Homebirth: why is it almost the same cost as a hospital? - Page 3 - Mothering Forums

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Old 07-02-2011, 10:05 AM
 
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Originally Posted by weemom3 View Post

 Had I not been in a hospital I could have lost one of them simply because i didn't have the medical tools necessary to save them. My youngest son came out so quickly that he had fluid in his lungs he was blue and didn't cry right away. Since I was waiting for his cry as my first son did this was a scary moment for us as they had to whisk him away to get him breathing. I don't believe that any should suffer the loss of a healthy infant due to a home birth.


Not to completely derail this thread, but my not-quite-3-week-old.was born, at home, in essentially exactly this same situation.  Very quick birth, blue, floppy, not breathing, and (we found later) quite a bit of fluid in his lungs.  His immediate care was handled very well by our midwives (who do carry emergency equipment, including oxygen), and we transferred to the hospital later (where the x-rays showed all the fluid) for ongoing respiratory issues. 

 

He's happy and perfectly healthy now; in fact, one of the benefits of being at home was that he wasn't "whisked away" to be worked on.  He stayed right next to me and we didn't cut the cord immediately, so he remained attached to his placental blood and oxygen supply.

 

This isn't to say that there aren't risks to homebirth (just as there are risks specific to hospital birth) or that there are never situations that would be better handled in the hospital- but trained midwives can handle most emergencies and transfer safely when appropriate.

 

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Old 07-02-2011, 10:43 AM
 
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Hello

There was no benefit in "not being whisked away" but risk. you are very fortunate that all turned out so well.

 

The benefit of late cord cutting is not  direct O2 but red blood cells.  It is beneficial if your child is anemic and it can reduce the amount of O2 one needs , but the amount of oxygen that red blood cells carry to a hypoxic child are minimal compare to the newborn's needs.    Right after birth the function of placenta is is not functioning as well as did before as the uterine wall blood vessels close up and now you have a separation as well.   You can look up what happens in uterus after birth in any maternal physiology book.

 

Also, if you think about specific case of lungs being filled with fluids, extra red blood cells will not make any difference . The problmes is fluid and decreased surface and movement  of the lung . In the hospital the extra fluid is removed either with medications (such as Lasix) by making the patient pee more of mechanically with a tube.

 

If you take an empty plastic bag and tie it around the straw and start blowing air in and out you will see how completely the bag filsl up  and empties. The the bag was a lung, there would be gas exchange all along the surface. Now, fill up the bag half way with the fluid. Not so easy to blow air in an out and only 1/2 of the bag moves.  Now , fill the bag with water completely?  What happens now? There is no  free surface. It is call covered with water and there is no way to push air in and out. If it was a person, the person would drown. And indeed, one can drown in one own fluids.

 

So yes, delayed cord clamping will help with increase blood supply and will benefit small % of anemic children, but  it is not a way of providing O2.   If there is risk of compromised respiratory  function, hospital personnel will take care of the essential function first because of the risk of brain damage.


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Not to completely derail this thread, but my not-quite-3-week-old.was born, at home, in essentially exactly this same situation.  Very quick birth, blue, floppy, not breathing, and (we found later) quite a bit of fluid in his lungs.  His immediate care was handled very well by our midwives (who do carry emergency equipment, including oxygen), and we transferred to the hospital later (where the x-rays showed all the fluid) for ongoing respiratory issues. 

 

He's happy and perfectly healthy now; in fact, one of the benefits of being at home was that he wasn't "whisked away" to be worked on.  He stayed right next to me and we didn't cut the cord immediately, so he remained attached to his placental blood and oxygen supply.

 

This isn't to say that there aren't risks to homebirth (just as there are risks specific to hospital birth) or that there are never situations that would be better handled in the hospital- but trained midwives can handle most emergencies and transfer safely when appropriate.

 



 

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Old 07-02-2011, 07:49 PM
 
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I really hate to pursue this, since it has nothing to do with the OP, but I also can't let the whole "omg, my baby needed some sort of minor medical attention and would have died during a homebirth" thing stand, as if having a homebirth somehow transports you 500 years into the past where portable medical equipment doesn't exist and hospitals, physicians, and intensive care are nonexistent instead of minutes away (although I don’t know the first commenter’s exact situation or what sort of care was required and can’t speak to the specifics of her case).

