What are your feelings about unaccompanied childbirth, or more "Terabith has a weird collection of friends?"

[KungFuPanda]

That is a level of hubris I would love to be able to feel.  It must be great, until it's not. I had both my kids in my mid-twenties.  I was healthy with no complications, but on the second one I was a bit of a bleeder afterwards.  In my new baby euphoria I completely missed the drama, but my husband tells a different tale of a scrambling midwife and hospital staff all springing into action and preparing for contingencies.  People kept telling me I gave them a good scare and I missed it all beyond vaguely registering more people in my room when it had just been my husband and midwife all night.  I guess I would have just trusted my body until I passed out if I was a person willing to go unattended.

[BakersDozen]

5 hours ago, Terabith said:

Yeah, as someone whose first child would have died if unaccompanied, the thought makes me incredibly anxious. 

This is what would have happened with my #12. Things went from textbook perfect to textbook bad in literally an instant. It took a doctor, two nurses with me and two more waiting to work on baby for things to turn out OK (and even after the immediate danger passed he remained on monitors just in case). Too many risks and too much at stake for unassisted. No way would my husband have even recognized that something was wrong and even if he had, he could not have done what those who were medically trained did. And we wouldn't have our little guy. Nope, not worth it.

 

1 hour ago, mommyoffive said:

I would never do a birth not in a hospital by choice.  Never. 

Same. I remember thinking as the situation happened with my son that help was seconds and steps away. Things were so bad that even the mile drive to the hospital could have cost my son his life.

My response to someone who suggested an unassisted birth to me once (with #9, I think?) was, "Not on my child's life."

[rebcoola]

No way, I am all for home births, water births, etc.  Things just go wrong sometimes and you can't always tell or feel.  I thought I was having back labor and it was really a kidney problem.  

[Shoeless]

Maybe we have an overlap in friends, @Terabith. I know someone that has had multiple freebirths and wrote a book about it.  😕 

I think it's incredibly risky and arrogant. Women still die in childbirth in developing countries, and it's not because they didn't "trust their body" enough. 😞 

[Amy in NH]

5 hours ago, kristin0713 said:

Unnecessary risk as others have said.  I did know a girl on another board several years back who lost a baby during an unassisted (by choice) birth.  It was not her first baby; IIRC, she had a large family and had birthed unassisted before.  I'm not anti-homebirth by any means. I had two water births with midwives in the hospital and would have considered a homebirth with a midwife if we had a third. 

I had a midwife-assisted homebirth with my third and fourth.  Dd, my fourth unmedicated birth, had shoulder dystocia, and would have died if not for the skill of the midwife.  If we had had a hospital birth, there is a very good chance they would have broken her collarbone.

Edited March 4, 2021 by Amy in NH

[Momto6inIN]

I labor and delivery very quickly. Longest labor ever was 6 hours, and 4 hours of that was light contractions with my 1st. 2nd one was born less than a half hour after arriving at the hospital and the entire labor from water breaking to birth was less than 2 hours. My obgyn said once my body was made for childbirth and I could probably do it without him, which I gather is not a common thing for obgyns to say 😉

But my 5th had some irregular heartbeats during labor because of the intensity and duration of the contractions and the lack of rest in between them and so did my 6th. In addition, for my 6th, I had issues due to high blood pressure that I'd never had before and just chalked up to being too old (age 45) to tolerate labor as well. I didn't know the high blood pressure was *why* I felt so crappy. And I bled way too much afterwards with #6 and needed meds to stop it because my uterus was "tired". All of this I was oblivious to and so was my DH.

I know most midwives are wonderful and competent, but some aren't, just like doctors. I have a friend at church who is my mother's age who insisted on a VBAC at home because of the trauma she'd had during her last birth which ended up as a Csection at the hospital. She really had to search for a midwife who would agree to do a VBAC at home in the mid 1990s. And her baby died and she almost did. I don't know what happened exactly but it traumatized her older kids enough that none of them will ever consider a non-hospital birth for any reason at all.

And the average pregnant woman and her husband definitely aren't competent enough. For the vast majority of births it would probably be just fine. But the problem is there's no way to know ahead of time whether that particular labor situation is going to be part of the majority or not.

[Soror]

I had 3 at home with midwives without issue. I would not feel comfortable with an unassisted birth. Maternal care in America needs a lot of work. Our infant mortality rates lag behind other countries. We have too many doctors that make decisions on maternal care that are not based on science or facts. We need many more options and no one should be choosing their provider (or lack there of) because of finances.

