Someone is going to get hurt - Lay Midwives

[Witsec7]

I said "last century". I know of lay midwives in many very populated and affluent counties in Arkansas, so I'm assuming there has been an update in the statutes.

The update to the statue is the current educational and training standards that have been previously noted in this thread.

[ErinIsSik]

The OBGYN I went to with my son only sees extremely high risk pregnancies. He has 4 or 5 CNMs that work under him who do all other exams and the actual birthing. These ladies birth at the hospital and they have a rotation that provides them to meet each mother before her actual labor so whenever it is you go to the hospital you will "know" the person who delivers your baby. We just found out I'm pregnant with baby no 2, but I'm not on state health care anymore so I will probably not go to this same center. Just my experience.

[VVV]

Several unassisted homebirthing friends have tried to convince me that my hemorrhaging, shoulder dystocia, tearing etc would not even have happened if I had a homebirth. All complications are caused by hospitals and no one ever had a bad outcome before modern medicine dontcha know.

My mother would not have grown up an only child if four years prior to her birth, her mother had not spent three days in labor only to deliver a perfectly formed stillborn baby boy at home. Ironically, the local hospital was just across the street. My grandmother wasn't choosing to deliver at home for crunchy reasons, however--it was 1922, and that's just how people in my grandparents' world did things. She almost died with that baby and she was very sick following my mother's birth. A timely C-section or two would have completely changed my family tree. And I say that as someone who was as crunchy as possible (in a hospital, though) about the natural deliveries of my own children.

[Coconut Flan]

my hemorrhaging, shoulder dystocia, tearing etc would not even have happened if I had a homebirth

Did we try to share a birth experience? I had sunnyside up baby who had to be turned, a fourth degree tear, shoulder dystocia, and hemorrhaged so badly after the birth they gave me a 25% chance of surviving. Yeah, right like birthing at home or a birthing center would have been appropriate.

I have relatives in AR and find some of the medical care there is difficult to obtain. There are some services only available in Little Rock such as very specialized eye surgery. There are also places that are a minium of 90 minutes by car from even a community hospital. It isn't the only state with that kind of issue though.

[roddma]

1) I think it's safe to say that a woman wanting a C-section can be considered to have volunteered for it.

2) The baby that is born by C-section isn't removed and then thrown away either.

You're changing your story a lot. First it's never okay to have an elective surgery if there's no medical indication for it. Then it's sometimes okay to have an elective surgery if there's no medical indication for it, but only if you have a good enough reason (reasons for having an elective C-section are never good enough) Then it's completely okay to have elective surgeries, but only if you can pay cash for them upfront (I do wonder about your opinion on elective reconstructive surgeries and why those wouldn't be similar to elective C-sections)

Have a nice night. Maybe sleep on the issue and try to get your opinion pinned down.

Maybe the same could be applied to having tubes tied without a medical need or wanting a hysterectomy. Any way, it is comparing apples and oranges comparing c-sections to plastic surgery . Anyway, I would not undergo any procedure without learning the risks.

[emmiedahl]

Did we try to share a birth experience? I had sunnyside up baby who had to be turned, a fourth degree tear, shoulder dystocia, and hemorrhaged so badly after the birth they gave me a 25% chance of surviving. Yeah, right like birthing at home or a birthing center would have been appropriate.

I have relatives in AR and find some of the medical care there is difficult to obtain. There are some services only available in Little Rock such as very specialized eye surgery. There are also places that are a minium of 90 minutes by car from even a community hospital. It isn't the only state with that kind of issue though.

I got to do that whole experience twice! Aren't I lucky? :D I had a few easier deliveries. Only one was actually "easy" and uncomplicated, and even then it was 6 hours of induced labor. But that is what I consider easy with my limited experience. All of my babies were sunny side up, something about my anatomy seems to turn them that way.

I completely understand why a woman might want an elective c-section, even if not medically indicated, after a very traumatic birth experience that involved potential loss of life and the need for surgical repair.

