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natural birth

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14 years 5 months ago #2760 by white_feather
Denta Mom - I'm just going to explain how your birth might have been handled had you chosen homebirth - not to convince you for next time, but to help you understand the mechanics of it:

I didn't seat at all until it was time to push and the baby came out quick....

I had a tear on the top rather than at the bottom...I lost a lot of blood.

In a homebirth, you'd probably have given birth upright or on all-fours (I'm not sure if you mean by seated, you were in lithotomy or birthing stool). Upright positions have been shown to prevent tearing. Also, episiotomies often cause some of the worst tears. However, tears still do occur sometimes. A life-threatening hemorrhage from a perineal tear is extreamly rare. If it was beyond what the midwife was capable of suturing, then you'd be transported to the hospital while midwife applied pressure to the area, and treated for shock. In some states, midwives are liscensed to give IV fluids if necessary.

My second had the cord arounbd his neck...so they took him away for 2 hrs.

A full 25% of babies are born with cords wrapped around their neck. That means, even at home 1/4 of all babies are born with cords wrapped around their neck, and homebirth is still shown as having at least as good safety outcomes as hospitals. Nuchal cord is really not a birth complication. The midwife simply slips the cord from around the baby's neck. In rare cases, it might be too tight to do that. The cord is clamped and cut then.

If the cord is too tight, and there are dangerous decelerations (keeping in mind that some types of decels are normal), the the midwife would've transported you to the hospital prior to the birth.

A baby with little oxygen is something to think about....

Midwives carry O2, as well as other emergency medications and supplies.

Sure, other countries support home birth, but I'd love to see how many women had to be rush to the hospital and how many babies had emergencies. US keep good track of numbers--maybe that's why they like to cover their backs so much.

European research is just as valid as American, and in some cases, countries in Europe actually surpass America in types of obstetric outcome reporting. True obstetric emergencies are rare. For the most part, they can be caught early by midwives, and the patient is transported before any issue arises. Transporting for any issue beyond failure to progress is unusual, but it happens. I think everyone is glad that hospitals are there when they're needed.

I think that technology has evolved so much, why can we instead change how we have our babies in a hospital? Like letting the mom walk, stand...and support her choice of no drugs?

I think this should be done. But a woman shouldn't be forced to birth in a hospital if she doesn't want to. Many women find the environment scary and disempowering. Hospital staff can be paternalistic and disrespectful. And frankly, giving birth at home is simply nice! Your own bed, your own germs. If a woman is fearful, labor is inhibited. The bottom line is that women should maintain the right to choose - not obstetricians, not politicians, not ACOG. Laws should safeguard a woman's choice, and allow midwives to provide safe care.

mbp said: I've thought a lot about going the midwife route instead of med school and I can't think that there can't be some nice balance.

I agree. I think womankind would really benefit from more obstetricians who understand midwifery philosophy, and can support midwives both as overseeing practitioner in states that require it, and to lobby for women's right to choose when lobbyists work against those rights. It's my personal theory that if obstetricians borrowed from some midwifery knowledge in their own practice, childbirth morbidity rates would improve.

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14 years 5 months ago #2761 by mommd2b
How do you think my births would have been handled as a homebirth? I'm just curious, but the decelerations I experienced were not at the beginning of labor. They began towards the end and within 10 minutes the doc was called. The midwife attending my delivery could not just slip the cord away from her neck. She was a vacuum assist delivery with an apgar of 3 and then 10 minutes later, a 7. There were no signs of trouble until that point and it was an emergency. Basically, at a home birth she would have died or suffered serious complications while we transported to the hospital.

Problem Delivery 2...textbook...until I hemmorhaged. Despite uterine massages, my uterus didn't contract. 30 minutes after delivery, I stood up and started passing grapefruit-sized clots. I had to have emergency surgery...as in..they put me on the bed, had someone get onto the bed with me...there was someone sitting on my bed while they wheeled me to the OR etc. When I left the hospital 3 days later, I had a hemoglobin of 7.

No risk there for a home birth?

Maybe 99 of the cases go flawlessly, but for that 1 that wouldn't, I'm glad that there is an ob there.

kris

In the midst of winter, I found there was, within me, an invincible summer.

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14 years 5 months ago #2762 by white_feather

How do you think my births would have been handled as a homebirth?

It's very difficult to conjecture - especially since I'd need to read your medical chart. You need to understand that midwifery and homebirth work on the assumption of cascades of intervention -- meaning for every routine obstetrical intervention, there are many possible complications and risks. Many traumatic births can be linked to interventions that probably wouldn't have occurred at home (ie. chemical inductions, lithotomy position at birth, cord tractions). Normal interventions used to get the placenta born ASAP have been linked to hemorrhage. From your post, there's no way I can conjecture what happened. Chances are, your baby would not have died at home. Midwives carry emergency equipment and rescuistation. They, too, have efficient techniques to get a baby out quick, if necessary. In an extreamly unusual pinch, an ambulance can be at the ready, or the hosptial can be called straight away with OB and OR at the ready.

Again, research bares out the safety of homebirth -- rather than arguing that fact, it makes more sense to try and figure out why it's so safe. What is happening different at home?

Maybe 99 of the cases go flawlessly, but for that 1 that wouldn't, I'm glad that there is an ob there.

Is this the second time you've used those stats? I'd like to see where you're getting them from, because those percents are nowhere near what I've seen in the literature.

1 in 100 babies don't die at home OR in the hospital. For low risk mothers, the chance of mom or infant dying at home or in the hospital is about equal - and very unusual.

Again, it makes more sense to ask 'why' research continuously displays the safety of homebirth. Something different is happening when labors procede as nature intended . . . something we can learn from.

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14 years 5 months ago #2763 by mommd2b
For both deliveries, I had midwives who attended to the entire L&D until the very end. I made a choice each time to be seen by a midwife because I believe in that philosophy. I labored and pushed on my side, on all fours and was able to bring my own labor ball, etc.

For my last delivery, I was unable to see a midwife because they felt my history was significant enough with the hemmorhage to make me too great of a risk. The OB I saw ended up doing a c-section because of her concern of hemmorhage risk. During the section, she noted (and showed my husband :rolleyes: ) that I had a portion of the wall of my uterus that was "thinner and full of vasulature". She felt that if I had tried again for a vag delivery that I may have experienced the hemmorhaging again.

During my L&D, I didn't have my membrane's ruptured or any fetal monitoring beyond the every hour hop back in bed type of monitoring.

In the midst of winter, I found there was, within me, an invincible summer.

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14 years 5 months ago #2764 by Karen W
I think it certainly is possible to have a natural birth, but for me personally I'd want to have it at a hospital where if things go south there's backup available. Of course being a pediatrician I just think of all the bad deliveries I was called to in residency, all the times problems weren't anticipated. I think anyone who is interested in a drug-free birth, they should find an OB or midwife who supports that. I'm not closed-minded, and if people want to have home births they should do it. I just can't as a medical professional recommend that people give birth at home. Help is so far away - what if your baby needs oxygen, what if you're bleeding excessively? I have seen many natural deliveries in hospitals where babies were placed right on the breast and abdomen of the mother and it is beautiful and we don't intervene. Just find supportive caregivers.

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14 years 5 months ago #2765 by Dental-Mom
Karen W, excellent point of view. I agree.

Dental mom.

Dental Mom<br />Determination: You don't know what you can do until you try.<br />Applying this summer<br />Dental school 2010!

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