Inbetween UC: birth attendant in another room

[Jaimee]

I am 35 weeks pregnant and just now reading books on UC (Unassited Homebirth and Unassisted Childbirth). I picked these books up searching for answers about the second stage of labor.

I had no urge to push with my first and my midwife at the birth center we went to just kept telling me to push! push! push! This was traumatic for me because up until that point, everything about my labor had been calm, relaxed, at my body's pace- and mostly at home. With baby #2 on the way, I started to have apprehension about pushing and since I quell my fears with knowledge, I turned to MDC for stories and book recommendations. Not surprisingly, you will find more information about not pushing (or laboring down until the urge to push arrives) in books about UC.

So, what started as a need for information about the urge to push, laboring down, etc. has now morphed into thoughts of experiencing the intense fulfillment of a UC. Or at least as close to a UC as I can get. I say that last part because I do have a midwife and my sister (who is also a midwife) is flying in to be at the birth as well. I am losing trust for my midwife as this pregnancy progresses and she questions my weight gain and my fundal height (both under the norm). I would prefer not to be measured at all. I know that my body knows how to grow a baby- I've done it before (with the same "issues" of low weight gain and fundal height, which resulted in a healthy 7 pound baby to my caregivers' surprise). But, we've already paid her quite a bit of money and I know that my dh wouldn't be fully on board in this short amount of time. Plus, there's my sister.

So, finally, here's my question... do you think you can get the experience of a UC with two midwives hanging out in another room? What if I spent most of my labor alone or with my dh (wait to call the midwife until I'm near transition) and then when I feel the urge or need to push, I go into the other room with just my dh? The midwife is there as "back up" but she's not there to coach my pushing, she's not there to catch the baby, she's not there in those first few moments. But, she's there in case the cord is wrapped around the head, there is shoulder dysotcia, I hemorrhage, or if I tear and need stitches.

I know this isn't technically a UC, but I'm wondering if I can blend the two approaches to increase my experience vs. a typical midwife assisted homebirth. Any thoughts from you veteran UCers?

TIA!

[Cersha]

is your midwife willing to do this? I would imagine that some midwives wouldn't, for fear that something might happen and the mother might sue. I think it's a great idea, but what would your midwife "allow"?

[basje]

It sounds like a great idea.

I think that you can have your birth experience look like whatever you want. If you feel most comfortable with having your midwife wait in the kitchen and just do post birth check-ups then I think it's a wonderful idea. If it is defined as a "UC" doesn't matter. What is most important is that you have an empowering and healthy birth! There's nothing wrong with doing it by yourself and catching your own baby and there is nothing wrong with having medical personnel nearby to get advice from if that's the way you want it. Scheduled C-section, hospital birth, birthing center, home-birth, UC... there are so many different ways that women can have a positive birthing experience each one as unique as we are. And there are a million variations in-between our only limits is our own creativity!

One thing I've learned by hanging around this forum is to be sure and get stitched up (if you need it) with six hours of labor before the major swelling kicks in. Having a midwife nearby to do the job would be rather convenient. Wishing you luck and no pushing prompts from the peanut gallery.

[KristaDJ]

I think you need to not worry about the UC label and talk to your midwife and your sister about your concerns. As a pp said, the midwife may not agree to being hands-off b/c of legal concerns. You need to make your wishes clear to both of them and your DH and make sure that the people who attend your birth support you and your ability to give birth. If they don't then it doesn't matter what room they're in they will interfere.

[Rockies5]

I've done this several times. My mw never had a problem with it.

[mamallama]

I did this.

I started my pregnancy with a midwife. I decided I didn't want her to attend my birth. I considered my other midwife options, and I found them all (far) less appealing than "my" midwife. I explored it further, and found I really just wanted to be alone.

My biggest fear was that I would have an unnecessary hospital transport. I wanted someone who could help with that decision.

I went to "my" midwife with the idea. We talked the subject into the ground. She had concerns, but in the end, she was willing. She offered to wait somewhere in my house. I said no. She offered to wait at a coffee shop in my neighborhood. I said no. She agreed to be on call for me.

