I have deliberately chosen to post in this thread because I generally think I know the views of many of the women who are regulars in here. And I am at work now so I haven't got time to go into great detail about my views but those of you who care too feel free to check and you will see I am VERY pro choice for women when it comes to birth (and think midwives rock )
My question - even for those of you who are birth activists and possibly even anti-OB or anti hospital - is if you could GUARANTEE that you would not be pushed into ANY unwarranted medical intervention (and I am talking even unwarranted internal exams, not just unwarranted inductions) would you have a problem with having a baby in a birth centre-type environment with an OB and hospital on standby? That is, are your concerns with having a baby in a hospital or near one (in an otherwise "home like" atmosphere) due to the fact that hospitals are, at the moment, not pro-natural birth at all? And if they were different, and OBs and surgery was ONLY used if REALLY needed, would you be ok with birthing there? Or is the desire for a homebirth, for arguments sake, driven by something other?
The reason I ask is that I personally had a fantastic experience at the Mercy FBC and would happily repeat it (I was supported, not hassled) but it is the looming threat that I am only a few doors from surgery and an OB that makes me think that I just might want a HB if I was pregnant again.
I would love to hear your thoughts on this........
If I have another one, my leaning towards a homebirth is half because of the intervention/constant monitoring (I'd be VBACing) and half because of the environment, I hated my hospital stay post-birth, and everything about it - the conflicting advice, the shocking food, the lonely days/nights if I had no visitors. So I'd much rather recoup at home, be comfortable in my surroundings, choose to sit in the lounge room, or in bed, or outside, choose when I eat etc.
So my wanting a homebirth is half because of the birth itself, but also half because of the time afterwards.
If a birth centre offered that exact same environment, I'd still want to stay home, because then the only difference is that I'd have to go to the birth centre while in labour, whereas a home birth I'd just stay home...
Hope thats the kind of answer you were looking for and I didn't go completely off topic!
I had two hospital births that were just fine, really. Of course, in my case, everything went quickly and smoothly - there was no need to ask for more time to labour or push or anything like that. And my doctor was a woman GP who was very calm and common-sense in her approach to labour and birth. I liked her a lot. The nurses in L+D encouraged me to stay active and keep moving around. I couldn't use the bath, but I was free to shower as long as I liked. Monitoring was done only occasionally, and I had a VE on admittance and when they broke my water (at my request). I was encouraged to breastfeed immediately, and DH, baby, and I were left alone in the delivery suite to nurse, and cuddle and bond. Epidurals are not available in my hospital, unless there is an emergency, and I did not require an episiotomy or induction.
So, all in all, a good birthing experience.
But, I prefer my home because I feel like the trip to the hospital is an unnecessary hassle. Why rush out the door in hard labour to go to the hospital when I could just stay home? I can walk around my own living room, or up my own street. Rest in my own bed, in my own PJ's or naked if I want. Use my own shower or bath, when and how long I want to. Call the midwife to come to me. And, the midwife would be the woman I have had nearly all my prenatal visits with - who knows me and who I am comfortable with. Or, if by some chance she is unavailable, be attended by my secondary midwife, whom I have had several visits with, and know as well. Not who ever happens to be on call at the hospital, which might change half-way though if it's shift change time. I want to give birth in the position I choose. Have a drug-free labour and birth. ('cause I know I'd take the drugs if they were there! I did that twice. And then discovered with my third - at home - that I could do without!) I want to snuggle up with my DH and my baby in my own bed after birth. Use my own bathroom, instead of a shared one 100 meters down the hall.
Hmmm.... there's probably more reasons, but that's what's coming to mind right now. You should give birth where you are most comfortable. For some people, that is the hospital or birth centre. For me, right now, it's my home. I don't need the hospital as long as everything is going well, so I don't want to go there if I don't have to. I have nothing against the hospital - it's just not a nice as my home.
Thanks girls, that's exactly the sort of answer I was after (in that you didn't go off topic, Leasha )
I guess where I am coming from is that IF hospitals were better places to birth, would we women with a birth activist leaning have a problem with birthing there per se.
