Sunday, January 26, 2014

What Drew Me To Home Birth And What Turned Me Away, Part 3


I’m trying to be as thorough as possible without leaving anything important out… there's really no other way to describe the my change of mind/heart without filling you all in on the moments that all played their part, however small they may be. My apologies for being so long-winded. Especially for this entry...

****

So I passed 40 weeks. My OB, trying hard not to crush my dreams by bringing up the "i" word (induction!!), wanted me to come in for an NST and ultrasound that week. So I did. When I got in the room, the nurse said “are we scheduling your induction today?” Ugh… great. Here we go. My OB came in and again brought up induction “I know you don’t want to and hopefully you won’t need to, but when you come back in a couple days for your 41 week appointment, we’ll at least need to put it on the schedule, ok?” Ultrasound tech also asked me if I was having an induction soon, too. Ugh! I was so hurt! I felt betrayed. I wouldn’t need an induction. There was no need. I promptly went home and had a little Facebook vent:

“doctor appt today for check up plus ultrasound & non-stress test. Induce, induce, induce is all I heard from doctor, nurses, techs, etc!! I don't care if I'm 3 weeks late w/ a 12 pound baby & they schedule me for one... this pregnant lady isn't going to show up. I am NOT getting induced unless baby is in danger, people! Ultrasound & NST both showed our baby is healthy & happy!”

(I’m cringing right now reading that. That’s exactly what I wrote a few years ago on Facebook – copy and pasted.)

Anyway. No need to worry more about induction because I went into labor that evening. I labored at home for 24 hours. Our doula joined us around hour 20.

We arrived at the hospital in the evening and I did not know it at the time, but I had 12 more hours of labor ahead of me. I thought I was nearing transition but was crushed when I found out I was only 4cm. I cried. 

My nurse was…. amazing. I couldn’t believe it. The hospital overall was so nice, people-wise. Our room was mellow, lights were dim, and I was in and out of the shower. I hated being monitored some times, but sometimes it didn’t matter because I was happy laying down anyway. I drank coconut water and was offered food but there was no way I could eat anything. No way.

I couldn’t believe how nice everything was for us. Aside from the monitoring, our nurse and the on-call OB (I’d never met her before) left us alone. And were kind to us.

I was so happy/overwhelmed when I had the urge to push (and nurse confirmed I was complete) but so, so tired. I had no idea where I would get the strength to push. I’d been in labor for over 34 hours now. I tried different positions… but my favorite – which was shocking to me – was on my back. My legs were jell-o at this point. All I wanted was to do was sleep in between contractions.

Our nurse stayed with me the whole time and encouraged me with every push. She brought in a fan that she would turn off or on, as I requested, because I kept going back and forth between being hot and cold. She held me up when I tried squatting. She dabbed my head with a cold wash cloth. She encouraged me to reach down to feel our baby's head when baby was crowning... I did and it gave me a boost of energy to keep going. She was so amazing. Her shift ended but she stayed with me until after the baby was born. I couldn’t believe it.

After an hour and a half of pushing, our baby was born.




He went straight on my chest where he stayed until I couldn’t hold him any longer… because of my postpartum hemorrhage.

I wasn’t fully paying attention as I had my new baby and he was nursing and I was in la la land so I didn’t really know what was going on. Though the crazy fundal massage snapped me back to reality. The new nurse said “OK Danielle, we are having a hard time getting your bleeding under control and we’d like to give you the Pitocin now.” I said “yes, ok, yes do whatever you need to do” and was getting freaked out. I got a shot in my thigh. More fundal massage. And now I was feeling woozy. I had to pass off our baby to my husband because I was getting too weak to hold him. And freezing cold. I was thankful for the hot blankets the nurses piled on top of me. It’s all a blur. I remember getting pretty scared and asking the nurse “am I going to die? Am I going to need a blood transfusion?” She said they were doing everything they could to keep me from needing a transfusion but I was still bleeding a lot and they didn't know why but I might need a transfusion. What?? I asked again if I was going to die and I told her I was scared. She said I wouldn’t die and was comforting me but all the while trying to help me, too. I now had an IV of Pitocin and Cytotec suppository and more crazy fundal massage.The doctor let out an "OK, here we go" / sigh of relief as two giant and gross clots came out. Finally the panic started to subside as the bleeding was slowing down / stopping. A boggy uterus and two large clots is not a good combination, apparently.

After that I was on heavy watch by the nurses for the remainder of our stay to make sure the bleeding didn’t pick up again.

I texted the yoga midwife later on the day of the birth and I told her about the postpartum hemorrhage. She told me that home birth midwives carry Pitocin with them, too.

