Ok, so I don't think I've let anyone on these forums know, but I'm due to have another baby within the next month (Jan 13th?)! I'm incredibly happy and excited, except for the "going to the hospital" deal. My daughter was born in a hospital, and it was terribly traumatic. They put a fetal monitor on me, forced me to have an IV, and made me labor on my back, which I'm certain caused labor to go on for about 12 hours. So when I got pregnant this time, I decided to have midwives, which was cool, except we ended up having a big unexpected move across the country about a month ago, and so now I'm stuck trying to find a midwife who will take me at this late stage of my pregnancy - I haven't been able to find one, and even most obstetricians are giving me a hard time and don't want to see me (though I had had consistent prenatal care prior to my move). The one that will, I have no interest in working with, and he delivers at a hospital that is NOT progressive at all. SO, I am at the point now where my husband and I are really seriously considering an unattended homebirth. Am I insane? I was hoping Maggie or Brighid (or another midwife/doula type) might have some insight on this, in particular... We're in a rural area, about a 30 minute drive to the closest hospital. I don't have high blood pressure, and all my prenatal tests (blood typing, gestational diabetes, triple screen, 3 ultrasounds) have been normal. I have no idea, though, which way the baby is turned. My daughter was born completely without incident (other than the trauma caused by the hospital) and had a "10" on the Apgar scale. Would we be insane to have an unattended birth? What type of emergencies might happen that would require IMMEDIATE care (more than the 30 minute drive to a hospital)? How could we tell if something were going wrong? Info? Opinions? Chastisement? Help?
Brighid can refer you to someone in your area. No Chastisment at all, but I need to be honest, Willow, unattended home births make me very nervous. 24 time out of 25, (give or take) you'll be fine, but something like a prolapsed cord or a baby who aspirates meconium, or transverse presentation or a bleed you might not notice right away, and things could go South very quickly. I, personally, am a big fan of having a trained person, who has been to a LOT of births and knows what to do in a real emergency, at a birth. I can understand your reluctance to be in a situation of feeling helpless at a hospital, but there should be someone who will see you, your midwives you were seeing may even be able to refer you to someone in the area, with your medical records, they should see you. People move during pregnancies all the time. Brig should be able to find you someone close. Congrats on your pregnancy. Please have a safe birth.
I am for unattended homebirth. But plan ahead! Know that emergencies can happen and be prepared if they do.
There are emergencies that cannot be dealt with, or even diagnosed properly, without a trained person at the birth. I've had a couple of clients with prolapsed cords, they did get the medical care they needed (one needed emergency transport to the hospital from her home birth) but some of theses diagnoses require years of traning to spot. An occult sealed placental abruption is virtually impossible to diagnose without training (the placenta breaks away from the wall of the uterus, but the edges stick, so you don't SEE any blood, only blood pressure readings, checking the baby's heart tones (they drop terribly) and other tests you simply can't do yourself can diagnose this rare condition. I am NOT trying to scare you, Willow, but I only want what is safe and healthy for you and your new baby. There have even been cases of planned unattended home births which resulted in death or injury where Child Protective Services stepped in. I had a client who had an unlisenced "midwife" at her birth (this womyn had NO training in birth, with the exception of giving birth herself) who had her placenta refuse to deliver. The "attendent" bailed, just lef the house, saying "Don't tell anyone I was here, I could get arrested." and the womyn was stuck with NO care, and no idea what to do. Her dh finally called an ambulance, and she taken to a hospital and was treated (she ended up with anemia which was so severe it effected her milk supply.) But it took them close to a year to get a birth certificate (which would have been a huge problem if she had needed Public Aid or WIC) and she came close to bleeding to death. DCFS also stepped in in this case, as she told the hospital she was alone. (It was a LONG labor, and it was obvious she could have gotten to a hospital, and her records had never been transfered to a licenced birth practitioner, so they knew she had planned an unattended birth.) They didn't take the baby, but it was VERY close, and very scary and could have been prevented. This womyn had HUGE fibroids and a good practitioner would have known there could have been serious problems with the placenta (did I mention that baby had Interunterine Growth Restriction, which was also missed by her attendent?) This poor womyn could have lost her baby to DCFS. She was a good mother, but just misguided by what she had been told by this "unattended birth" attendent. She also could have bled to death. I have real problems with unattended home birth. Because I care about the saftey and health of mothers and babies. There has to be someone who will see you and attend your birth. Maybe Brig can help or refer you to a service which provides health care for pregnant womyn. It is ridiculous that no one will see you, especially with good prenatal care and records. If worse comes to worse, you can take the doctor and make sure you have a GOOD birth plan and don't go to the hospital until your labor is well established (oops I didn't know I was in labor! ) at least you will have care. Let me see what I can find.
