Anyone here have experience with unassisted childbirth?

[funschooler5]

I hesitate to post this, as I know this is a controversial subject, but...

 

We are seriously considering this. Originally, I had planned to go with a midwife assisted homebirth. I've met with a midwife a couple of times and she is really great. The only problem is that DH has recently been diagnosed with a chronic illness, and this week we received bills from his specialist and his ER visit from Oct....they are over $5,000, and we are still waiting for some lab bills to show up. (We are uninsured.) We are applying for their financial aid program, but honestly, we can't even afford to pay any additional monthly payments right now. We are still working on paying off a $2500 bill from his general practitioner. In addition, we are waiting for more test results that may indicate he has another chronic illness that will require expensive treatments. (DH is working a temporary gov't job right now, which doesn't offer benefits, but he has had several interviews within his department that do offer them, so we are hoping that he gets one of those.)

 

All of this to say...I feel like spending another $2500 for a midwife is just something that we cannot do. We could only pay her half of the deposit she asks for for her first visit, which I felt terrible about, and we planned on using next year's tax refund to complete the payments. I just hate to do that when we are behind on so many other bills.

 

I don't want this to sound like this is a purely financial decision, or that I am making a big sacrifice or something. All of my labor and deliveries have been quick and uneventful (knock on wood). My pregnancies are healthy with no complications (knock on wood again). My last child was born at home, with a midwife attending, but she was completely hands-off (at my request) so I pretty much did the whole thing on my own. We had a waterbirth, and I "delivered" DD.

 

Also, because of DH's illness and my planned homebirth, MIL recently bought us a year's membership for an ambulance service. We live 3 minutes away from our small-town hospital that doesn't do births, and 20 minutes away from a big-city hospital that has a large labor and delivery center. So if anything did go wrong, we would have a quick way to 2 hospitals. I really think that we could do this. DH would be completely supportive of my decision either way. He reminded me that after my last birth I had remarked that I felt like I could have done that all by myself.

 

A few year's back I read Laura Shanley's (I think that's her name) book about unassisted childbirth, but I don't remember it having any really practical advice, which is the kind of stuff I'm looking for. What I'd really like is some sort of how-to manual that tells you the basic supplies I might forget, or some clues that you need to go to the hospital. If it's an emergency situation, I feel like I would be able to tell that we need to go to the hospital right away, but I just don't want to miss something subtle during or after the birth. I believe that my midwife will actually consult with people doing unassisted childbirth (checking to see that baby is head down in the last few weeks, etc.) but I haven't talked to her about it yet, as I've only seriously considered it this week.

 

I would really love to hear from somebody who has been through this. I totally understand if people don't feel comfortable posting here, so feel free to pm me. Thanks for listening. :001_smile:

[NicAnn]

Hi,

First, I'm really sorry that you have to worry about the cost of this. We are in a similar situation and it's stressful! Hugs and luck to you!

 

Second, you may have a few other options. Many midwives will barter or reduce/eliminate fees for client without another choice. If yours won't, consider contacting a midwife who lives farther away (if there is one). Depending on where you live, there may be other options as well...CNMs, preceptors, birth centers. They may be far away, but honestly, I've considered making the 3 day drive to The Farm Midwifery center in Tenn, for my own birth!

 

Do you qualify for any kind of state aid? Some states have insurance alternatives (state insurance, different than Medicaid).

 

Mothering.com has a discussion forum with a section just for Unassisted births. Definitely check it out. Those ladies can be a wealth of information. Also consider reading Spiritual Midwifery and Ina Mays Guide to Childbirth.

 

If attended, as a friend and doula, a few unassisted births and I while they went very well..there is a lot that needs to go into it. A neonatal resuscitation course is a must, in my opinion. It's still not something I 100% trust or agree with (though I see the benefits and the reasons why for most people).

 

Good luck with your decision!

[Oops, duplicate account :/]

Def. let midwives know your financial situation. They may be willing to do a lengthy payment plan and/or cut your costs significantly. I have had 4 wonderful homebirths and have never done or would do an unassisted. I have though been at one. A girlfriend had me at hers and they mostly did it for financial reasons as well. It was their 6th baby though, so they had some experience. ;) I will give this to them...they used a doppler to listens to baby's heartbeat during labor as often as a midwife would and practiced hearing the heartbeat prenatally. They were within the rec. distance from a hospital. They did need my help and for example were glad I was there to hold baby after birth because dad had to help mom get out of the birth tub and with some other benign issues. Anyway, it's not something I would do or necessarily support, but there is a way to be more responsible about it than not. Just my 2 cents. :grouphug:

Edited November 19, 2011 by JENinOR

[StephanieZ]

I'm sure you've thought of this, but just in case pregnancy fog has settled in . . .

