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Discussion Starter · #1 ·
Okay, I'm sold on homebirth! I want one. I've found a wonderful HBAC midwife, I've done my research, I've read Silent Knife and VBAC Companion, I know what I want
. I also know what I don't want: The high-intervention, mandatory EFM, mandatory epidural
, that my hospital requires.

The problem: My Husband. He won't talk about it. He won't listen to me talk about it. He refuses to acknowledge that it's what I want. He has admitted to me that he's scared to HBAC, because he doesn't want me or the baby to die. Every time I try and give him statistics, he says, "But what if you are the 1 in 200 who ruptures?" ARGH!!!!

So, have any of you been able to convince a reluctant husband/partner to try a homebirth? Homebirth after cesarean? I mean, I'm scared too, but I'm MORE scared to go to the hospital! Any suggestions for getting through to my husband?
 

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I am reading "The Thinking Woman's Guide to a Better Birth" The stats they quote on elective c-sections scare the crap out of me. Once you read this you will understand that elective c-sections are much, much more dangerous than HBACs.
 

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It is incredibly scary when you are informed of the risks, isn't it! What I'm hearing you say is that you do not feel heard. You need to feel safe when you are in labor. Your need for safety isn't going to be met at a hospital. The only person accountable for you is you. If you aren't communicating with your husband--start now. Acknowlege his fear--it is real, and it is deep. It is just as real as your fear of going to the hospital again. You need to be heard in this--it's your birth. I have a friend who *did* have her uterus rupture---and the dr. didn't know it for an HOUR and a HALF---and this is in a hospital with all the stupid bells and whistles. She and her baby almost did die---in the most obstetrically advanced medical facility around. The hospital many times, only gives an appearance of perceived "safety." For normal births, we know better. IMO, you are best off where YOU feel most safe. I'm certainly not saying that your dh's fears aren't important, they are---it's just that it might be very helpful to start really getting to the bottom of this issue---soon. Some people need reassurance, some need to meet the m/w, some need to meet other hb moms/dads, some need facts and figures, some need to have faith. Which is your dh? Here are some interesting stats:

According to a World Health Organization (WHO) report - subsection on Place of Birth: _

"It has never been scientifically proven that the hospital is a safer place than home for a woman who has had an uncomplicated pregnancy to have her baby. Studies of planned home births in developed countries with women who have had uncomplicated pregnancies have shown sickness and death rates for mother and baby equal to or better than hospital birth statistics for women with uncomplicated pregnancies."_

According to this published study: Mehl, L., Peterson, G., Shaw, N.S., Creavy, D. (1978) "Outcomes of 1146 elective home births: a series of 1146 cases." Journal of Reproductive Medicine, 19:281-90: _
_
Neonatal Outcomes:

*In the hospital, 3.7 times as many babies required resuscitation.
*Infection rates of newborns were 4 times higher in the hospital.
*There were 2.5 times as many cases of meconium aspiration pneumonia in the hospital group.
*There were 6 cases of neonatal lungwater syndrome in the hospital and none at home.
*Babies were 30 times more likely to sustain physical injury in the hospital. There were 30 birth injuries (mostly due to forceps) in the hospital group, and none at home.
*The incidence of respiratory distress among newborns was 17 times greater in the hospital than in the home.
*While neonatal and perinatal death rates were statistically the same for both groups, Apgar scores (a measure of physical well being of the newborn) were significantly worse in the hospital.

The Maternal Outcomes of the Mehl Study show mothers in hospitals have a five-fold increase of maternal hypertension during labor and a three times higher rate of postpartum hemorrhage than mothers at home. According to Mehl, 1977, the low use of obstetric interventions during planned homebirths explains the discrepancy between hospital and home outcomes. _

Here are some significant homebirth/hospital evidence-based research studies:_

*Wiegers, T. A., M J N C Keirse, J. van der Zee, and G. A H. Berghs. 1996. "Outcome of Planned Home and Planned Hospital Births in Low Risk Pregnancies: Prospective Study in Midwifery Practices in the Netherlands." British Medical Journal 313:1309-1313. _
_
* Ackermann-Liebrich, Ursula, Thomas Voegeli, Kathrin Gunter-Witt, Isabelle Kunz, Maja Zullig, Christian Schindler, and Margrit Maurer. 1996. "Home versus Hospital Deliveries: Follow-up Study of Matched Pairs for Procedures and Outcome." British Medical Journal 313:1313-1318. _
_
* Schlenzka, Peter F., "Safety of Alternative Approaches to Childbirth", Stanford University, 1999, available on the web at http://www.vbfree.org/docs/meadsum.html

Obstet Gynecol 1998 Sep;92(3):461-470, Murphy PA, Fullerton J.

CONCLUSION: Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary. Intrapartal mortality during intended home birth is concentrated in postdates pregnancies with evidence of meconium passage._

Meta-analysis of the safety of home birth:_
_
Birth 1997 Mar;24(1):4-13; discussion 14-6, Olsen, O

What is the relative safety of homebirth compared with hospital birth? Ole Olsen, a researcher from the University of Copenhagen, recently examined several studies of planned homebirth backed up by a modern hospital system compared with planned hospital birth. A total of nearly 25,000 births from five different countries were studied.

