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Birth and Beyond > Discussion about UC birth
shell024's Avatar shell024 10:23 AM 09-09-2006
Quote:
Originally Posted by fourlittlebirds
There is such a focus on arousal by another person and ultimately orgasm as the goal of sexuality in our culture, and I think this may be one reason women reject the idea of birth as sexual. Birth is regarded as too "pure" (and often too social) to entertain the idea of that. But if our sexuality is about more than orgasm... and knowing that birth is biologically a sexually hormonal process... then that opens up things quite a bit, doesn't it?

The question then becomes: assuming that an expression of birth as erotic or sexual is normal and desired, how realistic is to expect that in a social birth?
Yup, sooo unlikely to happen in an "unsexual" environment. There are so many things that have been drilled into my head that birth can't be sexual. It is a "painful rite of passage that all mothers must endure, and God help you if there isnt someone there to help you" as I've been told. So it would seem...birth...sexual?? But HOW??? You would really have to explain the hormonal process that goes on when a woman is aroused, and the hormonal process during labor and birth, and the similarities, etc. in order for someone to actually understand this concept in our society today. Until I read about it on Laura SHanley's site, I would have laughed about it.

gentlebirthmothr's Avatar gentlebirthmothr 01:32 PM 09-09-2006
Quote:
Originally Posted by pamamidwife
Perhaps those people who are new to the idea of unattended birth have questions, concerns, responses..perhaps those who are NOT new have some!

I'd like to start a discussion - a sane, rational, dialogue - about birth choices.

I've heard some UC birthers all lumped together as radical extremists that would rather die or have their baby die than go to the hospital. I think this is interesting, because I would venture to say that more UC birthers transport to err on the side of caution than maybe they would had they had an attendant present. Not that transporting is negative - that's not my intention to say, I just wanted to clear up some generalizations and stereotypes about those who choose to birth unattended.

As a midwife, many births I see are "unassisted". My definition of unassisted birth is one that happens under the woman's own power and her direction only. What I see UC birth being is "unattended". So, pardon if I get these crossed sometimes.

Years ago, when I was on the original cbirth email list, I came across a small handful of people (out of thousands) that would rather take fate into their own hands than to go to a hospital. That is their perogative. I do not feel this is selfish, irresponsible or stupid. A parent has the choice to do what they feel is best for their baby. Some parents do not vaccinate and people would call that selfish or irresponsible. Same thing with birthing at home with a midwife. See where I'm going with this?

We all have different belief systems. Just as there are a hundred different philosophies with midwives (and their own biases to go with those), there are different values with birth and parenting.

I feel like there is this idea that somehow saying "trust your body, trust your baby" means don't ever succomb to the medical model. That is certainly not the case with UC families I know. Overall, women know that there is a risk they are taking when they birth - whether it's in the home, hospital or attended. I don't feel like it's something that is done often with lack of foresight or thought. Every family I have ever known or worked with has been clear that when they need help, they will seek help. There is no medal for being the most "pure" birther as far as they are concerned. They love their babies, even the ones that believe that their babies are safer with unattended birth than with a highly interventive birth.

I support UC families. I offer on-call support for them - I always have and I always will. Why? Because they deserve to have options. Because I stand by a woman's right to choose. Because sometimes, mother does know best. I must be clear, though, that when I say "I always have" means that since I've started my own practice. As a student midwife, I was not very supportive of UC. In fact, I thought it was downright threatening and weird. I couldn't imagine. The more births I attended, the more complications I saw and heard because of our "routines" the more I understood. The first UC birth story that I found was so intimate that it bordered on erotic, I understood more.

Let's get it all out in the open. Let's discuss it. Ask questions. I ask that people are conscious of the UA when we go from here and refrain from name calling, generalizations or attacking.

(And this is NOT in the UC forum because frankly, those people have enough BS to deal with based on their choice and they deserve a haven of support)
Pam,

for being this topic up. Well, for me I rather be in a free standing birth center or hospital still, but want it to be hands off.
~~Mama2B~~'s Avatar ~~Mama2B~~ 03:27 AM 09-10-2006
Forgive me if I sound too forward or come across as rude...

I feel so sad when I hear women say, "I couldn't do it without medication" or "I have to have a midwife" or whatever.

Womens' bodies were deisgned to carry and deliver children. Unless there is something medically wrong, EVERY woman CAN get thru birth without doctors, midwives or medication.

I guarantee you that if you took the most medically-minded mama to be and you stuck her on a deserted island as she was preparing to go into labor, she would manage to survive the labor and delivery.

I have no problem with women choosing other birthing methods, but to say that they are physically unable to do otherwise is a shame. Do women really believe that it is a matter of pain-tolerance, psyching one's self up or some other criterion that predispose certain women to be able to "handle" birth and other women to be crushed under it? I can't understand this way of thinking as all women know that for the past however many thousands of years of recorded history, women have birthed with female relatives, non-medically trained midwives or alone. There were no hospitals, no doctors, no emergency c-sections to fall back on. If a person wants these things, they are entitled to their own choice, however to think they are mandatory is inaccurate.

Anyways, I'm rambling. I'm not meaning to be pushy or to put down anyone else's decision, but I think we as women need to realize that we CAN handle birth and our bodies ARE capable of delivery.

Best wishes and good luck deciding how to birth for yourselves!

Kristi
RiceMomma's Avatar RiceMomma 01:47 AM 09-11-2006
Quote:
Originally Posted by ~~Mama2B~~
I feel so sad when I hear women say, "I couldn't do it without medication" or "I have to have a midwife" or whatever.
I feel sad too, but I understand what they mean. While some might be saying, emotionally, they need a midwife, or they can't (don't want to) deal with the pain, there are many who, even though they are perfectly healthy and physically normal, they truly do believe that they must be delivered from birth, that they can't physically have a baby without a doc, midwife, medical care, whatever. They believe it on a subconcious level- we have been brainwashed from birth to believe this, as our own mothers birthed us in the hospital. We believe it on such a deep level.