I felt weird after all of that. Confused. I thought I had done everything right to avoid PPH. And I know home birth midwives carry Pitocin but that didn’t do the trick for me. The shot and fundal massage, it wasn't enough. Would I have ended up transferring after our baby was born if we were at home? That thought lingered. I didn’t focus on it because it worried me. So it just lingered.

I was happy that I had my unmedicated birth and my healthy baby. It all worked out at the hospital. I didn’t even have to fight. There were things I picked apart afterwards, thoughts like “well, this would have been better at home,” but for the most part, I knew my experience was good. I cannot lie and say that I didn't want to hate it, though.

Trying to fast forward a bit as I know this is such a long story… 

We changed our insurance at the next enrollment period so that our new insurance would cover future births at home. I started the official doula training process, aside from the book list which I had already started during pregnancy. I had my doula training workshop and met a new friend. Doula friend and I instantly clicked. She quickly became someone I would call one of my dearest friends. We became each other’s back-ups as doulas.

Around this time something else interesting happened… I was a member of a large, local doula group and someone sent out an email about hearing a woman named Dr. Amy, I believe she was on NPR (or some other radio station). Quite a few emails came through of people chiming in about her saying, basically saying she was awful and anti-home birth and her website is horrible. I was curious but vowed never to give her site the traffic. I asked about her here and there, though, to people I knew in the home birth community. More of the same responses. It was odd to me that someone would be “speaking out” against home birth. So I was very curious about this. It’s a safe option. Of course it was an obstetrician against home birth. Typical. Probably just doesn’t know or understand the normal process… Oh well. I let it go for the time being. 

I began doing an “internship” (with doula friend) with a local group of midwives – they were CNMs. During this time at the internship, my love of home birth midwifery only grew. I was attending births now, too, as a doula. At home, birth center and hospital. I knew I wanted to be a midwife for sure but didn’t know which route I wanted to go. It appealed to me to go the CPM or LM route because it would be faster. But I didn’t like that I wouldn’t be legally allowed to work in every state. What was with that?? As a CNM I would be legally recognized in all 50 states. It would be a lot longer route though and even with my 4 year degree I might still be starting from scratch, basically, since my degree was not science related at all. I went back and forth… I still had the impression that skill set and training was very similar, just different routes. One took longer because you had to earn a nursing degree – which I liked the idea of some days, and other days I didn’t.

I now struggled with the thought of which midwife to choose for future pregnancies. I now had these midwives I loved too, in addition to yoga midwife. How would I choose?

Doula friend and I met a new friend around this time, too. She was a childbirth educator. We became a quite the trio of birth lovers – a funny way to put it but our love of childbirth is what really formed that initial bond, that and the fact that we were just compatible as friends. I loved those two gals. Both are two of the most wonderful and kindest women I’ve ever met.

The last home birth I attended was one that was one of the biggest turning points for me. It was a home birth transfer for fetal distress. And it was very, very scary.

This was a low risk, young, fit, healthy mother. When she got to 9cm, the heart rate started dipping down very, very low. The CNM looked a little worried so she had the mom get into a different position. Heart rate, again, was not good. CNM told her to try her other side. Same. Then hands and knees. It was better for a bit then it dipped down again. As I’m typing it makes it seem like it happened so quickly but there were a few minutes tried in each position. It seemed like time had slowed down while we were listening to those little heart tones. Everyone seemed worried by this point. And now the heartrate wasn’t recovering in between contractions. Why?? What was going on? The CNM suggested we needed to transfer. She kept checking the heartrate and then said “yes, we need to go now.” The husband asked if he should call an ambulance but the CNM said it would take too long. Everyone was gathering their things quickly so we could go. Where are the keys? Where are clothes for the mom? Where are shoes? Etc, etc... rushing around. Keep in mind, the mom was 9cm at that point. Tiny, petite gal and even with her husband pretty much carrying her around, it was a process just getting out of the house. CNM gave a shot of muscle relaxer type meds to the mom to help the contractions slow down. I drove behind them in my car. The midwife stayed in the backseat monitoring the mom. Heart rate was better once the contractions stopped because of the muscle relaxer that she administered. I was sobbing in my car on the way there, called my husband and cried to him, I was so freaked out that the baby was going to die. Everyone was freaked out. Arrived at the hospital and they had her in a room, hooked up to monitors… Contractions started up again and down went the heartrate. They tried having her push because baby was low but it wasn’t going to be quick enough. Heartrate was not. good. OB rushed it, lots of commotion, episiotomy, vacuum, baby born.

I walked away stunned.

For a while I didn’t let it soak in completely. At the postpartum visit I had with the mother, our conversation left me shaken. There were just too many unanswered questions. I thought maybe her take on it would help me figure things out… as if she might offer up something that I missed, I don’t know. But it didn’t. So many questions. She didn't understand either. How did that happen??

