Easing Family Member Birth Worries?

[LilMommaR]

With my husband's support, I'm planning to have my baby at a free-standing birth center. We really love the place so far, and I feel as though it aligns with my birth philosophies. However, my mom is very anxious about it, worrying that if something is wrong with the baby, we will not receive proper care in time, since we won't be in a hospital. I feel good about my decision, but worries like hers bring me down and make me question myself. I know that the center I've chosen has a great track record, and the midwife explained to my mom that only healthy, normally-progressing pregnancies are accepted for birth there. Should anything out-of-the-norm occur, I would be transferred to care elsewhere. My mom will not be with me during the labor, but I'd still like her support. She says whatever makes me happy is okay with her, but I still feel her negative energy whenever we talk about the birth. She says she just wants the best care for me and the baby. My mind begins to wonder what kinds of things could possibly go wrong, and I fear that if something did happen, I'd never forgive myself. I want to smack myself for thinking like this because it feels like a trap of negativity, which I really don't need! I have eagerly been looking forward to the birth center birth, and I don't want to be bogged down with anxiety from other people. So I'm looking for support and tips on how to handle this or provide my mom some reassurance. Thanks for any advice you can offer!

[thencamehenry]

Hi,

I'm a lurker who rarely posts but I can relate to your situation and want to offer support. I had my first naturally in a hospital and am thinking about a birth center for (not yet conceived) #2. I have a lot of internal struggles similar to what your mom described, and here's my thinking: Life is a constant series of decisions and we are often ignorant about all the possible factors and outcomes. There are many scenarios in which the hospital is the ideal place to be, but sometimes it's not. You could deliver at a hospital and your perfectly healthy baby could contract MRSA and be seriously ill or worse. Bad hospital policies could lead to an unnecessary c-section, which opens you up to a whole world of possible complications, including a higher maternal death rate. Birth, like life itself, is unpredictable. You can learn as much as you can and base your decision on facts and your mama instincts, but there are no gaurantees.

Good luck with whatever you decide. Birth is a very divisive issue these days, especially between generations.

[MegBoz]

First off, CONGRATS on your pregnancy!
That's great that you have a wonderful FSBC in your area. I would have considered one, but there's only one in greater Baltimore & it's just too far for me.
This comes up a lot - especially about HB (home birth.) You have a few choices:
-Try to sway her by educating her. I've read other mamas pass on books & movies & say, "Let's talk after you've read through these things, so we can be on the same page."
Does she understand that the CS rate is over 32% now? Some Gmas-to-be don't realize how bad American maternity care is now & actually get in favor of FSBC or HB when they really grasp that stat.

-Be harsh & tell her you're not going to listen to negativity. She can be supportive & get on board, or you won't discuss any of it with her at all. Depending on how pushy she can be, you might need to get tough back.

Originally Posted by LilMommaR

I fear that if something did happen, I'd never forgive myself.

This is a really tough one & I thought it myself. But I've had years to decide I'm comfortable with HB & comfortable to accept the responsibility. It is absolutely just a fact that there are indeed rare instances where being in a hospital could save a baby - and therefore not being in the hospital could have negative consequences. But the fact of the matter is that there are more chances of hospitals interfering & causing problems.

As an eloquent mama here wrote recently (sorry, forget who!) Birth is more safe than not, interventions are more risky than not.

But there are no guarantees. There just aren't. That's life.

[Mommal]

You could always tell your mom that you considered homebirthing- when she hears that she might be so relieved that your chose the "middle path" that she stops criticizing.

I had similar reactions from my Mom when I told her that my new baby was going to be born at home. "But what if something goes wrong?" "I had good experiences at the hospital (except for the gigantic unnecessary episiotomy, and the unnecessary IV, etc.)." I just had to be very patient, and very strong in my convictions. I had to tell her "I trust the midwife. My options at the hospital are not good ones. I know too many women who went there and ended up with unnecessary interventions and c-sections to go there myself. No, there's no hospital midwife option in this town. The studies show that homebirth is safe, etc." Finally, I just had to shut down the discussion. "Mom, I need positive energy and support from you. I don't want to discuss my birth choices any more. I know we don't see eye to eye on those choices, but they aren't going to change."

[Twinklefae]

I would really stick with giving her the facts "they are aligned with X hospital, which is only a 5 minute ambulance ride away. If something went wrong, I would go to the hospital for sure."

If she keeps up with the worries, I would move to "I have already discussed this with you and it's my decision. I ask you to respect that."

[miami mommy]

Originally Posted by LilMommaR

I feel good about my decision, but worries like hers bring me down and make me question myself.
...I'd still like her support. She says whatever makes me happy is okay with her, but I still feel her negative energy whenever we talk about the birth...I have eagerly been looking forward to the birth center birth, and I don't want to be bogged down with anxiety from other people.