 

Especially when that argument is being propped up by nonsensical justifications like the idea that receiving oxygen and appropriate neonatal resuscitation with the cord intact is somehow riskier than being whisked away to receive oxygen and appropriate neonatal resuscitation with the cord cut. ( confused.gif)   Even if you think that extra minute or two of oxygenated blood (meaning red blood cells...that are carrying oxygen....which is exactly what we're trying to get into the baby at that point) is minimal in effect compared to aiding respiratory efforts, you can hardly argue that it's inherently harmful. I mean, it's not as if anyone said "Oh, nevermind, there's no need to get the baby to breathe, we've still got an umbilical cord!" eyesroll.gif

There are risks to homebirth, certainly, but let's at least be realistic here.  Having resuscitation done at the bedside as opposed to across the room is not causing dead and brain damaged babies.


 

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Old 07-03-2011, 12:21 AM
 
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There situation where receiving help whiting 2 mins, verses 20-40 minutes it takes to  get one to the hosptial will make a huge diffrence. The OP want to hire an illegla provider that raises several important issues. Will this person have all the equipment? What are her professional ethics if she is willing to work illegally ? Will she actually willing to do a transfer if that will leave her open to the investigation by authorities since she is working illegaly.

 

We do not live in the future with teleporters. Calling 911 takes time, ambulance getting to the house takes time and ambulance getting to the hospital takes time. What if there is traffic? Rainstorm, etc etc etc.

 

 

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I really hate to pursue this, since it has nothing to do with the OP, but I also can't let the whole "omg, my baby needed some sort of minor medical attention and would have died during a homebirth" thing stand, as if having a homebirth somehow transports you 500 years into the past where portable medical equipment doesn't exist and hospitals, physicians, and intensive care are nonexistent instead of minutes away (although I don’t know the first commenter’s exact situation or what sort of care was required and can’t speak to the specifics of her case).

 

Especially when that argument is being propped up by nonsensical justifications like the idea that receiving oxygen and appropriate neonatal resuscitation with the cord intact is somehow riskier than being whisked away to receive oxygen and appropriate neonatal resuscitation with the cord cut. ( confused.gif)   Even if you think that extra minute or two of oxygenated blood (meaning red blood cells...that are carrying oxygen....which is exactly what we're trying to get into the baby at that point) is minimal in effect compared to aiding respiratory efforts, you can hardly argue that it's inherently harmful. I mean, it's not as if anyone said "Oh, nevermind, there's no need to get the baby to breathe, we've still got an umbilical cord!" eyesroll.gif

There are risks to homebirth, certainly, but let's at least be realistic here.  Having resuscitation done at the bedside as opposed to across the room is not causing dead and brain damaged babies.


 



 

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Old 07-03-2011, 01:17 AM
 
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i have had 6 children 2 at a birth center, 2 at home with midwives and two UC. if you and your wife feel comfortable enough to do a UC, then do it, if not either pay for the midwife or the hospital. a midwife has to make a living they have bills to pay and a family to support. if she does 5 or 6 births a month that seems like alot, but there is equipment, gas, office, insurance, etc and that eats away at any up front money along with having to pay taxes. 

whether or not some one is "illegal" doesn't mean they have no supplies, it just means that they can not work legally in that state. they are usually educated in child birth and may have practiced for years and years. 

 

as for the people dissing homebirth... if it is upsetting to you that someone gives birth at home, maybe you should not read the stuff here. fear mongering isn't nice. i understand that having not had a homebirth and having had a scary hospital birth can make it seem as if people choosing to homebirth are being nutty, but really most are pretty darn educated and feel safer at home. i know i did. and since i can only speak for myself i would choose it again in a heart beat.

 

h


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Old 07-03-2011, 06:59 AM
 
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"I'm not sure why you're here if you don't "believe" in home birth.  How do you suppose the human species managed to avoid extinction before hospitals and doctors came along? "

 

This is a rather silly claim.  If you have 10 pregancies, and 2 survive, you are replacing the existing population and avoiding extinction.   You've lost 80% of your children, but the species is still not moving towards extinction.