After a while, I finally started really thinking about that birth. I couldn’t initially and it took me some time to get there. At first, I just sort-of… carried on. Went about life like nothing happened with my home birth midwifery friends and such. Though I did voice my concerns and worries a couple times to doula friend and childbirth ed friend.

I wanted to process what had happened, though. I wanted to make sense of it but I couldn’t. What if there had been traffic on our way to the hospital? Do all midwives carry such meds that the CNM had? Would a CPM or LM be able to carry those meds? What if that baby was in distress the whole way to the hospital without those meds… would that baby be alive? Or alive but with neurological damage? What if that midwife hadn’t been monitoring her so closely? I couldn't believe how long the transfer took... and we were going so fast... but it still took so much time... it felt like time stopped and was taking forever and yet it felt like it only took 5 minutes. But in reality it took much, much longer.

One night, my curiosity got the better of me and… I found myself at a website I swore I would never visit…

The Skeptical OB

Ugh! I hated myself for looking, for giving the traffic. But I just felt drawn. I had to see what she had to say. What if there are pieces to the puzzle that I’d find on her site? I don’t know. I don’t know why I went there other than my curiosity just had the better of me in that moment.

I thought I’d read one post and leave… but I didn’t. I stayed. And read quite a few. My face was burning red and my heart was racing. I will never forget it. Ugh. I felt mad at her. She was so…. mean with her posts. But I also felt confused. I read posts of hers that only were about home birth (because she covers other topics as well). One I read was about a home birth of twins where the second baby didn’t survive. One was discussing Doppler versus Electronic Fetal Monitoring. In other posts, I read about infant mortality versus perinatal mortality. There was more…

I read Hurt by Home Birth. Even then I made excuses like those midwives were just horrible… my midwives would never be so negligent. I was sobbing reading the stories though... and these stories, too, began to linger.

After a few hours of reading, I shut my laptop and tried to erase it all. But I couldn’t… I was so confused. And I did not like Dr. Amy. She was so harsh and so extreme.

Oh man did I have questions now… what the heck was all that??!

So I started asking questions to people I knew. I sent one of the blog posts by Dr. Amy to a couple of my birth world friends. I thought they could help me shed some light on it and say “no, this is false.” But that’s not what I heard. I heard “she’s too extreme, it’s unhealthy to be that extreme” and even heard “I’m having a hard time taking her seriously because there are grammatical errors in that post!” This did not give me any answers.

I read Dr. Amy's critique of the Johnson and Davis study (Outcomes of Planned Home Births with a CPM in the British Medical Journal) ---- a study that I loved and trusted and served as my "proof" of safety of home birth here in our country ---- I sent the critique to my cousin, she was in the process of becoming a home birth midwife. She didn't have any answers. She sent it to two of her midwife friends, she forwarded me the responses. Which I still have. I don’t know if it’s legal or not to post their responses so I will just paraphrase…

The first midwife said that Dr. Amy was the biggest anti-home birth doc in the USA. She twisted around stats to make things sound worse than they were. She comments on every home birth article that pops up.

The second midwife said that Dr. Amy was old news. She was way, way against home birth and is well-known and despised in the home birth community. As far as her critique of the Johnson and Davis study, all you need to consider is the source.

Again, no answers.

There was no resolve. So I looked at the numbers myself. It took a while. A long while. But… Dr. Amy was right… the study showed an increase risk, double to triple, at home with a CPM versus in a hospital.

And that wasn’t the only flaw in the study.

So now I had other things I just had to look at myself. Does infant mortality reflect childbirth or are we really supposed to look at perinatal mortality? So I looked up the definitions. I looked at what the World Health Organization had to say about it. I had my answer: perinatal mortality is the best indicator for childbirth / maternity care safety. It’s the only mortality rate that includes intrapartum deaths – deaths that happen during labor and delivery. It includes prematurity, antepartum mortality, intrapartum mortality and neonatal mortality. And the US does really well with perinatal mortality – tied with countries like France and Japan, and actually better than countries like the Netherlands and the UK. Next best measure is neonatal mortality. Infant mortality is not at all the correct mortality rate to consider.

So did the movies I had watched and books I had read know this and purposely try to mislead? Or did they all just not know what they were talking about?

I started looking at different perinatal and neonatal mortality rates, too, here in the US. Different papers and vital statistics data from as current as I could get all the way back to the 60s. I looked at the different studies for home birth and looked at their neonatal and intrapartum deaths… they shocked me.

That phrase I heard… that comment… “babies die in hospitals, too.” That comment was just… well, it was crap. It’s deceiving. Incredibly deceiving. Because the truth is: No. Full term babies don’t just die in hospitals here in the USA. And more importantly, they don’t die in hospitals at as high of a rate as they do at home.

