Trust birth? - Page 2

[accountclosed3]

Originally Posted by YoMama2002 

ElizabethE:

I have a question for you specifically. If a baby dies during a UC, or becomes very ill, is it because the momma didn't trust herself enough? Don't you think the very thing you encourage young mothers to rely on for decision-making swings both ways? If it all goes wrong, a momma doesn't recognize grunting (for example) and it turns into full blown respiratory distress, is it because she didn't trust birth enough?

I'm also not the one to whom this is addressed, but I'm probably fairly close to Elizabeth's camp, and so I will also answer. :)

As I wrote before, I support women's *choices*. I believe that women have the capacity to make awesome choices for themselves and their babies. I believe that -- in most cases -- intuition and love will encourage a woman to get help when she needs it. In addition, our unconditional support of her as a human being with the capacity to make a good decision for herself will also encourage her to get help when she needs it. 

This will, in most cases, circumvent most negative consequences that can be prevented. Most women will seek help for themselves and their child. 

That being said, some circumstances cannot be prevented -- whether a woman is UCing or has full medical care at her disposal. At the end of the day, death and injury happens in birth. It happens in hospitals, birthing centers, home births, and UCs. No amount of anything is going to prevent it form happening on occasion.

No one is to blame when this happens, nor is it due to a fault or lack on anyone's part. It just happens. It is tragic that it is so, but it is so.

[ElizabethE]

Originally Posted by labortrials 

Heh heh, Elizabeth.  You remind me of one of my friends on another board.  She'll get me all pissed off and thinking about stuff, and then I calm down and get back in gear.  She doesn't sugar coat a THING, and at times it's a bit 'in your face;' and she's completely unapologetic about it (which makes no sense to 'eager to please' me).  But you're right, even the more outspoken 'radicals' are necessary voices in the mix.

I don't mean to be so "in your face". I'm actually a bit more reserved and subdued in person. :) Unless I get comfortable or fired up... >:)

[ElizabethE]

Originally Posted by YoMama2002 

ElizabethE:

I have a question for you specifically. If a baby dies during a UC, or becomes very ill, is it because the momma didn't trust herself enough? My gut reaction to that is "of course not! **** happens." Then I thought, well, when a baby dies in a hospital, the pros aren't always blameless... so what of that, to you? Is that just how it goes? Is that an acceptable loss from not trusting ourselves/birth?

Then I thought that there ARE possibilities where a fearful mother may have a chain reaction occur in her birth that results in a tragedy. In that case, it could be argued that she "didn't trust birth enough". I think that's what you wanted me to say. I'm not a person who that tells people that they can just believe and will anything into existence, and that if it didn't come true, they didn't wish hard enough-- but I am aware of a cause and effect between a mother's panic/fear state and how her labor progresses and results.

Don't you think the very thing you encourage young mothers to rely on for decision-making swings both ways? If it all goes wrong, a momma doesn't recognize grunting (for example) and it turns into full blown respiratory distress, is it because she didn't trust birth enough?

I think the problem here with people who take issue with me is, they completely misunderstand me-- where I'm coming from, the total picture, etc. It's far more fun to generalize me and my statements rather than trying to read them word for word, and see me as an individual. I've been misquoted, misrepresented, and blamed for things in which I never even took part in the conversations.

As an example of what you are asking about, if my intuition told me to go to the hospital, I would, and I wouldn't beat myself up over it. I encourage all mothers to do the same. But, I truly hope that people recognize the difference between their intuition and just plain fear. That is the bubble I am hoping to burst here. A lot of women have to get over that "hump" of still being generally fearful and apprehensive about birth. Once they have truly conquered that, listening to intuition tell you to go to the hospital would be far easier to do.

