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Unassisted, but not unattended?

post #1 of 29
Thread Starter 
We are planning a homebirth in December/January, and I have been seeing two midwives whom I hope will be in attendance on some level. My husband is a former OB (now child psychiatrist). This will be my third birth, second with midwives, and I've never had any birth complications. The more I read, however, the more I feel I'd like to try to birth this babe on my own without a lot of hands-on management. I'm really enjoying pamelamidwife's blog--so smart and honest--and it's gotten me thinking that unassisted but not unattended birth is a possibility. What do you all think? Is it an impossible fence? Are there resources for preparing for it? And most importantly, how do I go about addressing this issue with my CNM/CPM midwives, who are supportive and warm, but still very attached to their perenium management, "suctioning when necessary," and so forth? I made the mistake of using the "hands-off" term with one the other day, and I saw the disappointment fall across her face. She asked me later with some trepidation whether I was okay with Doppler use. I really need them to be supportive and positive and to believe in me if they will be there. Any advice on achieving this?
post #2 of 29
Wow, your husband was an OB? Couldn't he handle anything that might come up? I think in your shoes I'd be pretty comfy UCing. But then again, w/a medical background like that he may be unable to relax and enjoy an unmedicated/unmanaged birth.
post #3 of 29
Thread Starter 
Quote:
Originally Posted by Usually Curious View Post
But then again, w/a medical background like that he may be unable to relax and enjoy an unmedicated/unmanaged birth.
Exactly. May be unable even to handle an emergency at home because of the fear of birth he has gained from hospital births. I'm hoping this will be a healing experience for him, too. One reason for the attendant midwives.
post #4 of 29
Quote:
Originally Posted by Kam View Post
Exactly. May be unable even to handle an emergency at home because of the fear of birth he has gained from hospital births. I'm hoping this will be a healing experience for him, too. One reason for the attendant midwives.
Ahhhh.
post #5 of 29
I think it really depends on the midwives. I didn't realize how managed my hb was until my recent uc which was pure bliss. The difference in being able to labor however I wanted and push when and how I wanted was amazing.

I think if I were to have an attended birth next time, I would want the mw in another room honestly and available when needed, preferably after the birth, but not too take the baby away for cleaning etc. Only to assist in clean up and with the baby while I am bathing/showering and delivery of the placenta when I am ready. I do not want anyone messing those first minutes of bonding with baby. After Lil C's birth, I stayed in the birthing pool with him and his brothers, all of us jsut welcoming him for at least 45 minutes before we even cut the cord. I even called my mother and best friend while cuddling him in the pool. (he was wrapped up in blankets). I think any MW I have met would have a very hard time backing off for all of that.
post #6 of 29
I'm hoping for the same type of situation. Midwives will be here, but in another room, and will be basically bystanders if there are any complications. Like a PP said, it's depends on the specific midwives. But it's your birth and you only get to have this baby once, so it needs to be on your own terms.
post #7 of 29
I guess its just personal interpretation. For me, even though I would have a midwife here if I found "the right one", it would be a totally different scenario than an unassisted birth as I see them. I think that a GOOD midwife assisted/attended birth is where the midwife does not direct the event, but stands by willing to help whenever needed, but not in control of things. For me, a midwife would be someone holding my hand, using a doppler every so often, talking "girl talk" during the earlier part, and just being support for me while simultaneously keeping an eye out for possible complications (without mentioning any possible bad outcomes that are not actually complications already - so to keep the birth "mood" positive) Even if she went into the other room and had coffee while I was in transition, she would still be there. Even if she never touched me or monitored me, if something seemed off, she would come rushing in and "fix" it, or suggest a plan of action. This would be a good midwife, but it would still be a midwife assisted birth. What it sounds like you need, is a heart to heart with your midwife, and a birth plan that you can both go over to see exactly what type of midwife assisted homebirth you are looking for and they are comfortable with. I think it would be incredibly difficult to find a midwife who would be ok just watching a movie in the other room and then packing up and leaving without ever doing "midwife stuff" like you would have in a UC.

