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I would never jeopardize my health, or the health of my babies by not going to a hospital and a doctor. If a woman wants to play Little House on the Prairie, that would be fine, but the baby doesn't get a vote.
I had two big healthy babies with no complications, and would have been a prime candidate for a home birth for number 3. But number 3 came early and was rushed into intensive care at birth. I'm glad I was at a medical center among professionals.
I would never jeopardize my health, or the health of my babies by not going to a hospital and a doctor. If a woman wants to play Little House on the Prairie, that would be fine, but the baby doesn't get a vote.
I had two big healthy babies with no complications, and would have been a prime candidate for a home birth for number 3. But number 3 came early and was rushed into intensive care at birth. I'm glad I was at a medical center among professionals.
You obviously do not understand. Homebirth is appropriate for low-risk mothers and low-risk situations. Babies who "come early" do not qualify for this. There are indeed studies to show that homebirth in low-risk women is actually SAFER than hospital birth. A good link for this is here: Home Birth Safety Research
There is nothing "Little House on the Prairie" about it. My home is clean and contains no "superbugs" like the hospital. My husband and I both work in medicine are able to handle, along with the midwife and her assistant, the same complications that are handled at the hospital (including specialized neonatal resuscitation). I was in perfect condition to labor and my midwife had thoroughly examined me. Intermittent auscultation with a fetoscope is proven to catch distress as quickly as an electronic fetal monitor.
In addition, from my nurse friend in L & D at our local hospital, the average time from "call" to emergency C-section is approximately 17 minutes at their facility. I could easily be at the hospital in that time had something gone seriously wrong....and of course we would have called ahead. Watch The Business of Being Born (noted earlier in this thread) if you would like to be further educated. Facts are facts, my evidence and decision-making was not based on anecdotal stories such as noted above.
I have one child and might try for another one in the next year (I'm getting anxious that I might be pregnant right now actually) and over the last several months have considered a midwife this time around. I have some major questions though, and really should call a couple of local places, but I want to ask here too.
With my first, I had an epidural and really think I'm going to need that the next time around. Is that an option if I go to a midwife? And do midwives deliver in a hospital if I prefer?
What are some major pros/cons I should think about?
Any information on midwives would be great.
(If I end up taking a positive test this week, I'll definitely be calling some midwives in my area, asap!)
Some "birthing centers" that use midwives have the resources to use allopathic (i.e. evidence-based) pain management, including epidural anesthesia, but not all. You should call and specifically ask. For example, in the Boston area, two hospitals in Cambridge are well known for "natural" birth and one won't have anything to do with allopathic pain management (Cambridge Health Alliance's Birth Center), the other, Mt. Auburn Hospital Bain Birthing Center does utilize anesthesia.
Some midwives appreciate allopathic pain management more than others; you should discuss this in your first visit (if you go with a midwife).
I would not recommend using a midwife. Complications arise in L&D and the fact that an OB and their OR is only two minutes away doesn't matter when the midwife spends hours convincing you not to go to the OB floor because the magic of natural childbirth will be lost.
Disclaimer, I am an M.D. and my wife delivered our first child with an OB. Our experience was excellent, though I do believe it was helpful for my wife to have her husband know medicine and be able to communicate with the medical team effectively. I admit, some doctors do not have a good bedside manner. But you can shop around for a good OB.
In addition, from my nurse friend in L & D at our local hospital, the average time from "call" to emergency C-section is approximately 17 minutes at their facility.
Not all "emergency" C-sections are the same. Some are more of an emergency than others. Just food for thought...
PB... just out of curiosity, did you use the same mid-wife for those 3 pregnancies? Its unbelievable and rotten to have such experience. I did not have the same experience as you. But I am lucky that my hospital offer a Midwife department and they're as great as having OBGYN.
In addition, from my nurse friend in L & D at our local hospital, the average time from "call" to emergency C-section is approximately 17 minutes at their facility. I could easily be at the hospital in that time had something gone seriously wrong....and of course we would have called ahead. Watch The Business of Being Born (noted earlier in this thread) if you would like to be further educated. Facts are facts, my evidence and decision-making was not based on anecdotal stories such as noted above.
