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#61 of 107 Old 12-02-2010, 08:57 PM
 
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That definitely sounds like a better hospital situation than most women have, but in that case, I would still lean towards birthing at home. Often, in a midwife-attended hospital birth, you find yourself fighting hospital policies and protocols that the midwife isn't in favor of but doesn't have the authority to over-rule, such as time limits. Many hospitals also don't permit waterbirths, which would be a deal breaker for me. And again, it's much easier to achieve a physiological, normal birth when you're in your own home environment. Birth is an incredibly psychological experience and it progresses much easier when you feel safe. We're just mammals, after all. If you put a cat or a horse or a deer into an unsafe environment, their labor will stall. We're just the same.

As far as what your particular midwife can do at home -- ask her. Sit down and talk with her about protocols for various emergency situations. I'd also ask her why she prefers homebirth, and what hospital protocols she disagrees with.

 

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Originally Posted by Mama Metis View Post

I am in the same position as the OP, but with a bit more time to decide (EDD in July). I have been reading about homebirth for years now and I am well aware of the benefits, but I have some concerns to overcome. I'd love to see some discussion about what specific forms of treatment the homebirth skeptics feel is not available at home. Particularly for the baby. I know oxygen is available, but can a midwife intubate a newborn? Provide CPAP? I don't think so but I'm not sure.

 

In my case, I have a homebirth midwife (CNM) who will also deliver in the hospital if you prefer (although she strongly favors homebirth). Her orientation is completely toward physiological birth, so I have no fears of excess intervention in the hospital. I also don't have any strong fears or anxieties about being in the hospital (although home is always nicer for sure.) I guess in part, I'm questioning whether I can justify a homebirth since I have access to a "safe" hospital birth.

 

I'm not making an argument here, just wanting to hear what others think. Thanks for the helpful thread, OP.


Jen, journalist, policy wonk, and formerly a proud single mama to my sweet little man Cyrus, born at home Dec. 2007 . Now married to my Incredibly Nice Guy and new mama to baby Arthur.
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#62 of 107 Old 12-02-2010, 09:50 PM
 
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Your plans sound very exciting, and having Valley only 10 minutes away is pretty safe in case anything happens. I'm not brave enough to do the home birth thing, due to my job and personality I guess, but I really admire those who choose this route in uncomplicated pregnancies. I know several people who chose home births w/ great success, but we're in Seattle after all. Best wishes to you!
 

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Pregnant@40-

Thanks for the reply. I'm in South Seattle, so Valley Medical in Renton is 10 minutes away. It was touring this hospital that really turned me off, even though it  is gorgeous and very homey. It is rather large, but allows a midwifery model and is close to home. I've been seeing the nurse midwives from Valley, and they are pretty great, and have a 17% c-section rate.  


After talking to my husband last night, we decided that home birth is our frontrunner right now, as long as we can transfer to Valley (since it's so close and in network). Seattle Home Maternity was impressive, but they are the group that told me about the 25% transfer rate for 1st time moms. I'm going to check some other midwives out, and in the meantime, still go to my appointment next week at the nurse midwife clinic.

 

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#63 of 107 Old 12-02-2010, 09:55 PM
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I planned a homebirth (midwives are not yet licensed for hospital births so choosing a midwife was choosing a homebirth here.) We ended up transferring after 60 hours of labor for exhaustion. I ended up with an epidural and pitocin (wanted to avoid both which is why I chose to stay home). It took a little while to come to terms with the birth, but I do not regret trying for a homebirth for my first baby. I will plan one for my second child as well.



 



My midwife stayed with me at the hospital as labor support. And, even if the hospital is not midwife friendly, and your midwife comes with you, you could just say she is labor support.



 



Good luck deciding. I know what a hard decision it is!






Whoa. Could have written the exact same response. No regrets for me either. Especially as I would have had to transfer afterward anyways (retained placenta).
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#64 of 107 Old 12-03-2010, 03:27 AM
 
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Mamametis, have you asked the MW why she favours homebirth?  It might be because she finds it much harder to do her job in hospital.  Or because she has to fight and fight the interventions she knows her ladies don't want.  It's worth having a conversation about it with her.

 

Ditto the intubation query.  Discuss the SPECIFIC situations you feel CPAP or intubation would be necessary.  My MW would have transferred me long before a baby who was going to be born needing that sort of help arrived.  She is very careful during the labour, she watches both mother and babe carefully, she observes very very astutely.  For example my labour was very stop-start prodomal then suddenly very active, at one point, when i was already fully dilated, DD's heartrate seemed very high.  It was reactive and came down with the contraction ending, but it was higher than she would have expected to see.  Was it tachycardia or an acceleration?  She asked herself this question, she observed that i was acting like a woman beginning the foetal expulsion reflex (which was NOTHING like the 2nd stage with DD1, with DD2 it was like throwing up out of my vagina, i had no control, i was merely observing my body, i couldn't even catch my breath and my body utterly took over, panting at the right moments and all!) and since when i had asked her to do a VE (which she doesn't require, she could tell i was fully from other signs) she had used the opportunity to guage how big DD's head was and how much room i had and she knew i had plenty of room.  So she decided it would be ok - i had a lot of room and pushing was likely to be very short given the expulsive reflex is very effective that way.  She was right.  DD was out in 6 minutes, apgars 10, 10, 10, and with a true knot in her cord.  The knot pulled tight as i held her, so it's likely it was tightening as she descended (and she was only at spines 6mins before birth, she did the "risky" bit of the descent in a huge hurry) which was causing her accelerated heartrate.  But my MW's experience meant she was able to get a good, full picture of it all.  If the heart rate had been having such fast accelerations early in labour she would have advised transfer.  Had the baby been bigger or my pelvis been smaller she would have called an ambulance.  As it was she had everything needed for an emergency set up when DD was born, we just didn't need any of it.  She had a student there observing and the student was amazed at the subtlety of my MW's observations, in hospital they rely on intermittent observations and/or a machine to warn them of such things and a doctor to save them if it's all gone too far before someone find time can read what the machine is saying.  The formula's which "keep you safe" in a hospital are set up to fight fires caused by a lack of continuous one-to-one observation by an experienced attendant.  Yes, some babies will be born needing help, but it's very rare that there is NO indication of that outcome before the moment of birth.