 

 

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Old 07-03-2011, 08:28 AM
 
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"Especially when that argument is being propped up by nonsensical justifications like the idea that receiving oxygen and appropriate neonatal resuscitation with the cord intact is somehow riskier than being whisked away to receive oxygen and appropriate neonatal resuscitation with the cord cut. ( confused.gif)   Even if you think that extra minute or two of oxygenated blood (meaning red blood cells...that are carrying oxygen....which is exactly what we're trying to get into the baby at that point) is minimal in effect compared to aiding respiratory efforts, you can hardly argue that it's inherently harmful. I mean, it's not as if anyone said "Oh, nevermind, there's no need to get the baby to breathe, we've still got an umbilical cord!" eyesroll.gif"

 

Quite frankly -- there are people on these boards (ElizabethE for one) who have made that exact claim -- that as long as the baby is still attached to the cord, there should be no concern about lack of respiration.  I have also seen that claim made on several natural birth websites operated by CPMs who seem deeply confused on this issue.  I have also seen that claim made in connection with the safety of waterbirth -- that you don't need to worry about the baby breathing immediately because they are still being oxgenated by the cord and placenta while underwater.   It is a completely and utterly wrong and dangerous claim, but it doesn't prevent people from making it and I appreciate the PP being so clear on the issue in her post above.

 

My understanding (and perhaps someone with more expertise can offer an opinion) is that there is a specific protocol to neonatal resuscitation just like there are protocols for providing CPR.   For example, there is a good position in which to offer CPR (you don't perform CPR with the patient lying on their side for example).  Can those protocols be properly applied while the baby is still attached to the cord? 

 

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Old 07-03-2011, 09:40 AM
 
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The NRP is laid out in detail on the AAP website -- unfortunately, I don't have time to review right now, but maybe someone else does.    Looking at the AAP website on this issue raises an interesting question -- it might be worthwhile to ask midwives you are interviewing whether they have passed the NRP evaluation/test (available online!).  Though the test materials themselves acknowledge that passing the test alone does not mean competence at the NRP skills, it might be helpful in evaluating the qualifications of a particular midwife.

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Old 07-03-2011, 09:55 AM
 
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My understanding (and perhaps someone with more expertise can offer an opinion) is that there is a specific protocol to neonatal resuscitation just like there are protocols for providing CPR.   For example, there is a good position in which to offer CPR (you don't perform CPR with the patient lying on their side for example).  Can those protocols be properly applied while the baby is still attached to the cord? 

 


That depends on the protocols of the exact location of the birth. There is nothing in NRP general rules that state the cord must be cut, but in many facilities, their NRP set up is going to require separation of mom and baby and resuscitation to take place in a warmer vs. bedside. I would say that in most facilities, the cord is cut well before it is even determined that the baby needs resuscitation simply because cords are cut so quickly. Certainly if the providers are used to doing NRP bedside then leaving the cord intact is not an issue and proper protocols can be followed.

 


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Old 07-03-2011, 10:04 AM
 
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I have also seen that claim made in connection with the safety of waterbirth -- that you don't need to worry about the baby breathing immediately because they are still being oxgenated by the cord and placenta while underwater.   It is a completely and utterly wrong and dangerous claim...


 


As far as I am aware, in the case of water birth, baby does not attempt to take a breath until exposed to the air.  So in the few seconds or minutes that baby's head is in the water instead of inside the vaginal canal (where baby is also not taking breaths- ordinarily), baby is receiving oxygen from the cord blood.  I have never heard of anyone letting their baby sit under water after birth- baby is pulled out and up to the mother immediately and takes their first breath then.   This was certainly the case for my dd who was born in the water.

 


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Old 07-03-2011, 12:53 PM
 
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just throwing this out there: BUT why if you are against home birth are you on this area giving advice to a person asking whether or not a midwife is worth the cost? if you are upset and/or afraid of homebirth then try another area where you can express your fears and concerns. homebirth is a safe and valid place to give birth for most healthy women. personally i think that women should be able to birth where ever they are most comfortable, which can mean home, a birth center, a hospital etc. if you feel better and safer at a hospital then by all means go there and birth because more likely then not you will have a better experience because you feel safe and calm. many here on mothering choose home because they feel safer and calmer there. one is not better then the other, they are just different choices. if you can not give homebirth advice with out trying to scare people maybe you should go someplace else. because i am betting most moms and dads who come here are looking for HB advice not someone to try and scare them. there are loads of books and research on the pros and cons of homebirth. like i said it isn't for everyone, but it is for some. 