Cricket you make a good point about why even leaving home to birth - I know with my first birth I was 8cm dialated when I got to hospital (my OB told me "not to wait so long next time" LOL!) and the day after my son's birth I actually said to my DH I didn't really feel like I "needed" to have gone to hospital, so I do know what you mean there.
Well, I can't answer for all "birth activists" but personally, I want women to be educated about birth choices. I want them to know that home is just as safe as hospital, and with much less risk of intervention. I want them to give birth in the place where they feel safest, and to know what is necessary and not necessary as part of labour and birth. (ie - induction because your OB is going on vacation is NOT necessary!)
If the research showed that the hospital was the best place, or that the birth centre was, or whatever, I'd be all for it, I think. But since research currently supports healthy women giving birth with minimal intervention, which is most likely to happen at home, I support and encourage home births.
Wow Rory - 8cm by the time you got to the hospital! That must have been quite the car ride! For me, it was more about the going home - I left the hospital about 7 hours after birth with DD2, and thought this is a pain in the butt! Had to pack everything all up again, get that poor tiny bean into a car seat, and drive home with her in the back where I couldn't see her, then take her back a day later for testing... With midwifery care here in Ontario, the midwife visits you at home as often as you need it for the first two weeks, and all your testing etc, is done at home too. Then at 4 or 6 weeks you go for your first office appointment. Much easier to manage!
This is a difficult question for me.
I completely agree with the hassle factor of having to go to the hospital. TBH, the trip to the hospital was the least enjoyable part of my labour with DD.
I had DD in a fabulous birth centre. I had NO vaginal exams (not a single one), had the same MW all through my prgnancy and labour (although I did get to meet my secondary MW once). Actually, I have the same MW with this prgnancy, too. I was not hassled, all my MW did was encourage me to do what I felt I needed to do and helped me get comfortable, fill the bath, etc. When the baby was crowning, she asked whether I wanted to catch or whether I wanted her to do it. I was calling the shots with everything. I left the hospital within 4 hours and spent the night in my own bed. The MW visited me every day for a week and then weekly for 5 more weeks.
By the way, it is a case-load model, so your chances of getting YOUR MW are pretty good. They do work in groups of 3, so you have a secondary and a tertiary MW and don't have to just birth with whoever is on shift.
It was so easy and straight forward that I did seriously think about having a home birth for any subsequent deliveries.
This is what made me decide on another birt centre birth:
I could have the same MW whom I love.
I don't have to pay for it (I know, this seems like a cop-out)
They have a beautiful birth pool and I have a bath tub that is only big enough for 3 year olds
I do have the backup if something does go wrong (but i also know that I can trust my MW and that she wouldn't push me into unnecessary intervention)
My family, although they would support me if I wanted a HB, are more at ease with a BC birth (I know, it is about me, but I also want the baby's father to feel comfortable in our birth choices.
If, for some reason, the BC was not available to me with my second baby, I am pretty sure I would choose a HB. It's just that I feel that in this BC, I don't really have many of the negative aspects of the birth, but it is a much easier choice than a HB.
Please don't slam me for my reasons. I've been trying to be very honest.
Sasa
xoxo
Last edited by sunshine_sieben; June 12th, 2009 at 12:50 PM.
It if were pro-natural, midwifery led model in a hospy, then I'd prefer it because you have the added bonus of knowing that the help is right there if you actually do need it.
And it would be nice if they offered up more comfortable beds in the PN wards. Your body is already going through re-adjusting to it just being yours again, those horrible beds do nothing for a new mums back... and don't even get me started on the food!!!
So basically I hate going there because I hate the pressure I feel like I am under the minute I walk in - and I hate staying there because the food is plastic and not even close to filling, and the beds are just not good for sleep.
I would dearly love a homebirth this time around. I had a pretty horrid birth experience the first time around as far as the m/w's were concernced- they were dismissive, unsupportive and would not let me up off the freaking bed o matter how much I begged them- but the hospital ob who came in when things went a bit haywire was fantastic. I'd like a hb to avoid the sterile, cold, brightly lit atmosphere of the hospital, to avoid the medical feel, to avoid he feeling of disconnection I got when my baby was scooped out of my arms into the arms of those who seemed to think they knew so much better than me.