There was a lot that started going on during and after this time.

The group of CNMs talked to me about working part-time as a coordinator for them. I was excited at the idea of it and said yes, I was interested… but I was stressed out about it. I still had so many unanswered questions and I didn’t know if I was OK with home birth for us now… I just had more to figure out. And if I had a job with them, well then, how could I not have them as my hired care givers for future pregnancies? Thankfully, they ended up wanting someone full time and found someone else for the job. I felt so happy it all worked out. I felt so relieved.

Before all of this - before the transfer, before Skeptical OB - I never went in search of home births with bad outcomes. I had read so much, so many birth stories, but the bad stories… stories of death and injury… were missing. They are missing unless you pretty much seek them out. And it’s not because they aren’t happening.

There were other people out there voicing their concerns over midwifery here in the US… blogs like Navelgazing Midwife and The Reformed CPM. More blogs that left me with questions and concerns.

And now weird things were happening when I started asking questions. I started being censored. I asked a question on the blog of a very outspoken home birth advocate. My question was regarding safety and worries I had. And the comment was not only deleted but I was banned from ever being able to visit the blog again. What the heck?

That was the first time my comments questioning home birth safety were deleted… but it was certainly not the last.

And then there were home births that ended with death and certain stories that made it in the news… and I was appalled at the comments I read. Parents of babies that died were blamed by others in the home birth community! The midwife was protected, comments like “this midwife delivered my baby and was wonderful! The parents need to own up to this!” And this sort of thing… it was happening over and over and over again. Midwives were protected even if clearly negligent. This didn’t make sense to me! I thought having a home birth was all about having a passionate care giver who gave evidence based care, the best care… better than what you could find in a hospital. But how can we be certain we are getting the best care at home if accountability doesn’t exist?? When negligent midwives continue to practice without being reprimanded and without a track record that is made public… then how do we know who is negligent and who is not? And why are these midwives protected by the other midwives and the community as a whole? And the families that seek accountability, why are they vilified?

I started looking deeper into the differences in midwives here in our country versus other countries. Majority of home births in the USA are attended by a CPM, LM or lay midwife. The education and training is so different than midwives in countries like Netherlands, where it is part of a 4 year university program, where midwives have earned hospital privileges. That is not so for CPM and LMs. But when I looked at websites like MANA and other home birth advocacy websites, they always site studies from other countries to show proof of safety of home birth here in the USA... but how did this make sense? How can we use studies based in other countries where the whole midwifery system and the education and training and health care as a whole is totally different than what we have here in the USA? 

I had more questions and concerns… more stuff I needed to figure out... and now we were pregnant with our second child... more to come in Part 4 on what the final decision was...


****

You are reading Part 3 of "What Drew Me To Home Birth And What Turned Me Away." Click to view:

Part 1

Part 2

Part 3 (currently reading)

Part 4




24 comments:

  1. What a powerful narrative! Thank you for putting your story out there!

    ReplyDelete
  2. Thanks for telling your story! I wonder if you've had a chance to read this examination of the Wax Home Birth Meta-Analysis: http://www.scienceandsensibility.org/?p=5628 I have grappled with a lot of the same things you are/have (both mine were born in the hospital), and the analysis from an outsider's perspective helped me come to terms with some of the concern I had.

    ReplyDelete
    Replies
    1. Hi Jenny,

      Thanks for your comment! Yes, I read that right after it was published. Can I ask what concerns you had that it cleared up?

      I was aware of the flaws in the Wax study before reading that review. There are more studies now, too, that have come out. Have you read the two studies about home birth that came out in 2013? Here are the 4 peer reviewed studies that look at home birth in the US: http://whatifsandfears.blogspot.com/2014/01/home-birth-safety.html?m=0

      I have more to share in things that swayed me that I will share in my next post. Thanks for reading!

      Delete
    2. Thank you! I will read your post. The main concerns for me that were cleared (after reading the Science & Sensibility post) was that it confirmed my suspicion that the Wax study may have had some issues. The review reveals that current homebirth and hospital practices may not be reflected since half the studies are more than 20 years old. Regardless of when they were conducted though, my own health and my own specific choices within the birth setting always matter. The training of the homebirth midwife chosen is significant; this led me down the path of deciding that if we ever did/do have a third child I would choose a homebirth attended by a CNM. The absolute risk of home birth is still quite low and that is meaningful to me. Your thoughts?

      Delete
    3. Also I would add that while I have very little firsthand knowledge of homeopathy, I do believe that in addition to the mainline drugs midwives carry, it can also be a powerful life-saving tool, so the CNM I choose would also need knowledge of how and when to use it safely and effectively. Reading Heart & Hands by Elizabeth Davis also helped me to come to a much better understanding of what a good homebirth midwife provides.