In the event of the favorite "grunting" topic as of late, I don't think that has so much to do with trusting birth (well, maybe indirectly) as it has to do with trusting your maternal nature and instinct. If you feel there is something to fear, by all means seek someone else's help. If I had even the slightest notion that my baby were not totally normal and healthy, that some unknown was wrong with it, I would seek a doctor. If you truly think you're in trouble and somebody else knows better, go for it! I think the problem with the "guests" here is that they are uncomfortable with just how often we UCers will not feel like we need outside help. If it's outside of your comfort zone, I just think it should be gotten over. We are the ones who have to live with it, not you.
 

[ElizabethE]

Originally Posted by YoMama2002 

Thanks for the response. I agree. It just seems some of the more "extreme" women on this site have the view that intuition and love will see an emergency through. I'll address this, below. I just don't believe that and I wonder how someone like ElizabethE would answer to it. If something happens in a home birth or UC, whose fault is it? That varies (duh?). I sense that ElizabethE would place blame on not being positive enough. Then you've completely misunderstood me. Ot trusting enough. Or open enough. Isn't that just placing blame on the mother? Yeah, and that's not my philosophy. I'm not about blame, but I am about responsibility and accountability. What that means to me is that I will do all I can within my power, and if that is exhausted, I will move on to Plan B. But I call the shots and make the choices. If a fatality occurs whether I made the choice to be at home or at a hospital, it was still always me who made the choice, and no matter what, I will have to live with that. If my baby had died in the hospital, I wouldn't be to "blame", but I could not remove my responsibility of the choices I made just because a doctor oversaw it. Dig? So, I have no illusions about that and my role in birth, and I am not comfortable with putting it in someone else's hands unless I feel it is totally necessary (say like, a truly warranted surgery, for example).  Isn't it downright dangerous to suggest that intuition should trump medical training and equipment? Only if it's misguided "intuition", or an across the board belief. There's exceptions to every rule and I'm open to that.

How would she reconcile my friends dead baby? How would I even know what happened to your friend? Even if I did, why would I speak to you on my opinions of it? You don't want me, you want to talk it out in therapy. That's a very angry question. I'm not the enemy, here. Homebirth is not the enemy. I didn't hurt your friend and I didn't invent homebirth, and it's not my fault if my story ended up being different from hers. I don't think singling me out is going to resolve anything for anyone.

I believe in intuition and I believe in love and I even believe in miracles. I believe in things you can't see right in front of your face. But they are not the only thing to rely upon (IMHO). There are lots of uncertainties in life and as much as we may put our faith in any concept or any deity, life throws us curve balls all the time and quite honestly, most of us will not truly understand all the reasons why every single event happens to us. We have to be prepared for the unexpected because of that. We have to know how to accept it, or how to manipulate the situation wherever possible, for the better. I have never told everyone that love would get them through everything and be the only answer. I'm a very practical person. While most UC mamas are recommending Gaskin, I'm recommending Emergency Childbirth. Neither one is superior to the other, and they serve very different and useful purposes. I find that if a woman feels technically prepared for all scenarios she can imagine, and has emergency plans in place for everything, the moral support and feel-good emotional stuff will just be icing on the cake to help motivate her and empower her.

HTH.

Edited by ElizabethE - 5/23/11 at 6:33pm

[labortrials]

I missed this before:

Isn't it downright dangerous to suggest that intuition should trump medical training and equipment?

I think that women that continue to ask this type a question may not be well-suited to homebirth with a trained professional much less UC.  I find a particularly odd question on a UC support forum.  It seems to me like a leading question for a debate.

[leahsmama]

Originally Posted by ElizabethE 

...In the event of the favorite "grunting" topic as of late, I don't think that has so much to do with trusting birth (well, maybe indirectly) as it has to do with trusting your maternal nature and instinct. If you feel there is something to fear, by all means seek someone else's help. If I had even the slightest notion that my baby were not totally normal and healthy, that some unknown was wrong with it, I would seek a doctor. If you truly think you're in trouble and somebody else knows better, go for it! I think the problem with the "guests" here is that they are uncomfortable with just how often we UCers will not feel like we need outside help. If it's outside of your comfort zone, I just think it should be gotten over. We are the ones who have to live with it, not you.