Having said all of that, a hb is just not possible. I have a heart condition that could prove very dangerous if it were to act up during labour, both for me and my baby. I've discussed the possibility with my midwife and cardiologist, both of whom have talked me out of the idea. (I know there are some people who will think i could definately have a hb anyway, and maybe I could. But that is a risk I'm not prepared to take.)
However, I am in the situation you describe- I'm in the public system with a caseload midwife, so she does all of my care and will be attending the birth. She has promised to be an advocate for me, to help me avoid intervention, and to follow my wishes in terms of birth and post birth care. The caseload midwives have 'control' of one birthing suite in the hospital, which is kept dimly lit and warm and has a bath, shower, bean bags, etc. So I will have a calming birth centre environment, minimal intervention, immediate acces to emergency care if it's needed, and an early discharge if I want it. I am having my cake and eating it too.
Thank you so much for all your responses girls, and Sasa I don't want you or anyone to feel attacked (I think as women were are attacked enough we should at least be same in a forum like this!)
You are all echoing thoughts I have had myself, and bearing out an inkling I had that many women don't actually mind the idea of hospitals, but its the reality of them that has us worried (ie: your mw/doc/OB might mouth words of support for a natural birth but the reality of being in a hospital "system" is that it is pro-intervention).
A really minor example of this - with DS#1 he was born 27 hours after my waters first broke, so he was given a shot of penicillin to prevent infection because hospital policy required the nurse to do so if the baby was not born within 24 hours. There was no sign of any infection, and I know some hospitals have a similar 48 or 72 hour policy. I remember thinking that was so dumb!
I had an awesome hospital birth with DS and my Ob was fantastic, the midwives were great, and I had a wonderful doula as well I really can't fault my birth... and I wasn't even in a birth centre and it was a VBAC. It makes me sad that 99.9% of hospital births aren't like this, I know it can be and I know that Ob's don't need to be intervention crazy to do their job. I hope one day it can all go back to being a team that works together for the woman rather than what the situation currently is.
Here's a different perspective though... would I recommend my daughter have a hospital birth... probably not. In fact I would want for her (provided it was her wishes obviously) the most natural birth experience possible with little intervention. Purely because I got lucky doesn't mean she will (unless something changes) and thats what is so sad.
Roryrory, i did not feel attacked
And I completely agree that having arbitrary time limits seems totally stupid.
I guess every situation is different. I really did feel that my MW was my buffer between me and the hospital system. She didn't push anything on me. She always gave me a choice. Like for example when it came to the Hepatitis shot, which I declined. Or when it came to the Vit K, where I chose the oral dose. I later found out that she (and her BC collegues) regularly get into trouble over this as the hospital is not happy with their vacc rates. But they don't care as they do what they believe in. They just have to be careful with how they word things, so it isn't perceived as if they discourage women from those procedures.
And I do really know how low intervention her attitude is as she is pregnant herself now and is planning a home birth. So she isn't just paying lip service.
Actually, this is the biggest beef I have with some health care providers. That they mislead women by saying they are pro-natural birth or pro-BFing. But once they gain the woman's trust, they start undermining the natural process. if they were up-front from the start, a woman could make a choice based on whether her beliefs are matching the approach this health care provider has.
It is such a sad state of affairs that we have to have this deep-seated mistrust towards the very people who are meant to help us.
For the sake of being clear to all who read this (I think you know my story).