[Starr]

18 minutes ago, Momto6inIN said:

the average pregnant woman and her husband definitely aren't competent enough. For the vast majority of births it would probably be just fine. But the problem is there's no way to know ahead of time whether that particular labor situation is going to be part of the majority or not.

Years of nursing, and a birth that would have resulted in the death of my baby and myself, I agree with the above. Also if you have to call for emergency help you are going to be treated by the person on call, not someone you have chosen. 

[TheReader]

My third had the cord looped around him; that could have been disastrous w/o the doctor's intervention...and I don't know that my husband would have been able to see that, catch it, stop me from pushing, fix it, etc. safely (nor would he have wanted to....he was very much a "stand at the head of the bed" husband, and would not have ever wanted to be in charge of delivery. 

Now....if this person's husband was fine with all of that, and they knew the risks, and.....clearly, her choice and all, but for me.....no way. 

 

[ktgrok]

The more I think on this, the dumber it is. I mean, I wouldn't fly a plane myself without ACTUAL training, not just "i read a book and watched yotube videos". I wouldn't hire a babysitter that had never babysat a kid. I'm not going to hire myself as midwife when I have no training nor experience. 

There is  spectrum of how birth can go, and as somone who had VBACs a home, including going to 42 weeks at 40 yrs old, I know I'm way beyond most people's comfort level. And yes, partly cause I HATE how mom and baby are treated in a hospital, more due to trauma from my first birth, the hospital one that ended up badly. But even then, I'm not just "ooh, everything will be fine!" I'm getting biophysical profiles starting at 38 weeks, weekly at first then more often. I'm having heart tones and blood pressure checked daily toward the end, with the biophysical every two days. At 42 weeks exactly I went to the hospital and had a full workout including non stress test, biophysical profile, full lab work, etc. stayed on the monitors a few hours. Determination was "You are really really good at being pregnant". My labs were perfect, baby was perfect, great variability without any issues, even with some contractions, I was 5cm dilated, etc.  My previous homebirth was a 10lb baby, and we all agreed this one wasn't any bigger than that, likely much smaller. So I talked it over with the midwife in charge at the hospital, and my midwife (who knew each other and had a great rapport) and we all agreed that if I didn't have a baby in the next 24 hours I'd show up at the hospital to be admitted and induced. I then went into labor on the way home and baby was born 2 hours from leaving, lol. Seemed I just needed a day of rest, away from my kids, to go into labor! (we sent the kids to my sisters while I was at the hospital, and she was going to keep them overnight for me.)

I was very lucky to live in an area with CPM/LM midwives - they do 3 years of college courses and then an internship and then pass national and state licensing exams. My midwife had been a doula first, working in hospitals and homebirths, so had made a lot of good relationships with the hospital doctors and staff, so they knew that if she called, to believe what she said. I knew from friends in the birthing world (photographers, doulas) that she was known for calling for a transfer sooner rather than later and erring on the side of caution - again something she could do because she had good relationships with hospital staff. AND I lived literally 1.5 miles from where an ambulance with EMTs is based, and 10 minutes from a small hospital 15 (with sirens, 20 without) to a very large, top level NICU hospital. Oh! And lucky that there are ways to have a homebirth as a VBAC - for first VBAC you must consult with an OB first, after that you don't have to. Acually, it is set up with a risk score thing - if you have higher than a particular score you have to consult with an OB to have a homebirth (they don't have to give permission, but they have to inform you of your particular risks, and that goes in your chart. If the midwife sees the risks are higher than anticipated, they drop you. And certain things risk you out entirely - known twins, etc)

Without that, would I have a homebirth? Not sure. But I'm SO lucky to have all that, and it makes me so angry that so many women have no legal, safe, trained midwife option available to them. Mine can and does carry the same equipment found in a birth center, and many midwives in this area will do a homebirth in a hotel type facility if you live too far from the hospital, basically creating a birth center for you. Plus we have birth centers, but realistically they were not closer than my house to a hospital. I had options. All women should have options. 

[ktgrok]

I also think that in most cases, it's like abortion. The way to reduce MOST abortions is to offer better alternatives, from medical care to housing to childcare, etc. Won't stop all of them, but a LOT. Same with unassisted birth. If we offer better options, both in and out of the hospital, that would stop most of them. (and deal with the finances....)