 

I would turn the question on its head.  Not can you justify a homebirth when you could have a safe hospital birth, but can you legitimise a hospital birth when you can have a safe homebirth.  Hospital birth is NOT safer.  Homebirth with a qualified MW is as safe in terms of mortality and safer in terms of morbidity because the interventions in hospital often result in injury that would have been avoided if the intervention had.
 

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That definitely sounds like a better hospital situation than most women have, but in that case, I would still lean towards birthing at home. Often, in a midwife-attended hospital birth, you find yourself fighting hospital policies and protocols that the midwife isn't in favor of but doesn't have the authority to over-rule, such as time limits. Many hospitals also don't permit waterbirths, which would be a deal breaker for me. And again, it's much easier to achieve a physiological, normal birth when you're in your own home environment. Birth is an incredibly psychological experience and it progresses much easier when you feel safe. We're just mammals, after all. If you put a cat or a horse or a deer into an unsafe environment, their labor will stall. We're just the same.

As far as what your particular midwife can do at home -- ask her. Sit down and talk with her about protocols for various emergency situations. I'd also ask her why she prefers homebirth, and what hospital protocols she disagrees with.

 

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Originally Posted by Mama Metis View Post

I am in the same position as the OP, but with a bit more time to decide (EDD in July). I have been reading about homebirth for years now and I am well aware of the benefits, but I have some concerns to overcome. I'd love to see some discussion about what specific forms of treatment the homebirth skeptics feel is not available at home. Particularly for the baby. I know oxygen is available, but can a midwife intubate a newborn? Provide CPAP? I don't think so but I'm not sure.

 

In my case, I have a homebirth midwife (CNM) who will also deliver in the hospital if you prefer (although she strongly favors homebirth). Her orientation is completely toward physiological birth, so I have no fears of excess intervention in the hospital. I also don't have any strong fears or anxieties about being in the hospital (although home is always nicer for sure.) I guess in part, I'm questioning whether I can justify a homebirth since I have access to a "safe" hospital birth.

 

I'm not making an argument here, just wanting to hear what others think. Thanks for the helpful thread, OP.



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#65 of 107 Old 12-03-2010, 05:05 AM
 
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I find it interesting when folks say a free standing birth center is the same as a homebirth.  IMO, it is similar, but not completely the same.  


I agree...it's not the same. You experience a disruption by leaving your comfort zone at home, getting in a car, then having to recreate that environment of comfort and safety all over again.

 

But it's still closer to the experience of having a home birth than having a hospital birth.

Just another voice of agreement.

I think they are "the same" in terms of medical safety. (Unless of course birthing at the BC would leave you significantly closer to a hospital in case of the need for transfer) - but aside from that, exactly the same.

 

Personally once I found that out, I totally ruled out BC as an option (I actually have several hospitals close by, one of which is actually fantastic & where I had my DS.) Of course, a BC could also offer other nice perks for some, such as big jetted jacuzzi tubs (yeah, you can get a birth tub, but hard to get one with jets), & not having to buy a birth kit & set up the tub yourself. I'd also imagine they'd take care of the birth cert for you - my hospital did - ZERO effort on my part, whereas for my HB, I have to deal with the Maryland state dept of health myself, which I've read can sometimes be a headache.

 

But all minor stuff & certainly nothing anywhere near compelling enough for me to leave the comfort of "my turf." Plus, with a BC, you get whatever MW & nurse are on call, whereas I know MY MW and her asst - no gamble that I'll be stuck with my least fav from a group.

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#66 of 107 Old 12-03-2010, 05:24 AM
 
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Quote:

Originally Posted by Mama Metis View Post

I guess in part, I'm questioning whether I can justify a homebirth since I have access to a "safe" hospital birth.

 

I think you've already received excellent answers from MamaJen & GoBecGo, but just wanted to add my thoughts.

 

I think that's a very good question & I have to say I felt the same way. The MWs & nurses at the hospital where I had my DS were really fantastic! Really great. So part of me has thought, "Well, I probably should go there just in case." I mean, if you're faced with an atrocious hospital with a 50% CS rate, 25% episiotomy rate, 90% epidural rate for vaginal births, mandatory eCFM, no hydrotherapy options, "nothing by mouth" etc. etc. etc. - then the choice is REALLY obvious - I would UC before I'd birth in a place like that!