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Old 07-03-2011, 02:12 PM
 
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I do not wish to sound harsh, but OP, you sound like someone I would not want to work with if I was a midwife or even an OB. A midwife is a professional who is charging a standard rate. $4000 is what it costs to have a homebirth midwife in NY state. That's just what it costs. You want to offer $1000 in cash along with your proposed barter (that may or may not include goods and services that the prospective care provider needs). Imagine that your midwife will spend one hour a month on meeting with your wife (this is very low, of course), an additional 24 hrs attending the birth, and four hours doing postpartum care. I hope you realize that this is an impossibly low estimate. Now imagine that your midwife has spent $100 on supplies that your wife will consume. $3900/37 hrs = ~ $105 / hr. If she is self employed, her taxes will be about 30% off the top. That means she will be compensated at less than $75/hr not including any time she spends on your case outside of those 37 hrs meeting with you. Note, also, that she cannot work a 40 hr week every week, because she is committed to being on-call and available to her clients.

 

If you want to compare this to OB care at a hospital, be careful. A hospital based OB practice does not give you YOUR individual practitioner on-call, nor does it assure that your practitioner will be there at the birth of your child. Instead it assures that the hospital will be available, that there will be highly trained L&D nurses available 24/7, possibly medical residents, and ONE member of the OB practice on-call at all times.

 

 

Note that in NY state many professions with comparable training and education pay substantially better.

 

In NYC, and in many parts of NY state, it is possible to have the same OB available on an on-call basis and committed to delivering your child. This is called 'concierge service' and costs $80-$100k inclusive for prenatal care and OB fee at the birth and is not covered by insurance. 

 

One questions what value you place on skilled and trained health care. 

 

I understand that you do not want to get health insurance for your wife, and that between the cost of health insurance for your wife (it seems you have health insurance?) and the cost of a homebirth midwife, you have decided to go for an unassisted birth (with no prenatal care, I assume). I am all for 'trusting birth.' However, do you really want to 'trust birth' with the life of your wife and child, just because of the fees involved in medical care? Perhaps this is not what you mean suggest by your post, OP, but it is what you have conveyed. I find this deeply disturbing. 

 

You make it sound as if you believe that medical care for pregnancy and birth should be free, and that those who provide this care should perhaps not be compensated. Surely this is not what you mean. 

 

We live in a country where medical care costs a significant amount of money. Indeed, medical care is a major expense for the self-employed (as it seems you and/or your wife may be). Remember, part of the cost of a midwife's fee is her own need to provide healthcare/ health insurance for her family. Similarly, a non-insignificant part of the cost of a hospital birth is that the hospital must provide subsidized care for those less fortunate than yourself and your wife. I suggest that you consider acting on your frustrations with your concerns about the cost of medical care through political action, or by joining the Freelancer's Union. I also suggest that you think seriously about the fact that indeed, it is women's and reproductive health care that are least accessible under the current conditions. 

 

 

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Old 07-05-2011, 02:19 PM
 
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Hm I had to chime in on the fluid in the lungs. DD was born at a birthing center and it wasn't super quick, we're talking 2h of pushing with the water breaking right before birth. She did great with her Apgars but about 1h later she turned blueish so the nurse turned her over and helped her expel the fluid. As she turned a little blueish again 30 minutes later the nurse and CNM gave her oxygen and stimulated her back and all the fluid came out. Their protocol was if DD had turned blueish one more time, we would have had to transfer to the hospital right next door, but luckily, all the fluid came out. I wasn't prepared for something like that and it was scary, but both the CNM and RN were perfectly prepared to handle the situation and had the equipment ready. A homebirth CNM carries oxygen with an infant mask as well.

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Old 07-05-2011, 09:04 PM
 
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CNM and RN are very different from CPM. CNM has RN degree plus masters.  CPM  can be a year long self study course. You can't compare those too in emergency

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Hm I had to chime in on the fluid in the lungs. DD was born at a birthing center and it wasn't super quick, we're talking 2h of pushing with the water breaking right before birth. She did great with her Apgars but about 1h later she turned blueish so the nurse turned her over and helped her expel the fluid. As she turned a little blueish again 30 minutes later the nurse and CNM gave her oxygen and stimulated her back and all the fluid came out. Their protocol was if DD had turned blueish one more time, we would have had to transfer to the hospital right next door, but luckily, all the fluid came out. I wasn't prepared for something like that and it was scary, but both the CNM and RN were perfectly prepared to handle the situation and had the equipment ready. A homebirth CNM carries oxygen with an infant mask as well.



