Disappointing answer to question for midwife

[katroshka]

So I had a list of questions about birth procedures for my midwife today. All of the answers were satisfactory except one: I asked if the baby would be handed to me to nurse right away, and she said for the most part, yes. So that's good, but then she went on to say that if there was anything wrong with the baby it would need to be taken away to the pediatrician, which mostly makes sense, except one of the reasons was if the baby's color wasn't good, it would be taken away to a warmer. Now, I'm pretty sure at the (progressive) hospital I gave birth to my daughters at, they had told me that instead of a warmer they would put the baby skin-to-skin with me, and pile on heated blankets, which makes WAY more sense to me, plus in my Sears baby book that's what it says to do, also. I told my midwife that and she pretty much brushed it off and just repeated that if the baby's color was off or if it seemed non-responsive it would be taken to a warmer.

So what do you think? It really bothers me, especially since that news story about the woman who had twins, one was pronounced dead, so handed to her while the other was not looking so good so they took her away... and then the dead one revived while the mother held, spoke to, and caressed him. I mean, I understand that in SOME circumstances the baby might need to be taken away, but I just feel like color and responsiveness seems like something that should be first treated by being with mommy, being held, smelling/ tasting milk, etc., not being put in a plastic bin with a heat lamp.

I have the option of switching to an independent birth center, that I have mostly heard rave reviews of. I initially wanted to go there but was put off by the receptionist and not being able to get an appointment for almost two months. And no one wanted to know how far along I was or anything, I could have been 8 months pregnant for all they knew. Anyway, would like to hear if anyone thinks this should be a deal breaker!

[homemademom]

Well, it's not a great answer for sure, but if responsiveness was an issue (I assume she meant breathing), I would definitely want some resuscitation measures taken, like oxygen. I'm pretty sure a hospital wouldn't do that with the baby on your chest. Chances are good that it won't even be an issue for you (the baby in the story you heard was an extreme preemie), but maybe you can gather some research about kangaroo care and see if some compromise can be made in the rare event your baby might need help, like administering oxygen while the baby is on your chest. Most mws are going to do some serious rubbing of a baby while it's on your chest if it's not breathing great right away, and usually that's enough to get the baby going without any other interventions.

I wouldn't let this be a deal breaker if everything else is good. Try not to let it worry you. Like I said, it most likely won't even be an issue.

[camprunner]

would definitely want some resuscitation measures taken, like oxygen. I'm pretty sure a hospital wouldn't do that with the baby on your chest.

My first baby was definately responsive (although she didn't cry but she didn't cry much after that either) but her coloring was a little blue when she came out. She was immediately handed to me (because I immediately asked for her) and I actually held her out in my arms while they gave her oxygen (I was still in shock that I was a mom and not well versed in the benefits of skin to skin). I'm sure if she wasn't breathing they would have taken her to work on her though and a baby with serious coloring issue would have been gray/black. Maybe talking with her about exactly what the coloring issue is would help? If it's just a blue tint, I'd want to keep the baby. If the baby is limp and gray and they need multiple people working on her,I'd let them take her.

[MegBoz]

Originally Posted by homemademom

Most mws are going to do some serious rubbing of a baby while it's on your chest if it's not breathing great right away, and usually that's enough to get the baby going without any other interventions.

Agreed. Blowing into babies face can help too - I just read a great MW blog post on that recently. It was an HB MW who was saying how it's better to rub, snuggle, talk to the baby & even how it can be nice for Dads to be the one to blow & help get baby breathing. If my memory serves, she was also making the point that a baby not breathing immediately isn't necessary cause for panic - take all the above steps, give it a min or so (baby's still getting blood & therefore oxygen from the cord) - & only if after that, there's no breathing, then it's time for action (i.e. removing baby from mama's chest for resus.)