 

First though - what are post-partum experiences like at this great hospital? Mercy in Baltimore city is widely regarded as the best for natural birth - they even allow water births! But I've heard TONS of stories on how awful PP care is. Even a friend of mine who's DH is a physician with privileges there said she still had a terrible time PP. So consider that too. Even at my awesome hospital, the lactation consults were ATROCIOUS - really awful. I have no doubt I would have been better off never meeting with them & being left to my own devices with the internet & library books.

 

For me though, I accidentally did ALL my laboring at home! Less than 5 hours from the first, "oh, huh, that was finally a contraction." To "AAHH! I really want to push, we gotta go!" I don't know if it would have been that fast & manageable if I'd been in the hospital. I personally DID have a lot of anxiety about birthing in a hospital and I"m fairly confident it would NOT have been so fast & smooth being in foreign territory. I also have huge issues with feeling "Bossed around" so the policies like being on CFM for 15 min out of ever hour, having a hep-lock, etc. would like have irritated me, ticked me off, and therefore not been too productive.

 

Plus, there is the fact that with DS birth, my first, having been so fast, I might accidentally have #2 at home anyway - even if I'd planned a hospital birth! So better to have a MW who knows me & is willing to come out when I say I've been laboring for only 45 minutes.

 

I'm lucky that I won't be hesitant to transfer since I know this hospital will be friendly & not hostile. (Plus, the CNMs there know my MW & are friendly with her! & I've seen them a few times to establish care & ease a transfer.) So I think I have the best of both worlds in this case. I just think the "what ifs" of HB for me are so slim that I'm willing to chance it. -- Yes, I do know it's possible for some unforeseen complications to arise that can't be dealt with adequately at home that could be better managed in hospital. BUT - even with a good hospital, the same applies, There's a possibility of hospital acquired infections, mistakes where I'm given the wrong drugs (happens ALL.THE.TIME)

 

So I guess all this is to say that I really don't feel that even a great hospital is all that much better on the risk side of the equation.

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#67 of 107 Old 12-03-2010, 06:18 AM
 
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Thanks everyone for the thoughtful replies. OP, I hope I didn't hijack. redface.gif

 

It was nice to hear that a couple of you had no regrets in planning a homebirth even after a transfer was needed. I think this was one thing I needed to hear.

 

MamaJen, it's true that I need to take into account the added safety of a normal labor progression, which can best be acheived at home.

 

GoBecGo, you're totally right that it's unlikely to have a baby who suddenly needs lots of support without a lot of warning ahead of time. This was also something I needed to remember.

 

MegBoz, you make a good point about postpartum care. The hospital I would go to is definitely not some kind of wonderland, it's just that they basically let my midwife run the show for her own clients, and she releases you when you're ready. However, it's hard to say what the situation will be with nurses, lactation consultants, etc. I guess I have been looking at these concerns as just nuisances, in contrast to my concerns about the baby's safety. 

 

I do realize what a low-liklihood event it would be to need an emergency transfer for the baby, but for whatever reason, this is the precise fear I'm always coming back to. I do need to talk to my mw, I know that will help. It's an odd experience for me to feel this way because I have been a strong advocate for homebirth for a long time now. Now that I'm actually pg, these latent fears are coming to the surface.

 

Can I blame hormones? shy.gif

 


Metis, partner to a peaceful soul, mothering DD born July '11

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#68 of 107 Old 12-03-2010, 08:46 AM
 
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Thanks to you all for all of your input and thoughtfulness! This is a big decision and you helped in my education around home birth. I've also checked out the Home Birth threads and they've also been helpful. Philisophically, I'm probably not as far on the homebirth side of things as people are here on the boards, but I believe that it is necessary for me to listen to all stories before I make a decision.


OP, I hear you on this.  I had never heard of homebirth until I stumbled across MDC forums last fall, and while I now believe it is a great birth choice for many women, it still doesn't really feel right for me.  (I felt anxious about the transfer process, and I felt like I wouldn't be able to relax at home as we live in a rowhouse with thin walls...ultimately I had a very peaceful waterbirth at a NCB friendly hospital with a great doula).  There are plenty of others who have provided you with tons of data about how homebirth is a safe option, and tons of other who can provide great homebirth stories.  I think its great to gather data and do research.  But at the end of the day, you and your partner need to make the choice that feels right for you, and where you feel most at peace, whether that be at home, a birth center, or a hospital.  Best wishes for a smooth pregnancy and a peaceful birth.


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#69 of 107 Old 12-03-2010, 09:31 AM
 
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I am a VBAC, so when I called the local hospital and found out all the "requirements", I started to cry.   Nothing by mouth (and I run hypoglycemic so that won't work), mandatory CFM (so no movement), heplock, etc.  It just seemed like too many obstacles.

 

You have to remember that even in an emergency c-section, it takes time to set up an OR and get the personnel in there.  The standard for "decision to incision" is 30 minutes.  My mom's group had a tour with the local fire department and I asked them about the timelines.  Once they have the call, they must be out of the fire station in 1.5 minutes.  The ride time to my place (they knew what subdivision I am in) is 4 minutes.  From my house to the hospital is 7 minutes.  If we called 911, we could then have them get an OR ready for when I get there and I will probably get there before the OR is even ready!  So, being in a hospital really does not "help" me get quicker access to care.  Sure, it will be scary as hell.  But you know what, having a midwife say "you need a c-section" when her c-section rate is about 5% is preferable to me.  If she says it, I know she means it.

