How do you prepare for HB not working?

[Maggirayne]

I had a disappointing first birth, and I really want a homebirth next time. But I am worried that I'm too rigid in my expectations of a very good birth, and if things don't go well it will be hard. So how can I loosen up without losing my expectations/focus on a good birth?

[TzippityDoulah]

I really think this is something you need to find within yourself. why do you think your expectations of homebirth are too high? almost all homebriths turn out fine. and if something actually does happen then you can seek more care. that doesn't make it a failure.

i think when we think of homebirth vs. hospital birth (esp us who have had hospital births before) we get this idea in our minds that we might not be able to "homebirth right". or that we might fail. but it's no test! the only failing is NOT listening to your heart. I completely plan on a homebirth - a normal birth. if at anytime something comes up that causes me to need extra medical input I will consider it. it will depend on the situation and the scenario. for me "labouring too long" isn't something I would go to the hospital for... but loosing a lot of blood is. (for example). you have to come up with your own boundaries. but i will not fail. failure isn't an option for me. I wll birth normally, and like I said, if something comes up with real cause for concern I'm not afraid to explore the idea of getting help. it doesn't mean my body failed, it just means it would be one of those times in life where having the opinion and help of another human being would be helpful to me and i would ask/accept.

[amydidit]

Hmm, this is a good question. I think it's very personal too. For me all I did was tour the local hospital maternity floor so to not be completely surprised if something happened, and then I put it out of my mind. I knew there was no reason I couldn't have a good homebirth. I put all my trust in myself and my body, and let it do its thing. It helped that I had a midwife with a teeny tiny transfer rate (like serious, nearly non-existant). I am also super stubborn so I knew I wouldn't give in and transfer from pain, or length of labor, etc. I knew in the deep corner of my mind that if I felt something was really wrong that I would go... but I also knew it wouldn't happen.

And sure enough, after 21 hours of posterior labor, and my DH asking if I wanted to go to the hospital because I was screaming and crying from the pain so bad (but that's all it was, just pain), I had my beautiful little girl, at home in my bed.

So for me, to prepare for HB not working? I basically didn't because I knew it WOULD. Some people may think that's stupid, but it's what I needed to do.

[barefootpoetry]

I was very set in how I wanted my homebirth to go at first too. But over time I realized I was being incredibly unrealistic. Birth happens how it wants to happen. Yes there are many, MANY things you can do to encourage the outcome you want, but you still can't control it, and that's what I was trying to do. My homebirth was amazing, but definitely not the romantic warm-fuzzy affair I'd imagined. There were minor complications, but nothing that "ruined" the birth itself, because I learned long ago to let go of my rigid expectations. The good moments totally overrode the not-so-good ones anyway, and when I think back on my birth, that's what I focus on.

[Otterella]

I think we're to some degree conditioned to think we have to fight like dogs for that "perfect birth" because we're thinking of a hospital birth with policies and procedures that don't mesh with our ideals. Once I made the realization that I wasn't going to have to *fight* for anything at home, I realized that it will go the way it's meant to go, and if that doesn't match my expectations, it will still be okay. Nobody is going to try to force an IV or EFM or Pitocin on me when I don't want it. So I can just give myself totally over to what my body needs to do and be free to listen and obey the messages coming from inside instead of fighting the messages coming from outside. Sure, things can still be less than ideal, that's just nature. But when you have trust in your midwife, you can have trust that it will be handled appropriately without having to be "on guard" for the shenanigans the doctors in the hospital might try to pull.

[dogmom327]

For me, it was all about making a back-up plan (knowing the fastest route to the hospital), trusting my midwife and then just completely focusing on having a home birth. I personally didn't find it helpful to think to much about contingencies--I needed all my energy to focus on having he birth I planned. If something had gone wrong, I'd deal with it at that time. I was well read in terms of procedures (probably too well read), etc. but I didn't feel a need to prepare myself for things not working out. Mentally it wasn't an option--but I could have changed gears if needed.

[barefootpoetry]

Originally Posted by Otterella

But when you have trust in your midwife, you can have trust that it will be handled appropriately without having to be "on guard" for the shenanigans the doctors in the hospital might try to pull.

This! I was not hung up on the complications at my HB because I trusted that my MWs made the best possible decision on how to deal with them. That's way more than I could ever say about a CP at the hospital!

[rockportmidwife]

#1 Don't overplan your birth. Let your birth unfold the way it is meant to, instead of trying to get your birth to follow your perfect vision. Women get disappointed when their birth doesn't follow the "ideal" plan that they set up even when it is a great birth.

#2 Beware of self-fulfilling prophecies. I have seen women end up with problems because they became too focused on the "what ifs" instead of focusing on having a nice birth/pregnancy.

[moderngal]

I was not hung up on the complications at my HB because I trusted that my MWs made the best possible decision on how to deal with them.

ditto.
trust your midwives and trust your body.