Sure that woman most likely would survive birth on a desert island, but if she is like most, it would be a very terrifying expereince. I've had 2 UC's- one of them was unplanned- it was the most terrifying experience of my life, (funny to contrast it with my second UC which was one of the most beautiful experiences of my life) becuase, yes, I believed my baby wasn't safe being born outside of the hospital, and that my life was in danger. I learned a great deal from the experience, but at the time, I was terrified, and it was tramatic.
crazy_eights's Avatar crazy_eights 02:08 AM 09-11-2006
Quote:
Originally Posted by fourlittlebirds
The danger of planning a first-time UC without previous experience in birth, it seems to me, is in not having a base understanding of what's normal, if you tend to be someone who is in her head. If you're not, I guess it's irrelevant, because you just listen to your intuition. (Most of us, though, I think aren't quite there.) I would have given birth physiologically more normally with a UC, but I also (with my first) would have been more likely to transfer. I wasn't expecting it to be as hard as it was, and I think I would have questioned whether it should be that way, or just given up without someone there to disappoint.
I think this is my biggest issue. I have seen/heard so many women who had failed UC's that either thought something perfectly normal was abnormal or worse, viseversa. I know two people personally who panicked at delivery thinking that the wrinkled, vernix-coated baby scalp was a cord prolapse and called 911 with less than desirable results (though not dangerous, thank G-d). There are stories with less than optimal outcomes right here on MDC. I notice people are always very quick to say 'well, it could have happend in the hospital as well'. Sure, anything can happen. But probable? The blogged story of the footling breech UC that ended badly comes to mind immediately. And whenever I try to bring up issues like this, I'm told that I'm no different than doctors that say homebirth is dangerous!

Personally, esp. after having a homebirth that turned UC, I know that for me, I don't want to be in that headspace during the birth. I want to turn the 'thinking' part of my brain off and let my midwife deal with any issues that might arise.

One final thing. I think a lot of women who attempt UC and transfer, even if they really didn't need to, are often treated really badly by hospital staff AND are more likely to get a c/sec as they are viewed as 'irresposible people to stupid to get prenatal care but will sue you the minute something goes wrong, so let's just section them now'. I'm telling it like it is from the hospital side having worked L&D.
shell024's Avatar shell024 10:57 AM 09-11-2006
Well I truly believe knowledge is power. The more you know about what can happen in a hospital, all interventions included, the easier it may be to prevent them, even upon an emergency transfer.

For me, I thought for awhile that I'd rather have a midwife to just "deal" with anything that came along, but the more I learned, the further I swayed away from that thinking. I realized that handing the responsibility over to someone else could increase the risks that something could go wrong. Especially if I were to turn the thinking part of my brain off!

A huge part of choosing UC was the responsibility that I was assuming for myself and my child. At first it was an ominous overwhelming cloud that I didn't think I could handle, but as I learned more about trusting my body and intuition, that cloud faded and it became empowerment. This is MY body and no one knows it better than I do, even if they have seen hundreds of bodies "like" it. I felt that for me, it would be much better to learn what normal birth is, what the variations from normal may be, what situations can happen in our society today regarding pregnancy/childbirth/newborns, how to prevent serious problems, and how to handle emergencies.

Ideally, I would have been learning all of this stuff at a very young age...but alas, our culture doesn't really induce that kind of learning.
~~Mama2B~~'s Avatar ~~Mama2B~~ 02:15 PM 09-11-2006
Quote:
Originally Posted by mom2seven
I think this is my biggest issue. I have seen/heard so many women who had failed UC's that either thought something perfectly normal was abnormal or worse, viseversa. I know two people personally who panicked at delivery thinking that the wrinkled, vernix-coated baby scalp was a cord prolapse and called 911 with less than desirable results (though not dangerous, thank G-d). There are stories with less than optimal outcomes right here on MDC. I notice people are always very quick to say 'well, it could have happend in the hospital as well'. Sure, anything can happen. But probable? The blogged story of the footling breech UC that ended badly comes to mind immediately. And whenever I try to bring up issues like this, I'm told that I'm no different than doctors that say homebirth is dangerous!

Personally, esp. after having a homebirth that turned UC, I know that for me, I don't want to be in that headspace during the birth. I want to turn the 'thinking' part of my brain off and let my midwife deal with any issues that might arise.

One final thing. I think a lot of women who attempt UC and transfer, even if they really didn't need to, are often treated really badly by hospital staff AND are more likely to get a c/sec as they are viewed as 'irresposible people to stupid to get prenatal care but will sue you the minute something goes wrong, so let's just section them now'. I'm telling it like it is from the hospital side having worked L&D.
While this does happen, a great deal of it can be prevented or eased by prior research, education, study and a support group of other women' who've gone through it. Fir me, the whole purpose of having ahomebirth is so that I can USE the thinking part of my brain and not just have to lay there while someone else takes control of my birth.

I am going to have a UC, but I will be sharing the moment with my husband and a friend who has birthed two healthy children herself, in natural hospital births. We will do as much reasearch as we can so that we can have as much knowledge about birth as is possible.

I'm sure that having my first child UC will be scary in some ways. However, I will feel more at ease in my own home, with my friend and my husband beside me, listening to the most reliable voice there is- my body's. I won't have to deal with an outsider telling me when to push, when to get in the tub, what position to be in, etc. My body will guide me as it is designed to be a birthing machine.

I don't want an ugly hospital experience to lead me to a UC, even if it would provide experience. I want ALL of my birth memories to be spiritual and comfortable and in a place I want to birth. Saying that a woman should not UC with her first is reenforcing the idea that women are not capable of getting through birth without firsthand knowledge of what the almighty doctors/midwives are doing so that we can mimic them. I find this an offensive notion.

