Would YOU ever have a homebirth?

kathc · Aug 30, 2005

Yes, I believe it. In fact, I believe you and I have debated it at another website (we were on the same side of the argument, IIRC). :)

I bet we have..

TweetiePieRN · Aug 30, 2005

Homebirth is not for me. My luck, all the nosey neighbors and everyone I wouldn't want around would be there. At least in the operating room (c-section) it's clear on who can be there and who cannot.

Jolie, BSN · Aug 30, 2005

If midwives weren't illegal in my state, I would definitely consider it for a normal healthy pregnancy.
I think women should be allowed the choice as long as they understand the risks and possible complications. Women were having babies at home for centuries before the advancements we have in technology and medicine available today.

While the pratice of "lay" midwifery is illegal in some states, I don't believe that any states have banned the practice of certified nurse midwives. Just something to consider should you opt to become pregnant in the future:)

JentheRN05, RN · Aug 30, 2005

My personal goal in life, well two actually, is 1st to become a Nurse Practitioner specializing in OB. Followed by taking Midwifery classes to become a midwife. My theory behind this is, I will be a Physician with the ability to deliver babies at home. I believe it is important to become a physician prior to the midwife for the simple fact that through education and care as a NP, I would recognize the s/s of a birth going wrong and take appropriate action (aka - getting mom to the hospital). And if something were to go wrong and I didn't notice it, I would be able (for the most part) be able to stabilize the patient enough to get her to the hospital. By no means do I want to be strictly a midwife and primarily deliver babies in the home. I just want moms to have an option if the pregnancy is going well and has a 'predictable outcome'

Jolie, BSN · Aug 30, 2005

My personal goal in life, well two actually, is 1st to become a Nurse Practitioner specializing in OB. Followed by taking Midwifery classes to become a midwife. My theory behind this is, I will be a Physician with the ability to deliver babies at home. I believe it is important to become a physician prior to the midwife for the simple fact that through education and care as a NP, I would recognize the s/s of a birth going wrong and take appropriate action (aka - getting mom to the hospital). And if something were to go wrong and I didn't notice it, I would be able (for the most part) be able to stabilize the patient enough to get her to the hospital. By no means do I want to be strictly a midwife and primarily deliver babies in the home. I just want moms to have an option if the pregnancy is going well and has a 'predictable outcome'

Jen, I think you are confusing some terms and roles. A nurse practitioner is not a physician. While the education necessary to become a Women's Health NP would make a great foundation for a midwife, it is probably not necessary to go that route. Certified Nurse Midwives are advanced practice nurses with the education and experience necessary to provide care for the female patient throughout the lifespan, including well-woman exams, reproductive health care, birth control counseling, and menopausal care. Their education and experience differs from that of "lay" midwives who are not nurses, and who complete their education, in part, thru an apprenticeship with an experienced midwife. Few lay midwives have hospital privileges, and so usually provide care in the home only.

JentheRN05, RN · Aug 30, 2005

Jen, I think you are confusing some terms and roles. A nurse practitioner is not a physician. While the education necessary to become a Women's Health NP would make a great foundation for a midwife, it is probably not necessary to go that route. Certified Nurse Midwives are advanced practice nurses with the education and experience necessary to provide care for the female patient throughout the lifespan, including well-woman exams, reproductive health care, birth control counseling, and menopausal care. Their education and experience differs from that of "lay" midwives who are not nurses, and who complete their education, in part, thru an apprenticeship with an experienced midwife. Few lay midwives have hospital privileges, and so usually provide care in the home only.

Well - I appreciate you pointing these things out for me. I guess I haven't throughly researched the subject! Now I have to change my goals - well shake them up a bit. Thank you very much, that actually helps alot. :)

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.

fieryrn · Aug 30, 2005

My personal goal in life, well two actually, is 1st to become a Nurse Practitioner specializing in OB. Followed by taking Midwifery classes to become a midwife. My theory behind this is, I will be a Physician with the ability to deliver babies at home. I believe it is important to become a physician prior to the midwife for the simple fact that through education and care as a NP, I would recognize the s/s of a birth going wrong and take appropriate action (aka - getting mom to the hospital). And if something were to go wrong and I didn't notice it, I would be able (for the most part) be able to stabilize the patient enough to get her to the hospital. By no means do I want to be strictly a midwife and primarily deliver babies in the home. I just want moms to have an option if the pregnancy is going well and has a 'predictable outcome'

First of all: Becoming a Family Nurse Practitioner does NOT make you a physician. Once you acquire your BSN, then you can work toward a Master's Degree in Nursing with a concentration in a particular area such as:

Clinical Nurse Specialist

Clinical Services Administration

Community Health Nursing

Family Nurse Practitioner

Neonatal Nurse Practitioner

Nurse Anesthesia

Nurse-Midwifery

Nursing Education

A concentration in Nurse-Midwifery will give you all the training needed to deliver babies anywhere...hospital or otherwise. A nurse practitioner knows very little about OB...because their training is generalized for the care of patients of various ages and complaints.