 

Remember that every birth is unique.

 

All my pregnancies and births were safe and healthy, but my first was "easy", my second was a "dream" . . . and my third was super hard! Even though she was the smallest baby, smallest head, and I was still very young and healthy. I would imagine that all 3 births could have happened safely on our own, but I would have surely lost it (mentally b/c of the pain and w/o an 'expert' on hand to tell me all was OK) with the 3rd birth and ended up at the ER. No. Doubt. I thought about dialing 911 all through the natural labor at home, lol.

Edited November 19, 2011 by StephanieZ

[mycalling]

I've had our last 3 unassisted after the first 4 were homebirths with midwives. This next little guy will be a UC also.

[LittleIzumi]

I would definitely talk to your midwife about finances first. I do have a friend who had two successful unassisted childbirths. http://itsallaboutthehat.blogspot.com/

Her "Some Important Posts" on the right side are almost all about her UCs. :)

Personally, I would prefer to UC but with a midwife next door just in case, LOL. Technically, I DID have a UC myself last time. I keep forgetting that. :lol: I wasn't planning it. I was planning a homebirth and preparing as much as possible, but I wasn't expecting to birth so quickly. The midwife didn't make it. I had The Love with just dh there; "caught" him myself, rubbed him a bit until he cried, stayed in the warm water of the birthing tub with the the cord attached, baby nursing, until the midwives showed up 8 minutes later. We actually stayed in the water until he finished nursing and I birthed the placenta, which was about an hour later.

[celticmom]

I wanted to second the mention of the mothering.com forums. The unassisted birthing forum is under birth and beyond. If I were in your situation I would probably have an unassisted birth. I have seen several people on mothering mention a book that is used to train firemen, ect. called the Emergency Childbirth Manual or something like that.

[celticmom]

I also seem to remember that the Trust Birth Initiative is supportive of unassisted childbirth.

[LittleIzumi]

I also seem to remeber that the Trust Birth Initiative is supportive of unassisted childbirth.

 

Yes, I think you're right. They call it "freebirthing."Or "DIY," lol.

[Oops, duplicate account :/]

I'm sure you've thought of this, but just in case pregnancy fog has settled in . . .

 

Remember that every birth is unique.

 

All my pregnancies and births were safe and healthy, but my first was "easy", my second was a "dream" . . . and my third was super hard! Even though she was the smallest baby, smallest head, and I was still very young and healthy. I would imagine that all 3 births could have happened safely on our own, but I would have surely lost it with the 3rd birth and ended up at the ER. No. Doubt. I thought about dialing 911 all through the natural labor at home, lol.

 

Absolutely. The couple I mentioned in my pp recently had another unassisted (I was invited but it didn't work out on my end to come) and their baby was born not breathing, limp, and his coloring way quite disturbing. They were getting ready to call 911 when another mom/friend felt led to pray over baby, so they did and baby came to and has no long term issues. Also the birth I was at the baby had a herniated belly button. AND, mom's placenta was attached at a certain part and was not completely coming out. That is why I needed to hold baby because dad had to help mom get to the couch while mom held the placenta so it didn't tear the uterine wall/possibly hemmorage. Not as serious as their last unassisted but somethings they had checked out by a midwife (my midwife!) Anyway, I'm just telling you my limited experiences for your information to do with as you wish and feel comfortable. God's blessings on your family and this precious baby!

Edited November 19, 2011 by JENinOR

[linguistmama]

Laura Shanley also a forum if you google her name and UC. I agree with some of the things other posters have said. Does your dh make too much for you to qualify for medicaid? If you don't have insurance and need to transport during labor then you would have to pay the hospital bill out of pocket right? I think UC is a valid birth choice. But for me part of the reason for having a midwife is for things that she could help us safely deal with at home instead of transporting. What are your instincts telling you about this birth? DD2 ended up being a UC because labor was fast and easy. While I was pregnant with her I always had a very strong feeling that things would be just fine and easy and that's what happened. With this pregnancy when I think of my midwife I have a very strong desire to have her at the birth so that is what we are planning (I'll call at the smallest sign of labor this time :)).

[Oops, duplicate account :/]

Laura Shanley also a forum if you google her name and UC. I agree with some of the things other posters have said. Does your dh make too much for you to qualify for medicaid? If you don't have insurance and need to transport during labor then you would have to pay the hospital bill out of pocket right? I think UC is a valid birth choice. But for me part of the reason for having a midwife is for things that she could help us safely deal with at home instead of transporting. What are your instincts telling you about this birth? DD2 ended up being a UC because labor was fast and easy. While I was pregnant with her I always had a very strong feeling that things would be just fine and easy and that's what happened. With this pregnancy when I think of my midwife I have a very strong desire to have her at the birth so that is what we are planning (I'll call at the smallest sign of labor this time :)).

