Planning an *unassisted* birth (but with a midwife in the house)

[Synchro246]

I know I'm not the only one who plans births like this. I don't know if this is the right forum or if homebirth would be better. I know some of you have personal definitions of UC that are more strict than mine. I am considering what I am about to do *unassisted*, but attended.
I have done most of my own prenatal care. I've met with my friend/midwife about three times in this pregnancy. She's very comfortable not doing anything unless I request it at the time. That's the default setting for our interactions. It works very well for me.

Ok-- here's where I'd like a little guideance/some ideas

When I go into labor I will be calling her at some point to come. She's a little over an hour and a half away. I have a room set up for the birth tub and with all the birth supplies in it. At the other side of the house is my bedroom/master bath. I imagine I birth in one of these three rooms (though you never know).
Anyway.
I'm really planning on not *needing* her for much of anything. At the very least I do want her to pop in when the baby comes out and hang back, and *should* the baby need any help she could hop in there. If the baby doesn't need help (most likey) just continue to hang back until the placenta comes out. I do want her to check for tearing and hemorrhage (I'm a little nervous about my cervix tearing again) and I want her to do a newborn exam at some point (after we settle in). I'm not at all worried about being or feeling "watched" as I deliver, though I don't want hands on or around me (unless I'm on land, then maybe a spotter for the baby, preferably DH if he wants)

Given what I want and the fact that I'm Planning on a normal healty delivery of a normal healty infant and the midwife coming is (or seems) very comfortable being very hands off is there anything that I should/could/might want to do just to make things go smoothly. Any suggestions about what to say if I start to feel my boundries being crossed?
Any suggestions of what to do should I feel myself doubting myself/loosing autonomy(from within)?

Geez, this post isn't very clear. . .I don't know *exactly* what I'm looking for. . .I want to make this as much unassisted as possible (without actually not having her there--that I just wouldn't be comfortable with).

Thanks

[2bluefish]

I'm not opposed to this idea. It appeals to me alot. But I figured out that I am easily angered during labor, and people giving me suggestions - even harmless, do what you want kind of suggestions - seems to irk me. I'm hoping that keeping people away this time will help my labor go more smoothly. I guess I'll know in 6 months.

I wish I had some good suggestions, but I've tried this scenario twice and it just didn't work out for me. Might for you though, it has for others.

[DreamsInDigital]

This is exactly what I had for my last birth and it was absolutely the best of both worlds. My midwife and her apprentice sat on my couch knitting while my DP caught our baby girl. It was beautiful.
I was thankful she was there for us for afterwards though because I hemmorhaged, and the extra hands to care for me while DP held the baby was great. We will likely ask her to attend our next birth and plan it very much the same.
If she had done anything that crossed my comfort lines, I'd just simply state "I'd like you to not xxxx" or something like that.
If you feel like you're losing autonomy, I would say go into another room and shut the door. My plan was to head into the bathroom if I felt disturbed too much. Thankfully my midwife really did respect my wishes and I didn't end up having to leave the room at any time.

[SublimeBirthGirl]

For me, I knew that to maintain inner autonomy, I could not have a birth professional in the house. I knew from my 1st birth i would look to that person because she was there. And I hate that feeling (not everyone does). The only way *I* could avoid that, for sure, was to not have a midwife there. Maybe if that happens to you, another room would be enough.

Eat well, take care of yourself, trust your instincts. IMO that's what most of us need.

[cottonwood]

Ohhhh -- these are great questions. This is not something I've thought about, really, because I have issues you don't (with being watched, etc.) that rule out a midwife being there in the first place. BUT, women have a spectrum of needs and while we talk about obvious ends of that spectrum, we never really talk about the inbetweens, which are totally valid for some people. Probably because most midwives wouldn't even entertain the notion of being that hands-off (although I have hope that's changing.) Anyway, as to your question -- the first thing that pops off the top of my head is -- code word? Or hand signal? Something simple that you agree on beforehand that means: my boundaries are being crossed, back off now. That way you wouldn't have to explain yourself or try to articulate your feelings.