The key word is "average".
There are some situations where you really want to be one of the ones who was in surgery in less than 17 minutes.
To each her own on whether they want to deliver with a midwife or an M.D., but I have to disagree with the characterizations of M.D.'s as automatons who spend 10 minutes with you every visit and swing by to catch the baby when it's time. My OB-GYN was wonderful and I felt like she really took whatever time was needed to talk to me and answer all my questions. One day I felt like my baby wasn't moving and I went to be examined. She felt and listened to my belly but still had questions and wanted to do a sonogram. The sonogram tech wasn't there right then and my doctor just told me, "Come on, I can work that machine" and we went in and she did a quick sonogram and saw that my daughter was ok. I was surprised and very grateful. I still see the same doctor and hope she's still practicing when my daughter needs an OB-GYN.
Also, while it is true that on the day of my delivery I spent most of it with the nurse, she was wonderful and took really good care of me and was regularly communicating with the doctor. A pregnancy and birthing experience with a doctor in a hospital does not have to feel cold or uncaring. You just need to find the right health care providers.
To serve every one, it is important to state opinions with more care,please, back up with references if stating something as fact. I'm not referring to anecdotal stories - those are obviously individual experiences (and should be taken as such) and are important.
Statements such as: "Delivery in a hospital or a birthing center attached to a hospital provides rapid access to surgical facilities" and "In most hospitals, a Cesarean could be done in the time it would take to get a laboring woman from her home to a hospital" .......require evidence -if they are to be presented without out prefacing with "It is my opinion that..."
Immediate emergency surgical capability is not the norm in our U.S. hospitals. There IS the arrival time of the surgical crew to consider. The World Health Organization has been on our backs for umteem years because we do not have in-house surg crews for OB emergencies. (WHO source can be found with a search).
It may help some to know that a resolution, "Increasing Access to Out-of-Hospital Maternity Care Services Through State-Regulated and Nationally Certified Direct-Entry Midwives" was formally adopted by the Governing Council of the American Public Health Association (APHA) October 24, 2001.
"Recognizing the evidence that births to healthy mothers . . . can occur safely in various settings, including out-of-hospital birth centers and homes"
I used an OB-GYN doctor for my first birth at a respected hospital and had a terrible experience. He put me on Pitocin without explaining the risks or even asking my opinion. (I found out years later that Pitocin can actually be dangerous to both the mother and the baby). He broke my water without telling me and used forceps during the delivery also without telling me. He acted like I was not a part of the birth! I got the impression he wanted to get the birth over with so I did not end up interrupting the upcoming holiday weekend. My oldest daughter happens to be my only child who has had learning and other issues, and sometimes I wonder if he did something wrong that contributed to the problem.
For my next two births, I went to the same hospital, but I used midwives. It was a world of difference. They discussed options with me and spent more time with me. They also did a much better job delivering my babies. My youngest daughter got stuck, and the midwife managed to get her out without instruments and before a potential emergency unfolded. (After the delivery, we discovered that the placenta was torn in two, so a slower delivery could have caused a major emergency). I normally am a cautious person, but after my experiences, I am a big fan of midwives!
"Aetna considers planned deliveries at home and associated services not medically appropriate."
"The ACOG Committee on Obstetric Practice's opinion on planned home birth (2011) noted that although the Committee believes that hospitals and birthing centers are the safest setting for birth, it respects the right of a woman to make a medically informed decision about delivery. Women inquiring about planned home birth should be informed of its risks and benefits based on recent evidence. Specifically, they should be informed that although the absolute risk may be low, planned home birth is associated with a 2-fold to 3-fold increased risk of neonatal death when compared with planned hospital birth."
The author asks the question whether planned home birth puts the birthing process ahead of the safety of the baby.
The thing about statistics is that they apply to groups of people, not individuals. Although the risk of an adverse outcome from a home birth in a carefully selected group of women may be small, it is not zero.
The question is whether you are willing to accept the risk that something might happen that results in damage or death to an infant or mother in a home birth that could have been prevented if delivery occurred in a hospital.
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From the Aetna insurance company and a Harvard Obstetrician