I'm on it! I'm looking for a midwife in her state that will see her and do her birth. Here's a little secret (and I hope women will still want to hire me to attend them!) Most women don't need us . Everything a woman needs to give birth is within her. I consider my self merely the Welcome Lady, ready and waiting with warm blankets and a little hat . I used to think unassisted birthers were nuts (and this after my own brothers were born unassisted! Both over 10 pounds, no problems) but the more I attend natural, un-interefered with birth, the more I trust the process to work perfectly. If birth is left alone, to progress normally, it owrks about 98% of the time perfectly. There are very few true life or death emergencies. Most can be prevented by good prenatal care and nutrition, which I'm almost positive willow has had. In fact, you are more at risk for complications in a hospital, with the constant cascade of interventions, starving labouring women and denying them food and drink, the excess fluids via IV the body can't process, the forced inactivity for the sake of the monitor, people sticking their fingers in your vagina every few hours, the lithotomy postion, and the general atmosphere of the hospital. Hospitals are for the injured, sick and dying, a birthing woman is none of the above! (people always said I was "sooo brave" for having my babies at home. That cracked me up! I thought they were brave for going to a hospital!:H ) If there is an Amish or Mennonite community near you, ask the women for the name of a midwife. They do not go to hospitals unless there is a life or death emergency, and choose to birth at home. They are somewhat exempt from the laws pertaining to midwifery because of their religious beliefs. There have been cases of home births with emergency situations, but if you really check the statistics, the rates are far, far lower than in the hospital. When a home birth goes wrong, we hear about it all over the news. But when a hospital birth goes wrong, no one exept the family hears about it. One of our biggest hospitals just had a maternal death last week, 12 hours after the baby was born. Another sent a mother home with a raging uterine infection, she died shortly after reaching home. I can recall dozens of cases where hospital interventions or carelessness caused the morbidity or mortality of a woman or baby. These things don't make national news coverage, but if a homebirther farts in Houston, everyone hears about it. True emergencies are extremely rare, and few are without warning signs, almost all can be prevented. A placental abruption is most likely to happen in a woman who smokes, has uncontrolled high blood pressure, is poorly nourished, is having a pitocin induction or augmentation, is an amphetemine user (crack smokers have a high rate of abruption). Healthy women make healthy placentas. If a woman has an abruption, her contractions will be extremely painful and won't go away, her uterus rigid and board like. The extreme pain alone would clue any one with an ounce of sense to seek medical attention. A cord prolapse is extremely rare, is most likely to happen when the baby is premature, breech, not well engaged in the pelvis, and if someone artificailly ruptures the membranes. I know midwives who have praticed for 20+ years who have never seen a prolapse. I know L&D nurses who have never seen a prolapse! It is a good idea to listen to the baby immediately after the water breaks for deccelerations in heart rate. I would recommend anyone planning an unassisted birth purchase or rent a fetal doppler, learn how to use it, become familiar with the baby's normal heart rates, and monitor the baby intermittently during labour. Babies can only communicate with us through their heart rates and bowel movements. So if the water breaks and there meconium, the baby needs to be born with someone who knows how to suction, before he takes his first breath. Meconium aspiration only happens after the baby is born and attempts to breathe. The placenta will usually deliver on it's own. After the birth, the cord will pulsate, and eventually stop. As long as the cord is pulsing, there is no need to cut it, and there's no need to worry if the baby is not breathing right away. Drying the baby off will stimulate the baby to breathe, and most homebirthed babies do not cry much. Unlike hospital born babies who wail pitifully from rough treatment, cold and loneliness. You can clamp and