 

Just wanted to add to that. I have another friend who has uced without incidence most of her 9 children! They absolutely could affort a midwife, but it's their preference. One of her UC births did end in a transport simply due to a posterior baby. She had never experienced such pain before! While she had a positive transport and the hossy staff were super caring, it is quite possible/likely that having a midwife's knowledge/diagnostic skills at home could have prevented the transfer and preserved her home birth. Either way every one is happy and they def. have the money to cover all the costs incured!

[Mom-ninja.]

I did. It was not planned though. The midwife just didn't make it to my house on time. She arrived about 5-10 minutes after my baby was born.

[linguistmama]

DD1 was posterior, welcome to hell! That was my biggest reason for having a midwife with dd2, having someone there to help with the pain. I figured if we weren't going to uc the person there to help might as well be a midwife with oxygen, pitocin etc. :) I have a friend who uc'ed and transported after birth for something that a midwife could have taken care of easily t home. The hospital staff were huge jerks to her. :(

[SunD]

I didn't find Mothering.com's UC forum to be very helpful, but Laura Shanley's forum was much more so.

 

My advice beyond considering carefully and researching (the forum is super helpful with that) would be to look into the HypnoBabies home study course, if you can find a cheap used one, and to be 100% sure of the process required to get a birth certificate in your location.

[funschooler5]

 

Do you qualify for any kind of state aid? Some states have insurance alternatives (state insurance, different than Medicaid).

 

 

 

You know, I'm not sure! I know that the last time I checked my state wasn't offering state aid for adults...I will check into Medicaid. But I don't believe that my midwife would be covered by that. I know that her services aren't covered by state aid.

[LittleIzumi]

I didn't find Mothering.com's UC forum to be very helpful, but Laura Shanley's forum was much more so.

 

My advice beyond considering carefully and researching (the forum is super helpful with that) would be to look into the HypnoBabies home study course, if you can find a cheap used one, and to be 100% sure of the process required to get a birth certificate in your location.

 

:iagree::iagree::iagree:

 

The Love was posterior. I didn't even admit I was in serious labor until 7 minutes before he was born, most of the thanks going to HypnoBabies. Hence the UC, LOL.

[LittleIzumi]

You know, I'm not sure! I know that the last time I checked my state wasn't offering state aid for adults...I will check into Medicaid. But I don't believe that my midwife would be covered by that. I know that her services aren't covered by state aid.

 

At least here, pregnancy is a "disability" for Medicaid. I only qualify for Medicaid when I'm pregnant.

[Oops, duplicate account :/]

:iagree::iagree::iagree:

 

The Love was posterior. I didn't even admit I was in serious labor until 7 minutes before he was born, most of the thanks going to HypnoBabies. Hence the UC, LOL.

 

HB has helped a lot of mamas! If we ever have a child again I'm seriously looking into it. Keeping it real though...I know moms who didn't have as much success as others with HB and I know moms who had a posterior baby (me!) who did great without it. (The bottom of a large metal bowl used for counter pressure on my lower back was amazing!) There are a lot of variables regarding pain and as much as we can prepare, sometimes that baby's position is just rocking moms world. :001_huh:

Edited November 20, 2011 by JENinOR

[Hypatia.]

After two midwife-assisted homebirths (midwife there for the last 15 minutes), DS2 was born unassisted. If we have other children then I would UC again, barring any complications. I also used Hypnobabies for all of my births.

[funschooler5]

Okay, too many great posts to quote, so I'll respond here. :001_smile:

 

First of all, thanks everyone for all of the info and advice. You've given me a lot to think about. If we do end up doing a UC we will definitely be taking an infant CPR course, and doing a lot of research ahead of time.

 

Also, I checked my midwife's website and she does offer a sliding scale and will barter for services. I will talk to her about that.

 

The points many of you have brought up are ones that have made me go back and forth on my decision. I do worry that I've "used up" all of my complication-free births....I'm afraid that this would be the one to have something go wrong, you know? Also, I have thought that a midwife could actually handle something like a breech or posterior baby without a hospital transport.

 

I guess the best thing I can do right now is read up on it all that I can, and discuss the financial options with my midwife. Maybe she has some ideas.

[funschooler5]

Okay, I'm not superstitious or anything, but it's a little unsettling that my last post was # 911. :tongue_smilie:

[Birdwinglips]

Must admit my jealousy at reading this thread. My first has a disability and was delivered via planned c-section. 2nd I wanted a VBAC but doc said no. Turned out for the best because I had a ruptured uterus (discovered during c-section). Third planned c as well. I wish we could had at least one natural birth.

 

Best wishes with your delivery.

