final chapter of the saga in post #108 (was "really conflicted about homebirth and need advice") - Page 3

[Dlynn918]

Originally Posted by mamahen2coop 

be forewarned, this might be long and scatter brained...  

I have two personalities- my L&D nurse/see what bad can sometimes happen/have medically oriented peers/ not totally into HB husband and my crunchy/no vaxing/ no circing/cloth diapering/homebirth wannabe side.  I come home and pour over Birthing From Within and forums like this and feel sure that I can do a hb if I could get DH on board.  Then I go to work and occasionally see the complications that can happen with even normal deliveries and makes me feel like I'd be more comfortable in the hospital.  How, OH HOW, do I choose!!!

Background- DS will be 23ish months when LO is born.  My labor with DS was 6 hrs only, delivered in the hospital, with epidural, not unpleasant but not amazing.  I was GBS positive and only got 1 dose because I was only there for 3 hrs before delivery.  I'm completely low risk, normal BMI, no complications whatsoever.  After DS was born I lamented about having the epidural for months because I really didn't want one but I think because I work there, they expected that I should know what I wanted.  I didn't tell anyone I didn't want an epidural because I didn't want to look like a failure if I ended up with one after saying I didn't want one.  I labored at home for 3 hrs, was 5cm/100% when I got there, was complete 2 hrs later then pushed for an hour.  This time, everyone will know that they will be strangled if they do anything but help me deliver without an epidural.  I'm not the kind of person to use a doula, I would need someone I know personally. 

anyway...  Im seeing my OB and I know this is totally chicken, but if I was able to talk DH into a homebirth, I think the way I would keep my work side from judging me (which Im scared of) would be to continue OB care as if I was going to deliver in the hospital and just pay a midwife out of pocket to do the home del then go to the hospital like it was an accident. 

I know it's totally gutless but it just all feels so complicated still.  I'm 17 weeks so I have some time to think about it.  I dont have a large pool of midwives to choose from so maybe I should try to start there and see if I can even find one that I like first. 

If you got this far, thank you for reading!  Any advice or guidance is very appreciated!!

PS how does one start to look for a midwife anyway?  the only one I know of that is also the closest, I'm not fond of. 

Jenica,

  I am also a health care provider and I work with OBs almost daily. I know EXACTLY how you feel. I am planning a home birth but I have been on the fence about it myself. I haven't told any of the doctors I work with my intentions, mostly because it isn't any of their business I don't want to hear their jaded 2 cents. Once you work in a medical institution it changes you! I am 100% for safe, educated, home birth...but when you have seen placenta abrupta and amniotic embolisms it truly is SCARY to know the risks. I'm 13 weeks with baby #3 and have my second midwife apt tomorrow. I am going to talk more in detail with her about my health history (2 babies in birth center/hospital 6 hr and 2 hour labors, one hemorrhage) and my concerns. As much as I want a home birth I also don't want to be foolish and take any chances if I were not the right candidate. I suppose we shall see as time progresses! I just wanted to let you know I totally understand your conflicts and although it may sound insecure and silly to others, it isn't!!! When your a medical professional there is intense scrutiny upon your person choices when it comes to your own health. Its a rough field, and you have to have a thick outer shell because it isn't always the warm fuzzy caring environment portrayed. I hope the practice you have chosen at least has a couple of CNM to offer you additional support of your choices and you have the peaceful empowered birth you desire!

[mamahen2coop]

Originally Posted by Dlynn918 

Jenica,

  I am also a health care provider and I work with OBs almost daily. I know EXACTLY how you feel. I am planning a home birth but I have been on the fence about it myself. I haven't told any of the doctors I work with my intentions, mostly because it isn't any of their business I don't want to hear their jaded 2 cents. Once you work in a medical institution it changes you! I am 100% for safe, educated, home birth...but when you have seen placenta abrupta and amniotic embolisms it truly is SCARY to know the risks. I'm 13 weeks with baby #3 and have my second midwife apt tomorrow. I am going to talk more in detail with her about my health history (2 babies in birth center/hospital 6 hr and 2 hour labors, one hemorrhage) and my concerns. As much as I want a home birth I also don't want to be foolish and take any chances if I were not the right candidate. I suppose we shall see as time progresses! I just wanted to let you know I totally understand your conflicts and although it may sound insecure and silly to others, it isn't!!! When your a medical professional there is intense scrutiny upon your person choices when it comes to your own health. Its a rough field, and you have to have a thick outer shell because it isn't always the warm fuzzy caring environment portrayed. I hope the practice you have chosen at least has a couple of CNM to offer you additional support of your choices and you have the peaceful empowered birth you desire!

