Natural childbirth, midwives and what is a duola?

[bookitty]

Ok, I'm freaking out. My cousin and one of my best friends is having a baby right now. She decided last week to go with a midwife and a birthing center because the hospital was too "invasive." I didn't question her choice of birthing center because we already had it out over the H1N1 vaccine (which she eventually got) and knew there wasn't any way to change her mind.

I just got the call, it's been 16 hours. It's a hard birth. She's 40, this is her first baby. and it's two weeks early.

There's nothing I can do at this point, except stay by the phone and avoid all articles about mid-wifery on science-based medicine.

But things are normal-ish, right? Two weeks isn't unheard of, the birthing center doesn't have any outstanding legal action, women have been doing this baby thing for thousands of years. Right?

[Uncayimmy]

My wife had a duola for the first one. Basically, she's not much more than a coach, cheerleader, and advocate to make your wishes known when you're stressed out.

[rjh01]

16 hours is a long time to be in labour. 40 is also old to have your first baby. A bit odd that they allowed her to give birth in a birthing centre.

[Uncayimmy]

16 hours is a long time to be in labour. 40 is also old to have your first baby. A bit odd that they allowed her to give birth in a birthing centre.

It depends on what stage of labor.

Boo, if you're looking for support, you might be better off moving this over to Community. I doubt there's anything from a science perspective that will make you feel better. We, through you, don't have all the facts. You weren't even specific about what stage of labor she's in or what "hard" even means. Commenting on the situation would be based almost entirely on conjecture.

Two weeks early is not a big deal. My understanding is that it's not "early" if it comes after 37 weeks, but I'm sure you've already looked that up.

[casebro]

"Birthing Centers" around here are affiliated with hospitals. Sofas for the hubby, regular bed. home style births. Not in an operating room, but handy to medical attention if required. The duola has done it before, even if the cousin hasn't. I'm sure everything will be fine.

[lionking]

We have had all our babies in the same hospital, and all births involved epidurals, and the last two were caesars. With one birth, the doctors were worried about the position of the baby, and they wheeled in all types of equipment. All went well in the end, but we were glad we were in a hospital rather than a birthing centre or at home with a midwife.

[Orphia Nay]

Surely the birthing centre would have a strict contingency plan for when things started getting tricky, and would call in an obstetrician or convey the mother to a hospital.

I hope your fears are needless, bookitty. Best wishes to you and to all involved.

[EeneyMinnieMoe]

:Pat on the back: I understand your "freaking out". I'd be freaking out, too.

However, you should hang in there and hope for the best. Maybe call your cousin's other friends and relatives for support, either to meet or just to talk. It's better to take it in a group and not be left alone to fret and worry and wonder and imagine.

As others have said, the people there will take the necessary measures if there is an emergency. Hopefully.

The likelihood that something bad will happen is low to none.

:Hugs:

[Uncayimmy]

As I recall, about 15% of women who go to birthing centers are transferred to a hospital and about 2% are transferred due to emergencies. Our thinking was if there was a 1 in 6 chance of landing in a hospital anyway, why not just start there? That was a convenience and peace of mind thing, not a safety thing. As I recall in our researching the birthing centers didn't have any different results overall than hospitals when it came to comparable births. Obviously, if you're at serious risk, you need to go to a hospital to be safe in the first place.

I have rather fond memories of the cheeseburger I got at 4:00 AM from the hospital cafeteria. For me personally, that's an important factor.

[ysabella]

I've been kind of freaked about two of my friends making the same choice - home birth with midwives, etc. I don't wish them ill of course, but I'm a little scared of things going wrong.
One successfully gave birth two days ago; it was her second baby, she's around age 40, and it was a VBAC (Vaginal Birth After Cesarean). It was her opinion that the birth of her first child was all eeeevil hospital interventions and that c-section wasn't necessary, and she was darn near traumatized by the whole thing because she was so upset about the c-section; personally, I think some of the current culture is making people feel needlessly bad about any birth that is somehow not granola enough. So, anyway, the birth at home of the second child was successful until the placenta, which wasn't cooperating, so she ended up in the hospital because of that. But mother and baby are both doing fine.

