So damn smug I need my own room.
July 2, 2009 7:15 AM   Subscribe

Is it worth it to switch practices just to have a better shot at getting a private room?

I'm pregnant, due at the beginning of October. While I'm technically classified as a high-risk on the account of being a diabetic, I've been very fortunate that everything has gone very smoothly so far. The practice of doctors that has guided me through this has been pretty great. I've had a lot of appointments, a lot of ultrasounds, and overall I've been very pleased with the people I've been working with. The only slight drawback is that it is a pretty huge practice, so while I know my main OB/GYN pretty well, there are about a dozen other OB/GYNs whom I haven't met, and my understanding is that, depending on when I give birth, any one of them could be delivering this kid.

Anyway, last night Mr. Shiu and I took the tour of the maternity ward of the hospital (call it Hospital A) that this practice is affiliated with. All told, it's a very nice hospital, and the MW seemed to be a good place to have a kid, with one major exception: they only have four private rooms, and all the rest can be converted to semi-private, if need be. Whether or not you get a private or semi-private room is luck of the draw, and whether or not your semi-private room has another patient in it is purely driven by how busy they are at that particular time. Pregnancy being the unpredictable thing that it is, there's no way to anticipate how busy they'll be when I go into labor, so maybe I'd get a private room, maybe I wouldn't.

And this is really, really worrisome to me (as if I didn't have enough to worry about, right?). The pregnancy has been a bit of a struggle for me, emotionally; like, I'm happy about it, obviously, but I've never been one of those OMG! BIOLOGICAL! CLOCK! women, I kind of hate the majority of twee shit that surrounds pregnancy and motherhood, and I am mortified at Victorian-era levels by even contemplating all the squicky details of the actual birth process. On top of that, I have a weird antisocial streak to begin with, which I can usually hide fairly well under normal circumstances, but I imagine that nice veneer will be thin and brittle indeed after the grueling process of giving birth.

Anyway, according to last night's tour, while the delivery is in a fully private room, you're in there for about two hours immediately post-partum before they move you into the room you'll be in for the rest of your stay. Maybe it will be private, maybe it won't, it all depends on volume on that particular day. Moreover, unless you luck into one of the four genuinely single-patient rooms, it might start out as private, but then you might get a roommate the next day. Can I just say, given all the details of the preceding paragraph, how very, very badly I do not want to share a room with another woman, separated by only a curtain? Seriously, the mere thought of it just makes me panicky. Not only that, but if you're sharing a room your S.O. can't stay overnight, whereas he/she can if you're in the room by yourself.

This morning I called the maternity ward at Hospital B in the area. It's a little farther away from us than Hospital A, but not unreasonably so. A friend of mine who lives in my neighborhood had her baby at Hospital B in February, and my next-door neighbor, who is also pregnant, will be having her baby there in January. According to the nurse I spoke to, the majority of the rooms in this MW are fully private, and they only do semi-private in the rarest of circumstances, e.g. when volume is ridiculously high. Furthermore, at the end of this month Hospital B will be opening their humongous new expansion, and when they do the maternity ward will be taking over the entire second floor, which means even more private rooms. As I said, this kid's not due until October, so things will almost certainly be settled with the expansion by the time I get around to having her.

On paper, at least, it would seem that Hospital B would be ideal. The problem, though, is that in order to have my baby at Hospital B I'd need to switch practices completely. Again, I'm technically high-risk, so this is a little more daunting than if it were a regular pregnancy. I have no idea how practices affiliated with Hospital B deal with high-risk pregnancies (although I'm certain that they do, they must), so I'm completely in the dark there. Since I'm diabetic, I have to be very closely monitored in the last eight weeks, too -- I have to go in for a fetal non-stress test twice a week. It also means that they might induce me early; at the very least, if I haven't gone naturally by my due date they are absolutely going to induce me on that date, because it's dangerous for women like me to go late.

So on one hand, I do feel sort of loyal to my practice, in that they've done a great job navigating me through this mess from the beginning, but on the other, I have major anxiety about sharing a room post-partum. Also, while I really like my current practice, it is, as I said, pretty huge, so I'm not, like, ultra-tight with any of the doctors. And I have no idea what to expect if I went to the other side of the fence. I'm fairly certain I'd be able to get a recommendation for a good doctor from one or both of my neighbors who are connected to two of the practices affiliated with Hospital B, but it's still a crapshoot. They'd probably be able to take care of me just fine, but there's no way to know that without actually pulling the trigger and making the switch.

Neither home-birth nor the crunchier birthing centers are options for me, given the high-risk status. Also, I <3 drugs, and intend to have the maximum amount of painkillers that they'll give me, so yeah, it's gotta be in a hospital.

