Mothering Forum banner
1 - 14 of 14 Posts

· Premium Member
Joined
·
1,166 Posts
Discussion Starter · #1 ·
(Cross-posted in Homebirth)

So, here's my situation: I'm a first-time mom, 37, have always been (thankfully) pretty healthy and therefore have no experience with hospitals other than to visit sick people.

I had been planning to do this birth at a nearby hospital that is quite modern, has room-in births, and even sent me a nice brochure about the importance of skin-to-skin contact with newborns. They do have one labor relaxation tub, but it's luck of the draw whether I'd end up in that room (and they don't allow women to birth in the tub, only relax). I have been working with a CNM whom I really adore and both she and the doc in the practice are very pro-natural childbirth.

But I can't get over the feeling with them that 1) there is a procedure for everything and I must go along, and 2) that even if my midwife wants to do things my way, she will not have the authority to protect me from the onslaught of unnecessary interventions, tests, and extra people in a hospital setting. Also, I noticed that my very modern, pro-skin-to-skin hospital has a 32% c-section rate. The more I read about hospital protocols, the more creeped out I get.

Also, I should add at this point that I've wanted a water birth pretty much since I first heard of them as a teen. When I found out they don't let women birth in the labor tubs, I was really disappointed.

So, last week I interviewed a local homebirth midwife. Well, more accurately, THE local homebirth midwife. She's the only one within an hour drive or so. And she's fantastic. Great attitude, decades of experience, she trained the other midwife (the one an hour away), and delivered her babies. She really seemed like she had the experience that would allow me to relax and trust her, and she's very crunchy. And I've asked around, and people rave about her -- she's quite beloved in the crunchy community.

She's an LM (licensed midwife, not a CNM), so her training is just this -- she's not a nurse. She's even more anti-intervention than I am, for example, preferring a fetoscope to Doppler, gives no shots at birth (except maybe pitocin to the mom only if necessary), she keeps a list of local pediatricians who are mellow about delayed vaccination schedules. She only advocates for an ultrasound if the baby is past duedate, but I told her I plan to have the 20-week scan done, and she was very fine with that too. She said she offers a GTT, but immediately told me I can waive it (I will) and said how if someone has gestational diabetes there are other signs to look for first.

I asked if she would attend a waterbirth, and she said yes, but was quick to admit that with first-time moms she prefers to have them get out of the tub to push. She said this is because of sometimes needing her to manually help the head get past the cervix and also to help prevent tearing (meaning, she does things to help prevent and she can't do them when you're in the water). But she told me if it was really important to me to birth in the water, she'd work with me and see what we can do.

She told me she attends around 30 births per year, and has typically one hospital referral. Almost without exception, her referrals are first-time moms who experience "failure to progress," which she assured me was more exhaustion than a fixed number of hours. If there is need for a referral, she calls the two closest local hospitals to see who is on-call and then chooses where to go. There is no other midwife to back her up (though she has a couple students), and no doctor backup except the hospital on-call OB.

Also, insurance won't likely cover very much, but I figure what was the point of that career I delayed babies for if I can't just pay for the birth I want. So that is not really a factor in this decision.

So, I figure in the best case scenario, the LM is worlds better, as I give birth at home, and maybe in the water, and at least get to labor in the water. And I can relax and not worry about defending myself against interventions. But, in the worst-case, I'd get sent to some random OB at the hospital and all my choosiness would be for naught.

Oh, and while I know it's my decision, I'm very happy that my closest advisors are all very supportive. DH is 100% with me on this. A dear friend (who is not crunchy at all) thought it made perfect sense to birth at home. And BOTH my parents told me they thought it was a reasonable choice.

So, any advice? I'm not super familiar with the LM certification -- any thoughts? Homebirthers: does she sound good to you? Any other questions I need to ask either midwife?
 

· Registered
Joined
·
816 Posts
GO for it!!!!

It sounds to me like you've already made the decision to home birth, but just aren't feeling completley confident about it. That's totally undersandable.

I had a home birth with ds, and will have one with this babe as well. First time mothers can easily do this, and have done this....well, forever!
I personally didn't want anyone near my perineum while I was birthing, so I wouldn't want my midwife saying that she "had" to do certain things so I won't tear. I did it all myself and didn't tear one bit. I also wouldn't want anyone telling where or how I can birth at all. If I want to birth in the water, then my midwife is going to have to work with me on that. That's just me though. I call the shots


There are many studies out there stating that if you and your baby are healthy and there are no complications, the home is the safest place to give birth for many different reasons. I'll find some and post later.