I think that you should say these things to your mom. It's so important to work through your own anxieties before birth, the last thing you need is to take on your mom's! Since she already knows your birth center's great track record and that you can transfer if necessary, it sounds like there's nothing you can say to make her anxiety go away, but she can stop spreading it to you.

I had a great birth center birth and am so glad I chose the birth center over a hospital. I had a family member question why I was giving birth out of a hospital and I let her know that a hospital was only 5 min away if I needed it. That was enough to ease her concerns (or at least get her to stop talking about them).

[rhiOrion]

I'd give her the facts, as a PP suggested.

Tell her what safety measures they have in place: for instance, oxygen, etc. If these are CNMs at the birth center, you can tell her a bit about their training- that they have masters degrees, etc. Tell her what they do in event of emergency. I know that at my local FSBC they timed it one time, and the time from the birth center to being in a room at the hospital was under 15 minutes. Considering they can do an IV in the ambulance, that means that in reality, your time to an emergency c-section is only very slightly longer than in a hospital. Then I'd tell her about the things that can go wrong in a hospital because it's a hospital... germs, mrsa, etc. Give her the c-section rate for your hospital, and then tell her that research shows that the ideal c-section rate would be more like 8 percent (I think that's right, I'd definitely double check). My FSBC's c-section rate was right about 8 percent, which to me meant that they were doing c-sections when necessary, but not when unnecessary. Here when the birth center calls for an ambulance for a transfer of the newborn, they send a NICU squad. I'm assuming they likely have OB back-up for consults.

Is it possible for your mom to take a tour of the birth center? I know the one hear has tours frequently and they invite family members to tour as well.

[MegBoz]

Originally Posted by miami mommy

I think that you should say these things to your mom. It's so important to work through your own anxieties before birth, the last thing you need is to take on your mom's!

Great advice! I especially like the phrasing, "Take on your mom's [anxiety]." Because that's exactly what is happening - she is making you more stressed & you don't need that.

[EmTheWife]

nak...
my dh and I decided to go the route of facts when our families offered opposition. We'd go into detail about the measures availale at the birth center, and then we'd also diiscuss how studies over the last 30 years showed delivering outside the hospital with a CNM was shown to be safer for a healthy, non-complicated pregnancy. these combined, over 6-7 months eventually won them over.
Try to remember that how you feel about your LO is how your mom feels about you, and that she wants what's best for you, but all she may know is OB's in hospials
congrats on your decision for a natural birth!

[kltroy]

she probably doesn't know much about FSBC's. You can help her understand what they ARE and what they ARENT, and this will probably ease some of her anxiety. I like the resources at www.childbirthconnection.org (click "choosing a place of birth" on the left). I'd point your mom towards this and let her read - this will probably help her understand the types of things that you were considering when you made your decision.

[Climbergirl]

My mom was worried about my deciding to do a VBAC at home. She would say "you just need to find a doc that is going to leave you alone and let you birth. My doctor did that and made the nurses leave me alone." I told her, yes, I agree. But now, the only way I am going to get that is with a midwife and at home. When I told her all the things I "had" to do because of VBAC, she was amazed and has been extremely supportive (shockingly supportive actually).

My MIL, whole different story. She was an L&D nurse in the 80s and so she "knows" that the only reason I am doing a VBAC is because I want the feel good experience. I mentioned a FSBC and she said, "but what if minutes count? you want them to be able to open the cabinet and pull out the oxygen". When I told her they HAVE oxygen, she ignored it. She does not know we decided on a midwife at home. I think she thinks that since I am getting ultrasounds, that I have an OB. I let her think it. I am not discussing it with her at all.

You need positive energy, not negative. I would ask her to be positive and to please trust the fact she raised an intelligent daughter who is able to weigh the risks, do the research, and make sound decisions.

Good luck!

[treeoflife3]

I had the same issue but the fsbc I went to was designed so that an ambulance could literally just pull up to the birthing rooms to put the birthing mother in need right in. They built it so that there were big doors... it was neat. That coupled with the fact that the ride to ANY of the hospitals in the area was only about 15 minutes put everyone at ease. I had to be registered at a hospital prior to going into labor so that I could quickly get in if necessary after the short ride.

Once I explained all of that, it became pretty clear that my being at the fsbc was no worse than something happening at home. 911 would be called and away I'd go.

[AustinMom]

It's pretty simple comparing the two, there are a lot of studies out there comparing in and out of hospital birth. Basically this is what they come up with:

Mom and babies die just as often, and deaths are usually due to congenital abnormalities, abuse, and other situations that birthing in a hospital would not avoid

Moms and babies fare better after an out of hospital birth, higher APGARs, more positive birth experiences, and quicker and easier recoveries for moms

Moms have less interventions (why the recovery quicker) like IVs, labor speeding drugs, pain meds, episiotomies, tears, forceps, vacuum, and Cesarean Section

Moms have less re-hospitalization due to infections, etc. in out of hospital birth.

