homebirth general discussion #9

[ummAadam]

Hi PZ

I was planning a homebirth for my first but ended up transfering. at the time I was pretty gutted and cried all the way to the hospital but I was also exhausted. then when I got home after giving birth my beautiful midwife said 'if we had just done such and such then you would have given birth at home.' she said it in a nice way, but it still opened my eyes because at the time I was a bit naive about birth and my body. I didnt trust enough or even understand enough. but im glad I still got a vaginal birth (with epidural) and my midwife was with me the entire time in hospital and was great in telling me that next time I can definately birth at home again. just because the first time it didnt work out doesnt mean it will be the same with subsequent births.

Ive had 2 successful home/water births since

[LionsandBears]

PZ, we transferred. I would have loved a homebirth. I feel like I've missed out on something wonderful. However, the birth with DS1 started at 35+3 and we didnt know his position. Transferring was the right thing to do in that case. We knew our IM'S 'rules' when we signed with her. We agreed with them which is why we were confortable with her. We knew she was more conservative than most IMs about transferring and we were fine with that. Like you, we ended up with an empowered vaginal birth. It wasnt a peaceful water birth in dim lighting, as I would have preferred, but that was the compromise we made to have a vaginal breech birth.

I feel really sad we'll never get our HB now. I hate feeling jealous of friends who have. I should probably stop stalking this thread however, I see HB as the gold standard of birth. There are reasons to transfer and following those still means a successful HB. There are reasons for a planned hospital birth. I see hospital as the place for high risk and we are now high risk. Which sucks but that's just life. Within that framework of a planned hospital birth, I feel it's important to emulate as much of what makes HB successful. To that end, I've identified the team that will help me with that, including our IM and an OB who has agreed to shared care. Whilst I'm unlikely to have a waterbirth, as MMC only has one tub (what is with that?), hopefully we can manage everything else to be as close to a gold standard as possible.

IMO, hospitals should be trying to reproduce the homebirth model of care as closely as possible.

[HotI]

for me, i would do anything to avoid transferring because i really do not trust hospitals or hospital staff. and so i selected a highly knowledgeable, experienced IM with a low transfer rate to try to facilitate birthing at home. when baby was not engaged and kept rotating from breech to transverse and down to cephalic position (therefore at greater risk of cord prolapse if i went into labour) the IM pulled out all her tricks and when we got baby into cephalic position again i bound my body up day & night and bounced my little touche for hours hoping he would stay that way.

during the birth, waiting for the placenta to come, i lay on my kitchen floor for hours with my IM next to me and i was so greatful to be doing that at home rather than sitting in a hospital bed.

we all make our decisions with the info that we have at the time, and influenced by our past experiences.

i don't think hospitals will ever get close to producing 'homebirths' no matter how many potplants or cushions they throw around.

[PumpkinZulu]

I did go into the homebirth program understanding it was still a hospital calling the shots, if that makes sense. But to me, I wanted to be one more good statistic that would help it move on from being a pilot program into something women could actively choose at any time over a hospital birth. Thankfully, because a safe transfer = success, it was noted down as a positive outcome for the program. Even so, the program isn't taking off because not enough women are choosing it.

In hindsight, I do think I should have hired an IM. I was a little too optimistic. But, and this may sound weird, I do feel empowered by the fact that I can own that transfer was probably not 100% necessary. I admit that freely, I would hate to be an apologist for my own transfer, espousing about how I 'had to' and all of that. I was scared at that point. And I think a part of me didn't want to fight so much anymore. I'd refused all routine testing up until that point. When we arrived at the hospital, and awful, totally cliched hospital midwife told me I had to stay on the bed strapped to monitors for the rest of my labour. I gave her one or two contractions so she could hear DD's heartbeat and in strapped myself and went into the bathroom. That was one of the most thrilling and terrifying and powerful moments of my life, telling her no, and realising I had taken absolute control over my outcome and from there onwards, it was on me. If I could have done that when faced with meconium...but, cant change the past. I would love to know so many things; why DD's placenta was so deteriorated, why she was so overlooked at 40+1, why there was mec. I know with my next birth I won't be so optimistic about contributing to the greater good (the HB program).

Thank you all so much for your thoughts here. I do draw inspiration from you all and I can't wait to be posting here again as a homebirthing mother.

[HotI]

We live and learn. i was way too optimistic that i could achieve a natural birth in hospital. should have taken a team of bodyguards with me.

