Dillards 32: To VBAC or not to VBAC

[Buzzard]

1 minute ago, Eternalbluepearl said:

I guess my big question reading all of this is why are fake midwives necessary? Couldn't Jill go to a real midwife (or doctor) for prenatal care and then have them deliver the baby? What am I missing? Why would there even be a market for midwife fakery?

The only thing I can think of is that fake midwives may be more willing to allow a woman to do something that a real one knows is unsafe, against the medical standard course of care, or is just plain stupid.

[justoneoftwo]

2 minutes ago, Eternalbluepearl said:

I guess my big question reading all of this is why are fake midwives necessary? Couldn't Jill go to a real midwife (or doctor) for prenatal care and then have them deliver the baby? What am I missing? Why would there even be a market for midwife fakery?

Midwives in Arkansas are not allowed to attend VBACs.  I would also guess that many doctors would be uncomfortable treating someone who is so rarely in the state to get check ups, but would deliver the child in an emergency situation.  Also it does not seem Jill is likely to want a real doctor with real prenatal care.

[PainfullyAware]

It seems almost asking for trouble not to allow midwives to attend home births. Since people are going to do it regardless, isn't it better to allow a midwife to attend? My caveat is that midwives need proper training, which I understand Jill's certification was not. 

(I may be misunderstanding this discussion - are there degreed midwives in Arkansas who are allowed to attend home births but lay midwives are not? Or just no midwives are allowed to deliver a home birth?) I find this all very confusing because where I live midwifery is a 4 year degree and can be used for home or hospital births. How do birthing centers fit into this whole jigsaw puzzle? We don't have birthing centers where I live so this is something I learned about watching the Duggars. 

[justoneoftwo]

3 minutes ago, PainfullyAware said:

It seems almost asking for trouble not to allow midwives to attend home births. Since people are going to do it regardless, isn't it better to allow a midwife to attend? My caveat is that midwives need proper training, which I understand Jill's certification was not. 

(I may be misunderstanding this discussion - are there degreed midwives in Arkansas who are allowed to attend home births but lay midwives are not? Or just no midwives are allowed to deliver a home birth?) I find this all very confusing because where I live midwifery is a 4 year degree and can be used for home or hospital births. How do birthing centers fit into this whole jigsaw puzzle? We don't have birthing centers where I live so this is something I learned about watching the Duggars. 

Personally I think there is a value in not allowing professionals to do things that would be dangerous.  Yes, some people will do dangerous things without professionals, but you can never stop those people.  The law protects people who may not know that something is dangerous, and who will believe that it must not be dangerous because the midwife is there.  They trust the professional and so the professional (who in this case is knowingly doing something dangerous and therefore should not be trusted) makes it seem something is safer than it is.  Further, it allows for punishment when someone does something that puts another life at risk.  Seeing for medical malpractice is almost impossible, but prosecuting for breaking a clear law is simple.  

 

edited to add:  Its not home births that are not allowed to be attended, but particular situations.  A VBAC is more dangerous, and should be done in a hospital where there is help a few steps away.

[socalrules]

I still think it's possible she has the baby in a hospital but they say it was a home birth. Although, I wonder if she is even getting prenatal care from a real doctor and not an unlicensed midwife. I can understand people having home births. What I don't understand is Those who do not get professional prenatal care to ensure they and the baby are in a position where a home birth is not a high risk. I could see them having an unlicensed midwife, whose primarily education is watching someone give birth, tell them their pregnancy is progressing splendidly and then the bottom dropping out at a home birth because of issues a medical professional would have caught months earlier. 

[justoneoftwo]

2 minutes ago, socalrules said:

I still think it's possible she has the baby in a hospital but they say it was a home birth. Although, I wonder if she is even getting prenatal care from a real doctor and not an unlicensed midwife. I can understand people having home births. What I don't understand is Those who do not get professional prenatal care to ensure they and the baby in the condition where a home birth is not a high risk. I could see them having an unlicensed midwife, whose primarily education is watching someone give birth, tell them their pregnancy is progressing splendidly and then the bottom dropping out at a home birth because of issues a medical professional would have caught months earlier. 

They could only do this if they don't show it, and I think they will want the $ more than the reputation.  

I never understand why people don't want to know everything they can to make sure their baby is healthy.  I just don't get it at all.

[speller24]

Probably already discussed, and I missed it, but why all the homebirths? Is this a fundie thing? Is it for money reasons? Insurance? Because Jesus can take better care of me? Anybody know? 

[Million Children For Jesus]

12 hours ago, Shadoewolf said:

And please don't flog me, Izzy is cute and all, but there is just something off about him, can't put my finger on it. 

