Dangers of Homebirth Blog - My Perspective

Safe Baby Partners said...

Woah ...I agree with you, Grandma, and let's back the bus up here.

Everything in a couple's lives prior to conception, and conception itself, and gestation create the dynamics of the impending birth as the family barrels down road of life -- love, stress, etc -- towards birth. There is a whole theory of how the conception through gestation experiences CREATE the dynamics of birth in the prenatal and birth psychology field -- not for here. Doctors and midwives both have no control over anything that leads to the multitude of possible issues that do happen. However, they are responsible for the outcome.This story says more about the total lack of support for a woman's choices than it does about this woman and her baby.

Amber took responsibility for her second birth. She CHOSE and STUDIED the option of homebirth and did everything right to move towards that, BECAUSE of the previous hospital birth. Pitocin, epidural, membrane stripping, and episotomy - a "normal birth", by medical standards that a woman is expected to just accept. But Amber knew better and she clearly had loving support from her partner. The financial choice is no small matter. Most people will go do whatever their insurance covers even if it is non-effective or traumatizing. She doesn't say, but I'd bet that the first baby was medically induced.

The most important issue in this story, is the contribution of a broken obstetric system to the lack of support for women to have a natural, peaceful, intervention-free birth. Most women choose homebirth to avoid unnecessary medical interventions. THIS is the problem. Is it a collaborative effort between hospital and insurance companies?

Like most Americans in need of ANY kind of health care, the important decisions were dictated for Amber by her HMO, not her. Often, very important medical decisions are not even made by one's physician who went through fifteen years of training. They are made by a insurance company employee with maybe a bachelor's degree.

Left with minimal options for what HER needs were -- to protect her baby by not being in that hospital environment without choice and control -- Amber had to make THE BEST decision she could, and that is what this whole birth debate is about. WHERE to best give birth safely, peacefully, and respectfully when the OPTIONS SUCK -- big time.

Not one meets the needs of the laboring and birthing mother and baby.

1) She could go to the HMO approved hospital knowing what she knows, and wants to avoid. Having the PRIOR birth experience she did and responding (correctly) to it as she did also made her a PSYCHOLOGICAL high-risk wherever she went unless she did the emotional, psychological work around that first experience.

There is not a social value for a woman to process this "normal birth" experience of traumatizing interventions.

Society, including MIDWIVES, doesn't promote the healing of a previous birth either before conception of the second one or during pregnancy. Doctors ignoring the impact of what they do is part of this stupid debate that perpetuates the system.

2) Her second option is a forty-five minute drive to birth center -- which always scares a mother-to-be. Even one who has a three day labor will fear not getting there in time.

Working in a birth center I observed the only time this is not true is in the case of a woman, like Amber, who had a long, protracted, painful labor in the hospital. At home she doesn't realize she is in labor and progressing so easily, so she waits too long, waiting for the intensity she experienced before that is "normal" with medical birth, but not with natural birth.

3) Amber made a good choice in choosing homebirth with a professional birth caregiver, a CNM, a team, within safe driving distance to a hospital. Sounds like the best option to me. (btw, same as the doctor drives to arrive to catch baby managed by an RN or CNM -- what's the big difference really?).

THIS DEBATE needs to SOMEDAY address how it is that women can work equally with birth care providers, insurance providers, and expect evidence-based care where ever it is. Hospital birth is not evidence-based and the means (for doctor's schedules and litigation avoidance) do not justify the end. This particular CNM made a judgement call to not go earlier when she saw the malposition. Probably not a wise one. WHY didn't she? Why do midwives often wait too long? I have observed for awhile now that this is a complaint of the obstetricians and the nurses. And, I have a theory.

The conditions and attitudes of medical caregivers TOWARD midwives and the woman who chose homebirth and transports PLAYS A HUGE PART in the CO-CREATED problem and the lack of partnership between midwives and doctors. WOMEN and BABIES are the ones harmed by the fervent control of birth by medical profession and disregard for midwifery care. I have heard many, many times by obstetric residents the sentiment, "That's your choice to have homebirth, but don't expect us to clean up your mess."