[party_of_seven]

I have had 2 home births that have gone exactly as you describe....unassisted yet attended. I just don't do very well with extra eyes on me....I feel inhibited and unable to listen to my body.

The two births that I have planned this way have gone very well. Normally I don't call the midwife until I know I'm about ready for transition. (I do call them as soon as I know I'm in labor though so that they can be ready) I like them to be there for as little time as possible so that I can labor freely around the house without feeling like I'm being watched. Once labor gets really serious and I am ready to be in the tub or in my room is when I want someone there. Both times the midwife has stayed out in the living room just reading a book or watching TV. I never even saw her until after the baby was born....no exams or checking on heart tones(at least by her anyway). Sometimes dh will go out and give a quick update if I feel like we should.

Both times dh and I have caught the baby together. With my last birth I actually paniced a bit because the baby was so peaceful and still that I was worried he wasn;t breathing. Dh called for her quickly and she reassured me that he was fine and left us alone. We always let the midwife stay long enough to make sure the placenta is complete and to do a newborn exam.

We are planning the exact same thing this time around. My midwife is very comfortable with our arrangement. She completely understands my need for privacy, and I trust her not to be any more involved than *I* want her to be.

The only advice I can give is to make sure you work it out with your dh so that he KNOWS to protect your space. I am never able to verbalize my need for privacy, but my dh knows how to pick up on when I am not needing extra people in my space. He knows that I can't communicate that when I am in labor so he does it for me. During our last birth my mom came to sit with the kids and they were all being noisy in the other room.....my dh knew enough to go out and ask my mom to take the kids outside for a little while.

[mimiharshe]

What a great thread! It's good to see this here. I haven't hired a midwife yet, b/c I can't decided what the heck I want! :All I would say is make sure your midwife is very clear about what you do and don't want and make sure you are all willing to improvise if things change. I totally agree w/the pp who said to make sure your dh knows what you do and don't want as well so he can be your advocate when you can't.

I think it's great you know what you want and you have found it! Happy Birthing to you!

[LilMamiBella]

This is exactly what we're planning on doing. We've already told our midwife we'd like her to be in the living room and that we don't want her with us unless we ask her to. Although, honestly I don't want her there at all but I'm trying to compromise with Dh. Its hard though. I think I'll probably wait till transition before calling her.

[Individuation]

Is it OK for this thread to be here? Because we're doing this too--and don't always feel at home with the very midwife-managed births in the homebirth forum.

Anyway, subbing!

[AugustLia23]

Originally Posted by SublimeBirthGirl

For me, I knew that to maintain inner autonomy, I could not have a birth professional in the house. I knew from my 1st birth i would look to that person because she was there. And I hate that feeling (not everyone does). The only way *I* could avoid that, for sure, was to not have a midwife there. Maybe if that happens to you, another room would be enough.

Eat well, take care of yourself, trust your instincts. IMO that's what most of us need.

YES, this is how I feel! Even though I know I don't need that presence, if it is there, I will feel like I need it. Especially in labor. And in my area, I don't know of any midwives that will come without an assistant. I don't want one extra person ther, nevermind 2!

As far as your post, you sound like you know what you want.

Having everybody leave you alone if you feel intruded upon is my best suggestion/

[homemademomma]

if you feel intruded upon, you just need to say so. it sounds like you have a great relationship with your midwife, and that she understands your needs, so she should be totally responsive to what you want in labor. talk about it prenatally, telling her what you think you want, but that you reserve the right to tell her that you want space.

i had an "unassisted" birth with a midwife with my last, and it was exactly what i wanted. she was there in case i needed her for anything (which i didnt, except i asked her to listen with the doppler twice), AND she cleaned up before she left!!! it doesnt get much better!

[homemademomma]

oh, and i wanted to add that i think it is a good idea to call her in sooner, rather than later, so that she isnt rushing in when you are close to delivery. it would be better (imo) to get her there early, and she can get settled in another room. i would also think about how much "help" you want with the placenta- do you want to birth it yourself, or are you going to want her assistance? i think alot of midwives get antsy over placentas, so it is good to hash this out ahead of time.

[MotheringBliss]

Awesome plan Synchro!

