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post #21 of 74
Quote:
Originally Posted by ima-06 View Post
i haven't seen a thread saying, "i really wanted to UC but because of <condition X> i chose not to for the safety of myself and my child." if those threads exist, please point me to them. i'd love to read them.
Those type of threads certainly exist, and can be found with key words such as "UC transfer". Threads by women who were not able to seriously consider uc due to complications would be more likely to be found in ddcs.
post #22 of 74
Well, the poster that mentioned prayer as part of her decision making process made no mention of praying fervently or correctly enough as a factor in getting a good/bad outcome. If someone has figured out a "correct" way to pray to get a desired outcome I'd like to know. There's not a "correct" way to insure you get what you ask for and, to insinuate there might be or that someone might believe there might be, seems so ridiculous that I equate it with zealotry.

I don't mind you being educated at all. It seems to me that you've likely read all the same books I have and I consider myself very well educated on the topic. I think part of the answer as to why women choose to up/uc cannot be found solely in a book - although there are some very thorough books that you've mentioned you've read that explain so so much. What's missing? When I read the uc books I think "Ain't it the truth." I have to guess (only guessing) that when you read them, you are unconvinced which leaves me confused. To be honest, I can't say it better than the two books I recommended.

Is it as simple as the risk factor? Why would ucers "risk it?" If so, and I can only speak for myself, I'm not a risk taker. I wouldn't uc if I thought I would be better off w/someone attending. That's the bottom line for me. My level of education/preparedness/personal birth history/faith are enough to insure a safe uc - or that, in the event of a complication, I will make the appropriate decision to transfer.

I'm really not trying to be snarky, I'm not that way. I want you to have your questions answered. I'm just not sure they can be answered to your satisfaction. For instance - even if I had had an open mind in the beginning about hb, all the research, stats, etc. I still would have continued to believe that hbers were taking a chance which is so silly. I gave birth w/a lay mw in her bc - which was basically like giving birth at your grandmother's house. I wasn't even doing anything different than a hber except they had the added luxury of climbing into their own bed after birthing.

There are some very well spoken women on the boards. Perhaps one of them can do a better job than I have.
post #23 of 74
Thread Starter 
thanks soso-lynn.

the studies i'm referring to pertain not to UC/UP versus attended birth but rather to specific interventions that are feasible only with an attendant. if you read about specific interventions, some (which require the power to prescribe medications or to cut into things) are shown to be more effective at savings lives than doing nothing.

trust me that i'm not saying there is anything magical about medical school. i'm related to too many doctors to believe there is. but i do believe in the nearly magical powers of attending many births, and medical school is good for attending many births. of course 99-100% of them are intervened-with births, which sucks. but it's better than my experience, with is to say only my one birth so far - and one laborious miscarriage. it's somewhat like surgery - the outcomes for surgeries are shown to be dramatically correlated with the number of that specific surgery the doctor has done. no, i don't think birth is as medical an event as a surgery, but i do believe in that intuition is more the product of experience than luck and feeling.

your point about feminism is well taken since i share your views (i think) on feminism.

i would not re-evaluate birthing in a hospital if she'd died. because i know death is a risk of hospital vba2c: a remote risk, but a risk nonetheless. to me everything is a cost-benefit analysis. i pick the moderate solution in general because i believe in shades of gray (as i said above) and i think having a vba2c is a happy medium that i hope to avoid but would do if i had to.

i don't want to debate the choice to UP/UC. i really don't. i just wanted to understand the underlying choice. and i think i am starting to get it now. thank you.
post #24 of 74
the studies i'm referring to pertain not to UC/UP versus attended birth but rather to specific interventions that are feasibly only with an attendant. if you read about specific interventions, some (which require the power to prescribe medications or to cut into things) are shown to be more effective at savings lives than doing nothing.
UCing is not about avoiding potentially life-saving interventions. The fact is that most of those interventions can be obtained in a reasonable amount of time by transferring to a hospital if needed. There are cases when that does not work, but I would be willing to bet that there is a much greater risk of bad or less than ideal outcomes if you start off in a hospital instead of only going if you need to. There is also the assumption that the woman would accept certain life-saving interventions. I really don't feel comfortable with that. I would personally do anything to save mine and my baby's lives, but I don't think it's up to anyone else but me to make that decision.