This one if my favorite:
http://www.bmj.com/cgi/content/full/330/7505/1416

These are great as well:
http://www.bmj.com/cgi/content/full/330/7505/1416
http://www.childbirthconnection.org/...e.asp?ck=10575
 

· Registered
Joined
·
292 Posts
I think she sounds great but I agree with Oliver'sMom. I wouldn't let anybody tell me that I couldn't birth in the water. First baby? Really, you're not any more likely to tear or have a cervical lip with a first than a second or even an tenth baby. Your body works and it works without anybody doing anything to you physically to "help" it. So if you want to push your baby out in the water without anybody touching you, do it. If she's not comfortable with that, maybe she's not the right midwife.

However, if YOU are comfortable with those restrictions, then I'd say she sounds just about perfect!
 

· Premium Member
Joined
·
1,166 Posts
Discussion Starter · #4 ·
Thanks! And she made pretty clear that while in her experience, she prefers first-time moms to push outside the water, she also said it was up to me and she'd work with me either way.

Interesting that you all don't think that restriction is necessary. I think I'll prefer to be in the water, but of course I'm not at that point yet.
 

· Registered
Joined
·
512 Posts
Quote:

Originally Posted by violet_ View Post
Interesting that you all don't think that restriction is necessary. I think I'll prefer to be in the water, but of course I'm not at that point yet.
I have had very few doula clients need extra help (cervical lip, sticky shoulders, etc) be she a first time mom or otherwise. I have also never heard a MW suggest a mom not push in the water for that reason either. Just observation on it. I think if you feel strongly about it, which is seems like you do, then I'd be firm about it. Home birth MW are just as capable of over managing as any OB. But, all that said, I don't want to put a damper on what sounds like a fantastic situation for you. If this is the only detail that you are at odds on and she's willing to back off on it, then I just say go with your gut on the whole HB idea.

I am planning to HBAC with a HB OB. I had originally planned to do it in a hospital but after hearing my feelings and anxieties on hospital birth, he offered to attend me at home. I know I want to and it feels right but I'm still a little nervous at this point. I think that's pretty normal but then again I'd probably be more nervous if planning a hospital birth!

Good luck!
 

· Registered
Joined
·
2,288 Posts
I wrote and then it was lost, arg!

I think that your midwife was just being honest with you about what she's experienced. I have heard midwives essentially say "This is your birth, I'm cool with whatever you want" and then be sort of bossy about positions, etc, when mom is getting tired and it's time for baby to be born. I don't know her, so it's just another possible perspective.

Midwives are licensed by state so they all have different standards but it does ensure that she's passed a skill test and written test, and has documented that she's been to x number of prenatals, births, and postpartum visits.

I was born at home and so was my husband, as were our kids. So obviously I'm comfortable with it. But it doesn't really matter what we think! What do you think?!

I'm believing more and more that it doesn't matter where and with whom you have your baby so much, but that you nurture yourself during pregnancy and that you believe in yourself and trust your body...that spending so much energy on a "birth plan" and worrying about details is a waste of energy, energy better spent just caring for yourself and your baby.

Down from soap box now : )
 

· Registered
Joined
·
120 Posts
Congrats violet- I'd say go for it.

I'm searching, searching, searching for a CNM who does homebirth- my insurance covers a CNM regardless of where the birth takes place, but not CPM. And
it seems like the CPM's do homebirth and the CNM do birth centers. I can't quite justify paying about 4k when I'm all set up free w/ great mw in great birthcenter where first 2 were born. I'd just prefer to be at home even though I had no problems with/interventions at birthcenter. You know!
 

· Registered
Joined
·
965 Posts
I agree with all PP in saying "go for it!!" As the mom to 2 C-section babies, I am now supremely pro-homebirth, and I would honestly encourage ANY mom who thinks she can and wants to homebirth to stay as far away from a hospital as possible! In my personal experience, even CNMs are guilty of getting into the "what's easier for the provider" mentality and treating birth like a disease. So, I'll be HBA2Cing this babe.

Ultimately, though, it does have to be your choice, and it boils down to your confidence in your environment. You're probably as likely to have problems at home as in a hospital if you aren't secure and comfortable there.

Good luck with your decision!!
 

