questions about homebirth

[briannas auntie]

Now, I am not pregnant yet, but I am just planning early.  I don't plan on getting pregnant until after I am finished with college (for my medical billing/coding degree) and have a job, but it doesn't hurt to plan ahead, in my opinion.  I will be done with college at the end of this year and plan on going through a sperm donor and becoming a single mother by choice.  I also have left the option of foster parenting open in case I can't get pregnant.

Anyway, I was looking through my old issues of Mothering Magazine, while I was organizing them at the natural healing shop my friend Gerri and I own. I found an article in one of them from the mid-2000's that described how a paralized woman gave birth to her daughter at home.  After reading this article, I told Gerri that if she could have a child at home, then so could I. It was such a wonderful story!

I have some medical problems, including having an ileostomy and no rectum/anus (had to have emergency surgery back in 2008 due to tearing of my colon because 1/2 stoped functioning).  I also have a GJ feeding tube to administer my medicine and extra water into my small intestine, so I don't throw it all up (due to gastroparesis and acid reflux disease). I can eat solid foods no problem, but have trouble absorbing my medicines without them going into my small intestine directly (that, and you need extra water if you don't have a colon to prevent dehydration).  Other than this, I am healthy and very active.  I do also have muscle weakness in my legs, but physical therpay is helping with this a lot, so I can walk easier.  My goal is to not have to use a manual wheelchair anymore.

Moving on, I did want to ask you guys who have had homebirth a couple questions:

1. Do midwives make exceptions to working with you through pregnancy and birth if you are disabled, yet healthy?

2. Does insurance normally cover homebirth? 

3. Do you have to have lots of supplies to give birth at home?

4. Should I do exercises prior to becoming pregnant, so my body will be all ready for that?  I already do perineal massage to soften my perineum, due to the bad scar from my anus removal surgery 2 years ago. My gyno suggested I do this to soften the scar more, so it wouldn't be as uncomfortable to sit for long periods of time.

5. What happens if you tear?  Because of not having a rectum or anus, I have a scar similar to an episiotomy scar, and I am worried about tearing, but don't want an episiotomy (it was bad enough to recover from the anus removal surgery and having a painful crotch for weeks).

6. Are birthing stools still made?  I'd like to give birth on one of them, rather than laying in bed.

7. Does a midwife or other helper check up on you after the birth, or are you left to fend for yourself once they leave?

8. Does the midwives help you get breastfeeding started after the birth, especially if its your first child?

9. Can you suggest any good books on homebirth?

Gerri suggested I ask you guys, then print off the replies, so we have them to refer back to. I know this is long, but it would really help me out to know all about homebirths.  Thanks!!

Jessie

[Plaid Leopard]

Hi Jessie-

how exciting to be almost finished with college and thinking about having a baby! All the best to you.

My advice would be to start interviewing midwives in your area, even before you get pregnant. Most midwives are very open to meeting women and answering questions about what they do. That way you can ask all your questions and find if there is a midwife that you are compatible with and who is competent and able to deal with special health issues in pregnancy and birth.

So, to answer you questions here:

-some midwives work with disabilities, but others do not.

-sometimes homebirth is covered by insurance, but it really depends on where you live and you insurance provider. Most midwives are willing to work out a payment schedule for clients that have to pay out of pocket.

-You don't need a lot of supplies. The main things that you would need to have are lots of old towels and sheets, a plastic cover for the bed,sanitary napkins, umm - my mind is drawing a blank now, even though I have had 3 homebirths.

The midwives bring their own supplies and equipment. Midwives generally give a list of things to have or buy, and there are companies that supply homebirth kits.

-It is not necessary to do exercises, but it can't hurt. Things like yoga and swimming are excellent ways to get in shape for pregnancy and birth.

-Most midwives will not perform an episiotomy and do their best to prevent tearing. Breathing through contractions as the baby is crowning, avoiding "purple pushing", birthing in water and avoiding pushing while on your back are ways to prevent tearing.

-Birthing stools are still made.

-Midwives do come to check up on you and baby post-partum, and help to establish breastfeeding. If there are difficulties with breastfeeding there are lactation consultants as well as La LEche League who can help. And if the midwife is concerned about you are the baby she will refer you to a doctor or hospital.

-Some Books: Homebirth by Shiela Kitzinger, The Complete Guide to Pregnancy and Birth, also by S. Kitzinger, Heart and Hands, by Elizabeth Davis.

Hope that helps!

-

[CookAMH]

I'm only preparing for my first homebirth next month, but I'm a planner like you.

1. Do midwives make exceptions to working with you through pregnancy and birth if you are disabled, yet healthy? It probably varies by midwife. I'm afraid I can't really offer any other advice on this question.

2. Does insurance normally cover homebirth? I believe it depends on the state and insurance company, it varies a good bit.

3. Do you have to have lots of supplies to give birth at home? midwives will give you a list, and there are other things that might be helpful. It often involves buying a kit that runs $50 that contains chux pads (to catch blood and fluids), bulb syring, clamp, other misc supplies

4. Should I do exercises prior to becoming pregnant, so my body will be all ready for that?  I already do perineal massage to soften my perineum, due to the bad scar from my anus removal surgery 2 years ago. My gyno suggested I do this to soften the scar more, so it wouldn't be as uncomfortable to sit for long periods of time. Regular physical excercise would help, any weight training or muscle strengthening for the endurance of labor

5. What happens if you tear?  Because of not having a rectum or anus, I have a scar similar to an episiotomy scar, and I am worried about tearing, but don't want an episiotomy (it was bad enough to recover from the anus removal surgery and having a painful crotch for weeks). Some tears require suturing, some don't. Some are severe. You would want to talk to a midwife who could examine you and give some experience feedback for your personal situation and history.