[Murphy101]

12 hours ago, KungFuPanda said:

That is a level of hubris I would love to be able to feel.  It must be great, until it's not. I had both my kids in my mid-twenties.  I was healthy with no complications, but on the second one I was a bit of a bleeder afterwards.  In my new baby euphoria I completely missed the drama, but my husband tells a different tale of a scrambling midwife and hospital staff all springing into action and preparing for contingencies.  People kept telling me I gave them a good scare and I missed it all beyond vaguely registering more people in my room when it had just been my husband and midwife all night.  I guess I would have just trusted my body until I passed out if I was a person willing to go unattended.

Yes. Hubris. Everyone thinks having 11 means I’m a “pro”. And let’s say it does. You know what genuine pros know? They know all the ways things go wrong and just happened to have survived it long enough for someone to think they are a “pro”. I got more and more vigilant and less and less willing to be risk taking with each pregnancy.  Because experience tends to kick hubris’ butt.

So I get it is hard to put faith in a medical establishment that all too often doesn’t earn it, but I’d still discourage a free birth and some home births too pending situations. Because bottom line, sometimes a mom needs a steady hand with a clean knife and a few pints of donor blood. 

[Terabith]

1 hour ago, ktgrok said:

I also think that in most cases, it's like abortion. The way to reduce MOST abortions is to offer better alternatives, from medical care to housing to childcare, etc. Won't stop all of them, but a LOT. Same with unassisted birth. If we offer better options, both in and out of the hospital, that would stop most of them. (and deal with the finances....)

Yes, I think this is EXACTLY right.  What a great way to put it!

[Arctic Bunny]

13 hours ago, KungFuPanda said:

That is a level of hubris I would love to be able to feel.  It must be great, until it's not. I had both my kids in my mid-twenties.  I was healthy with no complications, but on the second one I was a bit of a bleeder afterwards.  In my new baby euphoria I completely missed the drama, but my husband tells a different tale of a scrambling midwife and hospital staff all springing into action and preparing for contingencies.  People kept telling me I gave them a good scare and I missed it all beyond vaguely registering more people in my room when it had just been my husband and midwife all night.  I guess I would have just trusted my body until I passed out if I was a person willing to go unattended.

This is what I’m thinking!

The only complication with my first was that nobody believed me that he was coming, until DH was like, um, that’s a head, I’m getting the nurse.

The second.... from my POV, exactly the same. Sure, they said something about meconium and needing to attach a monitor, but honestly, that never registered as really bad in my focused-on-labour mind. And I thought everything went totally smoothly. I never saw the cart outside for an emergency c-section, or anything else that was different from the first one. If it was up to me “trusting my body” I’m not sure what the end result would have been.

Edited March 4, 2021 by Arctic Bunny

[Momto6inIN]

I get the whole "women have done this for millenia" argument. And it's true, to an extent. But women for millenia also watched and assisted in their mothers' births, and their sisters' births, and their cousins' births, etc. etc. so they had a lot more real life experience for what was normal and what was not. And they had experience with helping animals give birth too. Most women nowadays (myself included - the first birth I ever saw was when I was in labor with my 1st! that includes humans and animals😉) don't have that years of experience to draw upon when they are in their own labors. Books and movies don't cut it lol

This next part is not a judgement on anyone for having a home birth. But I do think the difference in perspective is interesting. I remember women from my grandmother's generation being disbelieving when they heard that home births were becoming a thing. They wondered why anyone would choose a home birth over being in the hospital in this modern era. I remember one saying, "Don't they know how many of our friends died in childbirth before we had hospitals to go to? And how thankful we were when that became an option?"

Edited March 4, 2021 by Momto6inIN

[ktgrok]

3 minutes ago, Momto6inIN said:

I get the whole "women have done this for millenia" argument. And it's true, to an extent. But women for millenia also watched and assisted in their mothers' births, and their sisters' births, and their cousins' births, etc. etc. so they had a lot more real life experience for what was normal and what was not. And they had experience with helping animals give birth too. Most women nowadays (myself included - the first birth I ever saw was when I was in labor with my 1st! that includes humans and animals😉) don't have that years of experience to draw upon when they are in their own labors. Books and movies don't cut it lol

This next part is not a judgement on anyone for having a home birth. But I do think the difference in perspective is interesting. I remember women from my grandmother's generation being disbelieving when they heard that home births were becoming a thing. They wondered why anyone would choose a home birth over being in the hospital in this modern era. I remember one saying, "Don't they know how many of our friends died in childbirth before we had hospitals to go to? And how thankful we were when that became an option?"

and even then, they were not supposed to do it ALONE! They had other women there - ideally calling in the most experienced in the area! 