Thanks!! 
There are no CNM's within 60mins of here. We have only the OB's I work with and the LM's.  We have our appointment with the LM tonight so we'll see how it goes and what feeling we get.  I'm excited to meet her and see but also scared because then I have to make a choice!  I called my insurance and although they cover LM's equal to OB's, the one I picked isn't in the network so...

[Dlynn918]

Originally Posted by mamahen2coop 

Thanks!! 
There are no CNM's within 60mins of here. We have only the OB's I work with and the LM's.  We have our appointment with the LM tonight so we'll see how it goes and what feeling we get.  I'm excited to meet her and see but also scared because then I have to make a choice!  I called my insurance and although they cover LM's equal to OB's, the one I picked isn't in the network so...

Wow, that's frustrating. We picked a CNM who does home birth but she lives an hour away, which makes me a little concerned. But I just found out that home birth is on the chopping block in CT and may soon be ILLEGAL. Nice huh? So cool to live is an ass backward state. :-(

[mamahen2coop]

Originally Posted by Dlynn918 

Wow, that's frustrating. We picked a CNM who does home birth but she lives an hour away, which makes me a little concerned. But I just found out that home birth is on the chopping block in CT and may soon be ILLEGAL. Nice huh? So cool to live is an ass backward state. :-(

If it makes you feel better WA is trying to be the first to remove exemptions for vaccines.

[Dlynn918]

Originally Posted by mamahen2coop 

If it makes you feel better WA is trying to be the first to remove exemptions for vaccines.

Oh, another touchy subject!!! Whooping cough just went around my daughters daycare. She only goes maybe one-two mornings a week so I can get to the OR by 7 and yes, she was vaccinated so I wasn't worried about it. But what about the babies that were 6 weeks old? That's scary! I was lucky enough to be at home with both of my kids for the first two years so I didnt jump to vaccinate till they were a little older than recommended. And my pediatrician was supportive too. So COOL! When you find out the reasons why they vaccinate for things like heb b at birth it doesnt really make you want to jump on board with it as a responsible parent.

Anyway, I will be going to my prenatal visit tomorrow...an hour away ...so I will let you know what kind of light was shed of my concerns. Let me know how it went with yours! Much luck with it!
 

[mamahen2coop]

So DH and I went to meet with the midwife.  It went very well and DH agreed that if a homebirth was something I really wanted we could!  However, he was a little less than impressed because she has only been practicing a year and has a 35% transfer rate.  We didn't ask if she kept specific statistics as to why she transferred, but that bothered him.  I was less bothered because she said she almost always brings another midwife with 20+yrs experience, and an L&D nurse that I work with as her birth attendants so I'd be happy with that.  MY biggest reservation, which is a deal breaker with her, is that she takes one month off per year and it's the month I"m due.  I'm due at the end and she said if I went to full term she'd deliver me but if I was early by any stretch Id be delivered by her back up who happens to be the only one midwife in our area that I've met previously and dont feel that I click with. 

So she's not the one, but if I really want a homebirth there are 2 other midwives that I think come to my area.  Now I have more to chew on but I'm glad that DH is on board.  Although I still think he'd be more comfortable in the hospital and he keeps joking that he wants 2 million in life insurance just in case ;) 

[Ldavis24]

I have been following your thread closely mama, since I am going through a somewhat similar situation in the sense that DH is having major reservations too...

Honestly, the 35% transfer rate seems really high to me? I am knew to this whole HB game though so maybe it isn't? I mean that translate to roughly 1 out of 3 women she has attended have transferred? I guess if it was me I would be seriously questioning that like your DH...Maybe more experienced HB mamas can chime in as to whether that is a high number or not.

I am so glad that your DH feels a bit better about the whole situation though, I am currently trying to convince DH that HB is ok for us and we are meeting with our first MW next wednesday. 

The whole thing about not being around the entire month of your due date? How would the final prenatal visits work then? I was under the impression that most HB MWs still do a weekly visit in the final month of pregnancy? Would she not do these or have a partner do them?

All in all good luck! I totally sympathize with the difficult DH aspect although I can't speak to how stressful it must be to have to consider your work in the whole equation!

[mamahen2coop]

Originally Posted by Ldavis24 

I have been following your thread closely mama, since I am going through a somewhat similar situation in the sense that DH is having major reservations too...