      Delete
    4. I think a CNM is a great route to go. I wrote a post about some guidelines for a safe home birth. http://whatifsandfears.blogspot.com/2014/01/home-birth-guidelines-for-safety.html

      I like homeopathy! But I wouldn't bank on it alone. I think Western Medicine has it's time and place.

      As far as absolute risk.... ya know, it all came down to asking myself a few specific questions.... because now that I've met a few women who were in that very small percent of experiencing a life-threatening complication, and I was having a hard time getting my head around the idea that it *couldn't* be me in that very small percent. I wrote out the questions in Part 4 of this, the questions that really got me to think and find some answers for myself. I looked at different complications... risks being at home, risks being at hospital... specific risks... etc.... does this make sense? Or am I just rambling? :)

      Delete
  3. I am enjoying reading your posts. You do a good job of explaining your thought processes and overall changes in perspective. Good job!

    ReplyDelete
  4. I thought about your post a lot today - I have been in the same place in my thinking and exploring in the past. I also acknowledge the narrow thinking that occurs in members of both positions - seeing only their side. Peggy O'Mara wrote a very powerful essay in which she said, "Birth is as safe as life gets. Actually, life is as safe as life gets." Safety is relative and no place for birth is without risk. Birth is risky and each place, home, hospital or birth center, is a better situation for some risks and worse for others. Each careprovider has their own set of skills and solutions for problems. What became obvious to me is that I needed to practice in places and with people who understood the nature of birth as risky but still had faith in that process. The place of birth became much less important than helping parents to match their paradigm to a caregiver and place that was the closest to their own. One of the reasons I have been satisfied as a doula (and trainer of doulas) is that I do not want the power or influence of making that decision for others as a caregiver does. Since you are deciding between midwifery paths, it is good for you to be in this crossroads. "How much do you trust birth, really? How much risk is acceptable to you? What solutions are acceptable? Who do you want as your clients? As your colleagues?" In other words, you are figuring out your paradigm as a professional. This may be different than your paradigm as a parent. Mostly I just wanted to say that I've been in your birkenstocks (or crocs) and while it may be uncomfortable, it is a place I wish more people visited before making these critical decisions.

    ReplyDelete
    Replies
    1. Thanks for your comment, Amy. Yes, I definitely feel more comfortable in a hospital setting, which is why I know longer support parents as a doula for out of hospital birth. I feel it has too much potential to put both parties (myself and the mother/couple) in an awkward/strained position. A couple should have a doula who feels comfortable in the setting where they choose to give birth. I will see as time goes by in my midwifery training (which won't happen for a while) if anything changes but I know I definitely want to go the CNM route. I agree that each setting has it's own set of risks. I felt in the questions I asked myself (in Part 4) and my search for the answers - seeking unbiased information - that I felt most comfortable with the potential risks in the hospital.

      Thanks again for commenting and sharing your thoughts!

      Delete
  5. Thanks for sharing your story. I've been around and around this issue - I was at the MANA conference when Betty-Ann and Ken announced their findings... and I was unimpressed then. (This was before the study was even published!)

    I also find it funny how popular censorship is in the midwifery community. The very first comment I ever made on the MANA facebook page (which was very mildly critical, and polite) was handily deleted.

    I was stunned, I've been a MANA member for over 10 years. This is how they treat members? This is how the 'inclusive midwifery membership' organization treats its members? Seriously?

    Any inkling of dissent, and you're banned. Your comment is deleted and you're accused of being a bully.

    I just want to let you know that there *are* midwives in the community who are critical of what is happening in home birth. My issue with Dr Amy is that she paints every midwife with the same brush. It is an unfair characterization - just as painting every OB/GYN with the same brush is.

    Maybe the reason you don't hear the voices of midwives questioning American midwifery is because midwives are so hell-bent on keeping others quiet.

    Thanks for your voice. Thanks for sharing your story.

    Yes. There ARE situations that can occur in OOH that would be better handled in a hospital. I think that is a truth. Any homebirth advocate or midwife who says otherwise is being deceptive. That is a fact, and risk, that all people choosing home birth should understand.

    I still support homebirth. But would like to see the safest practices employed. And that ain't happenin' now. Midwifery needs a wake up call.

    ReplyDelete
  6. I am loving your posts. I started having all these questions and had the EXACT same thoughts about Dr. Amy, after my son was born during a traumatic homebirth. He almost died because of a severe shoulder dystocia, but instead has a severe obstetrical brachial plexus injury. I was injured as well... It all didn't add up. I did everything "perfectly"... Sigh. My foundation was shook. A year or so later, Dr. Amy posted about a woman I know who had a homebirth with the same midwife... her birth ended worse than mine. I was so mad at Dr. Amy... but I kept going back to her site... and back... and back. So many questions, so many "can't believe this"!. It took years for me to come to terms with the risks I took, with the guilt over my choices that led to my son having a disability, and I still wrestle with the feelings toward my midwife who had no judgement and missed so many red flags during labor. Anyway, I went on to have 3 c-sections and 3 healthy children! YAY! I hate that we all got so lied to. Never can I support homebirth again.

