Tuesday, October 5, 2010

It's an OPINION!

I figured my comment about home-birthing might cause some stir.....and I think I was right. Let me just say up front (again!) that this is MY OPINION. It doesn't mean that it's the only opinion or heck, even the right opinion! It's just how I see things through my eyes.

Someone asked what we have in a hospital that wouldn't be available at home. I'll admit that I've never been to a home birth, but from the research I've done here's a small list (not all inclusive) of things we would have in a hospital (not necessarily at every delivery but available within seconds) that usually wouldn't be available at home:

~ 5 L&D nurses
~ 4 NICU nurses
~ 2 Neonatal Nurse Practitioners
~ a full team to take care of mom after delivery and a separate team to take care of the baby after delivery
~ a labor bed that can be adjusted to many different positions to facilitate McRoberts maneuver (plus lots of others)
~ a full OR team/equipment (including anesthesia) ready for an emergency C/S if/when we decided we needed it

In my situation I think the things that helped the most were having all the (very experienced) hands ready and able to help. If it had been just the doctor and me in the room things could have turned out very differently. There is also no way that I could have taken care of the critical condition baby after he was born AND taken care of mom at the same time.

I know the great majority of births (home and hospital) turn out fantastic, happy healthy mom and happy healthy baby. I know midwives are trained and many have more experience than some doctors. I know that sometimes in hospitals decisions are made because of the extra monitoring that lots of times happens and that lots of times in the hospital we err on the side of  "preventing" instead of "reacting." My experience over the weekend reminded me how quickly a situation can go from normal, routine, and uncomplicated to emergent, critical and life or death. The thought that keeps running though my head is "why would I want to take the chance of the one birth that doesn't go as planned being MY baby's?"

4 comments:

  1. I totally agree with you!! I had 2 shoulder distocia babies and they were incredibly hard to deliver. My last one weighted in at 9 lbs 4 oz and snapped his clavicle on the way out. He shoulders were so stuck that my doctor had to reach her whole hand and arm up inside of me to turn his head and shoulders... IT was traumatic for both of us, but I had a wonderful labor nurse who I credit for such great deliveries. I've had such great experiences with my labor and delivery nurses and heck, I don't even see the dr. come in the room and then they are only there for about 5 mintues... It the nurses all the way that make or break a delivery.

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  2. "why would I want to take the chance of the one birth that doesn't go as planned being MY baby's?"

    Because that's life. You drive to work every day, even though every day somewhere people are killed in car accidents. You eat every day, even though people choke and die on food.

    At home, there's 100% less risk of c-section complications - and failure to wait never results in an "emergency" section in my bedroom. WAY less chance of mom or baby developing MRSA, no hospital mix-up of which baby is mine, whether s/he gets formula or a pacifier, whether he's circumcised even though the consent for is clearly marked not to do so. No bitch nurse telling you that it's "hospital policy" that she gets to carry your brand new baby out of the hospital, even though you're walking out on your own two feet, which triggers your PPD (that happened... to me).

    I've had two mostly great hospital births. But the stats in this country are 1:3 (now inching closer to 1:2) births are now surgical. With those odds, my time is up. Thanks but no thanks - I'll have this one at home.

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  3. I see your points, and I think they're valid and important to think about because many moms are thinking about birth in this way as well. And I have been in similar emergency situations and know how scary they are -- and how contagious fear can be.

    However, I think a lot of families are becoming more and more frightened about what could go wrong in a hospital. Birthing in a hospital pretty much guarantees every third woman a c-section and interventions that could do harm to their birth process and the health of both baby and mom. These risks of being in a hospital are much more normal than an unplanned emergency -- for which homebirth midwives are trained and prepared for. My point is that not only are homebirths usually safe - even in the case of emergencies, but that the hospital can also be an unsafe place to birth.

    All that said, I think collaboration and mutual respect between hospital-based practitioners and homebirth practitioners is so so important. This is especially true when rare emergencies do happen.

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  4. I had a 3 minute shoulder dystocia with baby turtling on nuchal cord x2 down to 1 minute apgar of 0, and we were at home. It was scary as hell, but our midwives run drills on this stuff constantly, and at 5 minutes our daughter was up to Apgar of 8. We had 2 fully certified midwives and 2 apprentices at our birth, and they worked absolutely seamlessly together. We are very grateful for the care they provided.

    I can definitely understand why you'd feel so much safer with so many more people and a lot more equipment if something is going very very bad very quickly. I still choose and support home birth, but it made me very convinced regarding how terrifyingly unsafe unassisted birth is, and how qualifications for attending home births should be very very high and thresholds for transferring very low.

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