The results: There was no difference in survival rates between the babies born at home and those born in the hospital. However, there were several significant differences between the two groups. Fewer medical interventions occurred in the homebirth group. Fewer home-born babies were born in poor condition. The homebirth mothers were less likely to have suffered lacerations during birth. They were less likely to have had their labors induced or augmented by medications or to have had cesarean sections, forceps or vacuum extractor deliveries. As for maternal deaths, there were none in either group.
 

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What wonderful data.

My husband has always had a fear of the germyness of hospitals and so was all for me giving birth at home. It was not a VBAC however.

What REALLY convinced my husband was when I showed him the statistics of hospital births vs. homebirths. He also had a friend whose wife was having a homebirth and they were able to discuss it.

If at all possible, can you find another woman whose husband was supportive of this and get together with them? Maybe the other couple can talk about this. Cold hard facts seem to get them.

Good luck,
Tooby (2B)
 

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I think you also need to look at yourself/your husband objectively. Are you the type of person who will NEED your husband's strong support as you labor? Is the the type of guy who can give this support?

I bring this up b/c while pregnant w/DS, I thought I would need DH to be a support during labor. We talked about ways he could do this. During labor, he "crapped out" on me. No support!

So I informed him that I WOULD be having a HBAC w/the next one, whether he liked it or not. I realized that I wasn't getting the support I wanted while in labor, so I might as well be at home, where I could try to relax. I'm also hiring a doula, so I can be sure I'll have some support.

The way I'm looking at it: if I need support and DH isn't providing it, he loses his say in how/where I birth. I know it's his child, too, but I'm the one birthing. I need to be in an environment where I can let my body do what it knows how to do.

If DH was better support during Will's birth, I might think about this differently. If he had been supportive the first time around, I'd have faith that he could do it again, and would work harder making sure he was on board w/a HBAC.

I'm still working through my resentment towards DH and the medical "assembly line" birth I had w/Will. I ended up having a c/s, and now feel that it was a result of consenting to AROM (thus starting a cascade of interventions). The problem I have is that we discussed how I would need DH to stay strong and remind me that I did NOT want any interventions, including AROM (I was afraid that now matter how strongly I felt about this, once in the "system", I'd cave). The OB kept "suggesting" AROM and I refused several times. Finally, I asked DH what he thought, and he said "go ahead". I know, I made the ultimate decision, but that was a scenario we specifically discussed, and DH didn't follow our plan!

Sorry to babble about this on your thread, but I'm trying (poorly, I know) to make the point that you need to realistically look at how much of a support your DH will be, and how much of a support you need.

Like I said, I just TOLD DH I would have a HBAC next time, and I told him why, and he's working on accepting it. He does have concerns, and I'll admit I have some as well, but (for us) me presenting it as a fait accompli worked better than debating about it w/DH. Now we can both work to figure out ways to minimize a bad outcome together, rather than DH bringing negative energy in and us arguing about it.
 

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Discussion Starter · #6 ·
Thank you all for your advice, especially for your extensive message, succotash
. Your statistics might just be the thing to sway him. I understand how he is worried, really. And he is a great husband and was a wonderful support during my difficult c-section.

Thanks again!
 

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Some things to think about --

In the hospital, if you have a mandatory epidural, especially if they want to insert it early, you most likely will need some kind of augmentation to increase the strength of your contractions, like pitocin. Labors which have been augmented by pitocin show a higher rate of uterine rupture than labors which have not been augmented by pitocin.

Is your hospital of choice a large hospital with an ob and anesthesiologist on the floor 24/7? If not, the hospital will need to page the surgical team in case of a cesarean and it may take 30 minutes or more to gather them and the or. Regardless, there is some lag time as they scrub up and get the or ready. If you live less than 30 minutes from the hospital, your homebirth midwife can call ahead and have them prepare the surgical suite and team and essentially achieve an emergency c-section in close to the amount of time you would if you were already there.

Have you talked to any midwives? Perhaps your midwife of choice could share with your dh her plan for taking care of women who HBAC. Sometimes just hearing that there is a plan can be soothing to those who have a great fear of the unknown.

Good luck!
 

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I agree with Defenestrator. An experienced mw will *know* waaaaay before it's emergency time that it's time to go. Though it doesn't happen all that often, sometimes things don't go as planned. TRUE emergencies are rare. It's not like we've been brainwashed with on TV and in movies. Transfers are *generally* quite calm. BTW, my friend who had the uterine rupture was in with a hospital "attempted" VBAC---and was given pitocin...augmenting a labor that was already well underway...just not to the dr's time table. Pitocin (especially with a VBAC!) makes me want to scream.
 

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The simple fact is that the odds of a successful VBAC are better outside the hospital than in. In hospital they are likely to augment, despite the dangers in doing so. (Does NO ONE read the literature???) Or they are likely to get impatient and section again. Hospitals have very fast clocks for this stuff. Your house does not.
 
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