We settled on terms, she gave me my file (as I was no longer her client,) and that was that.

Then, I had an unexpected death in the family at 32wks. It wrecked me.

I got stuck on it in labor. I called her and asked her to come. She did, she said what I needed to hear, and then she waited unobtrusively in another room until my baby was born.

She helped my older kids brew a lovely post-partum herbal bath for me. At my request, she examined me and the baby, and then she was on her way.

This might not go over so well in this forum, but I don't see strict uc as being the ideal way to birth. I see autonomy as the ideal. A lot of times, the only way to get the autonomy is with uc. If you can get true autonomy with a safety net, why not??

[AugustLia23]

There are plenty of midwives who will do what you ask, but some may ask you to sign a release to do it. They cannot monitor in the same way from another room, which of course is your goal. I think if you look, you should be able to find the right midwife for your birth goals.

[Jaimee]

Thanks for all your comments! I don't have a lot of choice regarding my midwife for several reasons. Unless they are a CNM overseen by an OB, midwives are illegal in Maryland, so there aren't that many to choose from. There are many positives about the midwife I chose, I'm just getting concerned as the event gets closer, that she'll over react about something during the birth like she did about my weight and fundal height. I'm starting to really question if all the less than desirable things that happened with my first birth were actually all the result of midwife intervention. Of course, I'll never know and I don't want to take away from the positive feelings I have about my dd's birth. But, I do think that I can strive for something different this time around.

So, I talked it over with my dh last night and he's on board to be left alone as much as possible. He thinks our midwife will be open to it. I'm not so sure, but I will talk to her at our next appointment. Perhaps as a pp mentioned, she can have me sign a release. I have no interest litigation. There's a hospital 5 minutes down the road. The risks all seem very minimal and the benefits huge. I'm not at all concerned with the title "UC" I was just wondering how many people actually managed to have an "nearly unassisted" birth with back up near by.

One last question... for those of you that did have very fulfilling UC's (or otherwise) where you felt like you reached that other realm of connection, enjoyment, empowerment, etc. did you feel as though your planning and preparation helped get you there? Or was it really just a 'go with the flow' situation? I ask because dh has no interest in reading birth stories or books. He doesn't want expectations in his mind. He wants to experience it as it comes. While that idea sounds nice, I don't see how you can get the best experience possible without a little preparation- without at least setting up a conducive environment, communicating desires and intentions ahead of time (to each other and in this case to my sister and midwife), and having some knowledge to fall back on if situations arise. For example, had I know about laboring down and the fact that many women need to wait in order to feel the urge to push, I could have told my first midwife that I didn't want to push yet, that I needed some time. But, I didn't know, so I pushed unnaturally and painfully until my daughter came out.

So, what do you all think is most helpful in achieving your most fulfilling birth?

[boheime]

I think you should have the birth that you want and feel compelled to have.

[onyxravnos]

i think it's fine if that's what you want to do.

I've had friends who birthed in the birthing center and the rule was the MW could come in every 4 hours to do a quick check and make sure everything was fine but other then that they only entered the room when asked to.

[EmmaWoodhouse]

My dh hates to read stuff too. So, I read all the information and let him know what to do in case something happened~a very condensed version. Ie: if I am gushing blood, do this; if I am screaming, do this; etc. Even with that, I still had to give instructions during situations. But at least he had an idea where my comfort level was at and could respond to it. If your dh is a 'go with the flow' then just keep up the communication during the birth to help him with his emotional comfort. It might even be a good idea to come up with a code word that would mean for him to get the midwife.

I hope you get the birth you are looking for.