Here's where you are losing me. I am really, truly trying to understand your perspective. I feel like there are times when someone wouldn't realize that their baby was "not totally normal and healthy" in time to get help. You seem to feel that a mother always knows when something isn't right and in my experience that is simply not the case.

[accountclosed3]

In my experience, it is the case.

How many stories have you read/heard where a mother "knew" something was wrong, but no doctor would listen or could find something, and she finally found someone who DID find something, and with just enough time to get treatment? I have heard many, and I have seen this over and over.

I have also had the experience where the situation was serious -- a heart defect -- and a UC mama noticed/knew within an hour of the birth that her baby needed help. She went to get that help as soon as she realized it was time to go. Her doctor saw her right away, and sent the baby to the hospital for a specialist to have a listen. Her doctor suspected a certain heart condition, and it was verified at the hospital. later that day, the baby had surgery, and everything was fine. The mother didn't know to look for the heart defect, btu she just knew something wasn't right. And it's not like the defect runs in her family AND she had ultrasounds throughout and they did not pick up on this heart defect. She just "knew."

I think that if a mom feels any concern about her baby, she's going to seek help.

[accountclosed3]

Also, no one said that intuition should "trump" medical training and equipment, but rather that intution can help a woman determine when and whether medical training and equipment is necessary for her or her child.

We do not categorically eschew medical training or equipment, nor do I, personally, take issue with it. I only take issue with it's misuse and/or overuse. Much of medicalized birthing is not evidence based, it's based in philosophy, policy and law. When it is used but not necessary, it is more likely to cause harm than good, which is the antithesis of the very purpose of the medicine and the machines. When it is used unnecessarily, a finite resource is not adequately distributed, such that women who do need the care may not have adequate access -- affecting them and their children. 

There are times when medical training and machines are necessary, and a mother is very likely to know when this is before anyone else is. :) And honestly, a LOT of UCers use medical training and machines throughout their pregnancies to help facilitate their process, and wouldn't hesitate to use one should they feel it is necessary.

[ursusarctos]

Originally Posted by zoebird 

Also, no one said that intuition should "trump" medical training and equipment, but rather that intution can help a woman determine when and whether medical training and equipment is necessary for her or her child.

We do not categorically eschew medical training or equipment, nor do I, personally, take issue with it. I only take issue with it's misuse and/or overuse. Much of medicalized birthing is not evidence based, it's based in philosophy, policy and law. When it is used but not necessary, it is more likely to cause harm than good, which is the antithesis of the very purpose of the medicine and the machines. When it is used unnecessarily, a finite resource is not adequately distributed, such that women who do need the care may not have adequate access -- affecting them and their children. 

There are times when medical training and machines are necessary, and a mother is very likely to know when this is before anyone else is. :) And honestly, a LOT of UCers use medical training and machines throughout their pregnancies to help facilitate their process, and wouldn't hesitate to use one should they feel it is necessary.

 

I have to say, I have read many, many more stories where the mother *knew* something was wrong before the midwife or doctor picked up on it than stories where medical technology or expertise detected a problem out of the blue and saved the day. Not that the latter doesn't happen, but it seems to be far less common. I personally feel *least* safe putting my trust in someone other than myself, no matter how educated or experienced, to detect problems that might arise. I have just read way too many stories where the care provider discounted or ignored the mother's instincts, trusting their own external evaluation instead, with bad results. Even if I did birth with an attendant, it would be so that they could be around to help if *I* detected a problem. I simply do not trust them to do it for me, so I would definitely be "on" regardless of how much I was monitered from the outside. 

[labortrials]

I agree with these last 2 posts.  I think I may have used language similar to the 'intuition trumping medical-ism,' but it was in a completely different context on a different thread.

I'm not sure if I would 'know' something was wrong or not.  But I'm not sure that's really even the point or has anything to do with trusting birth or being prepared/capable in handling emergency situations from home.