LIke I said in my original post, women are free to choose the birthing experince they find the most satisfying and safe. However, just like I don't put women down for choosing meds, hospitals, etc. I shouldn't be made to feel irresponsible, ignorant or foolish for choosing a UC. In reality, many women who choose UCs do much more research and study on birth than other moms planning to "turn the thinking side of their brains off" and let somebody else control/manage the birth.

Choose whatever you feel is best for yourself, but respect the choices that other women make as well. We all want what's best for our families- we just have different views on what that is.

Kristi
cottonwood's Avatar cottonwood 03:40 PM 09-11-2006
Quote:
Originally Posted by mom2seven
I notice people are always very quick to say 'well, it could have happend in the hospital as well'. Sure, anything can happen. But probable?
Why would it be more probable outside of the hospital?

Quote:
The blogged story of the footling breech UC that ended badly comes to mind immediately.
Well, a story of footling breech attended by a midwife that ended badly comes to mind too. I'm not about to offer that up as an example of why homebirth with a midwife is dangerous... [continued below]

Quote:
And whenever I try to bring up issues like this, I'm told that I'm no different than doctors that say homebirth is dangerous!
...but most doctors would. So maybe they think you're doing the same sort of thing -- offering it up as evidence that UC is dangerous. (Are you?)

Quote:
Personally, esp. after having a homebirth that turned UC, I know that for me, I don't want to be in that headspace during the birth. I want to turn the 'thinking' part of my brain off and let my midwife deal with any issues that might arise.
This was my reasoning for having a midwife attend my second birth. It turned out though that her being there prevented me from turning off that "thinking part of my brain" as you put it, and there were other issues with her being there as well, like the wrongness (to me) of sharing something so intimate with someone that I do not have an intimate and enduring relationship with. For the next birth I felt that I was better off with full access to my intuition and instinct and without the inhibition that would hinder hormonal release.

Quote:
One final thing. I think a lot of women who attempt UC and transfer, even if they really didn't need to, are often treated really badly by hospital staff AND are more likely to get a c/sec as they are viewed as 'irresposible people to stupid to get prenatal care but will sue you the minute something goes wrong, so let's just section them now'. I'm telling it like it is from the hospital side having worked L&D.
Yes, and it's part of why we're staying away from the hospital in the first place -- because we don't trust that we'll be treated medically appropriately and with respect and kindness. It stands to reason that we would be even less so if they were aware that we had been planning something they regard as crazy and dangerous.
cottonwood's Avatar cottonwood 03:49 PM 09-11-2006
Quote:
There are stories with less than optimal outcomes right here on MDC.
Yes. Just as there are stories of homebirth-with-midwife, birth center, and hospital birth with less than optimal outcomes right here on MDC.

Sometimes this happens even with the best of intentions, to the most educated and confident women, when pains have been taken to do everything "right" and conscientiously. More often, though, it seems to happen due to ignorance and naivity. These are problems not limited to mainstream hospital birthers. My heart sinks when I see someone planning a hospital birth with blind trust in her doctor or under circumstances in which there would likely be a better outcome with a different choice, and my heart sinks when I see someone planning a UC with blind trust in nature or under circumstances in which there would likely be a better outcome with a different choice. I wish all women could have true choice, and choose with a full understanding of the risks and benefits, and with support and a sense of empowerment. Women who don't are far more likely to see complications arise.
haleyelianasmom's Avatar haleyelianasmom 04:42 PM 09-11-2006
This is a great discussion.

I have one daughter who was born at the hospital with an epidural and that's not how I wanted her birth to go, but I didn't even know that birthing outside of a hospital was an option. Now I know better and definitely will not be having any of my future children at a hospital. I don't think I COULDN'T have done it without pain relief, but I imagine it is made quite difficult when you have to get in the car and be driven to a hospital and met up by a bunch of people you don't know, being preoccupied about other things (I remember telling one nurse that my wedding ring wouldn't fit me anymore, partly because I was worried that people would assume I was young and stupid and having an "oops baby" when Haley was totally planned and greatly anticipated, but now I realize, who even cares? Does it matter if you're married or gay or straight or young or old and the whether or not the pregnancy was planned or not? Does it really matter? but that's another story)

Anyways, I've been thinking about the birth of our next child ever since, wondering how I can do things differently, researching my different options. This talk on UC gives me a lot to think about. I think if I ever decided to try a UC, I'd have a midwife on call. I've been thinking of finding a midwife in the area who'd be willing to be very hands-off and stay back and away unless I say otherwise. There's a birth center a few minutes away and we've become involved there, going to all the mom groups, so part of me feels an allegiance to the birth center (plus, dh says he'd feel more comfortable at a birth center than at home). However, the idea of being able to stay home sounds so nice. When I'm in pain (not in labor), I go into a hot tub alone. I also get distracted and self-conscious with other people around. So I've been thinking about doing a homebirth with a midwife in the other room unless I ask for her... (I'm not pregnant yet and not trying yet)

So here's my questions. What do you do in the cases of shoulders getting stuck? or major bloodloss? Or a baby born not breathing?
How much can you trust nature for things to go well?
Are there any books about UC that are good for people who don't agree with it and aren't too open minded? (for friends or family of people choosing an UC)
prettypixels's Avatar prettypixels 04:52 PM 09-11-2006
Quote:
Originally Posted by ~~Mama2B~~
Forgive me if I sound too forward or come across as rude...

I feel so sad when I hear women say, "I couldn't do it without medication" or "I have to have a midwife" or whatever.