The other gal is around 23 weeks and posting things on Facebook like "I'm so happy I'll have my baby at home! The hospital is only five minutes away, so that's fine!" Argh.

[Trent Wray]

Yea Bookitty !!!

For what it's worth, we tried to have my first baby with a midwife in a birthing center as well. My wife is also a critical care nurse, but it was very important to her.

And just so you can compare some notes:
My wife had her water break in the morning, a week late actually. We went to the birthing center, but no contractions. Also, the baby hadn't dropped yet. We waited about 16 hours as well .... and still only one contraction ever happened, and no baby drop :)

To kill time we went out to eat, watched TV, tried to stimulate contractions, etc ... and this was all AFTER the baby's water broke. Like 12 hours after.

Still no concerns. Finally though, the midwife suggested we go to the hospital and have the C-section. My wife was pretty upset, but we went, she had the epidural, and about 18-19 hours after the water had broken the baby was finally "removed'. She de-satted pretty heavily from the epidural and they almost had to intubate her.

The baby was perfectly fine, and still is 5 years later :) No issues whatsoever.

This phrase is arguable by many: "Birth is not a medical emergency." My opinion is that it depends on several factors, obviously, and hopefully the midwife knows what they are LOL :) But yes, we have been born for quite awhile without hospitals. I have evidence if you want it .....

Good luck!

[lionking]

My wife had her water break in the morning, a week late actually. We went to the birthing center, but no contractions. Also, the baby hadn't dropped yet. We waited about 16 hours as well .... and still only one contraction ever happened, and no baby drop :)

To kill time we went out to eat, watched TV, tried to stimulate contractions, etc ... and this was all AFTER the baby's water broke. Like 12 hours after.




After the first couple, we knew that the labours would be long, so after taking my wife to the hospital after the waters broke, I went off to work. The nurses said "but your wife's having a baby". I said "Yeah I know, see you in 10 hours".

[bookitty]

Yay! The baby is fine!! The mom is doing great!! The dad sounds like a human being again!! It's happy time all the way around.

Note: If you have never been involved with the birthing process, talking to the father-to-be while it is full effect will freak you out. They get a wee bit...tense. Especially when it's the first time and they've been drafted to help at the last minute.

[Uncayimmy]

Yay! The baby is fine!! The mom is doing great!! The dad sounds like a human being again!! It's happy time all the way around.

Note: If you have never been involved with the birthing process, talking to the father-to-be while it is full effect will freak you out. They get a wee bit...tense. Especially when it's the first time and they've been drafted to help at the last minute.

Help? I stayed in the Splatter-Free zone and let the people do what they were paid to do. I don't know why on TV they tell husbands to boil water. They should tell them to get a wet-dry vac, a shovel, and a garbage bag.

[Miss_Kitt]

16 hours is a long time to be in labour. 40 is also old to have your first baby. A bit odd that they allowed her to give birth in a birthing centre.Italics added.

rjh -- As someone who gave birth at 39, I wanted to tell you how insensitive, thoughtless, and inaccurate an assessment that post was.

It is certainly true that a woman over age 30 has a higher chance of certain kinds of birth defects than a woman who is younger; and it is also true that an older first-time mother will have a higher chance of labor problems. The medical picture is different at that age, and the healing time overall longer; and I would recommend having prenatal testing done to detect possible Down's or other genetic issue to--depending on your preference--either 1) terminate the pregnancy and try again; 2) decide to go for an adoption; or, 3) have time to physically, medically, and emotionally prepare for a disabled child. But to say it is "too old" is a judgment you have no right to make. It is not as though the majority of first-time mothers even at that age have serious problems with either delivery, or with the health of their child.

A 16-hour labor is not all that unusual, either, for a first-time mom. The trend in medicine has been away from use of pitocin or other labor stimulants unless the mother or fetus shows distress. Some women actually have labor for several hours, then stop altogether for several, then resume; some have long labors that do not become intense until later; some have rapid, intense labors; some have rapid, relatively easy labors. Labor and delivery vary greatly from woman to woman, and even from child to child with the same woman.