but i do believe in the nearly magical powers of attending many births, and medical school is good for attending many births. of course 99-100% of them are intervened-with births, which sucks.
Attending many natural births can be very helpful in becoming a skilled attendant but most graduating OBs have NEVER seen one. I can't find the link to that article right now, though.


i would not re-evaluate birthing in a hospital if she'd died. because i know death is a risk of hospital vba2c: a remote risk, but a risk nonetheless. to me everything is a cost-benefit analysis. i pick the moderate solution in general because i believe in shades of gray (as i said above) and i think having a vba2c is a happy medium that i hope to avoid but would do if i had to.
I don't have all the details of this particular case, but what you are getting at is that one should evaluate the risks and benefits of anything they do. That is exactly what UC is about, taking charge of your own health and making up your own mind.
post #25 of 74
Quote:
Originally Posted by ima-06 View Post
to me everything is a cost-benefit analysis.
I don't have a lot to add to the conversation except this. ITA with the above. After my two hospital births to me a UC is less risk than an attended birth.

that is all.
post #26 of 74
While I do feel like you will never be given enough "evidence" to really be satisfied I am coming out of my comfy lurking hiding place to address your questions.
is there any kind of pregnancy or condition that would cause you to feel that having a UP/UC was unsafe for you or for your baby? do you believe in "high risk," "moderate risk," and "low risk" pregnancies? how do you even know if you have a complication of pregnancy if you UP?
ofcourse there are conditions and situations that a loving mother would consider unsafe in which to choose a UP/UC

in the interest of full disclosure: i prefer unmedicated, CNM-attended births when possible, and i believe that pregnancy and birth have some inherent risk to them. i get prenatal care including ultrasounds because i want to be getting what i consider to be appropriate, evidence-based care: low-risk care for low risk, and high-risk care if i become high-risk.
I feel like for the most part every woman I have encountered who has chosen the UP/UC path is a woman who is intimately in-tune with her body both physically and mentally. If she is not her UC will probably not get off the ground. This is not said to sound superior, it is really just a vital ingredient in the ability to UP/UC. While all womens bodies are made to make and expel babies not all women in this day and age are mentally intune enough to take the leap required to just quietly trust their body to do a most basic function of its own human-ness.
I personally believe in GOD and to answer your question about that at the same time I feel like I put my trust in GOD and accepted that I ultimately have no control over when I die or when my baby dies. I pray for health and life and strength and clarity but I don't fool myself into believing that I can orchestrate control over the outcome of any day.

the reason i ask this question is that i recently read elsewhere the autobiographical account of a woman who attempted an hba2c. her uterus ruptured catastrophically, the baby died, and she had a hysterectomy. to me a vba2c is a HIGH-risk attempt and much deserving of a hospital and a doctor. certainly i don't want to give birth in a hospital with an OB, but all of life is a cost-benefit analysis. the costs frankly outweigh FOR ME the risks in a hba2c scenario. i'd love to hear your thoughts and understand a different perspective.
I would seriously consider a vba2c because like I said before I dont feel like its up to me to control my own fate or anyone else who comes into this world through me. All I can do is prepare myself and then I have to take that leap.
JMO
post #27 of 74
is there any kind of pregnancy or condition that would cause you to feel that having a UP/UC was unsafe for you or for your baby?

There are probably many conditions that cause me to feel having a UP/UC was unsafe for me or for my baby.

But, i do not have any conditions, and so it's not an immediate concern.

do you believe in "high risk," "moderate risk," and "low risk" pregnancies?