 

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Old 07-05-2011, 10:53 PM
 
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I really hate to pursue this, since it has nothing to do with the OP, but I also can't let the whole "omg, my baby needed some sort of minor medical attention and would have died during a homebirth" thing stand, as if having a homebirth somehow transports you 500 years into the past where portable medical equipment doesn't exist and hospitals, physicians, and intensive care are nonexistent instead of minutes away (although I don’t know the first commenter’s exact situation or what sort of care was required and can’t speak to the specifics of her case).


Doctors aren't magic, and hospitals aren't magic.  A lot of the support that makes modern medical technology effective at reducing neonatal mortality is the availability and more specifically the immediate avaliability of equipment, medicine, and staff trained in how to use both.  Speaking from experience, in the case of a distressed newborn, minutes spent in transport can be critical.

 

None of that invalidates homebirth as a choice for parents who understand their risk profile and prefer it to hospital birth.  But we owe a duty to moms and dads making decisions on these things to give them accurate information.  

 

If you have to transfer a distressed newborn to a hospital that is "only" 8 minutes away, I guarantee you those will be the longest 8 minutes of your life.

 

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Old 07-05-2011, 11:02 PM
 
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Yup, and that's what you're paying for with a hospital birth. It's a trade-off, for sure, because you won't know the people who care for you, but you will know that no matter what there are people who are highly trained to do what they do, there, with equipment that is certain to be in good repair.

 

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Doctors aren't magic, and hospitals aren't magic.  A lot of the support that makes modern medical technology effective at reducing neonatal mortality is the availability and more specifically the immediate avaliability of equipment, medicine, and staff trained in how to use both.  Speaking from experience, in the case of a distressed newborn, minutes spent in transport can be critical.

 

None of that invalidates homebirth as a choice for parents who understand their risk profile and prefer it to hospital birth.  But we owe a duty to moms and dads making decisions on these things to give them accurate information.  

 

If you have to transfer a distressed newborn to a hospital that is "only" 8 minutes away, I guarantee you those will be the longest 8 minutes of your life.

 



 

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Old 07-06-2011, 08:34 AM
 
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CNM and RN are very different from CPM. CNM has RN degree plus masters.  CPM  can be a year long self study course. You can't compare those too in emergency



 


You are correct that a CNM and RN have been to nursing school while a CPM has not.  However, I do not agree that the credential itself tells you how effective one or the other will be in an emergency.  Some CPM's have attended well over 1000 births and are quite adept at handling a variety of situations.  While some CNM's may not have the same experience or skills at all.  I believe, therefore, that it is of the utmost importance that great care is put into the research and interview process for choosing a homebirth midwife.  I personally would not automatically put more stock in a CNM over a CPM (legal or not!) and would focus instead on each midwife's statistics and references.

 


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Old 07-06-2011, 08:42 AM
 
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Jaimee --

 

I am not aware of any biological mechanism that would inherently prevent a baby from inhaling water during a water birth.   I understand that infants in the womb frequently "practice breathe" with the amniotic fluid which to me indicates that such a mechanism does not exist.

 

 

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Old 07-06-2011, 10:47 AM
 
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Quote:
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I am not aware of any biological mechanism that would inherently prevent a baby from inhaling water during a water birth.   I understand that infants in the womb frequently "practice breathe" with the amniotic fluid which to me indicates that such a mechanism does not exist.

 

 


Jane, I would like to read more on this in actual medical literature, but I was under the impression that while a baby does mimic swallowing it does not actually swallow any amniotic fluid as the throat closes off preventing it.  Similarly baby would not swallow water from the birth pool.  Searching for more information I quickly found this article written by a midwife.  Like I said I would like to verify it with medical literature and will look for that next, but I'm  putting this out there b/c it does support what I had previously thought.   http://www.homebirthsa.org.au/PDF%20Files/WhyBabiesDontDrown.pdf

 


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Old 07-06-2011, 01:06 PM
 
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Hi Jaimee --

 

Per this article from the Journal of Perinatology (http://www.nature.com/jp/journal/v25/n5/full/7211290a.html ):

 

"Removal of AF (amniotic fluid) is predominately accomplished by fetal swallowing (approx200 to 250 ml/kg fetal weight/day)."

