Homebirth question

[bec28]

We just met with our potential midwife the other night, and I loved her! I pretty much have my heart set on a homebirth, and was really excited to meet her and I think that we'll work really well together. The only thing that I'm not really sure about is that we found out that in the state of Virginia, she is not allowed to carry pitocin (in case of hemorrhage) or oxygen, or anything else like that.

We live right down the street from a fire station with an ambulance, and we could also drive ourselves to the hospital in 10-15 minutes. The midwife is also a licensed EMT.

Would it concern you that she can't carry things in case of emergency, and if so, would you still proceed with a homebirth?

Thanks so much!

[KBinSATX]

Wow. What a weird state law! That being said it sounds like you are really close to emergency care though so that might be less of a concern.
Does the firestation carry Pitocin?

In your case I'd probably still proceed with the homebirth.

Best wishes with whatever you decide.
Have a wonderful birth!

Karin

[azohri]

I'm in Virginia too, and I know that some (I had assumed all, actually) CPMs do in fact still carry oxygen and pitocin despite it being illegal because they don't think it is safe not to have it. I'm not sure if I would feel comfortable with a CPM who didn't carry it, to be honest - that's a tough one. I would probably see if there was a homebirth CPM or CNM who did carry it that I liked first.

[MamaQuest]

Honestly, it wouldn't concern me. I would ask what your midwife does in cases where she might otherwise use pit or oxygen. If she seems competent with other solutions, and with help so close by, I would really not worry.

[JorgieGirl]

Originally Posted by MamaQuest

Honestly, it wouldn't concern me. I would ask what your midwife does in cases where she might otherwise use pit or oxygen. If she seems competent with other solutions, and with help so close by, I would really not worry.

Ditto this.

[ShwarmaQueen]

What a crappy law.

I wouldn't really stress about it, but I'd look into alternate methods (herbal) to treat placenta/hemmorage issues.

[clemrose]

I would say the oxygen is close enough (firestation) and ask if she uses cayenne pepper tea or other form of cayenne pepper in case of hemorrage. My mom was a lay midwife in the late 70s early 80s and they used cayenne.

I found the following here
~ Cayenne pepper ~ One of the most useful herbs for childbirth, especially if the mother fears bleeding. 1/4 to 1 teaspoon of cayenne is considered a dose (it depends on how used to the stuff you are). One of the more popular ways to take it is in a honey/vinegar/cayenne (HVC) tonic with 1 Tbsp. of apple cider vinegar and 1 tsp. of honey diluted with 6-8 oz. of water.

[bec28]

Originally Posted by clemrose

I would say the oxygen is close enough (firestation) and ask if she uses cayenne pepper tea or other form of cayenne pepper in case of hemorrage. My mom was a lay midwife in the late 70s early 80s and they used cayenne.

I found the following here
~ Cayenne pepper ~ One of the most useful herbs for childbirth, especially if the mother fears bleeding. 1/4 to 1 teaspoon of cayenne is considered a dose (it depends on how used to the stuff you are). One of the more popular ways to take it is in a honey/vinegar/cayenne (HVC) tonic with 1 Tbsp. of apple cider vinegar and 1 tsp. of honey diluted with 6-8 oz. of water.

Thank you so much for that link clemrose! It had lots of good ideas. I'll have to ask my midwife about the cayenne, and anything else she uses when necessary. I don't think I specifically asked her that the other night. I had too many other thoughts and questions rolling around in my head

I think we'll probably go with a homebirth and just be prepared as much as we can. Thanks for everyone's thoughts!

[sellendie]

We have the same type of laws here in GA. A CPM cannot attend a homebirth legally and the midwives that can attend a homebirth cannot carry pitocin, etc. I am planning on having a homebirth with my first in a couple years, and will rely on natural methods and herbs if any issues come up.

[Burnindinner]

Originally Posted by MamaQuest

Honestly, it wouldn't concern me. I would ask what your midwife does in cases where she might otherwise use pit or oxygen. If she seems competent with other solutions, and with help so close by, I would really not worry.

