Help from the homebirthing mamas out there

I know it is a personal choice, but womyn have had support systems, (not just their partners) for milenia. I, personally, would not choose an Unassisted Birth. Those "just in case" things would want me to have someone there, who was NOT in labor, to keep her head about her, and know what to do.

It isn't something I have a lot of comfort about at all. (I just typed up two stories of unassisted situations I was called as an LC for, but they were both horror stories, and I decided not to post them.)

There are good assistants out there. Most can be QUITE inconspicuous, if you want them to be. Birth should certianly be a quiet affair. Life can throw you a curve ball, thuoigh. I'd like someone there who can keep their head and knows what to do, when I am not able to. Labor is when you are at your most open and vulnerable. I would not want it to be just myself and my (rather cluless) dh. JMO, I guess.

I think having an assistant, who knows birth backwards and forwards, is the safest way. You can't "assist" your own birth. Not in most cases. You really need someone there who can help you through it, even if things go really well. (with the exception of a precip birth, but those are usually pretty safely noneventful, anyway. )

 

I would love to have someone there with me when my kids are born..BUT I dont like the idea of being poked and prodded with tests..i think women know whats up with their bodies and i think women are smart enough to bring a child into this world through their own bodies and know themselves well enough . the only part of assisted pregnancy i dont like is the tests they do which in my opinion are unnecassary.

 

Hon, you can turn those tests down! I assume you're talking about those genetic blood tests and such.

 

I had no genetic tests for anything with any of my pregnancies. No Triple Screen or "diagnostic" amnio ect. The only amnio I had was the day I had my last two babies, to check their lungs, as I wasn't sure when I got pregnant, and the we had to have a section, and none of us wanted the baby preterm or to have trouble breathing.

 

I dont want ANY of those tests done..i think if a woman has problems she knows about it and would get help, but if things seem foine and normal i dont see why they would do such a thing as those tests yahno what i mean?..they seem to me to be more stress then their worth

 

That's the reason I didn't have any genetic tests. I was, no way, going to abort, so Bear and I were going to deal with whatever was in store for us. The amnio right before we had the last two babies, although not really pleasant, was to make sure thier lungs were mature. I did not want a preterm baby. I had been laboring with Sage, and wanted her to be ready to nurse, breathe and come home with me when she was born. And the test was OK, and she was, although a little small, and 3 weeks early, healthy as could be. Lennon was a little closer to his due date, but, again, we didn't want a preterm baby.

There is a huge risk, with a planned section, of having a premature or an "immature" baby. Meaning a baby who may not be techinally preterm, but isn't ready to be born. They have more problems feeding and even breathing. We were lucky, but we also tested. The first two babies, I labored for days with, pushed for hours and never gave birth. We had section then. But, we were pretty sure they were ready.

 

Most of my clients refuse a lot of tests. I like to have a prenatal profile at the beginning, for hemoglobin, blood type, any antibodies, a pap (unless she's had one within the last year) and a GC/Chlamydia around 12 weeks. Then a glucose and another CBC at around 28 weeks, and a final CBC and a GBS swab around 36 weeks. I offer an ultrasound at 20 weeks, that's usually the only ultrasound they have. The triple screen and MSAFP are useless, and have a very high false result rate, and cause a lot of stress. Down's syndrome and open nueral tube defects have visual markers that can be seen on the 20 week ultrasound (and we have a very good tech who knows to look for those things).

I do the glucose screening a lot different from most. I test 2 hours after the client has eaten breakfast, since the theory is to see how the body handles the sugar in foods, not 50 grams of pure glucose. Women feel pretty lousy, shaky, nauseus, after doing the glucose drink, and personally, I think it's abusive to starve a pregnant women and flood her system with pure, sickly sweet sugar. High glucose levels can also be corrected with diet, so I think it's important to screen for that.

I will not budge on the CBC, since anemia is easily correctable and can make a big difference about how she feels during the pregnancy, and how well she handles the blood loss after birth and how soon she recovers and feels like herself again.

The GC/Chlamydia culture I'm flexible with, if she's positive that there's no chance she could have picked up either. Gonnorhea and chlamydia are generally asymptomatic in the majority of women, sometimes the only way you will know is if you get cultured.

GBS I'm comfortable with the woman refusing, but I'm also very flexible with treatment options. But around here, if a woman has no GBS results, in the event of a transport, the hospitals will automatically place the baby in NICU and give IV antibiotics for 3 days. Most mommies would rather they got antibiotics than have the baby seperated and stuck with IVs so soon after birth.

 

Most of the tests that Brighid described are ones that I had done during this pregnancy. They aren't intrusive, they don't cause great amounts of fear or stress, and they inform the midwife and you about the best ways to monitor and change your diet for the better.