[Cran]

Personally, if I was to have a child, hopefully this will never happen, but you never know, I would try very hard to have an intervention-low homebirth, because I detest hospitals. I can't be relaxed in them, so FOR ME birthing there would be likely to contribute to complications. But that is ME.

As I said before, birth can be very traumatic for the mother. If a mother thinks a vaginal birth experience would be too traumatic for her, for what reason ever (I imagine some survivors of rape would actually prefer a caesarean to all the circumstances that come with vaginal birth, people checking you etc., or another women being extremely afraid of pain), they have the right to do so. It is their body. It is not like they are exchanging a walk in the park, absolutely risk free, for camping next to a bear's cave. Birth has always risks, and each woman has to make her own decision, weigh the pros and cons for herself. And it is absolutely possible for many women to have valid (not directly medical) reasons to prefer the risk of the operation, which is slightly higher, note slightly, not greatly, to natural birth.

This can't be denied to women. Doctors are no Gods and can't decide for the patient if the are supposed to go the high risk or low risk route. They can give advice, but they cannot decide. Sure, if they think it very irresponsible, they can refuse care, but for a procedure like a c-section, which is widely done and accepted, they should know and will know that a colleague of them will perform it without any qualms, and in my opinion rightly so. A friend of mine had breast cancer and wanted to try an... alternative treatment (which didn't work, btw) and her doctor couldn't force her to have the treatment he thought best either.

[Deleted03]

No one is stating this. There are positives and negatives to both vaginal births and C-sections. Personally, I think that for low risk pregnancies the pros of vaginal births far outweigh those of C-sections. However, I trust that women who choose to have a C-section have their reasons and it's not my place to judge whether or not those reasons are "good enough" to actually get a C-section (now I'm having flashbacks to people wanting to decide whether a woman's reasons to have an abortion are good enough)

What I don't get is how you think C-section are a women's choice (ok with that) without seeing that it increases risks to the baby, but then many of you bitch on women who homebirth because they take unnecessary risks for the baby. I think they're the same situation. Yes doctors are there, but elective C-sections also increase risks for the baby.

Every mother takes the chance she wants to, whether it is homebirthing or elective C-sec. and the chance is not just on her body, it also impacts her baby to be.

[slickcat79]

What I don't get is how you think C-section are a women's choice (ok with that) without seeing that it increases risks to the baby, but then many of you bitch on women who homebirth because they take unnecessary risks for the baby. I think they're the same situation. Yes doctors are there, but elective C-sections also increase risks for the baby.

You can't possibly know in advance if the c-section would increase the risk for the baby more than vaginal birth. In fact, most planned c-sections and nearly all emergency c-sections are done because they present a LOWER risk for the baby. C-sections can mean a greater risk of respiratory problems, but the same or worse can also happen in a vaginal birth, and many people don't know that there will be problems with their births until they happen.

[Kitchen Princess]

Did we try to share a birth experience? I had sunnyside up baby who had to be turned, a fourth degree tear, shoulder dystocia, and hemorrhaged so badly after the birth they gave me a 25% chance of surviving. Yeah, right like birthing at home or a birthing center would have been appropriate.

I have relatives in AR and find some of the medical care there is difficult to obtain. There are some services only available in Little Rock such as very specialized eye surgery. There are also places that are a minium of 90 minutes by car from even a community hospital. It isn't the only state with that kind of issue though.

No one has every type of specialized surgery within a half an hour, you know. You can't even get everything in New York City. So what's your point?

[formergothardite]

I hate the birth wars. Women are intelligent enough to look at the risks and decide for themselves. Birth is natural, but so is death and having a baby born with brain damage. If I ever had another pregnancy(not going to happen, but by some bizarre event it did) I would have as many interventions and then have a c-section as soon as I could. This doesn't mean that women who make other choices are wrong or that I am wrong, it just means that I am capable of making decisions about my body for myself.