I believe that life carries a lot of risk, that pregnancy carries risk, that birth carries risk. but, what constitutes what level of risk is really individual. what is high risk for me is not high risk for someone else which is based on a number of factors which can be weighed in various ways.

if i felt that i was at risk for anything that medical attention would prevent or help with, then i would certainly seek that care.

how do you even know if you have a complication of pregnancy if you UP?

there are two aspects to this in my mind.

the first is that many or most things have symptoms or signs that we can look to and then decide if it's at issue or not. So even if UPing, if something seems unusual, or feels bad, or what have you--we can take that and say "ok, i need some help." and then go and seek that help.

the second thing that occurs to me are those occassions during which even with extensive PNC, there is a surprise occurance.

in these occurances, the medical model didn't prevent or prepare for it, and if it occurs during birth, it may be something that the medical model can help or hinder. it really depends upon what shows up.

i believe that pregnancy and birth have some inherent risk to them.

i agree with this statement. for me, weighing the risks is what creates birth choices.

some people consider very normal, healthy pregnancies to be "high risk" scenarios just on how they view birth itself. they feel most comfortable in hospitals, with medication and technology. Others look at very normal, healthy pregnancies as very "low risk" scenarios, and therefore consider things such as UC or HB as a safer option than a hospital.

i'm of this latter category, and with it, i'm of the mind that attendants can hinder one's process in both pregnancy and birth. that hinderance at the emotional level can create something to be emotionally "high risk" when it is in fact actually "low risk."

i find that PNC appointments often do this to women--scaring them and often n ot reassuring.

the costs frankly outweigh FOR ME the risks in a hba2c scenario.

i think that this is also really individual, and i would also assert that it isn't always a cost-benefit analysis.

while i think the cost-benefit analysis (CBA) is a very beneficial process and often a good one, it is really rather "left brained" and not in an intuitive space.

i know that i can do that CBA, but it's not the end of the process for me. i then look at it from a completely intuitive or 'feeling' space--because what might be right "logically" or "on paper" isn't at all right for me in reality.

i've been in that sort of situation before--i'm sure that we all have.

so for me, it would depend entirely upon how i truly felt and believed about the situation. sure, the CBA might say one thing, while my spirit or total person is telling me something else. And of course, sometimes the CBA is right on.

but again, this is also an individuated process. i don't know about that woman's uterus, her process in regards to determining what was a risk and what wasn't, and what risks she was and was not willing to take. i can only support her decision based on the fact that she knows her circumstances best and is capable of making good decisions for herself.

and i take the same process with my own birth. i know my circumstances best, i know what i do and do not consider risks or problems or what have you, and from there, i make a choice that i think, believe, and feel is right for me.
post #28 of 74
hearing arguments about prayer and intuition me sad precisely because i believe in evidence-based (as opposed to faith-based) care.

i really can't ask you to believe differently than you do.

even though you speak of 'evidence based,' you actually start with a premise that is basically a belief--philosophical if you will--and not necessarily "evidence based." it's how you interpret that evidence, emotionally, that starts the process for you.

like you, i agree that pregnancy and birth carries inherent risk of injury or death to mother or child. emotionally, though, i do not consider that a very "great" or "high" or "scary" risk.

because our fundamental approach to this premise is different, what evidence we seek and how it convinces us is going to be different.

for me, one of the greatest risks to normal, healthy pregnancies and births is intervention. intervention begins at the level of "idea" in my mind.

for example, because i'm going through a trying bit and am emotionally susecptable, when a client said to me (she's an u/s tech) "wow, you're looking small! your baby could be dead or not growing!" i was really emotional about it. i started to fear and doubt.

she'd intervened; she'd planted a "bug-a-boo" in my mind.

but then i took a step back. what's the real evidnece that she's talking about vs what other evidence exists?

first, there is my internal 'evidence'--my experience. i am growing a lot, eating plenty, and i feel great. my baby moves nearly constantly (it's a blast). i can baby map easily. and intuitively, i feel that the baby and i are very healthy!

second, all women carry differently, some larger and some smaller. women who are first-time mothers, like myself, tend to carry smaller. women who are very fit and have strong abdominals also tend to carry smaller. women who are of my body type tend to carry smaller.

third, my mother carried small too. she and i look a lot alike in our pictures of when she carried me at this date and where i am at this date. it's amazing! and, my MIL was similar (and she was no where near as fit as my mother).

