Am I a good candidate for homebirth?

[JudiAU]

Could use some help with exploring if I am a good candidate for homebirth. TTC #3 right now and understand it is difficult to get a hb midwife if you don’t plan ahead so I think I need to know now… Many thanks for your help. Details of first two births below as well as some of my general situation.

Birth #1: transferred to hospital-based midwifery group late in pregnancy #1. Took a BFW class and panicked, did some hypnobabies at the end. Water broke. Posterior baby. Didn’t go into labor into 12+ hours later. Lots of family stres, including a lie to me about calling difficult MIL, her barging through the doors of my vaginal exam after DH said he didn’t call, relationship with her still strained, went into intense labor (no build up), dialated within a few hours to 8 and had an epi, dialated to 10 within the hour, baby had still not descended. Waited five hours, baby descended fully, pushed for 35 minutes and had a vaginal birth.

Birth #2: Water broke. Didn’t bother to call DH. Told him in the next morning. Called no one. About 12h later I called doula and sent DH and #1 to the park when I started to feel something. #2 born within 2 hoursof first labor bang. Very, very intesne. Doula missed birth. DH walked in about 15m before birth, frightened DS, was in the other room calling MIL for #1 and calling paramedics because he knew he couldn’t drive me. I delivered DD by myself, sitting on the toilet, the only place I could tolerate. Wisked off to the hosptial after paramedics arrived to deliver placenta. Totally unplanned. I didn’t have unassisted hombirth fantasies. No panic, probably because of hypnobabies. No relief throughout labor. I just remember it being intense the whole time. There were small ebbs but that was it. I have no idea what people are talking about when they discuss labor or I did X and waited for the next one. Based on the descriptions of others, I feel like my whole experience is transition. No experience yet with counter-pressure. Couldn’t sit on ball. Couldn’t do anything other than be naked on the shower or sit on the toilet. Complete previa at one point but it moved. Discovering that I was ready to push was a JOY because it meant labor was over. Gave a 2? 3? Pushes and she was out. Pushing was much easier than labor.

#2 I also had the care of chiro (flipped her when breech) and acupunturist who “started labor”. I’ll do that again. As well as regular massage.

DH will probably agree to a homebirth, but mostly because he knows I would wear him down and/or it is my body and I should choose. But he would be much more comfortable somewhere else, preferably in a hospital. A birth center would probably make him feel better too.

DH is not really helpful in labor, hates to see me/anyone in pain. Feels helpless that he can’t help. Pushes drugs at the smallest sign of pain. Would probably be comfortable not being in charge having someone else provide care/relief. Had hired a doula for second labor which had supported.

DH is very proud of me for the birth of #2. Maybe in awe of is a better term.

I don’t need a whole lot of touchy-feeling stuff from a midwife. If we did it we would have a very experienced homebirth midwife and a doula too, based on experience not insurance coverage. I’ll pay out of pocket if need be.  I’d probably go back to my hospital-based practice right in the beginning to make sure I could have CVS through our previous doctor and also plan a full ultrasound at 20w. It bothers me not to have a full newborn evaluation by an experienced pediatrician like I had at my old hospital. I liked her eagle-eyes and her experience of seeing so many newborns pass by. I’d still have standard newborn hearing/screening etc done, probably at my peds office but she won’t like it.  I am assuming I will be low risk and I won’t have other issues. I feel that homebirth for a low risk mother and with excellent support and good transfer/insurance options for birth weirdness is probably as safe as hospital birth.

Not personally worried about bf’ing support. Nursed two infants and would find the support I needed if #3 was having problems.

Not that worried about my after-care. Birth #2 required no stitches and super fast recovery. I actually annoyed the doctor who delivered my placenta after post-birth hospital transfer by popping up and asking to take a shower. He rolled his eyes. (My midwife wasn’t there so OB did it.) Birth #1 had a bit of tearing and stitches (pushed on back) but I recovered fine.

Like the idea of little babe in cloth diapers and no bath from the beginning but could probably manage that in a hospital.

I don’t think I want family or other support there. In fact, I probably don’t. Maybe my mom, just as a presence.  I probably wouldn’t choose to have my kids there either. I think of my myself as this wild, out of control being with no time for anything other than focusing on labor. There is no high sweetie give me a backrub moments.

Don’t find the idea of “being home” to be a huge motivator really. But I do find the idea of “not being at a hospital” with bad advice giving nurses, formula bags, and somewhat disdainful staff (who assumed I was an UC’er) a plus. I like the hospital bed and be slightly upright and I like the two days to focus on baby and not older kids.

My primary motivator is that I want to be away from the temptation of drugs. I really can’t imagine feeling the same labor pain and turning down an epidural. I probably would have happily crawled over glass if I had them in my apartment. But when DH got home I wasn’t begging to go to the hospital either. I just would have taken the epi if had been offered. Of course, I was expecting 10 more hours or whatever and had no idea that I was making tremendous progress. If I knew or expected a shorter birth than I would have a different mindset maybe. And I DON’T want that [epidural]  birth again whatever my in-the-moment me wants.  The birth of #2 was arguably the best, most amazing moment of my life and I very much want a chance to do it again.