These studies compared NORMAL low risks moms in both cases. In one study, the CS rate was 14% for in hospital and only 3-4% for out of hospital, and we all know how risky CS is compared to vaginal birth, like a mom is 4 times more likely to die, and the list goes on for that.

[thencamehenry]

You've gotten a lot of great advice. I agree that maternity care is so different now than it was a generation ago. I would imagine it's hard for the grandmother-to-be not to be the expert when she's the one who has done it before. How exactly one approaches her mother or mother-in-law really depends on family dynamics, etc. In my experience, birth is the first of many parenting choices that grandparents might question so it's a good opportunity to set expectations early.

When I was pregnant my husband told my in-laws that they had their turn as parents and now it's ours. We have to do the research, find a care provider we trust, do he worrying, change diapers in the middle of the night, etc. They just get to cuddle and play and show off photos to their friends. This was done in a kind and respectful manner, not in the heat if an argument. For us that approach worked well because my SIL has a polar opposite parenting style so whenever we get into specifics we have to try really hard not to come across as critical of her choices.

I wish you the best with your mom and your birth!

[babyjelly]

Originally Posted by LilMommaR

My mind begins to wonder what kinds of things could possibly go wrong, and I fear that if something did happen, I'd never forgive myself.

Maybe you should ask yourself- and your mom- what kinds of things could possibly go wrong...and then find out what would be done at your FSBC as opposed to in the hospital. For example, when I decided to birth my son at home, after two hospital births, my own mother brought up the fact the I bleed after birth- a LOT. She was worried about this, and understandably so. It helped everyone concerned to learn that If I were to hemorrhage (and I did), I would be given Pit, just like in the hospital, but via intramuscular injection rather than IV. If the Pit didn't work, my mw also carried methergine and Cytotec.

Knowing the risks, and what would be done in any birth setting if a problem were to arise, seems to me like part of responsible decision making.

[LilMommaR]

Thanks for all of the great advice! I ended up talking with my mom a bit about the way things worked in transfer situations. In my case, the BC is a few blocks away from two good hospitals, one with a level 3 nicu, whereas the hospital by my house (I live an hour from the BC) is really horrible. So that was the biggest reason for going to the BC as opposed to having a homebirth, which I was originally considering. I told my mom that the BC has a 17% transfer rate, and only 3% of those turn out to be C-sections. She had two C/S herself, so she doesn't necessarily see anything bad about them, but she does agree that they shouldn't happen unless needed. I also explained to her that the time it takes me or the baby to get to the hospital by ambulance would be about the same time it would take the OR to be prepped for our surgery, so that seemed to help her a little. I know she is just anxious by nature, especially since she hasn't researched this nearly as much as me, so I do understand her fears on some level. I've been doing much better over the past few days, and she told me that she knows she needs to work on her "stuff," which was good to hear.

[grumpybear]

I just quit discussing my birth choices with anyone who had doubts. It's not up to them anyhow.

[Tigerle]

Originally Posted by EmTheWife

nak...
Try to remember that how you feel about your LO is how your mom feels about you, and that she wants what's best for you, but all she may know is OB's in hospials
congrats on your decision for a natural birth!

I think this is a great point: it is hard for a mom to stop worrying about her baby having a baby! Is this your first? I know it is annoying statement but you may experience a whole new capacity for worrying yourself as a new mom (I did!), and understand her better soon. I think it's great she is trying to understand and support your choices even though she is worried, and that she is willing to educate herself on them. Maybe it helps you if you reframe this for yourself in this way rather than viewing it as "negative energy" or having to "take on her anxieties". You may also want to ask your husband to discuss "facts" (ie her anxieties) with her, and ask your mom to only discuss happy things with you, like baby outfits and nursery choices.

[JessieBird]

PPs have had lots of great advice and I'm happy that you had a good talk with your mom. I'd just suggest one last thing - take your mom on a tour of the birthing centre if you can. I went through the same situation with my MIL and it was really bringing me down. She told DH and I that we were making a selfish decision and that I was trying to be a martyr. It was awful - not only how she treated me but also I was saddened that she felt such anxiety. I really wanted her to be at peace with our decision as she'd be 3000km away at the time of the birth. She visited us when I was about 7 mos and I asked her if she'd like to tour the centre with me, though I knew that this was risky and it could go either way because our birthing centre most certainly does not look like a hospital (it looks more like an old country b&b). She bravely said yes. Turned out she was blown away impressed. She was amazed at how clean it was and this is all she cared about. We were able to wander around freely and I showed her all the high-tech looking equipment neatly hidden in antique armoires, that sort of thing. She ate it up and fully supported us from that moment on.

My FIL happened to be visiting during a home visit from my MW a few weeks later and so he reported back on that experience. Again, though the experience was very different from what they had in mind, they were really impressed and including them made all the difference in winning them over.

It was a relief not to have to be defensive anymore - I hope you can feel that way soon too!