[Deleted03]

You can't possibly know in advance if the c-section would increase the risk for the baby more than vaginal birth. In fact, most planned c-sections and nearly all emergency c-sections are done because they present a LOWER risk for the baby. C-sections can mean a greater risk of respiratory problems, but the same or worse can also happen in a vaginal birth, and many people don't know that there will be problems with their births until they happen.

we're talking about elective C-sections because the woman wants a C-sec. I am certainly NOT talking about emergency C-sec versus homebirth.

[MonkeyMomma]

No one has every type of specialized surgery within a half an hour, you know. You can't even get everything in New York City. So what's your point?

I think the point is hospital vs. homebirth and "decision to incision" time. If an obstetric emergency arises and you have minimal time to avert death or serious injury, if you are 90 minutes out, you and/or your baby are screwed. Even if you live close to a hospital, the distance can often be too far (have you ever tried to move a woman in active labor or pushing?? Good luck going anywhere, let alone fast!). There is no system in the US for smooth transfer from home to hospital, causing further delay upon arrival at the hospital if they won't accept the midwife's records, or if the records are incomplete, or if the midwife won't release the records. Shit goes south fast, and you're still getting your blood typed.

One of my dearest friends gave birth in the same hospital I did. We were both into homebirth, and would have had them except for the fact that our insurance covered CNMs at a local hospital. She had a placental abruption during labor, and the baby was out in under 7 minutes, no ill effects. Neither she nor I will have a homebirth after that. She lives 20 minutes out from the hospital. Can you imagine? This isn't a dig at any particular state, or people who choose out of hospital birth, but there are definitely places so far from the hospital that homebirth becomes untenable.

[slickcat79]

we're talking about elective C-sections because the woman wants a C-sec. I am certainly NOT talking about emergency C-sec versus homebirth.

Yes, but you can't assume that if she had chosen vaginal birth instead of a c-section that everything would have gone off without a hitch. You can't know what issues the baby would or wouldn't have had with the other method if the mother didn't go that route. There are lots of risks to a baby with vaginal birth also.

[Deleted03]

Yes, but you can't assume that if she had chosen vaginal birth instead of a c-section that everything would have gone off without a hitch. You can't know what issues the baby would or wouldn't have had with the other method if the mother didn't go that route. There are lots of risks to a baby with vaginal birth also.

I don't get why are arguing about risks. I am pointing out that both equally carry risks, and saying that only one makes the woman "irresponsible" is not true. You don't know either if the homebirth could have been easy peasy. It goes both ways.

[Nothing2CHere]

I had an elective c-section.

Now here's the rest of the story. I had gestational diabetes during my pregnancy, and at an ultrasound around 32 weeks I was told that they estimated my baby to weigh around 5 1/2 pounds, but that his belly area was two weeks bigger than it should have been, and whether I delivered vaginally or via a c-section, they did not want me to carry my baby the full 40 weeks because there could be an increased risk of him being stillborn due to the GD. I was also 36 years old when I became pregnant, so I was already considered higher-risk before the GD even developed.

Around 35 weeks, they estimated his size to be around 7 pounds. I was given the option to see about delivering vaginally around 37/38 weeks, but I would have had to have an amniocentesis done to ensure that baby's lungs were developed enough. I didn't want the amniocentesis, I was worried that the risks were too high. At 38 weeks, I had another ultrasound and they estimated his weight to be between 9 and 9 1/2 pounds. At my hospital (which I was fortunate had the best reputation in our area for births), they pushed for vaginal deliveries. The high-risk specialist I was seeing told me that the hospital's policy was to strive for vaginal births when i had asked him about the possibility for a c-section given my circumstances. Despite my son's estimated high weight, he wasn't weighing over the threshold for when a c-section would be considered medically necessary for a gestational diabetes pregnancy - he was up there, but he wasn't over it. (Unfortunately I can't remember what that threshold number was, it was in grams, something over 4,000.)

