Need advice: non-hospital birth?

fergus51 · Nov 3, 2003

I don't have a problem with homebirth for low risk women (I am assuming you are low risk and had no problems with birth #1). There has been research showing that this is a safe way to deliver, with some advantages over a hospital birth. Some nurses are completely against it, because an emergency could happen, but I don't think being 2 minutes from the hospital is going to delay your treatment enough to make a difference in the outcome AS LONG AS the midwife has a relationship with an OB who knows when you go into labor and is called at the first sign of problems.

That said, I think you need to be very well informed about the risks and what type of non-hospital birth you want. Personally, I would deliver in a birth center with a certified nurse midwife because I know their training and they have equipment needed to recusitate a baby. I wouldn't deliver at home, but that's because working in a high risk OB center has warped my perceptions a bit. If I were you, I would book an appointment with the midwife and talk to her. Many will point you to places where you can get info on homebirths and talk to other women who have experienced it.

SmilingBluEyes · Nov 3, 2003

You are NOT alone in wanting a more personalized, comfortable and natural birth experience. Many people feel this way, and I do not blame them. I will share my opinion as a labor/delivery nurse and mother:

As an RN I WOULD be comfortable birthing in a birthing center that is backed up by a hospital/physicians in case of emergency, IF mine were a low-risk pregnancy. Midwives provide very comprehensive, wonderful, sound care and most these centers DO have hospitals nearby they use as backup in case of emergency........

Make sure all personnel attending you have NRP (neonatal resuscitation cert.) and CPR. Yes DO check this out!

As an RN, I would NOT be comfortable delivering at home, especially if unassisted. MANY women are, but not me. I have seen too many things change on a dime. Even with a midwife present, DO make sure he/she has hospital/physician backup in case of emergency.

Ivillage has some excellent homebirthing and midwifery forums......these are people who have given birth at home and have seen midwives for their care. They have a lot of wisdom and opinions to share. Here are the links:

http://messageboards.ivillage.com/iv-pphomebirth

http://messageboards.ivillage.com/iv-ppmidwives

http://messageboards.ivillage.com/iv-ppunassisted

some may seem "far out", others may be just like you. Never hurts to read the stories of those who HAVE been there. Best wishes to you!

Dayray, RN · Nov 4, 2003

I agree with the other 2 posters about the hospital back up.

I personally am fascinated by home birth. I am also concerned that some of the info I have read is hmm how should I say.. wacky

but don't let that stop you.

I think there is allot to be said for birth centers and home birth. You are right midwifes tend to give more personal care and face to face time. Some even deliver all there own patients so you will know who is going to be at your delivery. these little things go along way in making your pregnancy and delivery go smoothly.

I would recommend that you be very careful in selecting your midwife. If she isn't a CNM (certified nurse midwife) make sure that she is registered or licensed by the state. There are allot of certifications out there that can make it confusing. Just make sure that whatever credentials she has are recognized by the local government or they might not mean much.

There are many midwives out there that have attended thousands of births and never attended a day of school or sat for a state test. While some of them may be very safe and highly skilled others may not and you have no way of knowing unless they are state licensed.

Ask her what criteria she uses in deciding to transfer delivery patients to a hospital and find out if she has an arrangement with a doctor to send her patients to if the pregnancy becomes complicated.

Lastly and most importantly make sure that you feel safe and comfortable. The whole point of birth centers and home birth are that the environment makes the birthing process less scary and more natural. If this is achieved it can actually make your delivery more healthy for you and your baby.

SmilingBluEyes · Nov 4, 2003

a pro-homebirthing article for you:

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http://www.parentsplace.com/expert/birthguru/articles/0,10335,166371_183241,00.html

SmilingBluEyes · Nov 4, 2003

and another:

http://www.parentsplace.com/pregnancy/labor/qas/0,,239071_113902,00.html

L&D_RN_OH · Nov 4, 2003

Originally posted by Dayray
I would recommend that you be very careful in selecting your midwife. If she isn't a CNM (certified nurse midwife) make sure that she is registered or licensed by the state. There are allot of certifications out there that can make it confusing. Just make sure that whatever credentials she has are recognized by the local government or they might not mean much.

I seem to agree with you Dayray, on most things. :) However, this portion I don't. Mainly because, it depends on the state you are in. Ohio, for instance, doesn not recognize or license direct entry midwives. This does not mean they are any less competent to attend births. It merely means that Ohio is a conservative, old school state that has not recognized the benefits and advantages of DEMs and homebirth.

That said, I agree that you should interview any midwife, CNM or DEM, about training, experience, NRP certification, reasons for transfer, physician back up, etc. While some women are comfortable with a midwife who will merely "be there", I at the very least, want a midwife who carries oxygen with her and is competent in neonatal resuscitation.