My DD14 (it's her birthday today!) was to be a homebirth - because I see birthing my babies as natural as doing a pee... A little harder work - but natural none the less. I am a nurse and had attended a number of homebirths and hospital births. It was a no brainer that my baby would be born into the water at home. Alas fate had other ideas! I transferred to hospital about 24 hours into the labour. My midwife was a beautiful woman very experienced at homebirth - but she was a born again Christian and her loud praying and "praise the Lord" exclaimations just about did me in... My beautiful girl was born vaginally but alas not naturally! I managed to keep at bay a very ferocious advocate for the unnaturalness of birth (his name is well known in Brisbane - he has about a 70% c/section rate...) Between pushes he "forced" me to sign a statement that I was birthing vaginally at my babies risk and peril... Now, I made an informed decision. My babies heartrate was normal, membranes were intact - I was absolutely exhausted but that was the only issue. I knew I wanted more babies and a c/section would only make vaginal births more difficult in the future. There was absolutely no way I was going to the OT.
I had a 2nd degree tear which I elected to not have sutured (again at my peril! )
Fast forward 6 years and I went to the birth centre at the RBWH. I had a beautiful midwife who supported my beliefs and advocated for me. It didn't even enter my mind that the surgeons knife was down the hall way. I knew my midwife and she knew me. She was my advocate and I trusted her implicitly. Importantly she trusted me and believed in me also.
My son was born into his Daddy's hands. My most vivid memory of that labour was my midwife cross stitching at a little table in the corner of the room - in between checks on me... It was beautiful.
My daughter was born much the same - but much faster and more furiously.
My next daughter was born at a private hospital - however I chose an obs who would agree to not enter my birthing space unless a doctor was required. He did so, and I had a midwife known to me (this hospital had a midwifery program that enabled this) support my labour. She was born into the water in a candlelit room surrounded by her siblings and my SIL...
Immy was an emergency c/s at 27+5 weeks...
So, would I have a home birth. You bet ya I would. Unfortunately I couldn't find a midwife to assist me in Brisbane at that time. However, knowing what I know now I had awesome births that really couldn't have been more empowering. The only down side was the drive to hospital that obviously wouldn't be needed if I had a homebirth.
The secret to empowered birth is education and support. Choose a birth place that will tick all your boxes. Care of another woman known by you and trusted by you is not just nice it is IMPERATIVE. Yep some women have great births without this - but when things stray by the wayside you need that woman. Be she a midwife or a Doula. Its not a negotiable.
You need to be educated and make it clear what your thoughts and decisions are. You need to ensure that your birth place have no restraints on movement, using water, managed 3rd stage, HEPB, candles, music, PV exams, what happens post dates, PROM etc etc.
There is no right place to give birth - however I'm a back to basics type of gal... Women have birthed their babies at home for ions - healthy women with uncomplicated pregnancies need not move from their loungerooms when labour begins. Provided they have in place good support.
If I were in your situation, with your history - I would be engaging an independent midwife, hiring a birth pool and trusting that your beautiful body will do it's job just fine. If something goes a little off track - you can transfer. That's not optimal but if it's necessary (and overwhelmingly things go fine!) then you will have a midwife with you to advocate for you and continue to support you...
i am reading this thread with so much anticipation! this has been my question for any future birth choices that i may have the privilege of making...
my optimal situation would be to go to the Mercy FBC. BUT i have immense fear in the strong possibility of transfer and to end up in a hospital environ if i had of been expecting a BC may catapult me straight back to PND land.
for that reason, if i suspected that there was too great a risk of not getting into the BC then i would most probably go HB. (unless of course there were actual risks to the baby or myself to birth vaginally etc).
hmm as you can see this has been a confusing decision. my DH is supportive of both BC and HB...so he's no help LOL!
either way i will have a ind. midwife or doula no matter what...
Yep, I would have no problems birthing where I did last time - Angliss FBC.
For my first I had a private hospital birth with a Ob (I have cardiac history too). It has a very high rate of c/sect. It was a terrific experience but I totally put that down to my midwife and the head midwife. There were 2 that sucked - one that kept asking if I wanted pain relief and one that jabbed me without warning or permission with the syntocin shortly after DD was born.
The 2 good ones - they both guided me gently and gave me quiet strength.
Third birth at FBC - freakin awesome. Waterbirth, midwife and doula. It was just the three of us, chatting softly peacefully. Everything I think a birth should have been, it was.
Again, the difference is the people who are caring (or whatever you want to call it) for you when you give birth. No matter where you are.