[library lady]

My first birth was a hospital birth so I had some of the same concerns with my second, which was a planned homebirth. One of the things that I did was make sure that I was comfortable with my midwife and trusted her. When I interviewed her, I had done my research and had about 50 questions to ask her. They included a lot of what ifs and why would she transfer and how many transfers she had. I also spent most of my pregnancy reading books. I think I read all of the books by Ina May Gaskin and several others that talk a lot about birth as a normal process. I also read a lot of birth stories from home births to get a variety of perspectives. One of the things that I have noticed is that every birth is different and every pregnancy is different even for the same person. I have had 2 home births and am preparing for my 3rd homebirth (4 child) and I don't really have a lot of expectations because each birth has been so very different. I had to trust myself and my midwife. Without that trust, I think you set yourself up for failure because you are constantly second guessing yourself and making everything into a crisis when it is really just a normal part of pregnancy.

[Maggirayne]

OP here, I guess I'm trying to sat in the remote case of something going wrong, how do I make sure(ha!) I'm not traumatized or disappointed.


I'm not expecting anything to go wrong, but I agree with Otterella, we're so used to fighting for things to be normal. At first I was thinking my expectations were too high. But really, like someone said, it is pretty rare.

As for midwife, I don't have one yet, but there's only 3 in my whole state and two are at least 3 hours away.

When DH and I were talking, he's not absolutely sure about HB, he said he'd be pretty okay if I went in if the midwife. Which I would want to try eating some placenta first if hemorrhaging, or would refuse to go in and rather UC if baby was breech, and MW wasn't comfortable catching. So yeah, a lot does depend on your trust in your midwife, and I think I need to think of what I would want to do "in case", most importantly, share the why of my choices w/DH.

I don't think I'll have issues if things are different because of necessity, but I've read of drs. refusing certain treatment unless the patient consented to things they did not want. But there are things that are out of my control. With my first birth, my DD was taken away for four hours and under the heat lamp and on oxygen, and the dr. later admitted it likely wasn't necessary. But I have been terribly angry for almost a year and a half about it. I just don't want that to happen again.

I hope that clarifies some things. Thank you!

[prothyraia]

Do everything you can to inform yourself and prepare and surround yourself with supportive people. And then trust that, having done everything your power to make it so, you will have the best birth you can for this particular birth.

Almost certainly, that's going to be a lovely, peaceful homebirth. There's a truly tiny chance that it could be a hosital transfer and a c-section. But if you've done everything you could to be healthy and informed, and you trust your midwives, and still end up in the hospital- it will be because that was the best place for you to be at the time.

There's a different quality to being disappointed because you wanted things to turn out differently, and being disappointed because something Went Wrong.

[2+twins]

Originally Posted by Maggirayne

OP here, I guess I'm trying to sat in the remote case of something going wrong, how do I make sure(ha!) I'm not traumatized or disappointed.

If it were *me* and I ended up transferring for one reason or another, I'm pretty sure I would be traumatized and/or disappointed. I just would be b/c I really, really wanted a birth at home. I think it helps to feel secure that you're making the right decision for you and your baby at that moment, but I doubt it would take away the hurt of having a dream crushed. I don't really think there is anything you *can* do to prepare for that remote possibility aside from being knowledgeable about normal birth and how you'd want any variations (as well as normalcys) to be handled. That way you make calls you feel secure with during the birth and can be vocal to your mw and partner about your wishes and feel confident that those wishes will be respected and upheld. I think it's very important to have a mw that ultimately defers to you on decisions so if you've been having good conversations with her throughout your pregnancy about what you want and do not want then I think in the end you can feel confident that you gave birth the best way for you, however or wherever that ends up being. I hope that made sense!

[claddaghmom]

Other than picking out my own fishy pool and wanting a good video of the birth, I am trying to go into this homebirth with no expectations. (e.g. how labor will present, how long, how painful, etc).

But no matter what I think of doing, nothing can make me feel "better" about the chance of a transfer.

I've tried making a birth plan
I've tried researching local hospitals/OBs (scarrrry!)
I've tried talking w/ DH about various scenarios


None of these has relieved the fear of ending up anywhere near a hospital. I am looking on the bright side about this! If I am so adamant not to end up at a hospital, perhaps I will not become one of those statistics where the woman became doubtful or exhausted and transferred only to find out nothing is wrong, or it's too late for an epidural.

I even typed out a reminder to DH that I don't want a transfer unless I'm bleeding before delivery, there is cord prolapse or the baby cannot be rescucitated.

[Kim919]

I would just try to totally let the feelings go. If it doesn't work you probably will be dissapointed, so cross that bridge if you come to it. Truely expect the best, but have a plan for the worst, and then take a deep breath and relax knowing your doing your best.

Do you not cross the street because you could get hit by a bus? No, you look both ways twice and do it. Pregnancy and delivery has risks no matter where you are, I personally feel that those risks are greater at the hospital and that being home lessons the risk, but everyone has their own opinion on that and I totally respect it. No matter where you are something can go wrong, and worrying really doesn't do anything to help it. Get a massage. Find a mantra that you find inspiring, do some relaxation exersizes. It sounds corney but I think it can help.

