My two big fears - Why didn't they stop you? - Mothering Forums
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#1 of 13 Old 05-05-2002, 06:19 PM - Thread Starter
 
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I have been doing a lot of reading, talking and thinking about birthing #2 at home, but there is one big fear I can't let go of. I think this is a long-time peril of childbirth, so I doubt I'm alone.

Prolapsed chord - I know it is rare, even rarer at home. I know that there are ways for a midwife to deal with it while being transported to the hospital. But, we are about 20 minutes from the hospital and that seems like a long and scary ride.

I think most importantly, I need to talk to my prospective midwives about this, but I was just wondering, for those of you who have chosen homebirths, did you have this fear? How did you put it aside? It's like Ok, so there's a very small chance of this hapenning, but I can't get over - What if it does? I would never forgive myself. Do you think I'm irrationally holding onto this fear as an excuse to not confront other fears or is this something lots of women worry about?

I know this is very, very personal, and I'm not expecting anyone to get inside my head (too much ), but for those of you who have birthed at home or assist those who do, why doesn't this haunt you?
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#2 of 13 Old 05-05-2002, 06:37 PM
 
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First of all... you said you had 2 fears, but only listed the prolapsed cord as being an issue - so I'll address that and if you want to post again, I'd be happy to talk to you about other concerns:

About prolapsed cord - the reality is, if this happened, you and your midwife would already have an idea that it could happen - that is, if say at 40 weeks you opted to have a cervical check and she noted that your baby was at a really high station (like -2) she would probably be conscience that if your water broke that a prolapse could occur (because there was so much room between your baby's head and your pelvis.)

The fact is, whether you are having a homebirth or a hospital birth you would handle the prolapsed chord the same way. As soon as you knew that the cord was prolapsed, you would immediately grab a phone, dial 911, lay yourself down with your hips elevated and you would wait for help to arrive.

It is so rare, that choosing homebirth over hospital had no bearing on this issue for me because the resolution to the problem is the same whether you are having a homebirth or a hospital birth. You could choose to have a hospital birth and then be at home, your water breaks and suddenly you feel a pulsating sensation in your vagina. You go to the bathroom to check the color of the fluid coming out and you either see the cord or can feel it in your vagina. So whether it is homebirth or hospital birth, you just have to lay down, elevate hips (to keep baby's head from pressing on the cord) and call 911.

Does that make sense?
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#3 of 13 Old 05-05-2002, 07:00 PM
 
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I'm not pregnant, but if I were, my one fear about homebirth would be hemorraging directly after birth. My OB/GYN FIL says that this is one complication that can happen with no warning signs. I feel like I'm at greater risk for hemorraging because I've already had 4 babies and my uterus has lost its tone. I'm not trying to say homebirth isn't safe, I'm just wondering how this sudden complication could be handled. If I were to get pregnant again, I'd want a homebirth.
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#4 of 13 Old 05-05-2002, 07:39 PM
 
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Hey MamaLeah, I worried about exactly the same thing. Mine I put down to neurosis due to losing my last pregnancy at 16 weeks in utero for no apparent reason. So I s'pose I realised that bizzarre obscure things could happen to me. Coz the one before had been ectopic, I realised that just coz you'd had one obscure thing happen, it didn't preclude another happening that was totally unconnected. Added all up with an unsupportive, generally dismissive midwife, plus access to the net & scary info, my brain worked overtime on paranoia when I was pregnant last time.

I had really wanted a home birth - simply coz I believe birth is not a medical event & I had really gotten to hate hospitals & associate them with bad things ( pregnancy loss, death, illness ). My midwife sort of changed tack on me & insisted on a hopsital birth & gave me scare tactics when I was about 7 months pregnant. The upshot was, I was right, she was wrong. Saffron was born at home by accident unassisted. I did have a brief moment of fear about the cord having prolasped since when her waters broke just before she came out, I felt something fly out & land on my leg. It was probably a bit of membrane or some water.