[WistfulRidge]

We strongly considered a UC for DS2. DS1's birth was traumatic enough for me that I've vowed not birth in a hospital again unless it is 100% medically necessary and finances are really tight for us. In the end we worked with a local midwife and did kind of a hybrid. I took care of most of my prenatal care and had a handful of appointments with the MW. MW came for the birth but was very hands off. In the end I was glad she was here because DS2 decided that after 5 hours of intense labor he was done with the whole process and he was born after less than 2 minutes of pushing, which caused some nasty tears. I would still love to have a UC someday.

 

The UC forum at mothering.com is great. I also found the book Heart and Hands to be a great source of information on pre/postnatal care and birth in general.

[Osmosis Mom]

I say do anything to NOT do Unassisted childbirth. I am sorry, but it seems some Westernized people think it is cool to go what I dare to call backwards. So much can happen so quickly in labor and delivery. Do you really want to be the one responsible for keeping your cool and making the right decisions, what about those decisions you have no clue about?

 

I am saying this after my last delivery which was at a Catholic hospital with charity care, a VBAC and incidentally the easiest and most wonderful of all my deliveries (dd has a double knot and the cord twice around her neck though). As I was laboring (and this was my easiest or one of my easiest labors) then I had flash backs of my first delivery (from hell) and lost a lot of confidence at some points. I had a very calming midwife and an amazing nurse who just watched me and made me feel safe and thus enable me to focus on the process and on not worrying.

 

I would go very far to not have unassisted delivery. Things can go wrong. As a mother then I'd rather argue with a doctor over which care I want than have a child stuck in the birth canal, his heart rate drop, or whatever scary things can happen while be on my own.

 

There must be a Catholic center near you or you could do walk in at the ER? I am so sorry this is your situation and was desperate myself however I ended up with the best experience ever.

 

And sorry if my answer is controversial.

[Bluegoat]

There must be a Catholic center near you or you could do walk in at the ER? I am so sorry this is your situation and was desperate myself however I ended up with the best experience ever.

 

 

I think this could potentially end up being a very expensive option. ER time cost a bundle.

[Homemama2]

I'd try to have someone with medical experience with you if at all possible. Of course, I had one baby who was born blue and ended up in the NICU, and the other one I needed an emergency c-sect because he was turned completely sideways (even though I had been to the dr. right before he was born and he was postioned correctly.) There are just so many factors that come into play with child birth.

[ktgrok]

My biggest concern is that even if all goes great with the baby, if you need stitches you would have to go to the ER for them right after giving birth. That seems like it could open a whole kettle of fish with DCF, social services, etc, and then do you bring a newborn to a germy ER with you? Or leave the baby at home away from mom? Either way, a real issue over something simple like a few stitches in the perineum.

[Veritaserum]

UC is outside my comfort zone. I've had four midwife-assisted home births with good outcomes. However, I needed midwife assistance after my first home birth (heavy bleeding on its way to hemorrhage despite breastfeeding and uterine massage; got a shot of pitocin), during my second home birth (fluke complication), and after my fourth home birth (baby needed a bit of help). I benefitted from emotional and physical midwifery support during my third home birth, but of my four home births I supposed this one would have been ok as a UC.

 

I'm not at all confident that dh or I could have handled the bleeding after my first home birth or the complication at the second one. I am glad that at my last home birth my baby was in the far more experienced and unemotional hands of my midwife when she needed help.

 

Yes, birth usually goes fine when you leave it alone. However, that's not a guarantee and it is unsafe to put on rose-colored glasses and adopt a belief that birth is without risk. Birth carries risks. Safety can be enhanced or made worse by the birthing choices we make.

[mommymilkies]

:iagree::iagree::iagree:

 

The Love was posterior. I didn't even admit I was in serious labor until 7 minutes before he was born, most of the thanks going to HypnoBabies. Hence the UC, LOL.

 

My 4th was a UC. Planned hypnobabies waterbirth. The water and hypnobabies were lifesavers! That and not having to be on my back like with my other 3 births!

[AHASRADA]

Yes, but not intentionally! :lol: I had already decided I was going to take more control of my labor and delivery the 3rd time around, and while giving birth at home pretty much on my own was a very empowering, beautiful experience, I would never have planned to do so. We were very fortunate and blessed that both the baby and I were just fine, but I wouldn't have risked our health on purpose.

[mommymilkies]

My biggest concern is that even if all goes great with the baby, if you need stitches you would have to go to the ER for them right after giving birth. That seems like it could open a whole kettle of fish with DCF, social services, etc, and then do you bring a newborn to a germy ER with you? Or leave the baby at home away from mom? Either way, a real issue over something simple like a few stitches in the perineum.