[zoebird]

i think you can blend it, and i think it's a good compromise considering the various elements of your situation.

first, i would talk to her about whether or not she would do the "next room" scenario. if not, then i would definitely wait to call her.

second, i would talk to your sister about the next room situation. it is likely that she is there more as a sister than a midwife, and you know her best so only really you'll know whether or not that statement is true. assuming it is true, she's probably likely to do as you would prefer and take care of your other child so that you and your DH can focus on the baby.

the truth is, your husband will have "back up" emotionally (birth-wise) by having your sister there (a midwife), and so if your midwife is late in coming (because you don't call her until the last possible moment), then he can feel assured by your sister's presence, and you can birth together without any concern or worry for him, your sister, or your midwife.

[zoebird]

ps, i love the title "in between uc." gave me a giggle.

[MyLittleWarrior]

My midwife recently did this for a friend of mine. Her 3rd baby was a UC, but they lived in the city then and were fairly close to a hospital in case of emergency. When their 4th was born they kind of lived out in the sticks, and felt more comfortable hiving someone there who caried pit and O2 and could handle most emergent situations. But the midwife spent the whole time in the other room, took a quick peek at mom/baby once the baby was born, and that was that. It worked out really well for all involved. So I think the main issue is whether your mw is comfortable with that situation.

[Jlcampbellkidz]

So glad I saw your post. This is exactly where we are too. This is baby #5 and my first reaction to this pregnancy was the desire to have this baby unnasisted. I am a student midwife and certified doula and feel that I have aquired a great deal of knowledge over the coarse of my last 4 pregnancies and births. My husband told me he would be supportive regardless of my decision but wanted to add that he would feel more comfortable if I had a midwife here.
I spoke to one of my very good midwife friends and asked about the possibility of her just staying in the other room. She said she would be perfectly fine with that as long as someone was taking heart tones since legally she is considered liable if she's even in the house at the time of birth. Although this is a happy medium Im still not sure I want her there at all.
It sounds like a fantastic option for you. I would just have a talk with your midwife and sister to set up a plan. And it's not a bad idea to wait to call too.
Can't wait to hear about your outcome.

[Jaimee]

So, here's an update. I communicated my desires to my MW and my sister. I described my ideal birth and what I would like their roles to be. Well, it was very disappointing. My MW told me to maintain her CNM license she needs to do certain things at the birth including (but not limited to) taking fetal heart tones every 15-30 minutes (depending on where I'm at in my labor), witnessing the actual birth, and making sure the placenta is out within an hour. I don't think I can have the birth I want with these stipulations. To add a whole other element to the situation, my MW communicated to me that she's experiencing a stressful situation in her personal life and is discontinuing her solo practice as soon as she can. She passed or only other client on to another MW already and asked if I would like to do the same. But she also said she is willing to see me through this birth.

So, I called my sister to ask her how she would feel being the only one there as back up to our otherwise unassisted birth (if we discontinued with our MW). As it turns out, the answer was unequivocally NO. She can't risk her license either and she claims if she is simply present in my house (even as just my sister with some knowledge) while I'm in labor that she is liable. I don't understand this, but she says it's true. So, she's willing to be present if I have another licensed MW present as my primary caregiver. And her list of stipulations for birth are even longer and more medicalized than my current MW's! This shocked me since she's a CPM and an ND- no conventional medical school. But, she's also new to the field and I think quite attached to her training.

So, this leaves me few options: continue with my current MW and accept her stipulations, seek out this other MW and find out her stipulations, continue with my current MW and not call her during the birth (unless we need help), or go completely unassisted. My dh and I have ruled out the first two. We are leaning toward keeping our MW and just not calling her during the birth. We see the advantage to this being we have a MW as back up and she can come for the postpartum stuff (clean up, checking on the baby, checking on me, stitches if necessary, and postpartum visits a few days and 6 weeks later). The unfortunate part of this is my sister can't be around, but I sort of feel like this is her choice.

Anyway, now I'm moving my thoughts toward what I need and need to know for this UC! I may post separately for this question, but if anyone is following this and has thoughts, please write a list of the top things you were happy you had (or wished you had) and were happy you knew (or wished you knew) for your UC.

Thanks!