Womens' bodies were deisgned to carry and deliver children. Unless there is something medically wrong, EVERY woman CAN get thru birth without doctors, midwives or medication.
Well, first of all, I'd guess that the majority of women planning homebirths attended by a midwife do trust their bodies to give birth, or they'd go straight to the hospital. I surely do trust my BODY to give birth. I am not so sure however, of trusting my own HEAD while I am giving birth. It's not easy to overcome a lifetime of being told it is going to be horrible, it is going to be painful, you're going to need drugs, you're stupid to deny yourself drugs, etc. Not to mention the worries that most birthing moms have about the things that can (and do, sometimes) go wrong. That is all head stuff.

I did not hire a midwife to "fix" my body or "deliver me" from labor. I hired her to support me emotionally through the labor, to help me in the event of something I couldn't handle on my own, and to be there for me in the event that something goes wrong and I need a hospital transfer. I can tell you unabashedly that in the event I do need to go to a hospital, I'd 100 times prefer being there WITH MY MIDWIFE as my advocate... so my husband can focus on me and our baby, and I can focus on doing what I need to do instead of fighting all those silly battles that come with being in a hospital.

Does that seem like not trusting my body? I guess it might to someone who believes with every fiber of their being that their birth will go 100% perfectly. My best friend had two preemies and I have had so many friends have soooooo many problems... I could debate with you at length about whether or not medicine helped or hindered some of those problems... but for me, I want my bases covered. I want someone who knows what they are doing there with me to help my BRAIN through this process. My brain is always the trouble, darnit.

I'm all for women being given every option in the world to choose the birth that is perfect for THEM. But I would not presume to determine what is perfect for someone else, and I wouldn't assume that someone else is uneducated about their body or untrusting of their body because their choice is different from yours.

Quote:
I guarantee you that if you took the most medically-minded mama to be and you stuck her on a deserted island as she was preparing to go into labor, she would manage to survive the labor and delivery.
Agreed, that the majority of women would survive... after all, humanity is HERE after all these millions of years epidural-less. But frankly I'd prefer to do more than survive... I'd prefer to feel safe, secure, and relaxed through my birth. And if a midwife that I trust will enable me to do that, or if being in the hospital would enable me to do that, or if being home alone would enable me to do that, those are all valid choices.
accountclosed3's Avatar accountclosed3 05:09 PM 09-11-2006
i think that, for me, i want to be totally and completely aware during my birth on the multiple levels of my being--the physical aspects obviously, but also that 'thinking part of the brain' and that 'feeling/being' part of it--as they are not separate parts to me, but integrated parts.

i also feel that having someone there would make me 'think more and be less.' by that i mean i would be watching that other person like a hawk going--is she thinking i should transfer? does she want me in this position because it's easier for her to see what is what? is she going to try and pull on the cord to get the placenta out? etc etc etc. So, i would not be focusing on my birth, but on what the midwife is or isn't doing.

whereas, on my own, all i have to focus on is myself and going into that deep, intuitive, spiritual, primordial space where i engage with my baby in the process of birth.

i know that there are risks--there are risks inherent. but, i can learn about those risks, learn to deal with them appropriately, and learn how to mitigate them as well. I don't need someone else to do that for me--but i can udnerstand why someone else would and i support that in their circumstances.

but this is what is right for me. this is what i'm working toward.
crazy_eights's Avatar crazy_eights 05:19 PM 09-11-2006
So when I say 'less than optimal outcomes' that people rush to say 'they could have happend in the hospital' two examples come to mind. One is a footling breech, the other an urecognised cord prolapse. These are real-life examples, btw. So, in both cases the mother's were well prepared, knowledgable, etc. But in both cases the baby died. The immediate response is 'well, it could have happend in the hospital too' or 'it could have happend with a midwife at home'. Could have, yes. But my question is how much more risk is there in not having a trained attendant. Stay with me here. My point being that I do believe that some births ARE riskier and need someone with more training to recognise, intervene. I'd really like to see an analysis of what the increase in risk there is to having no attendant.
Defenestrator's Avatar Defenestrator 05:29 PM 09-11-2006
I have been thinking a lot about UC and how I might intersect with it as a midwife. So far, I am totally comfortable providing prenatal care to families planning a UC, either spot care or on a full schedule, and totally comfortable sitting and knitting in another room during a labor with a family that wants that privacy but also a safety net.

Except . . .

when I think of the birth as high risk, a la twins, non-frank breech, etc. I haven't quite swept out the cobwebs enough in my own psyche to determine why it is that I am willing to let go of control and trust the process with a low-risk birth (as determined by me and my own experience) and not with a higher-risk one. I think that back there is the idea that those births go better with an attendant, even though I am not sure that they really do.
BelgianSheepDog's Avatar BelgianSheepDog 05:40 PM 09-11-2006
Quote:
Originally Posted by mom2seven
So when I say 'less than optimal outcomes' that people rush to say 'they could have happend in the hospital' two examples come to mind. One is a footling breech, the other an urecognised cord prolapse. These are real-life examples, btw. So, in both cases the mother's were well prepared, knowledgable, etc. But in both cases the baby died. The immediate response is 'well, it could have happend in the hospital too' or 'it could have happend with a midwife at home'. Could have, yes. But my question is how much more risk is there in not having a trained attendant. Stay with me here. My point being that I do believe that some births ARE riskier and need someone with more training to recognise, intervene. I'd really like to see an analysis of what the increase in risk there is to having no attendant.
I think you and I are on about the same page, here. One thing that comes to my mind is that all the studies we have that say "home birth is safe, maybe even safer than hospital birth" are based on having a qualified attendant there. And the ones where home birth doesn't come out looking quite so good, like the Washington state study, don't differentiate between planned, attended births, unattended births, and "oops" precipitous births where the baby was born at home on accident. So while there is ample evidence that home birth with a trained midwife is safe and again, maybe even safer than hospital birth for some, there is NO evidence to the same effect about UC. And yet its proponents act as though there is no difference between the two.
cottonwood's Avatar cottonwood 06:16 PM 09-11-2006
Quote:
Originally Posted by haleyelianasmom
What do you do in the cases of shoulders getting stuck? Or major bloodloss? Or a baby born not breathing?
To be honest, I don't have fear of these things happening to me in an undisturbed birth. That doesn't mean they won't happen to anyone planning a UC. It means that in each unique individual these things are more or less likely to happen naturally depending on factors specific to their situation, and one of those factors is whether the birth is spontaneous, instinctive, and uninhibited.

