I've got a home birth question

ASmallWonder · December 2011

I'm genuinely interested in people's answers and not looking for a battle or anything. I had a hospital birth that turned into an urgent c-section due to the cord being wrapped around Aiden's neck, causing his heart rate to stay dangerously low after contractions. For people who chose a home birth, how did you deal with questions about something like that happening? Did you rationalize that it's rare or that if there were an issue you felt comfortable getting to the hospital in a timely fashion? I honestly don't know how long Aiden would have been ok without the c section but I do know that once they realized the issue, I was in surgery less than 15 minutes later. If I had been home it would have taken me that long to even GET to the hospital, much less get registered and checked (because I assume they won't just whip you into surgery on someone's say so, right?)

Now that I've gone through that I would be way too petrified to risk a home birth (well, that and the fact that I am shameless in my love for my epi haha) I've just always wondered how people reconcile their desire for a home birth with the potential risks.

BelhurstBride · December 2011

I have a girlfriend who had a home birth. She had two midwives present to monitor and help and a hospital 5 minutes away if an emergency arose.

Regarding the need for emergency surgery, not only do I imagine the doctors would take the word of a trained midwife, but if it's an emergency they make it happen pretty quick. My SIL just had to have an emergency c/s two weeks ago. Her son's heart rate was through the roof; they had him delivered in minutes. Her husband called us on their way to the doctor to let us know something wasn't right and then didn't call us again until after the surgery, it happened that fast.

BelleIsa · December 2011

I did not have a home birth but I've thought about it for this LO.

The answer will be different in Canada and the US because in Canada, you can run into a hospital and just be treated. You don't need to fill out forms or show any ID or whatever. So, in an emergency you could just arrive and be treated ASAP.

Also, midwives here are registered with a hospital and are well known to OBs in the area, so, if you're delivering at home and you all of a sudden need an emergency c-section, I'd think the midwife would be on her cell phone in the car calling the hospital to warn them ahead of time to have everything ready etc.

Andplusalso, I live like, a 10 minute drive to the nearest hospital.

The reason why I'm not doing a homebirth with my second is because I know I wouldn't be able to relax with DD in the house (I would be all, "can she hear me? is it freaking her out? will my water break all over my new sofa?"). If it wasn't for my weird neurosis about getting the house dirty with birth goo I would totally deliver at home.

ASmallWonder · December 2011

ashleysyn2:
My home is close enough to the hospital that I'd be able to get there within 15 minutes and midwives are trained to handle emergent situations like that (not necessarily the section itself, but on knowing when you need to consider other options, giving the hospital the heads up, etc.)

My birth was very uncomplicated, but if I had something happen like the cord wrapped around the neck the first time I'm not sure I'd be able to choose home birth for the second. I think I'd be too nervous.

This is interesting. But since it's not a factor where past experience dictates future experiences, wouldn't (shouldn't?) the concern be the same for the first birth? KWIM? I'm not asking you specifically but it's things like this that I wonder about.

emriley84 · December 2011

I have unfortunately seen babies born after home births gone wrong. The complications are rare, but are very serious. We've had babies who were born without heart rates and things like that. They aren't monitored as closely as they are in the hospital, so it's more difficult to act when the baby has distress.

I understand why people would want to do it, and I respect that. I personally would never take the chance because I'm too nervous.

BelhurstBride · December 2011

elmoali:

This is interesting. But since it's not a factor where past experience dictates future experiences, wouldn't (shouldn't?) the concern be the same for the first birth? KWIM? I'm not asking you specifically but it's things like this that I wonder about.

I know in my GF's case she strongly felt that the chance of someone pushing for an unnecessary intervention in a hospital setting was much more likely than something going wrong at home. She did a shitton of research before making the decision to have a home birth so I never doubted that her choice was a well educated one.

Jake's Mom · December 2011

I was going to do a home birth with my DS. My kids are 10 years apart, my DD was also born in a hospital.

My BP started going up so I got kicked back to the OB full time. As I understood it though, if anything went wrong they would either drive you to the hospital or call an ambulance. I believe they can also do crash c-sections on the table in the ER if they need to. So if it took you 10 to get there they could still have the baby out in another 5.

My birth with my DD was complication free aside from being 10 days late and induced. Pretty much the same with my DS although they took him at 39 weeks for my BP. Both had birth defects that could have been dealt with later at the doctors office if needed. Them both having those issues was the only thing that may have freaked me out if I did deliver at home.