I agree that I find it surprising that a first-time mother who is 40 was not encouraged or even required to have a doctor prepared to do an emergency c-section on-site, or to deliver where such facilities and personnel are within a few minutes--assuming this birthing center does not have such--but perhaps this woman is very healthy, has a family history (mom and sisters) of non-complicated deliveries, and has had an uncomplicated pregnancy.

Having a child is one of the most personal, difficult,and life-changing decisions a woman can make. Having done a lot of research into how the numbers run before I decided to try to have my own child, I can tell you that your judgment that she is "too old" is unsupported by medical evidence.

If you are making a value judgment that you think she is somehow emotionally or physically unable to care for a child, you are thinking in terms of a time when people were old at 50 and dying at 60 years of age. Then, a woman was considered getting old at 40; she generally was giving birth in her teens and having half a dozen children before she was through, often with more pregnancies that did not succeed dispersed in between. We are no longer in the pioneer era; that view of women as broodmares that should be bred young for maximum productivity is at best anachronistic and at worst, demeaning to women. Better medical care, better nutrition, better education and less hard physical labor for women has made 40 a healthier, more vibrant age than 30 years old was a century ago.

Having a child later in life has different challenges and different benefits, for both mother and child, than having one young. An older woman is more experienced, usually financial and emotionally more stable, and often has a better physical environment to raise a child in than a 20-year-old. She will generally have made a conscious decision to have a child rather than have suffered a birth control failure; she is usually in a stable relationship rather than a new marriage. The younger mother often has more physical energy, which especially in the newborn period is a big asset; and she will be younger when her child is a teenager, which may help her to be more accepted (or to better accept) her teen's peer group.

Forty is no more "too old" to have your first child than it is to run your first marathon. While it is true that it takes more preparation and determination to maximize your odds of having it come off smoothly, it's a choice that is well within the bounds of rationality.

Been there, done that, and proud to be mother, Miss_Kitt


ETA: The term "doula" has several meanings, most commonly a sort of labor coach / mother's helper during labor and delivery; there are also doulas who serve as the mother's helper at home during the first few days to a week, especially for women who do not have an experience female friend or relative to join them at that critical time. My doula was am active NICU (neonatal ICU) nurse, a former licensed midwife, and my close personal friend, and she was a godsend for about 10 hours of my labor. She and my doctor had a get-acquainted meeting a few days before I delivered, and my doctor was thrilled that I had a competent medical assistant on hand throughout my labor. If your cousin has someone half as good as Polgara (my doula) working with her, she should have as good a labor as is possible for her! Without Pol, I would have fretted myself a lot, I think, and my husband would have probably hyperventilated. I did 16 hours of labor and delivered without incident. I do recommend, however, that any mother Get The Drugs! I decided to wait until my labor had progressed along some; when I went from 2 cm to ready to deliver in an hour after taking all day to get to 2 cm, the hospital staff missed the change and were unable to line up an anesthesiologist until it was too late to give me anything. I do not recommend this. Get the epidural and have them 'turn it down' until you really need it; because once you hit transition and then have to push, you really REALLY REALLY want to have some pain relief.

Trust me on this. I once had my dental anesthesia fail when getting a crown put on, and the worst of labor is worse.

[lionking]

Well said Miss Kitt. My wife had three kids after 40 (and seven after 30).

[Wildy]

Help? I stayed in the Splatter-Free zone and let the people do what they were paid to do. I don't know why on TV they tell husbands to boil water. They should tell them to get a wet-dry vac, a shovel, and a garbage bag.

If My Wife and Kids is anything to go by, it's just to get rid of the husband.

[rjh01]

Miss_Kitt - I think you have expanded and added on what I have said. You have said nothing that shows that I am wrong.

Lionking - you wife would have had her 8th child after 40 not the first.

Edit. Wildy - I was also told that was the reason. But then my sources for that were not the best.

[Wrathernaut]

Miss_Kitt - I think you have expanded and added on what I have said. You have said nothing that shows that I am wrong.

Lionking - you wife would have had her 8th child after 40 not the first.

Edit. Wildy - I was also told that was the reason. But then my sources for that were not the best.

So what, the 3 she had after 40 don't count towards the 7 after 30?