 

Anyway, just another way of looking at it.....

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#70 of 107 Old 12-03-2010, 09:42 AM
 
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For me, I cannot imagine getting into a car after 1st stage of labor.  I also couldn't imagine having to put DS in a car seat immediately after having him.  My thoughts on birthing somewhere other than home....  smells are different, people I don't know there (other women's family members, etc.), not my comfort zone.  I agree with the idea if you are not comfortable in your current space to go to a birth center.  We had DS in a OLD cottage that was pretty run down (looking back).  I wasn't completely comfortable with our home at that time but I knew my things were there, my scents, etc.... 

 

I have had a few women say that a birth center is the same as home and those conversations really didn't end up that well.  They didn't "get it". 

 

Everyone does what is best for themselves. 


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#71 of 107 Old 12-03-2010, 10:01 AM
 
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I think if you study up on stages of labor and have an idea what to expect you could have a very successful homebirth with your first. 

 

I gave birth to my first in the hospital with an epidural and pitocin which was recommended by the nurses since I was taking too long. I really wasn't. It's perfectly normal to take longer to go through labor with a first baby. They simply said it will get it done with faster and didn't tell me there were any potential side-effects. It was really not at all what I'd expected and it sucked. I was also given an episiotomy that I am sure I didn't need. And that took over a year to stop being painful when DTD.

 

I planned an unassisted homebirth with my second but I ended up living with my in-laws at the end of the pregnancy so it didn't happen sadly and I ended up having a very traumatic hospital birth experience but the labor and most of the pushing went great because in Romania they just shove you off in a room with a bunch of other laboring moms and leave you to do your thing until the end. That part was good. It was the end and the horrible hospital care baby and I received after that sucked.

 

I far preferred the natural birth over the epidural/pitocin birth. 

 

I know I would have been able to do the birth myself without an issue at home as the doctor didn't even do anything til the very end and every she did do messed things up.

 

So, if it were me and I could go back, I would give birth at home every time unless there is a very particular complication that forces you to be in a hospital. 

Hospitals just suck. It feels like you lose all control and they take over.

 

I'd look for a homebirth midwife that is somewhat hands-off but very supportive and then I would study up on labor and delivery like crazy so you could feel confident about it. If you were at all comfortable with it I'd even recommend unassisted birth of a first baby.

 

Hope that helps.


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#72 of 107 Old 12-03-2010, 10:50 AM
 
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Can I blame hormones? shy.gif

 


LOL, yes, absolutely!

The most important thing is to birth where you feel safe - and where you feel most comfortable. For me, the more I read, the more anxiety I had about a hospital. I've never really had any significant anxiety about HB - even prior to having DS (I was just misinformed on my MW options). Sure, I realize there are risks, it would be silly to say I have "ZERO" anxiety, but it's never been significant and it's always felt right for me.

 

But if if doesn't feel right for you, and the hospital DOES make you feel safe, secure, cared-for, etc. then that is where you need to be. Nothing wrong with that given it IS a decent hospital. (of course, I'd definitely recommend a doula in that case.)

 

Yeah, I didn't think about the PP care that much myself, but it really does effect your baby's health too. Some things are just a nuisance, such as if they aren't prompt in getting your paperwork for you to checkout. But my friend made it sound like the problems were major & actually potentially a threat to her baby's health! We didn't get into details, this was over email & we're not super close, so I didn't want to pry, but that's my impression based on her statements.

 

& obviously I can see how bad PP care can be a threat to your baby. I've heard all kinds of nutty horror stories such as mandatory blood sugar tests for bigger babies & mandatory formula if their blood sugar is low (hello - killing BFing!), mandatory nursery time. That latter is particularly unlikely at a good- pro-NCB hospital. But certainly a risk to consider & factor into the equation.

 

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But you know what, having a midwife say "you need a c-section" when her c-section rate is about 5% is preferable to me.  If she says it, I know she means it.

This is another excellent point! Yes, so true. I'm so much less stressed this time around - I don't think I'll even have a formally written birth plan for my MW & her asst! (Although I will have one just in case of transfer.)

 

There is such a deeper level of trust here! I won't wonder if my birth is just being "pushed" & rushed along for convenience or if something is recommended because someone is concerned about her liability risk. My MW doesn't practice defensively (I believe she doesn't even has any sort of malpractice insurance.) I can relax, trust her, know that she & her asst know me, know they know my wishes, and I can know, with confidence, that if she recommends something I don't really want (transfer, CS, pushing in another position, etc.) it's because it really & truly is the best thing. That is a huge weight off my shoulders! It hadn't really hit me just how significant this is until I read Climbergirl's statement above.

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#73 of 107 Old 12-03-2010, 01:15 PM
 
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I thought the same way with my first baby, and did have a hospital birth.  I went on to have both birth center and homebirths with later children.  I was amazed during my out-of-hospital births by how much better the care was for my baby and me.  At the hospital, I went hours without anyone even coming into the room.  Monitoring was sporatic and was done by machine.  Once they put the monitor on, they would tell me they'd be "right back" and not return until my husband went and begged them to come back, often over an hour later.  We eventually started taking the monitor off after the 20 minutes we had agreed to.  No one cared or mentioned it.

