midwifemamma

unless there are problems, babies go right up to the mother's chest, skin to skin, and stay there for at least an hour. we encourage them to breastfeed during that time. vital signs are done on mom's chest (q30x4, qhourx2, then q4hours). eye ointment and vitamin k can be delayed up to an hour. baths should get done before transferring to postpartum (usually 2-3 hours or so). i feel it is very important that the babies go right up to their mothers who have waited their whole pregnancy to see them and worked hard to birth them. unless complications arise, i don't feel that babies should be taken to the warmer for drying, or vital signs, or meds. all that can be done on mom's chest, including the meds. our healthy term newborns do not go to a nursery for transition, they constantly room in with their parents.

I agree that the child abuse analogy is going too far, and it could very easily be turned around the other way. As parents, I believe that we are doing what we perceive as the best for our children when we choose where to birth them, whether it be at home, a birth center, or a hospital. I had my last child at home, and I plan to have my future children at home as well. I am a high risk labor and delivery nurse, and I still feel that having my babies at home is the right choice for my babies and family. And I am not the only nurse where I work who has chosen to have her babies at home, there are a number of us.

she's probably retracting the foreskin which would, of course, make a baby scream. the foreskins are not supposed to be retracted on babies. that is very painful.

i am a small woman (5'2, 95lbs prepregnant). i weighed 122lbs at the time of the birth of my son. my son was born weighing 10lbs 6oz. i was not diabetic. he did have a shoulder dystocia, but it was handled very well. he made it out of me without a broken clavicle or any damage. and he was born at home over my intact perineum. and we see 11lb'ers where i work. normally it is from the diabetic moms though.

i've never seen that show, but i do know about out of hospital births and hospital births. i am a high risk ob nurse, and i also had my last child at home with a midwife (and my son had a shoulder dystocia, needed resuscitation and all- and it was handled wonderfully at home). pph does happen in homebirth settings and birth center settings. midwives here carry pitocin, methergine, cytotec, iv's, iv fluids, etc. pph can happen unexpectedly as it did in your case, but the midwives here are well prepared for it. if they have to transfer into the hospital they do. also, my sons shoulder dystocia was a serious one. if i would have had him in the hospital, i could be one of those people who says that their baby would have died if i had him at home. yet i had him at home and it was handled wonderfully. we just don't always know how our situations who have been handled in a different setting.

actually, where i live it is 50/50 for boys who are circ'd and boys who are left intact. for the original poster, my son is intact also. retraction is not necessary. it used to be recommended that parents retract their newborn's foreskins, but that is no longer recommended.

i think it does vary from place to place. some places have ldrp's like you mentioned, and to work in those i'd assume that you have to be trained in both l&d and postpartum. other hospitals have those units separate, and i would assume that some of them have nurses crosstrained to do both units, and others do not. for me, finding a job in ob was tough at first, so i did a few years of med-surg first. then i found a job that started in postpartum, and then they train you to do labor and delivery. i love postpartum so much! i'm working on getting my hours for my IBCLC, breastfeeding is one of my passions. my understanding is that for the most part (at least in my area), postpartum seems easier to get into, and then it seems like it's easier to transfer to l&d once you have pp experience.

was curious about what different hospitals do in regards to preventing abduction (this stemmed from another thread where abduction was mentioned). for us, we have a security system. the baby has a security tag on, and if it gets cut or taken off, the alarms will go off. or if the baby even gets to close to the door of the unit, the alarms go off. i guess i assumed that most hospitals did this type of thing, but i'm finding maybe not. what is done at your hospital?

It's been found to not be necessary. The alcohol can kill the bacteria that help the cord dry up and fall off. So they've found that when alcohol is used the cord can end up staying on longer. It's recommended now (at least where I work) to not use anything to clean the cord. We just recommend keeping it dry, keeping the diaper below it, and watching for and reporting signs of infection.

just wanted to add that we do not advise women to use alcohol anymore on the cord.

if there is no meconium, do you still suction no matter what? i'd be interested in seeing the evidence that all babies need suctioning.

like i said earlier i think there tends to be a misunderstanding about homebirth. as a mom i felt it so important to educate myself about all options and really research. i too had a complication as i mentioned earlier (though i was at HOME) and my baby lived. this was because my midwives were very well trained and prepared for emergencies. i also mentioned my coworker who had the same complication in the hospital and her baby died. i feel safe at home. like i said earlier, educating oneself and researching is so important, especially with having children. i feel everyone should educate themsevles and make the choice that is best for them. i wonder if you read any of my posts earlier? with homebirths, like i have already said, we are well prepared for emergencies due to our equipment and training. we also will transfer to the hospital if things are not going right. we monitor mom and baby closely. saying that homebirths are unsafe is not a true statement. once again, research has not shown that to be true. there is not a higher incidence of mortality/morbidity with homebirths.