And that's the conundrum currently percolating in my brain. Any suggestions, recommendations, and been-there-done-that insight would be deeply appreciated.
posted by shiu mai baby to Health & Fitness (27 answers total)
I changed providers midway through my pregnancy, and it was fine. I got a better hospital, a more personal relationship with my, in this case, midwife, and I was very happy I did. You've given no compelling reasons to stay with Practice A, other than a vague sense of loyalty, but gave plenty of good reasons why you should switch.
posted by Ruki at 7:30 AM on July 2, 2009

Switch. You should explain to your practice why -- they might be able to work something out, too, or help you transition to a new clinic -- but there's no point in panicking for the next months about the hospital rooms if there's a reasonable alternative.
posted by jeather at 7:45 AM on July 2, 2009

Explain your concerns to your current OB, get her/his recommendation for a colleague who deals well with your type of pregnancy and has privileges at Hospital B, and make the switch. Don't let these concerns be poo-poohed by your current doc -- if s/he won't give you a recommendation, go to your neighbors. You've got a high risk pregnancy -- there's no reason to add anxiety to the mix as well.
posted by amelioration at 7:45 AM on July 2, 2009

We had private (paid extra) for our first and shared for our second (no private available). Shared was not as bad as we imagined. You really are very occupied with other things but we know that in hindsight! What was important was that we were still at the same hospital that gave us such excellent care through wonderful staff and facilities (Mt.Sinai Toronto). So, I suppose what I am asaying is that you will probably get through a shared room with little problem, but if it is such an issue (and it apears from your short question it might be), then you might want to change. Only your call.
posted by Frasermoo at 7:48 AM on July 2, 2009

Switch if only for your piece of mind. In hindsight, sharing a room was not as bad as it could have been, but certainly worse than private room. You have pointed out that there is a good chance you will not even get the Dr. with whom you are most familiar. Move on and worry about something else like the lack of sleep you will be getting come October.
posted by JohnnyGunn at 7:56 AM on July 2, 2009

I was terrified of not having a private room at my hospital, but did not want to switch from the BEST practice in town to another practice for a different hospital with a private room. My mom counseled me - WHO CARES? You won't notice, you'll be so enthralled with your new baby, who cares? Focus on being with the doctor you want.

Was she right? I don't know - I nearly died in childbirth and had a hysterectomy within hours of my c-section, and so spent the first 24 hours of my daughter's life in the ICU and then earned one of the few private rooms due to the severity of my condition. But, I will say this - I was enthralled with my daughter, I would not have cared about ANYTHING. I didn't even care that I lost so much blood I couldn't stand up, couldn't nurse, could only hold the baby with help.

Everyone's childbirth experience is different - I followed my gut instinct, and I think you should follow YOURS. So, if it's to change, do it. If you'd rather stay with the doc you have, stick it out. The birth is one day, and then about 48 hours - focus on the joy of the rest of your child's life. The one thing I did learn is no amount of planning and worrying will allow you to control what will happen - it's just going to go as it goes.
posted by bunnycup at 7:57 AM on July 2, 2009

Not sure how we're going to help you here; this is a pretty individual thing. If it's such a big deal to you, then switch. Personally, I think switching practices is way too much hassle just for a shot at a private room for 24-48 hours, not to mention that most of that time you will be sleeping and fawning over your baby. If you're generally unhappy with your current practice, this is a good excuse for switching, though.
posted by Polychrome at 8:16 AM on July 2, 2009

And that's the conundrum currently percolating in my brain.

That's the thing, you're super anxious about this small tidbit and you have every right to be, but...

I would say to take some deep breaths and think things through a bit more rationally.

Some things to consider:

As you said, you will be laboring and delivering in a private room

Semi-private rooms are not terrible. I'm an RN and have taken care of thousands of patients in semi-private rooms. I have also been a patient in a semi-private room.

There are visiting hours so there will be no worries of families in the room at all hours.

There is no reason why you have to be sociable to your roomate. You can say hello if you'd like and keep to yourself.

There is a chance that you will have a room to yourself.

If your delivery is uncomplicated you will be in the hospital for a very short time. It will be a distant memory once you are at home with your new baby.

We cannot plan everything and things will happen beyond our control.

If you have a particularly annoying roomate that is loud, has boisterous family members, etc., tell your nurse.

If you like and trust your doctor stay with them. Moving to another practice sounds more stressful than sharing a room for 24 hours.

Good luck to you and congratulations.
posted by Fairchild at 8:19 AM on July 2, 2009

Congratulations on soon-to-be Baby Shiu!