then, we look at my client who is an u/s tech. she's saturated with scientific evidence; she's trained to look for anomolies; and she works with women of all body types and sizes, but most of those carrying small whom she sees are considered "high risk" even though the u/s indicate that very few of these infants are even problematic.

so, ultimately, i went back to my own evidence--what i think and feel and experience as well as what i know.

i look for both external 'evidence' and internal 'evidence.' while the internal is largely subjective rather than objective, i usually make decisions utilizing both aspects of my person.

i know that not everyone does, and i'm ok with that. i think that's fine, but it's not fine for me. i need to utilize both.

and trust me, even if all of the external evidnece in the world said that i was "just fine" and i didn't feel that way, you can darn well better believe i'd keep knocking on doors until i got an answer that i felt was satisfactory.
post #29 of 74
Thread Starter 
> I feel like I put my trust in GOD and accepted that I ultimately have
> no control over when I die or when my baby dies.

i'm so confused about this statement. it seems to suggest that you would not accept any medical care.
post #30 of 74
Quote:
"i really wanted to UC but because of <condition X> i chose not to for the safety of myself and my child." if those threads exist, please point me to them. i'd love to read them.
You must have missed my threads from last fall! I decided not to UC based on a very strong gut urge to hire a midwife. At my 20 week prenatal we found twins. I chose a much more medical route than I would have preferred and in fact my birth was rife with necessary interventions. I would not have chosen this route for myself but I felt it was necessary to ensure the safety of my daughter, who presented footling at the last minute.
post #31 of 74
Quote:
Originally Posted by ima-06 View Post
> I feel like I put my trust in GOD and accepted that I ultimately have
> no control over when I die or when my baby dies.

i'm so confused about this statement. it seems to suggest that you would not accept any medical care.
Did you not read my whole post?

But do I think that if it was my time to die that it would matter where I was or who was present? Nope.
post #32 of 74
I am not going to say much because I also do not think that there will be anything that gives you the response you are looking for, whatever that may be.

First I would like to say that most research is pure crap. I have reviewed too many studies to think otherwise. These studies did not have anything to do with pregancy or childbirth but they were studies nonetheless.

Studies can be skewed to make it look any way the person doing it wants. They add numbers to the total to make up for the people they "may" have missed etc. Not to mention all the other things that can change from study to study or from person to person. I won't even get into all the things that can be wrong with it, it would take me forever.

Secondly, woman.....humans are animals. Animals instinctively know when something is wrong and instinctively know what to do to fix it. Why? Because they don't constantly rely on some other animal to tell them what is wrong and what to do about it. An animal can completely stop their labor if they are put into danger for example.....it happens in women too. Call it what you will, instinct, intuition, faith. We all have it most just don't know it.
post #33 of 74
Quote:
Originally Posted by ima-06 View Post
the reason i ask this question is that i recently read elsewhere the autobiographical account of a woman who attempted an hba2c. her uterus ruptured catastrophically, the baby died, and she had a hysterectomy. to me a vba2c is a HIGH-risk attempt and much deserving of a hospital and a doctor.
Anecdotes are not facts. A mama on here recently attempted a uca4c (yes 4 previous c-sections with no vbac to test the strength of the scar). The outcome was she went into labor, it did not progress in a manner she felt to be safe and she transfered to the hospital and had a c-section--as she had planned to do if she felt there would be a problem. Mom and baby are doing quite well.

Does that mean that 50% of homebirths after multiple c-sections result in uterine rupture? Nope. Does that even mean that 50% of births after multiple c-sections result in uterine rupture? Nope.

Also, and I know I'm cynical, but did the story you read happen to mention if labor was induced? I've noticed a tendency for people to blithely mention using castor oil as though they believe it isn't a form of induction.
post #34 of 74
Thread Starter 
sapphire:

1. i like your postscript note about the lack of sarcasm in your posts. i may steal it if that's okay.

