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Entries in hospital vs homebirth (1)

Tuesday
Nov232010

Comment to “Ummm… not so much”

I was asked to remove the blog owner's name, she thinking her blog was private. Therefore, you will not be able to read the post I'm referring to. However, I'm leaving what I have because it's a great discussion even without the entire piece. She wrote “Ummm… not so much” about an article she read about a homebirth, how the article reaffirmed her decision to birth in the hospital. 

“One of her (the woman in the article she read) reasons was hey its the way people did it back in the day it must be the right way to do it. Well people also used the bathroom outside and took baths in the creek but we don't those things anymore right? What is so bad about having the baby in the hospital? I had a wonderful dr and labor and delivery nurse and I knew if there was a problem, I was in the right place. There was also the issue of her child being home for the birth. This lady was sitting on the toilet screaming having a baby while her child is coming in and out trying to figure out what is going on. At least take the child to a babysitter!”  

It’s so interesting reading others’ take on what many of us find pretty typical, if not downright normal. When moms or family members worry what the kids will think, I remind them that kids usually do better than grandparents… they don’t have the preconceived brainwashing they do. You know, no decades of watching fake-births in movies and on tv; to them, it’s not that big of a deal. 

Regarding the peeing in the woods analogy, I always find that so gross. Birth isn’t an elimination function… it’s the bringing forth of a life. And sure, there are advancements we can and should embrace, even in birth. For goodness’ sake, it’s a rare woman who wouldn’t accept medications for hemorrhage or blood products. And I can’t imagine any woman not wanting anesthesia for a cesarean, but when we mechanize the simplicity that is the majority of birth, that’s where the complaints come in. 

The analogy of hospitalizing a woman, putting monitors on and in her, people wandering in and out, measuring blood pressure and pulse… and penis size? while having sex with one’s mate… that’s what normal birth foisted into the hospital setting is like. An absurd picture, isn’t it? 

The blogger goes on: 

“Midwives can't give pain meds and u have to footprint ur child on ur own, they don't do it. They never mentioned going to get the baby checked out by a pediatrician; she just said they cut the cord and then she ate breakfast at the table with her expanded family and then they sat outside watching the other child play. What?? What about all those tests they give when the baby is born? What about height and weight? This article was a little disturbing to me. I understand this may be more comfortable for the mom but what about the safety of the baby? What if something went wrong?” 

Actually, dear blogger, if a woman wants pain medication in labor, she does need to be in the hospital because they are so patently unsafe she and the baby must be monitored. Even something as simple (simple?) as a sedative needs constant attention. Nothing given for pain is benign. Nothing. 

Most midwives do footprint, but it’s a memorabilia sort of thing since there is no chance your baby will be mixed up with another baby… something that can (and has) happen in the hospital. 

We do all the routine tests and administer the state required treatments -if the parents consent to them. Many (most?) of us also do the Newborn Screen which is done about day three postpartum.

Most midwives do recommend the baby be seen by a care provider, usually a pediatrician, within the first few days after a birth. We are able to keep a mom and baby safe through the passage of birth, but we are not specialists in complications of either. If there are any signs of a problem, they are referred (if not transported immediately) to a specialist (obstetrician/pediatrician). 

However, we do postpartum visits, checking mom and baby several times after the birth. My own rhythm is 24 and 72 hours, then two and six weeks postpartum. This is more observation than hospital birthing women get; once they are released from the hospital (24 hours or so postpartum), they are not seen again for six weeks. 

It seems the mom in the original article (that she does not name) was demonstrating the simplicity that is homebirth… that it was as easy as cutting the cord and then sitting down to eat her breakfast. But, I promise you, the midwife was doing much more than just scrambling eggs and buttering toast. 

We do examine the baby, head to toe and side to side. We weigh the baby (see the scale picture below) and measure him/her. How can anyone not want to know those basic facts? Besides, the weight is necessary for the birth certificate, which, in my state, I get to complete and file for the family, too. 

We watch the baby during the postpartum period, usually two to three hours, which is what happens in the hospital, too. We make sure mom is nursing well, that her bleeding is under control, that the baby’s breathing well and adjusting to the outside world nicely. We’re taking her blood pressure, both their temperatures, helping mom to the bathroom, helping her to shower, cleaning the room/bed, making the house so that you cannot even tell a birth occurred there. We start the laundry and make sure someone will be with her at all times for the next day or so. 

And if something goes wrong, we immediately attend to it and/or move into the hospital setting where, we absolutely acknowledge, they are the specialists in complications. We do carry medications to stop bleeding/hemorrhages, but if it continues and needs more help, we don’t hesitate to get the mom to the hospital. Why would we wait? As midwives, our most outstanding job is to keep the mom and baby alive. No “experience” is worth dying for. 

And having a homebirth is not just about “the experience” or to brag about natural birth. For most of us, it is to eliminate the massive amounts of technology shoved onto (and into!) women during birth. While the judicious use of technology is a great thing, the indiscriminate use is what’s abhorrent. When birth is going along swimmingly normal and the wonders of science are required (or highly encouraged) hospital policy, each intervention (continuous fetal monitoring, IV, remaining in bed, no food or drink, pain medications, etc.) carries with it enormous risks. In remaining at home, those risks are avoided and birth can continue unhindered by the commands of impersonal, faceless bureaucrats. 

So while you may still scrunch up your face at not ever wanting a homebirth… and you have that right, of course… I felt it was important to clear up a few misconceptions mentioned in your blog post. (I wanted to leave a comment, but the settings are not set to Name/URL, so couldn’t; decided to write here instead!)

Sarah (lifting) and me weighing Katelynn Belle.

(photo by Nova Bella DeLovely)