[Bella29]

PZ, I had mec tinged waters with my dd and after I had been convinced to have every intervention known to man which ended in a c/s, they told me it was really normal to have mec with babies after 41 weeks because their bowels are developed. It is only a concern if it is a sign of fetal distress. Which it doesn't sound like ur dd was in distress. Midwifethinking , has written an interesting peice on mec stained babies. I am lucky this last time that dd2's water didn't beak till her head was out.

[PumpkinZulu]

Thanks Bella. I feel...lucky isn't the word, not is grateful, but it's somewhere between those two...that aside from a little gas upon arrival (while I was strapped down on the damn bed!) I had zero interventions. Oh, I requested an internal. Aside from that, once the HB midwife arrived, it was great. Doppler on the belly for a minute every 40 mins or so and that was it. I chose to set up the bathroom with the lights off and birthed DD on my hands and knees in there, with DH and my middie in the room with me. It was peaceful and I wasn't ever told to do anything (or not do anything). I really think I had the best hospital birth I could have hoped for. I feel satisfied with it, just not complete itms.

[meow]

PZ, there are a few transfer stories in the HB birth stories thread. FWIW I prefer the HB transfer stories to the unplanned HB stories. Funny because they're hospital births right? But it's about knowledge and empowerment... key elements that seem to mostly occur in HB stories.

[Cassius2]

is it weird that now that i have had an awesome HB that i now am even more concerned about transfer?? i was thinking last night that when i was pg with DD2 that i was more willing to consider transfer as 'one of those necessary things if the time arises', but now, now that i had such a beautiful experience, the thought that this time could end up in hospital is just scary?

AFM: found a HB midwifery group here in LA that will take us (even without...insurance!). loads of money but not as medical as the place we went this morning (checked out a couple of places...no sign of the PTSD...yet!).

[Cricket]

Cassius - how is it that I never realized until now that you are in the US? On the opposite side of the continent from me, but still a whole lot closer than most of the BB crowd.

I can't add a whole lot to the transfer discussion, really, but I'll throw in my two cents. I thought about it a bit with DD3, but I had a calm and confident midwife (whom I really miss!) and everything went beautifully. With DD4, I suppose you could almost say that I transferred, because I had to switch from a home birth to a hospital birth on the day I went into labour, because my GBS test came back positive, and the rule here is that they can't hang IV antibiotics at home. It was still a great birth - my midwives handled everything for me at the hospital, and aside from having that stupid IV in my hand, the rest was pretty much natural. I asked for an ARM, because I wanted to hurry things along, but that was it for interventions.
DS was almost a transfer, right at the end. I laboured at home with him, and things went really quickly and easily, but then his head was in a bad position (posterior brow presentation) and I had a very hard time pushing him out. It was when my (annoying, worries-out-loud, and indecisive) midwife said that we should transfer that I finally got mad enough and found a final burst of energy and pushed him out. A transfer at that point would have been terrible for me. I was naked, upstairs, in my own bed, worn out and in a lot of pain, and the thought of having to get onto a stretcher, down the stairs, out of the house, and to the hospital (20min drive) and possibly have a c-section at that stage was unthinkable! My baby was not in distress - he was handling everything very well. If he had been stressed, that would have changed my mind pretty quickly, I think.

About mec in waters - I believe if there's solid mec in the waters when they break then you have to transfer, here. But if it's just mec staining from an earlier BM, you don't, I think.

[Cassius2]

Cricket: hahaha, it is only a recent move! We are doing a 6 month stint (was meant to be more like 8 months until suprise baby...). There are now 3 of us in the US in this thread

Tash: well, one tub is better than at the RWH where for about 6 months they told women that they kept losing the plugs for the baths...when in actual fact they never bought them (I kid you not). seriously, pack a plug JIC lol.

[HotI]

Or at RWH where they tell you there is a tub in your room and there is none.

[TeniBear]

Or at RWH where they tell you there is a tub in your room and there is none.

Or they assure you that you'll be allowed to jump in the tub for pain relief, you almost wet yourself with excitement when you see you have a room with one, then they strap you to the bed as soon as you get in the room

[LionsandBears]

I had a tub at RWH both times. First time, didnt use it. Second time, got to use it after intervention from our IM. Apparently they don't have a 'policy' for using the tub in a stillbirth. FFS. So I was allowed to labour in the tub, but not allowed to birth. My team, including DH, IM and Mum were back and forth to the staff kitchen filling up jugs of hot water to pour into the bath, as the water was only lukewarm. What's the point of using water as pain relief if it's cold? At least we had our IM, both times. Irrespective of place of birth, I wouldn't birth without our IM. No way, no how.