cut the cord before or after the placenta delivers, it's up to you. If the placeta is being stubborn, (placentas can take anywhere from 10 minutes to several hours) nursing the baby or stimulating the nipples will bring on a contraction. There will be a small gush of blood, followed by a contraction. Helping mama up into a squat and having her give a gentle push will usually bring the placenta out. I also recommend continuing prenatal care with the OB, even if you don't plan on using him. Ask for a copy of your chart, so you have proof of pregnancy for the birth certificate. Choose a pediatrician, and make an appointment for an interview, even if you don't plan on using one. The more people who know about your pregnancy, the easier it will be for you to obtain a birth certificate. Plus, if you end up going to the hospital, you will be on record as having prenatal care and have a name to give them. In the event of an emergency, the doctor's personality won't matter much, and you will receive better treatment from the staff. No where is home birth illegal, although non-nurse midwifery may be in some states. You may be charged with child endagerment if you do not seek help in the event of an emergency or complication. There are also a lot of books you can get about attending births, Where There Is No Doctor is one, Spiritual Midwifery is another I highly recommend, for the inspirational birth stories and the instructions in the back. Some more reading on unassisted birth, or FreeBirth. http://unassistedchildbirth.com/ http://www.birthlove.com/ http://www.unhinderedliving.com/variations.html http://www.thelaboroflove.com/birthstories/327.html http://www.gentlebirth.org/archives/bstories.html http://www.empoweredchildbirth.com/index.html I don't recommend unassisted birth for everyone and anyone. You must be willing to take responsability for your own well being, trust your body to work according to it's design, be healthy, intuitive, prepared, unafraid. You must be willing to listen to your body, and follow it's cues, set aside any pre-conceived notions about how birth is supposed to be. If your body is telling you to stand up, do it! If your body is telling you to squat, do it! If your body says, eat a steak dinner, do it! If your body is telling you something is not right, listen and seek help. Personally, I like having someone take care of me, even if it's not in the hospital. But I know that the power to birth normally and naturally is within me, and no one else.
Wow. Thank you so much Brighid. It was so inspiring. I really wanted to have at home Birth but we were living in an apartment complex with bad vibes, and I was on ACCHS at the time. I ended up having Gaea in the hospital without any painkillers, but they FORCED me to lay on my back, and also cut me. I remember the doctor actually pulling my placenta out of me, and I asked if I could keep it. They all gave me a dirty look, and told me it was a biohazard. Yeah right. Put those nasty drops in Gaea's eyes, and didnt give me enough time to give her a good latch. They also threatened me if I did not pee, they would put the god awful catheter in me. So after she had come out, my precious time was taken away so that I could sit in the bathroom and try to pee so hard. Assholes. A week later I was taking a shower, and noticed the membrane sack was coming out of me. It was in there for a week and caused a small infection. Next time, I will never ever go to the damn hospital again unless it is an emergency. I will definately find someone like you Brighid to help out! My pregnancy and labor was beautiful and psychedelic. Even Gaea coming out felt so GOOD. It was amazing, but a bunch of uncaring doctors, and nurses looming around hurt the experience.
You rock, Brighid!! i loved reading your educated and well-balanced post. Women have been birthing babies since the beginning of time...we're designed for it. i've gone the way of the "good birth plan" with the obstetrician, and ended up being ARM'd, had an internal fetal monitor, a pitocin drip and a huge episiotomy. and i found out after my baby was born, that the hospital staff had pretty much scheduled a section for me without my knowledge. luckily i birthed my own baby before they got a chance to cut him out of me. next time i'd rather do it on my own. even with a good birth plan, you might run into a lot of unneccesary interventions in a hospital, especially if it's not a progressive area.