[KristaDJ]

I was happy I had no one there to poke or prod me or ask me to move so they could listen to or check anything. i was happy no one was waiting around for it to be over (26hours). I was happy that no one made me go to the hospital when my placenta didn't come out for 10 hours. I was happy that no one messed with my baby but me. I was happy that I had learned to trust my body completely. I was happy I had peri cold packs lol
I wouldn't go with that CNM at all and unless you have grave reservations about UC then I say go for it all the way!

[zoebird]

seriously, i can't imagine having someone wanting to be in my business every 15-30 minutes of my birth, particularly once i was in the ecstatic movement.

what i know nwo (having been through my birth), is that had i had a midwife for back up, i would have called her around 10:30, and she likely would have been present for the birth.

and had she needed to even touch me during the ecstatic dance i was doing, it would have been terrible. as it was, i did a quick experiment during this time--trying not to move and sound.

and let me tell you, my movement and sounding was extreme! on hands and knees, big camel-pose back bend and one scream/tone; then forward toward upward dog with another scream in another tone, and then push back toward hands and knees and the body would push (no active push from me) with another sound/scream. i did this for two hours, with three deep breaths in between each push-back.

let me be entirely honest, if some busy body had said "for my license, ineed to interrupt you and get fetal heart tones" i might have kicked her in the face. as it was, if my husband came too close (he was sitting behind me quietly meditating/watching), i would go "back off!"

because the baby was posterior and came out 'facing up', and i was hand's and knees, my husband had to catch him, and so he only came close at that moment.

he was truly an amazing support--nearly invisible unless i asked for him or he was really needed.

anyway, yeah, i don't think i would have had an entirely pleasurable, ecstatic birth if i'd had someone there wanting to touch me every 15 minutes over the course of that last two hours.

and, i am also curious as to whether a midwife would have "let" me continue the dance (because it was intense and necessary--without it, i don't think things would have gone as quickly or smoothly), and i don't know if it would have been possible for her to check anything while i was moving so extremely/dramatically.

so, yeah, i'm so glad i UCed.

[iluvmy4girls]

Jaimee-
I too am in Maryland, we are using a DEM. Who will be here if we need anything. There are actually several cnm's in Maryland that do homebirth and a few direct entry midwives also. I just switched to this new midwife about 2 months ago. I toured the hospital my CNM was using and well , it was less than ideal and had too many "rules" I would head over to the Maryland board and they can share names.
If you are comfortable and you baby and body are saying go for an UC then go for it! I would ideally LOVE to, but have compromised with hubby, he wants someone here.
Best wishes.

[Jaimee]

Another Update

So, in case anyone is following this thread, we have made yet another change- final as of just yesterday (37 weeks). Dh and I had decided on a UC and when I communicated with my sister and my mom (I had to since I had invited both to help at the birth originally), my family went into intervention mode. There was a lot of fear, some anger, some hurt, and a whole lot of stress. Travel plans were being canceled and there were oh so many emotion-filled epically long phone calls and emails. Suddenly our calm, quiet UC was becoming something huge and overwhelming. The negativity of everything was totally overshadowing my excitement for the birth.

Dh and I decided to call the one other midwife in the area that does homebirths. I had interviewed her months ago and thought that we were a very bad fit. But, my birth vision was very different months ago. When I asked her about doing as close to a UC as possible, so readily agreed. She said to provide her with a blanket and pillow and she will sleep on our couch outside our room. She'll be there in case something isn't right and she'll be there for postpartum stuff (birth cert, Rhogam, suturing, clean up, etc. and three pp appointments). Otherwise, she'll let dh and I do everything ourselves! She believes firmly that babies come out and that her job really starts after the birth- making sure that mother and baby are supported as they adjust to life with a new little one. She's a CPM and is so well established here in the state that apparently no one really touches her (hospitals and OB's respect her). She works a lot with the Amish- a culture of women who don't tend to need their hands held through labor.

So, here we are back to our original plan of an "inbetween UC." Hopefully my family can now calm down and dh and I can start feeling excited about the birth again. For anyone looking for this type of situation, I would say go for LM's or CPM's and especially those that work with cultures like the Amish.