my thoughts on home births

I have thought long and hard about writing a post like this. It’s a touchy subject, especially in the natural childbirth (NCB) arena and I’m still having a hard time finding my words but I’ll try.

When I was pregnant with Logan, I had no desire to ever enter the medical field other than working in administration. When I was 28 weeks, we watched The Business of Being Born and I thought my world was turned upside down. I cannot explain how one documentary on childbirth, home birth, and how OBs are only surgeons, changed my mind in 90 minutes and made me question every decision we had made up until that point about our care. We were with an OB office and had a decent, uncomplicated experience so far. We had started going to natural Bradley Method childbirth classes and learning more about the birthing process. But as I reflect on that time almost 5 years ago, I am dumbfounded how easily influenced I was, and how I tried to manipulate my  husband into thinking that a home birth was the only way and that hospitals were just a place where they wanted to perform all these interventions so they could get more money.

Um….crazy thoughts, right??

Even still, we checked into our insurance options and switching providers and to a home birth was not something our insurance would cover. Good thing since our son had a spontaneous pneumothorax at birth. When I shared this with a local home birth midwife recently, she said it must have happened when they tried to suction him since he had meconium in the waters and she had never seen a spontaneous pneumo in her 30 years of doing home births. Not so. I have a video of Logan laying on my chest immediately after birth and you can tell he is really struggling to breathe and cry. And he didn’t actually aspirate any meconium. Had we been at home, it would have taken at least an hour to transfer to the hospital if the midwife attending was able to quickly determine that there was something wrong. By the time Logan was an hour old, he had been treated with an oxygen hood, chest xray, and diagnosed with the pneumo. It was, by far, one of the scariest nights of my life, but I am so incredibly grateful that we delivered in a hospital with a level 3 NICU.

After his birth, I found my passion. It took many months for me to accept it, but I knew pretty quickly that my career path was about to change. I toyed with the idea of what kind of midwife I wanted to be. I even considered home birth at one point but I never felt comfortable with the liabilities and risks. Even as I type this, I feel a lump in  my throat. My husband also expressed his concerns and thoughts and we have always had a deep understanding with each other that if one of us felt strongly about something, that we would respect each other’s thoughts and feelings on the subject. He’s a very easy-going guy and for him to feel strongly about my career path means the world to me.

Since then, I have busted my butt to really figure out what kind of midwife I want to be and what I believe. I know that there are good CPMs out there, just like I know there are good OBs and CNMs as well. This is not a post where I am going to knock CPMs and talk about how terrible they are and how home births should be outlawed. I’m not that close-minded or disrespectful. What I will say, though, is that I do not agree with the safety of home birth and how it is portrayed in the NCB. I think it feels like brainwashing and I can say that as I was one of those new mamas feeling the pull to make a rash decision without any education behind my choice to have a home birth (or not). I can say that I felt brainwashed into thinking that OBs were just surgeons looking for the big bucks and that they have no invested interest in their patients. In general, this is not true! I know and work with some incredible OBs, both male and female (not that that matters). I also know some OBs who I would not want to be under their knife, but isn’t that the case about any thing? You can have good lawyers and bad lawyers, good engineers and bad engineers, good OBs and bad OBs. 

There is a huge part of me that wants this to sound like I am a devil’s advocate, comfortable with either side of the debate of home birth vs hospital birth but the truth is, and what I believe, is that there IS a difference and that there are countless statistics showing how much safer hospital births are than home births. I am not going to list those here because most of us know how to use Google and other people have already gone the distance to do all that work. This blog is one of them. And here is another.

Long story short, I am not a fan of home births. I respect you if you’ve had one and if you are planning on having one, I hope you’re doing everything you can to learn about risks and complications for both mom and baby. Post partum hemorrhage, nuchal cord (around the neck), shoulder dystocia, meconium aspiration…just a few to name as complications that can happen even to a low risk healthy mom. Some of these become even greater risks if mom has other identifying factors, but they can still happen. I had a mom come in recently who had been laboring most of the day. She came in to be checked, was a 3, contractions kind of all over the place so she was sent home. She came in later that night when I was on and was a 6, but complaining of terrible pain in her stomach and baby heart tones were pretty low, despite position changes and even after contractions ended. Baby was not recovering and something was wrong.  We rushed her to the OR and it turns out her placenta was abrupting. Had we waited much longer both of them could have been in a world of trouble and had she been at home…I don’t even want to think about how badly that could have turned out.

I am constantly learning. The more I learn, the more I realize that home birth really is not a safe choice. It wasn’t for me, and for so many others it has ended in absolute tragedy. I have worked in the hospital for over 3 years and in that time, no babies or mothers have died due to something we were able to treat them for. Yes there have been hemorrhaging and codes and even an amniotic embolus in which both mom and baby survived!!

In closing, I would like to officially join the #notburiedtwice movement. I’m not going to go into detail about it here as I’d like to encourage you, dear readers, to find out for yourself. I am a firm believer in self-education and this is an opportunity for you to do just that.

