Homebirths vs Hospital

[treehugger]

Amen. I was all "Natural birth! Squee!!!" and then I was all "fuck that shit. I want drugs. Now."

:lol: I am super crunchy/granola - and I was so pumped about having my daughter all natural. Hubs and I even took a 12 week Bradley course before she was due. I did have her in the hospital. But our doctor is also crazy crunchy (which is weird, even for Canada)... and so he was totally okay with me labouring for 49 hours before my daughter was born (with no drugs). I will never do that again! Drugs and epidural are high on the list for the next baby! My natural birth was way less empowering and more of a kill-me-now before the pain gets any worse situation.

[Irishy]

:lol: I am super crunchy/granola - and I was so pumped about having my daughter all natural. Hubs and I even took a 12 week Bradley course before she was due. I did have her in the hospital. But our doctor is also crazy crunchy (which is weird, even for Canada)... and so he was totally okay with me labouring for 49 hours before my daughter was born (with no drugs). I will never do that again! Drugs and epidural are high on the list for the next baby! My natural birth was way less empowering and more of a kill-me-now before the pain gets any worse situation.

Your next baby will be far quicker, don't worry ;)

[Lulu]

It took me until my 3rd birth to actually get how I labour and give birth. My first 2 were filled with pain and fear. For my 4th I knew what I wanted and what I needed and still it was going great until midwives, nurses and drs intervened telling me I needed to lay down not stand upright. If I am left to how I know I need to birth I am relatively pain free, its bloody hard work, but not screaming from the rafters in pain like in the movies.

Disclaimer-emergencies happen and I am not talking about those but all that routine monitoring, checking, inserting IVs etc. Oh and when they say "oh you can't do that, dr wouldn't like it"

[Kitty Luna]

Actually, schedule I drugs are things like heroin that no one prescribes. Technically, THC is a schedule I drug as well, which gets into some of the issues with medical marijuana.

Prescriptive authority for CNMs varies by state. In my state, I am allowed to prescribe anything that the physician that I work for can prescribe. I prescribe schedule II medications on a pretty regular basis - stuff like fentanyl, percocet, etc.

I made a mistake and meant schedule II drugs, lack of sleep will do that. :shrug:

[argypargy]

Yes, anaesthesiologists are doctors. There are also nurse anasthesiologists, but not at that hospital. Why do you think an OB would be giving epidurals?

I don't. That's why I said, "if you had an OB, he/she still would not have given you the epidural". I guess I don't understand why you originally wrote "I had a midwife, but the doctor put the needle in my spine".

[Savoring Samsara]

My pregnancy was supervised by CNMs and I gave birth in a "certified baby-friendly" hospital. For me, that was the best of both worlds. I got supportive, caring, patient-centered attention from my midwives who respected my desire to have a natural birth with few interventions. However, as my originally routine pregnancy slowly became something less routine (2 weeks postdates, polyhydramnios, an induction, 30+ hours of unmedicated labor, and finally a c-section to remove a baby who had decided to meet the world face first and was simply not coming out on his own), I had the full resources of the hospital right there when they were needed. Even as things dragged on into infinity, the midwives never rushed me. When they suggested interventions, they didn't pressure me at all, and made it clear that all of their suggestions were given with an eye toward balancing my wishes with what was safest for the baby. They even offered to let me labor for another hour before calling in the OB once the third check in a row showed no progress past 9.5 cm (yeah, I was in transition for 7 hours, which was as awesome as it sounds), and stayed on past the end of their shift to be in the OR with me. My baby's birth was nothing like I thought it would be, but because of the unceasing respect I received from my team of CNMs, I have no regrets. So I guess this post is just to say that it doesn't have to be (and usually never is) an "all or nothing" kind of philosophy here.

[August]

I don't. That's why I said, "if you had an OB, he/she still would not have given you the epidural". I guess I don't understand why you originally wrote "I had a midwife, but the doctor put the needle in my spine".

To point out that midwives and OBs both have scopes of practice, but it's the doctor with the honkin great needle who everyone loves.