The "messes" of homebirth are never greater than the ones in the hospital. Midwives, unless they have a good relationship with the doctor or hospital, can be very affected in their decision-making by what they know will happen at the hospital --how she and the mother will be treated.

Highland Midwife so eloquently says -- the location was not the problem. This same situation happens all the time in the hospital. So, sometimes the midwife delays in transporting. Why? Lots of reasons. Just like a physician will respond to a situation based on recent experience, perhaps she has just experienced a previous similar situation, she knows who is on call, etc. A thousand reasons.

I have known homebirthsAPGAR of zero, but it was at home. I have issue with these homebirth doctors and midwives who have then proceeded to use hospital lingo, "Baby was juuuuust fine." NO ONE -- midwife or doctor at home or in the hospital -- wants to admit that the means don't justify the end. No one wants to believe that they have profoundly affected that baby.

NO ONE wants to ask the baby who had a 3 day labor with every intervention exception extraction or surgery or the homebirth attempt that ended up "just fine" without interventions, or ended like sweet, baby, Jewel's. Like Amber, I support a blending of nature and medicine. I believe we need to participate in birth with awareness that everything we do profoundly impacts the baby. I agree with homebirth opponents that birth should not just be about the woman healing her body --after a surgerical or traumatic birth. It should be about the baby. It's the baby's birth.

There is so much good in Amber's story. It is great testament to the power of a woman to make choices, be responsible for her body and birth, and to labor without drugs and stay focused on her labor and her baby. Mother and baby undrugged, whatever they go through is the most ideal.

Finally, and this is a CONSEQUENCE of the HMO, the lack of GOOD options, and the need to satisfy the needs and timetables of others -- Amber began induction of the baby in order to satisfy others' time frames and needs. One can call it "encouragement" but it is still induction - for the needs of others besides the baby.

WHENEVER ones uses ANYTHING to induce the baby's labor, it is INDUCTION. Herbs, castor oil, acupuncture, and homeopathy are natural and do not have the total effects of pitocin (such as the central nervous system effect of creating false sense of trust in the caregivers), but it is still induction and a disruption of the baby's innate biological, physiological impulse to begin labor when he or she is ready. CLEARLY, the baby was not ready and not in the right position for birthing. I suspect the first baby was also induced.

Would the baby have ever turned to the ideal, correct position? Who knows? Baby does. Baby knows why she was in that position as she prepared for birth. She may have physiologically needed up to two weeks (average gestation) and then would have had time to move. Many times in healing work there is a very good reason for baby to be in a certain position until labor sometimes -- comfortable position, cord could be compromised.

COMMUNICATION with the baby in utero is the best but least used form of supporting a baby to prepare for labor and birth -- by physicians for sure, and even midwives. When it is medically necessary to induce conscious, respectful interaction with the baby is very effective.

Any way I look at it, the bottom line is that baby Jewel's labor and birth was that Amber was "induced" and "disrupted" by the medical establishment before they even got to the intersection of labor and birth. Amber, Jewel, and daddy have every right to be feeling whatever feeling they are -- the whole darned spectrum from joy to anger.

I have a particular interest in the father's experience in the medical machine (that includes insurance dictates, hospital policy dictates, the anti-midwifery sentiment). I am touched by his obvious support of his wife to make the best decisions possible for his children, and the financial sacrifice he obviously made. I acknowledge the powerless a man feels in witnessing the first birth and how our society does not honor his internal God-given impulse to protect his partner and child. My regards to an amazing man and dad.

What an unfortunate addendum here about the trip to the hospital. I wonder if the good doctor would see this as NOT affecting this child, as she refuses to even consider that everything that happens at birth in the hospital is insignificant to the laboring and birthing baby.

The baby is unaffected by what happens at the hospital but is everywhere else, and yet prior to admission in the hospital drugs are bad, but they are good in the hospital. So confusing.

Thank God for the new understandings of the brain and healing, so that whatever happens in birth we can mediate and heal.

Blessings to Jewel and her family,
Janel
www.infantparenthealing.com
www.hospitalbirthdebate.blogspot.com
December 17, 2006 1:40:00 PM PST