    ReplyDelete
  7. Well I have had 4 births, 3 at home and I would never have a child at a hospital again. The nurses had no care for privacy or listening to the patience wishes we are just another number to them. I was pretty much harassed to do as they wanted (might I say my first was actually my easiest birth uncomplicated-as they all were) but the staff kept insisting on this intervention or that. I am glad that I was not a push over and did not let them bully me, one nurse did insist on feeding my child a bottle-I was breast feeding-well I could go on, but will just say I had grouchy nurses and not a good hospital experience.

    To hear people say I was injured by a home birth, hmm well it happens in a hospital births too; as a matter of fact my friend’s child was severely injured by a doctor in a hospital. She like many women pelvis was too narrow to accommodate a child. Home birth for low risk pregnancy is a viable option for both mother and baby. All the interventions at a hospital birth are usually unnecessary and lead to many complications, and a greater need for interventions, such as a C-section. My Midwife brought all the needed "emergency" equipment she may need such as oxygen and meds to stop hemorrhaging if needed. She studied at a college where she earned her certificate as a CPM, a nutritionists, and new born care; just to mention a few. It was mentioned that deaths and injuries where hidden for home births, well I really don't see them advertised at hospitals either, also many doctors do harm to patience’s and are still allowed to practice medicine. So, you should advocate for accountability across the board, not just for home birth midwifes. Birth is a natural physiological process not a medical process, it has happened for years without medical intervention and will continue to do so. Yes, there can be complication at both ends, but for the most part it is safe.

    I do know that if I would have had my sons at the hospital our outcome would have been different, I am sure they would have forced me to forgo many interventions that would have more than likely lead to C-section and a devastated mother. Instead, I gave birth to four (considered) big babies and I did it with no interventions, nor did I need even a single stitch; all attended by midwifes. I would not change having my sons at home for anything. There will be back lash and misguided information from both parties, but it must ultimately be the mother’s choice of where she gives birth.

    ReplyDelete
    Replies
    1. I'm sorry for your bad experience in a hospital. I truly believe having a good birth team can go a long way. I discuss this in the 4th part of my series here: http://whatifsandfears.blogspot.com/2014/01/what-drew-me-to-home-birth-and-what_27.html

      "Home birth for low risk pregnancy is a viable option for both mother and baby."
      And that's not true, generally speaking for home birth in the USA. Even for low risk women it is a substantial increase of risk. Now, the chances of a low risk woman having a safe home birth are in a woman's favor. But that doesn't mean it isn't a gamble. Especially if your midwife doesn't know how to handle emergency situations. Have you ever heard of We Are Abel? Abel was injured at birth. He was born not breathing and his midwives didn't know what to do or how to handle the situation. He went too long without oxygen and has cerebral palsy because of it. And the midwives didn't have insurance. So Abel's parents have all kinds of expenses to care for their son and no help to pay for them.

      "All the interventions at a hospital birth are usually unnecessary "
      What proof do you have to back up this statement?

      The CPM credential is not nearly rigorous enough. Even going through an MEAC school (which is not the same as a typical college or university), it is not the same. A CPM would not be allowed to practice in any other first world country.

      "It was mentioned that deaths and injuries where hidden for home births, well I really don't see them advertised at hospitals either, also many doctors do harm to patience’s and are still allowed to practice medicine."
      Again where is your proof to back up that statement? It seems you have lots of ideas here but they are built on all the same nonsense and misinformation I once believed. You can look up mortality rates in the CDC for hospitals. And now that they have separated place of birth and care provider, we know outcomes for midwife-attended out-of-hospital births as well.... and the outcomes for out-of-hosital births with non-nurse midwives are the worst! BY FAR.

      "Birth is a natural physiological process not a medical process, it has happened for years without medical intervention and will continue to do so"
      Do you know what mortality rates used to be, before we had all of the medical advancements we now have?

      "I do know that if I would have had my sons at the hospital our outcome would have been different, I am sure they would have forced me to forgo many interventions that would have more than likely lead to C-section and a devastated mother. "
      You don't know that. That would be like me saying "if I would have chosen a CPM for a home birth, I'm sure my baby would be injured or dead."

