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.
I'm a student nurse, who will actually be doing OB for the first time this semester. But I'm older (2nd degree), and will be having kids in the next few years...
I would like my first to be at a birth center. I don't think I'm ready to go all the way homebirth for the first.
After that, I'd like to do a home birth for subsequent children. In the DC-MD-VA metro area, there is a CNM group that specializes in homebirths--direct entries MW are illegal in MD and DC. I also personally like the idea of having a CNM attend my birth over a CM (although I would take Ina May Gaskins over CM, CNM, and OB-GYN any day!)
I would only plan to labor in a hospital after researching the hospital thoroughly vis a vis IV, routing fetal monitoring, C-section rate, episiotomies, etc. I know that by saying this, I sound like I would be a pain in the a** in the hospital, which is why I've chosen the way I have.
Absolutely, if I could. I went from being convinced during my first pg. that an epidural was the only way to go, failing to educate myself on alternatives, and almost ending up with a c-section because I couldn't feel to push effectively. I am still so incredibly thankful to the OB who delivered my dd that he was patient for 3 1/2 hrs...because the lady partsl delivery was the only "normal" thing for either one of my pregnancies, and I absolutely cherish the experience.
I then actually did some research, became very educated on the options, and was determined to go unmedicated with the 2nd. (A homebirth was not an option b/c I had a cerclage). Circumstances prevented it and I ended up with a c-section--totally the right decision by the OB.
But if I did have a choice in the future, I would choose a freestanding birth center with a midwife right next door to a hospital with a level III NICU!
Shannon
PS the book Babycatcher is awesome, for anyone interested!
Do you think a staff nurse who works in the L&D department of the hospital at which she would be giving birth, and has very strong opinions regarding the use of medications and interventions, has a better than average chance of being able to AVOID these things?
Of course she does, depending on the environemnt in which she works.
(A bit off topic here....) It's funny, I think I may be one of the few woman who shudder at the very thought of getting an epidural. I don't like the risks involved whatsoever - the possible hypotension, chronic back pain, spinal headache, prolonged labor, side effects to baby..... :uhoh21:
Not to say these are common, but they do happen, and that's enough to scare me away. I plan to do it all au natural.....LOL
Actually an epidural, properly placed in the epidural space, will not give you a spinal headache or cause chronic back pain and in my own experience as an L&D nurse does not prolong labor but allows the woman to relax and the cervix to dilate and there are no real side effects to the baby except if you do get hypotensive, which is quickly fixed with fluid.
Of course we need Kevin here, who has gone over all this extensively on other threads.
The CRNA I work with tells women that usually the back pain they experience is from having a baby rather than the small catheter in their back.
Please don't think I'm advocating for women to get epidurals - I'm all for natural childbirth. I just want people to have all the information they need to make an informed choice.
I thank everyone PROFUSELY for keeping this on-topic and being respectful. It's been a great discussion. Definately things to consider on "both sides" here. Thanks for keeping it pleasant!
With my second, I delivered in my hospital with a CNM: no meds, no IV's no nothing except routine intermittant monitoring. It was great. I probably could have done it at home, but being a L&D nurse and having seen how wrong things can go so fast, I would not risk a home birth, but am fine with it with a qualified care provider who has good OB back-up.
With my homebirth, we used lots of chux, a shower curtain under the sheet, and the midwives cleaned up EVERYTHING. And I wouldn't want an epidural anyway. :)
I have a friend who has had all her 4 of her babies at home with a midwife and she says the same thing about the clean up.
Still . .. it is a little something that bugs me. :imbar
I'm not a L & D nurse, but I thought I would add my 2 cents. I don't even have children yet, but when I do...I was 10 lbs. 12 oz. when I was born, my brothers and sisters were all over 9 #. My boyfriend was a hefty baby too. With all those big big babies...ouch! I am not that big and there is no way a 9 or 10 # baby is fitting through my birth canal.