Thank you for reading and allowing me the space to express these tough feelings. All I ask is that if you choose to comment, be respectful.

shadow

I have been thinking about how I can start to get more hands-on experience in the field of women, pregnancy and childbirth. I can certainly shadow the midwives that I know here at the hospital, however, I feel like I need something different right now. I need a new perspective on the whole birth thing. So I contacted a local CPM, a midwife who does home births. She has attended more than 3000 births and has the kind of experience and statistics I am seeking to learn from. We have emailed a few times. I can’t wait to meet her!

Have you shadowed a midwife? What was your experience like?

Improving Birth article

Have you heard of improving birth? Have you heard of the blog Improving Birth? As a huge birth advocate, I am always trying to figure out ways to improve birth in our country. How can I become an asset? How can I provoke change? How can I teach and encourage women?? These questions will always be asked until there IS change. That is what Improving Birth is all about. I found an article posted back in December that I wish I could have written. If I had written it, these are the words I would have used. And because I love how well this is written, I am posting it word for word with a link, rather than just linking it. Thank you, Improving Birth, and all birth advocates who are working to make a change.

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I Don’t Care How You Give Birth

Cristen Pascucci, a political and communications specialist, recently joined Improving Birth’s executive board.

Elective C-section?  Ocean waterbirth?  Seriously, go nuts.

You may think that because I chose (and fought) to give birth with no drugs in a hospital, I think everyone should.  Or, that because I rant and rave about our bloated surgical birth and artificial induction rates, that I would do away with these medical interventions.

Absolutely not.

First and fundamentally, I believe that it’s your body, your baby, your birth.  There are many options around birth, and I hope you avail yourself of them–and when you do, it’s none of my business.  There is no one-size-fits-all birth.  I have friends who have given birth across the spectrum from homebirth with no access to pain medication, to a planned epidural at 2 cm dilation, to full-blown elective “convenience” surgery scheduled months ahead, and I stand firmly behind each of those women in their human right to make their own decisions.

For me and my baby, a drug-free birth was of the utmost importance.  It was for personal reasons, really, not because I’m some flaming hippie who doesn’t believe in hospital voodoo.  It was a choice I made and prepared for because I knew it was the best thing for both of us–mostly my baby–that had absolutely nothing to do with being anti-medication or anti-establishment.

Second, these medical interventions save lives when used appropriately.  That is why they were created in the first place.  Sure, their overuse contributes to more dangerous conditions for moms and babies, but when they are used prudently and out of necessity, they preserve life.  In the U.S., in theory, we have the resources to have the best possible outcomes.

What IS important, and what I care deeply about, is that you go into birth with your eyes wide open; that your decisions are based on full and accurate information; that you understand the risks, benefits, and alternatives of your various birth options; that you work with your care provider, and that he or she respects and supports your wishes.

Birth doesn’t always go according to plan, which is why it’s not enough to create a “birth plan” and call it a day.  Sure, most of the time it is safe, but that doesn’t mean it’s predictable.  It’s very possible, even likely, that you and your support team will be called upon to make decisions during labor.  It’s these gametime decisions that can make the difference between a positive experience and a traumatic, dangerous, or disappointing one.  There may not be time at that point for in-depth explanations about the risks, benefits, and safety of various interventions or procedures, so you’ve got to be informed ahead of time of what might come up.

And, probably even more important, you’ve got to have a support team who is on the same page.

If you go into birth unprepared, you are placing your dignity and the safety of your self and your baby directly in the hands of people you may have never met and who may or may not respect you and your wishes.  It could go either way. It’s a huge risk to take.

good example of this is my own birth story: when my care provider was strongly suggesting to me a procedure (an artificial induction at close to 42 weeks pregnancy) that was NOT the only or even the safest option.  I was lucky enough to have better information that allowed me to make a different decision, for a different outcome, that I firmly believe was the safest for me and my baby.  But a little less preparation on my part, and it never would have happened.  What happened with my care provider happens all too often.

I say all this to say that what is truly important, and I think a lot of “birth advocates” would agree with me about, is that you are prepared, informed, and supported in whatever you desire.  You can’t make decisions about what’s best and safest for the two of you if you aren’t informed and supported.  And information and support don’t happen on their own.

When you’re educating yourself about these decisions, you might be surprised at what the evidence shows: surgical birth increases your chances of death by six times, but it can also save your life.  Epidurals can prevent a surgery, just as they can increase the odds of your having to have it.  Natural, unmedicated birth can be the safest option, or it can be impossible.  Every one of these things has lasting effects.  How will you navigate these choices?

Remember: ”If you don’t know your options, you don’t have any.”

So, no, I don’t care how you give birth, as long as it’s your way–and I trust that, as your baby’s mother, you’ve made certain that “your way” thoughtfully considers the best scientific evidence, supported and vetted by your care provider.  (Here is a wonderful summary of the current best evidence for common birth practices and procedures.)  The final decisions about your baby and his or her birth lie with you, the person who is ultimately most invested in your own and your baby’s safety and best care.

