Homebirth General Discussion #3

Well i sent a rambling email to the lovely MW that was my homebirth MW with Tom but rememeber she missed the birth cause it was so quick... Please remember i wrote this in the middle of the night and hit send without re reading incase i then didnt send it!


Dear ^&%&%$%#$,

Wow where has the time gone???

How are you? How was your trip to &*^^$% ? Amazing?? I bet.

Well i think the below is going to be a bit of a dribble so please hold in there :)

Well i am 28weeks today Holy cow, best start trying to get my head around the idea that this is really going to happen ;)

I have been on a bit of a rollercoaster as to what to do with the delivery of this little one.

As you know there was a lot of stress around DS birth with DH being away and missing DD2 birth. I am not proud of the way i handled myself or the situation. Maybe i am remembering it a little worse than it was but mum assures me that no, it wasnt very nice....

Not sure i mentioned it to you but i went and saw the OB that did the Op for the ectopic at the start of this pregnancy. His advice was to be induced at 36 yes 36 weeks and have steriods OMG no thank you. So dumped him rather quickly. The found out that the OB that was so supportive at the redlands public hospital had gone private so i thought it might be a good idea to see her. Well you guessed it not so supportive now she gets paid the big bucks. 36weeks inducement or a hospital stay until baby is born! Hello i have 3 other kids that i never leave and you want me to teach them that a mummy needs to stay away for 2 or more weeks waiting in hospital for a baby! Thank you but no i wont be seeing you again either...

Pubic hospital. Explained my delema over fast & early labours. Dr seems nice and just said dont plan on being at home (risk to me and baby blaa blaa blaa) but to just call and ambulance...... Then i get to my next MW appointment at the hospital and she is reading to me that the Dr has written "for induction at 36weeks"!!

So where does that leave me! Well homebirth of course but the only thing that is stopping me is the cost. Since we have moved we have a much bigger morgage and the money is just not there... And I also have the huge thought that if we have paid you, DH and i to a certain extent will be putting me under pressure to call in time to have you here.... I totally understand why you get paid your full amount even if you miss the birth, i am not asking you to do anything special for us. But just trying to limit that same negitive pressure that were on me when i had Thomas.

So where does that leave me... Well to some extent at ease with the fact that this baby has a right to choose where and when it comes, which yes probably means a free birth. Either are home or BILO hehe. Free birth - NOT something i thought i would ever concider or do.

But I also do NOT want to call an ambulance. I feel that i have more experience and infact probably DH does than they would. I do not need some actioned ready stranger at my birth or rushing me after.

SO (i did warn you that this would be a boring dribble) what i am asking you is would you? do you? do just post natal care? or pre and post but not birth? would this/could this include the birth cert paperwork? I really really dont want my girl to think mummy has to take baby to hospital after. I just want to lie in bed with my family and enjoy our new baby.

Can you please (and i know its a lot to ask you out of your time) take the time to tell me your optinions on what i have written.

I know as a professional you can not support a freebirth. I agree with you but in reality after 2 very quick births this baby really is going to come when its ready and on its own time. That is something i can not control and feel better admiting to myself than trying to control it with medical intervention.

Thank you %^$$#$, you really are a lovely person and i respect you,so i look forward to hearing from you, i hope,

Cheers Tegam.


Well what do you think??

well done Tegam :hug: i think that it was written from the heart and is a first step in getting what is best for you and baby xx (also, mebbe it is worth PMing Tanya on here for practicalities etc things to consider if you do indeed end up birthing without a midwife being able to make it...you've read her latest birth story no doubt!).

I think it's great Tegam. I don't think she would be able to give you too much advice in writing but perhaps your midwife might be happy for you to pay her for an appointment to chat it out. A pre-brief for this birth. I hope she supports an ante & post-natal package for you... sounds like a good idea. I've heard of freebirthers having an appointment with a MW to gain some emergency childbirth 'first aid' education too- maybe she might be willing to do that with you?

