Would YOU ever have a homebirth?

[klone]

Sorry if this topic has been done to death. I've been working since June in OB, focusing mainly on L&D. I have two children of my own, the first one was a fast and uneventful hospital birth, the second was a homebirth (acynclitic and OP, so labor was VERY long and difficult - if I had been in a hospital, I'm pretty sure I would have been sectioned, but all turned out well in the end).

I'm facing the prospect of perhaps having one more in a couple years. I had previously thought that any other children would also be born at home. But now that I've been working in L&D and getting a glimpse of all the potential emergencies and behind-the-scenes things that could go wrong, I'm seriously questioning the safety of homebirth. I guess you could say I'm having a crisis of faith that birth is a natural process that doesn't HAVE to be managed in order to have a good outcome.

Anyway, I was just wondering if other L&D nurses, knowing what they know, would ever opt for a homebirth for their own.

[Spidey's mom, ADN, BSN, RN]

Not by choice, I wouldn't, but we all know accidents happen.

I've told this story before but . . .

I have a friend who planned a home water birth. She was in labor and decided to take a shower while her husband and the midwife got the hot tub ready . . while in the shower, the baby just came out. It was her 6th baby.

steph

[Spidey's mom, ADN, BSN, RN]

BTW - the reason I said 'Physician' is because many hospitals suggest instead of asking a patient if they have a "doctor" some may answer no, because they have a nurse practitioner. They now suggest the term Physician because it is broader and encompasses both. Not meaning I would be a Dr = MD if I got my NP.

I didn't read all the posts but I wanted to just correct this. If someone is suggesting that the term physician refers equally to Nurse Practitioners and Medical Doctors they are mistaken. I think that other folks have clarified that Nurse Practitioners are not only NOT physicians they probably would be offended to be called a physician!! They are proud of their nursing roots and personally I respect those roots almost more than those of the physician. I choose to see Nurse Practitiones instead of physicians whenever possible.

If you want to be sure to include nurse practiioners, nurse midwives as well of physicians when talking to a patient it is appropriate to ask them who their "medical care provider" is. That term includes it all!

I think it is great that you are participating in this forum, getting some of the answers you need, and I wish you the best in your future career!

********************************************************

You're right - a physician IS a doctor.

steph

[palesarah]

I've told this story before but . . .

I have a friend who planned a home water birth. She was in labor and decided to take a shower while her husband and the midwife got the hot tub ready . . while in the shower, the baby just came out. It was her 6th baby.

steph

That's hilarious Steph!

One of my coworkers had her 2nd baby at home, unplanned, about 19-20 years ago. She had been uncomfortable for a couple hours, then had one contraction and had to push! She had been working as an L&D nurse already for a couple years, so she told her husband to call 911 and meet her in the bathroom with extra towels. Squatted, head delivered, told her husband "you have to check for the cord!" a couple times but he was too squeamish (and confused, as he had no idea what she was asking him to do) so she made sure there wasn't a nuchal cord (she says she was really focused on that part!) and delivered her daughter herself. And yelled at her husband for grabbing the nice towels!

The funniest part of that story is, before I started working on my floor there was another nurse there who had almost the exact same story- including yelling at the husband for grabbing the good towels!

Sorry to go OT, I love those stories. Personally I would love to have a homebirth if I were low-risk but I have some medical problems that put me in the higher-risk category. But, I considered becoming a Certified professional Midwife and doing homebirths before deciding to go to nursing school, and have a good friend who is a CPM and has had 2 homebirths herself.

[Lacaza3]

Hell no give me the damn drugs and give them now lol lol lol

Just teasing...I almost had my last child 9lbs 3 oz at home due to the nurse telling me I wasnt in labor and I told her I was...She sent me home anyway...I waited until that nurse was off shift before I went back I didnt want her sending me home again.When we got to the hospital I was already a 10 and crowning...yuk!!!

I got my damn pioneer woman patch...

After a very rough delivery and lots of bleeding the Dr said...you wont something to help you now..

I said Hell yeah..After what I just went through I need a stiff drink..

He laughed...

[lawc2315]

For what it's worth I will give my 2 cents.

I am pro home birth, but even better I would think a birthing center. Now I am not fully read up just yet on how the birthing center is different from the actual home birth. If I could lay out the perfect scenario for me personally it would be to combine all the wonderfulness of having a midwife and a natural birth, but in a setting like a level III hospital for those just in case emergencies. (peace of mind). A close at hand back up plan if things go downhill quick.

I had the pleasure of witnessing a home birth about a month ago, and I have also watched many on Discovery Health Channel. I loved being a part of the home birth. You had the close family and friends there, the midwife and her helper there. We all sat in the kitchen nibbling on yummies, drinking coffee, and talking birth war stories. The midwife was so insightful, and they really encourage the laboring mother do go with what her body feels naturally and not be ashamed (breath, moan, pant, yodel if it makes you feel better). With a hospital birth it's get them in, get them on Pitocin, they are laying mostly flat on their back, hooked up, and have limited mobility. It's like let's get this show on the road, bam bam bam. With the home birth, she was able to take hot showers, walk, squat, turn side to side, lean, do the ball, try lots of different pushing positions to see what worked best. It wasn't bam bam let's get this going, fast fast fast. It was much more relaxed, it was warm and friendly, and very touching. She had the baby nursing and skin to skin immediately. I asked the midwife, she said that she had delivered well over a thousand and had never lost a baby yet (knock on wood).