The only test I didn't do was the Gestational Diabetes test. Instead of that crazy test, which I don't agree with in any way shape or form, I met with a dietician for 10 weeks as well as monitored my blood glucose levels seven times a day for those ten weeks. Those results and my diet were discussed with the dietician, who saw absolutely no anomolies whatsoever in my glucose tolerence and so I wasn't placed on any restrictive diets, no more tests were done, and I didn't have to starve myself for 12 hours.

And with the Group B Strep test, I did it. I didn't see the controversy. If it's positive, I get IV antibiotics two/three times throughout labour. Not a huge deal. Plus, if I'm not, my baby isn't going to be taken away from me if I were to have to transfer to the hospital. In my opinion, it was best to avoid those stresses than to just refuse that test for whatever reason.

 

pap tests are notoriously inaccurate during pregnancy or for six months afterwards, with an outrageously high incidence of false abnormal results. that's another test I would refuse (my OB actually refuses to do them during or immediately after pregnancy for that exact reason).


I did take the GBS culture because, like Brighid said, hospital automatically treat you with abx if you do not have a negative test for it. I did everything I could to make it less traumatic in the event I might transfer to the hospital for any reason.

 

I only use the thin prep pap, which is way more sensitive and has far less (67% less) false abnormal result than the traditional slide pap kits, which only have a 57% accuracy. It's also sensative enough to differentiate the normal cellular changes of pregnancy. I have had no false abnormal (or false normal) results for hundreds of paps. Only one client showed abnormal results, and a post partum pap and biopsy showed she did in fact have early cervical cancer which was succesfully treated.
Interpreting results is very important as well, and can mean the difference between freaking a mama out or giving her useful information. A low grade dysplasia, which is a common result for pregnancy, is really not a cause for alarm, since they typically resolve on their own without treatment.
Plus, I offer it because a LOT of my clients only have insurance coverage for the pregnancy (pregnant woman Medicaid) and have gone years without a pap, and quite a few have never had a pap. Same reason I do a complete physical at the first prenatal visit. A good amount of my clients are from a high risk population, too, so it also influences the way I practice (early sexual intercourse, mulitple partners, Hx of STI's) That said, I have no problem when a client declines.


A lot of factors influence the results of a pap smear; birth control pills, douching, soaps and soaking in bubble baths, sex within the 24 hours previous, using sex toys, timing of cycle, using suppositories for yeast infections, etc., etc., so my clients are advised accordingly before the pap to maximize accuracy. I never run tests without discussing them at the visit prior, and always encourage them to research both sides of the issue.

 

is this really true? My OB/GYN wanted to do a pap 6 weeks after leane was born, but i got my period at the time of the appointment and he told me to come back. I never did call him back, but when i was talking to our family doc about birth control, he said that he wanted me to get all my final tests done before he put me on any. so i called him the other day and now have an appointment...it's over 6 months...almost 7 now.....
but why would he want to do a pap test at the 6 week checkup if it's inaccurate?

 

i just remembered this.....4 days before i went into labour with leane, there was a lady in the bed beside us in the case room who was 17 weeks and started to have contractions after having an amnio.
The nurse who was helping her walks up to her bed and says, (quite rudly if i might add), "you do know most babies don't survive at 17 weeks..." that was about the rudest thing that I'd ever heard....and also scared me out of having an amnio ever....

 

Because generally 6 weeks PP is when most women are thinking about resuming intercourse and choosing birth control methods, and hormonal b/c can accelerate abnormal cell growth.

 

That was horrible, and reportable. She should be disciplined for that remark.

 

really? i didn't realize that....I never saw the nurse, though, so i wouldn't have been able to do anything anyhow.
What would you say/do in that situation? Since I'm going into this feild of work, I want to find out all I can.....
Should the nurse sit down with the mom and explain to her what's happening and why the baby may not survive? Or would that just totally be left up to the OB or midwife?

 

The doctor or midwife should be the one explaining to the mom what is happening and the expected outcome. Not the nurse.

 

The doctor should have explained the procedure, risks, and such BEFORE the procedure, correct?

 

I'm not sure if her doc did or not. It was just the way the nurse was handling it. She made it sound like it was all the mom's fault.

 

Okayi thought i would update you guys on my husband and mine plans for having kids...were trying, and i decided when i do get prego i am going to have my children in my bed with ny husband there with a midwife. my only question is and i cant seem to get a clear answer...are you required by law to accapt any kind of tests they do?..like can you refuse any and all of them..the only one i see necessary is the glucose test for diabetes...but are any of the other thousands of tests really required?

 

I went through a bit of hell with my second daughter when my midwife(bless her little heart) insisted that I have the 4 hour glucose test where I drank one of those nasty drinks and then they drew blood every hour for 4 hours. I'm terrified of needles and start hyperventilating the moment one comes near me.

I think needles and tubes should be banned from pregnant women. Blech!