Unassisted birth is, to me, a totally different animal. Its hard to explain and I don't want to offend anyone, but the feeling of birthing without an "expert" is something I just can't put to words. I was in labor for 3 days, and never once did I feel like I had to rush or like there was any time limit, or anything at all. I never worried about someone's approval or if they would say something was wrong or want to intervene, or about fighting over the details with someone. There was no one to fight with except DH and he was as into our birth as I was. I felt no need to call anyone or wait for anyone or ask for help or to look for someone else to make decisions for me, or "advise me". I did a LOT of research and was confident in "being my own midwife" in that I had a doppler (although I think I may have used it once in very early labor and never again) and I knew the signs to look for that something was wrong (too much blood, retained placenta, etc) and that was just so empowering, being able to rely on myself instead of someone else. If I were to birth in the hospital, DH would stand at the door and basically keep people from touching me or interfering with me w/out my permission (we discussed this option just today, in the event that something happened to make us feel we'd be better off there). That would technically be unassisted, if we went from start to finish without being touched by the medical personnel. But it wouldn't be a birth where I had to rely on myself or could block out the naysayers, ya know? I hope I explained that right...
post #8 of 29
I am fortunate enough to have a midwife who is very hands-off and actually loaned me her copy of "Unassisted Childbirth" (which she totally supports). She calls herself "the glorified clean-up crew". She attended ds birth and she really left me alone even though I had a very long labor. I told her I wanted a very hands-off birth without cervical checking and such and she told me I should have whatever I want. It seems there are not many mw like her unfortunately.

I am planning on calling her later and just having her hang downstairs and calling her up if I feel I want her there. I am going to talk to her about this next time, but at my last birth she took a nap in the other room while I was laboring so she seems okay with that. My dh is very supportive of mw attended homebirth, but told me he would rather not be "back-up emergency care". I want to give birth to my baby with just dh and I, but I don't want to be taking on dh's fears the whole time, KWIM?I feel like the situation I described makes both of us comfortable.

It would be very hard for me to have a mw attend my birth who felt entilited to be there and disappointed that I wanted to do it more myself. I hope you find a situation that works for you. Are there any other mws around that are more hands-off?

Jen
post #9 of 29
The title sums up the experience I am going for right this moment.

Back in January/February I had a strong pull toward doing this pregnancy myself. Doing my own care and birthing with just DH and DD at home. DH, unfortunately was not at all comfortable with this (for his own, very valid reasons).

So we compromised and I have been doing my own care with with my midwife from DD's birth (which happened 200 miles away in another state) consulting. The plan was for my MW to have her family vacation here starting around my due date and she would stay on until baby was here.

Fast forward to 2 days ago and my water broke. So My MW hoped on a plane and was here within 6 hours. Of course almost 48 hours later I'm still leaking, no contractions and we are waiting. My MW is at the beach at the moment.

I guess what I'm trying to share is that although I wanted a UP/UC DH was just not comfortable so having a trusted family friend here, who is qualified to step in when DH and I feel out of our depth (meaning a repeat PPH combined with a retained placenta or something just as rare but serious) seems like a great compromise.

We are fortunate that our MW is not confined by a state license that forces her to do certain things and who is perfectly OK with doing as much or as little as we want. I found out when interviewing local MW's just how rare find she is.

To me it's more important to feel comfortable and relaxed then try to stay within a strict definition of an experience I am looking to have. Part of me being relaxed is knowing that DH is relaxed so that meant having a professional available as immediate backup. DH gets his comfort needs met and I can have a relaxed DH present, part of my comfort needs.


BTW, I totally understand why your former OB husband might just want to be a father and partner for his child's birth and not have to be a professional at the same time.
post #10 of 29
I've had a very nice UP this pregancy and have been planning UC. But I had a dream and suddenly felt strongly like my intuition/baby/God/? was telling me to hire a midwife to come at the end or after labor. The day after my dream, I was parked next to a midwife's car - I looked her up and contacted her, and turns out she is very comfortable with coming and doing nothing but sitting on her hands. I'm just kind of seeing how it will go - maybe she will be there for the birth, maybe she won't make it but will be there to check up on us afterwards... I really feel strongly like there is a plan for this, and it will work out. If she is present, I wouldn't call it unassisted since that is a term used pretty exclusively for unattended births, but I would call it unhindered - and for me unhindered is my primary goal.
post #11 of 29
Quote:
Originally Posted by Kam View Post
We are planning a homebirth in December/January, and I have been seeing two midwives whom I hope will be in attendance on some level. My husband is a former OB (now child psychiatrist). This will be my third birth, second with midwives, and I've never had any birth complications. The more I read, however, the more I feel I'd like to try to birth this babe on my own without a lot of hands-on management. I'm really enjoying pamelamidwife's blog--so smart and honest--and it's gotten me thinking that unassisted but not unattended birth is a possibility. What do you all think? Is it an impossible fence? Are there resources for preparing for it? And most importantly, how do I go about addressing this issue with my CNM/CPM midwives, who are supportive and warm, but still very attached to their perenium management, "suctioning when necessary," and so forth? I made the mistake of using the "hands-off" term with one the other day, and I saw the disappointment fall across her face. She asked me later with some trepidation whether I was okay with Doppler use. I really need them to be supportive and positive and to believe in me if they will be there. Any advice on achieving this?
when i was pregnant with DS we toyed with the idea of someone being there, just in case. the more i thought about it, the more i felt that anyone's presence would be a hindrance. especially someone like your midwife, who is upset by your desire for a hands off experience. i'd be under pressure, one way or another.