we posted at the same time. i think we can agree to disagree too.

and i am not willing to risk the problems that the hospitals have. having a homebirth with a midwife dramatically reduces the risk of cesareans, episiotomies, instrumental delivery, and YET does NOT have an increased risk of morbidity or mortality.

also, your hospitals sound much better than the hospitals here. therefore, many women do make the decision to birth at home for many reasons including the care the hospitals give. i don't feel they should be judged for that.

it's a personal choice. we can review the same literature and reach different conclusions. based on my experience, my education, and my research, i feel safer being at home. like i said, we have equipment so help is right there. if a transfer is needed, we transfer. it is a choice that i and other women make. it does not make us bad moms, or mean that you then have the right to judge us, not at all. but you've already said you judge anyway. that is your right, i just choose not to judge others, especially as a nurse. i guess i just have different values.

i became a nurse, have seen the realities of childbirth, and am convinced of the safety of homebirth. education is so important, i'm so glad i have chosen to truly educate myself about this, i love my children that much that i took it on myself to research, be educated, and make the choice that was right for us. i don't feel that saying "i've seen a homebirth(s) go wrong" is enough. the same is said for hospital births. TRULY educating oneself and being very informed is so important.

also, i know i'm not a NICU nurse, but i am an RN, and i feel very passionate about this and couldn't resist the urge to jump into this thread.

so do you advocate for decreasing the number of unnecessary cesareans? do you advocate for natural birth, avoiding epidurals and medications due to effects on the baby? do you also judge the moms who choose to have medicated births and end up with babies with respiratory depression? do you judge the moms who choose circumcision?

I was wondering what equipment you think are brought to homebirths? also, do you have no sympathy for the people who chose hospital birth and had bad outcomes due to interventions that led to more interventions, which would not have happened at home? In my area we bring (to name just a few items): oxygen, suction, resuscitation equipment, IV fluids, IV equipment, antibiotics (for GBS), epinephrine, meds for PPH (pitocin, cytotec), mag sulfate, and many other items. I think there tends to be a misunderstanding in general about homebirth, hospital births, and evidence. It was also mentioned that one bad homebirth all it takes to convince you. Well for me, I’ve seen too many bad hospital birth outcomes to convince me that it is not the choice for me.. I used to feel that homebirths were too risky and unsafe. But during my last pregnancy I decided to research for myself and make the decision that I felt was the best and safest option for my baby. Choosing a homebirth was not a decision I made lightly. I did my research, interviewed midwives, and asked a lot of questions about training and equipment brought to births. A coworker had hospital birth a few years back and her baby died after a shoulder dystocia. Had she been at home, the homebirth would have been blamed. The hospital is not perfect either. I saw an OB until 36 weeks and was planning on delivering in the hospital. I researched homebirth and interviewed around and changed my mind. My OB also thought my baby would be small. I am a tiny woman and gave birth to a 10lb 6oz baby, with a 14.5 inch head and a 16 inch chest (over an INTACT perineum) at HOME. My son did have a shoulder dystocia and required resuscitation (PPV) to come around. My midwives were well prepared and handled it very well. We did not end up needing to go to the hospital. I can completely understand that as NICU nurses you have seen bad outcomes (for hospital births and homebirths) and I respect that many of you choose to birth in the hospital. For me, as a RN, I have seen too many bad outcomes in the hospital and I feel safer at home. If I were ever considered high risk during a pregnancy I would definitely birth in the hospital. I think that having a choice in childbirth is important, as is making an informed decision I think with hospitals and cesareans, I’m glad that option is there if NEEDED. For me, I personally felt that having a hospital birth was a risk I didn’t want to take. I didn’t want to increase my chance of an unnecessary cesarean, episiotomy, instrumental delivery etc. It was a personal choice that I made in the best interest of my child due to bad outcomes I’ve seen I felt quite safe at home. I do not feel that my son was at increased risk at all. I recommend researching and learning more about birth if you truly believe that. In my area, as I mentioned, we do carry emergency equipment and are trained to use it. We are also very near to many hospitals as well.