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HBAC no co-care crazy?  

post #1 of 10
Thread Starter 
I will be 38 when I have my second child this Jan. I'm hoping for a home birth after a c-section 20 months prior. I blindly followed the doctor last time and was one of those that was left emotionally wounded. This time i have chosen to: never see a doctor - only a midwife; take charge of my own, very fragile and depressed, well-being; and have a baby at home.

I 'only' have about 15 weeks to decide..am i crazy or smart?
post #2 of 10
Lots of women see only a hb mw, no med. backup. There is nothing about your general situation as you've described it, that makes me think you *should have med backup. And especially w/VBACs, I tend to believe that it's better NOT to have an OB on board--which too often means that the mom is receiving too much fear along with her prenatal 'care'. Calm and confidence are always important to normal birth--ever so much more so with VBACs, IMO.

so--enjoy your pregnancy, and may you have a lovely birth!
post #3 of 10
I agree - plenty of women have homebirths with only midwives as care.

Good luck and I hope you have a magical birth too
post #4 of 10
the issues would be
is it legal for your mw to attend your birth in your state? if not then how will you get your labs done and how will a birth certificate be filled?
can your mw order an ultrasound to be sure of placental location? (higher incidence of partially retained placenta, it is still a small percent of births that this occurs but if the placenta is located over the scar greater chance it could happen)
legal or no with the current anti vbac climate and you have a non-emergency transfer of care and you have not established care with a doc you have a higher chance of getting an doc who is not going to support your desire to have a vbac, if you pick a practice that will offer vbacs ahead of time- then that protects that choice for you

what does your mw think?
post #5 of 10
Only issues I see are that you want to make sure your HB midwife has a good relationship with your (potential) transfer hospital, just in case things go badly. The last thing you want is to rush into the hospital because of suspected rupture (or something less urgent) and have them give you and/or your MW crap about having a baby at home.
post #6 of 10
I'm planning an HBAC in March/April w/ a lay midwife. I don't plan on seeing an OB or CNM. I can't see any advantage to it. We've decided not to do an ultrasound and the MW can do an iron test and a GBS test, which we want. If we decide to have an ultrasound or other tests b/c of some problem then I'll go to the CNM-run birth center I used last time. I don't think my MW has much experience w/ my local hospital, but the hospital she and another MW mentioned using is about 40 min. away, making it impractical for a transfer. So, if (God forbid!) I need to transfer we'll use the local hospital and hope for the best. I figure if we need to transfer then we'll need interventions and I'll have no choice but to trust the doctors there, regardless of whether I've met them before or not.
post #7 of 10
Quote:
Originally Posted by vagabondbaby View Post
I will be 38 when I have my second child this Jan. I'm hoping for a home birth after a c-section 20 months prior. I blindly followed the doctor last time and was one of those that was left emotionally wounded. This time i have chosen to: never see a doctor - only a midwife; take charge of my own, very fragile and depressed, well-being; and have a baby at home.

I 'only' have about 15 weeks to decide..am i crazy or smart?
smart. IMHO having an OB w/ a VBAC is really really difficult (not for everyone, but those cases are in the minority unfortunately..i know so many will say their OB was great but for me, in my area, its like looking for a needle in a haystack and just not worth it).

research how to take care of yourself though, especially the depression. my MW gave me some herbal recommendations when i dealt with a difficult situation in teh middle of my pregnancy. I also learned the very REAL value of making my own pregnancy tea and how that helped w/ my energy, iron, emotions, etc. etc. It helped me sooo much. Taking charge of your pregnancy is not difficult but does involve more work than simply visiting an OB (which i did w/ ds1 and ds2 but not ds3 or this pregnancy).

Quote:
Originally Posted by mwherbs View Post
the issues would be
is it legal for your mw to attend your birth in your state? if not then how will you get your labs done and how will a birth certificate be filled?
can your mw order an ultrasound to be sure of placental location? (higher incidence of partially retained placenta, it is still a small percent of births that this occurs but if the placenta is located over the scar greater chance it could happen)
legal or no with the current anti vbac climate and you have a non-emergency transfer of care and you have not established care with a doc you have a higher chance of getting an doc who is not going to support your desire to have a vbac, if you pick a practice that will offer vbacs ahead of time- then that protects that choice for you

what does your mw think?
these are good Q's to have the answers to but shouldn't preclude you from a
HBAC. my MW is NOT legal in my state b/c of some new regulations. i decided to simply find someone who would attend me and no it wasnt easy, but its ALMOST ALWAYS possible to find a MW SOMEWHERE that will be willing to attend IF YOU WANT IT BAD ENOUGH.

if you want labs (i didnt) then you can simply go see an OB to get those done and then bolt on them. i see no issue with this at all.

you didnt say whether you wanted u/s's, but we didnt do them to check placenta location, etc. etc. A good MW can generally tell where your placenta is (not the scar though). Regardless, i chose not to have any u/s but ended up having one to check for number of embryos b/c we suspected twins and weren't happy w/ our MW at that time so wanted to make sure we only had one (we ended up firing that MW anyway so im bummed that i succumbed to that u/s but it was what it was).

My advice to you is to deal w/ all the really scarey possibilities NOW instead of later. I hear a bunch of stuff now at 40 weeks and 5 days....i dealt w/ all that crap at 10-15 weeks, so they aren't phasing me as much now....but don't wait to deal w/ your fears....one of the biggest things for me is that i have to OWN thsi birth. If something happens to me, or to the baby, its MY issue to deal w/ and not my MW's. She is not licensed in my state and won't be mentioned in case of an issue. However, in case of a transfer, we will be going to a hospital in HER state and we will say I was birthing at her home. That protects her, which I find very very important to do. The hospital is about 40 minutes from my home and from the research I have done, I feel comfortable w/ that timing.

good luck to you. this is obviously a very passionate issue for me. its something very personal and something you have to feel 110% committed to IMHO. Less than that will cause you alot of problems over the pregnancy and stress hormones are not good for the baby.

I wish you luck and believe you can have a HBAC if you want it bad enough.
post #8 of 10
Around here, it is completely normal to "just" see a midwife for care with no co-care..in faqct, the hombiorth midwives are the ONLY ones who will do Vbac, so there is NO "co-care" available.
post #9 of 10
The ONLY reason I have an OB on co-care (and he doesn't know of my HB plans) is b/c my midwife is unlicensed. I was unable to use a licensed midwife b/c of my previous c-section (state law prohibits them from attending a VBAC).

I completely and totally trust my MW, but I have heard some horror stories about how the hospital here treats HB transfers. Dh and I decided it'd be a good idea to establish care with an OB just in case I have to go in.
post #10 of 10
Thread Starter 
Thank you for your responses. I have a midwife that has assisted in over 1,000 births and has looked over my past medical birth record. I am working so hard on my depression because I want to have a birth at home. My fears come from the fact that NOBODY IN MY CIRCLE OF FRIENDS/FAMILY THINKS I WOULD OR COULD BE OK WITH THE PAIN. WTF. I go to ICAN meetings, Birthworks classes and home birth meetings to find any support FROM WOMEN. Funny thing, my husband and another man we know is TOTALLY OK WITH IT. again WTF.
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