I had read spiritual midwifery & knew what to do if the cord did prolaspe. I also remember now that out of all Ina May's listed births, they never mention losing a baby to prolased cord. I think it's probably really rare. To be honest, I think you're better off in your own environment, where you feel safe & secure, than being freaked out in a hospital just in case something goes wrong.

I think too a lot of the scarey tactics about homebirths, miss out the hospital ones. Sure you're in hospital, but doesn't it take them a certain amount of time to prep the theatre & scrub up & get assembled for an emergency ? I could be wrong, but presumably if your fear was to come true, they could do this whilst you were on route ?
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#5 of 13 Old 05-05-2002, 08:54 PM
 
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Complications can happen anywhere, and I don't believe that simply being in a hospital is insurance that they will be properly handled. Also, many complications are caused by interventions--at home, with the midwife I chose, I felt I had less of a chance of problems occuring than if I was in a hospital.

Whenever I'd come up with a "what if?" fear, I'd ask my midwife directly, "What would you do if____________?" Every single time she had a definate plan of action and she was confident and realistic. I truely felt secure in her care.

If/when you do interview midwives, ask them what they would do for each of the situations you're concerned about. They should be able to put your fears to rest.

Single Mom to 3 (12, 17 & 21)  luxlove.gif and dog2.gif.

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#6 of 13 Old 05-05-2002, 09:03 PM
 
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i almost hemmorhaged the first birth which was in hospital. after the second birth at my midwife's home i realized that the cnm at the first birth had hurried the afterbirth and pulled my placenta out.
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#7 of 13 Old 05-05-2002, 09:28 PM
 
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All reputable midvives have Pitocin on hand and if a mother is hemmorhaging, they give a dose of Pitocin - they may also transfer if they feel that a transfusion is required...plus there are other things you can do - nursing stimulates the uterus to cramp, as well as simply massaging the uterus from the outside.

All reputable midwives are trained in how to handle this issues and usually because they know their patients better than most docvtors, they can head these complications off at the pass (so to speak.)

really, my fears about having a homebirth were more about handling pain and not having access to pain relief if I felt I couldn't handle it.

Now after having a homebirth - having a long labor (28 hours) I am so glad I didn't have drugs available to me...even though I asked several times to be transferred...it was hard work, but so much better than what it would have been like in the hospital.
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#8 of 13 Old 05-05-2002, 09:37 PM
 
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WHat's funny is that I had practically no fear about delivering at home- I was confident that my midwife knew what to do in any situation, and I guess I was right. My daughter was born with severe meconium aspiration but because the midwives realized and acted immeditely (she was on oxygen before her APGAR's were even done- make sure yours will carry an oxygen tank to your home) she is fine today. We are also 20 minutes away from the hospital, but dd was born at 9:24 am and admitted to the hospital at 10 am. She was transferred to the university hospital and underwent radical surgery, but we all feel thather gentle homebirth was good for her recovery and has helped her in the longrun. Also the complications would have happened if we were in the hospital as well.
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#9 of 13 Old 05-06-2002, 12:18 AM
 
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Mamaleah - first thing you should know is that prolapsed cords in spontaneous labor are extremely rare. I've seen 2 in the past 1 1/2 year working as a L&D nurse - both OB induced. One was cause by OB deciding to rupture membranes with a very high head (the house doc. refused to do it, b/c the the head was so high - so the private OB came in to do it himself - and whoops! a cord). The second one, a woman had an amnioinfusion running and the OB thought that too much fluid might have run into the uterus. She decided to push the baby's head upward to let some fluid escape, and a torent of fluid came out - with the cord. Two things to remember - 1) the cord floats, so generally speaking if a woman has enough amniotic fluid, it should float upward and out of the way of the head and 2) in spontaneous labor, the head is generally well applied to the cervix, which prevents a cord from prolapsing.