I tend to believe SD is a created complication. There is fascinating reading here about causes and techniques to manage SD: http://www.gentlebirth.org/archives/...rDystocia.html

Extreme blood loss: I see my risk factors as being virtually nonexistent. I'm healthy, no interventions, third stage not disturbed. Some UCers have lost more blood than they liked and didn't die. They managed it with rest, uterine massage (after the placenta is out,) herbs, ingestion of placenta.

Baby not breathing: Know that the transition to breathing isn't usually immediate, and also what the variation of normal is for a just-born baby. If there's trouble, infant CPR.

Going to the hospital is always an option.

Quote:
How much can you trust nature for things to go well?
How much can you trust nature for anything to go well? It depends on nature's goals, and on whether we allow or hinder those goals.

Quote:
Are there any books about UC that are good for people who don't agree with it and aren't too open minded? (for friends or family of people choosing an UC)
Not about UC, no, but I'd suggest Gentle Birth, Gentle Mothering (written by a doctor) as an introduction to the benefits of undisturbed birth.
cottonwood's Avatar cottonwood 06:35 PM 09-11-2006
Quote:
Originally Posted by BelgianSheepDog
So while there is ample evidence that home birth with a trained midwife is safe and again, maybe even safer than hospital birth for some, there is NO evidence to the same effect about UC. And yet its proponents act as though there is no difference between the two.
I beg your pardon. I know very well what the difference is. As requested in the OP, please leave insulting generalizations out of this thread.

Quote:
And the ones where home birth doesn't come out looking quite so good, like the Washington state study, don't differentiate between planned, attended births, unattended births, and "oops" precipitous births where the baby was born at home on accident.
They also don't differentiate between the various motivations behind choosing unattended birth.
sarahmck's Avatar sarahmck 06:41 PM 09-11-2006
I'm only about half way through reading this thread, but I thought I'd pose my question anyway (before my baby wakes up and I have to go to bed for the night) since it's unlikely to have been asked already.

I have one baby. She was born at home with a midwife and doula in the US. I feel like it went well, and am very proud of myself for sticking to it since I had a huge amount of pressure on me to induce her early in the hospital (but that's another story). Now we live in the Netherlands, the #1 home birth country in the western world (as far as I'm aware), so you'd think that I'd be in a great situation for my next birth. However, my concern is that home birth is so normal here that being a midwife is just another job. In the US, I feel like a homebirth midwife has to be super dedicated to home birth, and has to be a bit of an activist. So I felt very confident that I would not be advised to transfer unless I really needed to, and I felt confident that I could generally trust that unexpected situations would be dealt with in the most natural way possible, even if there wasn't a lot of time to discuss options.

Since we've moved here, I've heard nothing but not-so-great birth stories. I've heard that all the midwife practices are groups, so that you don't know which midwife you'll get, and if your labor is long, there will be a shift change. I've heard that episiotomies are very common. I've heard that breaking the amniotic sac of all overdue babies is standard (to check for meconium and transfer to the hospital if any is found). I'm really wondering whether I'm going to be able to find a midwife who is really passionate about home birth, as opposed to on who hasn't thought a heck of a lot more about it than obstetrical doctors and nurses have thought about why they support hospital birth.

I'm not pregnant now, and don't intend to be for at least several more months. I have a niggling little thought in the back of my mind that I could get around the midwife problem by just doing it myself. But I know that I felt like I really needed my doula and, to a lesser extent, my midwife during my daughter's birth. The next time around I'll still have the same largely-useless husband, and now I'll have a toddler too! So I'm not sure if it's a good choice for me. But I really don't want some apathetic, unthinking, clock-watching midwife there, especially after having had a very nice home birth experience in the States.

I really want my birth experiences to get better and better, not worse. I tried hard to make my first one as good as possible because I hate the idea of not knowing much when you're first a parent and making all your mistakes on the first and then being all sad about how your first one got short-changed. But now I don't want my next one to get a worse birth because it would be doubly bad to experience something bad when you've already had a good one and know what that's like.

Okay, I'm rambling. If you can find a question in there and feel like answering it, I'll be thankful.
Rico'sAlice's Avatar Rico'sAlice 06:54 PM 09-11-2006
Quote:
Originally Posted by fourlittlebirds
They also don't differentiate between the various motivations behind choosing unattended birth.
:

I see a conscious decision to have a planned UC as very different than a genuine oops, whether it is b/c you didn't get to the hospital fast enough or the midwife didn't arrive in time or b/c you were in denial about pregnancy, on drugs, etc. That is not to say that those situations necessarily will have bad outcomes, but if you end up with a UC when you don't want to have one, it would seem likely that you will be panicked, upset, etc. And that would likely have a negative effect on the process.

Similarly, when someone choses to UP for philosophical reasons and either is very intuitive and pays close attention to their body's messages or else does more traditional care on their own (heart monitoring, urine testing, etc.) also while making an effort to get superior nutrition, avoid dangerous substances, etc. that it is not comparable to someone who doesn't have any sort of prenatal care due to financial reasons, drug addiction, mental illness, etc.

Also, although many UCers say that you don't have to read books or study to prepare, it seems that pretty much all do. Although they may not have the same level of experience in witnessing births, many have as much technical knowledge as a typical midwife in terms of how to deal with most complications/variations on normal.