I had a great hands-off midwife on call who offered to hang out someplace nearby until I called her to my home. The understanding between us was that she was not to DO ANYTHING unless I or my partner directly requested assistance.

That seemed to simplify communication issues.

[Synchro246]

Awesome advice everyone! I had no idea so many people would have similar plans/feelings.

Originally Posted by party_of_six

I have had 2 home births that have gone exactly as you describe....unassisted yet attended. I just don't do very well with extra eyes on me....I feel inhibited and unable to listen to my body.

The two births that I have planned this way have gone very well. Normally I don't call the midwife until I know I'm about ready for transition. (I do call them as soon as I know I'm in labor though so that they can be ready) I like them to be there for as little time as possible so that I can labor freely around the house without feeling like I'm being watched. Once labor gets really serious and I am ready to be in the tub or in my room is when I want someone there. Both times the midwife has stayed out in the living room just reading a book or watching TV. I never even saw her until after the baby was born....no exams or checking on heart tones(at least by her anyway). Sometimes dh will go out and give a quick update if I feel like we should.

Both times dh and I have caught the baby together. With my last birth I actually paniced a bit because the baby was so peaceful and still that I was worried he wasn;t breathing. Dh called for her quickly and she reassured me that he was fine and left us alone. We always let the midwife stay long enough to make sure the placenta is complete and to do a newborn exam.

We are planning the exact same thing this time around. My midwife is very comfortable with our arrangement. She completely understands my need for privacy, and I trust her not to be any more involved than *I* want her to be.

The only advice I can give is to make sure you work it out with your dh so that he KNOWS to protect your space. I am never able to verbalize my need for privacy, but my dh knows how to pick up on when I am not needing extra people in my space. He knows that I can't communicate that when I am in labor so he does it for me. During our last birth my mom came to sit with the kids and they were all being noisy in the other room.....my dh knew enough to go out and ask my mom to take the kids outside for a little while.

OK, I tried to talk to him just last night. I thought it would go better than it did. At first he seemed to understand, then he demonstrated that he didn't undertstand by saying "we're paying the midwife, right? Then we should let her do all she can." UM (only last night I didn't strait laugh, I cried) I cried when I was trying to explain that I want autonomy and I want to let my body work, and see my body work, and that I want to let my birth unfold. He didn't say anything after that. I think I need to revisist the issue. I don't want to harp. He just kinda shuts down when he doesn't understand, and he doesn't understand all the things I feel and want. I get upset when I don't feel undertsood and that breaks down my ability to communicate.
He did totally understand that I only want people called who *need* to be called during labor. He understands that aspect of protecing my birth space (calling friends/family during my last labor turned out kinda ugly last time).

Originally Posted by homemademomma

if you feel intruded upon, you just need to say so. it sounds like you have a great relationship with your midwife, and that she understands your needs, so she should be totally responsive to what you want in labor. talk about it prenatally, telling her what you think you want, but that you reserve the right to tell her that you want space.

i had an "unassisted" birth with a midwife with my last, and it was exactly what i wanted. she was there in case i needed her for anything (which i didnt, except i asked her to listen with the doppler twice), AND she cleaned up before she left!!! it doesnt get much better!

You know my midwife very well.

About calling. . .I'm a little nervous unsure of *when* to call. Because she lives far away I was going to call as soon as I was pretty sure I was in labor just to say "Hey looks like a baby is on the way some time in the near future" and to call again when I am ready for her to be here in two hours. I get that I don't want her coming in very late in the game possibly disrupting whatever is going on. . .I just don't know how to gauge how long my labor will be. I had a pretty abnormal set of circumstances last time (scarred cervix, OP asynclytic baby, and PROM) so things were SLOOOOOOOOW. My default setting right now is to assume birth is a long ways away, but this attitude with this pregnancy might result in baby coming before I expect OR this experience could *feel* so differently that I think the baby is coming fast and I call for her to come too soon. I wish I knew what to expect of my body.



