opinions about homebirthing

[momma/babyrn]

I have a few friends who've decided to have homebirths. I'm curious about this seemingly growing trend. I'd love to hear some opinions from those who've done it, participated in it, and delivered some of these babies at home.

TIA!! :redpinkhe

[shortstuff31117]

Let me clarify myself. I was referring to hospital based birthing centers. If there even was one around where I live I'd consider one. Simply saying delivering at home wouldn't be my preference. Kudos to those that do, I've just seen too many deliveries that would have been really bad if they had happened at home.

Do elaborate...

[babynurse357]

Shoulder dystocia is my greatest fear because you never know when it will happen and how bad it will be. We had a t/f in with dystocia, the head was delivered and all attempts and maneuvers they tried to deliver the rest of the baby failed. They put her in an ambulance with the head left out. Needless to say the baby was already dead when they arrived.

It's totally a personal choice and I respect that, just wouldn't be my preference.

[Booty Nurse, BSN]

I agree that shoulder dystocia is terrifying. My last delivery before I sat for my midwifery boards was a shoulder dystocia, and I was unable to get the baby out. However, I only tried for a moment before asking the senior midwife (who was at my side) to take over, and she got the baby out without much difficulty. This didn't improve my confidence level, and the possibility of shoulder dystocia has given me the willies ever since (actually, it was my biggest fear from the very beginning of my interest in midwifery).

This article on shoulder dystocia in American Family Physician presents many techniques for dealing with shoulder dystocia. All of them can be done at home, except the ones that require immediate transfer to an OR. As I said before, many small hospitals have no in-house anesthesia or OR crew, and the OR may not be ready for half an hour; by this time a home-birthing mom could transfer to the hospital.

Shoulder dystocia is slightly less likely to occur in a home-birthing population because there would be no mothers with gestational diabetes. Also, epidural anesthesia increases risk of shoulder dystocia. Management of shoulder dystocia could be more difficult in a hospital because the mom is likely to be less able to change positions due to epidural anesthesia and things in the way such as IV tubing or fetal monitor straps. Flipping the mom to hands-and-knees position is one of the best ways to deal with a shoulder dystocia because it increases the pelvic outlet by 1 to 2 cm, and it's hard to flip a mom who is hooked up to lots of equipment, whose mobility is hampered by an epidural, or who is groggy from narcotics.