· Registered
Joined
·
816 Posts
Quote:

Originally Posted by homew/two View Post
. I can't quite justify paying about 4k when I'm all set up free w/ great mw in great birthcenter where first 2 were born. I'd just prefer to be at home even though I had no problems with/interventions at birthcenter. You know!
Doesn't it totally suck how money has to play such a huge roll in where we birth?! It really ticks me off. It shouldn't have to be like that. I'm curious though what the price ranges for a homebirth. Mine was and will be just under 2k for everything. That includes all prenatals and birth supplies. I had a friend who couldn't afford that price, so she gave our midwife a great dane puppy as trade
 

· Registered
Joined
·
512 Posts
Quote:

Originally Posted by Oliver'sMom View Post
Doesn't it totally suck how money has to play such a huge roll in where we birth?! It really ticks me off. It shouldn't have to be like that. I'm curious though what the price ranges for a homebirth. Mine was and will be just under 2k for everything. That includes all prenatals and birth supplies. I had a friend who couldn't afford that price, so she gave our midwife a great dane puppy as trade


I agree, it sucks that money has to play into it.


My HB fee is 5 million Korean won, which right now is about the equivalent of $4200 American. But mine is an OB an not a midwife because I am a VBAC and that's pretty rare here in Korea.

His fee structure is 5 million won for a HB with him

3 million won (about $2600) with MW Rosa (who he works closely with in HB's and as a team for breech vaginal in hospital). The MW would be the primary attendant and he'd be the back up, so it's more like a OB/MW team.

And for MW Rosa alone the fee is only 1.5 million won or about $1000 American which is super cheap.

None of these fees include prenatal care though so you can figure another $1000-2000 for that depending on how many u/s and what lab work you have done.

Luckily for me, Tricare (military insurance) is paying 100%.
 

· Registered
Joined
·
882 Posts
Yeah, I'd birth at home. I would also hire a Doula, they are a great addition to the homebirth atmosphere, and are there solely for you and your hubby and y'all's comfort. Plus, if the MW is at another birth, you can have the Doula come over to help support you through labor while you wait for the MW to get there. Also, if for any reason (God forbid) you have to go to the hospital, a Doula will act as that safe guard, in "protecting you" from all the medical intervention. They will help you to stand up and be your own advocate as they usually know the hospital systems and teach you words like "no, I do not consent to that", "we want time to think about this before we do (any procedure)", etc.

I don't see why you would have to push outside the tub. I have been told from many women in the NCB community that they have never seen a woman tear when she was supporting her own perineum. So maybe mention this to your MW as an option for you? Most tubs (birth tubs, not kiddy pools) you can get in almost any position in to push and still be submerged enough to feel the effects of the water. Maybe talk about getting on hands and knees with her so she can more easily access your cervix?

Just some thoughts. Happy Birthing!
 

· Registered
Joined
·
158 Posts
I had a homebirth with my first child, but am not going to do it this time.

I had some serious lacerations - and the stitching-->transport-->REstitching process gave me some serious trauma so now it's too scary


I was was born at home, as were my siblings and nieces. So it seemed like the right way to have a baby. But CNM were not allowed to attend HB in my state. And my lay midwife, in retrospect, did not seem to have the appropriate training to deal with the circumstances of my birthing.

I think it's interesting that your MW said she was leery of mom's pushing in the water. My dh is convinced my tearing could have been prevented if MW had her hands down there to ease the baby coming...he really shot out after being "stuck" (turned head) for some time. MW was very hands-off, and maybe that wasn't so good? I was in the bathtub. I hadn't planned a water birth, but that's where I was most comfortable in the end.

I'm really glad there's a free standing, CNM-run birth center where I am now. Otherwise I'd be in the hospital with a midwife, doula, husband and serious commitment to a natural birth.

Does your MW work with a Dr. in the area? I think part of my bad experience came from having my back-up/transport plan too vague. I needed to have a committed Dr. to go to, instead of thinking the emergency room would be my second choice. I did not feel like I protected myself and my child well enough.

From my birth experience (and I can only speak for myself, obviously!!!) I learned that the top priority is having a healthy baby. Keep your options flexible...what you think you'll want might not be what's needed in the moment (I was convinced that being naked in the water wouldn't be what I needed, thus no aqua-doula tub or other preperation for h20). I was convinced my body could handle anything. And mostly it did. The pushing/pain part was intense and transformative, and I loved having my baby with me right away. But the fear I experienced when I was laboring and realized that I was on the 2nd floor of my home, crowned but not progressing, then delivering a slow-start limp baby, then seriously tearing up my lady parts wasn't worth it. I felt negligent for my choices.

Luckily we got a Dr. friend referral to a gynecological surgeon in the early am hours who put me back together (after the MW's incomplete, ouch, attempts!!!!!).

My son started breathing after I handed him back to the midwife to clear passages, he is a smart, healthy kid and I do remember is birth with great love. But I would do it differently. That's just me.

Best of luck to you and many blessings to your child!!
 
1 - 14 of 14 Posts
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.
Top