I feel like I got to experience some of the best and worst of both worlds. Which honestly was the best continuing education experience I could have ever hoped for (I worked as a postpartum doula for years without having to navigate that whole system for myself).
We planned a home birth, but had a backup with a birth plan and arranged to have our midwives go with us to the hospital if need be. I had a little over a week of "false labor" (which I have to say didn't feel any different from "real labor") from about 11pm until sunup every night until one morning my water broke and the contractions continued into the day.
After a week of practice, and drawing on my Hypnobirth and Calm Birth study, I have to say I was pretty good at navigating those contractions, and my endorphin response was superb. Being able to lounge in the labor tub in my bedroom was so amazing, and where I actually made the most progress. If I had started in the hospital I doubt I could have achieved that level of relaxation. I also loved that if I got hungry or thirsty I had complete control over my intake at home. I could've smuggled something into the hospital, but there was something comforting about perusing the pantry and staring into the fridge when I was up in the middle of the night. I could also crank up the dance music when the endorphins were making me giddy, and dance around the living room without worrying about disturbing anyone else. I have to say, the home birth part of it (except for the crazy vomiting and diarrhea from the castor oil) was fun.
But, after laboring and not sleeping or being able to lie down for 36 more hours my labor spontaneously stopped. When 2 doses of Castor Oil, nipple stimulation, walking around the neighborhood, and dancing didn't restart things, my midwives mentioned that this would actually be a medically appropriate time to go to the hospital and get some pitocin (being Group B strep positive and needing IV antibiotics every 4 hours after the water broke also put us on more of a clock to get the baby out). It actually still took them 2 hours and a taco run to convince me that we really did need to go to the hospital (supposedly, the most low key hospital transfer my doula had ever encountered). After having that yummy taco lunch, I also stepped back into our bedroom where I had been doing most of the laboring, to pack a hospital bag, and felt compelled to exclaim, "this place is all out of energy!" I'm still not sure what exactly I meant by that, but it didn't feel like a birth was going to be happening in that room any time soon, and the hospital seemed like as good of a place as any at that moment.
The continuum of care with our midwives was great because I didn't have to abandon the team who had been working with me for the entire pregnancy. It was also such a reassuring thing to be able to run interventions by my midwives before having to commit to anything I didn't understand fully. My favorite moment was when the ultrasound tech said, "The baby might be too big for you to push out." (which they apparently say to everyone) and one of my midwives leaned down and whispered, "Bullshit!" in my ear. That right there was worth the extra fee to have them transfer with us.
The midwives were also great at convincing me to accept several interventions that I would have fought if they weren't there to reassure me that it really was the right option for the situation. I had no interest in getting an epidural because I was managing the pain just fine, but when my blood pressure started to rise and was not responding quickly enough to the magnesium drip, they suggested it as a way to lower my blood pressure and prevent an emergency c-section. It worked, and the added benefit was I managed to get a nap after being awake for 3 days, and had a lot more strength to bring to the pushing stage than I think I would have had otherwise.
My other favorite thing with having the midwives with me at the hospital, was that they actually knew how to position me and coach me to deliver a "sunny side up" baby with minimal stress and injury. Even with the epidural they got me up into a squat with squared heels, and gave me a sheet tied to something to hold onto. When I got to the pushing phase, the actual attending OB leaned down and said, "Yeah, we're probably looking at 4 hours of pushing here." and then disappeared. With my midwives help and having trained with an Epi-No it barely took 20 minutes, and they actually made me stop because they aren't allowed to do the actual delivery, and we had to track down the OB, which took another 15 minutes. For the real delivery it would have been nice to have been back at home instead of in that room with the bright lights, but I felt like I somehow managed to still get most of what I was looking for in my home birth experience in the hospital. Plus I got to teach the attending OB students some new birth positions, and explain to them what an Epi-No was and how it worked.
As far as after the birth, that is where I really wish I would have been at home. I was very happy we were at a progressive teaching hospital where they practice rooming in, so breastfeeding was easier to start than it might've been, they had pain medicine for the after pains, and there was an endless supply of tapioca pudding, but other than that it would've been nicer at home. They kept me for close to 3 days for observation, and checked on me every 2 hours and the baby every 2 hours, but the checkups were staggered, so it seemed like there was a conspiracy to keep me from getting any sleep while we were there. For the 6 days around the birth I think I got maybe 8 hours of sleep total. I got some visits and high fives from the medical students who attended the birth, which was awesome, but never had a chance to talk with the OB directly (I think we might've bruised her ego by bringing our own birth professionals who knew more than she did. They did some re-education about proper anesthetic and suturing techniques with the student who took care of the one small tear I had).
Should we be lucky enough to have more children, I'll definitely plan for a home birth again.