 

With my out-of-hospital births, my caregivers actually cared for me!  My baby was monitored by hand, far more frequently.  My progress and I were both closely observed, and assessed regularly.  Someone was with me every minute, usually 2 or 3 people, but I also had the option of asking for privacy if I wanted.  That was never an option at the hospital.  The staff was so busy, they came in my room when they could spare a minute and my needs/desires had nothing to do with it. 

 

I've since heard the arguement that choosing a homebirth for a first baby is arguably even more important than making that choice for subsequent children, and can see the logic.  Why?  Because the first birth does tend to be a bit longer and being in a hospital for a longer time increases the odds of unnecessary interventions which can lead to an unnecessary c-section.  Avoiding that first c-section can make an enormous difference in the course of someone's reproductive life.  I still shudder to realize how close I came to a c-section with my first baby, and how much smoother things would have gone had I avoided going to the hospital in the first place.  If any other OB in the practice had been on-call that day, I have no doubt I would have had a c-section - a couple of them told me that themselves. 

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#74 of 107 Old 12-03-2010, 02:02 PM
 
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You have to remember that even in an emergency c-section, it takes time to set up an OR and get the personnel in there.  The standard for "decision to incision" is 30 minutes.



Yes, that info was really helpful to me when I was deciding whether or not to birth out-of-hospital.

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#75 of 107 Old 12-03-2010, 02:36 PM
 
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I had number one (and number two!) at home, after having many of the same feelings.  I started seeing my MW at 20 weeks (kept shadow care with the OB during the first in case I *did* have to transfer) and had the best birth experience at home, in my own bedroom.

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I chose to do hospital birth for my first-born (less than 4 months ago!) because I felt that as much as I read and studied and questioned, I really had no idea what birth would be like - so the hospital was my security blanket. Now that I do know, I absolutely plan to choose home birth next time. My hospital experience wasn't bad, but it wasn't anything like what I imagine birth could be in your own familiar, relaxed environment. They will turn it into a clinical, streamlined (in their way) situation - it's what they're programmed for, and they don't do anything else. (One of the biggest issues for me was that I wanted to wear my own clothes, and they wouldn't let me - I had to change into a gown. Simple and silly, perhaps, but it was such an important thing for my own personal comfort - a small comfort that would have meant a lot to me - and it was a no because it didn't fit into their regular operation.) Also, even though the nurses in the birth room were great, and my midwife was there with me, the ward I went to afterward was awful - crowded, loud, hot, and one busy impersonal nurse for 4-8 new moms and babies - I couldn't wait to get out of there and get home!

 

Ultimately though, the best advice I've had and will give as a mother - do what feels most right for you - you won't regret it. :)  Best wishes for your birth!


"But if I knew everything, there would be no wonder, for what I believe in is far more than what I know." ~ Madeleine L'Engle
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#77 of 107 Old 12-04-2010, 06:12 PM
 
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I chose to have a homebirth with my first after doing a lot of research. I was determined that my first birthing experience be a positive one, physically, emotionally, and spiritually. As a healthy woman with a low risk pregnancy, I recognized I was just as physically safe at home, and my other needs were more likely to be met. I chose a midwife I trusted and never looked back.

 

A lot of people asked me why I didn't have my first baby in the hospital, "just in case I couldn't have a vaginal birth", but I preferred to assume that I could rather than assume that I couldn't.

 

Our second homebirth is planned for the spring.


Catherine, mama to Preschooler Girl 9/08, and Toddler Boy 3/11

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#78 of 107 Old 12-04-2010, 07:08 PM
 
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I had my first at home.  It wasn't a decision I took lightly as I live over an hour away from a hospital that handles births.  Finding this site was very helpful to me:

http://www.homebirth.org.uk/firstbaby.htm

Don't let your birth attendant (if you choose one) decide for you.  If you choose one, search until you find the right fit.  I cannot stress this enough.  If your attendant is uncomfortable with homebirth, your chances of transfer are higher.  Do some soul searching on the reasons why you are uncomfortable with homebirth.  If after research and reflection, you discover you still have reservations, then explore your other options.

Do the research, but follow your heart.  Don't let a statistic decide for you.  And fear based decisions--live without them!  Most of all, remember that YOU know what's best for you and for your baby!

Best of luck!

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#79 of 107 Old 12-04-2010, 07:34 PM
 
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I had double footling breech twins and serious pre-eclampsia - not a midwife nor Ob on the planet would knowingly allow that natural birth to happen. It was a "planned" c-section. When I say planned, I mean when I went to my OB the Monday before they were born, he told me point plank that I was starting to go into the early stages of kidney failure and if I wanted we could drive over to the hospital and have them right then and there. I said no way, I'm not ready, so we negotiated. He told me Thursday was the latest this pregnancy was going and I was to be monitored daily to make sure nothing changed. He tired to get me to go in Tuesday, but I just wasn't quite there and everything was stable plus I was supposed to teach a self defense class that Wednesday night and they don't let you do that after surgery in the morning. I'm glad we waited because I really needed that time to mourn the loss of the natural birth we had planned, as I had a textbook pregnancy until two weeks before that. He was really cool and even did a quick ultrasound before the C-section to triple check that the lower twin hadn't turned - he hadn't. c section took 27 minutes from rolling me in to rolling into recovery. I was blessed to have him and would go back for other pregnancies. the hospital staff were also amazing. It's a really small rural hospital and they treat their patients really well. All the rooms are private and the babies automatically room in unless you ask for them to be out. And each room has it's own jacuzzi - which i didn't get to use. greensad.gif