I happen to think that homebirth is the safest option for most low risk women. But, mm1021, I am thinking that if you have to ask if it is "worth the risk", you are not exactly convinced that it is the safest option for you. I think in order for a homebirth to be successful, all parties must feel confident in the safety and relative low risk involved. I think you should definitely perform more research about your options before making a decision. :)

Forgot to mention, I am an L&D RN who did plan a homebirth.

rpbear · Nov 5, 2003

I agree with L&D_RN_OH, if you don't feel comfortable with a birthing center, then it may not be the right option for you. You need to feel comfortable with the person you choose to deliver your baby, whether it be a midwife, OB, or NP. You also need to feel safe in the environment you are in (hospital, home, birthing center ect.) Find a place and a person that fits your needs, shop around, and do a lot of research.

Good Luck!

mm1021 · Nov 5, 2003

Well, I have to say I'm a lot more encouraged about the idea of a homebirth/birth center after these replies. In an ideal world I'd be able to have a midwife's care in a hospital setting, but that isn't an option here.

I will definitely follow up on your suggestions for interviewing midwives. I think a lot of my comfort level with a home or birth center birth will depend on finding someone whose experience and expertise I can trust. Thanks so much for the encouraging advice!

joyflnoyz, LPN · Nov 5, 2003

I had my first two children in the hospital.

1982

Dr #1 induced me for 20 hours over 2 days D/T BP being up a bit..pitocin, mag sulfate, monitor, foley (and they "FORGOT" to pull it when I pushed, and to this day I have a leakage problem) flat on my back for 2 days. No control what so ever. The IV pump kept beeping, and the nurse kept coming in and resetting it.. Beeps again. Husband took a look at it and saw the tubing was threaded the wrong way Pointed out to nurse and she said

and it worked beautifully.. Hubby was the one putting me on the bedpan, wiping my butt, etc cuz nurses were no where to be found when I needed them (remember, I was confined to bed)

1983

BP elevated a small amount. Dr confines me to bed on phenobarb and aldomet

OH except for the fact that I have to have someone drive me to his office everyday for a BP check.

Dr#2 had been up for more than 24 hours when i went into labor. I was at the hosp 3-4 hrs before baby was born. My uterus "clamped down" on placenta so after no drugs at all, they transferred me to the delivery room, gave me a spinal . As soon as the spinal was given, placenta expelled. They did a D&C "just to be safe" even though placenta was complete. Then, because my hemogloblin was 11.5 he transfused 2 units packed cells. HUH??

baby born 3 AM..I went home 36 hours later.

1987

#3

When I became pregnant with #3 I went looking for a midwife for a homebirth. Found a WONDERFUL lay midwife. She taught me about nutrition and exercise. NEITHER dr said a word!! there was a dr doing "back up", and if needed we weren't stupid enuf to say no hospital.. Beautiful birth at home, husband and daughter #1 were there, MIL was with daughter #2 sleeping as it was about midnight when daughter #3 was born.

1992

Pregnancy #4

By this time, the midwife's apprentice with the previous birth has become a good friend. She even started homeschooling because of me LOL. The dr doing "backup" has stopped, due to pressure from other drs. We figure if it's an emergency, we'd get whomever was at the hosp anyway, so no big difference.

I go into labor, and walk around the neighborhhood.

Son was born around 6 PM, all 9#4oz

Same "problems" with all 4 pregnancies, 2 different approaches by 2 different drs and and 3rd approach by the midwives.

One of the best things?? Not having to travel to hospital/birthing Center while in labor. With #2 it was about midnight, and we were stopped at a traffic light with NO ONE else around 'cept for one car behind used. Strong contraction begins as light changes and I tell Tom DO NOT move this car. Idiot behind us leans on the horn ..he coulda just gone around. pfft Having the birth attendent come to ME and work with Tom and I.

Drs see pregnancy as a disease to "cure" a woman of.

I'll take homebirth with midvives over hospital birth.

fergus51 · Nov 5, 2003

Not gonna flame you, but some Drs are actually good. The traditional disease approach is not taken by all. I like practitionners who are somewhere in the middle, know what I mean? Not "I am the doctor, aka God, and will control everything" or the "I am a midwife and everything is natural, don't worry about that cord prolapse...". Fortunately, I find the majority of providers have a good amount of common sense and actually do care about what their patients want:)

Texagain · Nov 5, 2003

Personally, I would never have a home birth.

My personal experience included a perfectly normal hospital delivery (short and sweet with excellent care) followed 2 years later by a completely disastrous delivery with practically every complication possible.

I understand the desire to have a pleasant birth experience. Who doesn't want that? Hope for the best, but plan for the worst.

A birthing center would be an acceptable alternative for me (except I won't be doing *that* again!). Full court medical backup would be a requirement.

JMHO