Maybe that's what your MW meant? If being on your chest, under blankets, and STILL there's not a good color, then baby has to be removed from your chest. And that sounds reasonable. I wonder if it would help you feel better if she gave you a specific amount of time - i.e. does the first breath have to come in 5-10 seconds, or just within 2 minutes before they remove baby?

All that being said, I wouldn't be too quick to write off a birth facility because of the receptionist. Also, my hospital-based CNMs were FANTASTIC about being able to get an apt, being quick in, always great - no long waits. But it did take maybe 4 weeks or more for the initial apt - but that's because the "OB intake" apt (first apt for each pregnancy) is scheduled for an hour, whereas all prenatals are scheduled for 15 min, so it's harder to schedule. Doesn't mean all your apts will be hard to schedule. & they were even great about fitting me in the same day I called a couple times (once to have my membranes stripped when I was 41W4D, twice when I was concerned about my 1st degree tear healing PP.)

Certainly not saying you should switch, just saying, difficulty scheduling the first apt doesn't mean you'll always have that difficulty getting in.

[Banana731]

you have to go with your gut on this one. You'll be glad you did. FWIW, a bad receptionist doesn't always mean a bad care provider.

If your baby is just a little "slow to start" ITA with you. You're not saying that you're not going to allow them to resuscitate a seriously non-breathing baby! But as far as baby in a warmer vs chest. If you want that baby on you, demand it. Your baby, your body, your birth-period.

[katroshka]

Yeah, I guess it was mainly the absoluteness of her statement that bothered me the most, she didn't talk about degrees of color, or time, but obviously wasn't willing to. If she had said, "we can wait a couple of minutes to see", or "only if the baby looks like it is in serious distress", that would not bother me, but there was no discussion of that, and when I tried to engage her in a discussion about it she totally shut me down. That bothers me almost more than the policy, really.

Also, she didn't even talk about a case where the baby needed to be worked on really, she just said if the color wasn't good they would put it in the warmer. Just a warmer, which doesn't really sound like a better idea than warm skin and blankets!

As for the other birth center, it was actually the second time I had tried to make an appointment there, the other time was after I had been hospitalized for a ruptured ovarian cyst. I was told I should see an OB after I got out of the hospital, and when I called this place (which provides an array of obstetric/ gynecological services) they couldn't get me in that time for 2 months, either. I explained to them that I had nearly bled to death and that I was told to see somebody soon, but I just got a bland "Well, that's when our next appointment is." I just kind of felt like I wanted to go somewhere I felt like I could get seen when I needed to get seen.

It's not a HUGE deal that would make me rule out the place, but it did make me look at other options, and start care elsewhere. Plus another friend had similar issues with them that dragged on to the point that she wasn't seen until she changed to my current provider, which at that point meant she was 5 months pregnant! But I know other people that love the place and had great experiences there, so I am going to take a tour and speak to one of their midwives, and I'm going to a tour and Meet the Midwives event at the hospital I'm currently going to be birthing at, so I will be able to compare.

All this is kind of making me wish I didn't have three crazy dogs and a tiny house, otherwise I would just do a homebirth and find a midwife I really like. I just can't picture it, though, sounds waaaaay to stressful in my current circumstances.

[weliveintheforest]

Do you have a friend who could come pick up your dogs and take them to a kennel or something? Your midwife doesn't sound very nice to work with.

[katroshka]

No, I wouldn't want to put the dogs in the kennel, it would be pretty expensive for 3 dogs, and one of them has some serious emotional issues (I know, but it's true) and I would hate to put her through the trauma of it... And like I said, my house is small, I just think about giving birth here and I can feel my blood pressure go up!

The midwife I saw today isn't the only one I will see, and probably won't be the one at the birth, as there are 12 that work at the hospital. I've heard really good things about some of the other ones, but it is kind of a craps shoot.

So we'll see, maybe I'll like the ones at the independent birth center better.

[lunarlady]

I'm with you. Her answer would bother me. And why is the baby taken to a ped instead of the ped coming to you? I would look into the birth center and maybe transfer care. Good luck!