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#80 of 107 Old 12-04-2010, 07:49 PM
 
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Well, I just had to add my two cents as I did briefly consider a homebirth with my first...almost in a wistful "wouldn't that be great?" way - and when my DH seemed freaked out by the mention I thought that being educated and strong in a hospital setting would be my best bet. I did EVERYTHING I could think of to prepare for the birth - Hypnobirthing, a great one page birth plan that the staff asked us if they could use as a "how to" example in their classes, signs for the door, informed cooperative OB re: our plan and goals. That said - with all my research - you CAN'T prepare for exactly how your birth will go - because there is simply NO way of knowing...I NEVER dreamed that I would do exactly as I'd planned - have a completely unmedicated labor and stay strong in all my wishes...to have the "residents on call" at our teaching hospital - MISS that my son was frank breech until I was pushing. I ended up with an emergency cesarean and a "T" incision - and was unconscious when my son entered the world. I say this NOT to put negativity out there - only to say that TRULY the reason for my cesarean was staff that LITERALLY did NOT know how to deliver a breech baby vaginally - and were in a setting where it was protocol not to. It changed my story - it changed my future - I'm 28+ weeks pregnant now and TOTALLY planning a homebirth. There was NO other option for me this time as I simply don't trust hospital care unless there's a need - unless something's wrong - and if you know your research - a frank breech baby and Mom who've made it to fully dilated and pushing - are NOT a reason for an emergency cesarean. To put it in perspective as well - I'm VERY strong minded and what they told us in the moment was "We know this is the opposite of what you wanted - but none of that matters now - THE BABY'S IN DANGER AND WE HAVE TO GET HIM OUT - NOW." They had no signed consent form - and truly - there never was informed consent - b/c I would have chosen 200% to continue to push my baby out. My point is that the truth is you CAN'T control you labor or birth - truly - there's no way of knowing how the story will play out. I will always have to wonder how easily my son might have been born beautifully were a midwife waiting to watch him enter the world instead of the terrified residents I had. What you CAN DO )here's the positive part) is give yourself the BEST ODDS of having a peaceful, natural, beautiful birth if that's what your shooting for!! In a perfect world I'd deliver in a home-like peaceful supportive environment with immediate access to medical care if necessary - but with no medical involvement unless necessary. The truth is I'm MORE scared about possibilities in a hospital environment than I am risks of being at home and having to transfer. Another consideration is that my DS, now 5 years old had a shocking, glaring, opposite-of-what-I tried desperately for type of birth. This time around he has the chance to be part of a beautiful birth. That's the best I can do for him now - for his story. It doesn't heal my heart - but it would help - a little. ♥ Again - my point is really to say that ANY BIRTH CHOICE has risks and different possible hurdles - you REALLY have to search your heart for your OWN BEST CHOICE - and realize that no matter what - you will probably be nervous - and the truth is that things may not go perfectly - but if you prepare well - and choose well - odds are GOOD that you overall you will have a GREAT BIRTH! ♥ Here's wishing us all the right informed choices and a BEAUTIFUL BIRTH

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#81 of 107 Old 12-04-2010, 08:31 PM
 
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My one and only was born at home, with a midwife. I felt very confident my decision, despite the fact that my nearest transfer hospital was 30 min away. The book that cemented my gut feeling about it was Ina May Gaskin's - Guide to Childbirth. Best health care decision I have made to date.

 

Transfer rates very A LOT by midwife; yes, many have about a 25% transfer rate, but some have a much lower (and a few higher) transfer rate. That is a crucial question to ask any midwife during an interview. If you have ANY concerns about your ability to complete a natural homebirth, I would also highly recommend getting a doula. Most transfers are due to "lack of progress" (I really hate that phrase), or "maternal exhaustion", both can be mitigated by having a doula by your side to coach you (and your spouse, if present) through the roughest spots and keep things progressing.

 

What ever your decision, be sure it is one you feel VERY comfortable with; only a comfortable, confident, relaxed mother can birth successfully. Any fears or trepidation will stall the labor process. This is not touchy-feely, goddess, mother earth speak, this is based in science and the body's hormonal/chemical reactions that take place when in fear vs in a relaxed state. Adrenaline shuts off the body's functions (fight or flight) and inhibits Oxytocin production (the naturally produced chemical needed to keep labor progressing).  Birth where ever and with whom ever you fell most secure and comfortable.

 

Do your research, interview practitioners, READ Ina May's book, and search the MDC forums and then make the best decision for you. YOU have to birth this baby, no one else. 

 

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#82 of 107 Old 12-05-2010, 10:09 AM
 
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My oldest was born at home too. I had no complications and everything went smooth, but labor was long and drawn out until the last few hours. I feel strongly that he would have been a c-section for failure to progress if we had been in the hospital.