Honestly, the 35% transfer rate seems really high to me? I am knew to this whole HB game though so maybe it isn't? I mean that translate to roughly 1 out of 3 women she has attended have transferred? I guess if it was me I would be seriously questioning that like your DH...Maybe more experienced HB mamas can chime in as to whether that is a high number or not.

I am so glad that your DH feels a bit better about the whole situation though, I am currently trying to convince DH that HB is ok for us and we are meeting with our first MW next wednesday. 

The whole thing about not being around the entire month of your due date? How would the final prenatal visits work then? I was under the impression that most HB MWs still do a weekly visit in the final month of pregnancy? Would she not do these or have a partner do them?

All in all good luck! I totally sympathize with the difficult DH aspect although I can't speak to how stressful it must be to have to consider your work in the whole equation!

She said a lot of her transfers are women who wanted pain management.  If I was really dedicated to trying to make it work out with her I would ask her for a break down of how many she transferred for medical vs other reasons.  So, with her 2-4 clients per month and having only practiced for 12 months, that's pretty high I think. 

She would have her partner (the one I dont love) see me for the weekly visits during the last month and chance her being off vacation by the time I deliver.  This is not OK with me since having the person I'm comfortable with do the delivery is a big part of the whole reason I would want to have a homebirth.  Although my OB will be on call for me 24/7.  If she were not available for some reason, since I work with them all, I would be able to hand pick who to see as her back up vs who ever is on call for the group that day.  

But, after talking with her DH feels better about being able to handle emergencies and said we could have a homebirth if it's what I really want.  And like I said earlier, he's not the best at fully thinking about/internalizing then expressing how he feels.  I think he would say if he still felt against it but I dont think he'd say that he was still worried and would really feel better at the hossy. so... we'll see!
 

[Marissamom]

I think my midwives' transfer rate is about 30% (I would have to go look at the stats, and I'm not sure where they are). but that includes transfers because the pregnancy turned high-risk, transfers for pain management, transfers for Failure to progress, and transfers for actual emergencies. but they also have had over 1000 clients over 10 years, and have only had one loss, and that was due to Trisomy 18. I personally would rather have a transfer rate on the higher end than one on the very low end. to me it shows that the Midwife is willing to transfer if needed. 

[Ldavis24]

Originally Posted by Marissamom 

I think my midwives' transfer rate is about 30% (I would have to go look at the stats, and I'm not sure where they are). but that includes transfers because the pregnancy turned high-risk, transfers for pain management, transfers for Failure to progress, and transfers for actual emergencies. but they also have had over 1000 clients over 10 years, and have only had one loss, and that was due to Trisomy 18. I personally would rather have a transfer rate on the higher end than one on the very low end. to me it shows that the Midwife is willing to transfer if needed. 

Thank you for that perspective! as a noob to HB, I always assumed lower transfer rates=better but I see it is not always so!

OP, at it served to help get your DH more on board, that is a big plus.

[douladianne]

A typical transfer rate for midwives is 5%-10%, so you are right that 35% is very high! I would be interested in the percentage of those that transferred due to wanting pain meds vs. due to her not comfortable with the situation. I'm glad she works with a seasoned midwife; but it's too bad you don't feel like you click. Any chance a second consultation with her could put you at ease a little more?

You might check this midwife out...She's also a friend of mine http://www.pacificnorthwestmidwifery.com/

[mamahen2coop]

It wasn't that we didn't click with her, it's that I dont click with her backup.  And since she's going on vacation for the month of July I'd have to see her backup that whole month for weekly visits and if i delivered early by more than a day or two, I'd have her back up doing the delivery.  If she would have been on vacation a different time I think we might still go with her, if we could figure out a little better why her transfer rate is high.  It makes DH a little nervous because she is green and maybe just gets nervous.  Which, I'm more OK with having a higher transfer rate than having a low rate and more bad outcomes. 

One good idea did come up with her though.  Plan a birth center birth and if I go too quickly then just deliver at home.  I would be good with that plan except its NO LESS than 1 hour of driving or driving/sailing to get to a birth center.  We drove 20 mins to the hossy when I was just getting active/5cm and it was the longest 20 mins ever!  So I'm not sure about that either.  UGH, when am I going to have the epiphany!

Douladianne-  where does she practice?

[douladianne]

In my previous post, I meant that it was too bad that you didn't click at all with the backup midwife just in case it turned out you needed her. But then if that were the case, you probably would have gone with her in the first place, right :0/  Tinneca has assisted with Toni Erickson in Enumclaw and Nancy Spencer in Bonney Lake and just opened her own practice in the Tacoma area. She is taking on new clients in the all of the Puget Sound region.