 

The ER is no more germy than any other part of the hospital. I've worked in 2. I did have a hospital transfer and got care faster than with my induced hospital birth. With my hospital birth (#2), I had a severe hemorrhage, shock, and seizure. It took them hours to finally deal with it. With my transfer, I was in and got care immediately. We had no illness from that episode. We were also never investigated. They did the routine drug tests, etc. and could see that I was responsible and it was planned.

 

As far as using up your "easy births", I had only one that was "easy" before my 5th and my 5th was super easy and by far the shortest. You never know what you'll get!

[mycalling]

Posterior is really nothing in need of transfer. It's a bit alarming as you're pushing but reading up on things beforehand would prepare you. My twins were both posterior and I was unprepared for the feeling of them "coming out the wrong exit," so to speak. Push through it, and they make a 90 degree turn and come out where they're supposed to...I promise.:001_smile:

As I was laboring (and this was my easiest or one of my easiest labors) then I had flash backs of my first delivery (from hell) and lost a lot of confidence at some points. I had a very calming midwife and an amazing nurse who just watched me and made me feel safe and thus enable me to focus on the process and on not worrying.

This is something to consider. With a uc you are completely dependent on yourself and your DH to get you through things mentally. You really have to trust your body and believe in yourself to uc. If you can't do that in the thick of it, uc is probably not for you. It's really not for everyone.

 

That said, this is how I u/c:

1. I get a Level 2 ultra sound beforehand. I check the heart, the spine, the brain for fluid, for 3 vessels in the cord, placental position and thickness, etc.

2. During, I refocus and calm myself multiple times. It's for the baby. A calm mom makes for a calm baby.

3. Deep oxygenating breaths between contractions and I'm never on my back. #2 and #3 are the most important in keeping baby's heart rate healthy.

4. Don't get dehydrated. Our only heartrate spike in a baby was from dehydration and lying down. Remedied both and he was a-ok.

5. I labor as upright as possible to dilate faster/easier. Yay gravity!

6. Water birth. A lot issues can be lessened with water birthing, but I'm sure you've read up on that.

7. We know infant CPR and have an O2 tank with adult and infant nasal cannulas, though A bulb syringe and back massaging are all we've had to use for breathing difficulties. Don't cut the cord and you have multiple minutes of oxygenated time to get baby breathing without worry. Not all babies come out wailing and that really is OK. Mind you, I've had two partial abruptions, one with a true knot, and one with the cord around his neck twice. They were all completely fine.

[Oops, duplicate account :/]

Posterior is really nothing in need of transfer. It's a bit alarming as you're pushing but reading up on things beforehand would prepare you. My twins were both posterior and I was unprepared for the feeling of them "coming out the wrong exit," so to speak. Push through it, and they make a 90 degree turn and come out where they're supposed to...I promise.:001_smile:This is something to consider. With a uc you are completely dependent on yourself and your DH to get you through things mentally. You really have to trust your body and believe in yourself to uc. If you can't do that in the thick of it, uc is probably not for you. It's really not for everyone.

 

That said, this is how I u/c:

1. I get a Level 2 ultra sound beforehand. I check the heart, the spine, the brain for fluid, for 3 vessels in the cord, placental position and thickness, etc.

2. During, I refocus and calm myself multiple times. It's for the baby. A calm mom makes for a calm baby.

3. Deep oxygenating breaths between contractions and I'm never on my back. #2 and #3 are the most important in keeping baby's heart rate healthy.

4. Don't get dehydrated. Our only heartrate spike in a baby was from dehydration and lying down. Remedied both and he was a-ok.

5. I labor as upright as possible to dilate faster/easier. Yay gravity!

6. Water birth. A lot issues can be lessened with water birthing, but I'm sure you've read up on that.

7. We know infant CPR and have an O2 tank with adult and infant nasal cannulas, though A bulb syringe and back massaging are all we've had to use for breathing difficulties. Don't cut the cord and you have multiple minutes of oxygenated time to get baby breathing without worry. Not all babies come out wailing and that really is OK. Mind you, I've had two partial abruptions, one with a true knot, and one with the cord around his neck twice. They were all completely fine.

 

Thank you for sharing! I have to say, you sound well informed and proactive. It isn't for me, but you have my respect! It sounds like you used a doppler as well? I have a question if you don't mind? Did someone need to remove/cut the cord from baby for him/her to come or come safely? I've had several with cord around the neck and this has needed to be done, but not each time. We're really big on not cutting the cord (unless medically necessary) until it's stopped delivering oxygen, too! Also, did you and your dh rehearse what you would do in case of hemmorage? I had a friend who had to transfer by helicopter (she had airlife for the last month of preg. just in case-she wasn't close enough to the local hossy) from home due to hemmoraging! Her midwife had to insert her fist up mom and put pressure on the uterus (presumably at the spot through trial and error that caused the bleeding to slow) to minimize bleeding all the way to the hospital. She said it was so painful, but in the end was just so thankful her midwife knew what to do and everyone was okay! Her next baby was born in a birth center near the hossy.