 

I have seen several references in fetal development websites to the fact that the fetus inhales amniotic fluid during practice breathing, but nothing in a journal article yet. 

 

However, given what I have heard to be the usual (fecal) content of the birth pool, I'm not sure if I'd be terribly excited about a baby swallowing that water either!

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Old 07-06-2011, 01:14 PM
 
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Here is one example of the description I am talking about:

 

Amniotic Fluid. The developing fetus practices breathing activities beginning in the fourth month of pregnancy. During these fetal breathing exercises, amniotic fluid washes in and out of the fetus' respiratory tract. Cells from the fetal respiratory system are carried out into the amniotic fluid, which can be analyzed to tell the maturity of the fetus' lungs if necessary. The fetus drinks the amniotic fluid and urinates back into this fluid 

 

From:  http://www.healthline.com/yodocontent/pregnancy/lamaze-method-pain-relief.html 

 

 

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Old 07-06-2011, 01:33 PM
 
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Yes I am seeing now that baby is not breathing in the fluid, but swallowing it.  I mistyped my thoughts- my apologies for any confusion!  The throat closes off to prevent breathing in the liquid and instead causes the fetus/baby to swallow (also known as the "dive reflex").  I'm seeing this supported all over the place.  So the idea is that the baby will not breathe in the pool water, but swallow it if it does try to take a breath.  But it appears that a healthy baby will not try to take a breath for several other reasons including: a marked decrease in breathing movements just prior to the onset of labor (caused by increased prostaglandins), acute hypoxia which causes apnea and/or swallowing instead of breathing, and the hypertonic/hypotonic differences between the water and the lung fluid.  Still searching for a concise article to back this all up.

 

Anyway perhaps a topic for another thread...


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Old 07-06-2011, 03:22 PM
 
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I'll answer the original question.

 

I paid my cpm a global $1500 for prenatal, birth, and postnatal care- I also call her anytime I have a health or ped question.  She came to me for all the appointments (Which I believe were 17- DS was 3 weeks late, one time I freaked and she came for a reassuring listen to the heart visit).  She also headed out twice for false labor, plus the birth.  I also paid $40 trip fees for each visit since she came to me.  She didn't charge me for any supplies, other than suppliments and vitamins.  I bought all the birth supplies which were about $150 total.  All told- it was over $3000.  And this is in podunk IA.  Is she making a killing?  Absolutely not.  I never offered to barter with her- a worker is worth her wages.  If she needed or wanted something from me she would have asked.  Was the care I recieved from her worth way more than what I paid?  Absolutely.  I had 3 babies in a hospital- all the bs that occurs there costs a fortune. 

 

OP- where the appointments at your place or hers?  Not that it matters much- if at yours- she pays gas- if at hers- she needs a space. 

 

Also- does it matter?  It is a sellers market after all.


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Old 07-06-2011, 08:36 PM
 
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Could you show me a link , please, about prostaglandins, as in peer reviewed study, as it make no scientific sense  at all.

Ireland is actually re-considering water births because of baby drowning in the water. Thee are other cases as well.

 

If there really was such hypertonic/hypotonic difference between water and lung fluid, no one would ever drown.

 

I am not trying to be rude, I just want to see a scientific tested sourse for it. I understand laboring in the water, I loved my bathtub , but it make no sence to give birth in the water. We lefts ocean evolutionary eons ago.

Quote:
Originally Posted by Jaimee View Post

Yes I am seeing now that baby is not breathing in the fluid, but swallowing it.  I mistyped my thoughts- my apologies for any confusion!  The throat closes off to prevent breathing in the liquid and instead causes the fetus/baby to swallow (also known as the "dive reflex").  I'm seeing this supported all over the place.  So the idea is that the baby will not breathe in the pool water, but swallow it if it does try to take a breath.  But it appears that a healthy baby will not try to take a breath for several other reasons including: a marked decrease in breathing movements just prior to the onset of labor (caused by increased prostaglandins), acute hypoxia which causes apnea and/or swallowing instead of breathing, and the hypertonic/hypotonic differences between the water and the lung fluid.  Still searching for a concise article to back this all up.

