How would you plan your next birth if you were me? - Page 2

[sharr610]

With my first homebirth, I was a wee bit hesitant. What I kept telling myself was that, by being at home, I could go to the hospital anytime I felt like I needed to. BUT, being at the hospital, its much tougher to go back home.

I agree with many other posters that your best shot is at a homebirth with a midwife, espcially one with with survivor experience.

[lizsky]

Its seems that PPs have given great advice and homebirth might be a great option for you. I'm pregnant with my 1st so no real experience yet, but I also have SA in my past and I'm in a situation where homebirth would cost several thousand dollars we just don't have and hospital birth is completely covered. I guess I just wanted to encourage you to feel hopeful about your prospects for a much more empowering birth even if finances or pregnancy complications prevent a homebirth.

I do feel nervous about this birth (I'm due in 2 weeks!) and worried about the way privacy and body identity stuff could impact my experience, but I've been trying to think positively and take the steps I can to have a good experience. I did a lot of research and chose a hospital MW group that has a strong reputation for supporting natural birth and being low-intervention. We can't do homebirth without going into major debt, but with some careful budgeting we were able to hire a doula. I spoke very candidly with my MWs about my fears of vaginal exams, and they have indicated that they might want to check 1 time to see that I'm completely dilated before I begin pushing but are fine leaving it at that. I've also been doing pre-natal yoga exercises for relaxation and also to remind myself how strong my body is. I can't say if any of this will work out like I'm hoping, but I do feel fairly peaceful and hopeful as I prepare. Best of luck to you mama!

[crunchy_mommy]

I didn't even think of the financial aspect of it. I doubt our insurance would cover HB but I will have to look into it. The other thing I'm worried about is that the closest hospital is the one I delivered my DS at. I would NOT want to deliver there again. If I *had* to be in a hospital, there is a mother-friendly designated one where several good midwives deliver that I've been looking at, but it's a 1/2 hour away. I guess I am pretty worried about transfer & that I'll get stuck at the same hospital again.

Lizsky, I wish you a very peaceful & gentle birth!! I hope yours goes way better than mine. I felt so prepared & calm ahead of time and then when the time came, everything just went wrong. Luckily for you, you found MDC ahead of time -- I really think for me that would've made a big difference (especially knowing I could refuse vaginal exams etc. & all the other things I've learned on here since DS's birth!)

[MegBoz]

Originally Posted by GoBecGo

I know how you feel, except i'm the opposite - if i went to hospital and something happened to the baby i would beat myself up over it

The only problem with this is that probably 99.5% of Americans feel HB is flat out dangerous, therefore if something goes wrong you are to blame because you chose to take such a completely insane risk. Of course, we know those 99.5% are ignorant & wrong (because that is simply not true.) But that is the fact of the matter.
So I personally DO see this as a disadvantage of HB. I can imagine there would be some negative feedback. of course, YOU CAN LIE! I've already planned to not tell my Mom & MIL I"m planning an HB since I don't want to deal with the "I TOLD YOU SO" BS if I transfer . & if I had something go wrong, I'd probably not tell acquaintances like co-workers that it was a planned HB because I just wouldn't want to deal with it.

But, that is the reality of life, around here anyways.

Originally Posted by crunchy_mommy

I didn't even think of the financial aspect of it. I doubt our insurance would cover HB but I will have to look into it.
<snip>
there is a mother-friendly designated one where several good midwives deliver that I've been looking at, but it's a 1/2 hour away. I guess I am pretty worried about transfer & that I'll get stuck at the same hospital again.

At least here in Maryland, many mamas have found "don't ask, don't tell" to work for insurance coverage! They simply have the MW submit the bill as the health care provider... the insurance company never realizes the "facility bill" never comes! Whereas if they ask in the first place, they are told it's not covered. Talk with MWs - many of them are experienced with billing insurance & getting coverage.

I've read on the HB forum that many mamas, obviously, plan to transfer to the closest hospital in the unlikely event of an emergency transfer, but for non-emergencies (such as exhaustion), they'll drive further to a better hospital. 30 min sounds reasonable to me to go further. So just bear in mind, transfer does not have to equal that same hospital.