He's really tall without baby pudge, so your mind knows that he's 2, but he looks like a small, non-verbal kindergartner, and so what you see and what you know don't reconcile.

I have a soft spot for Izzy since I think he gets relegated to the side while Spurgeon Special Pants gets attention for being cute. Izzy was really mellow in several scenes that went unmentioned, including being content in the high chair while Grandma Cathy fed him. 

[FakePigtails]

35 minutes ago, PainfullyAware said:

It seems almost asking for trouble not to allow midwives to attend home births. Since people are going to do it regardless, isn't it better to allow a midwife to attend? My caveat is that midwives need proper training, which I understand Jill's certification was not. 

(I may be misunderstanding this discussion - are there degreed midwives in Arkansas who are allowed to attend home births but lay midwives are not? Or just no midwives are allowed to deliver a home birth?) I find this all very confusing because where I live midwifery is a 4 year degree and can be used for home or hospital births. How do birthing centers fit into this whole jigsaw puzzle? We don't have birthing centers where I live so this is something I learned about watching the Duggars. 

The main problem is that midwifery in the US is a mess. We have nurse-midwives (CNMs), who are equivalent to those in other countries. They have to have to get a bachelor's degree in nursing and then a masters in midwifery (a small number are CMs, who have the same masters but their bachelor's isn't in nursing). Then we have CPMs (certified professional midwives), who only need a high school education and not much else (this is a great comparison of CNMs, CMs, and CPMs), and then there are plain lay midwives and direct-entry midwives (LMs and DEMs) who have basically no requirements. Also, which types can work in which environments varies by state, and different states may or may not allow CPMs and LMs/DEMs at all.

So most home births in the US are attended by CPMs, and honestly I doubt enough CNMs would do home births even if they could to meet demand (most work in hospitals - they're who I chose for my birth and they were excellent, and OBs were literally steps away during my prenatal care and birth and were consulted and brought in to help as needed). There are also a few CNMs who do stupid shit at home births, to be clear, and they get away with it too because overall legislation and consequences around bad decisions by home birth midwives of any type are pathetic if they even exist at all. Many (most?) don't even have liability insurance.

We also have lots of people (I would say the majority, unless they've already been exposed to a bad home birth situation IRL or read about them through a site like FJ and researched) who have no idea that a midwife is NOT a midwife is NOT a midwife here, so it's easy for them to overlook these issues and end up in bad situations because they assume that someone going by the term midwife and registered with the state and everything is as competent a medical professional as their OBs and midwives in other countries that require high levels of training, regulation, and integration into the local medical systems.

As for birth centers, depending on the state they may be staffed by CNMs or CPMs. Often they're no safer than birthing at home because they have no more medical equipment than a midwife (either type) would bring to a home birth, and, of course, especially if they're staffed by CPMs, crazy scary stuff can happen just like in home births. Not every state even regulates them. Some may be closer to hospitals for some patients but transfers can still take a long time because moving in labor is just plain slow. Thankfully, more hospitals are adding attached birth centers where any and all medical equipment is available immediately if needed, and having an actual hospital overseeing the operations keeps everything in line much better.

I hope that jumbled mess helped some!

[Million Children For Jesus]

11 minutes ago, speller24 said:

Probably already discussed, and I missed it, but why all the homebirths? Is this a fundie thing? Is it for money reasons? Insurance? Because Jesus can take better care of me? Anybody know? 

I'm sure some people choose it for financial and insurance reasons, especially if you're popping out eleventy kids on one income. Insurance usually doesn't cover everything. Fundies might be putting their faith in God? Others just like the comfort of being at home and having control over their environment. Celebrities choose it for privacy, like Gisele Bundchen and Pamela Anderson. I think it has become part of the Fundie culture, and some women don't even question it. It appears fundies love becoming midwifes and pilots. 

[speller24]

12 minutes ago, Million Children For Jesus said:

I'm sure some people choose it for financial and insurance reasons, especially if you're popping out eleventy kids on one income. Insurance usually doesn't cover everything. Fundies might be putting their faith in God? Others just like the comfort of being at home and having control over their environment. Celebrities choose it for privacy, like Gisele Bundchen and Pamela Anderson. I think it has become part of the Fundie culture, and some women don't even question it. It appears fundies love becoming midwifes and pilots. 

That last sentence is gold. I literally spewed some of my water out because it made me laugh so hard lol. But I like you insight here. It's good! I can see the Duggars wanting privacy too, they are famous, and because of where they live I'm sure somebody would blab to the paps. But would they come to get a picture of the new blessing? hmmmm more questions. 