As for hospital vs home, I think it is important to realize that women may plan a homebirth but also (in most circumstances) plan for transfer to a hospital as well. There is always plan A, B, C, and D. Plenty of women transfer to the hospital either out of caution "things look good still, but we are verging on where we need to be more ready if that changes so lets go where the OR is just in case" or "you are exhausted, lets get you meds and sleep" or "there is meconium in the fluid, lets transfer so we can deal with that better" or "You tore more than I'd like, lets get a surgeon to stitch you instead of me" or "you are bleeding more than expected, my assistant is calling 911 while I give a shot of pitocin, and put in an IV line" or "baby changed position" or yes, "heart tones are not recovering after a contraction the way I'd like, I'm calling 911, now lets change position to get pressure off the cord/baby" to "your cord is prolapsing, my hand will be in your vagina holding the baby's head off of it until we get to the ER". None of that is a "trust your body, it will be fine" approach that free birth seems to encourage. Won't solve every emergency, but it sure is not "my body knows what to do" either. And in all those scenarios, a trained person is imperative. 

[busymama7]

I think one thing that some people don't realize is that now is pretty much the best time in history to have a home birth. It is often compared to "women on the plains" who "died all the time" (they didn't) but now we have the benefit of pitocin,  antibiotics, c sections etc when they are needed.    The key though is only using these tools when they are actually needed.  Current c section rates are around 35-40%(varied by area but that is what it is here) That is outrageous and no where near evidence based.  When I chose to have a home birth it was because I couldn't trust an OB to tell me if a c section was *actually* needed since the vast majority of the ones they were doing were not. Or at least wouldn't be if they hadn't intervened so much leading up to it.  

Inappropriately using medical tools for child birth has actually lead to *more* maternal deaths.   

But this was about unassisted and that really is a different situation.  But again, midwives are in short supply in many areas and non medical midwives who aren't controlled by the medical system are even more rare.  So women are in fact forced into unassisted in some cases although some do so for other reasons. 

[Dmmetler]

Well, I've had two pregnancies that both required emergency C-sections done prematurely. I very literally would not be here if I'd trusted my body. 

 

Having said that, during my second pregnancy, I qualified to have a nurse case manager with the idea of keeping me out of the hospital as much as possible. It was that wonderful woman who told me, when my numbers looked good, but I felt odd, that I needed to go in, NOW. She was right-I was in labor, and within 12 hours, was in full blown Pre-eclampsia as well. She was able to pick up over the phone that things were starting to go south, even when I couldn't. 

[bookbard]

@Melissa in Australia there are definitely homebirth midwives in Australia. The situation with insurance is complicated but there's now Medicare funding for a certain portion of midwife care which has reduced some costs. It's still expensive and there aren't many of them. There is certainly midwife-led care in hospitals, but it's tricky if you've had a previous caesarean etc.

There are some awful stories about losses at home due to midwife incompetency . . . . and there are some awful stories about hospital-based mistakes too. Remember the woman paralysed for life when they injected antiseptic into her back rather than the epidural meds? Or the babies who died when they were given nitrous oxide instead of oxygen to breathe? (Australian incidents). I can imagine if that was your story or the story of someone you knew, even though statistically rare, hospital might be very traumatic for you. I myself was yelled at by the OB for crying when he said I'd need a C-section ("why are you upset? 30% of all women need one!) 

[busymama7]

1 hour ago, bookbard said:

@Melissa in AustraliaI myself was yelled at by the OB for crying when he said I'd need a C-section ("why are you upset? 30% of all women need one!) 

Argh I can't figure out how to delete the tag

This is why I believe men and surgeons should get out of the baby birthing realm.    Let midwives manage all low risk women and bring in the surgeon only when someome competent and trained in normal physiological birth determines it is necessary. Women are NOT well served by doctors with that kind of attitude. Quit going to doctors for normal birth! Save them for the complications that happen and when their skills are greatly needed.  But anyone who thinks 30% of women *need* a cesarean shouldn't be caring for routine pregnancies.   