[mamahen2coop]

Originally Posted by douladianne 

In my previous post, I meant that it was too bad that you didn't click at all with the backup midwife just in case it turned out you needed her. But then if that were the case, you probably would have gone with her in the first place, right :0/  Tinneca has assisted with Toni Erickson in Enumclaw and Nancy Spencer in Bonney Lake and just opened her own practice in the Tacoma area. She is taking on new clients in the all of the Puget Sound region.

Oh, duh.  sorry- can I blame it on prego brain?

I contacted Tinneca yesterday and she got right back to me.  It sounds like it'd be far for her to come but she said she'd be willing to do it.  Just talking with her on the phone I really felt good.  Shes going to send me some info and we'll see what happens from there.  I need to get DH to have a sit down with me and really tell me what he's feeling.  He said if its what I really wanted he'd be OK with it but like Tinneca said, he needs to be 100% OK with it or else it'll feel tense the whole time. 

[douladianne]

I'm SO glad you talked with her...You will love her! Tell her that Dianne who was a doula in Tacoma that moved to AZ sent you her way! She's also very good friends with Patti that you're taking the workshop with. Are you considering have a doula? I think it really helps dad to not feel like all the pressure is on him to remember every way possible to comfort/distract or relieve pain. As a doula, I work really hard to create an intimate environment for the couple and encourage Dad with different ways of helping you. I'm there to get mama's back while her head is burried in her partner's neck :0)

I'm excited for you!

[artemis33]

Hey mama - are you still trying to work this out?  I live in North Kitsap and had a homebirth last spring - I believe with the 2 midwives you are referring to.  If you want some insight, please feel free to PM me  :)

[artekah]

I missed this thread until now but just recognized your name because you're in my DDC!

How exciting that it looks like you'll probably get your HB after all! I hope you find (have found?) the perfect midwife for you. It's frustrating when your options are limited like that. I have a friend who wanted a HB for her first but got a hospital birth instead only because her DH wasn't onboard. She now wishes she would have been more persistent in asking him to consider it (he now agrees to a HB for their future 2nd). So I'm really glad you got him to meet with a MW. I think that the more research you expose him to the more open he'll be to the idea. (After all, hospital transfer is always an option!)

Good luck, I hope you will have the birth of your dreams. Of course I'll be watching for your updates in our DDC come July.

[mamahen2coop]

and finally a conclusion...

So after much though, anguish, and many calls to area midwives, we've decided to deliver at the hospital. What I finally flushed out after all of everyone's awesome input and guidance () and many great PM volleys with some wonderful mamas, was that I wanted to be surrounded by attendants that I trusted and wanted to be there. I found a midwife that fit my needs and DH was on board. But, unfortunately she takes 1 month off each year and it just happens to be the month I'm due. If I was certain that I wouldn't deliver more than a day or two early, then she would be able to attend and all would be well. But, it's LO#2 and I cant be sure so I dont want to invest all the emotional energy of switching providers only to end up not having my provider at the delivery.
I love my OB and she's willing to do what ever I want as far as intermittent monitoring, moving, eating, positions, etc. I know who will be provider if I deliver at the hospital and although the nurses on duty that day aren't decided by me, our manager is lenient enough to let us call someone in just for us.
It's not the setting that I eventually envisioned but it'll be the support people that I want there. I'll labor at home and have that horrible 20 minute car ride again but it feels right in my gut and it's quieted my mind so that it's not running 24/7. I'm still reading all the books I can find. I signed DH and I up for a good birthing class by Patty Ramos and I'm trying to find a hypnobabies homestudy to do but if I cant I'll probably just buy it.

I really do appreciate all the interest, thoughts, advice, stories, and support you all have given me while I worked through this in my head. I really couldn't have done it without you all!!

[labortrials]

Well then, it's meant to be.  Sounds like you'll be able to have a good experience in the hospital! ;)  You might like Marsden Wagner's Birth Plan book.

[mamahen2coop]

Ugh,
the more I read the more I dont want the hospital people all around doing "stuff". I was trying to take a nap today and thinking of the stuff I'd have in my birth plan and thinking I'll just plan to just wait a little too long and have him at home. But then it'll be unattended and maybe it'd be better to have a midwife, whom I"m not fully comfortable with her level of licensure, than to have no one at all. ugh! I feel like I'm trapped in a maze!!!