Any "high risk" homebirths? Can that happen?

[mammamoon]

Hello,I've never posted here, but was wondering if there is anyone who is high risk and still having a homebirth.
Anyone being allowed HB after having a late miscarraige, still birth or even a child born with a congenital defect?

Without going into to all of my history and the current issues that are going on in my life I'm just trying to figure a way to have a homebirth with my complicated history. I must be crazy, but I share everyones passion about birthing at home but can't achieve it and feel so victimized by the medical professionals. I know my body and with sonograms every two weeks since the first month we can obviously see that the baby is healthy. Anyway, I'm rambling, I am just looking for others in my situation (which is hopefully rare).

[lolar2]

Originally Posted by mammamoon

Hello,I've never posted here, but was wondering if there is anyone who is high risk and still having a homebirth.
Anyone being allowed HB after having a late miscarraige, still birth or even a child born with a congenital defect?

Without going into to all of my history and the current issues that are going on in my life I'm just trying to figure a way to have a homebirth with my complicated history. I must be crazy, but I share everyones passion about birthing at home but can't achieve it and feel so victimized by the medical professionals. I know my body and with sonograms every two weeks since the first month we can obviously see that the baby is healthy. Anyway, I'm rambling, I am just looking for others in my situation (which is hopefully rare).

I had a stillbirth at 6 months' gestation, and am having a homebirth this time with a CNM practice in conjunction with a perinatologist. I am on blood thinners, and took the AFP test to confirm that I was at a lower risk this time (I have a thrombophilia which showed up in my first pregnancy as an abnormal AFP result). My perinatologist will do regular growth ultrasounds starting at about 32 weeks, and my CNMs may do NSTs around then-- they have not decided for sure.

Anyway, in my case, the thrombophilia ONLY shows up in pregnancy, ONLY ever seems to affect the fetus (I took birth control pills for years without a clot), and if the baby starts to have problems I am willing to have an OB do a stat C/S if necessary. Though I don't expect it will be necessary with the treatment I'm on.

Whether you, yourself, can have a homebirth safely and/ or find someone to do it, depends on the reason for your former loss and probably on the laws in your area. In California, CNMs can do homebirths and can work with perinatologists no problem.

[alegna]

I think it largely depends on your midwife. I know a midwife here that would be willing to take on such a case in the right situation.

-Angela

[lolar2]

Yes, the way I figured it out was to contact my first-choice midwife group and see if they would/ could take my case. If they hadn't, I would have gone down the list of midwives until I found one or found that no one would do it.

[kerikadi]

Originally Posted by alegna

I think it largely depends on your midwife. I know a midwife here that would be willing to take on such a case in the right situation.
-Angela

I agree.

I have a friend who has had 2 miscarriages that were pretty late (not sure how many weeks) AND had a baby with trisonomy 18 I think - her heart was not developed and her skull wasn't fully formed. We have the same MW and during the pregnancy the MW felt there was something 'not right' and strongly recommeneded a U/S even though this Mama doesn't dig U/S. They found the defect, they knew that their baby would never live outside her womb. She went on to have that baby at home and then a healthy baby at home after that one.

I think it depends greatly on who your provider is and how much trust she has in the whole pregnancy/birthing process. Unfortunately, you live in a state where it is already hard to find a HB MW, I am sure there are some but they can be hard to find.

Good luck,
Keri

[rachelagain]

I have had 4 m/c- but they have all been in the first trimester. In the medical community this makes me high risk-- I'm seeing a Dr. who is talking w/ a OB specialist... for her own reasons! I'm having a hb w/ my mw- but she is out of state and won't come until April.
The Dr. is thinking (and actually said) if you have to transport in labor it will most likely be a c/s- so that is what we'll plan for.
My response was- ok, if you feel you need to... but I already know I feel more comfortable w/ the birth process than she does. My mw has no qualms about assisting-- she herself has had alot of m/c's.
But it would depend on your history and the mw's knowledge, etc. I would encourage you to look for a mw though.

[torio]

Lolar2, I'm impressed--it sounds like you've got a great attitude for a potentially difficult situation. Good luck.

It's interesting to me to learn about the incredible range of what's considered high risk. I feel lucky that my only risk is age. I'll be 42 when (universe willing!) our first baby is born. I also feel lucky that our midwife has confidence in me/my body.