[GoBecGo]

Crunchy_mommy i don't think you'll need to transfer. Over 70% of those who transfer do so for pain relief and i don't think in your own home, given your experience last time, you will feel tempted to do that. I think if you HAD to transfer it would be for something which meant you could drive the 30mins to the good hospital (i have a friend who transferred for a brow presenting baby, after being fully dilated and pushing for over 5 hours, she and her MW and DH drove a further 75mins to the hospital where they let mama's room in, skin to skin and generally be as natural as possible after a cs - she's planning an HBAC later this year ). Those things you read about which would mean you needed help RIGHT NOW are very very rare, even in hospital. Even more so when you're at home where there is no-one to break your waters early (and cause cord prolapse) or augment your uterine action (and cause foetal distress and possible PPH by exhausting your uterus with artificially strong relentless contractions).

One of the most powerful thing my DD's birth taught me, which i did not believe before i had her, is that my body is not broken. Or dirty. Or bad. It is perfect. What my abuser did to that me cannot change that. I am like the good earth, even after a nuclear war, eventually, the grass grows again. It was tough going through the labour i got to learn that, but i would never choose to do it another way.

It is ok to want and long for and plan and strive for the birth you want. I know you know that, but i think you might need reminding. It is ok for you to want this for yourself, and your baby, and your family in general. It is ok for you to have a plan, and a plan B and a plan C if you like. It is ok for you to do and say and decide whatever you WANT for the next baby you bring to earth. None of us have the RIGHT to a perfect birth, but every single one of us has the right to strive relentlessly and unashamedly for it.

[MegBoz]

Originally Posted by GoBecGo

None of us have the RIGHT to a perfect birth, but every single one of us has the right to strive relentlessly and unashamedly for it.

I love how you phrased all that. Great post!

[crunchy_mommy]

GoBecGo, you sure have a way with words. THANK YOU!!

I like the idea of planning for a HB & then emergency transfer to nearest hospital or non-emergency transfer to the further, better hospital. I also like the idea of everything going exactly according to my plan though, even if I have to modify my ideal plan to make sure it happens!!! I guess I'm saying, I'd prefer a planned hospital birth to an unplanned/"plan B" transfer... I want to set myself up so it's very very unlikely that my first plan will fail! I am starting to do more research on HB to try to get more comfortable with the idea. I'll have to start looking closer at the local midwives etc. I also think if I do plan a HB that I wouldn't tell anyone except the midwife ahead of time. I definitely wouldn't want to deal with all the criticism beforehand or "I told you so"s afterward.

P.S. I like your "good earth after nuclear attack" analogy GoBecGo, that's beautiful

[Youngfrankenstein]

Originally Posted by GoBecGo

I would have a planned homebirth with a midwife. I would start looking around before i ttc'd for a MW i was comfortable with and who can deal with me not wanting to have any vaginal exams (i am also a SAS). I would accept i might have to go for one which is not a CNM.

There is no need to check for dilation, it happens whether there are fingers in there or not, most women in the world and pretty much ALL animals give birth without anyone ever checking their dilation. Likewise the fingers inside during pushing - that is horrific. I'm sorry you were assaulted like that, there is NO reason to do it, and NO excuse for her continuing to do it after you told her not to.

I think someone who could endure what you have both in the past and during your birth can DEFINITELY do labour without an epidural, provided it was a labour where you were treated with humanity and not sexually assaulted, medicated and stressed out. I would also look into hiring a doula or other similar female support companion to look after you if your DH decides to check out again.

I agree completely. My mw did no exams during labor or anything.

[gillibean]

I'd go for a homebirth (preferably a waterbirth) with a midwife.

Originally Posted by crunchy_mommy

homebirth does sound like a nice option, although my biggest fear with that is something happening to the baby. From what I've researched it sounds like the same problems could arise at home or in the hospital, but if I were in the hospital I wouldn't blame myself to the same degree. But I do live less than 15 mins from the closest hospital so that's some consolation.

When I had my first I was originally thinking that I'd have a hospital birth with a midwife. Then my midwife told me that it takes time to get things set up at a hospital even for an emergency c/s. Basically, by the time they would be ready for me, I'd be there in the ambulance.