[justoneoftwo]

7 minutes ago, Million Children For Jesus said:

I'm sure some people choose it for financial and insurance reasons, especially if you're popping out eleventy kids on one income. Insurance usually doesn't cover everything. Fundies might be putting their faith in God? Others just like the comfort of being at home and having control over their environment. Celebrities choose it for privacy, like Gisele Bundchen and Pamela Anderson. I think it has become part of the Fundie culture, and some women don't even question it. It appears fundies love becoming midwifes and pilots. 

Many people don't trust doctors to put the mother's needs first.  Many people don't trust doctors to not do more interventions than they think are necessary, many people don't trust doctors to allow mothers to move around and give birth how they feel is best.  In general there is a large distrust of the medical field, particularly for things that are not considered "illness."  All of this means some people think that they should be able to give birth "naturally" without doctors interfering.  Its both a funny thing and a "crunchy."  

[lumpentheologie]

Is it just my impatience or does this seem to hint that Izzy is with his grandparents because Jill is in labor?

They could totally just be trolling us, though. 

[freshlemonade]

2 hours ago, Million Children For Jesus said:

Side Note: Maybe with Venessa Giron in Tulsa, Jill and Derick will move there. At least they know someone. 

It's not far from TTH, but just far enough for them to gain independence and mental clarity. If the Josh scandals are part of Derick's downward spiral, being immersed in the TTH culture is not going to help the situation. 

Plus Izzy and Sam could get in-state tuition if they become third gen Petes!

[ladybug15]

40 minutes ago, justoneoftwo said:

Many people don't trust doctors to put the mother's needs first.  Many people don't trust doctors to not do more interventions than they think are necessary, many people don't trust doctors to allow mothers to move around and give birth how they feel is best.  In general there is a large distrust of the medical field, particularly for things that are not considered "illness."  All of this means some people think that they should be able to give birth "naturally" without doctors interfering.  Its both a funny thing and a "crunchy."  

we seriously considered doing home birth, until we learned we are having twins. I actually was in the care of midwives who have admitting rights at the hospital and deliver there, with doctors affiliated with them. I felt that they were more understanding and working more with my needs and gave great support. And I am not anywhere fundy living in North East in quite populated area.

[Million Children For Jesus]

 

22 minutes ago, justoneoftwo said:

Many people don't trust doctors to not do more interventions than they think are necessary,

Avoiding a c-section is a big reason for some people. The nationwide c-section rate for hospitals is 31%, compared to 5.2% for home births. Some hospitals have rates as high as 47%, and bans on VBACs. My doctor has a 12-hour time limit on births, and he was pitching a wild fit at the 8-hour mark. At home, you can take your time, within reason. (70 hours is not reason.) Also, if you object to any medical procedure in a hospital setting, you run the risk of having Social Services notified.

I support whatever a woman decides, hospital or home birth, as long as it is safe. For Jill's particular situation, I hope she chooses a hospital. I support VBACs under the right circumstances, but a VBAC at home (with an unproven birth canal) is a terrible idea. 

8 minutes ago, freshlemonade said:

Plus Izzy and Sam could get in-state tuition if they become third gen Petes!

Derick said he wanted Izzy to go to Oklahoma State, and nicknamed him "ThreePete," in hopes that he would become a third generation mascot. It would make sense to put roots down in Oklahoma, and get that in-state tuition. The TTH is really close to the OK border anyway. It's not as if they would have to (permanently) live far away from family and friends. Jill would be close enough to maintain codependency on the TTH and Derick could get enough distance to reclaim his sanity. 

[JDuggs]

My hope for Jill is that an experienced birth giver like Michelle will be able to convince her that having or at least attempting a vbac in a hospital would be the wisest choice in respect to future pregnancies and births. A successful vbac in the hospital would make the possibility of future successful home births more plausible. An unsuccessful vbac at home attempt could jeopardize any future pregnancies. Be safe now. Have the next ten at home.

[AlternativeVoice]

I just saw a pic of Israel in a baby's carseat which I can only assume is meant for Samuel, which gives me hope that maybe they are getting all their items checked off in case of a hospital transfer or maybe trying for a VBAC in the hospital. Most hospitals won't let u go without a carseat. But I could be reaching , after all they are gonna need a carseat regardless of whether they do a hospital birth or not. 

[HarleyQuinn]

14 hours ago, Shadoewolf said:

nd please don't flog me, Izzy is cute and all, but there is just something off about him, can't put my finger on it. 

It's because he looks like Jim Bob. It's hard for me to call any of the Duggar babies "cute" because at certain angles all I see is JB. Same with the M kids, sometimes all I see is Josh. 

Henry is probably going to be the cutest because right now he looks more like Ben than he does Duggary. 

[Jug Band Baby]

On 7/5/2017 at 11:11 AM, flycat said:

BIRTH POOL! I took the liberty of pulling together everyone's guesses. If I missed you, please forgive me and let me know!