Edited November 20, 2011 by JENinOR

[amo_mea_filiis.]

First of all, thanks everyone for all of the info and advice. You've given me a lot to think about. If we do end up doing a UC we will definitely be taking an infant CPR course, and doing a lot of research ahead of time.

 

Look into the CPR before you take the class; During our class (EMT), CPR was newborn-1 month, 1 month and up (and borken down into child and adult).

 

My point is to just make sure it's newborn specific and not just infant.

[Bluegoat]

The ER is no more germy than any other part of the hospital. I've worked in 2. I did have a hospital transfer and got care faster than with my induced hospital birth. With my hospital birth (#2), I had a severe hemorrhage, shock, and seizure. It took them hours to finally deal with it. With my transfer, I was in and got care immediately. We had no illness from that episode. We were also never investigated. They did the routine drug tests, etc. and could see that I was responsible and it was planned.

 

As far as using up your "easy births", I had only one that was "easy" before my 5th and my 5th was super easy and by far the shortest. You never know what you'll get!

 

I think that the issue was that without an extra pair of hands, if the husband needs to help the wife, there may be no one to take charge of the baby. And that includes if there is a need to transfer to hospital.

 

Hospitals in general are germy, and can include some serious germs as well as just lots of them - that is a big advantage of home birth over hospital birth. Many many hospitals are infected with difficult to treat bugs.

[ktgrok]

The ER is no more germy than any other part of the hospital. I've worked in 2.

 

Oh, I know the rest of the hospital is germy too, lol. Although I would argue that there are more cases of flu and pneumonia in the ER waiting room than on the L/D floor. But I wasn't suggesting she birth in a hospital, I meant that having a midwife at home would avoid the need to go to the hospital at all, at least for something simple like stitching a perineum.

[Oops, duplicate account :/]

Posterior is really nothing in need of transfer. It's a bit alarming as you're pushing but reading up on things beforehand would prepare you. My twins were both posterior and I was unprepared for the feeling of them "coming out the wrong exit," so to speak. Push through it, and they make a 90 degree turn and come out where they're supposed to...I promise.:001_smile:This is something to consider. With a uc you are completely dependent on yourself and your DH to get you through things mentally. You really have to trust your body and believe in yourself to uc. If you can't do that in the thick of it, uc is probably not for you. It's really not for everyone.

 

That said, this is how I u/c:

1. I get a Level 2 ultra sound beforehand. I check the heart, the spine, the brain for fluid, for 3 vessels in the cord, placental position and thickness, etc.

2. During, I refocus and calm myself multiple times. It's for the baby. A calm mom makes for a calm baby.

3. Deep oxygenating breaths between contractions and I'm never on my back. #2 and #3 are the most important in keeping baby's heart rate healthy.

4. Don't get dehydrated. Our only heartrate spike in a baby was from dehydration and lying down. Remedied both and he was a-ok.

5. I labor as upright as possible to dilate faster/easier. Yay gravity!

6. Water birth. A lot issues can be lessened with water birthing, but I'm sure you've read up on that.

7. We know infant CPR and have an O2 tank with adult and infant nasal cannulas, though A bulb syringe and back massaging are all we've had to use for breathing difficulties. Don't cut the cord and you have multiple minutes of oxygenated time to get baby breathing without worry. Not all babies come out wailing and that really is OK. Mind you, I've had two partial abruptions, one with a true knot, and one with the cord around his neck twice. They were all completely fine.

 

Okay, this is maybe slightly ot (maybe not because sharing our knowledge is super important IMO, maybe, but not necessarily more so UCing--BUT I'm probably preaching to the choir on this thread, lol!) but YES!! I'm in total agreement! With my first I actually felt better being somewhat on my back to the amazement of those present. It was actually slowing down the contractions which was nice.;) (side lying can do this too and is much better for babe) Anyways, when my MW checked the hb babe was not doing so hot, but up until then and until laboring on my back babe had been fine. MW had me get up and walk around and change positions and sure enough babe was fine the rest of labor. So sad to think of all the interventions that can result from something so incredibly common as being on your back to labor. Better for birth care givers, but generally NOT babe. :glare:

[funschooler5]

Look into the CPR before you take the class; During our class (EMT), CPR was newborn-1 month, 1 month and up (and borken down into child and adult).

 

My point is to just make sure it's newborn specific and not just infant.

 

Thanks for pointing that out. I will double-check the types of classes.