[ponderingturtle]

I've been kind of freaked about two of my friends making the same choice - home birth with midwives, etc. I don't wish them ill of course, but I'm a little scared of things going wrong.
One successfully gave birth two days ago; it was her second baby, she's around age 40, and it was a VBAC (Vaginal Birth After Cesarean). It was her opinion that the birth of her first child was all eeeevil hospital interventions and that c-section wasn't necessary, and she was darn near traumatized by the whole thing because she was so upset about the c-section; personally, I think some of the current culture is making people feel needlessly bad about any birth that is somehow not granola enough. So, anyway, the birth at home of the second child was successful until the placenta, which wasn't cooperating, so she ended up in the hospital because of that. But mother and baby are both doing fine.

Hospitals have been so successful in lowering maternal mortality that people forget just how dangerous being pregnant can be. It seems to me to be a lot like the anti vax movement, if measles was killing kids left and right no one would be anti vax, but the very success of it has let people question its need.

There are people who are very actively anti hospital.

[ponderingturtle]

This phrase is arguable by many: "Birth is not a medical emergency." My opinion is that it depends on several factors, obviously, and hopefully the midwife knows what they are LOL :) But yes, we have been born for quite awhile without hospitals. I have evidence if you want it .....


It all just depends on what mortality rate for both maternal and infant you are willing to accept. If maternal mortality rate was what it was 150 years ago people would react differently.

[The Drain]

I'm so happy for you, Bookitty, that your cousin and new baby are well and fine. And her husband, too, of course.

On the subject of husbands, and birthing pain, I wonder if women appreciate just how painful it is having your hand squeezed really really tightly?:D
:bricks:

[Professor Yaffle]

[ETA-I rushed to post this without reading the whole thread, so it is redundant. Congratulations!!]

I think in the UK things are a lot more midwife based than in the US and thay have a much more professional status in the eyes of the public, so I don't know if ours are better trained, or if that is just a public perception thing.

I had midwife led care for both of my babies. They were both about 2 weeks late. My first labour was about 36 hours in total and I had the birthing pool and everything. When it became clear that things weren't going to happen on their own (my labour kept stalling and I was running out of energy - in ketosis) they transferred me to the consultant led unit - which was just the next ward along - and let them do their thing. How far is the birthing centre from a hospital with consultant led facilities? If its not all that far, I wouldn't worry. The midwives (in my experience) are well trained to recognise problems and be able to transfer care in good time.

[Mark6]

Yay! The baby is fine!! The mom is doing great!! The dad sounds like a human being again!! It's happy time all the way around.

Note: If you have never been involved with the birthing process, talking to the father-to-be while it is full effect will freak you out. They get a wee bit...tense. Especially when it's the first time and they've been drafted to help at the last minute.
Somewhat OT: I am firmly convinced that the modern practice of having father in a delivery room so he would "bond with the baby" (or something) is nuts. He serves no useful function, adds to the stress, and very likely freaks out himself. I was out in the waiting room during birth of my three children, and had no problem bonding with any of them.

[pgwenthold]

As I recall, about 15% of women who go to birthing centers are transferred to a hospital and about 2% are transferred due to emergencies. Our thinking was if there was a 1 in 6 chance of landing in a hospital anyway, why not just start there? That was a convenience and peace of mind thing, not a safety thing. As I recall in our researching the birthing centers didn't have any different results overall than hospitals when it came to comparable births. Obviously, if you're at serious risk, you need to go to a hospital to be safe in the first place.

It's interesting, those who advocating birthing centers and homebirthing are quick to point out that those births that occur there don't have any worse complication rates than those that occur at hospitals. However, as you note, it is also the case that, if there are any signs that there will be complications, they get transported to the hospital and don't actually have their child at the birthing center or at home.

So I'm never sure of how to interpret what they are saying. It seems to me to come down to, "Those deliveries that occur without complications have the same complication rates as those that occur in hospitals." Or something like that.

Remember that only the low-risk deliveries are tried at the BCs in the first place. And they STILL transport 15% to the hospital due to complications.

As to the OP, my biggest concern in this case would be her age. 40 yo for a first child should not be considered a low-risk delivery.