DATE GUESSES:

 

7/11, 9lb15oz for me.

On 7/5/2017 at 11:12 AM, speller24 said:

If Jill technically is one, that would mean for  Henry's birth Jessa had one.

Not so.  When a woman gives birth on a plane and a doctor is on board, that doctor isn't her doctor.  The doctor just happened to be present.  If a midwife is present for a birth, she's not automatically the woman's midwife.  My midwife's daughter gave birth shortly before I had my first, and she acted as doula while another woman was midwife.  Having 2 licensed midwives there didn't mean her daughter had 2 midwives.  A midwife isn't everyone's midwife just for standing there.

23 hours ago, IReallyAmHopewell said:

The result should be a healthy Mom and a healthy child.

Thank you for mentioning healthy mom.  I want to scream at people who say that all that matters is a healthy baby, like the mom is disposable.

[justoneoftwo]

48 minutes ago, Million Children For Jesus said:

 

Avoiding a c-section is a big reason for some people. The nationwide c-section rate for hospitals is 31%, compared to 5.2% for home births. Some hospitals have rates as high as 47%, and bans on VBACs. My doctor has a 12-hour time limit on births, and he was pitching a wild fit at the 8-hour mark. At home, you can take your time, within reason. (70 hours is not reason.) Also, if you object to any medical procedure in a hospital setting, you run the risk of having Social Services notified.

I support whatever a woman decides, hospital or home birth, as long as it is safe. For Jill's particular situation, I hope she chooses a hospital. I support VBACs under the right circumstances, but a VBAC at home (with an unproven birth canal) is a terrible idea. 

Derick said he wanted Izzy to go to Oklahoma State, and nicknamed him "ThreePete," in hopes that he would become a third generation mascot. It would make sense to put roots down in Oklahoma, and get that in-state tuition. The TTH is really close to the OK border anyway. It's not as if they would have to (permanently) live far away from family and friends. Jill would be close enough to maintain codependency on the TTH and Derick could get enough distance to reclaim his sanity. 

Its important to trust your medical provider, and to have a good relationship with them.  Hospitals can be great, they can be terrible.  Taking the time to find what is right for you is important.  

15 minutes ago, Jug Band Baby said:

7/11, 9lb15oz for me.

Not so.  When a woman gives birth on a plane and a doctor is on board, that doctor isn't her doctor.  The doctor just happened to be present.  If a midwife is present for a birth, she's not automatically the woman's midwife.  My midwife's daughter gave birth shortly before I had my first, and she acted as doula while another woman was midwife.  Having 2 licensed midwives there didn't mean her daughter had 2 midwives.  A midwife isn't everyone's midwife just for standing there.

Thank you for mentioning healthy mom.  I want to scream at people who say that all that matters is a healthy baby, like the mom is disposable.

I think most people who don't mention a healthy mom aren't thinking she is disposable, most likely they are just forgetting that child birth is dangerous for the mom too.  I believe maternal problems are less common than problems for the baby in birth, so people forget it can happen.  They shouldn't, but its not that they don't care, its that they don't know.

[Jug Band Baby]

19 hours ago, Georgiana said:

(y'all I've never been worried about a fundie birth before, but for some reason I have a bad feeling about this one and I REALLY want to be wrong. Jill annoys the living Christ out of me (which is why I am an evil Catholic I suppose) and her decisions offend me, but I am deeply concerned for her wellbeing and want her to be OK.)

I have a really bad gut feeling she's going to die giving birth by child 5, at the most.  

[Eternalbluepearl]

I just go to my obgyn doctor for prenatal care that I already went to in the past for check ups. I had no idea there were so many options. Maybe if I was planning a pregnancy and childbirth career that would span from my 20's til my 40's, I might be more interested in all the different options. 

[Lurker]

Both of mine were delivered by an OB in a hospital birthing room.   I though my female OB was terrific.  I would have had no problem with being delivered by a midwife because in NY they are educated, qualified and regulated.

But one if the reasons midwifes's C section rate is lower is that they refer higher risk cases to OBs immediately and if things are going wrong in a delivery they call in an OB.

 

 

[Elvis Presby]

I just don't understand why they don't want pain relief when having a baby.  I would have never had any of my children at home because, gross.  Who is going to clean that up?  My first and 3rd were fast and easy deliveries (July babies), but my 2nd and 4th were awful hellish ordeals.  You don't know that things will go wrong until they go wrong.  If things go wrong you really don't have the extra hour or so for the ambulance transport to spare in some cases.  And drugs.  Really, if one of these sisters had some good pain relief I think we would see an uptick in hospital births in NWA.