 

Anyway perhaps a topic for another thread...



 

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Old 07-07-2011, 07:17 AM
 
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Perhaps a discussion for another thread, but very interesting anyway! 

 

I think we have all had the experience where we have accidentally inhaled something we were eating or drinking, so obviously this is not a fool proof mechanism.  In fact, there is something called "aspiration pneumonia" which may occur when food or drink enters the lungs. 

 

I suppose an appropriate inquiry would be whether researchers have seen an increase in aspiration pneumonia in waterbirth babies over landbirth babies, though I cannot determine if that point has been researched.

 

I have to disagree with you about the dive reflex -- from what I have read the dive reflex only occurs in cold (not warm or room temperature water).   It is why children who have (for example) fallen through ice and been rescued have lived though they were underwater for an extended period of time.  It also has some rather nasty potential accompaniments -- slowed heart rate, reduced or minimal blood flow to major organs, etc.

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Old 07-08-2011, 07:28 AM
 
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Lots of midwives have a reduced cost if paying in cash. I do, and I take Medicaid & will submit claims to all insurances. Less paperwork headach if someone payes cash. My cash payment charge is 3200 and that includes the fee to pay an assistant.  Up in NY state the cost of living etc. is probably more expensive than where I am near Hickory, NC. $4000 is still way cheaper than total cost of a hospital birth, even one without complications and even if you leave before 24 hrs. & even if you were to take in your own supplies, i.e. sanitary pads, etc.

Karen Benfield, CNM & owner of BirthTender, a homebirth, well woman, family planning nurse-midwifery practice covering western/central NC

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Old 07-08-2011, 10:08 AM
 
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I recently saw an article on babble that was showing the cost of hospital births. Its way more than 5-7,000. That is just for you to birth a baby vaginally, that doesnt include your bed and room, and your babies. They also charge you for every little thing. 1 ibeprofen will cost you $7. A midwife will always be cheaper.

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Old 07-08-2011, 10:48 AM
 
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The going rate for midwifery care here is 4500. As far as I could find out (and I searched high and low) there are only 3 homebirth midwives in the area, so they are in high demand and all are CNM.   It includes everything except for lab and u/s fees.  One midwife I talked to said, she takes no more than 2 patients per month.  That's the most she feels she can handle and still maintain a good work-life-family balance.  It sounds like a lot, slightly less than 100k a year which sounds like a very good salary.  Until you realize that she is self-employed (read no paid vacation, ever and extremely high insurance costs in both medical/life for herself and mal-practice which eats a huge percentage of her income).  Then there is the accountant to pay, her back up midwife, her assistant, rent and insurance for the office/clinic, medical supplies as unlike some midwives, she provides all the necessary birth supplies like chux and then of course medical supplies, office supplies and furniture for her office. When you compare that to an OB who makes close to twice that and only has a fraction of the costs and provides less care per patient, it sounds like a pretty sweet deal. 

 

BTW, here is an econ 101 lesson.  If a business can get 4000 for a service or 1000 for a service, they will in all likeliness, choose 4000. 

 

A friend of mine said her hospital bill was $5000.  She was there one night, never had an epi, never took any medicine, refused to use anything the hospital provided (like diapers and such), delivered within minutes of arriving and was discharged the next day. So while I don't think it's likely, it is certainly possible.  Of course it does not include the fee for the prenatal or postnatal care.

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Old 07-13-2011, 03:15 AM
 
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whoa....i thought it was a group for all mothers???? with all different backgrounds and experiences and something to offer in the world, i was simply offering my thoughts from my own experiences. I don't see how you can speak or represent everyone's opinion thats on this sight "i don't see why you come Here if you don't believe in the home birth?" i'm fine not connecting with those who can't handle another's opinion or experience you sound young.

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Old 07-13-2011, 03:24 AM
 
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i appreciate your insight and story. I think we all have something to offer and can learn from one another for some reason what right for one isn't for another and vise versa but i love that we can share our ideas while figuring it all out. Glad your babies are healthy that is a blessing i think we can all agree apon : )

 

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