I would think a planned UC by a thoughtful educated mother would be much closer (in statistical outcome) to a midwife attended birth than it would be to a drug addict who births their baby in a back alley. (Maybe that's a bit extreme, but I assume it would have been an example of an out-of-hospital birth included in the study)
While there is no studied evidence that unattended births have as good (or better)outcomes as HB w/ MW, there is no evidence that they don't. It's just not something that has been studied.
And although they are not really acceptable according to the scientific rules of statistical sampling, the info at unhinderedliving seems to the best actual stats on planned UC we have at this point, and it is very positive.
cottonwood's Avatar cottonwood 07:06 PM 09-11-2006
Quote:
Originally Posted by sarahmck
I have a niggling little thought in the back of my mind that I could get around the midwife problem by just doing it myself. But I know that I felt like I really needed my doula and, to a lesser extent, my midwife during my daughter's birth.
You could do it yourself. But that still doesn't mean it's the best choice for you, right? And that's your problem, obviously. Well, I know that Midwifery Today has conferences in the Netherlands and they're pretty progressive, so maybe if you contacted them they would be helpful in pointing you in the right direction? There are radicals everywhere, and I would not yet lose hope if I were you. Maybe also PM Pamamidwife, I don't know how closely she's following this thread, and she might have some suggestions.

Quote:
The next time around I'll still have the same largely-useless husband, and now I'll have a toddler too!
The difference in my husband between my first and fourth births was just incredible. What I remember of him during my first labor was not terrible, but it wasn't impressive either. He had no idea what to do for me and pretty much just sat there looking helpless and scared. With my last labor he was a rock. He was calm and passionate and nurturing. I think part of it was just getting used to what normal birth looks like. But it was also that he felt unsure of himself in a setting that was dominated by other women, and felt very inhibited and powerless (much like I felt, actually.)
caedmyn's Avatar caedmyn 07:15 PM 09-11-2006
This is a great thread--got me thinking about how my homebirth went and what, if anything, I would like to do different with the next baby. It also made me think about how I could birth with fewer "interventions", although really there were very few in my birth.

I had a mostly unattended homebirth--my labor went much faster than I expected and I was in second stage labor when DH and the midwife arrived. I actually liked being alone for most of labor--nobody was there to try to get me to eat or drink (which DH would have done), or to tell me not to do housework, or whatever. But it was scary toward the end when I knew the baby was ready to come now and there was no one there. Even though I knew (and told myself) that if the baby came when I was alone it would be just fine, I was still scared. Whether I would have felt differently if DH had been there with me, but not the midwife, I don't know. Once they arrived there was a little more "intervention", although not a whole lot. I went on my knees to push (that's what felt natural). The midwife checked me and said the baby's head was right there (yeah, I knew that)--it didn't bother me and I couldn't feel the check, but I'm glad that was the only one there was--I was planning to refuse checks before I felt ready to push anyway. She did perineum support during pushes, from behind, but I wasn't really aware of it other than knowing she was doing it. She did also listen to the heartbeat once, after my water broke, which I was okay with, also. After the birth she was mostly concerned with making sure the baby stayed warm and with helping us get started nursing. There was never a second midwife/assistant there as it happened so quickly. I absolutely loved my midwife, and she was very hands off overall during pregnancy and birth--unfortunately we've moved so I'll have to find a different one for my next birth.

I think for my next birth (ideally) I will have DH there the whole time, but I may be in a different room, or even send him out for a while, since things went well and I liked being alone for most of labor (although I also want the reassurance next time of having someone else there for support if I want them). I will probably wait (although not quite so long!) to call for the midwife since I don't want dilation checks or much fetal monitoring, anyway. I think I would prefer either to not have a second midwife/assistant present, or for them to be in a different part of the house and not be at the birth unless there is a complication. I might think about having the midwife be more off in a corner during the birth, too, although the perineum support seems like a good idea and that's not something I want to do myself (and I don't think DH would feel comfortable doing it, either). I think I will have the midwife back off a little more after the birth, also, since now I know what to expect and what needs to be done afterward. (Does it sound like I'm starting to lean a little toward an unassisted-but-attended birth?)

I personally don't feel comfortable with UC. I feel more comfortable having an attendant at least present, and I don't think I could live with myself if something did happen with a (planned) UC, whereas I think I could live with myself if something happened with a homebirth. But if I were in a situation where I couldn't find a midwife I was comfortable with, or one wasn't an option, I would seriously seriously consider UC before going to a hospital.

Thanks for giving me a chance to process my homebirth and prepare for the next one
cottonwood's Avatar cottonwood 07:20 PM 09-11-2006
Quote:
Originally Posted by Rico'sAlice
And although they are not really acceptable according to the scientific rules of statistical sampling, the info at unhinderedliving seems to the best actual stats on planned UC we have at this point, and it is very positive.
Ours here are limited (only tracking live births and transfers at this point) but we have a bit larger group (of close to 200.) Our transfer rate is 7% (higher than hers) and c-section rate is about 1.5%. There may be a bit of cross-over, with about 35 of our births happening before her study ended. She also didn't have any deaths, and we have one reported.
haleyelianasmom's Avatar haleyelianasmom 07:58 PM 09-11-2006
Quote:
Originally Posted by fourlittlebirds
I'd suggest Gentle Birth, Gentle Mothering (written by a doctor) as an introduction to the benefits of undisturbed birth.
who is it by? I can't find it on Amazon (or at our library!)
cottonwood's Avatar cottonwood 08:15 PM 09-11-2006
Quote:
Originally Posted by haleyelianasmom
who is it by? I can't find it on Amazon (or at our library!)
Sorry! Sarah J. Buckley, MD

http://sarahjbuckley.com/html/gentle...-mothering.htm
mwherbs's Avatar mwherbs 09:41 PM 09-11-2006
mom2seven wrote>>>"Personally, esp. after having a homebirth that turned UC, I know that for me, I don't want to be in that headspace during the birth. I want to turn the 'thinking' part of my brain off and let my midwife deal with any issues that might arise."