I, however, did not like the idea of being induced. I was very worried about complications that could happen to my baby during a vaginal birth due to his estimated size. I didn't want to be in a position where they'd want to do an episiotomy on me. I was afraid that my son's shoulders or belly would get stuck in the birth canal because of his size. I didn't want anyone to have to use forceps or a vacuum to get him out, fearful of what harm that could cause him. I had this fear of his umbilical cord getting stuck around his neck (it had happened during a friend's birth, and her son did have some medical issues because of it). I also had this nagging feeling that if I tried for a vaginal birth, I was going to end up needing an emergency c-section anyway. I didn't want to go through hours and hours of labor only to need surgery after all; I was also fearful of the harm hours and hours of the stress of labor would possibly cause my son. Although the doctors' recommendation would be for me to be induced, I ultimately decided that I wanted to schedule a c-section, that it would be the safest option for my son.

I had the c-section at 39.1 weeks. Again, I was fortunate to be at an excellent hospital and my c-section experience was wonderful (well, as wonderful as major abdominal surgery can be). The anesthesiologist and nurses explained to me all the drugs I'd be given and their possible side-effects. I was scared shitless when they brought me into the operating room (I had never had any surgery before, other than my wisdom teeth being removed), but my spinal worked so well I didn't even feel any pressure as they were cutting and pulling. I had no idea my baby was out until I heard him crying.

And my baby ended up being 10 pounds 6 ounces, above the threshold for a medically-necessary c-section for a woman with gestational diabetes. As they announced the weight, my OB (my regular OB performed the c-section, not the specialist) said that I had made the right call.

But my c-section is still considered elective. Could I have delivered my 10+ pound baby vaginally? Probably. My grandmother gave birth vaginally to a 12 pound baby when she was 42 years old. Granted, it was also her sixth baby; this was my first. But my uncle also had an emergency baptism almost as soon as he was born because he had some medical issues from the birth and they weren't sure he was going to make it. The only issue my son had was with his tongue; it needed to be clipped. I also probably would have had a worse recovery from a vaginal delivery with my son. I have had a remarkable recovery from my c-section (I gave birth on May 30th). I know it's not the case for everyone, but for me, my pain meds were excellent and I was up and walking around within two days.

tl;dr - My c-section was technically an elective c-section, and if I had to do it all over I wouldn't change a thing

[Olivia]

So does anyone really argue that an unmedicated, vaginal birth isn't the best option for the health of the mother if possible? Of course what matters most is the final outcome, but avoiding an epidural and its possible complications was important to me (and I found labor was not nearly as painful as all the BS you hear would lead you to believe) It's the same as breastfeeding -- what's most important is feeding your child, of course, but breastfeeding is still the best option if possible.

[Guest Anonymous]

So does anyone really argue that an unmedicated, vaginal birth isn't the best option for the health of the mother if possible? Of course what matters most is the final outcome, but avoiding an epidural and its possible complications was important to me (and I found labor was not nearly as painful as all the BS you hear would lead you to believe) It's the same as breastfeeding -- what's most important is feeding your child, of course, but breastfeeding is still the best option if possible.

It's the "if possible" that is the problem here. Essentially, what it means is that unmedicated, vaginal birth is great... except for all of the myriad ways that it can and does go wrong.

[ladidah]

So does anyone really argue that an unmedicated, vaginal birth isn't the best option for the health of the mother if possible? Of course what matters most is the final outcome, but avoiding an epidural and its possible complications was important to me (and I found labor was not nearly as painful as all the BS you hear would lead you to believe) It's the same as breastfeeding -- what's most important is feeding your child, of course, but breastfeeding is still the best option if possible.

Um, the pain of childbirth varies greatly from birth to birth. I had a pretty easy childbirth and would say that "labor isn't that bad" if I only knew of my own experience, but I actually know of many, many women who've had extremely painful experiences that little resembled my own. And I also know that my transition and pushing times were much shorter than the median times for first-time birth. Which is why I don't go around telling other women that labor, in general, is "not nearly as painful as all the BS you hear would lead you to believe."