[Coconut Flan]

Disclaimer-emergencies happen and I am not talking about those but all that routine monitoring, checking, inserting IVs etc. Oh and when they say "oh you can't do that, dr wouldn't like it"

It helps to be prepared with sayings such as he isn't pushing this baby out, I am or you know what he and I discussed this and he said if it makes me happy tell everyone else to shove off.

[sandberry]

As a midwife (in the UK), I would prefer to use best evidence to make decisions about place of birth. In the UK that definitely means for a low risk pregnancy it is safest for a second or subsequent baby to be born at home, for a first baby there is a slightly increased risk of an averse outcome for the baby in a home birth setting but other outcomes are improved so it would be a difficult decision for me personally.

Even in dire emergencies outcomes are not necessarily better in a hospital setting.I recently cared for a woman who had a cord prolapse at home, from cord prolapse to birth by caesarean was 18 minutes, baby spent two hours in NICU and then was back with mother breastfeeding. The cord prolapse was identified immediately because a midwife was with the woman. A few years back we had a cord prolapse, less than 100 metres from the operating theatre, the baby died because the cord prolapse wasn't identified as the midwife was out of the room when the waters broke. At least one to one midwifery care is pretty much a guarantee at home.

As for midwives qualifications and training. I am a direct entry midwife, not a nurse midwife and that is the way things are moving in the UK. Midwives are the lead practitioners in all normal births and since this is both safest and cheapest the NHS has obviously opted for this. Midwives consult medical staff when women's needs fall outside their sphere of practice. I am still surprised by how OB led US maternity care is, even when women are low risk and want a normal birth. Here you don't get a choice, you get a midwife, you see an OB if you need to because you are high risk. It is unlikely you'd even see an OB if you had one previous CS, VBAC is pushed hard and the counselling regarding birth choices is usually done by a senior midwife. Most obstetricians here barely see a normal birth in their career, they do sections, ventouse, forceps and may be present for multiple births and breech births but depending on the experience of the midwife they may just stand in the corner in case they are needed.

[Irishy]

Hi sandberry. Your above post is so spot on. It exactly describes the childbirth experience in Ireland too. I was nodding vigourously while reading.

Would you say that NHS midwives tend to steer women (gently, with lots of encouragement) toward a no-epidural birth? It's just an observation I have that most of my UK friends didn't have epidurals and they're not particularly crunchy. I would say that midwives in Ireland tend to do that too. For the sake of fewer interventions and a faster delivery.

[sandberry]

I think it depends on the midwife a bit but that's definitely the way most midwives trained in the last 10-15 years tend to go. It isn't that you withold epidurals (though some midwives do use the 'the anaesthetist is in theatre' ploy which personally I think is unethical) but that you offer choice, after all there are a lot of options to go through before you get to an epidural being the only thing left to try. Gas and air is wonderful, add in the birth pool, some aromatherapy and in a straightforward labour most women don't need an epidural. Though epidurals are great if the labour is more complex, there is definitely a reason they were invented.

[formergothardite]

:lol: I am super crunchy/granola - and I was so pumped about having my daughter all natural. Hubs and I even took a 12 week Bradley course before she was due. I did have her in the hospital. But our doctor is also crazy crunchy (which is weird, even for Canada)... and so he was totally okay with me labouring for 49 hours before my daughter was born (with no drugs). I will never do that again! Drugs and epidural are high on the list for the next baby! My natural birth was way less empowering and more of a kill-me-now before the pain gets any worse situation.

I was going to be all crunchy/granola. :lol: There wasn't a Bradley course close enough for us to take, but I read the books. I was so prepared. At least I thought I was. There was no push by the hospital or doctor to get an epidural, stay in bed or anything like that. The nurses kept encouraging me to walk, change positions, get into the birthing pool and it did nothing. Maybe I am just a major wimp, but it was torture. I was ready to sell my house, car, soul to make the pain stop. And I might have threatened to kill my husband when he was all "Remember the birth plan! Remember what the books said! You can do this!"