I agree with this, except I think it would concern me. Mainly because it took me an hour and a half to deliver the placenta, and I think it really required pit. I don't know what the mw would have done if that didn't work (they'd already tried two natural/herbal options).

[ShwarmaQueen]

Originally Posted by Burnindinner

Mainly because it took me an hour and a half to deliver the placenta, and I think it really required pit.

While I'm certainly no HB expert, I seem to remember reading somewhere that it can take up to 4 hours to deliver the placenta and that's ok.

[D'sMama]

What a f***ing dumb law! What in the world is the rationale for that?!

It would concern me a little because I hemorrhaged after the birth, before the placenta came out. My MW didn't use pit, but she did use methergine and cytotec. I had shepherd's purse tincture on hand too, but in retrospect, I'm not sure I would have wanted to rely solely on that. However, I don't think hemorrhage is all that common, and with an ambulance so close, I would probably be okay with not having drugs on hand.

[Burnindinner]

Originally Posted by ShwarmaQueen

While I'm certainly no HB expert, I seem to remember reading somewhere that it can take up to 4 hours to deliver the placenta and that's ok.

Well, I sure as heck wasn't interested in doing it myself. I had decided that 2.5 hours was enough to push, the baby was out, why would I try to push again just for a stupid placenta? Had I known how much better I would feel, I would have tried a little harder.

[ShwarmaQueen]

Originally Posted by Burnindinner

Well, I sure as heck wasn't interested in doing it myself. I had decided that 2.5 hours was enough to push, the baby was out, why would I try to push again just for a stupid placenta? Had I known how much better I would feel, I would have tried a little harder.

Wait, you have to push the placenta out just like the baby? I thought it just sorta slides out (ok, bad choice of words, but I don't know how else to describe ) with minimal effort when it detaches?? OMG...let me find that phone number to just schedule the repeat c/s...

[Talula Fairie]

I would not feel safe if my midwife did not have oxygen or pitocin, personally. The pit especially becuase I bled heavily after #2 (however, that was an induction), and bled a lot with #1 too.

[Guinevere]

I agree that no pit and no 02 is beyond my own comfort level for HB, even if they're available down the street. Here's why:

I've attended two of my BFF's HBs (in prep for my own ), and with the first one (baby #3 for her), baby had a very short cord that actually broke as she pushed him out. Fortunately, she could tell immediately that something was wrong and her MWs were downright amazing -- they clamped the cord immediately before he could bleed out further and then gave him O2 right there on mom's chest while still in the tub -- it was done so swiftly and so competently that her other children and DH didn't really even know what had happened until much later, when he had already pinked back up. But basically, for all of us who knew what had just happened, it was completely terrifying, and the O2 unquestionably made ALL the difference in that situation. By the time someone would have showed up with it (even from just down the street), he could have been in really bad shape.

If there are CPMs in your area who do ignore such stupid regulations : and carry these two items with them, then I would keep searching and seek one out. As with so many things about birth, you aren't necessarily likely to need either of them, but if you do, you tend to need them *immediately*, not 10-15 mins. down the road.

Guin

[marrymeflyfree]

It's the same situation in my state (Ohio), because homebirth midwives are not regulated or legally recognized. Most, however, carry these items anyway, courtesy of sympathetic licensed providers. It is a bit of a risk for them to carry and use these items, but most feel the potential benefits outweigh that risk. If you're really concerned about it, you could consider meeting with some other midwives to find out if there are others in your area who do have them.

It was an issue for me when looking for my HB midwife this time around...pitocin (and methergen) was definitely needed after my first birth. I was in a birth center for that one, but certainly would have required a hospital transfer if my midwife had not had pit on hand.

[Jilian]

No pit and no oxygen would scare me. I would not HB without access to oxygen. There are substitutes for pit, some Midwives use cytotec inserted anally for PPH. DS2 was born @ home and there were no indications of anything being wrong until he was born and the cord was cut and he turned blue/gray. He needed oxygen to pink up. Turns out he had a congenital heart defect that went undetected during the u/s @ 20 weeks. I'm not sure he would have made it without the immediate oxygen.