[staceyobu]

Oh, I know the rest of the hospital is germy too, lol. Although I would argue that there are more cases of flu and pneumonia in the ER waiting room than on the L/D floor. But I wasn't suggesting she birth in a hospital, I meant that having a midwife at home would avoid the need to go to the hospital at all, at least for something simple like stitching a perineum.

 

Typically, you should be able to walk into a l&d floor for stitches post baby. An ER should really put you in a wheel chair and take you straight there. Of course, another great option would be to call a local midwife who is willing to support UC and have her come and do the stitches. There is also a lot of information about healing the perineum without sutures. Personally, I want the stitches... but not everyone does.

 

A few additional comments:

 

If money is the main issue, medicaid is typically much, much easier to get when you are pregnant.

 

We UC'd for our last birth. I wish we had another person there besides DH and I. I needed help getting up to the bathroom after having the baby and DH couldn't help me and hold the baby. It sucked leaving her lying on the bed crying fifteen minutes after she was born. We just needed an extra set of hands.

 

We printed an emergency childbirth manual online.

 

Getting a birth certificate can be a real issue. Especially if you don't get prenatal care. Getting a pediatrician to see the baby can also be a problem. And that can compound the birth certificate issue. It probably depends a lot on the area of the country you are in.

 

If anything goes wrong, it's all on you... or, really, your DH. It was a responsibility I was willing to take on my last pregnancy. I'm not sure I could do it again, though.

 

The UC statistics I have seen are very encouraging. There is a huge difference between laboring and having no access to a c/section and being a short ambulance ride away from an anesthesiologist and a surgeon. Can your nearby hospital section a baby in a dire emergency? 20 minutes from a good hospital is still within the realm of comfort... but those are things to consider.

 

It's a hard decision. One thing I disliked about UCing is that I did not feel like I had the freedom to just focus on laboring. Instead I felt like I needed to be aware of what color fluid I was leaking, how much the baby was moving, etc. However, the options we had to have a caregiver present were much worse. Overall, I felt like it was a good decision and an amazing experience.

Edited November 20, 2011 by staceyobu

[Monica_in_Switzerland]

I've only skimmed, but thought I would add...

 

When you add up the cost of purchasing your own doppler, oxygen, urine test strips for pregnancy, chux pads, umbilical clamps, etc, etc, you may find the midwife is not significantly more expensive after all.

 

I'm not opposed to UC in any way, it's sort of my dream-that-will-never-come-to-fruition (my DH would have a heart attack), but you might want to purchase one of the entry-level midwifery texts so that you know if anything veers off of "normal" and when to transfer.

 

A midwife can handle sudden emergencies, but one of her biggest roles is to identify situations she is unable to handle, and get you to more appropriate care- this takes skill and experience to judge. Make sure you feel comfortable identifying deviations from normal and getting yourself to appropriate care if necessary.

 

Best of luck!

[caedmyn]

I have a question if you don't mind? Did someone need to remove/cut the cord from baby for him/her to come or come safely? I've had several with cord around the neck and this has needed to be done, but not each time.

 

This wasn't addressed to me, but I didn't see it answered. From what I've read, in most cases the cord DOES NOT need to be cut or removed from baby's neck (even though that's common practice). If the cord is loose it's not going to interfere with the birth. If it's tight enough to actually prevent the baby from descending you would most likely see decels (heart rate dropping) as the baby decends, before the head is out, and that might be an indication that a c-section is needed. If the cord is tight enough to restrict the baby's oxygen to some extent, but not tight enough to prevent the baby from descending, it's likely best to leave the cord attached anyway, as those are the babies that most need the extra oxygen they get from the cord still being attached (assuming delayed cord cutting). Once the head is out and a tight cord around the neck is discovered the baby will likely be out in just a minute anyway. Some midwives will hold the baby's head against mom's leg if they think the cord is tightly around the neck and then the baby sort of somersaults out (again from what I've read). The cord actually stretches to help allow room for the baby to be born. Also, as the baby decends the fundus (top of the uterus) moves down, so the spot where the cord is attached to the placenta is moving down also...again giving more room for the baby to born.

 

Personally I don't think a breech baby (at least a frank breech one, butt down) alone is reason for a transfer, UC or not. My 3rd was a surprise breech home waterbirth and that was my easiest pushing stage and the only birth where I didn't tear (all 3 of mine were homebirths). The labor was different than the others but I listened to my body and it did just the right things for a breech birth. I did not know he was breech until he was born.

Edited November 20, 2011 by caedmyn

[abbeyej]

Yes, I've had a planned UC. For your practical information question, here's the book I found useful at the time: http://www.amazon.com/Emergency-Childbirth-Gregory-J-White/dp/0934426015 It's been a number of years, but I still think this would be a helpful volume.

 

I would simply recommend becoming as informed and knowledgeable as you can. I ultimately came to the conclusion that I did not want someone else in my home while I birthed, and should any contingencies arrive that we could not handle ourselves, I would rather transport immediately to the hospital anyway.

