What are the limitations of homebirth?

Re: What are the limitations of homebirth?

• bea0422

  January 2011

  Each state has different regulations. This really is something you should talk to your midwife about. Here there is no pain meds, they are allowed a few medications in the event of an emergency (hemmorage..) and have a numbing cream for stitching if you tear. It isn't like that in every state. The best option is to ask your midwife and if you don't have one, look up your states midwifery laws.

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• LittleEgypt

  January 2011

  These are good questions.

  1) You will not have access to pain medication at a home birth. I don't think Percocet is going to do much for you, anyway. The usual alternatives to epidural/spinal anesthesia in the hospital are injectables like Nubain, but you won't have those at a home birth. You can use alternate measures like a tub (really nice), breathing/mental exercises, and massage. It is still going to hurt, LOL. It's much harder to "wimp out" at home, but you can definitely ask to transfer and get an epidural. If you really want an epidural, though, you should just plan a hospital birth in the first place!

  2) You need to check with your MW and the cord blood bank. We aren't able to donate cord blood, either at the birth center or home, but the requirements may be different for commercial banking.

  3) Only if you have extensive blood loss or a very bad tear. Midwives should definitely be able to handle a 1st or 2nd degree tear, but it's doubtful they'd fix a 4th degree tear (you are very unlikely to have one at a HB since you won't get an episiotomy). They use injectable local anesthesia to stitch you up, like lidocaine.

  4) You do not have continuous fetal monitoring at a home birth. Your midwife will monitor the fetus intermittently throughout your labor. Research shows that continuous EFM does not improve results, and leads to a higher rate of (seemingly unnecessary) interventions. Your experience will be different having a MW attend you throughout active labor and monitoring you intermittently, as opposed to a hospital setting, where you have a nurse check in on you, (likely) continuous unattended monitoring, and an OB who shows up for the delivery.

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• iris427 member

  January 2011

  If you want pain meds, you should probably be in a hospital.  There are things you can do at home like laboring in a tub to deal with pain, but if you are taking a pain medication that is strong enough to be effective in labor, you should probably be in a hospital where they can be better equipped to handle any problems that might arise from the pain meds.  I doubt Percocet would be effective for labor.

  Midwives monitor fetal heartrate using a doppler or stethoscope.  If you have a minor tear, the midwife can usually deal with it.  It's my understanding that if you need a lot of suturing or reconstruction, you would most likely need to transfer to the hospital

  
  

  
  

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• Sagenhaft member

  January 2011

  Thanks for all the info, ladies!

   

  I don't want to use pain medicine, I love the idea of  a completely natural birth. But the reality for me is that I don't deal with pain very well and I know that once the pain starts up, I will want something. I've heard that they can give percocet to take the edge off without totally making you out of it.

  I will definitely talk to a MW about it and see what she thinks. Thanks!
  

  I love someone with Autism
  Etsy shop
  

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• julyjennifer member

  January 2011

  If you are concerned about pain relief but are considering a homebirth, you should fully research the many methods of managing labor pain that don't involve drugs.  In addition to relaxation techniques and comfort measures (e.g., laboring in a tub, hypnobirthing techniques), if I were you I would also look into using a TENS unit (transcutaneous electrical nerve stimulation).  Perhaps you can use a HB midwife who is experienced with using one.
  

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• Sagenhaft member

  January 2011

  julyjennifer:

  If you are concerned about pain relief but are considering a homebirth, you should fully research the many methods of managing labor pain that don't involve drugs.  In addition to relaxation techniques and comfort measures (e.g., laboring in a tub, hypnobirthing techniques), if I were you I would also look into using a TENS unit (transcutaneous electrical nerve stimulation).  Perhaps you can use a HB midwife who is experienced with using one.
  

   

  I'd never even heard of this! Thanks so much, I will definitely look into it more.
  

  I love someone with Autism
  Etsy shop
  

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• Texas77again member

  January 2011

  iris427:

  If you want pain meds, you should probably be in a hospital.  There are things you can do at home like laboring in a tub to deal with pain, but if you are taking a pain medication that is strong enough to be effective in labor, you should probably be in a hospital where they can be better equipped to handle any problems that might arise from the pain meds.  I doubt Percocet would be effective for labor.

  Midwives monitor fetal heartrate using a doppler or stethoscope.  If you have a minor tear, the midwife can usually deal with it.  It's my understanding that if you need a lot of suturing or reconstruction, you would most likely need to transfer to the hospital

  most likely it would be a fetoscope, not a stethoscope.  not all mw's do sutures, but the ones that do tend to be able to repair up to a second degree tear.  i know that suturing is not my strong suit and so i just worked really hard to keep the perineum intact. 

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