if they are showing hesitation, and are not completely there for you, this will influence you a great deal, even if they are not in the room with you. even if they say they will be, but you sense reservation, the situation has a potential to be stressful.

do you think there is another way for your DH to heal? i think going into a UC that it will be a healing experience for someone else, can be stressful as well.

i have no real advice on how to achieve this. our plan was to have a doula who was a midwife in new zealand and not allowed to practice in canada. her purpose was to be DD's support person, and to let us know if she thought i needed to transfer (if we asked her). it was a bit of reassurance for DH as well. ultimately she didn't make it to the birth, and i was so glad.

up until recently DH felt that UC was great, but if we had a chance to have a midwife, that would be even better. i told him that a midwife at my birth is not my idea birth, and we talked about it. i feel very confident and secure in my decision to UC, and i think it is contagious, as DH is gradually thinking, that UC is pretty good without any backups.
post #12 of 29
Thread Starter 
Wow. You all are so accepting of my not-quite-UC birth hopes. Thanks for the thoughts. I'm thinking maybe I'll post this in the professionals' forum, or maybe just write to Pamela and ask her about approaching my midwives. It really is a fragile relationship--we've only just met, after all, and only a few times. Hard to put so much trust (with my baby's birth, and their state licensure and professional reputation at stake) in a near-stranger. I'm not sure they really know where I"m coming from, and I'm not totally sure where they are coming from, although I'm starting to get a feel for it. I wish Naoli Vinaver Lopez would fly up for this birth!

Quote:
Originally Posted by AbbieB View Post
To me it's more important to feel comfortable and relaxed then try to stay within a strict definition of an experience I am looking to have. Part of me being relaxed is knowing that DH is relaxed so that meant having a professional available as immediate backup. DH gets his comfort needs met and I can have a relaxed DH present, part of my comfort needs.
That really sums it up for me, Abbie. I don't care whether what we do is technically one thing or another. I just want the chance to do what feels right and safe in the moment without having to feel guilty or pressured or whatever.
post #13 of 29
One thought and clarity that I was able to formulate for myself in my last pg was that my CNMs have an OB as backup, and essentially, I see my CNMs as MY backup. I think "hands-off" or "be there but in another room" may not work as a concept for many midwives even if they are/see themselves as non-interventive because they do have scope of practice codes and professional ethics & standards of practice, etc. to deal with. But for me, communicating to my midwives (through my written birth plan and my attitude) that it was MY birth and I was inviting them to be there to do only what I asked them to do when I asked them to do it, was very helpful. They got it. Or at least, the one I actually invited did (it is a practice of 5 CNMs but I chose my fav to call when I went into labor).

I did not feel that I wanted to UC - I did honestly want the MW there to intervene in certain ways if I chose those interventions. In the moment, I did actually request that the MW check me to confirm what I was feeling when checking myself (anterior lip, swelling cervix). I asked her to push on the lip while I pushed past it, since doing both myself wasn't working. I asked if she had anything to help with the swelling, and she had homeopathic arnica, which did the trick nicely. Her standards of practice required her to check the baby's heart tones several times while I was pushing, but that was okay with me. Other than that . . . apparently she unlooped DS2's cord from around his neck while I was catching him, but oddly enough I have no memory of that happening (I know it did b/c her notes and DH agree that it did, I just didn't 'see' it.) That was about it. Otherwise, she DID pretty much keep her hands off and stay in the other room. And help with the clean-up. I was especially worried about PPH, having had one w/DS1, and I asked her to check my bleeding several times in the immediate PP period.

FWIW, my experience. Good luck working out what will work best for YOU and your family.
post #14 of 29
interesting that your husband is a former OB.

no matter how things work out, i hope it is a healing experience for him.

i hope you can have hands off care.

would making a plan with the OB be less akward if you wrote down your ideal birth plan? you could then see how they felt about it.
post #15 of 29
When I first got pregnant I just knew I wanted a homebirth. But the more my belly grew the more I knew I wanted to have an unsassisted birth. It is my first pregnancy and at first my husband almost freaked out about it. His problem is, that even he might not be here for the birth. He is in the Army and currently in the field for training again. He is gone since 3 months already and I am due any day now.

So we decided to hire a midwife just in case he would not be here. That made him feel more comfortable and I did not really care since I like the midwife. But I want her just for the "after care"... just in case I should need someone if my husband won't be here.

Like I said, I was fine with it, but the closer I get to birth, the more I am worried. Will she really stay away from me like she promised? Or will she try to get me to let her check me etc... I mean, I could still say NO and she would accept it. I am sure about that. But I do not even want to be asked. I do not want to have to say NO to anything.