 

 

 

Edited March 5, 2021 by busymama7

[gardenmom5]

21 hours ago, stripe said:

I think the “trust your body, everything will be fine” thing works when you don’t actually comprehend the medical concerns women are in during childbirth, and what it’s like when such care is inadequate. Not unlike many teenagers who say, “what’s the worse that could happen?” as they do something horribly dangerous.

There is a vast realm between “medicalized birth” (with or without humiliation....I have elderly relatives who gave birth under twilight sleep and seemed to be fine about it) and DIY. Not to be ridiculous, but where does all this homegrown medical expertise end?

Or just how fast things can go south!   

[gardenmom5]

30 minutes ago, busymama7 said:

Argh I can't figure out how to delete the tag

This is why I believe men and surgeons should get out of the baby birthing realm.    Let midwives manage allow risk women and bring in the surgeon only when someome competent and trained in normal physiological birth determines it is necessary. Women are NOT well served by doctors with that kind of attitude. Quit going to doctors for normal birth! Save them for the complications that happen and when their skills are greatly needed.  But anyone who thinks 30% of women *need* a cesarean shouldn't be caring for routine pregnancies.   

 

 

 

Having had five kids - I've had multiple OBs. (I think only two were attended by the same OB)  One - was definitely a misogynist, unprofessional, and didn't belong anywhere near women.   I'd happily join the cohort chasing him down to castrate him.

But, I've also had male OB's who were great.   

 

[Janeway]

I think it is fine.

[Melissa in Australia]

3 hours ago, bookbard said:

@Melissa in Australia there are definitely homebirth midwives in Australia. The situation with insurance is complicated but there's now Medicare funding for a certain portion of midwife care which has reduced some costs. It's still expensive and there aren't many of them. There is certainly midwife-led care in hospitals, but it's tricky if you've had a previous caesarean etc.

There are some awful stories about losses at home due to midwife incompetency . . . . and there are some awful stories about hospital-based mistakes too. Remember the woman paralysed for life when they injected antiseptic into her back rather than the epidural meds? Or the babies who died when they were given nitrous oxide instead of oxygen to breathe? (Australian incidents). I can imagine if that was your story or the story of someone you knew, even though statistically rare, hospital might be very traumatic for you. I myself was yelled at by the OB for crying when he said I'd need a C-section ("why are you upset? 30% of all women need one!) 

I live rural Vic, we don't have OB, rather a GP with some extra training and midwives in the rural hospital. I think the closest OB is about 300 km away. There are no midwives doing home births in my area, and believe me, cleaning up my mother's home birth has given me enough trauma to make sure I never had a home birth. 

[busymama7]

1 hour ago, Melissa in Australia said:

I live rural Vic, we don't have OB, rather a GP with some extra training and midwives in the rural hospital. I think the closest OB is about 300 km away. There are no midwives doing home births in my area, and believe me, cleaning up my mother's home birth has given me enough trauma to make sure I never had a home birth. 

This is so strange.  My husband was worried about the mess as he had seen my hospital births but was pleasantly surprised to realize that there was none.  I have had other clients have the same surprise over how nice and neat we keep it.  I have attended over 200 home births. Not once has there been any kind of mess left for the family. We are super careful to protect everything and instruct the family how to do so if they are going fast and we aren't there yet.   Sounds like some serious incompetence to leave a mess for a family to deal with.  

[Melissa in Australia]

2 hours ago, busymama7 said:

This is so strange.  My husband was worried about the mess as he had seen my hospital births but was pleasantly surprised to realize that there was none.  I have had other clients have the same surprise over how nice and neat we keep it.  I have attended over 200 home births. Not once has there been any kind of mess left for the family. We are super careful to protect everything and instruct the family how to do so if they are going fast and we aren't there yet.   Sounds like some serious incompetence to leave a mess for a family to deal with.  

Well my mother didn't have a midwife, she had some lady who had assisted a midwife once. nor did she cover the couch with anything. Dad put the afterbirth in a casserole dish and told us kids that it was going to be fore dinner 😞  I had the joy of scrubbing the couch, and the floor and washing all the stuff. I was 10 . 

[Eos]

 

In answer to the OP's question: I hold the opinion that women have autonomy.  Period.  End of discussion for me.  

Edited February 6, 2023 by Eos

[HS Mom in NC]

15 hours ago, Melissa in Australia said:

I live rural Vic, we don't have OB, rather a GP with some extra training and midwives in the rural hospital. I think the closest OB is about 300 km away. There are no midwives doing home births in my area, and believe me, cleaning up my mother's home birth has given me enough trauma to make sure I never had a home birth. 