I completely understand where you're coming from. I had my children at home but I think I would have lost my mind if I'd had to share a room with someone.

The discomfort you may feel about loyalty to your current docs (which I totally understand) is nothing compared to the emotional discomfort it sounds like you'll have if you get stuck with a roommate. Heck, even if you don't get a roommate, you'll be on edge about it the whole time you're there. In fact, it sounds like you'll be on edge for the rest of your pregnancy if you stay with Hospital A.

You'll need emotional support during your stay, so the ability to keep your husband with you is another check mark in the plus column for Hospital B.

You'll only have one shot at collecting memories about the birth of this baby. Make them about your husband and baby, not the lady in the next bed. :)
posted by _Mona_ at 8:22 AM on July 2, 2009

One of the things that I wish I had researched a little more earnestly was the family history w/r/t childbirth. Turns out my paternal grandmother had ridiculously short labors; my mother gave birth to my older sister in the labor room, she didn't make it to delivery, and both sides of the family combined to give me a ridiculously short labor, as in, I didn't make it to the hospital in time to deliver and had the baby via firefighter on the floor of my bathroom. Yeah, no drugs either. And mr. ambrosia is trained as an ER doc, has delivered a bunch of babies, and had never seen a woman go from walking and talking and contractions lasting 30 seconds and then wham! into transition, and do it standing up unassisted the way I did.

I tell you this to remind you that sometimes the most carefully though out birth plans go right out the window.

However, after baby ambrosia was delivered, they bundled us up in the ambulance and took us to the nearest hospital (not where I had planned to deliver, and not one where my OB/GYN practiced) and there I found myself in a semi-private room. It sucked. It sucked giant stinky moose farts it sucked so bad. Since it wasn't the hospital I had toured, I didn't know that the rules said SOs could only stay overnight if they cleared it with the roommate first. My roommate did not clear it with me, she and her SO stayed up all night talking. In Dutch. I was too exhausted to think straight, because I should have just barked at them through the curtain to STFU but I was too tired to manage that. I was having real difficulty with nursing, and my roommate was having a constant stream of visitors and well-wishers. It added extra stress at a time when I was already freaked out and exhausted.

For the next baby, I have scoped out my own version of nearby hospital B. (Assuming, of course, that I make it on time.)
posted by ambrosia at 8:26 AM on July 2, 2009

Best answer: I might be the lone voice of dissent here, but I would recommend staying with your current practice. Pregnancy is a crazy time. There is so much to worry about and with your hormones out of whack, it’s extremely easy to lose perspective. I don’t blame you for being anxious, but keep something in mind: your anxiety level is based largely on your assumptions. First of all you’re assuming a worst-case scenario (that you WILL end up sharing a room). Secondly you’re assuming you’ll end up with a chatty roommate who’ll expect constant conversation and embody all those “twee” characteristics that nauseate you. Don’t forget: that woman will have just given birth as well. After having a child, most women want to 1 – spend time with their child/SO and 2 – sleep. Of course you’ll be expected to exchange the basic social niceties with your roommate should you end up with one, but she’ll be just as much wrapped up in her own world as you’ll be in yours. As well, you’ll probably spend a maximum of 48 hours in that room – likely even less (I’m not sure how your diabetes will play into this, but most normal deliveries are discharged within 2 days).

The biggest reason for you to stay with your practice is that you are happy with them. The single most important thing that will help you relax through the pregnancy and delivery is knowing you’re in good hands - especially given the fact that you’re classified as high-risk. I can’t tell you how many women I know who were unhappy with their doctors and didn’t have any choice but to stay with them. Of course the other practice may be just as good, but is that a risk you’re willing to take for the tradeoff of a private room that you’ll likely only stay in for 48 hours?

My personal anecdote: The hospital my practice was affiliated with was very old, had tiny rooms and was much further from me than the huge, newer hospital that many of my friends and coworkers delivered in. It was also the 2nd best children’s hospital in the state. I had a completely uneventful, low-risk pregnancy, but for reasons beyond anyone’s control, my baby had to spend the first few days of her life in the NICU. Believe me when I say I was extremely glad to have delivered in that hospital. The bottom line: weigh your pros and cons very carefully.

Good luck with everything – I’m sure it will turn out well in the end.