Daylily - hemorrhage is always a concern, but most can be handled at home the same way they are handled at the hospital, although many midwives will try herbs before meds. If a woman is having an uncontrollable hemorrhage (*very* rare) a midwife will do "bimanual compression" - literally compressing the uterus to controll bleeding while transporting to the hospital. Just for the record - I had babies #4 and #5 at home. I got a shot of pitocin to help my uterus contract after #4 (but there were other things complicating the delivery, including a very fast labor and borderline anemia) and needed nothing after baby #5. So much for my lax uterus.
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#10 of 13 Old 05-06-2002, 12:25 AM
 
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well, what I would say about this matter is, as someone else mentioned, if you have done a lot of reading or talking to people who had hospital births, there are a lot of really scary outcomes there that I didn't feel good taking the chance with. at least if you did have a prolapsed cord at home, you would know that your interventions are necessary. TO me, I couldn't handle the thought of the birth being out of control and in the hands of others. I felt that teh "risks" were much higher w/a hospital birth.
everyone usually has there particular fear that they hang onto...mine was hemoragging. (For the record, both of my two babies were homebirths, the last a freebirth/unassisted) W/baby one, I lost a lot of confidence, was told which positions to assume, had high BP, boderline gestational diabetes, possibly beta strep pos, meconium, midwives worried about hemorage, baby born floppy,--and all within the realm of okay. W/baby two, I worried and worried. (and worried!! LOL) But after reading Dr. Gregory WHite's "Emergency Childbirth", he said that in a study of hemoragging women that no mother died in under 2 hours of hemoraging. Which helped me relax that I would have plenty of time. We also had herbs etc. chosen from susun weed's "herbal for a childbearing year".
anyway, my point is. (and I DO have one <g>) that you just need to look deep within and chose your birth of your dreams. cuz it is possible for you. Only you know what you truly want. Maybe you are using prolapsed cord fear to protect you....or maybe you really want a hospital birth! it is really just imperative that you chose where you personally are comfortable. There will always be worries but w/homebirth, you are chosing to take the road less traveled and assume more responsibility for your birth and baby. Which is awesome IMO. AND also leads to much more empowered birthing and lives!! Each pregnancy is usually a journey through fear. But if we have faith in ourselves, our babies (and you can communicate w/the little one!), our families, our bodies, we are usually rewarded w/more than healthy baby.
just my .02 good luck
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#11 of 13 Old 05-06-2002, 01:08 AM
 
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YES! Homebirths are so empowering. I struggled until the last month with a full commitment to a homebirth with ds #1. My fear was hemmoraging (i think someone had told me a horror story) and I had to look beyond that to deep inside and find what I really wanted. A tour of the hospital made me realize I just couldn't labor and deliver there unless absolutely necessary. And I questioned my midwife about what she would do. Ultimately, I had a beautiful labor and birth at home and did hemmorage. My midwife gave me pitocin and a great uterus massage and all was well . I lost alot of blood but nothing that rest, bed time and food didn't cure. I was so thankful not to be in a hospital because I know that things would have been much different. A cesarean because of some complications I had at the end. And if not, for sure a transfusion after the bleeding.

THEN (to address the prolapsed cord fear)... my water broke 6 weeks early with ds #2. My midwife was able to find a great doc who (after 2 days of no labor and begging) let me return home for self monitoring, strict bedrest, and ultrasounds every few days...even with the rare chance of a prolapsed cord. He said the baby's head was on the cervix and that would keep the cord from prolapsing. He told me what it would feel like should it happen and what to do (basically--what Iguanavere wrote).

It's a difficult decision, especially if you are without support of others who have had a homebirth. Ultimately it has to be in your heart.

good luck
jackie
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#12 of 13 Old 05-06-2002, 08:12 AM
 
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Thank you, Iguanavere and Mom2five. I feel reassured. I did need pitocin after baby #4, but didn't actually hemmorage. I had been taking raspberry leaf capsules for months and I don't know if they helped prevent a hemmorage or if they didn't work at all.
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#13 of 13 Old 05-06-2002, 05:08 PM - Thread Starter
 
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Thank you awesome mamas! You have given me good information and good stories. I still haven't met face-to-face with a midwife (talked to one for a long time on the phone), because I felt like I needed to gather my thoughts and more information, but I think I'm ready for a first visit.

I can't thank you all enough for sharing. Writing and listening have helped me so much.
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