There was nothing to clean up after my homebirth on my bed because the midwives took care of all that.  When it's a waterbirth the midwives clean all of that up too. I almost had oldest in the inflatable pool (so comfy and warm to sit in with no hard bottom or sides) but they couldn't get a good read on her heart rate at that angle (which was unusual)  so they helped me stand up in the pool, got the reading that the baby's heart rate was starting to drop, helped me on the bed (already set up as I describe below)  put me on my left side, put the oxygen mask on me, her heart rate immediately stabilized,  I pushed for 15 minutes and she was out.

The birthing pool and the bed were set up when early labor started per the midwife's instructions: mattress then plastic sheet then regular fitted sheet then chux (sp?) pads- just like the ones in the hospital under patients for the mess. Clients get a shopping list at 6 months into the pregnancy and have to have all items on hand the earliest day they can birth at home, which was 35 or 36 weeks if I remember correctly (it was 25 years ago, so I could be wrong.)

After the birth the midwife and her midwife in training (they always work in pairs) got the bed back to normal (mattress then a fresh fitted sheet, more chux pads in case feminine hygiene products fail while sleeping) then a flat sheet, then the blanket/duvet/comforter) while my husband helped me with a quick shower and getting dressed. They put the regular fitted sheet that was between the plastic sheet and chux pads in my washing machine (there were some messy parts on it) and stayed with me for a few hours checking on me and the baby frequently. They took the messy chux pads away with them to dispose of properly.

[busymama7]

3 minutes ago, Ordinary Shoes said:

Well, surgeons can be women too. In fact, most OBs are women today. And it's not surgeons who do c-sections but OBs. 

And how do you know whether your birth will be "normal" until after the fact? How do you know if you'll have complications before you give birth? 

I went to an OB and had DD in the hospital. I'm glad I made that choice since I ended up needing a c-section. 

 

OB/gyn is a surgical speciality.  They are all surgeons.  Family practice doctors used to deliver babies but I haven't heard of that for years and years. Maybe in some rural areas it is still true.  And sure there are lots of female ob/gyns but they are still surgeons.   It isnt the best use of their training and education to use them for routine pregnancies and deliveries.  It just isn't.  And we have learned this the hard way by the fact that way too many women are delivering by c section. 

Midwives of the CNMs variety deliver in hospitals and can call in an OB if a c section becomes needed. The vast majority of women believe that their c section was needed but the truth is that most were not.   Of course I have no idea if yours was or wasn't and I'm not addressing that,  but many many many are not.  I know dozens of women told their pelvis was too small or they just couldn't dilate and they had to have a c section who went on to have future babies with no issues.  

Of course there will be need for some c sections.  Things do not always work as they should.   But 40% is unacceptable and completely indefensible.   Midwives receive different training and much more training on normal birth. They need to be the primary caregivers of normal pregnancy with a good back up of doctors who can step in when things don't go as hoped.  

[gardenmom5]

22 minutes ago, Ordinary Shoes said:

Well, surgeons can be women too. In fact, most OBs are women today. And it's not surgeons who do c-sections but OBs. 

And how do you know whether your birth will be "normal" until after the fact? How do you know if you'll have complications before you give birth? 

I went to an OB and had DD in the hospital. I'm glad I made that choice since I ended up needing a c-section. 

 

Aside from my male chauvenist pig OB with 1dd, my 2nd worst attendant was a woman.  She was power tripping, went against hospital policy and went against my drs order.  to be honest, I was afraid of her and afraid if I complained while I was laboring - she'd retaliate against me.  She left me with so many bruises the mom baby nurse's first thought was dh was physically abusing me.

my consolation was she was gone before I delivered.  I've had nurses who stuck around after their shift was over when I was close to delivery.

Edited March 5, 2021 by gardenmom5

[Shoeless]

18 minutes ago, busymama7 said:

OB/gyn is a surgical speciality.  They are all surgeons.  Family practice doctors used to deliver babies but I haven't heard of that for years and years. Maybe in some rural areas it is still true.  And sure there are lots of female ob/gyns but they are still surgeons.   It isnt the best use of their training and education to use them for routine pregnancies and deliveries.  It just isn't.  And we have learned this the hard way by the fact that way too many women are delivering by c section. 

My family practice doctor delivers babies, as does her partner. Her practice is in a big, suburban area. 