[ElizabethE]

Originally Posted by leahsmama 

Here's where you are losing me. I am really, truly trying to understand your perspective. I feel like there are times when someone wouldn't realize that their baby was "not totally normal and healthy" in time to get help. You seem to feel that a mother always knows when something isn't right and in my experience that is simply not the case.

First of all, YES to everything Zoe and Urs just said in response to this below you.

Now for me to answer you. My point that I keep trying to bring up is that if you really distrust new moms to recognize the signs of trouble in their newborn, how in the hell do you expect them to keep up for the next year of their infancy? The next 18 years? The next lifetime? 'Cause when disaster strikes, it doesn't just strike in the beginning. It could even happen the very day the newborn is released from the hospital and is at home. Day 3 or 4 is not some magic number in terms of being ready for life outside the hospital. But, yet, we still send moms home with their babies in that time and expect them to fare well. When you become a parent, a certain amount of responsibility and trust is placed with you that you have what it takes to do what's best for your baby. Sadly, sometimes this doesn't work out, but has little to do with homebirth vs. hospital and a lot more to do with the individuals involved and how they react in whatever particular circumstances come their way. And sometimes, just plain bad luck occurs to even the most observant of parents OR practitioners. Trying to pin that on home birth in some crude generalization is unfounded.

So many things in life could be "missed signs" for something or another, but who's going to live their lives that way? Why not just live in a hospital, if that's your point of view? My opinion is if the mom is fit enough to take the baby home from the hospital or birthing center, she may also be fit enough to spend the first couple of days at home with the baby in the first place. If we think moms are that incompetent, there are greater questions at hand here regarding parenting and choices.

Now for people who know people who had personal experiences with "not knowing" and disaster striking, I can't obviously speak about them without knowing everything, and nor should I since that's personal for each case, and could potentially be offensive. In the interest of being fair and cutting everyone a little slack, giving benefit of the doubt (which is MORE than is being given for me/us/UC), I will say that sometimes even the best of moms miss things or make mistakes. That's not the rule, but the exception, and does happen. But, you don't need to be at home for that to happen. It can happen anywhere and at any time. In a hospital, or at home. Failing to realize that is just an (not conscious?) attempt to absolve oneself of ultimate responsibility, IMHO. We can attempt to place all the risk and all the blame in the hands of any number of so-called "professionals", but at the end of the day we always have a choice and it is always THAT choice we have to live with. I UC because I have no illusions about that and had finally become comfortable with that. I accept. To reject, for me, would to be in denial of what is.

I notice that so many tragic stories have that turning point, that moment of doubt. I call that the intuition. If at any moment you were thinking that something was not quite right, by all means get it checked. This is not and never has been just in the nurse's, doctor's, doula's, or midwife's hands. It's in yours. Don't hesitate. If you get a professional opinion that doesn't sit well with you, get a second one. By all means listen to your instincts and do what you feel is right. You could save a life.

This is why I encourage mamas to listen to theirs [intuition, instinct]. But they can't do that as long as everyone is making them fearful that theirs isn't enough, or doesn't compare to a pro's skills. I am trying to dissolve those conditioned views of fear and distrust of themselves. Hopefully you can see how this averts tragedies.

And again to reiterate from the others-- I'm not totally anti-medical care. I just realize there is a time and a place for it, and my belief is that we abuse it.

[labortrials]

Originally Posted by ElizabethE 

'Cause when disaster strikes, it doesn't just strike in the beginning. It could even happen the very day the newborn is released from the hospital and is at home. Day 3 or 4 is not some magic number in terms of being ready for life outside the hospital. But, yet, we still send moms home with their babies in that time and expect them to fare well. 

Mmmm, very good point.  We had a 'blue baby' scare within 24 hours of leaving the hospital.  Baby was napping, and if MIL hadn't noticed her . . . I think we'd have lost her.  Nearly 2 years later . . . it still makes me feel sick (and thankful for my baby girl's life).

Thanks, Elizabeth.  A really good thing for me to keep in mind.  Puts my mind at ease . . . not that I'm particularly concerned about a 'strange' baby emergency at home.  Oh no, I have other birth baggage bopping about my crazy brain. 

