I've wanted to write up my summary of our change in birth options this time around. I did a copious amount of research (and praying) prior to making the home birth decision, and want to share what I learned about our own situation, but also how it relates to birth in general.
My first 3 kids were hospital births, the first 2 with epidurals/induction/episiotomy/continual fetal monitoring, etc. For #3 we had a doula with us in hopes (and success) of avoiding an epidural to also avoid an IV, as well as other interventions that may have causes boy #2's jaundice => allergies (as per a snippet of information I had read somewhere). So, after a successful 'real' birth, (thanks to the doula and Bradley method of childbirth) I had the confidence that we could have a home birth without pain meds (my biggest fear for all my births), since we had done so already.
The only drawback was that my dear husband wasn't on board. So, back to my hospital midwife I went. At the first checkup, we brought the kids so that they could hear the baby's heartbeat. The midwife (who I love) asked the kids if they wanted to see their new baby. Of course they answered 'yes' and so she brought in the portable ultrasound machine and proceeded to find baby and take a few pictures of him/her. Less than 5 min was spent with the machine, we finished the appointment and out the door we go. Well, later that week we get a bill in the mail for $280 for that ultrasound. Ouch. Didn't even think of that when we gave our okay to it. This gave G the motivation to explore other options. He had just started a new job and there was a guy there whose wife had had all their babies at home, and they were expecting baby #5 at present. He and G got to talking, and he got a 'guys perspective' about the whole situation and soon G came home with the midwife's number. I prayed about this constantly, and then talked to the midwife myself and made an appointment, was still feeling pretty unsure and anxious about exploring a new avenue.
After our first appointment though, the midwife (Laura) had calmed all my fears and answered all my questions. She is about as experienced as they come (delivered 3500+ babies) and has never lost one. She's done many midwifery mission trips in 3rd world countries, and explained the licensing standards in the state of WA (of which I was confused prior). She is a Christian lady, and we felt like our prayers had been answered. She doesn't do the 'fasting glucose', but instead just tells you to eat before your appointment and she does a finger stick glucose when you get there. She has a little ultrasound machine and is able to check for fetal position, sex of baby, amount of amniotic fluid, cord length and placental position. Her pricing includes everything except the lab fee (for group B strep) and a birth kit (which you order yourself online to have at home when baby comes). Her mantra is "healthy moms have healthy babies", and if for some reason a mom ends up being high risk, then she doesn't even consider taking them on. That is what an OB/gyn is for, and she'll refer them as necessary.
So, what is considered high risk? High blood pressure, diabetes, multiple births, breech/transverse position, placenta previa. Not: first time moms, laboring too long/lack of dilation. (the state of WA has guidelines on what midwives can deliver and can't). The more information beforehand, the less chance of surprises at delivery. Good thorough prenatal care is key. My next question was: Why do you send moms to the hospital then? Answer: preterm labor (before 37 weeks), the baby flips to breech between last checkup and delivery, and pain control due to exhaustion. Hmm, none of those sound emergent. (she has a 4% hospital transfer rate, and the majority fall into the preterm labor category and are at 36 1/2 weeks) The next fear I had was hemorrhage. Why do women bleed (sometimes to death, as we hear of horror stories)? The number one reason is that the Dr/midwife/caregivers don't wait for the placenta to detach itself and they pull on the cord causing bleeding. Or, bits of the placenta are retained and this causes bleeding (quite rare, but requires a D&C usually).
Fetal distress (a common cause of C-section these days) is almost always remedied by change in moms position at home, and by not inducing the mom in the first place. Mom's are rarely told the hazards of induction (I know I wasn't), but rather the 'safety of the baby' is so highly stressed that interventions are started before they're even necessary.
Another question I had, which I read the answer to in "Ina May's Guide to Childbirth" by Ina May Gaskin was: Why did women die in childbirth so often 100 years ago (as we hear so much about, which led to hospital births becoming the norm)? The answer to this is many fold, but the main reasons are 1) when the settlers came to America, the majority were young men and women. Skilled midwives stayed in the old country, so many deaths were caused by not having skilled help at deliveries. 2) many women had rickets due to vitamin D deficiency which caused them to have a deformed pelvis which could not properly birth babies. Neither of these reasons are present today that we should concern ourselves with.