[AmyP]

Um, the pain of childbirth varies greatly from birth to birth. I had a pretty easy childbirth and would say that "labor isn't that bad" if I only knew of my own experience, but I actually know of many, many women who've had extremely painful experiences that little resembled my own. And I also know that my transition and pushing times were much shorter than the median times for first-time birth. Which is why I don't go around telling other women that labor, in general, is "not nearly as painful as all the BS you hear would lead you to believe."

I know two women who were permanently injured by their unmedicated vaginal births. One woman has had multiple surgeries to correct the damage done to her insides, she experiences constant pain, episodes of bleeding, and is incontinant. So no, it is not necessarily the best option for the health of the mother. A c-section would have been a much better option for this young woman.

[formergothardite]

I was all set for a drug free birth with my first and then labor started and I was like "Hell no! This fucking hurts way more than I expected, pass me the drugs!" And I may have cussed at my husband when he gently reminded me all the stuff I had said about having a drug free birth. :lol:

[meda]

So does anyone really argue that an unmedicated, vaginal birth isn't the best option for the health of the mother if possible? Of course what matters most is the final outcome, but avoiding an epidural and its possible complications was important to me (and I found labor was not nearly as painful as all the BS you hear would lead you to believe) It's the same as breastfeeding -- what's most important is feeding your child, of course, but breastfeeding is still the best option if possible.

If you had actually read the thread, including the post above yours, you would see that for a number of women an unmedicated vaginal birth was not the best option for the health of the mother. Also, how stunningly small minded and arrogant of you to assume that all women will experience as easy a labor as you did.

it's telling to me that the bulk of the sweeping generalizations about childbirth and conspiracy theory accusations are coming from the "trust birth" folks.

[Deleted03]

So does anyone really argue that an unmedicated, vaginal birth isn't the best option for the health of the mother if possible? Of course what matters most is the final outcome, but avoiding an epidural and its possible complications was important to me (and I found labor was not nearly as painful as all the BS you hear would lead you to believe) It's the same as breastfeeding -- what's most important is feeding your child, of course, but breastfeeding is still the best option if possible.

the whole discussion has been around the idea that it's possible is not the only factor coming into the decision. What the mother wants is also another factor because both options carry risks, and only the woman in question can have a say about what is done with her body.

Just as it is not mandatory to breastfeed just because you gave birth, it is not mandatory to have a vaginal or hospital delivery because you got pregnant.

At least that's what I take from the discussion.

[emmiedahl]

It is best not to have pain relief in *any* medical procedure. Pain meds can cause complications. Why is childbirth the only time medically when you are morally inferior if you choose not to be in pain?

I had an epidural with my fifth child and nothing with the others (except for a shot in the private parts with #4 when the doctor saw I was about to tear badly). I don't think the unmedicated births were holier and they certainly were not easier. Pain relief is standard in most medical procedures; so, no, I do not see an unmedicated birth as the ideal any more than I see getting stitches in my face without medication as the ideal.

[StarrieEyedKat]

So does anyone really argue that an unmedicated, vaginal birth isn't the best option for the health of the mother if possible? Of course what matters most is the final outcome, but avoiding an epidural and its possible complications was important to me (and I found labor was not nearly as painful as all the BS you hear would lead you to believe) It's the same as breastfeeding -- what's most important is feeding your child, of course, but breastfeeding is still the best option if possible.

It's people like you saying shit like this that causes so many women to feel shamed about "not doing it right" or being unable to go all natural. "If possible?" Just because avoiding an epidural was important to you and your labor wasn't nearly as painful as "all the BS you hear" led you to believe, doesn't mean that every other woman experiences the same thing. Does that mean they're not as strong as you are, or are their experiences just BS?

Jesus Christ, Mommy Wars piss me off.