[leavemealone]

I try to focus on all the things that can go right and not all that can go wrong. It's not that I don't think about the "what ifs" - I do keep them in the back of my mind and think about them occassionally, but I don't dwell on them. I also don't think I have unrealistic expectations and am generally a 'take things as they come' kind of person. I don't have a set thought that 'this is how I want things to happen' so I hope I won't be disappointed if they turn out differently.

I ended up with a c-section with my first and I always kept potential complications in the back of my mind, but I also kept the odds of things going well in the front of my mind. That (hospital) birth went great and we are now planning a homebirth for baby #3. I still keep the odds of things going bad in the back of my mind, but like others have said, I have trust in my midwife and my body that we'll know if something isn't going right.

[Maggirayne]

Originally Posted by 2+twins

If it were *me* and I ended up transferring for one reason or another, I'm pretty sure I would be traumatized and/or disappointed. I just would be b/c I really, really wanted a birth at home. I think it helps to feel secure that you're making the right decision for you and your baby at that moment, but I doubt it would take away the hurt of having a dream crushed.

Exactly. I guess this is most what I am afraid of.

Originally Posted by prothyraia

Do everything you can to inform yourself and prepare and surround yourself with supportive people. And then trust that, having done everything your power to make it so, you will have the best birth you can for this particular birth.

Almost certainly, that's going to be a lovely, peaceful homebirth. There's a truly tiny chance that it could be a hosital transfer and a c-section. But if you've done everything you could to be healthy and informed, and you trust your midwives, and still end up in the hospital- it will be because that was the best place for you to be at the time.

There's a different quality to being disappointed because you wanted things to turn out differently, and being disappointed because something Went Wrong.

True.

Originally Posted by claddaghmom

<snip>But no matter what I think of doing, nothing can make me feel "better" about the chance of a transfer.
<snip>
None of these has relieved the fear of ending up anywhere near a hospital. I am looking on the bright side about this! If I am so adamant not to end up at a hospital, perhaps I will not become one of those statistics where the woman became doubtful or exhausted and transferred only to find out nothing is wrong, or it's too late for an epidural.

Right, that would annoy me terribly. I transferred for *no* reason.
I very firmly believe that you can tell if something is wrong if you listen to your body, like Ferrum said.

[Arwyn]

For me, it was expecting the unexpected (that is, other than having a good knowledge of the full range of normal birth patterns, I had no particular expectations of how this birth would go. on the intake form I filled out for the midwife, where it asked about what I pictured the birth being like, I said something like "My partner is with me. There is water. I birth my baby at home." that's it.), and then knowing that if I transferred, it was for a good reason. Homebirth is about maximizing the odds of safety; most of the time, for most women, homebirth is safest. Set up the situation to maximize safety, then deal with complications as they come, and know you've done your best.

Thirdly, I gave myself permission to be upset about a transfer, if I had needed it. We don't have to like it; it's OK to be ambivalent; it's OK to hate the necessities sometimes. It's OK to grieve, and be angry. It's right to feel that way; it would have been my right.

Having all that set up in my mind made me much less anxious about the possibility of needing a transfer; but, like the majority of all attempted homebirths, I didn't.

(Also remember that primips are about four times as likely to transfer as multips, even those who have transferred before. Just because it happened with your first birth, doesn't mean it will, or even is likely to, with this one. )

[k13]

just echoing the wise words already expressed by everyone...

Definately agree with letting go of feeling the need to "control" or overly plan anything... it's good to be able to "Go with the flow" or "let go and let god" (to use an AA saying even though I'm neither conventionally religious or a recovering alcoholic - I like the saying!)

Keep a positive attitude, don't fret or dwell on "what ifs" but be mentally prepared to be flexible - every birth is different!! There's no one recipe for a good birth.

Also being trusting of midwives, having support - partner/doula to know what you want but also know it's okay to change your mind.

For most people the most important goal is a healthy baby so don't feel like a failure if something "goes wrong"

I also expect that birth is going to be difficult and painful and in ways we might not be prepared for... but this is part of the process.

[library lady]

My first birth was an intervention filled hospital birth. I was pretty torn up about it until I gave myself permission to be upset. I also reminded myself that I did the best I could with the tools that I had at that particular moment. It is really easy to second guess yourself and beat yourself up. Don't do that. If you are trying to hammer a nail without a hammer, the outcome may be a little screwy. It is really easy to say, if I had a hammer, everything would have been perfect. Guess what, you didn't have a hammer and no amount of second guessing or wishing for a hammer is magically going to make a hammer appear. (Sorry for the goofy analogy.)

No matter what the outcome is you always have to remind yourself that you did the absolute best you could in that particular moment. If you equip yourself with knowledge and self-understanding and self-forgiveness, then you are prepared for whatever may happen. If you have studied everything you possibly can and end up transferring, it is because you can be content knowing that you truly needed it. That need can be emotional as well as physical. For me, I have a really strong need to stay home so I am pretty confident that a transfer would be the result of something really, really serious.