[HS Mom in NC]

37 minutes ago, Ordinary Shoes said:

Well, surgeons can be women too. In fact, most OBs are women today. And it's not surgeons who do c-sections but OBs. 

And how do you know whether your birth will be "normal" until after the fact? How do you know if you'll have complications before you give birth? 

I went to an OB and had DD in the hospital. I'm glad I made that choice since I ended up needing a c-section. 

 

Homebirth midwives screen out high risk clients to begin with.  Mine wouldn't even take smokers.  They are able to handle quite a range of complications at home and they are able to transfer to a hospital during delivery for those they can't do themselves. They actually have rules about how far away a client can be from a hospital just in case complications arise. Unlike OBs, homebirth midwives are criminally liable should things go wrong, so there's a constant tension between getting paid to provide care for a homebirth, and being very careful to only take the healthiest women to minimize the likilhood and severity of complications. So those are rare and can be dealt with effectively.  Just because someone can't imagine how a homebirth midwife would manage complications doesn't mean homebirth midwives can't manage those complications. They manage them all the time whether someone can imagine it or not.

It's the other side of the "I know my body, so I'm going unassisted."  Knowing your body won't stop complications from happening to an unassisted birther or give an unassisted birther the skill set and equipment to deal with complications.

[busymama7]

Yes of course every woman should be able to make their own decisions regarding childbirth including the desire for pain relief.  Those options should be left wide open and unfortunately I have heard of "bad apple" CNMs who bully their clients about pain relief and that should never happen.   However, having the vast majority of births attended by surgeons has caused an increase of surgical births and of maternal mortality and morbidity.   And those effects can and do trickle down to future generations.   

[ktgrok]

4 hours ago, Homeschool Mom in AZ said:

The birthing pool and the bed were set up when early labor started per the midwife's instructions: mattress then plastic sheet then regular fitted sheet then chux (sp?) pads- just like the ones in the hospital under patients for the mess. Clients get a shopping list at 6 months into the pregnancy and have to have all items on hand the earliest day they can birth at home, which was 35 or 36 weeks if I remember correctly (it was 25 years ago, so I could be wrong.)

 

Oh, see, we were taught to do waterproof pad, then fitted sheet, then waterproof pad, then fitted sheet. Give birth on the top one, peel that off and the first waterproof pad, and bed is all ready to go for post partum use. I remember yelling at my husband he was doing it wrong a few minutes before having the last kid, lol. Midwife wasn't there yet! Luckily my friend was, and knew what to do and took over. 

 

3 hours ago, busymama7 said:

 

Midwives of the CNMs variety deliver in hospitals and can call in an OB if a c section becomes needed. The vast majority of women believe that their c section was needed but the truth is that most were not. 

Yes, my first birth was in a hospital with a CNM. She was terrible though, I had planned to deliver with a different one, trained in England, but this one was on call. She had no idea how to help reposition my asynclitic kid, and when heart tones dropped at one point after 40 hours she called in the OB. He went straight to the OR without checking me first (no one would check me even though I told people I was pushing!) and called up from there demanding to know why I wasn't there. They got me to agree to a C Section because I thought the heart rate was still low. Later, I found out they'd gone back to normal before I ever left to go to the OR. No one told me. No one checked me. I figured I was broken, he was stuck, and I had no idea what pushing really was since they acted like I wasn't. (I'd been 5cm at last check). They put in my chart that the reason for the c-section was that he was too big for my pelvis (CPD). 

Years later I had a successful VBAC with a baby 2lbs bigger and a much bigger head. And found out that I DO know what pushing is, and darn it, I'd been pushing! My chanting and shaking was what I do in transition, and then I was pushing. Had they bothered to check, I have no doubt I'd have had a vaginal delivery. 

But yeah, if you need a c-section they call in an OB. Most places have hospitalists on staff for that. 

2 hours ago, Homeschool Mom in AZ said:

Homebirth midwives screen out high risk clients to begin with.  Mine wouldn't even take smokers.  They are able to handle quite a range of complications at home and they are able to transfer to a hospital during delivery for those they can't do themselves. They actually have rules about how far away a client can be from a hospital just in case complications arise.

And they call ahead, as soon as things look iffy, so the OR is being prepped and doctor can scrub in while you are enroute, if it is an emergency. I'm not claiming it is as fast from decision to incision as it would be if you were laboring in a major teaching hosptial, but it can be faster than I think some realize. Normally though, they realize that things look "iffy", as in decels a bit too often or a bit too long, and transfer before it goes from "we are going to watch you" to "run to OR". And MOST C-sections look more like "let's watch you, and if  things don't change, you are going to need a c-section". With a home birth, they transfer at that point, when they think a c-section might be in line. That's not going to work for everything, but most. 

