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This is a genuine question, not intended to get anyone fired up :)
Reading about others needing to go in early to have bubs delivered because of lack of growth. How does this get handled if you are planning on having a home birth and private midwife? Can they/how do they pick up on those things?
Thanks
My private midwife palpated my tummy at each appt. This was how we identified that he was transverse/breech at different times (he was highly mobile right until the end). The fundal measurement was also measured. These can be used to see how baby is growing.
The same measurements were taken when i went through the hospital system. Homebirth midwives often have greater experience at using their hands to check bub because that is their primary tool.
When you have one care provider who does all the clinical assessments (palp, measures, FH) they will know each time if babe is growing appropriately for you. some care providers rely to heavily on other forms of assessment and use only small pieces of the puzzle.
IUGR is poorly diagnosed antenatally and can be over diagnosed but not accurate at birth, as many issues factor into why babe may or may not be growing.
A midwife can identify poor growth in the same way as an ob, through fundal height measurements and, if necessary, ultrasound scans.
Good point. I had an Ob for my first two boys, and had shared care through my GP/hospital for my third (delivered by a midwife). I think if you're getting consistent care from an experienced caregiver then it shouldn't matter which way you go. The Ob I had (same for DS1 and 2) was very hands on, she was great. She was concerned about DS1's size and I had to have a couple of growth scans in the last trimester, but everything was fine - he was just smallish (2.9kg at birth). Similarly my GP was quite hands on. I felt I was in good care with every pregnancy.:
