Homebirth General Discussion #3

[Tegam]

Tegam- I had to say too, when I first glanced at your letter I thought it was going to be a really bad rant because I thought you were calling your MW a swear word

Ooops sorry for the boring letter after that! What a let down!

[meow]

Tegam- No, quite the opposite! It was interesting to hear what you have been through and where you are at... I really hope your MW can help you resolve it

Water_lily- congratulations on your pregnancy and choosing a HB!!!

I booked into my local birth centre at the beginning of the pregnancy so I could avoid seeing a doctor to order blood tests and so I could get the morphology scan for free. Independent midwives don't have prescribing rights for these things but do check with your midwife if she is working through a hospital/collaborative program.

I ended up going to the GP for referals for:
- initial blood tests (rubella, HIV, iron etc etc)
- 12 week ultrasound & blood test
- iron test around 26 weeks?
- repeat iron test at 35 weeks (to check supplements are working as I was anemic)

A GP can do your 19 week ultrasound referral too, but as I said I had that done through the birth centre then I dropped out of the public system and had my notes sent to my midwife. Hope that helps

[Tegam]

Hi Tegam. I just got home now.

Wow this is a really difficult thing to answer. Especially as so much has changed now. Our reporting requirements are so structured and formal now. The scrutiny is incredible. The costs of actually continuing in this line of work has prevented many homebirth midwives from even being able to afford to continue to practice. It is very hard to imagine, but the arse-covering stage has really hit us badly now. Which is why I find your position such a difficult one for everyone involved, especially of course for you and your family.

Attending the past 47 homebirths has taught me to expect the unexpected with birth. You just never know. And yes, even though you have had 3 quick births, that doesn't mean that you can fully predict this one too. You can guess that this one will be around 37 or 38 weeks and fast. But that is not a certainty. eg. I just had a lady having her 4th vaginal birth who was in labour for 24 hours - something neither of us expected.

The big learning curve in my mind is my September baby who became stuck after the head was born. This was this lady's 5th vaginal birth at home. Labour went well, birthed the head without a problem, but then the rest of the baby didn't come. Finally, as a last resort to get the baby out I actually had to put my hands inside this lady and locate and pull out an arm to try to free the shoulders - baby was born a good 5-7 mins after the head and was then in a good condition, but mum bled of course and went into shock. By the time we got her to theatre, she had lost 4 1/2 litres of blood and was blue. She required 6 bags blood, 3 bags platelets. And 5 weeks later she is still recovering.

There are other stories I could scare you with, but I wont. My aim is to let you know that you cannot expect that everything will go well. It probably will go well. Birth is normal and natural and certainly should not be subject to the amount of medical intervention that happens here, but I am always ready to put my training into action. This is why I take all that equipment to the birth. This is why only the midwives with advanced practice are now able to apply for a medicare provider number. And to be exempt from needing insurance for homebirth for the next two years, we are mandated to report our outcomes to the government. I have insurance for antenatal and postnatal care, but none for the birth - this is where I have to meet the exemption criteria.

So, hopefully by now, you can see that I cannot support you to freebirth. As much as I believe in women's choice, I need to protect my family too and keep my licence. And at the same time, I have seen births that dont go to plan. In that case if you are freebirthing you will be on your own in the event of an emergency.

So to help you....what will you do - if freebirthing, and your labour goes on for several hours or more? Will you then go to hospital?

Unfortunately, me preparing to sign the birth paperwork means that I acknowledge that I am responsible for your birth outcomes. I am mandated to report statistics on your birth to the government. For the next 21 years that I have to keep these records, my name is the one the government holds responsible. Even though I was never intending to attend the birth? Again, things are serious now. I need to keep my licence.

As for antenatal visits - yes, that's fine. I have insurance for that. I'd be happy to help.

As for just postnatal visits - yes, that is possible from Day 1 after the birth if you would like. The difficulty there is that you would just have to call me to see if I am available to visit at short notice - since I would not be "on-call" as such and wouldn't be planning, organising etc the same way I do when I am actually "on-call" for a birth. eg. around the time of birth I dont plan any social life, my husband and I take two cars everywhere we go, I dont drink any alcohol, I plan emergency care for the kids, my husband doesn't start any new projects at work because if I am on-call, he is also on-call for the children etc. Our whole family is on "alert" when I have a birth due so that I can drop everything at a moments notice.

I didn't mean for this to be all about "me". All I wanted was to explain my position so that you can think this through a little more.

I really don't know what is the best option for you. But I do think if cost is the biggest problem, perhaps going public through a midwifery group practice at Redlands might help? That way you have a named midwife who you can call at any time, may even visit you at home before and after. And plan on going to hospital for the birth at the first sign. If you do labour fast, you would only have to transfer in for a few hours and then come home again. And yes, I would call an ambulance for the birth.

I know this probably isn't the answer you were looking for.

Hope you work things out


********* x

[Tegam]

Ladies please give me your honest opinion!


I am so disappointed... No in the fact that she wont support me, as i said in my letter, i understand as a professional she couldnt support freebirthing but really i feel like ive been talked to by an OB the scare tactics came as a huge shock!

"There are other stories I could scare you with, but I wont. My aim is to let you know that you cannot expect that everything will go well."


Gee then why do any of us homebirth. Im not wanting an UNASSISTED birth im just NOT wanting INTERVENTION at 36weeks by the hospital and if i dont go that option then really what else do i expect.

TWO labour out of my THREE have been 12 or 10mins from NOTHING to baby and placenta in my arms. IN REALITY an ambulance will not even make it to my house in that time!!

Oh i dont know but this coming at the end of an already long and stressful day really through me.

So with that in mind id like to hear your opinions seeing you can be none emotional about it.

I have not replied yet. I was trying to let it sink in and try seeing it in another light. But re reading it this morning to de identify her i am just as shocked at the way she went about this...

Not sure i even have the self belief to birth now other than in hospital

[Arimeh]

Oh Tegam I'm so sorry that you didn't get the response you wanted from her. It is incredibly hard for midwives now to just do their job without worrying about losing everything - puts everyone in a terrible position.

I don't have any suggestions - just wanted to give you a