      Delete
  8. I'd love to know though, the quality of life left to hospital born babies. How many really do die, just not right upon birth? I saw a little guy in the hospital, oh yes he didn't die during birth but he was hardly alive, all drugged up like he was, you can't blame the doctor for causing his death, but I wonder if he is alive today and if he is, is he normal?How many have written in their death certificates that they died from this or that failure after several days of living when this or that failure that was caused actually by the hospital interventions? If I didn't fight for my baby born in thehospital, my baby might have been a personal example. I had her in the hospital after 3 very beautiful home births. I think the whole medical system in the US is messed up. Homebirth type midwives should be able work freely in complete harmony with doctors. Having a sister give birth in a foreign country made me realize how messed up we are. There they have bedroom like suits, homebirth atmosphere, not too much intervention but all necessary equipment for any emergancy and great care the support so needed during a birth but everything right there, including the doctors with the ability to give emergancy C section if needed. In my mind, this is perfect. Why the fight between home birth and hospital birth when you can have that? I think we want to go there in the US that's why so many try home birthing but unless something like this has recently popped up somewhere in the US we have a long way to go. And youtalk about a home birth baby dying and home birth advocates say the baby would have died in the hospital, I know such a baby. Not because I helped deliver him (i am no midwife, no staunch homebirth activist) but am very close friends with the baby's mother. I know the whole history, and the baby pprobably would have died in the hospital. Most babies born with what he had do die Even in hospitals. They may live a few days longer than he did but most die within 2 weeks. The rest are left a vegetable for life. Its just that the coronor won't blame the doctor for that type death. Besides doctors make you sign all kinds of papers that make everything appear to be no one's fault. Like I said, I am not against hospital birthing, I had my 4th child in a hospital because it was the right place to be for that birth, having all emergency things right there, however, I am not impressed with the system. Not at all.

    ReplyDelete
    Replies
    1. "And youtalk about a home birth baby dying and home birth advocates say the baby would have died in the hospital,"

      Who are you referring to? Gavin Michael? Because I know the mother as well. And I know the official cause of death. Do you?

      Many hospitals in the USA are coming around with L&D, making the rooms more like delivery suites. I have seen many, and they are lovely. Not all hospitals have caught up, but there is a demand so hopefully in time, more and more will be better.

      If a baby doesn't die right upon birth but hangs on for a few days or weeks, would still be included in perinatal mortality rate. It includes deaths within the first 28 days after birth.

      Delete
    2. No, I don't know Gavin Michael or his story. Is there only one baby like that born in the US so that you would assume that I know someone you know? Interesting. No, it's not a baby you would most likely have heard about. And even if it is, the couple wishes that their names NOT be put online unless they choose. Sometimes the official cause is not always the true conclusive cause. Since sometimes those making that official cause are a little mystified as well not having watched mom and baby from the beginning. (she was out of country for part of the pregnancy and I sincerely think those doctors who cared for her there are to be blamed more than the midwife but since you and I and the doctor and the midwife and the mom and the dad can't prove that, we should just blame the midwife I guess ~ it was all her fault right? ~ smells like someone just has a problem with midwives)

      Honestly tell me, do you know any hospitals where they allow parents to actually give parents some choice in their child's care after birth? I think there might be some, I am looking. Do you know of hospitals who care and watch over the mother and baby to the degree that both have nothing missed? Yet they don't have to poke and prod every three hours.... Is there any hospital who really knows your history and your parents' history in a personal way so that they can help make informed decisions based on your life and your family history? I was a treated dumb, like I didn't know what I was talking about. I was not believed at the hospital. I was right and I suppose if I go there again they will believe me better next time. The nurse deliberately lied so that nothing would be put in the paperwork (because I assumed it could have gotten her in trouble). That part of the story didn't have a sad ending. But having things done without consent to your child even though you ask to be informed for EVERYTHING and it wasn't like I was out of it and wasn't able to communicate. I am not so worried about hospital birthing hurting me. I will do anything for my baby, but I don't want to see my child suffer for life when I could have protected them!!!! But you are not allowed in most hospitals! I was in the hospital because I knew they had everything in case of emergency there but you basically have no control, do not own your child until you are released. You have to beg for your baby's right to a good life. You have deal with nurses who don't care about your baby (I can put with with all kinds of things I am grown up! But rough nurses handling my baby is too much!). Don't tell me it doesn't happen. Because I lived it. There are good nurses and under those hands my baby thrived. And from my comparing notes and asking questions and observing, I see that I had it good. So much better than most of my friends that I would chose that hospital again if needed, but I dread having the watch like a hawk to be sure no one does things unnecessary... to protect my child with my life.