I’ve sort of assumed I would have a homebirth with #3 all along.

So ultimately, if feels like I want to be in a position to birth naturally but not have the options of drugs which makes birth center or homebirth the best option. But I somewhat concerned that some of the warm and fuzzy aspects of homebirth are not important to me, and some of them I would circumvent [CVS, 20w structural ultrasound, newborn examination]  but basically being denied drugs is really important, that therefore I really need to explore this choice. Am I missing something? Do I need to feel a certain way about homebirth to do it? Are birth center midwives “as good” as hombirth midwives?

Am I a good candidate for home birth?

[Marissamom]

the only "warm fuzzies" of my homebirth were from my mom who ended up acting as my doula, and it was just stroking my hair, and I think maybe holding my hand at one point. I had asked my midwife to be really hands-off during labor aside from making sure baby and I were doing well, so she checked heartbeat, checked to make sure I was dilated before I started to push (I wouldn't have had her check, but I was convinced I hadn't gone through transition yet, and the urge to push came a lot sooner than I expected), suggested a position change when baby had some heart decels, and helped with a sticky shoulder. I didn't choose homebirth for warm fuzzies, I chose it because I hated my hospital birth experience, and I felt we would receive better medical care and be treated with more respect at home. 

for the prenatal testing, in some states homebirth midwives can order those tests, in some they can't, it's something to ask a potential midwife, and if they can't then you can do OB prenatal care until after you've had the prenatal screenings you want, any midwife should be okay with that. 

most midwives are trained to do the basic newborn exams, the same exam you would get from the pedi at the hospital, and will do weight checks at all your post-partum appointments. and they will know how to get the hearing screen, etc. 

and birth-center midwives can be the same midwives that attend homebirths, or they could attend hospital births. either way, like any other care provider, there are both good and not-so-good. 

I don't think there's any reason for you not to have a home birth, if it's what you want. you do need to research the options in your area, who are the midwives, interview them, if there is a birth-center, take a tour. and think about what you would want logistically, who would you call to take care of your older kids, etc. 

good luck deciding what you will feel best about, it can be a hard decision. 

[Amatullah0]

I think the biggest thing you need to do is get your DH on board. Show him that you know what you're doing, that labor pain is good pain, and that you do not want drugs. Let him know that he is NOT to call MIL or call 911, or answer the door or phone for anyone without your permission. 

But after these family issues get cleaned up, you'd probably be good to go for a home birth. Whichever HB midwife you choose to hire would be able to tell you that though---they won't take you if there's something in your history to say that you are not a good candidate. 

And be prepared for another accidental UC, in case this labor is even shorter than DD2's. 

[bird_verde]

Quote:

Originally Posted by JudiAU 

So ultimately, if feels like I want to be in a position to birth naturally but not have the options of drugs which makes birth center or homebirth the best option. But I somewhat concerned that some of the warm and fuzzy aspects of homebirth are not important to me, and some of them I would circumvent [CVS, 20w structural ultrasound, newborn examination]  but basically being denied drugs is really important, that therefore I really need to explore this choice. Am I missing something? Do I need to feel a certain way about homebirth to do it? Are birth center midwives “as good” as hombirth midwives?

Am I a good candidate for home birth?

In general, yes, I think you are a good candidate for a homebirth. You have had sucessful vaginal births, trust your body and will probably be healthy during your pregnancy.  Ultimately, I think the determining factor of your candidacy and willingness to birth at home will come from your relationship with your midwife.  Each midwife is unique and they have their own personality and you may want to look for one that is more hands-off and perhaps a bit on the more professional side.  When you interview midwives, tell them your story and see how they react to your preferences and needs for birth.  Only you will know if it is the reaction you want from the person who is going to be at your birth.

Not everyone initially wants a hb for all the warm and fuzzies that come with it. For me, I wanted a hb primarily for financial reasons at first and also for the desire to control my environment and have a natural birth. It was after I had this amazing hb, that I started to appreciate all the warm fuzzy feelings that came along with a hb. 

Good luck in ttc and your search.  I think many midwives will give you a free consultation even while you are ttc.  Meeting with some of them now may help in your decision process. 

[JudiAU]

Thanks all. I should have said I am not opposed to warm and fuzzies. I just see it as a motivating factor on a lot on the boards which is why I brought it up. It may be that the midwife group I was with wasn't very warm and fuzzy and I didn't push it or really seek it out.

DH will likely do as I ask as long as I am low risk and have competent care. I wasn't planning on a homebirth before and he came home and didn't think he could get me to the hospital, hence the phone call. I was annoyed at the time because I thought I had a long time to go (i.e. minutes) but not at the time.