Shayna0182 · December 2011

This is kind of a sad area for me, because my daughter Hannah was stillborn in 2010. Granted, I wasn't fullterm, just 29 weeks, and it wasn't a home birth, but I was too late to get to the hospital in time, and she was gone by the time I was rushed into surgery. Who knows if I had been closer to the hospital if the circumstances would have turned out differently. Why take the risk.

I can't understand why you would take the risks. Who cares if you can't get the "perfect" birth. The baby in and of itself is perfect.

Sorry my post is probably flameable, but It's my honest opinion.

TiffanyBerry · December 2011

If we have a second, I am seriously considering a home birth (and my first was out of hospital, at a free standing birth center, so was the same as home in terms of this sort of thing).

The thing is, a good midwife IS monitoring heart rate often. Every other contraction if you're pushing, every 10-15 minutes in early labor if you're doing well and there have been no indications of a problem, and more often than that by far if they've heard or seen anything (whether it's a heart rate reading OR how you are laboring and your symptoms) that gives cause for pause. They* transfer (or at least ask you about transferring) far earlier than would be the case in a hospital, specifically for these sorts of time reasons. It really depends on the scenario whether or not you'd drive in to the hospital or call an ambulance (depends on how early in "not sure this is going as well as we want it to"), but either way, they will call ahead and even CPMs, who cannot have hospital privileges, have OBs they work with and can start getting things going while you are in transit.

Home birth (or even out of hospital birth) is not right for everyone, and is very clearly contraindicated for some, but it can be a perfectly safe option, particularly if you are able to be flexible and give up that "picture" in the moment if necessary.

* "They" in this case means a GOOD midwife. Are there some who wait too long? Yes. Are there some OBs that don't practice optimally as well? Yes. You have to do your research and do your best to pick the best person for the job.

emiliemadison · December 2011

emriley84:
I have unfortunately seen babies born after home births gone wrong. The complications are rare, but are very serious. We've had babies who were born without heart rates and things like that. They aren't monitored as closely as they are in the hospital, so it's more difficult to act when the baby has distress.

First, babies are born with serious complications (including death) at hospitals every day, even when they're being monitored constantly. Most worst case scenarios that happen in home birth settings would have happened the same way in a hospital- not because of negligence or not enough time, but simply because some babies and some mothers dont make it no matter what anyone does.

Second, it's VERY RARE that a competent, certified midwife would not pick up on distress and/or other issues that would require a hospital transfer. Most home birth midwives are trained and practiced in spotting potential issues EARLY, so that they can transfer a patient before it becomes an emergency. In the rare case that there is a true emergency at home during the birth, midwives are able to handle just about anything aside from a c-section. Keep in mind, however, that many "emergency c-sections" are the final domino in the chain of events. It's just a fact that some interventions increase the risk of being in a situation that could lead to a c-section. This includes things that are seemingly innocuous, such as laying in a hospital bed during labor, getting an epidural and having your water broken.

So, to the OP: Studies have shown again and again that home birth is AT LEAST as safe as hospital birth for low-risk pregnancies. In further in depth studies, it appears that home birth may actually offer a lower risk.

hannahbagels · December 2011

I trust my midwife to monitor for problems. I've gotten to know her really well and trust her with my life, just as you trust your OB and the L&D nurses. She has some doctors at a nearby hospital she's associated with for in case of an emergency. 9 times out of 10, everything ends up being fine when she's taken someone to a hospital.

My mom nearly got killed because they put her epidural in incorrectly. How do people get epidurals knowing all the risks associated with it? I'm going to add a "LOL" so you guys know I'm not trying to be mean :S

ASmallWonder · December 2011

intheflowers:
TiffanyBerry:
The thing is, a good midwife IS monitoring heart rate often. Every other contraction if you're pushing, every 10-15 minutes in early labor if you're doing well and there have been no indications of a problem, and more often than that by far if they've heard or seen anything (whether it's a heart rate reading OR how you are laboring and your symptoms) that gives cause for pause.
That's a good point to make. I might even argue that you're being monitored more closely at home with a MW because you have a real person with you that knows you and is constantly assessing you and the baby, rather than a monitor and nurses checking in here and there. How often do women even see their MD/MW when they're in labor at a hospital? I actually don't know the answer to this, I'm curious.