Anyhoo. I dont believe that a hospital birth can come close to a HB. I just see HB as the standard other environments should be reaching for. Yanno, in an ideal world. In my dream world, I'd birth at home, in or out of a birth pool, with only my chosen support people around me, rather than strangers rostered on for a shift. I wish I could have that, but with our history and fear etc, it's not going to happen next time and I won't have a baby just to have a HB, ITMS. I do like the idea of hiring a birth pool for use at home and then transferring at the last minute.... and maybe baby slipping out at home anyway. oops.

We'll cross that bridge if we ever manage to get there.

[Jennifer13]

PZ, I think most of us can look back on our first birth experiences and wonder if we'd known what we know now whether it would have gone differently, or even know that it would definitely would have been different, and certainly better.

I question the need for my c/s for the low lying placenta I had with DD. Maybe I should have known better to just book in, because even when I researched I couldn't find much info on the grade I had. An IM I've spoken to since suggested my ob was being overly cautious.

BUT I learnt so much from going through it that way. I would never have even looked into homebirth had I not been faced with the interventions that a VBAC entails in a hospital birth. I could sit here and question forever, why I didn't at least wait until I went into labour, since there was no immediate concern. And knowing now how quickly I can labour, maybe I would have gotten a lot further in without incident and had a vaginal birth with DD1.

I think being able to question the decisions we made in a previous birth means we can make better decisions in a subsequent birth or at the very least improve the way we look at things and probably the advice we give.

I have absolutely no questions from DD2's birth. Probably because I spent so much time preparing for it so that I was fully informed and confident I could make decisions and probably also because I was incredibly lucky in having everything line up so that there was no need to make any decisions.

I got to talk to some of the Mums at my postnatal exercise class about my homebirth today. Two of them said they could see themselves having a homebirth. One was really interested to hear I'd had a HBAC because she'd ended up with an emergency c/s with her DD.

Loving your comments, L&B, but I think we are also in a situation where at the moment that's the gold standard because it isn't mainstream. We need to see more HBs and then in time, I bet the policies would change and more acceptance of a woman's ability to judge would be there. Also, the more care providers that are experienced in caring for women and babies in HBs, the better their skills and care will be.

[Cassius2]

tash: i like an *oops* scenario hehehehehehe....

I definitely agree that hospitals should be aiming for that: knowing that it wont be the same (i doubt they have my old sheets lol), but i totally get what you mean. there is little in the way of respecting a birthing families wishes and that, as the bottom line, is what ruins the system time and time again.

[Tegam]

Cass I totally understand your fear of transfer and having a hospital. Irrh after a Hb was terrible. If we go again I feel I'll struggle to even form a relationship with a MW. When I daydream I imagine wishing to be just on my own. I will have a lot to work through. I so want another baby and Hb but I'm that scared of havi g to have a hospital birth I think I'd rather not risk it.

[*Ash*]

Yep, I'm the same. The thought of going to hospital to have a baby is not an appealing prospect for me.

I am starting to come down off cloud nine unfortunately. I had such a beautiful birth but my post natal period has been a bit marred. I am having a difficult bf journey. I feel really disheartened. I have basically been breastfeeding for the last eight years with only 2 short breaks in that time. So why is it so hard this time around? I had a cracked nipple then mastitis and now I have thrush- all in the same breast. Bf has been painful since about day 4 after the birth when my cracked nipple started. I just want to get to pain free bf. I didn't realise thrush was so painful - thankfully I only have it in one breast. It hurts to feed, it hurts when I'm not feeding. I feel really gutted. I have been resting and babymooning, and we just had a two week period of friends cooking for us. Why did it all go so wrong? Sorry for the carry on. I've hardly had any sleep tonight because the pain is unsettling me. I dread feeding him on my left side. I become anxious and nervous. I'm worried about how long it will take to heal.

Dear Arcadia, I know you have endured ongoing thrush. I really feel for you now that I have some inkling of what you have been through. Do you have any advice for me?

I am so grateful that I have the positive experiences of long term bf with my other kids. I am clinging to that now.
So disheartening to have a beautiful, natural, peaceful birth and then struggle post-natally. Thankfully my MW is still doing home visits. That makes such a difference. And my little guy is so gorgeous. He makes it all bearable.