Home Birth...Education :0)

I am awake with a bad case of hip pain, baby won't be still, insomnia so I thought I'd take advantage to share about our hopes for this baby's birth.

Shortly after Riley Joy was born I started looking at my birth options. As a VBAC mom they are limited. I could
1) Have a repeat elective or scheduled c-section (not a VBAC option obviously). Elective: go into labor on my own and then head into the hospital for the surgery (safest option for baby- cuts down on risk of NICU stay because baby says s/he's ready not a date on the calender). Scheduled: pick a date between 37-39 weeks and go in and get cut (not as safe as conception date could be off and babies lungs might not be fully developed resulting in a NICU stay). I won't go into the risks (that OB's completely ignore) of a repeat c/s...

I will say though that repeat ceseareans tend to take twice as long as the first (which means more time away from new baby getting sewn up) becuase of all the scar tissue. And with every c/s you have the risks increase a lot. I believe the statistic is that 1 in 500 women die on the table for a c/s where 1 in 2,000 die in a vaginal birth. As you can see this option really didn't appeal to me. Oh and I'll double check those statistics but I'm pretty sure they are correct.

2) I could labor in a hospital with constant fetal monitoring (which would limit mobility which can slow labor), a manditory IV in my arm (which HURT and are annoying- annoyance isn't helpful when in labor), and pressure of knowing that at any time the back up OB (if using a nurse midwife at the hospital an OB has to be present the entire time of labor) could get sick of waiting for things to progress and push me into another c-section. I considered this, really really did, but honestly after all I've been through in hospitals I do not feel SAFE there...Feeling safe (unless you're going to be artifically augmented which leads to a lot of other things that increase the risk of complications for mother and baby) is the #1 thing that will keep labor progressing.

3) I could have a homebirth. Labor at home with intermitant fetal monitoring, under the care of ONE midwife (and assistant) whose attention is undivided- completley on ME... Allowing me to move around in my own home, in my own clothes (no drafty stupid hospital gowns thankyou!), eat what I feel like (if I feel like it), and have no time constraints on how long things take.

#3 definitely sounded good to me! I prayed a long time about it, several months. Researched like crazy and read and talked to as many Mom's who'd done HBACs (home birth after cesarean) as I could find...Prayed about it some more and then was shocked to find myself preggo again!

Then came the difficult part, finding a midwife. Midwives are hard to find in our area, technically (depending who is interpreting the law) home birth isn't legal in this state. This is a good thing, and not a good thing...The nice thing is that there aren't arbitrary regulations that the midwives have to adhere to Examples: baby HAS to be born by 42 weeks, or some states have regualtions against midwives being able to bring life saving equpiment with them... Like I said, really nice in some ways and can make things harder in other ways. God seemed to have that worked all this out for us though, a home birth midwife got in touch with me and she's every thing I was looking for- best of all we share the same faith which means a lot to me! Knowing she's praying for me and praying for wisdom during labor makes me feel a lot safer.

In my research I was surprised to find that home birth is statistically SAFER than hospital birth- especially in this country. The USA has the 2nd highest mother/infant mortality rate in the western world. With all our grand hospitals and interventions we're losing more mama's and babies- sad! A home birth midwife doesn't just show up with a shoe lace and a prayer...She is highly trained and brings lots of fancy equipment... doppler to pick up heart tones, IV Pitocen to conrol a hemmorage, oxygen for mother and baby, trained in neonatal resucitation (sp?), CPR (obviously), IV fluids and a few other things I won't go into. She is equipped to handle the beginnigns of any emergency so that a transfer to the hospital (if warranted) will go smoothly and safely. Becuase she is caring for ONE person at a time that person is getting great care and the outcome is much more likely to go well than in a hospital when every thing is being manaaged by several different nurses on changing shifts.

That said, hands down we choose home birth! And I have to say I'm really really glad we did. I found out recently the CNM (certified nures midwife) group I was with for Riley Joy's pregnancy and delivery (and the beginning of this pregnancy) has been kicked out of the hospital. AND (from what I understand) the hospital has banned VBAC's. This isn't because of any bad outcomes of VBAC's with the midwives-they had an extremely good track record. It's a money and power issue. The Midwives were EXTREMELY popular and one of the only reliable VBAC practices in the area- they were costing the hospital too much money in insurance. Because since the ACOG's recall on recommending VBAC's in the late 90's insurances rates to cover malpractice on VBAC's has sky rocketed and it's not profitable for hospitals to allow them. So I would have been left high and dry and scrambling to find a birth alternative if I had decided to go forth with a hospital birth. There is unfortuneately only one other hospital in the area that is allowing VBAC's now.

I have to say I'm a bit angry about it all. In a society that is constantly touting about "Women's Rights!" and "She should be able to choose" why are they pushing unhealthy choices and leaving woman with very very few HEALTHY ones?!?! I think it's a shame that there are no real options for Mom's who would like to VBAC but feel SAFE in the hospital and want to do it there.

Like I said the risk of a VBAC is practically NO different than that of a 1st time mother...A VBAC Mom's risk of uteran rupture is .03-.07% a risk of a first time Mom? .02-.05%. It all comes down to money and control and it's a shame. This is a very long, rambly and disorganized post but something that I was laying awake thinking about for over an hour and thought I'd type it out. Goodnight (erm good morning!).