Home births gone wrong

[MNNICU, RN]

Do you see this often in your facility? In 2.5 years we have had 2 babies die and 2 be severely disabled from home birth. I have a really hard time with this. I understand my role is to care for babies and families without judgement to the best of my ability (which I DO!) but I come home and just stew on these situations. Recently we had a mom who was told she needed a C section by two different physicians at two different facilities for a breech baby and low fluid and she refused, signed out AMA and attempted a home birth with midwives. The baby of course became stuck with the body born and required a 13 minute code. We cooled her immediately for 72 hours and she spent two weeks on a vent. She just now is extubated but will require a trach because she can't cough or swallow or gag so secretions just build up. She is more or less vegetative and on a slew of anti seizure meds. This stuff just really makes it hard for me to sleep! I feel like these poor innocent babies end up paying for their parents risky stupid decisions. Does anyone else see these situations? How do you handle it? I am not looking to hear about how my job isn't to judge, I get that. But I am human too and this job is very emotional sometimes!

[Horseshoe, BSN, RN]

And for the poster who wrote about a midwife stating that a baby that had died 'just wasn't meant to live' , well that's the statement of a psychopath, plain as anything. Too bad it was a midwife, but they're found anywhere.

I think it's the statement of someone trying to cover their ass.

[Emergent, RN]

I want to revive this thread to get your input. There is a gal at work with whom I'm friendly. We are both counterculture on health management, as I mentioned earler, I had my children at home. I'm not extremist, but grew up in a very healthy conscious home, avoid processed foods, get exercise, and generally distrust the medical establishment, etc.

She texted me about midwife references a couple of weeks ago, I asked around and gave her some. It turns out, she is the pregnant one! The thing of it is, she's 57 yrs old. She has 5 grown kids, is raising a couple of grandkids, and is in a relatively new marriage.

Now, I'll mention, this gal is someone I admire, for her stamina, energy, positivity, commitment to health etc. She appears the picture of health, but has had cardiac problems, has a pacemaker, I think she had a valve replacement, did a lot of self healing she told me. She looks 40. She's planning a homebirth I've heard.

How can I effectively approach her?

[LibraSunCNM, BSN, MSN, CNM]

I want to revive this thread to get your input. There is a gal at work with whom I'm friendly. We are both counterculture on health management, as I mentioned earler, I had my children at home. I'm not extremist, but grew up in a very healthy conscious home, avoid processed foods, get exercise, and generally distrust the medical establishment, etc.

She texted me about midwife references a couple of weeks ago, I asked around and gave her some. It turns out, she is the pregnant one! The thing of it is, she's 57 yrs old. She has 5 grown kids, is raising a couple of grandkids, and is in a relatively new marriage.

Now, I'll mention, this gal is someone I admire, for her stamina, energy, positivity, commitment to health etc. She appears the picture of health, but has had cardiac problems, has a pacemaker, I think she had a valve replacement, did a lot of self healing she told me. She looks 40. She's planning a homebirth I've heard.

How can I effectively approach her?

57! My goodness. Basically if she has a pacemaker and had valve replacement surgery, that combined with her age risk her out of midwifery care. If she somehow finds a midwife who would accept her, I wouldn't trust that midwife's judgement. The more likely scenario will be that she's unable to find a midwife to accept her, in which case she'll have to find an MD, hopefully a more progressive, holistically-minded one.

When you ask how you can effectively approach her, I assume you mean if she makes a decision you're uncomfortable with, like an unassisted homebirth or something? If that's the case, that's tough. You can always point her to studies or other info outlining the appropriate candidates for homebirth, and leave it to her to deduce that's she's not one of them. Ultimately she will have to make her own choice, no matter what it is.

[IrishIzCPNP, MSN, RN, APRN, NP]

I want to revive this thread to get your input. There is a gal at work with whom I'm friendly. We are both counterculture on health management, as I mentioned earler, I had my children at home. I'm not extremist, but grew up in a very healthy conscious home, avoid processed foods, get exercise, and generally distrust the medical establishment, etc.

She texted me about midwife references a couple of weeks ago, I asked around and gave her some. It turns out, she is the pregnant one! The thing of it is, she's 57 yrs old. She has 5 grown kids, is raising a couple of grandkids, and is in a relatively new marriage.

Now, I'll mention, this gal is someone I admire, for her stamina, energy, positivity, commitment to health etc. She appears the picture of health, but has had cardiac problems, has a pacemaker, I think she had a valve replacement, did a lot of self healing she told me. She looks 40. She's planning a homebirth I've heard.

How can I effectively approach her?

I don't think she has to be outside of midwifery care but....she's not getting a home birth! She may very well get a midwife in a hospital setting with great MD coverage but that's it. There's no way. I don't think you have to really approach it. I would give her names and they will handle it. You could also easily tell her that you aren't sure they will take her but maybe hey will and maybe they will consider her for a hospital birth. Not your responsibility to deny the care...let the midwife do it.

[wannabeny]

birth is a natural process..women have given birth with little to no medical intervention for decades.

personally, it sounds like poor decisions by parents and poorly educated midwives alike, rather than "home births".

plenty of people continue to deliver at home..this is common abroad. why is the US so against a natural birth? mind boggling.

i think we need to stop intervening so much unless it is truly necessary.

we always hear the horror stories; where are the other stories where everything was just fine?

[NICUNurseEliz]

we always hear the horror stories; where are the other stories where everything was just fine?

Again, this is a thread on a NICU nurse forum. When NICU nurses see babies who were born at home, something went wrong, ranging from a minor problem to a tragic outcome. If you want to hear stories of smooth home births, try a forum that is not geared to NICU nurses.