If you have an Ob breathing down your neck, your support people will buffer you from them. Get a Doula chickie
So after all that blather, I actually felt more comfortable at the FBC than I would at home. For lots of silly reasons, but I was grateful that I could feel comfortable there as well as at home and create the sort of peaceful and safe environment I need to give birth.
I wouldn't object to a birth centre and was looking forward to going to one with DS (didn't happen though due to stupid lying dates which weren't right). TBH, I'd give birth in a hospital if there were an option for giving birth in a hospital rather than being bullied and treated like a lump of meat and cut up without your knowledge or consent. I had a good midwife for one shift in the hospital and, despite the bully on the ward, would have been able to give birth if I'd have had that sort of treatment (ie head around the door every two hours to see if I were OK!).
In fact, if I were to have any medical input in #2 then I'd go to a birth centre no problem. But I'm not even telling my GP, nor any midwives, nor any hospital that I'm pg next time so can't really book into a birth centre. The reason for that is because of the trauma around the whole DS thing. I just don't trust anyone. I actually would trust my current GP but can't risk getting anyone involved - and I will have a different GP next time due to having moved a long way out the area.
No, Flowerchild, I don't have anything to report but a few other threads on these boards just got me thinking about whether it was inherently the hospital or the nature of what goes on there that was the evil we often seem keen to avoid.
Before having Phoebe I was of the opinion that it was just the hassle of being in hospital and the car ride that made me want a HB (which is why I didn't persue it further - DH was going to take a lot of convincing, and finances were tight etc. I chose hospital because my reasons for HB were not overwhelmingly important to me, not enough to cause tension between DH and I).
However, were I to give birth again (not planning on it, but lets just say the unexpected happened) I would insist on a HB because:
1. I had a similar experience to you - arrived in hospy and was in transition already. Why go through that painful car ride when you've done all the hard yards at home already?
2. The MW was lovely, but she hadn't seen my birth plan. As much as DH tried to communicate what was in it to her, I wish I had've had a MW who was aware of my wishes. I ended up birthing semi-reclined again. I wasn't in a position to argue with her when she told me to hop up on the bed so she could see where we were at. I stayed there waiting for her to examine me for what felt like ages. By the time she examined me Phoebe was on her way. I wish I hadn't have had to get up on that bed at all. I'm experiencing some physical problems that I'd lay money on being caused by pushing uphill.
Also, she let me try for a physiological 3rd stage, but she was really reluctant to. While that wasn't a problem really, it was just extra stress that I didn't need while in the throes of labour.
I don't feel violated by the care I received, I just know the care would've been tailored to my needs had I have had a HB, and not dictated by standard procedure. And if there's a next time, a HB's what I'll have.
I wouldn't go to hospital to birth even if they could guarantee me a natural experience for the same reason i don't go there for lunch even though they serve decent enough food. I have my own kitchen here, i don't need to go to hospital to eat, likewise i feel i have all i need to give birth at home and that for me hospital would be a hassle and a compromise, which unless i had to make it for medical reasons, i wouldn't be happy with.
I really don't see birth as an inherently medical situation, to me it is like eating, pooping, sex - yes, ok, on a grander scale, but not of a DIFFERENT nature. I wouldn't go to hospital for a really big meal/poo/orgasm. I'm not ill, why go to somewhere set up to deal with illness and pathology? Birth is just something i prefer to do at home, in close company, on my own terms.
I accept i might need to go to hospital, but i would never plan my birth around the possibility of something going wrong. That's like getting an annual script for anti-B's in case you have a cold every spring, or getting fitted for your casts every year in case you break a limb in the next 12 months. To me it makes no sense unless you have strong reasons to believe there will be a problem (i.e. a previous problem which wasn't caused by poor care and is likely to reccur).
So no, there's nothing about hospital that i find attracting barring medical emergency.
a question about choices
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With midwifery care here in Ontario, the midwife visits you at home as often as you need it for the first two weeks, and all your testing etc, is done at home too. Then at 4 or 6 weeks you go for your first office appointment. Much easier to manage!
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