The concept of 'choice'

[thepixie]

Agreed

[Arcadia]

I can answer for homebirth and say the hiring of an IM is a guarantee you will at least be accompanied throughout your labour (usually by two midwives and assuming you call them in time to come lol).

I am appalled that women in hospital do not necessarily have anyone there for them (and I know two women whose husbands almost missed the birth coz they were trying to find a dr or midwife). People have an idea that hospital is a place you will be looked after but I think I received much better care at home. I live in a big city though and felt safe knowing I could go to hospital if needed and my midwife would be there for me at all times.

The cost of a midwife is expensive to some, but we paid using the baby bonus. It was also less than many private obs who do not offer after care in the home (daily then weekly visits until 6 weeks) plus a midwife offers breastfeeding advice.

I kind of think the choice is actually stay home and take full responsibility for your own and babies health or go to hospital and hope your emotional wellbeing is catered for as well as the 'healthy mum, healthy baby' outcome is. At the moment we kind of think homebirth style of births (no intervention, drug free etc) can happen in hospitals or even birth centres, but that seems like it is unlikely. It sets up unrealistic expectations. It also does not take into account the reasons why some women need intervention. I really think the majority should birth at home, so hospitals can use resources helping those in need.

Birth is not an emergency every time. Why do we always asssume the worst?

[Lulu]

Agreed. We certainly do have choice and a HB ensures continuity of care - no luck, no chances. It will happen.

[thepixie]

I agree with much of what you say.... but just speaking for myself, I don't actually want to give birth at home. There are a variety of reasons for that, some important, some completely trivial. But for me the clincher is this - there is one thing that you will never have at home, and that is a neonatal ICU. And unfortunately when my daughter was born, that was what she needed. She just did not start breathing. Her heart rate was fine, but she had zero respiratory effort, apgars of 2 at 1 and 3 at 5. The obstetrician, in perhaps the only moment in which he earned his exorbitant fee, figured out something was wrong while she was being born, and there was a paediatric registrar in the room before her body was out.

They worked on her for 20 minutes before rushing her to neonatal high dependency. The thought of having to call an ambulance, wait for an ambulance, ride to hospital and be triaged while my baby's life hung in the balance - and while having a PPH myself - makes my blood run cold. And truth be told I believe that if I had given birth at home I would not have a 2 year old daughter now.

Apart from being post-dates, there was absolutely no warning or reason why she didn't start breathing. My pregnancy was completely uneventful, I had monitoring the previous day and through the entire labour and she was fine. Never even had significant decels. No one was ever able to offer any explanation for it at all.

FWIW my birth experience itself was OK, not amazing but OK.... in terms of the hospital system I guess you would say I was lucky. Yes I had ARM and synto augmentation and continuous monitoring (I was 11 days post-dates which rang alarm bells for ob - I recognise a midwife would be unlikely to see this as a problem), but I gave birth in six hours using only gas for pain without a tear, graze or stitch. By the following morning the only thing that hurt was my feet which were still massively swollen and suffered from schlepping 5 floors to see DD in SCN (where she was moved to after observation overnight).

Having said that I have friends - including my MIL - who have had wonderful homebirths, and wouldn't have it any other way. I absolutely support the choice to homebirth with midwifery support. Horses for courses. I just don't see why I should HAVE to give birth at home in order to access worthwhile maternity services.

[Fleur]

I just don't see why I should HAVE to give birth at home in order to access worthwhile maternity services.

I agree. Although I love the idea of a homebirth, I don't think I could do it ... I wish I could but I don't think I could. After having an emergency CS with DS2 it put the fear in me, not that I'm proud to admit it but there you go.
What I would have liked is the opportunity to have continuity of care, a waterbirth, a midwife who understands what I want in a hospital setting, or even a birth centre - and it wasn't an option for me with my VBAC.
Why can't we all have it, you know? It's ok, I know I'm preaching to the converted it just bugs me.

[Lulu]

I hear you, I do

[onthefly]

When it comes to maternity care I think our expectations are far too low, to be honest.
And absolutely every woman should get continuity of care - and the right kind of care and support for her - no matter where she births.

I think one fundamental problem with teh medical model of care is the presumption that it is the doctor/midwife's job to get the baby out. Lack of continuity of care is one symptom of this. We need to embrace the truth that this is mum's body and mum's baby and her responsbility to do the birthing. All care and support should be aimed at facilitating this process. Only in the most extreme medical emergencies should medical caregivers actually take over.

I wonder. When my OB threatens stillbith if we don't induce, is it really my free choice when I go along with it?
But again, it was my choice to see an OB in the first place. I said I wanted a natural birth, but the truth is I chose a medical one.