This is my only worry about giving birth I have. I am not worried about the birth itself at all. So now I think I might just call her as late as possible.

I think you should talk to the midwife upfront. Just let her know what you want and don't want and do not leave any questions open. And don't feel bad or like you could be frustrating for her. If she does not like your conditions she does not have to be your midwife. Her choice!

Good luck!

Saskia
post #16 of 29
In this place we are staying dh and I have separate bedrooms - it's a 2 story apartment suite with a bedroom upstair and a bedroom downstairs, so it made the best sense to have dh upstairs with dd, and me downstairs with ds. Last night I was breathing through some pretty intense prodrominal labor contractions, and I was really enjoying them in a very sensual/sexual way. I realized through that I am inhibited even with dh - there is no way I would have allowed myself to fully enjoy what I was feeling if dh was observing me. I'm uninhibited if we are having sex together, but no way would I be comfortable having him watch me behaving sexually without participating. I don't really worry about the actual delivery - by that point in labor, I'm pretty much forced to abandon any inhibition and just go with it. I'm also very agressive at that point, and very clear about what I want other people to do. But laboring is a different story - I think this experience last night taught me that I'm need to labor solo. I'll invite other people into the process when I feel ready to include them.
post #17 of 29
Thread Starter 
I've been doing lots of thinking and reading and sitting with my true feelings. Very instructive! Saskia, I think you're right about being very honest with my mws. I respect them, and there's no reason they shouldn't feel the same about me, especially if I'm honest with them.

Here is a really great thread on unassisted/attended (or not!) births on the Midwifery Today forum. I would bet there are many more, if you search as I did for "unassisted" in the childbirth forum.

http://www.midwiferytoday.com/forums...rms=unassisted

2bluefish, maybe you'll be one of those mamas we hear about who has an ecstatic birth! Wouldn't that be amazing!
post #18 of 29
Thread Starter 
Saskia, I just saw your post there. I'm glad you found a midwife in the end who will help you, and hope the birth goes well and as you hope it does.
post #19 of 29
Quote:
Originally Posted by Kam View Post
Wow. You all are so accepting of my not-quite-UC birth hopes. Thanks for the thoughts. I'm thinking maybe I'll post this in the professionals' forum, or maybe just write to Pamela and ask her about approaching my midwives. It really is a fragile relationship--we've only just met, after all, and only a few times. Hard to put so much trust (with my baby's birth, and their state licensure and professional reputation at stake) in a near-stranger. I'm not sure they really know where I"m coming from, and I'm not totally sure where they are coming from, although I'm starting to get a feel for it. I wish Naoli Vinaver Lopez would fly up for this birth!
oh i just love Pamela so much! she was my midwife and is one of my friends and the love i have for her is endless. she is a fantastic midwife and i am sure she can give you some advice in what to say to your midwives so their guards dont come up in reflex, but also so you get your UC.

i had an attended unassisted birth with dd2 almost 8 weeks ago, pamela and her assistant lennon were there and most of the time they sat and talked or knit or read, when i needed some moral support (transition) or DH needed to be reassured they were there for that "you can and ARE doing it honey!" and them being there and being calm just really put DH at ease when i was saying things like "i just CANT do this, i was not meant to birth a baby this way!!!" and they were calm and almost amused by it (looking back i am SO amused!) helped him see it was normal to hear a woman say things like that in transition.
also it was REALLY nice to have someone there to help DH clean up, and to handle the placenta, etc.
i am one of the lucky ones that are friends with their midwife and ahve a special place in their heart/lives for their midwife, she wasnt just my birth attendee, she is a friend who supported me and helped give me the inner confidence and self trust i had inside all along, just needed to find.

ok enough bragging how rad she is and how lucky i am.

really mama you CAN have an attended unassisted birth, make sure you tell your midwife/s how you feel, what you ae comfortable and uncomfortable with. BEFORE you birth. establish your desires before hand.
post #20 of 29
If you want this sort of thing, be very upfront with your midwives. Ask if they are comfortable not doing any fetal heart tones and being out of the room for hours at a time, even during crowning and not touch the baby after birth unless you request it absent a clear medical emergency. If they don't want to do it, you've got your answer right there and a clear direction to switch healthcare providers. I did find two midwives who would agree to this for my second birth. One was a DEM and one was a CPM. Many said they'd be "hands-off", a "fly on the wall", etc. but when it came down to it and I asked questions like this, they said well of course EXCEPT that they "had" to do fht, be there for crowning, etc. To be possibly too blunt. I'd guess that you would have to switch mws (or of course, go UC) to get what you want. Suctioning isn't even evidence-based from what I've read, for one thing.

We used the DEM and called her during transition. She was 1.5 hours away so got there well after the baby and placenta were born. She had her own birth semi-UC, i.e., with a midwife downstairs.
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