Monday, February 15, 2010

Homebirth Questions and Answers :: Part 2

Part 2...

- What happens if there are complications that require an actual physician? My friend had a placental abruption, and she was grateful she was in the hospital, but I'm thinking about homebirth or a birth center, and feel nervous because this happened to her.
This is completely understandable and something I hear a lot of.  I actually contacted some of my midwife friends to get an answer to this question for you.  I knew they could answer much more eloquently than I could.  So, I will turn this question over to my dear friend, and Midwife, Vivian.

  Fortunately complications are rare. Most physicians are not at births in order to resolve complications. In the event of an uncomplicated births, physicians use their skills to do other procedures. The majority of women who choose a home birth consider those procedures unnecessary and invasive. The choice to have your baby at home comes down to your individual perception of risk: Do you feel that you are more likely to experience natural, unpredictable complications (such as a spontaneous abruption) or iatrogenic (physician-caused) complications (such a misoprostol-induced abruption)? Birth, like life, has inherent, irreducible risks.

- Have you ever considered delivering in a bed? What is the advantage of delivering in the water? 
I have not considered birthing outside of the water.  My sister had both of her homebirth's on her bed and loved it.  I just love the buoyancy of the water.  I feel so much more comfortable in the water and honestly can't imagine giving birth "on land".  I like having the options and if it seemed that the water wasn't the right place for me, I would get out and give birth where ever was most comfortable.  That is one of the great advantages of being at home.

- Are there any pain medication options when midwives attend to you, or is homebirth automatically a "no pain med" option?
There are no pain medications.  However, your Midwife comes equipped with many tools to help you through the pain.  As I mentioned before, a good childbirth education class is a must and will help you tremendously.

- Do you walk around, do squats, or do other things around your house to get more comfortable or get the baby to come, before you get in the water? 
Yes yes yes!  I don't get in the water until I am at least 5 cm. dilated.  So, when I am in early labor, I am walking, going about life, squatting and mentally preparing for meeting my baby.

- Is there a disadvantage to not knowing if the baby's heart rate is dropping, or if the cord is around their neck, and other things you might be able to know in a hospital? 
When you have a homebirth, you know your baby's heartrate.  My Midwives have all checked heart tones every 20 or so minutes with the doppler.  She will check during a contraction to be sure the baby is handling everything well.  You never know if the cord is wrapped around the neck until the baby is born.  Libby's cord was wrapped around her neck twice, quite tightly.  Because I was so intune with my body and what was happening, I was able to tell the Midwife that when I pushed she needed to get the baby.  She didn't know why, but she trusted me.  She knew that I knew my body and my baby and went with it.  She was able to push on Libby's head as her body came out and untangled her.  She needed a little oxygen and lots of skin-to-skin contact with Mama.
- Is it quite necessary to have a midwife? Do you know anyone who just delivers at home on their own? Yes, in my opinion it is necessary to have a Midwife.  When you are giving birth, you are not always in the clearest of thinking.  It is very important to have someone there who can see things objectively, who has the experience necessary of helping Moms and who can help you with whatever you and the baby need.  There are some women who choose to have unassisted or free births, but those make me very uncomfortable.  I don't agree with that way of birthing, even though I have some very good friends who have chosen that path.  That is their choice and their decision and I will not judge them for that.

I have had some sort of complication with each of my homebirths.  I tore quite badly with Seth, had a slow trickle hemorrhage with Amelia and Libby's cord was wrapped around her neck twice and she didn't breathe for about 5 minutes.  If I had tried to go it alone, these situations would have ended very badly.  In the hands of a skilled Midwife however, each of these situations were resolved with no lasting effects.

Now, about the mess...I have not cleaned up one thing in any of my births.  My midwives take care of everything, so really, I don't even know what all goes into it.  It is so nice to be recovering in my bed, snuggling with my baby and knowing that when I get out of bed the next day, there will be no sign of the actual birth itsself.

Missy writes:

I recently learned that there is a good chance that I could have the option of having an hbac legally (ND attending birth) and now I feel really torn as to what I should do. I hate the hospital and all that can potentially come with it, but I have also felt that with the right "birth team" I could have a successful vbac and a better experience (and have hbacs for the rest of my kids). I also have that fear in the back of my mind that "what if I'm that >1% that has a rupture and the baby is harmed or dies before I can get to the hospital." At the same time I understand that a hospital doesn't guarantee a risk-free delivery either. Some have had ruptures that weren't caught in time etc. So I guess my question is did you ever second guess yourself when choosing to have a homebirth? What would you recommend to someone in my situation who is having a hard time deciding and needs some clarity?

One thing I have always said is that one way of birth is not right for every baby.  If I ever didn't feel right about homebirth, I would go to the hospital.  I try really hard to listen to my body, listen to the baby, and listen to the Spirit to know how this baby needs to be born.  With Libby I did second guess myself.  However, after really doing some soul searching and pondering, I knew that she would be fine born at home.

You are right, there are no guarantees to a risk-free birth.  However, you need to do what is right for your family, your baby, your body.  If you feel more comfortable with the birth team you have assembled and really feel that this is the best way for your baby to be born, do it.  Talk to the ND who would attend the birth.  Talk to your doula.  Talk to your husband.  Get their input, share your concerns.  Talk and talk and talk and then sit back and listen.  Listen to your heart, listen to your baby.  You will know how s/he needs to be born.

I am so glad that you all have listened to me ramble on about this.  I love my homebirths.  I love being able to educate other Mothers and potential Mothers about this subject.  There is so much negativity and misconceptions out there about homebirth.  It is something that is not for everyone, but is for a lot more people than I think realize it.

There are so many options for birth out there.  Do research, take your time and make your decision.

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