:

---

well done Tegam :hug: i think that it was written from the heart and is a first step in getting what is best for you and baby xx (also, mebbe it is worth PMing Tanya on here for practicalities etc things to consider if you do indeed end up birthing without a midwife being able to make it...you've read her latest birth story no doubt!).

---

Tanya?? Whats her user name?

:

---

I think it's great Tegam. I don't think she would be able to give you too much advice in writing but perhaps your midwife might be happy for you to pay her for an appointment to chat it out. A pre-brief for this birth. I hope she supports an ante & post-natal package for you... sounds like a good idea. I've heard of freebirthers having an appointment with a MW to gain some emergency childbirth 'first aid' education too- maybe she might be willing to do that with you?

---

Yes we did all the emergency stuff with her last time. I am also NICU trained so a off baby doesnt worry me.

Thank you for your advice ladies. I have been meaning to email her for weeks but couldnt come up with the right words.

Tegam: her user name is Tanya

:

---

Tegam: her user name is Tanya

---

Wow thats a hard one, hehe

Ill go and take a look, i know i read a beautiful freebirth one not long ago! In a bath with DH and the kids!

here it is just in case you had trouble finding it

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 :rofl:

I think your letter is great - I hope the midwife is able to help you out.
I was thinking the same thing as Meow about the expletives :D

Hello everyone! Thought I'd pop my head in & say hello....planning a home waterbirth for #4...my first outside of the hospy. Can't wait till past 12 weeks so I can really start making some concrete plans....a few questions though if you guys don't mind?

Do you guys still meet with a gp when having a hb throughout your pg? I can't see the point in forking over $80 to my GP so he can tell me "yes, you are pregnant. Don't smoke. Don't drink blah blah...yessss Iknow all that!"

What about the blood tests you normally get (I don't do the NT testing, but the iron levels etc?)

The 19 week scans?

I am really keen on a little-intervention-as-possible birth & pregnancy letting nature do it's thing, I know my body deals with things when they go wrong in its own way, I'm lucky I've met a great HB middie down here & excited about birthing my bub in a pool in the lounge room, in front of the fire (yay winter bub!) with my music going as loud as I want, without being told to turn it down, & without hearing labouring women around me, & without nosy nurses poking their heads in when I'm in all my glory....and especially looking forward to not having to share a toilet with people who leave blood everywhere....gross!

TIA xxx

Hi and congratulations on your pregnancy!
You don't need to see a GP for general check ups etc, your midwife can do all that. You might need them to order tests, however, depending on how your midwife is set up. Best talk to her about that.

:

---

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 :rofl:

---

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

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 :D

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

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 :D

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

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 :(

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 :hug:

:hug: I know it will take a bit to let it all sink in babe. My honest opinion, is that I agree with her. Mainly on the fact that, although your birth *probably* will be normal and just like your others, you can never know for certain, unfortunately :( I do think that she got a bit stuck on the buzzword, 'freebirth', but I think as an IM practicing in these times, it's hard to see someone mention it and not feel the need to comment on it the way she did. I thought your email was very reasonable, and I do think she got stuck on that (freebirth) and didn't address your email in it's entirety. I really hope you can find another option, maybe even another midwife? :hug:

i think that what her intention with the reply was to highlight that her role at a birth is important (not that you need to be told!) and goes beyond 'making it' to the birth...this was my impression (i agree that she was emotive, but i guess given the current environment: particularly in certain states of Aus, this is to be expected).

my impression is that she would recommend that you go the whole hog and book for a HB. which of course holds the very real possibility of her not making it in time for the baby coming out bit...BUT it does mean that even if she were to miss that bit that she would be there immediately after attending to you and bubs and going through placental checks etc and providing support (in whatever capacity...measuring, weighing, checking for tears, retention, or at the worst, helping with resus or helping with transfer).

in the antenatal period i guess you guys could come up with various action plans that suit you all (going through possible scenarios etc)...and this *could* be really helpful in allowing you to 'claim' or 'own' your birth no matter how it happens ITMS.

of course, this all comes at cost...for me, it would be worth it, because having her arrive in that immediate post birth moment would be really important, BUT that is my journey...