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Homebirth after pre-term deliveries?  

post #1 of 7
Thread Starter 
Hello everyone! This is my first time here, so please bear with me in what may turn into a somewhat long post.

I am 33 years old, and 6 weeks pregnant. This is my 5th pregnancy, and we are planning a homebirth. However there may be a problem

In the state of Florida, midwives cannot deliver a homebirth before 37 weeks gestation. My first two pregnancies, with the exception of hyperemesis, went beautifully, both born on their due dates, labor 2 1/2 hours both times, and absolutely no complications, no interventions, no drugs at all. However my last two were a different story. Both pregnancies were awesome, no morning sickness at all, however both were born "premature" at 35 weeks, and for entirely different reasons.

1st preterm birth happened when I had an awful case of bronchitis. I was coughing really hard one night, and ruptured my membranes. When we got to the midwives office the next morning (7 hours later), the litimus test said my membranes DID rupture, but I wasn't dilated or effaced at all. I was rushed into the hospital and induced with pit. It was awful, horrible, nightmarish... you get the picture. The doctor refused me an epidural, because in his words "You are making a stupid choice to put this baby up for adoption. The pain is your reward for it". I went through 37 hours of HELL before this baby was born healthy at 5 lbs. 6 oz.

2nd preterm birth was much different. My midwife delivered this one, also in the hospital. No interventions, no drugs in 4 1/2 hours. Delivery was PERFECT (except for the hospital aspect). Baby was born weighing 5 lbs even. The cause of this early delivery was caused by intense emotional stress at the time.

Both babies were completely healthy, no NICU, and went home when I did.

For this pregnancy, even before TTC, I took all the steps to minimize the risk of PTL. I'm eating better, avoiding stress, taking yoga classes.... but my midwife threw a brick in my path at my first appt. with her.

She said I have to be cleared by her supervising OB, before she can homebirth me, because I am now "High Risk" because of the two preterm births. I was told it was highly unlikely that I will be approved to homebirth, even if I do make it to 37 weeks. I just don't see the logic in that! If my pregnancy is healthy and complication free, how can I be denied a homebirth? Why write me off at the outset? As much as I would love to, and am comfortable with the idea, going UC is out of the question, because this is a surrogacy. The baby isn't mine, and it's parents really don't feel comfortable with UC.

Do you have any advice on how to try and convince this OB (who IS pro homebirth, BTW) to let me give this a shot? Also, any additional advice on avoiding PTL again?

Sorry this has turned into a book, but I'm really sad about this. I really DO NOT want to be in a hospital ever again. I'm sure you can understand why.

TIA,
Kathleen
post #2 of 7
It's probably part of their state licensing protocol which means a homebirth would put them on shaky ground legally -- say if something happened and you decided to sue.

You are so early in the pregnancy though -- surely you have plenty of time to shop around and find someone more accomodating?

Sorry I don't have more suggestions, good luck!
post #3 of 7
P.S. I hope you reported that doctor to whatever organizations he is accountable to -- state licensing board, hospital board of directors, etc. -- because his behavior was incredibly unprofessional and inappropriate. Sorry you got treated so poorly.
post #4 of 7
Thread Starter 
I reported the doctor to the head of the practice and the state board. The state gave him a repremand and he was suspended from practice for a month, nothing more

It isn't looking so good now for homebirth... I searched out the two other midwives in my area that do homebirths. One of them I have a personal conflict with, and won't use her services. The other is 100 miles away, but does deliver in my county.

I suggested to baby's mom that I contact the other midwife, give her my case history and see what she said. IM (intended mom) replied that she wants to stay with the practice we are with, and doesn't want to switch at all. If that doctor says no homebirth, then there will be no looking for an alternative.

I'm a bit disapointed at this point, but I won't let it depress me. Whatever happens, I will enjoy this pregnancy, and just hope that the doctor will allow me to homebirth once I make it to 37 weeks. Wish me luck
post #5 of 7
Good luck MamaKat. I hope you make it to 37 weeks and can deliver at home. May this birth experience be peaceful and life affirming!

I should say, it sounds kind of odd that the IM should be able to dictate where you have the baby. Yes, it is her baby, but isn't it your body that will be doing the labor? Is it always like that?
post #6 of 7
I am sorry that the intended mom does not agree with your choice of care givers, but YOU are the one in control here. YOU need to find a care giver who will make you feel comfortable, who will guide you and help you have a wonderful, healthy pregnancy. Maybe it woudl help to point out to the IM that a happy, healthy mama means a happy, healthy babe. I can't understand why IM gets to make the decisions....does she also get to make the decision as to whether or not you have pain medication, or your birthing position? Surely not! I hope you can help her understand how important this is to you. After all, you are both working to grow a very healthy baby, and *your* health and comfort directly affect the baby's.

While you certainly are at higher risk for another preterm birth, that does not mean that it is inevitable. I urge you to find a care giver who will not do routine vag exams, who understands the importance of nutrition (in both boosting your immune system to ward off infection as well as growing a strong bag!), and who spends alot of time with you. All of these factors will help prevent preterm birth. In general, OBs cannot provide this sort of care.

I also don't understand...why can't they just have two plans? I am a nurse at a free standing birthing center.....we accept people with a history of preterm labor. If they make it to 37 weeks, great, they have a birth center birth. If not, well, we all tried everything we could, and now, that is what hospitals are for as far as pregnancy and birth go: preterm labor and/or complications. The back up doc has privileges at both hospitals in the area, so she assumes care of our clients who, for whatever reason, end up in the hospital. So we *always* have plan A and plan B.

Hopefully you can convince your mw (and the IM) that you are a homebirth candidate. Let her know it is not "homebirth at all costs" that you understand that, if preterm birth is imminent, you of course want to go to the hospital; but that if you make it to 37 weeks, what reason can they give you NOT to have a homebirth? If they say, well, sorry, it is our policy, show them what you think of their policy by walking.

Good luck! I hope you can resolve this to a situation with which you are comfortable. Happy pregnancy!!!
post #7 of 7
2 consecutive Preterm labors with small babies is a risk factor, but one that can be worked out with an OB. You are certainly a candidate for home birth. Your midwife will want to consult with an OB, at least to ascertain your health, and so she has a back up in the event of another preterm birth you have a receiving hospital with a friendly OB. (In fact, any public hospital has to take you if you are in labor). As long as you reach your safe dates, you are at low risk.
Now, when you say "supervising" OB, is your midwife a CNM? LM's don't have supervising OBs. CNM's have less freedom when it comes to scope of practice. We do have a back-up we refer to/consult with when past history warrents. Maybe you need to find an LM (if your midwife isn't)? Or find another midwife.
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