[mycalling]

Thank you for sharing! I have to say, you sound well informed and proactive. It isn't for me, but you have my respect! It sounds like you used a doppler as well? I have a question if you don't mind? Did someone need to remove/cut the cord from baby for him/her to come or come safely?... Also, did you and your dh rehearse what you would do in case of hemmorage?

With our last baby who had the cord wrapped twice, my husband loosened it and kept his fingers between the cord and baby's neck while baby somersaulted out in the next push. He was slow to breathe so we knuckle rubbed his chest off and on for 10min. He never needed the O2, just that reminder to take deeper breaths. We suspect his shallow breaths had more to do with my having Whooping Cough instead of his cord being wrapped. We had consulted a doctor about any worries of WC and birth beforehand and were told he would not have any issues. Baby's cord took that entire time to stop pulsing, which is why we weren't worried. In fact, all 3 of ours who were slow to breathe had cords that kept pulsing a lot longer.

 

I hemorrhaged with all of mine (except, oddly, with the last where I had a bit of blood come out with the placenta then not a drop for another WEEK!). We used midwives with the first 4, including our twins, so we knew what they did for me and just did it ourselves. Lots of nursing and massaging, and NEVER rush the placenta out. My husband knows the signs of too much blood being lost and keeps a watch over me. He checks the placenta and sack afterward to make sure I didn't retain anything.

[mycalling]

Personally I don't think a breech baby (at least a frank breech one, butt down) alone is reason for a transfer, UC or not. My 3rd was a surprise breech home waterbirth and that was my easiest pushing stage and the only birth where I didn't tear (all 3 of mine were homebirths). The labor was different than the others but I listened to my body and it did just the right things for a breech birth. I did not know he was breech until he was born.

I agree. I know a lot of my confidence comes from experience with my own body's way of birthing and know most wouldn't feel this was safe. I believe waterbirthing is the safest way for a breech baby to be born.

[Kate CA]

From the mom that had all five of hers at home with midwives, I would not recommend UC. With our last, we were in a similar financial situation to your own and the midwife bartered work from my dh as payment.

 

I kept going back to this: if my baby died or something happened that we could not address on our own it would always be our fault. That would forever be between us in our marriage. I didn't think that was the best choice when there were others to be had.

[Sara R]

Don't cut the cord and you have multiple minutes of oxygenated time to get baby breathing without worry./QUOTE]

 

Actually, the placenta starts to separate immediately after the baby is born, which means you can't count on it delivering oxygen. The pulsating cord is caused by the baby's heart, not mom's. The advantage of delayed cord cutting is extra red blood cells, not oxygen. Please do not delay neonatal resuscitation based on a false belief that the baby is getting air through the cord! Brain cells are precious!

[jennsmile]

This wasn't addressed to me, but I didn't see it answered. From what I've read, in most cases the cord DOES NOT need to be cut or removed from baby's neck (even though that's common practice).

 

I was one of those rare cases where yes it needed to be cut. Baby's head was out and the cord as too tight. My midwife was able to cut the cord and baby slipped right out. She had never cut a cord before nor after me (3 years ago now.) I have thought of UC but for me I like having an expert even if she is very hands off (mine is) just in case.

 

YMMV.

 

Jenn

[happypamama]

I think UC can be a reasonable option, but I think you need to do it for the right reasons. There is a lot of responsibility on the parents, particularly the mother, with a UC. I definitely understand the financial concerns (btdt, and in your case, I'd look into Medicaid for a backup -- even if you do end up planning a MW-attended homebirth, Medicaid could help in case you need to transfer to the hospital), but they would not be the biggest reason, IMO, to UC. If you choose to UC, I believe you should do it because you believe it to be the right option *for your family at this time,* same as I believe you should birth at the hospital for the same reason, regardless of the financial cost. I am a huge believer in prayer and personal calling, and I do think God can call people to a UC -- but I also think he can call them to something else and provide the money for that too.

 

You might discuss doing a few prenatal visits with the MW to see if anything shows up that is a bit odd or disconcerting. You might also see if she's willing to be a backup to a UC -- come and attend if you feel that's right, sit on your couch downstairs if that feels right, or just be available by phone/to come after the birth if that is what is right at the time. Then you could pay her a larger fee if you do end up calling her for the birth, or just a small amount for checkups and the postpartum exam.

[milovany]

I think UC is an incredibly poor choice. I think it borders on ignorant and dangerous and is definitely irresponsible.

 

And this is opinion, yes? Or have you based it on research? Because my research (and experience) has proven that it's neither ignorant, dangerous OR irresponsible if done well.

Edited November 21, 2011 by milovaný