      What do you do about another friends twins whose doctor caused a special surgery, possibly needed possibly not, its not clear to me, and sent her home in 12 hours. Shouldn't he have known the surgery would or could cause labor to start in the short term after? Why did he send them home? She went back in but lost both babies. Ok. Perhaps that is normal. But I am not so sure. Of course they can't sue him because they signed all sorts of consent forms to let him do it (and they probably included the possible death). Something doesn't smell right to me. I think they were misused, misinformed and used for their inexperience and total trust in doctors and used as a science experiment. My interaction with doctors has showed me that they can't really pay attention to you as a patient and only some really care about you. It could also be the system, so computerized that doctors can't be what they should. I don't know.

      What do you think?

      Delete
    3. Oh, and in case you think I have a thing against doctors. I don't. I have an Uncle who was a doctor (retired now) several nurse aunts, and some cousins who are nurses, and we have a good family friend whom I would trust with my life. Unfortunately he is not a doctor who does birthing though and he lives too far from me.

      I am not wishing to sound mean, I am stating what I have seen, and am willing and would be more than happy to see family friendliness in the a hospital setting.

      Delete
    4. Just responding to this particular comment right now, the rest I will get to this evening after my kids are in bed.

      You said "Is there only one baby like that born in the US so that you would assume that I know someone you know? Interesting."

      No. The way you worded your first comment, I thought you were discussing a specific example that I previously wrote about on my blog (Gavin Michael).

      I unfortunately know way, way too many babies that died at home births who likely would have lived had they given birth in a hospital. Not that anecdotes prove anything, which is why we rely on stats. And home birth mortality rates in the USA are consistently much higher than hospital births.

      Will reply more this evening.

      Delete
    5. I'm not at ALL against midwives. I LOVE the midwifery model of care and would love nothing more than for more women to have access to CNMs and CMs.... that is my DREAM!

      "I saw a little guy in the hospital, oh yes he didn't die during birth but he was hardly alive, all drugged up like he was, you can't blame the doctor for causing his death, but I wonder if he is alive today and if he is, is he normal?"

      Do you know the child? Was the baby born at term? Was the mother healthy and low risk? Was the baby healthy?

      I'm not here to protect hospitals at all costs. My blog is not about "hospitals are perfect, home birth is horrible." That's not what I believe and that is not my message. My blog is about issues in the home birth system. Why is it so easy to dismiss the issues - dismiss babies dying preventable deaths - by trying to justify it, like "OK well yeah home births might not be safe, but hospitals suck, too!" What does that prove?

      All it shows is that people are willing to accept our subpar home birth midwifery system... they'd rather make excuses than DO SOMETHING to make home birth better. Why?

      When a system - be it a hospital system or home birth system - refuses to look where it is falling short and refuses to make improvements, then no one wins. Hospitals have clearly come a long way since the 60s... and no, they are not perfect, but they are certainly making improvements for care and for experience. Time and time again, ACOG releases new and revised practice bulletins like VBACs and reducing the primary cesarean section rate.... recognizing that changes need to be implemented. What about NARM? What about MANA?? The 2005 CPM mortality rates for home birth were the exact same horrible mortality rates as the 2014 MANA mortality rates for home birth..... nothing has changed! No practice guidelines, no acknowledgement that our system is not doing a good enough job, nothing. That's not OK.

      Delete
  9. Oh and what about my friend who had to have a c-section and who laid out on the table getting ready for the surgery had so many students and doctors in the room laughing and making jokes about her "nekkid" body. That's not forgivable even if the baby is alive and well today! And that was a specialist hospital! One very well respected!

    ReplyDelete
    Replies
    1. I would never make excuses for that!! That's horrible and I sincerely hope your friend filed an official complaint with that hospital. Just b/c I recognize very real issues in our home birth system in our country, do you think I think all hospitals are perfect and infallible?

      Delete
    2. No, not at all. And I like to hear you say it. Thank you. I also don't like the home-birth system in its entirety either as I said in my first comment. Of course, there are good midwives (I think, I only know one personally), and nerve wracking midwives and midwives I would never trust. But after all I am thinker and don't just do because its the latest craze.
      Thank you for your kind and thoughtful replies. I am not trying to be aggravating but would like to "talk some of these things out".

      Delete
  10. Thank you for sharing your thoughts. One thing I can't get out of my mind though the question of why the midwife at the birth you witnessed did not do the episiotomy when the baby's heart rate dropped so low. A midwife is trained in how to do that, certainly. I'm not a professional, but to read it, it seemed as though that would have been the immediate course of action to take in order to help the baby.

    ReplyDelete
    Replies
    1. At that time the mother wasn't yet fully dilated, she wasn't in second stage of labor yet... so an episiotomy wouldn't be done at that time during labor. After the transfer, the mother was fully dilated and an episiotomy was performed and a vacuum used as well. Had the vacuum not worked, she would have had a cesarean section.

      Delete

Related Posts Plugin for WordPress, Blogger...