so what is your UC story?
It is not just you but I think most people do not want to be tooling the finer points and going into labor land at the same time. Odent talks about this and is even careful during pregnancy/prenatals to recommend less clinical care and more community like sing-a-long because too much clinical focus ends up equaling too much stress-
not disturbing birth is nearly a lost skill in our society- and there are new things in the mix all the time- like a generation of moms who as infants were in daycare- so does institution=home and safety to these women on a deeper unconcious level?

people talk about brainwashing but women are who they are when they come to birth "brainwashed" or not- the alternative birth movement is rife with thinking that we have to know every tiny detail about birth this is it's own culture and you know what even if you are completely ignorant a baby will come out so we are guilty of our own biases but more than education what I want to is integration in care around birth
crazy_eights's Avatar crazy_eights 09:56 PM 09-11-2006
My hb turned UC story is merely this - had a 50 minute labor, mw lives 1 hr. away. Doula was freaking out, cord around neck, sticky shoulders and I was in the bathtub. I had to basically talk dh and the doula through what we were going to do, but I did need assistance moving and squating, as well as dealing with the CAN.
mwherbs's Avatar mwherbs 12:24 AM 09-12-2006
Quote:
Originally Posted by mom2seven
My hb turned UC story is merely this - had a 50 minute labor, mw lives 1 hr. away. Doula was freaking out, cord around neck, sticky shoulders and I was in the bathtub. I had to basically talk dh and the doula through what we were going to do, but I did need assistance moving and squating, as well as dealing with the CAN.
whew a 50 min labor alone is alot to integrate-- our #2 was born in 1 hr - half of that was spent in the car...
I have one friend who had 3 labors this fast...
I also find it hard to be the most organized and calmest head when it is happening to me- it is absolutely just not fair-I don't like the division.

so what did you do? how did you manage it? how long was the baby stuck?
crazy_eights's Avatar crazy_eights 12:54 AM 09-12-2006
Quote:
Originally Posted by mwherbs
whew a 50 min labor alone is alot to integrate-- our #2 was born in 1 hr - half of that was spent in the car...
I have one friend who had 3 labors this fast...
Yeah, tell me about it. I've had 4 that were under 1 1/2 hour.

Quote:
I also find it hard to be the most organized and calmest head when it is happening to me- it is absolutely just not fair-I don't like the division.

so what did you do? how did you manage it? how long was the baby stuck?
I don't know how long the baby was stuck - it seemed a long time. Enough time for the bathtub to drain. The doula was trying to get me out of the water and I said, 'if you are really worried about it, let the water out'. It was totally unnecessary, but whatever. Anywho, yelled for dh to come help, he came in and helped me get one leg up and out she came. Her head was PURPLE for a day or so after, but she pinked up right away and was fine. I'm really glad she didn't need more extensive manouvers to get her out though.
~~Mama2B~~'s Avatar ~~Mama2B~~ 01:04 AM 09-12-2006
Quote:
Originally Posted by prettypixels
Well, first of all, I'd guess that the majority of women planning homebirths attended by a midwife do trust their bodies to give birth, or they'd go straight to the hospital. I surely do trust my BODY to give birth. I am not so sure however, of trusting my own HEAD while I am giving birth. It's not easy to overcome a lifetime of being told it is going to be horrible, it is going to be painful, you're going to need drugs, you're stupid to deny yourself drugs, etc. Not to mention the worries that most birthing moms have about the things that can (and do, sometimes) go wrong. That is all head stuff.

I did not hire a midwife to "fix" my body or "deliver me" from labor. I hired her to support me emotionally through the labor, to help me in the event of something I couldn't handle on my own, and to be there for me in the event that something goes wrong and I need a hospital transfer. I can tell you unabashedly that in the event I do need to go to a hospital, I'd 100 times prefer being there WITH MY MIDWIFE as my advocate... so my husband can focus on me and our baby, and I can focus on doing what I need to do instead of fighting all those silly battles that come with being in a hospital.

Does that seem like not trusting my body? I guess it might to someone who believes with every fiber of their being that their birth will go 100% perfectly. My best friend had two preemies and I have had so many friends have soooooo many problems... I could debate with you at length about whether or not medicine helped or hindered some of those problems... but for me, I want my bases covered. I want someone who knows what they are doing there with me to help my BRAIN through this process. My brain is always the trouble, darnit.

I'm all for women being given every option in the world to choose the birth that is perfect for THEM. But I would not presume to determine what is perfect for someone else, and I wouldn't assume that someone else is uneducated about their body or untrusting of their body because their choice is different from yours.



Agreed, that the majority of women would survive... after all, humanity is HERE after all these millions of years epidural-less. But frankly I'd prefer to do more than survive... I'd prefer to feel safe, secure, and relaxed through my birth. And if a midwife that I trust will enable me to do that, or if being in the hospital would enable me to do that, or if being home alone would enable me to do that, those are all valid choices.

As I said before, the most important thing is that the mother feel comfortable and safe. I'm not encouraging everyone in the world to birth a certain way. In fact, the post you're responding to merely advocates that women should not feel obligated or unable to birth any other way than society teaches.

You said,
"Does that seem like not trusting my body? I guess it might to someone who believes with every fiber of their being that their birth will go 100% perfectly. My best friend had two preemies and I have had so many friends have soooooo many problems... I could debate with you at length about whether or not medicine helped or hindered some of those problems... but for me, I want my bases covered. I want someone who knows what they are doing there with me to help my BRAIN through this process. My brain is always the trouble, darnit. "

You don't know me or know how I feel or what I think. I don't believe that every birth will go 100% perfectly. However, I believe in the power of thought, affirmation, suggestion and prayer to ease stress and help make delivery more smooth. Are there women who have sick babies, preemie babies, still born babies, etc. and no one is to blame? Absolutely. I never hinted that this was not the case.