:) Jaime
There is no way you know that such a baby will not fit through your pelvis. I have seen very tiny women (under 5 feet) deliver 10 pounders without a tear.
I would only deliver in a hospital with a level III NICU. I don't chastise those that do/want a homebirth, but personally I know s#*t happens. It doesn't happen often, but it does.
The only problem with that thinking is that in a hospital with a level 3 NICU, you (as the laboring woman) are probably far more likely to get unnecessary interventions that could cause your baby to need a NICU in the first place. Big, teaching hospitals (with interns and residents) are far more likely to overuse interventions in the first place.
Well I think ANYone who spells out her wishes clearly has that chance, not just a nurse. I know for a fact it can happen cause we have done it....
We did have a nurse (not an L/D nurse) who delivered some months ago, who refused all baby shots (but allowed eye ointment) and refused IV and any interventions beyond position changes and massage. She did go on to the "precip" for us---yep---- we delivered her baby before dr. arrived. Her wishes were well-spelled-out and we respected them to a "T". She understood, however, that if medical complications occurred, we may have to have an IV and meds. Both sides were willing to compromise some. Both sides had clear communication going, as to expectations and the whole (short) process.
But she got the med-free, low-intervention, immediately- to- the- breast, birth she wanted. IN a hospital, no less!
I delivered a baby just the other night. She was there about 5 minutes before the baby came. She stayed home with her doula and SO. It was such a great feeling. I love when that happens!
Specializes in Vents, Telemetry, Home Care, Home infusion.
Due to my high risk status, not an option for me. You certainly don't want me birthin babies as not my area of expertise---great with C section wound dehisence though!
I thank all the Nurse Midwives over the past 20 years who have been responsible for reintroducion of Midwifery and home births/birthing cneters/water births for appropriate low risk women.
It is a shame that due to medical malpractice rates in PA and reduced reimbursement (along with increase in woment with no health insurance),that 5 hospitals with strong Midwives practices were forced to close their OB departments in Philly area in past 2 years. We do have a Birth Center across the street from one hospital in my area so women still have some choices.
I highly recomend the Frontier School if anyone interested. More power to those who choose this area.
I would only deliver in a hospital with a level III NICU. I don't chastise those that do/want a homebirth, but personally I know s#*t happens. It doesn't happen often, but it does.
Might not be a popular opinion, but I'm with you! I think I'm just a paranoid mama...I had two c-sections and worried to death both times. It made me more comfortable to deliver in a hospital with a level III NICU--I didn't do it the first time, but I did the second time. Absolutely nothing against those who are fans of the home birth. I just think I would be a nervous wreck.
It is a shame that due to medical malpractice rates in PA and reduced reimbursement (along with increase in woment with no health insurance),that 5 hospitals with strong Midwives practices were forced to close their OB departments in Philly area in past 2 years. We do have a Birth Center across the street from one hospital in my area so women still have some choices.
Karen,
I worked in a suburban Philly hospital with a strong midwife presence, but moved away about 6 years ago, and haven't kept up with the local changes. Do you mind listing the hospitals that have been forced to close their OB services? Such a shame!
Merovingianne
23 Posts
I'm a student nurse, who will actually be doing OB for the first time this semester. But I'm older (2nd degree), and will be having kids in the next few years...
I would like my first to be at a birth center. I don't think I'm ready to go all the way homebirth for the first.
After that, I'd like to do a home birth for subsequent children. In the DC-MD-VA metro area, there is a CNM group that specializes in homebirths--direct entries MW are illegal in MD and DC. I also personally like the idea of having a CNM attend my birth over a CM (although I would take Ina May Gaskins over CM, CNM, and OB-GYN any day!)
I would only plan to labor in a hospital after researching the hospital thoroughly vis a vis IV, routing fetal monitoring, C-section rate, episiotomies, etc. I know that by saying this, I sound like I would be a pain in the a** in the hospital, which is why I've chosen the way I have.