a family practice physician, or an OB/GYN, depending on what your care requires and who is available during the time you deliver.

General Birth Experience

During your labor, your nurses will attend your care and support you and your team, answer questions you have about your medical care and help you strategize, and liaise between you and your provider. Your doctor will visit once or twice during the day, and generally stays connected through updates by the nurses to what is happening during your labor. When you are pushing and the baby is crowning, the provider will come to catch your baby, take care of any bleeding or repairs, and then once again, you’ll largely be cared for by the nurses.

Each hospital has routine procedures they require of all patients birthing in their facilities. Some of these might include:

• IV access via a saline-lock upon admission
• Routine cervical exams at certain time intervals, and/or marked changes in your labor
• Use of Pitocin routinely after the delivery to help prevent postpartum hemorrhage

During your stay, the staff does not remain in the room with you during your labor, they are oftentimes busy working with other patients as well. The nursing staff changes shift every 12 hours, so you will have a fresh face in the morning and late evening, every day.

Different hospitals have different amenities, from having midwives on staff or not, to things like labor tubs, peanut/yoga balls, telemetry units for mobile monitoring of your baby, even down to microwaves and refrigerators in your room, or in a common area, space for your support people to rest, etc. Both hospitals offer the gamut of pain medication options, have anesthesiologists/anesthetists on staff to serve your needs, and have operating room in case a cesarean is needed, as well as lactation staff for after the birth. Both facilities also offer childbirth classes, and may have other types of classes as well.

You will remain in the hospital for 24 hours after your uncomplicated vaginal birth, and 48 hours after your uncomplicated cesarean, and then will be discharged to go home with your baby. You may stay longer if you or the baby has a health issue. If your newborn is required to stay longer, you’ll be allowed to stay at the hospital as a “boarder”, which means you will have a room, and a stipend for one meal a day, but will not receive interaction from nursing staff as you will technically be discharged.

Neither hospital has advanced special care for your newborn; if there is an emergency that goes beyond their ability to care for your baby, they will be transferred to Mary Bridge Children’s Hospital in Tacoma, or Seattle Children’s Hospital, or Madigan Army Medical Center, respectively.

Choosing a provider for your hospital birth

All obstetricians are surgeons, and some OBs are more comfortable with unmedicated, active birth, than others. Some OB’s are more comfortable doing cesareans as an earlier intervention, than others might be. Some providers are very comfortable offering Vaginal Birth After Cesarean (VBAC) in low risk patients, or, as it’s known in the hospital, Trial of Labor After Cesarean (TOLAC), and some are less so.

If you and the provider you are working with are not a match, you have the right to change providers at any time in your pregnancy. The further along you are, the more challenging this might be as calendars fill up for due dates, so if you are feeling a disconnect or a lack of alignment in goals, don’t wait to interview other providers.

All of the providers serving families in Kitsap County, in the hospital and outside it, offer safe, licensed medical care for you and your baby. When you imagine your birth, beyond safety, what do you want that experience to feel like? How do you want to remember it? Use those questions to help guide you in your research on which provider, and which venue, is right for you.