While many babies do struggle, have emergencies during birth and die, the vast majority of babies born to healthy women live and are born healthy and fully developed. While I am aware of the possible troubles that potentially could arise, I am much more focused on the probability that I will have a normal, healthy birth and a baby.

Like you, I'd also prefer to feel safe, secure, and relaxed through my birth. That is precisely why I choose to view birth as a normal, spiritual, personal part of the human life cycle. It is not a medical crisis, a critical emergency, and illness or a disablitiy. By understanding what birth really is and how it was designed to be, I become more safe, secure, and relaxed.

I don't know why you seem to be aiming hosility at me. I have tried to be polite and understanding in this thread. I don't presume to tell other women what birth they should have, nor do I assume that women are uneducated or untrusting if they choose a different method. However I DO assume that a woman who says, "I would be unable to survive birth without medication" or "I could not birth outside of a hospital" must be uneducated on alternate birthing methods and must not understand how the power of the female body. If they did, they would not make statements citing their body's inability to do its job.

If a woman weighs the evidence, studies the different options available to her for birth and chooses to have a medical birth, that is her choice and I have NEVER put anyone down for making that choice. The comment I made displayed my sorrow that many women don't even know that there are options available and have been brainwashed into believing their bodies are incapable or untrustworthy of giving birth uncontrolled.

Again, I don't know why you are directing your hostility towards me, as I have not made ungly or judgmental comments towards you. I'm sorry you choose to view me as a bigot or self-righteous, or whatever you think.

Kristi
shell024's Avatar shell024 09:30 AM 09-12-2006
Quote:
But frankly I'd prefer to do more than survive... I'd prefer to feel safe, secure, and relaxed through my birth. And if a midwife that I trust will enable me to do that, or if being in the hospital would enable me to do that, or if being home alone would enable me to do that, those are all valid choices.
I feel the same, sort of. I'd prefer to do more than survive...I'd prefer to feel safe, secure, and relaxed through my birth, which means being at home, with no midwife there to possibly hinder the birth. You are right, they are all valid choices. No one said they weren't. I don't think anyone here is trying to judge whether your choices are right or wrong.

Quote:
when I think of the birth as high risk, a la twins, non-frank breech, etc. I haven't quite swept out the cobwebs enough in my own psyche to determine why it is that I am willing to let go of control and trust the process with a low-risk birth (as determined by me and my own experience) and not with a higher-risk one. I think that back there is the idea that those births go better with an attendant, even though I am not sure that they really do.
Yes, it is very difficult to let go of control and trust the process when there are what seems to be higher risks. Often, it became easier for me to let go when I learned more about what it was I was worried about. The higher risks you mention aren't really more risk in my mind, just another variation. It is unfortunate that there aren't any "real" studies on UC, as then we may be able to see what the "dangers" are in comparison with hospital births, homebirths w/midwife, oops UCs, and planned, thought-out UCs.

Quote:
I tried hard to make my first one as good as possible because I hate the idea of not knowing much when you're first a parent and making all your mistakes on the first and then being all sad about how your first one got short-changed. But now I don't want my next one to get a worse birth because it would be doubly bad to experience something bad when you've already had a good one and know what that's like.
I totally agree! I wanted so badly to birth my first child in the most gentle way possible, because I didn't want to start out with a bad taste in my mouth about birth. I didn't want to have to have a not-so-great experience be my reason for trying to have a better birth next time. I want each of my births to be as positive as they could be. While it was scary going against the grain and deciding to have a UC with my first, it was oh so empowering. Like a huge "AHA!" So there IS a way to bypass this huge negative block am having about giving birth. There is a way to break free from this weight on my shoulders. Once I decided to go the UC route, it was like almost-instant clarity. So THIS is what I've been searching for!

Quote:
The difference in my husband between my first and fourth births was just incredible. What I remember of him during my first labor was not terrible, but it wasn't impressive either. He had no idea what to do for me and pretty much just sat there looking helpless and scared. With my last labor he was a rock. He was calm and passionate and nurturing. I think part of it was just getting used to what normal birth looks like. But it was also that he felt unsure of himself in a setting that was dominated by other women, and felt very inhibited and powerless (much like I felt, actually.)
Thank you for sharing that. It is very encouraging.

Quote:
I feel more comfortable having an attendant at least present, and I don't think I could live with myself if something did happen with a (planned) UC, whereas I think I could live with myself if something happened with a homebirth.
I think this may have something to do with the sharing of the responsibility (?). I am not trying to judge anyone here, and am treading carefully with my words, as this can become a touchy subject. The possibilty of a death is a valid concern in ANY birth. It seems to get a little tricky when it comes to UC, because the issue of the parents soley carrying the responsibilty of the birth can be a bit scary to some when the thought of a death crosses the mind. It has definitely crossed my mind before. Obviously, it would all depend on circumstances and the mother's intuition about when to get help if she thought she needed it. I have read of some UCers who have had the intuition that something was majorly wrong but at the same time, that intuition told them that they were better off staying at home. That nothing more could be done by getting "help", that their babies would become subjects of test/analysis/etc and they would much rather spend that extremely sensitive grieving period in peace where they feel safe and loved. That is just the way some people feel. Others have intuitive messages that they are best off going straight to the hospital, NOW, and there is usually a reason in the end. I truly believe in going with your intuition, but it can be very difficult to really tune in to it, especially in distracting situations. Personally, I would be able to live with myself if we had to endure a death at home. Sure, there may be scrutiny from others like "WHY didn't they just go to the hospital??" but they have absolutely no right to judge a situation that they were no part of and have no understanding of, including what the parents' values, beliefs, and intentions may be. We are all human, and we all have different beliefs about life and death. There is a wide comfort range for all, and we just have to support each other in any situation like that.
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