And on preview - what Fairchild said.
posted by yawper at 8:34 AM on July 2, 2009 [1 favorite]

Best answer: First off, everyone's experiences are different and each one is valid. That said, I had to share a room for 24 hours after my very traumatic c-section with my first child and it was, without a doubt, one of the worst parts of the entire birth experience. I, too, have an anti-social streak, and I also had a hard time emotionally with the pregnancy. I don't think people who aren't shy understand how taxing it is to share living spaces with other people. My roommate had no concern whatsoever with the fact that someone else was there. The TV was almost the whole time, she talked - loudly - on the phone for hours, and people were coming and going during visitor's hours. Once a semi-private room was available it was given to me for the rest of my stay (five days total) but there was always the understanding that I would be expected to share if they needed the space. I was never able to really relax (not that a lot of relaxing goes on in the hospital) and I had just had a major surgery. With my second child, I had a private room from the get-go and it was a much more enjoyable experience. I was able to sleep when the baby slept and have visitors without worrying about my roommate. I was able to nurse in private, which is nice in the beginning when the baby is getting the hang of it.

There's nothing to be lost from investigating the other practice. If it's awesome, then your choice is just that much easier. If it's good, then the private room option can tip the scales. If it's not good at all, then start preparing yourself for the fact that you might have to share. Once you're prepared it should be easier. We didn't do a tour of the hospital with the first (and looking back, I can't believe we didn't do a tour) so the sharing was really a shock. If you have to share, you can bring ear plugs, and you can advocate for yourself through the nurses (or better yet, have your partner do it so you're not the "bad guy") if your roommate becomes too self-centered.
posted by cooker girl at 8:34 AM on July 2, 2009

Oh, one more thing: make sure Hospital B is on the same level with Hospital A. If A has a higher-level neonatal rating, that should be your hospital. Higher is better. The levels go from Level I, which is basic neonatal care, to Level IIIC (you likely won't find a Level IIIC unless it's a dedicated children's hospital).
posted by cooker girl at 8:38 AM on July 2, 2009

I switched practices latish in my second pregnancy and was glad to have done so. I would suggest that you look carefully at the doctors you're thinking of switching to - not just the issue of the room in the hospital but the size of the practice and their rates of interventions. Since you're already starting out considered high risk it's work looking into how much that increases your risk of being induced or sectioned. I've interviewed doctors to ask about these issues - what are their criteria and what sort of rates do they have of non-intervention vs c-section. Your first few months of motherhood will be far more impacted by recovering from a c-section than whether you had a roommate at the hospital so if you're thinking of switching practices be sure to look into the quality of both the doctors AND the hospital.

I've had annoying roommates in the hospital post-surgery a couple times and it was definitely something I wish I had avoided but it wasn't enormously traumatic.

good luck - and congratulations!
posted by leslies at 8:47 AM on July 2, 2009

Of course you’ll be expected to exchange the basic social niceties with your roommate should you end up with one

Why? I didn't. I pulled the curtain and didn't say a word to the other woman until we left, when we had a 3 minute conversation and wished each other luck. The sharing thing wasn't ideal, but mainly because my baby spent the second night crying *a lot* and I felt so guilty that I was keeping the other mother awake. (I really didn't want to send her to the nursery).

It sounds like you value a private room more than you value the continuity of care, and that's fine. You have to go with what feels right to you.
posted by gaspode at 8:51 AM on July 2, 2009

@gaspode: we had a 3 minute conversation and wished each other luck

This is what I meant when I said 'basic social niceties'.
posted by yawper at 9:08 AM on July 2, 2009

Best answer: I would totally switch to get a private room. There's no way I would want to deal with anyone else after birth. I had a private room for the 5 days before and the 3 days after I had my baby (complications) and I would have hated to deal with anyone else's screaming baby (the baby roomed in with us) in the post-partum state. Also, my husband did stay every night with us in the room and that was very important to us. Post-partum, I was in a total bubble and maybe it would have been easy to shut out anyone else but I really didn't even leave my room for more than a walk down the hall a few times. I just wanted to be alone with my baby and my husband in our own little new world.
posted by otherwordlyglow at 9:15 AM on July 2, 2009

If it were me, I would make an appointment with a doctor affiliated with hospital b and see from there. If you find and like a doc with b then switch. I understand you are high risk but being comfortable while in labor and delivery was very important to me. I switched mid pregnancy from a doc to a midwife(I understand it's probably not an option for you, just explaining) and I was very happy with that decision. As a fellow semi-anti-social person I would not have wanted a shared room; I had issues with privacy and the nurses as it was.
posted by shmurley at 9:29 AM on July 2, 2009

I would switch. You're not that attached to the doctors, which would be the biggest reason to stay.