For me I know I was on a constant HR monitor so someone was in my room the very first time that HR didn't come back up.

historychick79 · December 2011

I think it's really about knowing your medical provider, and knowing the resources in your area. Originally, I went with a midwife and liked the idea of a home birth (though DH would never have consented). After 2 missed miscarriages, I was definitely more comfortable with an OB. For labor, I was stuck at 9 1/2cm for over 3 hrs with no pain meds (and then pushing for 1 1/2). The dr. in charge said for most cases like mine, they move to a C-section within an hour, but since both baby and I were handling the stress well I ended up with a regular delivery after all (I certainly didn't feel lucky in the middle of all that, that's for sure). But that easily could have gone another direction entirely...I like our hospital, my office has a great reputation, and it was the best option for us. But we may have made different choices under other circumstances.

historychick79 · December 2011

intheflowers:

How often do women even see their MD/MW when they're in labor at a hospital? I actually don't know the answer to this, I'm curious.

I was assigned a (fantastic) labor nurse, and she was never gone more than 10-15min the entire time. And when I was stuck at 9 1/2cm, someone was in the room the entire time. I'm sure it can vary by hospital/dr policy.

sschwege · December 2011

intheflowers:
elmoali:
intheflowers:
TiffanyBerry:
The thing is, a good midwife IS monitoring heart rate often. Every other contraction if you're pushing, every 10-15 minutes in early labor if you're doing well and there have been no indications of a problem, and more often than that by far if they've heard or seen anything (whether it's a heart rate reading OR how you are laboring and your symptoms) that gives cause for pause.
That's a good point to make. I might even argue that you're being monitored more closely at home with a MW because you have a real person with you that knows you and is constantly assessing you and the baby, rather than a monitor and nurses checking in here and there. How often do women even see their MD/MW when they're in labor at a hospital? I actually don't know the answer to this, I'm curious.
For me I know I was on a constant HR monitor so someone was in my room the very first time that HR didn't come back up.
A MW at home monitors the HR too.
I mean how often normally, if there isn't a machine beeping at them.

I can answer this based on my hospital experience with a CNM. I saw my CNM three times in the 7 hours I was in the hospital. 1) when I was admitted 2) when I asked her to check me 3) when I started pushing. It was the L & D nurse I saw much more frequently. When I got to the hospital I had to have continuous monitoring for 20 minutes. After that my L & D nurse came every 15 minutes to listen to DD's heartbeat with the doppler (listened for 30 sec or so). I wasn't hooked up to anything not even an IV. So I would venture to say that I was being monitored in much the same way a woman doing a homebirth would be (less personal attention but the technique would be similar. The ACOG says that intermittent monitoring is an acceptable form of monitoring a woman while in labor (provided she is low-risk).

I would never do a home-birth myself, perhaps partly because my hospital is very pro-natural childbirth. However I have a lot of respect for women who do and think it can be done in a safe, in some cases even a safer manner than some hospitals handle birth.

sschwege · December 2011

ashleysyn2:
emiliemadison:
First, babies are born with serious complications (including death) at hospitals every day, even when they're being monitored constantly. Most worst case scenarios that happen in home birth settings would have happened the same way in a hospital- not because of negligence or not enough time, but simply because some babies and some mothers dont make it no matter what anyone does.
Second, it's VERY RARE that a competent, certified midwife would not pick up on distress and/or other issues that would require a hospital transfer. Most home birth midwives are trained and practiced in spotting potential issues EARLY, so that they can transfer a patient before it becomes an emergency. In the rare case that there is a true emergency at home during the birth, midwives are able to handle just about anything aside from a c-section. Keep in mind, however, that many "emergency c-sections" are the final domino in the chain of events. It's just a fact that some interventions increase the risk of being in a situation that could lead to a c-section. This includes things that are seemingly innocuous, such as laying in a hospital bed during labor, getting an epidural and having your water broken.

So, to the OP: Studies have shown again and again that home birth is AT LEAST as safe as hospital birth for low-risk pregnancies. In further in depth studies, it appears that home birth may actually offer a lower risk.

You said it! And let's not forget the Pit they hand out like water!