[chantald]

I am considered High Risk, I have had 2 prior c/sections & I am over 35.. My MW is confident that we can do this and we have discussed the critera for a transfer.. I'll only do that if I need a c/s.. And I am planning a homebirth in Jan..

Good luck to you.. *hugs*

[lolar2]

Originally Posted by torio

Lolar2, I'm impressed--it sounds like you've got a great attitude for a potentially difficult situation. Good luck.

It's interesting to me to learn about the incredible range of what's considered high risk. I feel lucky that my only risk is age. I'll be 42 when (universe willing!) our first baby is born. I also feel lucky that our midwife has confidence in me/my body.

Aw, thanks! I had to do lots of research, but I had a secret weapon-- a friend who works in a hematologist's office. She helped me cut through a lot of my confusion by telling me what terms to look for in PubMed searches, etc. And living in California makes a difference; if I couldn't see a perinatologist in conjunction with a homebirth midwife without getting one or both of them in trouble, I don't know that I would have continued pursuing a homebirth.

[mammamoon]

Thank you so much. All of the responses are helpful. There is really no reason why I can't have my HB, But unfortunatley it is up to the MW's and Dr.'s here and I don't have many chioces.
I had an early miscarriage then I had a still birth at 6 months, and after all of that my son now 3 was born with a serious congenital heart defect that required 2 open heart surgeries. They never did test to find out why I had the still birth, and our sons heart was just taht 1%, it's not hereditary and there was nothing we could have done to prevent it. Sounds scary, but I birth beautifully, and this baby appears to be so healthy, we've had over 20 sonograms by now at least. I trust my body to the fullest. You know an God or the universe or whatever you want to call that omnitient force is in control of the rest, am I right?

I'm going to look for another practitioner that might attend a homebirth, maybe threaten my doc and MW to go unassisted if they do not help which I'm still debating (though I might be burning bridges by doing that)
And if that does not work I am writting an elaborate very strong birth plan that I know will be hard to acheive in a hospital down here.
To make matters worse my dr. is going out of town the week before I deliver. I might be stuck with his back up.

The stars are not linning up for us right now, but things have to start looking up. The universe has given me way to much trauma in the past. I think it is my turn for some peace.

Thanks for listening!

[lolar2]

Okay Mammamoon, if you had an unexplained stillbirth at 6 months, that is a strong indication of a thrombophilia. Did you see a hematologist or a perinatologist? If your baby is growing normally so far and you are past 22 weeks or so, things are probably fine with the baby. But you should know that if you have an unexplained stillbirth, and no further testing is done, it can be a sign that you are at a higher-than-average risk for having a blood clot at any time in life or a heart attack or stroke when you are 50 or 60. So make sure you are crystal clear on ALL the warning signs of blood clots, heart attacks, and strokes so as to protect your own health in the future. If you are not yet past 22 weeks, be aware that the baby might slow down in growth at that point. (Sounds like you are though, if you've had 20 sonograms!) Also if you plan to have more babies, it could be protective of both your health and theirs if you get a perinatologist or hematologist to test you for thrombophilias.

A fairly common pattern is that of a woman I know who is in her 50s. She had two late miscarriages (4 months and 5 months), one baby born perfectly healthy, and one low-birth-weight baby who is a healthy 24-year-old now but had a rough start. Then when she was about 40, she had a blood clot on an airplane, so now she takes low-dose aspirin every day.

[velcromom]

Originally Posted by chantald

I am considered High Risk, I have had 2 prior c/sections & I am over 35.. My MW is confident that we can do this and we have discussed the critera for a transfer.. I'll only do that if I need a c/s.. And I am planning a homebirth in Jan..

Good luck to you.. *hugs*

Same here. 2 prior c/s, will be 40 soon. I have not chose a midwife yet but have spoken to 3 who had no problem considering me as a client. A fourth expressed reservations because of political concerns, not because of any medical reason.

I highly suggest just getting on the phone and calling some midwives. It really helped me figure out what I wanted to plan for this next little one.

[cynde]

any signs of thrombophilia?

Are there any signs or symptoms to look for for thrombophilia?
I have been concerned about not gaining more than 4 pounds - I am at 22 weeks (although I was a little overweight to begin with) and I have a weird warm, pooling, numb sensation in my hip when I try to sleep in my left side for very long.

