OB says I'm too high risk for homebirth - Page 3

[janasmama]

Has your ob told you what the problems are with delivering at home? What might happen that makes you need to be at the hospital?

[claddaghmom]

The only thing that would concern me is the mention of medication.

Have you researched the medication, dosage, effect on the baby, etc? Are you going to continue the same medication all the way up to delivery, and in the same dosage?

[GoBecGo]

My initial thoughts were that if you deliver in hospital your Ob gets his cheque, even if he isn't there, whereas the HB MW has your LIVES in her hands, and if you're high risk it's her risk too. You think your Ob would get fired if you got sectioned and died?

But i'm hypOthyroid, and i don't know how much of a concern your situation is, in real terms. I'm really glad your midwife feels phoning the Ob is a good idea - he will find it muchharder to fleece another birth professional if that's what he's in fact doing.

[lwuertz]

Originally Posted by janasmama

Has your ob told you what the problems are with delivering at home? What might happen that makes you need to be at the hospital?

This is what he said:

"The PTU that you are on does cross the placenta and could have an effect on the baby. She could have problems breathing, latching on and even have a goiter upon birth that would need to be treated seriously and right away. Plus the stress of labor could cause your thyroid to get out of control. It could increase your heart rate. With hyperthyroidism you are at an increased risk for eclampsia and pre-eclampsia."

Originally Posted by claddaghmom

The only thing that would concern me is the mention of medication.

Have you researched the medication, dosage, effect on the baby, etc? Are you going to continue the same medication all the way up to delivery, and in the same dosage?

I have done some research on PTU. The risks of uncontrolled hyperthyroidism are far outweighed by potential risks from taking it. I'm on 100mg a day which my OB said was the the lowest possible dose. I will be taking this through the end of pregnancy and possible afterwards too if I'm still having thyroid issues.

[janasmama]

Originally Posted by lwuertz

This is what he said:

"The PTU that you are on does cross the placenta and could have an effect on the baby. She could have problems breathing, latching on and even have a goiter upon birth that would need to be treated seriously and right away. Plus the stress of labor could cause your thyroid to get out of control. It could increase your heart rate. With hyperthyroidism you are at an increased risk for eclampsia and pre-eclampsia."

Any baby could have problems breathing and latching on so that doesn't seem like a reason to birth in a hospital. Plus, both of those things aren't necessarily emergent since a mw can resuscitate and help with any latch on issues.

I am also under the impression the pre-e and eclampsia have symptoms that go along with them and then you would be going for an induction...if you make it to labor/birth then you are free from those, right?

If you become stressed in labor then a transfer would seem appropriate and doable at that time.

Do you know what the chances of a goiter happening? That would be something I would look into. Maybe the risk of it happening has something to do with the dosage of medication.

[GoBecGo]

I had a goiter for 11 months. It didn't harm me. Do newborns die of goiter faster than one could transfer to a hospital? Can't see it personally...

[janasmama]

I actually did a google search and found some information.

The incidence of fetal goiter after PTU treatment in reported cases is approximately 12% (29 goiters/241 patients).

Goiters from PTU exposure are usually small and do not obstruct the airway as do iodide-induced goiters (see also Potassium Iodide) (43,44 and 45). However, two reports have been located that described PTU-induced goiters in newborns that were sufficiently massive to produce tracheal compression resulting in death in one infant and moderate respiratory distress in the second

So what I'm reading is that only one newborn has been reported to have died from tracheal compression and one other newborn had respiratory distress.

Read the original at http://drugsafetysite.com/propylthiouracil

[chaoticzenmom]

Originally Posted by lwuertz

So I had an appointment with my OB today and we broke the news to him that more than just thinking about it (what I told him last time) we definitely want to birth at home with a midwife.

At first his response to this was like the typical OB response you'd expect... "Your baby could die!" etc.

My husband told him we'd done our research and were aware of the risks, but we wanted to know if there was anything specific to my pregnancy issues that made it more risky for me to have a homebirth.

He said that because of the HG and hyperthyroidism that my pregnancy is classified as high risk.

He said the hyperthyroidism could cause the baby to have breathing problems at birth and there could be some side effects from the medicine I'm taking because of the hyperthyroidism.

He said that he's not the typical OB and was trained by midwives and has worked with many over the years and that he'd do everything possible to be the one attending my birth instead of some other random doctor in the practice.

He also said some really dumb stuff too like about homes not being sterile.

My midwife says she'll do some more research on my medications and condition, but that the research she's already done suggests that I'm not high risk. That hyperthyroidism is an on the line kind of thing, but moreso if it is something that you've had your whole life rather than something that developed in the second trimester of pregnancy (my case).

I just feel so confused and frustrated. Anyone out there had hyperthyroidism and a home birth?

No, when I was hyperthyroid, I had a hostpital birth and it was a baaad idea. My heartrate sped up in reaction to the epidural and it was as fast as my daughters! It was pretty scary. Thier reaction was to say "don't worry, anything we cause, we can fix" um, no thanks. My daughter only had low blood sugar (probably because I didn't get to eat during labor) and she had a small bottle of sugar water. Next time, I gave birth in a calm free standing birth center with midwives in a big tub of warm water. It was great and my heartrate was fine the whole time.

You're better off with the midwife.
Lisa

[homebirthing]

Originally Posted by lwuertz

We don't know any other person IRL that has had to have IV hydration for two months of their pregnancy

I was hospitalized for three days and had IV hydration for almost five months of this pregnancy. With my last pregnancy, I had at home IV therapy for almost as long for severe HG. I had a wonderful homebirth last time, and if these babies ever decide to be born, I expect the same this time around!