 

My next two births were in the hospital - one a non-emergency transport because I was exhausted and swollen after trying to push out a baby whose head was cocked funny. She was born vaginally in the hospital an hour or so after we arrived. Next baby we chose to transfer care to the on-call OB for an AROM induction and NICU care for our baby whom they suspected had birth defects. (She is okay and thriving at 6yo.)

 

As far as hospital births go, I think they were great but I still prefer and believe home birth is safe and often safer for both mom and baby. My next two were born at home as well with no complications.

 

 

 


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#83 of 107 Old 12-05-2010, 10:30 AM
 
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Quote:
Originally Posted by Sudonk View Post

 

I've since heard the arguement that choosing a homebirth for a first baby is arguably even more important than making that choice for subsequent children, and can see the logic.  Why?  Because the first birth does tend to be a bit longer and being in a hospital for a longer time increases the odds of unnecessary interventions which can lead to an unnecessary c-section.  Avoiding that first c-section can make an enormous difference in the course of someone's reproductive life.  I still shudder to realize how close I came to a c-section with my first baby, and how much smoother things would have gone had I avoided going to the hospital in the first place.  If any other OB in the practice had been on-call that day, I have no doubt I would have had a c-section - a couple of them told me that themselves. 



That is such an important thing, and I wish that more women truly understood and considered it as heavily as they should. There are so many places where VBAC is not an option right now. Some things can't be undone. 


Banana, doula wife to Papa Banana and mother to Banana One, Banana Two, Banana Three, Banana Four...

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#84 of 107 Old 12-05-2010, 12:21 PM - Thread Starter
 
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Thanks, mamas, for sharing your unique perspectives. You all are gems and contribute so much to my own story when my friends and family don't have experience with home birth.


Mom of DS born 4/1/11. Wife and Middle-school teacher. Expecting Di/Di boy twins in June, 2012.

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#85 of 107 Old 12-05-2010, 06:38 PM
 
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It seems to me that you are nervous about a hospital birth whether it is intentional or emergent, so maybe the answer is more simple than you think.  Being comfortable in your surroundings is very important for the progression of labor.  Fear leads to tension and pain, which can in turn, slow labor.  I suggest that wherever you choose to give birth, accept this decision and don't think about the "what ifs."  Both are equally acceptable decisions, so the important factor is yout comfort level with giving birth in your home or the hospital.  To help prepare for birth, wherever you decide to do it, you could try hypnobirthing classes.  During sessions you could work through any fears you have so that they don't surface during your labor.

For what it's worth, I chose to give birth in my local hospital for my first child and don't regret it.  The only reason I did this was because I felt completely comfortable there (I work there and knew the midwives, and one of my coworkers was my labor nurse).  However, I will choose homebirth for my next child because of an insurance change which would require me to go to a different hospital.  Just remember to have peace with your decision, whatever it may be.

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#86 of 107 Old 12-06-2010, 09:25 AM
 
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I have had two births, both at home.  I am very glad I had my first at home.  I would write more but my hands are full with baby number two.

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#87 of 107 Old 12-06-2010, 11:30 AM
 
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I just had my first baby at home 5 weeks ago. Everyone I knew IRL thought we were nuts! But it went so smoothly (ok it hurt much worse than I thought it would!!), but I'm so glad I did it. We didn't even tour the hospital or pack a just in case transfer bag. I had 27 hours of back labor and then my body pushed for 20 minutes and baby came out. No issues and our midwife was really hands off. It could have been a UC, as smooth as it was. Baby and I were laying in my clean bed within a few minutes and no one bothered us. I was mostly worried about the hospital because of what they'd try to do to the baby, rather than me. Our baby wasn't weighed or measured for a few hours and her cord and placenta stayed attached for a couple of hours. It was just great to be able to relax and not worry about fighting off nurses or hospital "protocol". I just trusted birth and my body and knew that if we had to transfer that it would be for a true medical reason and I trusted my birth team with that determination. Good luck, OP, and trust your gut to do what's best for you and your family.

Beth- WOHM slinggirl.gif  -Madly in love with my Wife- SAHMhola.gifandbabyf.gifSophia, born 11/2/10, at home! homebirth.jpgExpressing love, one ounce at a time!  1pump.gif

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#88 of 107 Old 12-09-2010, 11:26 AM
 
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After so many great responses, I'm hesitant to add my own $.02... but I'm going to anyway. :) 

 

We planned a home birth for #1, but ended up among the small percentage of first-time birthers who transfer in labor.  I hated the idea of going to the hospital (it was a NOT natural-birth-friendly place, just like all the others that our HMO would cover) but by the time I got there, it was OK because I really did need their intervention.  It was a non-emergent transfer for exhaustion (after 3 days in labor). 

 

We're actually planning a hospital birth with a midwife this time around, in part because our transfer experience made DH so anxious, and in part because I have a 'gut feeling' that this baby might need more help at birth and I'd rather be somewhere just in case that hunch turns out to be correct (I hope it's not, of course). 