2 hours ago, Ordinary Shoes said:

 

I'm fine with women choosing to see a midwife instead of an OB. However, I want to have the ability to choose an OB even if I'm not high risk. I know that trained midwives can effectively manage complications but I felt more comfortable giving birth in a hospital where they could do a c-section within 3 minutes if it was needed. I was aware of that it was more likely that I would get a c-section if I delivered in a hospital with an epidural. I weighed the risks and made my decision. 

Another reason I chose to give birth in a hospital with an OB was that I wanted an epidural. Choosing to reduce pain is normal and women should have that right. 

Oh, I don't think she meant women shouldn't be able to deliver in hospitals! Lots of places have women deliver in hospitals, get pain meds, etc, but they are seen by midwives OR general practitioners, not OBs, who are surgeons. The OB is brought in (he's already at the hospital, on staff for this) when things go wrong. He's there on the floor, used when needed, but not managing what doesn't need his expertise. Sort of like you don't go to an oral surgeon for a cavity. 

Edited March 5, 2021 by ktgrok

[Carrie12345]

My baby #4 would likely have died. He surprised us with  a double wrapped cord plus true knot. My midwife kicked me out of the tub when she recognized his distress, called for a c-section to be prepped, and told me to try to push him out NOW. So I did and all was good, but it could have been very, very bad.
Also, baby #2 had broken her clavicle getting out (at 9lb2oz) so I always knew I could end up with tricky exits. She did hang on to the record for size though. Not always by a lot. 
Baby#3 aspirated meconium. I would NOT have wanted to pack us up for observation. It was stressful enough lying in bed while she was being tended to.

The other two were boring, but there was no knowing that in advance.
 

My nephew wound up being caught by a firefighter in the front seat of my sister’s car and was perfectly fine. Still don’t recommend it. 😉 

[EKS]

On 3/3/2021 at 3:07 PM, Terabith said:

Yeah, as someone whose first child would have died if unaccompanied, the thought makes me incredibly anxious.  

This.  I suspect that both of us would have died, actually.

[Hannah]

My sister in the UK is a midwife and worked for an agency that did home births, but unfortunately they had to close due to insurance issues. 

The scenarios I like best is where she would sit outside the door or around the corner from the birthing mom.  She'd be listening for the mom's breathing and movements and respond when she thought it was appropriate, but mostly keep herself out of the way.

That seems like a good compromise to me.

 

[busymama7]

I think there was a tipping point where new medical advances with regards to childbirth that saved moms and babies tipped over to medical interventions used too frequently that cause harm. I suspect it would be around the 1970s/80s(maybe later for pre term babies).  There is no doubt that c sections and pitocin save lives.  But there are also mothers and babies harmed at this side of that tipping point by the extreme over use of these tools. 

 

 Since we are talking anecdotes, I know a 60 year old woman who had a c section for her twins 30 years ago.  She has had repeated surgeries to try to fix the damages and struggles to this day with her health. Her doctors acknowledge that her issues are from the c section.(not a botched one. Just scar tissue and such). 

[ktgrok]

22 minutes ago, busymama7 said:

I think there was a tipping point where new medical advances with regards to childbirth that saved moms and babies tipped over to medical interventions used too frequently that cause harm. I suspect it would be around the 1970s/80s(maybe later for pre term babies).  There is no doubt that c sections and pitocin save lives.  But there are also mothers and babies harmed at this side of that tipping point by the extreme over use of these tools. 

 

 Since we are talking anecdotes, I know a 60 year old woman who had a c section for her twins 30 years ago.  She has had repeated surgeries to try to fix the damages and struggles to this day with her health. Her doctors acknowledge that her issues are from the c section.(not a botched one. Just scar tissue and such). 

I definitely have a ton of adhesions that cause me issues from my c-section. One OB was surprised I could even get pregnant given how tied up my uterus is in scar tissue, and has said I'm a candidate for surgery if I ever want it. My uterus is adhered permanently to my abdominal wall at this point. And I've known babies who have permanent scars on their face from the scalpel, and a woman who had both uterine arteries severed and nearly died. These were non emergency situations. 

So yes, risk either way. We definitely need more middle ground.