Keep the advice coming.
Right now I think I need to spend a bit of time
1)doing affirmations about trusting myself and maintaining my own autonomy 2)giving myself permission to say "no" or "I need to be left alone now" and making sure I know that those things are OK to say, that they aren't impolite or mean.
and
3)talking to DH and making a couple of lists so he has some direction during labor. I have a feeling I may want him to leave me alone a bit too

[dancebaraka]

Hey Laura! Another May DDC Mama here :

I have a somewhat similar situation- my dear friend is a traditional midwife (she is also this baby's godmother) and is going to be a "back-up" person for dh and I in case I feel I need more support, more hands, another's presence, whatever during this birth. She has agreed to do this as a friend- no payment. We are all very close and have discussed really openly on many occasions what exactly all this means, what possible stuff could come up, our fears, etc. etc.... these conversations have been nothing less than revolutionary, and I almost wish they were gathered in a book or something b/c they really have highlighted some of the main issues around culture/women/birthing/automony/empowered support. Who knows if she will be in the house, in the room, here just for post partum- we have even discussed the possibility of her just going somewhere close by and writing down her experience! Anything could happen, and it doesn't feel authentic for me to plan it too much either way. I just don't want my birth scripted, kwim? If I could offer one piece of advice, it would be to try and have this kind of authentic communication with your midwife- it will be educational for her! IMHO, midwives need to hear from empowered women about birth- it's such a good source of their continued education. I think the relationship is, at best, collaborative, authentic, and mutual... of course, we don't really see that reflected in our culture, but hey....
we must be the change we wish to see in the world, right?
OK- just my 2 pennies here. Anyone can take what they want from these ideas, and let the rest go!

Happy Birthing- we are both so close! Bloody show for me all morning!!!

[cottonwood]

Originally Posted by Individuation

Is it OK for this thread to be here?

Good question, and I'd recommend that anyone who has concerns PM a mod, so that we can keep this feeling like a supportive thread.

Originally Posted by homemademomma

i would also think about how much "help" you want with the placenta- do you want to birth it yourself, or are you going to want her assistance? i think alot of midwives get antsy over placentas, so it is good to hash this out ahead of time.

Yeah, this is what happened to me with my unassisted-but-observed mw-attended birth. She didn't worry about the baby getting born, obviously I was handling that, but once the baby was out she started worrying about *me*, wanted me out of the tub so she could assess blood loss, then when the placenta was taking a while, wanting me to take herbs, wanting to do cord traction (although she restrained herself,) etc. She later apologized because it *was* unnecessary. But yeah -- I know she's not the only one. A lot of midwives get antsy about third stage even while they "trust birth".

Originally Posted by dancebaraka

We are all very close and have discussed really openly on many occasions what exactly all this means, what possible stuff could come up, our fears, etc. etc.... these conversations have been nothing less than revolutionary, and I almost wish they were gathered in a book or something b/c they really have highlighted some of the main issues around culture/women/birthing/automony/empowered support.

You know, and I mean this very seriously, you should think about trying to remember as much of the conversation as you can and writing it up and submitting it to Midwifery Today. This is the exactly the kind of thing they need and want.

[Synchro246]

Ok about the third stage. I haven't been very sure myself about what I want. I know I am very comfortable waiting for the placenta as long as I'm not bleeding a lot.
Does the placenta need to be out for any perineal and cervical tearing to be assesed?

[georgia]

Moving to the Homebirth forum

[~Megan~]

That sounds exactly like what a midwife should do! Observe, step in for support if needed, recognize emergent situations, give advice if asked or they recognize mama is having trouble. Not someone to be touchy, a director, or wants to push her agenda/ideas/etc.

[GinaRae]

I'm going to have my first homebirth this Nov/Dec and so I have quite a while to wonk out the details with my midwives. I am still getting to know them and still working on what it is I think I personally want.

I want them there! But to what extent to I want assistance, I don't know. At this point I am thinking unassisted until after transition??

The two mw's have very different personalities and that might come in handy should I either be fearful or at ease.

Thanks for this thread! I love to hear what others are most comfy with and I start to formulate the labor and birth in my head and I can "see" what I would be most comfortable with -- I THINK!

I just don't know and that's why I want them there in case I need more handling than I think. However, I do want them to know ahead of time that I plan to handle most of it myself.