2. she didn't mention castor oil. understandably the story left out a lot of details.

dauphinette:

does your note about when you die mean to say that you don't think doctors make a difference, helping some to live who otherwise might not live?

intertwined:

thanks for the info. i read your blog. i really appreciate what you wrote about situations that would have caused your plan to change instantaneously. i wish more people would include that in their stories.
post #35 of 74
Quote:
Originally Posted by ima-06 View Post
does your note about when you die mean to say that you don't think doctors make a difference, helping some to live who otherwise might not live?
I'm going to jump in for a second as a person of faith even though this wasn't addressed to me. For those who believe that God is the ultimate arbiter of life and death, it does not matter where you are or who is with you or what the circumstance is. If it's your time, then it's your time.

I also want to address what seems like a misunderstanding that a woman who is doing UP/UC is someone who has decided to be left alone to birth alone come hell or high water, regardless of the progression of her pregnancy or birth, and that is simply not the case at all.

UP/UC (speaking for myself) is about allowing and encouraging pregnancy and birth to be absolutely normal and natural unless I sense that I have a situation that is above what I can address on my own. While I will do everything I can to avoid interventive care of any sort, I also would not hesitate to seek professional help should I determine that I was in need of it. As a person of faith, I believe that my self-knowledge and intuition comes directly from God who speaks to me through those things and will let me know in one way or another if I need to seek another path.
post #36 of 74
Thread Starter 
that's so interesting to me. my one birth - and recently, natural miscarriage that felt like a birth - were not so intuitive to me. i bled quite a lot (despite having had a basically un-mucked-with birth) after my little one was born. the midwife did uterine massage with third-stage IM pitocin and methergine. the whole time i'm telling her, "i feel fine! it's going to be fine! please stop hurting me! " but i'm quite confident now that i would really not have been fine. so i guess that's where my bias comes in.
post #37 of 74
I'm another former UC tranfer-er here. I still haven't ironed out what happened with my birth and whether I really needed to be there or not, so I don't know where I fit in the anecdote pool, so to speak. File me under uncategorized.

I find it interesting that you mention that you believe in ultrasounds as part of your preferred evidence-based prenatal care plan. Did you know that even ACOG does not recommend routine ultrasounds absent any reason to suspect a problem?

I'm not sure if we have anyone here who is of that philosophy, but I don't have a problem with people who would not choose to receive any medical help under any circumstances for reasons of faith. And I think faith can be pretty broadly defined. I think that as adults we have the right to make those decisions for ourselves. It seems like you would have a problem with that.
post #38 of 74
When I did my first UP/UC, I found that my level of connectedness to my own body and well-being was very different when I was in charge of my care as opposed to when I had given charge of my care to a physician or midwife.

I had not realized that there was / would be such a great difference until I experienced it. I thought I was in tune before, but it was NOTHING like when I was on my own. I don't know how to describe that well in words. I don't even know if it's possible to describe it properly with words, but the level of awareness is simply not the same.

It's quite possible and likely that had you intentionally decided to UP and then experienced your MC, you would have had a very different perspective or instinctual response as to what needed to be done.
post #39 of 74
Thread Starter 
paquerette: i do ultrasounds because i want the information they provide and believe the research suggesting their safety.

unassistedmomma: it's interesting, actually to both of you, about my mc. with my first pregnancy i had had some mild-moderate nausea/vomiting and severe exhaustion in the first trimester. with the second pregnancy i had no nausea/vomiting and instinctively i had a sense that the pregnancy was not okay. i had a dating ultrasound for my mental health at seven weeks and everything looked fine, but a second ultrasound at 11 weeks showed no heartbeat. i passed the so-called "products of conception" a week later after 24 laborious hours. so my point is, i guess, that i had some intuition and anecdotally turned out to be correct. but i'm not sure i'd trust my intuition about whether i was bleeding to death because, well, blood loss affects your ability to think clearly.
post #40 of 74
I remember reading a UC woman's story about how she knew from her first contraction that she needed to be at the hospital NOW. Nothing specific phsyically or otherwise happening, she just KNEW. She arrived at the hospital in time to be helped with a situation where she could literally have bled out in 20 minutes... a very rare situation where even starting out in a hospital a woman's chances are extremely grim.

I truly believe that if we pay attention, our bodies really do speak to us quite clearly and loudly. We just have to realize it's possible and then take note.
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