Meggybear · December 2011

intheflowers:
TiffanyBerry:
The thing is, a good midwife IS monitoring heart rate often. Every other contraction if you're pushing, every 10-15 minutes in early labor if you're doing well and there have been no indications of a problem, and more often than that by far if they've heard or seen anything (whether it's a heart rate reading OR how you are laboring and your symptoms) that gives cause for pause.
That's a good point to make. I might even argue that you're being monitored more closely at home with a MW because you have a real person with you that knows you and is constantly assessing you and the baby, rather than a monitor and nurses checking in here and there. How often do women even see their MD/MW when they're in labor at a hospital? I actually don't know the answer to this, I'm curious.

The answer to that is not often at all. My OB came in once to see how dilated I was and then it was mainly me and the nurse (who was awesome and the person I remember most out of my L&D experience.) My OB's call duty ended and the new OB on call ended up being the one Dr in the practice I never met. He ended up being called away for an emergency c section. A random OB who happened to be available delivered my son. I can truthfully say I dont even remember her name. The OB really only came in every half hour or so to check progress and to catch he baby at the end. Oh and stitch me up. I am really leaning towards a midwife for my future children because of this whole experience.

sschwege · December 2011

intheflowers:
sschwege:
I can answer this based on my hospital experience with a CNM. I saw my CNM three times in the 7 hours I was in the hospital. 1) when I was admitted 2) when I asked her to check me 3) when I started pushing. It was the L & D nurse I saw much more frequently. When I got to the hospital I had to have continuous monitoring for 20 minutes. After that my L & D nurse came every 15 minutes to listen to DD's heartbeat with the doppler (listened for 30 sec or so). I wasn't hooked up to anything not even an IV.
Thanks to you and kilo for the info. It sounds like the L&D nurse can really make or break the experience. I'm in nursing school now so I hope to be one of the good ones.

Good for you, you will most certainly be one of the good ones!

ChibiMommy · December 2011

I had a pain med free induction and I saw my mw 6-7 times. She checked on me as often as she could because this whole business was on a Monday and she had other patients she had to see.

I had to fight with the damn l&d nurses the whole way: Hep lock, water, walking, monitoring, showering, every single thing was fight and my mw went to bat for me every time. I got almost everything I wanted but I would give anything to have a HB this time. I had stupid GBS or there would have been no IV until she started pit.

bstrangely · December 2011

sschwege:
ashleysyn2:
emiliemadison:
First, babies are born with serious complications (including death) at hospitals every day, even when they're being monitored constantly. Most worst case scenarios that happen in home birth settings would have happened the same way in a hospital- not because of negligence or not enough time, but simply because some babies and some mothers dont make it no matter what anyone does.
Second, it's VERY RARE that a competent, certified midwife would not pick up on distress and/or other issues that would require a hospital transfer. Most home birth midwives are trained and practiced in spotting potential issues EARLY, so that they can transfer a patient before it becomes an emergency. In the rare case that there is a true emergency at home during the birth, midwives are able to handle just about anything aside from a c-section. Keep in mind, however, that many "emergency c-sections" are the final domino in the chain of events. It's just a fact that some interventions increase the risk of being in a situation that could lead to a c-section. This includes things that are seemingly innocuous, such as laying in a hospital bed during labor, getting an epidural and having your water broken.

So, to the OP: Studies have shown again and again that home birth is AT LEAST as safe as hospital birth for low-risk pregnancies. In further in depth studies, it appears that home birth may actually offer a lower risk.

You said it! And let's not forget the Pit they hand out like water!

i just want to say that sometimes you don't know you're not low risk until you're already delivering. i was 10 days overdue. i was induced. i eventually needed a c-section. there was no way for me to have a home birth and there was never a sign of it at any time in my pregnancy. i'd taken classes to prepare myself for a med-free delivery and it was just never going to happen. and it kind of pains me to see the distaste a lot of people seem to have for hospitals and pitocin. there are legitimate reasons for both.

sschwege · December 2011

bstrangely:
sschwege:
ashleysyn2:
emiliemadison:
First, babies are born with serious complications (including death) at hospitals every day, even when they're being monitored constantly. Most worst case scenarios that happen in home birth settings would have happened the same way in a hospital- not because of negligence or not enough time, but simply because some babies and some mothers dont make it no matter what anyone does.
Second, it's VERY RARE that a competent, certified midwife would not pick up on distress and/or other issues that would require a hospital transfer. Most home birth midwives are trained and practiced in spotting potential issues EARLY, so that they can transfer a patient before it becomes an emergency. In the rare case that there is a true emergency at home during the birth, midwives are able to handle just about anything aside from a c-section. Keep in mind, however, that many "emergency c-sections" are the final domino in the chain of events. It's just a fact that some interventions increase the risk of being in a situation that could lead to a c-section. This includes things that are seemingly innocuous, such as laying in a hospital bed during labor, getting an epidural and having your water broken.