[MittensKittens]

Originally Posted by labortrials 

Mmmm, very good point.  We had a 'blue baby' scare within 24 hours of leaving the hospital.  Baby was napping, and if MIL hadn't noticed her . . . I think we'd have lost her.  Nearly 2 years later . . . it still makes me feel sick (and thankful for my baby girl's life).

Thanks, Elizabeth.  A really good thing for me to keep in mind.  Puts my mind at ease . . . not that I'm particularly concerned about a 'strange' baby emergency at home.  Oh no, I have other birth baggage bopping about my crazy brain. 

Of course, the time after birth IS unique. The baby switches from a system in which oxygen is received from the placenta to using its lungs for the very first time. Apparently, breathing often requires quite a bit of effort right after birth. This is not to say that parents are not fit to watch out for warning signs themselves, but we should not just assume everything is fine I think - the responsibility of UC does not end after your baby got out, but continues for the rest of his life (as Elizabeth said). This includes watching out for those dreaded "grunting sounds".

[leahsmama]

Originally Posted by ElizabethE 

'Cause when disaster strikes, it doesn't just strike in the beginning. It could even happen the very day the newborn is released from the hospital and is at home. Day 3 or 4 is not some magic number in terms of being ready for life outside the hospital. But, yet, we still send moms home with their babies in that time and expect them to fare well. 

No, but the immediate post-birth period is one of the riskiest in a persons life. The transition to life outside the womb requires a lot of effort and there is a lot happening. Once the first 24hrs or so have passed, there is a lot less risk to the baby developing problems. Most things have presented themselves by this time.

Thank you for your explanation, but I think you are over reaching when you are saying "So many things in life could be "missed signs" for something or another, but who's going to live their lives that way? Why not just live in a hospital, if that's your point of view?" Again, the immediate post-birth period is when most problems with the baby are going to present. If there are congenital malformations that are immediately threatening, if the baby is not transitioning well, this is when it's going to crop up. So having the baby assessed and observed by a professional post-birth is going to catch things that no one can reasonably expect a parent to notice.

[labortrials]

Originally Posted by MittensKittens 

Of course, the time after birth IS unique. The baby switches from a system in which oxygen is received from the placenta to using its lungs for the very first time. Apparently, breathing often requires quite a bit of effort right after birth. This is not to say that parents are not fit to watch out for warning signs themselves, but we should not just assume everything is fine I think - the responsibility of UC does not end after your baby got out, but continues for the rest of his life (as Elizabeth said). This includes watching out for those dreaded "grunting sounds".

Ok, I get ya.  But (and this is not uniquely a UC thing) isn't that part of the justification for delayed cord clamping?  To aid the switch from placental oxygen to room air?  And regardless of birth venue, a woman can leave a hospital or birth center within hours of a 'normal' delivery.  And I'm just saying that based on my previous experiences, I would not anticipate having any 'hidden' issues with a new baby.  But that's just me.  And regardless, I'm probably not doing this birth unassisted.  Probably not this time . . . which means, probably never.

Oh, and one more thing . . . just because I'm hiring a CP doesn't mean that ensures that strange baby stuff would be caught (at home or hospital) and/or dealt with in a timely fashion.
 

[ursusarctos]

Originally Posted by labortrials 


 And regardless of birth venue, a woman can leave a hospital or birth center within hours of a 'normal' delivery.

Yes, this. In fact, in the country where I live, which has a far lower infant mortality rate than the US, 2nd and 3rd (and more) time mothers generally leave the hospital about 6 hours after birth. It's obviously not that dangerous considering the statistical results. And I also very much agree with Elizabeth's point that there is no magical time when the baby is suddenly "out of danger" and therefore the mother can then be trusted with it. I think the main thing is that mothers are informed (by themselves or their care providers) of signs to look out for that might mean the baby is in trouble.