I had a private room after each of my deliveries, and I will tell you that I would have been extremely pissed off if I'd had to share - and I am a pretty social and easygoing person. The thing is, you'll be exhausted and hormonal and you'll want that time for just you, your little one and your SO. Yes, you might be too enthralled/exhausted to really notice, but why not try to arrange it the way you'd like?

Cooker girl's point about the level of the NICU is important, though - especially since you are marginally high-risk, do not lower the level of post-birth care for the child. (I've had experience with this!)
posted by widdershins at 9:58 AM on July 2, 2009

Response by poster: Thanks so much for the answers, everyone. Hospital A is Chester County Hospital in West Chester, PA, while Hospital B is Paoli Hospital, in Paoli, PA. I've heard good things about both of them, but I really appreciate all the first-hand advice in this thread.

At the very least, I'm definitely going to contact one or two of the doctors associated with Paoli, just to explore the issue a bit further.

All anecdotes and personal experiences are still very much welcome.
posted by shiu mai baby at 10:21 AM on July 2, 2009

Response by poster: Minor update: I just called the office of the OB/GYN that my next-door neighbor goes to. In order to get an appointment with the doctor, I have to transfer all my records to her office. I asked the receptionist if there was no other way to get a sense of whether or not I would actually like Dr. X; if, for whatever reason, I don't feel comfortable, the last thing I want to do is go through the hassle of transferring all my records, only to transfer them back to my current practice. The receptionist told me my alternatives were to read more about Dr. X on their website, or come in and pick up a brochure. Sigh.

I get that doctors have to make money, but it's spectacularly lame that I have to jump through so many hoops just to talk to a woman I might or might not like.
posted by shiu mai baby at 11:17 AM on July 2, 2009

Seriously, you want to discuss this with your current practice. Maybe one of them knows someone at another clinic, or at the other hospital. Maybe being high risk can give you a better shot at a private room. You don't have anything against your practice: you like them, even. Why not find out what they can do?

There are quite possibly liability issues about seeing someone -- a high-risk someone at that -- without their medical records.
posted by jeather at 11:51 AM on July 2, 2009

Are you absolutely certain you can't get a private room at Hospital A? With my first kid we paid extra for a private room (because there was no frikkin' way I was sharing one). I don't think our insurance paid for it, but it was worth it.

Also with my first kid, I ended up getting one of the doctors I'd met only briefly. It wasn't a big deal, because I saw her only for a few exciting minutes here and there -- most of my time was spent with the maternity nurses. They were the ones who actually got me through it.
posted by The corpse in the library at 11:53 AM on July 2, 2009

Re: minor update, well, that phone encounter has already told you *something* about the practice as a whole, if not the doctor personally.
posted by tigrrrlily at 2:46 PM on July 2, 2009 [1 favorite]

A lot of doctors are reviewed on websites like Yelp. I don't have kids, but I picked my gynecologist based partially on Yelp reviews. Everyone on there loved her and she's been awesome for me, too. Maybe you can get a feel for how Dr. X's patients like her based on something like that, or a site especially for pregnant women.
posted by ishotjr at 4:40 PM on July 2, 2009

Not only that, but if you're sharing a room your S.O. can't stay overnight, whereas he/she can if you're in the room by yourself.
This is the best reason to switch. I am much the same as you in terms of preferring privacy, not being terribly sociable etc. That alone would make me switch, but the SO thing is a total dealbreaker. I ended up with a c-section, and having spent nights in the hospital with and without my SO, I can say that sans-SO sucks hard if you are recovering from a c-section.

Switch. Find a different doctor than the one you phoned already. Good luck with the pregnancy!
posted by Joh at 10:51 PM on July 2, 2009

Response by poster: An update for anyone still interested: I did end up switching practices. There was another doctors' group who was associated with Paoli that didn't give me a hard time about wanting to meet with them before transferring all my records. I met with one of the doctors there, liked him, and felt like I'd be in good hands if I switched.

What really was the deciding factor, however, was that I learned during that meeting that I'd be able to keep going to the perinatology practice that I've been seeing all along. When I was agonizing over this decision, the thought of losing them was the biggest drawback, as I've had all my ultrasounds there, and I've seen those folks more than anyone else. But it turns out that that group works with OB/GYNS at *both* hospitals, so transferring from one regular practice to another wouldn't affect my ability to keep seeing those perinatologists.

So really: best of both worlds. I'm with a practice I like, I get to keep going to the Maternal Fetal Medicine group that's guided me through all the rough spots, and I get to deliver at the nicer, larger hospital with all the private rooms.

Thanks so much to every single person who contributed to this thread. Your opinions on both sides of the issue were incredibly valuable.
posted by shiu mai baby at 4:36 AM on August 4, 2009

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