I have 2 children, both lady partsl. When I had my first baby, my OB gave me an episiotomy with a 4 lbs 14 ounce baby. Because I had too much epidural I couldn't feel to push. While in labor I guess I was panting and moaning (nothing major), the nurse told me to stop, and treated me like that was wrong. When I had my second baby (6.5lbs), different OB, no epidural, no episiotomy, better nurses, a bit more encouraging. If I could have had the midwife experience, in a nice homelike room at a hospital, that would have been the ultimate. I think if most women could have it that way you would find most women opting for it. What is not to love about it. Of course you have those women who are like - give me an epidural! And that is fine, it's a personal choice, but having that option would be heaven for a large number of women. Midwifery just takes a real different approach. They don't treat it like a medical condition, more as a natural part of the life.

[FrumDoula]

I'm sure this has been said many times already but here goes. No way would I have a home birth. I guess that people opt for home births because they feel more comfortable and relaxed in the home setting than in a sterile hospital with a bunch of strangers around.

By sterile, I'm assuming you mean the atmosphere, as opposed to th e physical reality .... I always assumed hospitals were pretty filthy, especially after I worked in one.

You know what makes me comfortable? The reassurance that, should something go wrong, that I will be within seconds of help. I wonder sometimes, if the people who opt for home births really have any idea of the things that can go wrong during childbirth, and that precious time is lost when you have to make a mad dash for the hospital.

I can respect that you want to give birth in a place that you feel comfortable in. However, I have to address this point one more time, because it's one of the biggest myths of homebirth. Homebirthers are well aware of the risks involved, if only because everyone REMINDS you how "risky" it is to homebirth. (Despite the fact that this is also a myth.) In fact, I would gander that homebirthers are actually much more educated as to risks than most non-medical personnel who have hopitals births. People who homebirth end up educating the people around them often, because it is such a rare choice in the US. (Only 1% of us choose it, despite its' track record of safety.)

Second, please know that many emergencies are handled at home, without a "mad dash" to the hospital. Most homebirth transfers are not for emergent reasons. And my midwife has handled cord prolapses, shoulder dystocia and a host of other problems at home without negative outcomes. (And let's not forget that some obstetric emergencies are iatrogenic.)

By the way, even during my own homebirth, I had a little bleeding, and was given methergine. They also had Pit drawn up in case I needed that, too. Just an example of how one particular complication was dealt with.

Just for the record, I would not recommend homebirth across the board, even for women who are medically low-risk. L&D RN's know this more than anyone, but so many women have no desire to truly take responsibility for their pregnancies and births that they are poor candidates for this kind of birth.

Alison

[fergus51]

Ok, I have to say it. Just as homebirths aren't crazy hippies chanting at the moon, trying to allign the mother's chakras, hospitalbirths aren't get them in, pit them, cut them, send them out.

[jennblon]

I'm an L/D nurse and i say "go for it" especially if you've done it at home with an OP baby!

in fact, i'm 28 weeks and the only reason i'm not having a homebirth is because my partner is one of the OB docs and we both feel very much at home... at work!

yes, emergencies happen. but knowing that does not predispose you to them (although sometimes it seems like we have the worst luck!) i think you should just be thoughtful in your choice of CNM, check fhr's during some ctx's in the active phase, and if things seem to be headed in a bad direction, don't stall on getting to the hospital. chances are things will go just fine. (what is it 90+% of babies are born perfect??) you already know a baby can fit through your pelvis, so the chance of needed a section are pretty slim.

good luck! but if you think you'll be too nervous, you won't be able to relax at home....and then what's the point?!

[jennblon]

I've told this story before but . . .

I have a friend who planned a home water birth. She was in labor and decided to take a shower while her husband and the midwife got the hot tub ready . . while in the shower, the baby just came out. It was her 6th baby.

steph

and was her baby okay??

[lady_jezebel]

No. My baby had to be emergently resuscitated. This was unforseen. I'm very thankful that he was born in a hospital under the skill of an excellent physician. I'm all for nurse midwives, but only in a hospital setting.

And I wanted to clarify -- I think birthing centers attached to hospitals are the best of both worlds. The setting is intimate & roomy, yet all the technology & various professionals (RN, MD, RT, etc..) are there ready for action & can respond to emergencies stat.

[TinyNurse, RN]

I'm an ER nurse, and I had a homebirth. My son will be 6 in October. I won't bore you with the birth-story, but it was beautiful, and I don't think I could give birth any other way. I strongly believe that as long as you have a healthy pregnancy then it's the best way to go.

kudos to ALL the moms out there.....no matter how you birthed!!

Jen

[TinyNurse, RN]

( please see above post, yes i had a home birth in 1999 and it was great)

I guess I need to add that the ORIGINAL reason I got into nursing was to be a lay midwife. My plan as a single mom was to go to nursing school, graduate, get experience in L&D, ( make enough money to support my son and I) and do a lay internship. Then eventually move away from the hospital birthing setting into lay midwifery..........................

Well........I went through L&D clinicals in nursing school, and wanted to cry every single day when I went home. During class, and in clinicals I pretty much kept my mouth shut, and at that point I KNEW L&D wasn't for me.

After I graduated I started in the ER, and I've been there ever since. I don't really know if I could do L&D, but I could definitely handle assisting a midwife at home.

kudos to all the L&D nurses out there, especially those that support home birthing!!!