6. Are birthing stools still made?  I'd like to give birth on one of them, rather than laying in bed. Yes, many midwives still have and bring birth stools.

7. Does a midwife or other helper check up on you after the birth, or are you left to fend for yourself once they leave? Midwives typically come on the first post partum day and the third, for example. Then you have other visits maybe around 2 weeks, 4 weeks, 6 weeks. That too can vary by midwife, but you can expect at least one or two home visits in the immediate post partum period.

8. Does the midwives help you get breastfeeding started after the birth, especially if its your first child? Yes, they will help you. You could also, upon being pregnant, attend a few La Leche Meetings in advance of giving birth to get advice, meet other women, and have a support network for when/if you need to talk to someone on the phone or get some hands on help. Also, they could recommend a lactation consultant. But yes, I would anticipate the midwife would help you for those first couple feedings immediately following birth.

9. Can you suggest any good books on homebirth? Ina May's Guide to Childbirth has a lot of homebirth stories and she teaches you a lot about the natural aspects of childbirth.  I'm sure there are others specifically on homebirth...I bet others will weigh in.

And, it'll be a good idea to keep a list of these questions and others to ask specific midwives that you might later interview when the time comes.

[briannas auntie]

Thanks for all the great advice!  This will really help me out.  I found a copy of Homebirth by. Sheila Kitzinger, that you guys mentioned, on amazon.com for a quarter in the used books, so I am going to order it this weekend.

I do know there is a La Leche League that meets in Olympia, WA (from what my sister told me last year), so I might check out going to a meeting or two before I have a child to actually get some know-how on breastfeeding, so I won't be totally dumbfounded and scared during pregnancy and after having a baby. 

Plaid Leporard,

Yea, I can't want to get done with college and have a degree for the first time in my life! College has been rough, especially in algebra (I am not good at math) and having to learn how to do medical coding and filling out insurance claim forms, but its all worth it!  Right now, I am on SSDI, through a program called Adult Child Disability benefits.  This program is offererd to children and young adults aged 23 or younger, who are disabled and have had a parent (or grandparent if they are the legal guardian) who died, but worked and drew into social security.  I get Medicare and Medicaid.  The big thing with being on SSDI is that they also offer a work release program, where for 9 months, you still get the same amount of money they give you every month, while you are begining to work.  This way, after the 9 months, they can evaluate if you can work part-time in the workfield.  After this, they start deducting part of your SSDI money, based on how much you are making at work.  They still keep you on the insurance, though, especially if you have medical supplies that are life-sustaining or necessary (like urinary catheters and ostomy supplies).  I plan on doing this program for work when I graduate in a year.

All I know is that it will be worth it to be out in the workforce like a normal person, not just doing volunteer jobs exclusively. 

Jessie

Edited by briannas auntie - 3/3/11 at 11:46pm

[CookAMH]

As far as nursing books, The Nursing Mother's Companion has been a great resource for me.

[briannas auntie]

Originally Posted by CookAMH 

As far as nursing books, The Nursing Mother's Companion has been a great resource for me.

I read that book before!  That is a wonderful book.  My sister found a copy of it at a local used book store 2 years ago before she had her baby.  It was an older copy, where some of the breastpumps are no longer on the market, but the other advice was great.  I am planning on getting a copy of this book for future reference.  I also have a copy of Ina May Gaskin's breastfeeding book, but it doesn't show proper latch-on or anything like that.

Jessie

[MountainMamaGC]

I am TTC. I have crohn's disease, and I have a chance of developing a fistula if I tear during birth. Its not a certainty though. I actually found a midwife that is willing to help me give birth when I do get pregnant with #2, so I dont have to have a c-section again. I am sure you will be able to find a midwife to help you.

Good luck!

[briannas auntie]

Originally Posted by Lydiah 

I am TTC. I have crohn's disease, and I have a chance of developing a fistula if I tear during birth. Its not a certainty though. I actually found a midwife that is willing to help me give birth when I do get pregnant with #2, so I dont have to have a c-section again. I am sure you will be able to find a midwife to help you.

Good luck!

Thanks for letting me know this.  I had one gastroenterologist tell me that women with chrons, ulcerative colitis, or ostomies can't have babies, and yet several people from the UOAA site told me that they have had kids no problem with an ostomy and these medical conditions, and my new gastroenterologist told me that the previous advice I got from the last doctor was a bunch of bull.  He told me that he has had several women with ostomies successfully have babies without having to have a C-section.  The only thing he said would be difficult in the third trimester was fitting the appliance on perfectly, especially if you have a stoma that doesn't stick out well.  That doesn't bug me very much, since I have been used to my appliances fitting well one day and not fitting well the next day.  My ostomy nurse says I have a sneaky stoma that will stick out fine for a while, then sink back into me and cause appliance leaks constantly.  I'm so used to it that it doesn't even phase me anymore. 

Oh, I wanted to let everyone else that replied know that my friend got me a book today called Birthing From Within, by. Pam England. She had read about the book online and thought I might like it. I read the first chapter practically out loud in the car while we were driving to Costco and thought it was a very well written book and can't wait to use the tips during pregnancy and birth next year or so! 

Jessie