Good day, Mamas!
First, a little bit of background: I'm writing from a remote rural community in Canada's Yukon. While there is no midwife in my community, I've been seeing one in the capital city, Whitehorse, a 5 hour drive away. Our original plan was to head down there about a week before I'm "due", stay in a friend's home, and give birth there. This is standard practice here (except that most families choose hospital births rather than home). My midwife, however, told us from the beginning that she is willing to come to our home. Basically we would call her as soon as labour began, and she would start driving. Here in my community there is only a basic health center. In case of emergency, I would need to be sent by air to Whitehorse. This is my second child, the first was born in Whitehorse after about 20 hours of prodromal labour, 2 or 3 hours of strong labour, and maybe an hour of pushing. My husband is not comfortable with us being so far from emergency services, but I really love the idea of having my baby in my own home, with my friends around to support me if needed. We don't know many people in Whitehorse...it feels a bit like an exile, having to go down there and wait for a baby. I called it my confinement last time around!
I guess I'm coming to you all today looking for any similar experiences with homebirth in a rural setting, particularly if it was remote from emergency medical services. What is your opinion? Would you consider it to be too great a risk? I realize that ultimately this is a question my husband, my midwife and myself must answer, but I'm curious.
Thank you so much for any input you might be able to share with me!
I have no experience for you -- it sounds like such an interesting life! Do any of our rural mamas have some information for this new member? One thought would be to read some books on HB. My favorite is this book called "Pushed". I think that author followed a fairly rural MW if I recall. Good luck on your research!
I think there are a few issues you need to consider. The first being, in case of emergency, how much time would lapse before you actually are airlifted, travel, and arrive @ a hospital to receive emergency services? Also, how comfortable would you be having to deliver the baby without your midwife, a 5 hour drive is a long while, and second labors are usually shorter than the first.
I know for my comfort level, I would not do it. Proximity to a hospital is an important factor for me to be comfortable with home birth.
Yes, Steph, I agree.
Tara, another thought after reading Steph's post is the stress of the time around your due date and what that may feel like for you as you start to wonder if labor has started. With time being of the essence, that seems like a stressful scenario that I think many of us HB mamas expect to avoid as one of the advantages of HB, yk?
Have you spoken to your MW about her experiences with births far from Whitehorse? What does she say?
To me, HB kind of fits into the hospital birth system and the safety of HB factors the reasonable availability of hospital intervention. Even with a non-emergent transfer, that drive would be such a terrible pain if you felt you needed to go...
That said, many people live quite far from a hospital and don't go wait near the hospital for weeks, right? Can you find some alternative?
I like the articles at Midwifery Today. Maybe do a search over there to see if you can find some articles on remote HB.
How experienced is your MW in dealing with things that would normally take transfer? My rural MW services a lot of moms who are completely against hospital transfer and has caught babies almost 30 years.
I went to her house through a snowstorm, it was almost a car birth we were there 9 minutes before he came.
A transfer would take some time. It is a half hour drive from our home to the health center in town, and then the pilots and air craft would have to be made ready in case of an air transfer. It would be several hours before we were at the hospital in Whitehorse.
My MW was totally comfortable with the distance, but has never done a birth in Dawson before. I think the furthest she's traveled was an hour. Up until about 25 years ago, births were regularly done in our town, but then it was decided that unless we could keep a surgeon on standby (never going to happen) women would have to go to WH.
IdentityCrisisMama, it's interesting you bring up the point of stress around the due date. I found with my first baby, being in WH, it felt like we were all just sitting around waiting for the baby to come. We were lucky then, and lucky this time, too, to have a free place to stay, but for many families, it can be very expensive. The territory gives us $70/day but that only covers a little more than half the cost of a hotel room (and many families end up in hotels for the duration). It also separates many families, as often the partner isn't able to take as much time off work. It just feels like so much pressure to have the baby. But taking the risk of having the baby 500 kms from a hospital definitely comes with it's own stresses!