So, to the OP: Studies have shown again and again that home birth is AT LEAST as safe as hospital birth for low-risk pregnancies. In further in depth studies, it appears that home birth may actually offer a lower risk.

You said it! And let's not forget the Pit they hand out like water!
i just want to say that sometimes you don't know you're not low risk until you're already delivering. i was 10 days overdue. i was induced. i eventually needed a c-section. there was no way for me to have a home birth and there was never a sign of it at any time in my pregnancy. i'd taken classes to prepare myself for a med-free delivery and it was just never going to happen. and it kind of pains me to see the distaste a lot of people seem to have for hospitals and pitocin. there are legitimate reasons for both.

Indeed there are legitimate reasons for both and I'm so glad we have them. I delivered in a hospital (always planned to). So I am neither anti-hospital nor anti-pitocin. However, I don't like the direction this country has taken in terms of labor and delivery. The Latin root word for obstetrician is 'to stand by' and sadly that has been lost in our modern day society. There is far too much emphasis on 'moving things along.'

My comment was not intended to offend and clearly there are good uses for the interventions modern science has given us. They are just used far to often IMO.

barnwife · December 2011

I once read of a midwife saying "There are situations and there are emergencies. And we never let it get beyond a situation."

That is, midwives are trained to recognize when a situation might go downhill and further help might be needed. Any midwife worth his/her salt would get you to that help before it's an emergency.

Of course, not all situations present warning signs. But the times when things go downhill so quickly are rare.

And, in my case, the hospital is about a 5 minute drive (10 if you are stuck behind a horse and buggy or tractor). But you can bet DH would get me/baby there faster if necessary

Also, birth is risky no matter where you choose to give birth. While I was pregnant with DS, my midwife attended a birth where meconium was present in the water when the mom's water broke. Had that happened at the hospital, a c-section would have been performed. The baby was born vaginally and it was clear he needed to be transferred. So he was.

Basically, having a HB allowed that mom to avoid having major surgery. And, fwiw, they have already had a non-eventful HB with LO#2.

I also know that I could never be as comfortable laboring in an impersonal hospital room as I was in my own home. Basically I am saying you need to weigh the benefits along with the risks.

BelleIsa · December 2011

intheflowers:
TiffanyBerry:
The thing is, a good midwife IS monitoring heart rate often. Every other contraction if you're pushing, every 10-15 minutes in early labor if you're doing well and there have been no indications of a problem, and more often than that by far if they've heard or seen anything (whether it's a heart rate reading OR how you are laboring and your symptoms) that gives cause for pause.
That's a good point to make. I might even argue that you're being monitored more closely at home with a MW because you have a real person with you that knows you and is constantly assessing you and the baby, rather than a monitor and nurses checking in here and there. How often do women even see their MD/MW when they're in labor at a hospital? I actually don't know the answer to this, I'm curious.

Well to answer this, I only saw my OB when I was already pushing. (I was ready to push at 6 am on a Sunday morning and fortunate that he came in and didn't just tell the attending to deliver me.)

Since I was low-risk, I wasn't monitored at all after the initial 20 minutes when they made me where the belt-thingy to monitor the baby. I went drug-free for pretty much the whole thing so my memory is sketchy but I think a nurse came in once every 30-40 minutes to check my blood pressure.

Mostly I remember being alone with DH and kind of freaking out. I had no idea if what I was feeling was normal as it was my first baby. I felt more pressure than pain if that makes sense and I felt like my lungs were being crushed so it was really scary for me. It's why I went with a midwife this time. She will be there the WHOLE time I'm labouring, offering support, helping and just being there. I can't tell you how much this relaxed me already about giving birth again. (I mean, DH is great and everything but he's pretty clueless about what it feels like to push a baby through your vag so having another woman there will be a great comfort to me.)

**I delivered in Beijing, so I'm not sure what would have happened in Canada.**

Want a personalized experience?

I've got a home birth question

Re: I've got a home birth question

Choose Another Board

Search Boards