And I hope you have the safest, most wonderful experience you can have, bringing your baby into the world.

Defining Midwifery

I have seen this article floating around the childbirth interwebs and cannot help it any longer. I must post this and share the anthropological aspect of midwifery. It’s kind of funny because, not a few weeks ago, a friend had mentioned to me that the study of childbirth by an anthropologist mainly focuses on midwifery around the globe. I had not really thought about anthropology, however I have had thoughts about creating and influencing the childbirth atmosphere to be more like other countries’ views of this life-changing event. In my own opinion, pregnancy and childbirth are thought of in the medical world as a disease or illness, which is far from it! Granted, there are situations in which medicine is necessary. I’m not talking about those situations. I’m talking about a normal, healthy pregnancy with little to no risks…those are the births that belong in a home surrounded by a midwife, family and friends (or not, in some cases…see Unassisted Birth).

The link below goes to my “Behind the Midwife” page where I think this article belongs. This is why I want to become a midwife, this is what and who a midwife is and if anyone has questions, it’s a great way to give answers. Sometimes, I wish I could whip out something witty and awesome when someone asks me WHY or WHAT IS THAT when I tell them why I’m going back to school. It’s easy to say that I don’t care what anyone else thinks, but the truth is that I do care and that some people just don’t get it. Fine, but at least this article does a wonderful, beautiful job of defining midwifery from an anthropologists point of view. Enjoy.

Midwifery by Robbie Davis-Floyd, PhD

Networking

Good evening everyone!! I want to, again, welcome new readers! This makes me so happy! I hope that this blog and the networking I gain from it can be a resource for all of us. I want to be able to connect to others who are doing the same thing, as well as anyone who is going through pregnancy. I did not have the knowledge of childbirth education until late in my pregnancy and by the time I learned about midwives, it was too late in my pregnancy to switch. My insurance would not support it and we could not do this whole birth thing without insurance so we felt stuck.

I have watched The Business of Being Born FOUR TIMES!! Does that make me crazy?? Or passionate?!? I hope the latter. 😉 Anyway, I have decided that it is time to open this blog up to more networking avenues like Facebook and Twitter. I have created accounts for both. I have also created a direct email for questions, thoughts and suggestions which I am ALWAYS open to. 🙂 See the side bar for all those options. And lastly, spreading he word about childbirth education and my journey is the only way to continue to make others see that there is more than one way to birth, more than one type of provider, and more than one way to do just about anything when it comes to pregnancy, childbirth and parenting. I am so grateful for this blog. I have no intentions of using it as a way to make money. That is not AT ALL what this journey is about for me and I hope that is obvious.

Thanks for the continued support!!

Update on Brio Birth

As many of you know, I posted several months ago about becoming a childbirth educator through Brio Birth, a company which I thought I’d love joining. I had been scouring the website for months, waiting for a date in Denver to arrive for a workshop.

In July, before a Denver date appeared, I made the leap and put a $600 deposit down. A deal had been posted and my eager, yet naive, eyes (or heart), could not let that one slip through the cracks. For nearly two years now, all I’ve wanted to do was somehow work my way into the child-birthing community, one which I was certain was exactly where I belonged. Never before has my heart been so happy and passionate about one thing. I was elated to find a deal with Brio Birth and continued to wait for that special date.

A month later the date was posted for November. I jumped for joy! Finally, my dreams were slowly coming true. I had just started this blog and realized my even bigger dream of becoming a midwife. All along, I’ve believed in the more experience and education, the better. I want to get my hands wet where ever I’m able be it as a childbirth educator, doula, nurse and midwife. I wrote THIS post and quickly received many emails and comments warning me of Brio Birth. My heart sank. Where were all these warnings in my searches for the last 8 months?? Why NOW, after I’d already made my deposit, was I just finding all this out?!

I felt cheated. Embarrassed. Betrayed. After 8 months of regular correspondence with Naomi, the owner/creator, I never would have guessed what had been going on and now, what has become a part of our family. Thankfully, this has not stopped me from pursuing my dreams. It has only helped me become more aware about business and people and doing even more research before I invest in it.

As of today, after I requested a refund in September, I have yet to see that $600 and at this point, I don’t think I will. There are rumors swirling around that they may declare bankruptcy and such and honestly, I don’t care. If that happens then I will most definitely not be seeing that money again. The timing was terrible. Only a few weeks prior to my request one of our dogs had a terrible accident and before I learned about the issues with Brio Birth we had been talking about me not going through with the workshop and requesting a refund anyway. It was heartbreaking, all at once, to learn that financially it was not going to work out and dealing with a tragedy.

So the lesson learned is to fully educate yourself BEFORE you invest in anything, especially if it’s a newer, less-known business (or whatever it is). Regardless, I WILL become a childbirth educator, most likely through Bradley Method (which I KNOW is legit) in September and start a few pre-rec classes in the fall for nursing.