[MittensKittens]

Originally Posted by labortrials 

Ok, I get ya.  But (and this is not uniquely a UC thing) isn't that part of the justification for delayed cord clamping?  To aid the switch from placental oxygen to room air?  And regardless of birth venue, a woman can leave a hospital or birth center within hours of a 'normal' delivery.  And I'm just saying that based on my previous experiences, I would not anticipate having any 'hidden' issues with a new baby.  But that's just me.  And regardless, I'm probably not doing this birth unassisted.  Probably not this time . . . which means, probably never.

Oh, and one more thing . . . just because I'm hiring a CP doesn't mean that ensures that strange baby stuff would be caught (at home or hospital) and/or dealt with in a timely fashion.
 

Sure, delayed (physiological) cord cutting would help, but it would not guarantee no problems. If there is a fundamental problem, you will start noticing it after the placenta stops providing oxygen regardless of when you cut it. And yes, hiring a "professional" does not ensure anything, I agree. It could even cause problems that you would not have had with a UC. But... It is good to be aware of these things, no matter where we give birth, but especially for a UC.

[ElizabethE]

Originally Posted by leahsmama 

No, but the immediate post-birth period is one of the riskiest in a persons life. The transition to life outside the womb requires a lot of effort and there is a lot happening. Once the first 24hrs or so have passed, there is a lot less risk to the baby developing problems. Most things have presented themselves by this time.

Thank you for your explanation, but I think you are over reaching when you are saying "So many things in life could be "missed signs" for something or another, but who's going to live their lives that way? Why not just live in a hospital, if that's your point of view?" Again, the immediate post-birth period is when most problems with the baby are going to present. If there are congenital malformations that are immediately threatening, if the baby is not transitioning well, this is when it's going to crop up. So having the baby assessed and observed by a professional post-birth is going to catch things that no one can reasonably expect a parent to notice.

Not generally speaking! That's part of the "miracle of life". Surprisingly little is typically needed. Adaptation normally occurs. The first 24 hours or so of a baby's life is precisely the point. Just when is it safe to fully entrust the mother and her instincts to be able to parent her child without any help? Or is she never fully capable, and intuition is just some crackhead idea to make mothers feel all magical and special?

So, your logic basically says babies need to be born in hospitals. You know, just in case. Because those first 24 hours or so are major scary and deadly. And only a doctor could spot it. And doctors always save the day and catch everything, even before mothers. In fact, nothing bad ever happens to babies in hospitals, especially not of the preventable nature. Babies never contract anything from hospitals, either, during those fragile first days.

Some of us have seen enough in the hospital that we'll "take our chances" at home. The role of those dice seems far more benign than the alternative.

[MittensKittens]

Originally Posted by ElizabethE 

So, your logic basically says babies need to be born in hospitals. You know, just in case. Because those first 24 hours or so are major scary and deadly. And only a doctor could spot it. And doctors always save the day and catch everything, even before mothers. In fact, nothing bad ever happens to babies in hospitals, especially not of the preventable nature. Babies never contract anything from hospitals, either, during those fragile first days.

But birthing in a hospital does not mean you are actually there 24 hours. In many countries, mom and baby can go home after four hours.

In my personal opinion, all this means is that one should be on the look-out for breathing difficulties - it is something parents should know about.

[leahsmama]

Originally Posted by ElizabethE 

So, your logic basically says babies need to be born in hospitals. You know, just in case. Because those first 24 hours or so are major scary and deadly. And only a doctor could spot it. And doctors always save the day and catch everything, even before mothers. In fact, nothing bad ever happens to babies in hospitals, especially not of the preventable nature. Babies never contract anything from hospitals, either, during those fragile first days.

Some of us have seen enough in the hospital that we'll "take our chances" at home. The role of those dice seems far more benign than the alternative.

I though you might be interested in helping me understand you point of view. Clearly, I was mistaken. There was no need to be snotty. I was quite respectful to you.

Last thing I'm going to say here: I said professional which does not necessarily mean a doctor, Nurses, midwives all fall under the professional category.