[wombatclay]

The short answer is "where ever you, personally and after soul searching, feel the most safe". And that is going to be a very individual and personal decision since only you are going to be able to address all the elements of your experiences. I know some women who have been through SA find their home to be the most secure place while others find a hospital to be more comfortable. Some want or need an epidural in order to relax while others want or need to feel every sensation. So much depends on the individual woman, her individual experiences, her memories and her hopes.

Penny Simkin's books are very helpful. When Survivors Give Birth is one of the best books on the subject. And her Labor Progress Handbook is an excellent resource for anyone, but especially for women who have had a traumatic/unexpected birth experience or a history of SA. (basically it walks through the birth process, outlining all the different potential bumps along the path and providing flow charts of potential interventions/outcomes. an excellent book for any doula, care provider, partner, mom, etc). Survivor Moms is less "how to" and more personal experiences, but it's another one to look for. I found it very supportive and reassuring. There's a website and a good article here on Midwifery Today.

You may also find that an in depth birth technique like HypnoBabies (with the "fear release" script) may help. Professional one-on-one therapy may be helpful too... hypnosis or a trauma specific technique like EMDR might be useful. Or try Tapping (a free, diy version of emdr) or EFT? A doula experienced in SA or birth trauma is a plus, even if you're at home, if you are able to be comfortable with her there.

In the end, sooooo much depends on you and your specific needs. In my case, I planned a homebirth but changed my mind after I realized the thought of being "in my home/in my bed" was causing panic attacks. I assumed that a homebirth would be less emotionally traumatic but in my case, that wasn't true... after months of planning and soul searching I realized that I simply couldn't "give up control" at home and would have an easier time in the less "charged" atmosphere of the hospital. I found a supportive midwife team, a supportive doula, and had an amazing hospital birth with my third child. So I guess my only piece of out and out advice is to try things on and be open to change... pay attention to your feelings and be willing to try different options, even if those options aren't what you expected you'd want.


Good luck and happy birthing when the time comes!

[newmommy7-08]

I want to add, that if you decide against a home birth and find a midwife at the mother friendly hospital that you are comfortable with that you ABSOLUTELY can have an epidural. Also, when I was pregnant w/ DS I asked about VE once in labor and was told by my midwives that they didn't have to be done if I didn't want them done. I personally wound up not caring and in my 14 hours at the hospital they checked me only 3 times. There's no excuse for frequent checks regardless of the situation.

[AustinMom]

I totally feel where you are coming from. I was sexually abused for the majority of my childhood. We planned with baby 1 to go through a birthing center, I was fine with everything they did there, the exams and such, but when we got to the hospital (we transfered because I was EXHAUSTED after contractions 2-3 min apart for 27 hrs and only +2 cm dilation) it has horrible. When the nurse and the OB checked me, they tore the insides of my vaginal walls, and my brain went right back to being a kid. Then, had a CS, and that was worse, as they were "doing" stuff to me that I couldn't see, and only felt parts of it, and my body shook tremendously from the epidural, I was totally out of control.

This time around, we are planning a homebirth. Our MW has had a HBAC of her own, so that helps, our Doula specializes in moms who have had sexual abuse history as she herself was previously abused, and she works with HBAC a lot too. She told me that during both her births, she checked herself, but I can understand one not being comfortable with that. I do plan on doing it some, but I'm going to build a strong relationship with our MW to where vaginal checks are not as traumatic, something idon't think you can do with an OB.

I'm a planner also, and especially after having to transport with our last birth, I want to have all my grounds covered. I'd suggest making a list of all the possible fears you have about birthing at home. IE-stalled labor, sexual abuse flashbacks, stalled second stage, etc. And then, talk to your MW about what they do to help these situations. I think the stalled second stage you had that needed a vacuum could have very well been from the epidural, the anxiety, you most likely pushed on your back, etc. MW help in all these areas. Also, just in case you do transfer, have a birth plan, and have it ready, and take your MW and Doula (as I wouldn't advise anyone to labor without a Doula, especially in your situation) with you, so they can help be your advocates.

[phathui5]

Do you have a midwife-run birth center nearby so that you could have an out of hospital birth without having to have a homebirth if you don't want to? I'm all for homebirth, but only if it's something you want to do.