[MotherWhimsey]

I had a miscarriage at 16 weeks, then had a healthy baby, and now am having a homebirth. Not quite as many complications or "high risk factors" as you have, but my midwife never said anything about my late miscarriage making me high risk.

[lolar2]

Signs/ symptoms of thrombophilia in pregnancy: high alpha-feto-protein level in the absence of a neural tube defect, three first-trimester miscarriages or one second- or third-trimester miscarriage/ stillbirth, intrauterine growth restriction. Outside of pregnancy: occurance of an actual blood clot (DVT, pulmonary embolism, stroke or heart attack, etc.)-- more common if taking birth control pills or pregnant but possible without either. Many thrombophilias are detectable by a hematologist (it's a blood test) but there are thought to be some which haven't been discovered yet. In my case, I had the high alpha-feto-protein level without NTD plus a late miscarriage, plus I have ulcerative colitis and autoimmune disorders are a risk factor, so although no thrombophilia was detected by the blood test, my perinatologist gave me the option of taking anticoagulation during pregnancy. He presented it in a very mild way-- like "I can't outright say that it's necessary, but you can make a reasonable case for taking it." I have taken it. So far, things look good.

[wildthing]

I didn't realize I had any risk factors, because I have had my last 5 babies at home and always had midwifery care. However, when I was talking to a midwife who works at a local birth center, she told me that I would be automatically risked out of the BC. Grand multi-para, 39yo, one bad shoulder dystocia. I sure don't feel high risk.

[mammamoon]

Lolar thanks for the warning.
After the stillbirth they did notice a possible clot in the plecenta, so for my son I took low dose asprin. I am not taking it with this pregnancy, I was afraid it contributed to his heart defect.
I was really unhealthy when I had my stillborn son. I was only 17 at the time and I had been a heavy smoker through out highschool and just had that unhealthy lifestlyle which I think all played a part. After that I transformed into a health nut, practicing a macrobiotic diet, doing yoga regularly and had a healthy strong pregnancy 2 years later.

I seriously doubt that I have that condition. I am a very healthy 23 year old, with no history of any medical problems. But of course it wouldn't hurt to test for thrombophilias just in case.

[lolar2]

Yes, smoking is of course a risk factor for blood clots both during and not during pregnancy. Even very healthy 23-year-olds can still get them though, since some types of thrombophilia are 100% genetic and have nothing to do with lifestyle, so it is worth a blood test to be on the safe side.

[Spark]

I think it really depends on the mother's viewpoint and the MW (if she chooses) who assists her.

My water broke at 31/32 weeks. I used a MW to monitor me at home and she helped us seal the bag of water and refill it. Later I birthed my baby at 41.5 weeks. I wouldn't consider that high risk, just a variation of normal.

[moonfirefaery]

The safety of sonograms has not been proven, and there is a high chance that prolonged exposure to ultrasonic rays can cause problems for the child. I'd really suggest you ask to start having them every 3 or 4 weeks instead, especially if the baby is healthy so far. There are links in some of the stickies about the possible dangers of repeated ultrasounds.

If everything seems fine on the ultrasound screen I don't see why a homebirth wouldn't be a possibility; you could always transfer to the hospital if something goes wrong. There are plenty of cases where high risk patients deliver healthy babies at home.

Where you birth is not up to the doctors or midwives, but to you. Perhaps you should look for another attendant who will be more open to a homebirth? That may mean paying out of pocket OR going through the hassel of trying to convince the insurance company to cover someone else.

I think threatening to go unassisted may help sway them, but it's not likely. They may end up causing trouble for you by calling CPS, for though it should be illegal by our laws to harrass people about their birth choices, unfortunately that still happens.

You could seriously consider birthing unassisted, perhaps with an EMT team on standby just in case? If you are continuing to receive medical care and sense no problems, I don't see how UC would be unsafe if THIS pregnancy is going well.

If you end up going into labor a few months premature again, you can go birth in the hospital instead; homebirth doesn't mean you birth there no matter what, just that you plan to do so if everything goes to plan.

You are much older now, much more ready to have a baby physically, and much healthier, and I think you should be a fine candidate for homebirth or even UC. I'm no expert, though. Good luck. I hope you get the birth you want! Just don't give up!