 

Here's my perspective: If I had to do it all over again, knowing I would transfer and knowing I would plan a hospital birth for #2, I would still have done it exactly the same way.  Here's my reasons:

 

  • As an anxious first-time-mom, I had tons of questions, and needed loads of advice about "what to do" with my pregnancy.  (Which chiropractor do I see?  What supplements should I take?  Is raspberry leaf tea a good idea?  Can I take hot baths?  Is my diet ok?  Should I be doing yoga every day?  Etc.)  My home-birth midwives spent a huge amount of time answering all those questions, asking me all sorts of questions about my lifestyle and diet and emotional health, and just piling on love and attention to me AND the baby.  It was wonderful.  I went to several HCP's before choosing them, and always left feeling sort of cold -- I was just an object to be poked, prodded and measured.  My midwives treated me like a person.  And they treated my baby as a person, too, long before she was born.  It was the perfect kind of environment to be in to prepare for motherhood. 
  • I felt that I got a lot of advice about ways to prepare for a natural birth -- even though I ended up medicated, it wasn't for lack of trying or for lack of resolve or for lack of education.  It was because I really needed medication.  If I hadn't done all that preparation with the midwives, I would not have been able to be OK with the decision to get an epidural in the end. 
  • Having a home birth plan made me feel very empowered and prepared.  *I* had to do the work to prepare -- nobody else was gonna do it for me.  Nobody was going to "save" me if I chickened out.  It meant that I felt spectacularly well-prepared for labor and birth, and very powerful in labor. 
  • My transfer, though I didn't want one (obviously), actually went really smoothly because I had prepared an extensive backup birth plan "just in case."  It meant that I received the kind of care I wanted (as much as was possible in that place), and knowing what I wanted/didn't want meant that I felt very empowered to refuse unnecessary interventions. 
  • My MW strongly suggested that DH and I take a natural-birthing class -- we drove over an hour each way to get there, once a week for 8 weeks, and it was worth every minute, because it was totally the opposite message of the 2-hour hospital "birthing class" we went to (which was basically, 'here's how to behave so we will treat you nicely here').  It really prepared us both for birth.  I don't think we would have bothered if we hadn't been planning a home birth. 
  • Now, in my second pregnancy, I feel much more laid-back about most things, and I feel much more comfortable trusting myself and my body to birth the way that it is supposed to.  Ironically, that means I am much less afraid to birth in a hospital, because I feel confident that I can manage my care the way that I need to for my own health and the baby's. 
  • Our experience with the HMO meant that this time around, we switched health insurance providers BEFORE we got pregnant!  Choosing an insurer who would cover a good CNM with a stellar reputation is making all the difference in the world to my peace of mind and overall health in this pregnancy.  Trying to get a home birth, or a midwife, or even a natural birth that didn't involve stirrups, covered (or even considered) by an HMO was a 'learning experience,' to say the least. 

 

So, with all of that said, I say -- go for it, plan a home birth, have a good backup plan in case you transfer, get well-educated and make sure you have lots of strong women around you to help you feel empowered and able, and see what happens!  Nobody can 'plan' what will happen in birth, but we can certainly set up the circumstances so that they are most favorable!!! 


I'm traveling the world with my kids without ever leaving home and blogging about it -- watch, taste, and share our adventures at TheGlobalStayCation.com!
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#89 of 107 Old 12-09-2010, 01:25 PM
 
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I have had a few women say that a birth center is the same as home and those conversations really didn't end up that well.  They didn't "get it".

It's not the same, but - as someone who planned a HB for her first baby (but ended up with a hospital induction for pre-e) and is planning a birth centre birth this time... not everyone feels the same way about birthing at home.

 

For some reason, I just don't feel that attached to a HB this time around. Partly it's disappointment from having invested SO much energy (and some money) planning my first HB. We hired the pool, I had pads and tarpaulins and all that jazz set up, and I focused so much on the experience of birthing at home that when that was taken away from me, it really threw me for a loop. I had put all my expectations into the birth pool and the atmosphere and having chicken soup simmering on the stove... and not enough thought into how I'd cope with the PAIN!

 

But also...I dunno. I like this house, but it's a rental and doesn't feel like "mine" exactly. It's not usually pristine. :p And I'd have to have the curtains shut for privacy from the neighbors - so for me, labouring at home might actually be somewhat dingy and depressing. The birth centre, on the other hand, has huge awesome jacuzzi-type tubs for waterbirthing, pretty good food, and a nice clean bright atmosphere. Also, we have a flatmate, so kicking him out of the house while I laboured would be somewhat awkward! And in a way I'd rather have the first wave of visitors at the birthing centre than at home, because at home I'd feel guilty if I didn't have homemade cookies to offer them, or if the house was dirty. (I know, I'm odd.)

 

Don't take this to mean I'm anti-homebirth now. If I'd succeeded in HBing the first time round it's probable I'd be doing it again. But for me, a birth centre birth just seemed like less of a hassle. And because it doesn't have quite the same emotional grip as a HB, if I have to go to the hospital again I won't be so upset (and I won't have spent all that money on the birth pool!). Maybe if I have a successful birth this time, and buy a house in the nearish future, I'll have any subsequent babies at home. I dunno. But I'm definitely not as dogmatic about it as I was. There are definite advantages to homebirth - the whole "your own germs" theory, for one - but for me, there are advantages to being out of my home as well, which have nothing to do with snazzy emergency care (which the birth centre doesn't have - it's like birthing in a hotel).


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#90 of 107 Old 12-09-2010, 01:31 PM
 
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I think that the transfer rate is more like 15% and almost always non-emergent. Meaning long labor and maybe pain relief is needed, or IV fliuds or pitocin.


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