[vintagemother, BSN, CNA, LVN, RN]

We are both counterculture on health management, as I mentioned earler, I had my children at home. I'm not extremist, but grew up in a very healthy conscious home, avoid processed foods, get exercise, and generally distrust the medical establishment, etc....

she's 57 yrs old...She appears the picture of health, but has had cardiac problems, has a pacemaker, I think she had a valve replacement, did a lot of self healing she told me. She looks 40. She's planning a homebirth I've heard.

How can I effectively approach her?

I loved your use of the phrase "counter-culture", That's me, too!

Never had kids at home, but almost did with my last, just couldn't afford it. It was an awful experience r/t my treatment at the hospital (it sucks to be knowledgable, ignorance is truly bliss sometimes) Baby was/is healthy, though; but have sworn I will never have a baby in a hospital again. This means I may not give birth again, but that's ok.

How to approach someone who is planning to do something potentially dangerous.... That's a tough one.

Perhaps use therapeutic communication to say, "I understand you want to have a home birth. I get that. I did it also. But have you considered the impact of your pacemaker and other health issues on your baby during labor?"

Then sit back and listen.

Perhaps she has a contingency plan.

[dinirn]

Safer than a hospital? What stats are there to back that up?

[Horseshoe, BSN, RN]

I want to revive this thread to get your input. There is a gal at work with whom I'm friendly. We are both counterculture on health management, as I mentioned earler, I had my children at home. I'm not extremist, but grew up in a very healthy conscious home, avoid processed foods, get exercise, and generally distrust the medical establishment, etc.

She texted me about midwife references a couple of weeks ago, I asked around and gave her some. It turns out, she is the pregnant one! The thing of it is, she's 57 yrs old. She has 5 grown kids, is raising a couple of grandkids, and is in a relatively new marriage.

Now, I'll mention, this gal is someone I admire, for her stamina, energy, positivity, commitment to health etc. She appears the picture of health, but has had cardiac problems, has a pacemaker, I think she had a valve replacement, did a lot of self healing she told me. She looks 40. She's planning a homebirth I've heard.

How can I effectively approach her?

She might look 40, but it doesn't mean her body isn't 57. I'm amazed she could even get pregnant, even with help.

I cannot imagine any ethical provider agreeing to have anything to do with a home birth in this 57 year old woman with cardiac issues, a pacemaker, and a history of valve surgery . Her pregnancy is the very definition of "high risk," no matter how good she looks or even how uneventful the pregnancy has been.

[jenniecaporelli]

I always wonder after reading the comments "I was low risk and healthy but my baby and/or I would have died if we weren't in a hospital" what interventions did you allow that caused these severe complications? I'm an RN in a cardio/vascular icu and had my babies at home. I had a new traditional midwife for my first, I was her 6th mom as an independent practitioner, the others were just a family affair. My babies were born between 1984 and 1993. I had never even thought about home birth until my first lpn ob clinical in 1980. I saw an ob cut a well womans thick perineum, baby was not even near crowning yet, and baby had good heart tones with internal monitor. Blood everywhere. Mom pushed out baby, ob immediately pulled out placenta with extreme cord traction , dropped it in basin, and spend 45 min stitching. 48 hours later, next clinical I'm in well baby nursery, baby is in what we called isolation then for a scalp abscess and mom was hardly able to walk 2nd to what I got in report was an extended tear into rectum. All of this was documented as "normal vag delivery, no complications. That sure got me to explore my options.

[jenniecaporelli]

I always wonder after reading the comments "I was low risk and healthy but my baby and/or I would have died if we weren't in a hospital" what interventions did you allow that caused these severe complications? I'm an RN in a cardio/vascular icu and had my babies at home. I had a new traditional midwife for my first, I was her 6th mom as an independent practitioner, the others were just a family affair. My babies were born between 1984 and 1993. I had never even thought about home birth until my first lpn ob clinical in 1980. I saw an ob cut a well womans thick perineum, baby was not even near crowning yet, and baby had good heart tones with internal monitor. Blood everywhere. Mom pushed out baby, ob immediately pulled out placenta with extreme cord traction , dropped it in basin, and spend 45 min stitching. 48 hours later, next clinical I'm in well baby nursery, baby is in what we called isolation then for a scalp abscess and mom was hardly able to walk 2nd to what I got in report was an extended tear into rectum. All of this was documented as "normal vag delivery, no complications. That sure got me to explore my options.

[Horseshoe, BSN, RN]

I always wonder after reading the comments "I was low risk and healthy but my baby and/or I would have died if we weren't in a hospital" what interventions did you allow that caused these severe complications?

What interventions did I "allow?" Wow. Judgmental much, are you?!

Well, to answer the question, I guess I "allowed" myself to be born with a very small pelvic outlet, even though I had no reason to suspect such a thing since Mom had several 10 lb. babies lady partslly and relatively easy (what was I thinking?), I "allowed" myself to conceive and nurture a child who was healthy and well nourished, I "allowed" myself to go 42 weeks into a pregnancy in spite of taking all safe and natural interventions to hurry things along, I "allowed" myself to try to have a normal lady partsl birth, and 16 hours into the labor, with only 2 centimeters dilation and signs of fetal distress, "allowed" my doctor to perform a c-section. Did the same thing the second time, trying really hard to have a safe v-bac after going almost 2 weeks overdue again, only to go 18 hours and dilate only 1 centimeter.

I don't know why I didn't try harder to not "allow" circumstances to put my baby and myself at risk. If only I hadn't "allowed" these things to happen, maybe I could have had a safe, happy birth experience at home.