More to come in part 2....
My first 3 kids were hospital births, the first 2 with epidurals/induction/episiotomy/continual fetal monitoring, etc. For #3 we had a doula with us in hopes (and success) of avoiding an epidural to also avoid an IV, as well as other interventions that may have causes boy #2's jaundice => allergies (as per a snippet of information I had read somewhere). So, after a successful 'real' birth, (thanks to the doula and Bradley method of childbirth) I had the confidence that we could have a home birth without pain meds (my biggest fear for all my births), since we had done so already.
The only drawback was that my dear husband wasn't on board. So, back to my hospital midwife I went. At the first checkup, we brought the kids so that they could hear the baby's heartbeat. The midwife (who I love) asked the kids if they wanted to see their new baby. Of course they answered 'yes' and so she brought in the portable ultrasound machine and proceeded to find baby and take a few pictures of him/her. Less than 5 min was spent with the machine, we finished the appointment and out the door we go. Well, later that week we get a bill in the mail for $280 for that ultrasound. Ouch. Didn't even think of that when we gave our okay to it. This gave G the motivation to explore other options. He had just started a new job and there was a guy there whose wife had had all their babies at home, and they were expecting baby #5 at present. He and G got to talking, and he got a 'guys perspective' about the whole situation and soon G came home with the midwife's number. I prayed about this constantly, and then talked to the midwife myself and made an appointment, was still feeling pretty unsure and anxious about exploring a new avenue.
After our first appointment though, the midwife (Laura) had calmed all my fears and answered all my questions. She is about as experienced as they come (delivered 3500+ babies) and has never lost one. She's done many midwifery mission trips in 3rd world countries, and explained the licensing standards in the state of WA (of which I was confused prior). She is a Christian lady, and we felt like our prayers had been answered. She doesn't do the 'fasting glucose', but instead just tells you to eat before your appointment and she does a finger stick glucose when you get there. She has a little ultrasound machine and is able to check for fetal position, sex of baby, amount of amniotic fluid, cord length and placental position. Her pricing includes everything except the lab fee (for group B strep) and a birth kit (which you order yourself online to have at home when baby comes). Her mantra is "healthy moms have healthy babies", and if for some reason a mom ends up being high risk, then she doesn't even consider taking them on. That is what an OB/gyn is for, and she'll refer them as necessary.
So, what is considered high risk? High blood pressure, diabetes, multiple births, breech/transverse position, placenta previa. Not: first time moms, laboring too long/lack of dilation. (the state of WA has guidelines on what midwives can deliver and can't). The more information beforehand, the less chance of surprises at delivery. Good thorough prenatal care is key. My next question was: Why do you send moms to the hospital then? Answer: preterm labor (before 37 weeks), the baby flips to breech between last checkup and delivery, and pain control due to exhaustion. Hmm, none of those sound emergent. (she has a 4% hospital transfer rate, and the majority fall into the preterm labor category and are at 36 1/2 weeks) The next fear I had was hemorrhage. Why do women bleed (sometimes to death, as we hear of horror stories)? The number one reason is that the Dr/midwife/caregivers don't wait for the placenta to detach itself and they pull on the cord causing bleeding. Or, bits of the placenta are retained and this causes bleeding (quite rare, but requires a D&C usually).
Fetal distress (a common cause of C-section these days) is almost always remedied by change in moms position at home, and by not inducing the mom in the first place. Mom's are rarely told the hazards of induction (I know I wasn't), but rather the 'safety of the baby' is so highly stressed that interventions are started before they're even necessary.
Another question I had, which I read the answer to in "Ina May's Guide to Childbirth" by Ina May Gaskin was: Why did women die in childbirth so often 100 years ago (as we hear so much about, which led to hospital births becoming the norm)? The answer to this is many fold, but the main reasons are 1) when the settlers came to America, the majority were young men and women. Skilled midwives stayed in the old country, so many deaths were caused by not having skilled help at deliveries. 2) many women had rickets due to vitamin D deficiency which caused them to have a deformed pelvis which could not properly birth babies. Neither of these reasons are present today that we should concern ourselves with.
More to come in part 2....