A nurse midwife is a NP in OB.

"By no means do I want to be strictly a midwife"...I believe when you research the various concentrations in an MSN program, you will see that you DO want to be the midwife...she is the most knowledgeable when it comes to delivering babies!

Simply a clarification and hope this helps....

FieryRN

lisamc1RN, LPN · Aug 30, 2005

My 4th baby was born at home with a CPM. If I were to get pregnant again, I would definitely consider another homebirth. The thing that is incredibly frustrating to me is that you just can't look in the phone book for a CPM when you get pregnant, at least not here. You get pregnant and want an OB, you have a million to choose from in my area. You want a midwife and you will have to ask around and see if you can get any recommendations. I moved too far away to have the same midwife as I had with my son so I'd have to start the search and interview process all over again. I'm tired just thinking about it. I can understand why women who might want to have a homebirth may end up with a hospital birth anyways because they might not even know where to look for a midwife!

JentheRN05, RN · Aug 30, 2005

First of all: Becoming a Family Nurse Practitioner does NOT make you a physician. Once you acquire your BSN, then you can work toward a Master's Degree in Nursing with a concentration in a particular area such as:
Clinical Nurse Specialist
Clinical Services Administration
Community Health Nursing
Family Nurse Practitioner
Neonatal Nurse Practitioner
Nurse Anesthesia
Nurse-Midwifery
Nursing Education
A concentration in Nurse-Midwifery will give you all the training needed to deliver babies anywhere...hospital or otherwise. A nurse practitioner knows very little about OB...because their training is generalized for the care of patients of various ages and complaints.
A nurse midwife is a NP in OB.
"By no means do I want to be strictly a midwife"...I believe when you research the various concentrations in an MSN program, you will see that you DO want to be the midwife...she is the most knowledgeable when it comes to delivering babies!
Simply a clarification and hope this helps....
FieryRN

Again - I appreciate the extra info you have provided. I'm actually researching this right now :)

ljds · Aug 30, 2005

I have had complicated pregnancies and preterm births. If I had healthy pregnancies, I would TOTALLY have a homebirth.

I feel that alot of the complications we may see are often caused by managed labor and routine practices, or by poor maternal health and lifestyle. Not ALL, but alot.

I feel like, as a nurse knowlegable in L&D and postpartum, I would have the best of both worlds at home! I was also totally happy to be able to give birth in a hospital, which could treat my dds for any problems with prematurity.

I totally respect other opinions on this, and think it is most important that we are able to birth in an environment where we feel comforable, safe, and respected. For some that is the hospital, for some that is home. I feel lucky to have the education and options to pick what is right for me during a given pregnancy.

Lori

lauriesalRNC · Aug 30, 2005

As an OB nurse, I will tell you there is NO way in hell I would ever do it. I've seen too many shoulder dysotocias. If you have a really bad shoulder dystocia, all the backup in the world is still going to take several minutes ....and you dont have that kind of time with a dystocia. Also, I've seen some cord prolapses.... you dont have 10-15 minutes to get to the hospital. I just dont understand why anyone would risk serious problems like that. Granted these things dont happen often but they are unpredictable so who knows when they will?

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.

fieryrn · Aug 30, 2005

Midwifery care at home if governed by set regulations designed to reduce the risk of certain complications. Shoulder dystocias are often expected in the hospital setting when labor is extremely long or the fetus remains above zero station when labor begins in a primip etc. In these instances, home birth becomes less safe and transfer of care should occur.

Also, rarely do midwives rupture membranes until delivery is imminent and never until the fetal head is well applied. Most of the problems that occur in the hospital setting are the result of interventions and not from a normal course of labor.

Midwifery training is much different than that of a physician! Midwives utilize many interventions that physicians do not because they are acutely aware of what can happen if complications arise. Midwifery care is safe care....for low risk pregnancies!

FieryRN