[pgwenthold]

I've been kind of freaked about two of my friends making the same choice - home birth with midwives, etc. I don't wish them ill of course, but I'm a little scared of things going wrong.
One successfully gave birth two days ago; it was her second baby, she's around age 40, and it was a VBAC (Vaginal Birth After Cesarean).

HOLY SMOKES!

There are friggin DOCTORS who aren't willing to do a VBACS because of the risk involved. The problem is that, if complications were to occur with the scar tearing, surgical intervention is required within 10 minutes. Our doctor won't do it because anesthesiology can only guarantee intervention within 30 minutes.

The chance of type of problem happening is not high, but when it does, it is lethal without that intervention.

Your friend was playing with disaster. I'm glad it went ok, but that does not make it a good choice.

I'm trying to think of a good analogy. It's like trying to diffuse a bomb. If you are successful, everything is ok. If you are not successful, you die. There is no in-between. Even if it has a 99% chance of turning out ok, the seriousness of that 1% failure is awfully high.

That was a VERY dangerous thing she did, and was extremely thoughtless toward her baby and the baby's father.

It's amazing what expectant moms will do. They can spend 9 months avoiding bleu cheese dressing and lunchmeats to prevent a one-in-a-million chance of listeria, but are willing to accept a 1 in a 100 chance of dying in childbirth for their own insecurities.

[pgwenthold]

Somewhat OT: I am firmly convinced that the modern practice of having father in a delivery room so he would "bond with the baby" (or something) is nuts.

I might agree, if that is actually why they were really there.

The reason the father is there is because the mother wants him there. If the mother were to say, "Get him out of here" don't think for a second that the nurses would hesitate to bar him from the room.

However, there is a kind of famous doctor who claims that fathers in the room get in the way, too. Most moms aren't too fond of the idea.

[Professor Yaffle]

HOLY SMOKES!

There are friggin DOCTORS who aren't willing to do a VBACS because of the risk involved. The problem is that, if complications were to occur with the scar tearing, surgical intervention is required within 10 minutes. Our doctor won't do it because anesthesiology can only guarantee intervention within 30 minutes.

The chance of type of problem happening is not high, but when it does, it is lethal without that intervention.

Your friend was playing with disaster. I'm glad it went ok, but that does not make it a good choice.

I'm trying to think of a good analogy. It's like trying to diffuse a bomb. If you are successful, everything is ok. If you are not successful, you die. There is no in-between. Even if it has a 99% chance of turning out ok, the seriousness of that 1% failure is awfully high.

That was a VERY dangerous thing she did, and was extremely thoughtless toward her baby and the baby's father.

It's amazing what expectant moms will do. They can spend 9 months avoiding bleu cheese dressing and lunchmeats to prevent a one-in-a-million chance of listeria, but are willing to accept a 1 in a 100 chance of dying in childbirth for their own insecurities.

Being a little over the top there, aren't we..... There are advantages and disadvantages for both VBAC and repeat C-section.

For more balanced information, here are some NHS information leaflets for those considering VBAC:

http://www.uhcw.nhs.uk/files/uploaded/download.php?filename=Birth%20after%20previous.pdf

http://www.pat.nhs.uk/uploads/20090213_0411-PI(WC)VBAC.pdf

ETA: I would add, though, that a homebirth for a first VBAC is not a good idea, though it could be ok for a subsequent VBAC. My sister had a c-section, a hospital VBAC and then 2 homebirths.

[Mark6]

I might agree, if that is actually why they were really there.

The reason the father is there is because the mother wants him there. If the mother were to say, "Get him out of here" don't think for a second that the nurses would hesitate to bar him from the room.
Except does mother really want him there, or she THINKS she wants him because that's what is expected of her?

My first wife was a bit miffed (not really upset, just miffed) when I absolutely refused to be in the delivery room. Afterward she agreed it was a right thing to do, and that her original desire to have me there came from peer pressure. With our second child there was never any question on that matter. My second wife never wanted me at the delivery in the first place.

[casebro]

My niece and her husband recently had a home birth in a tub.

They recommend a book "The Business of Birth".

One complication with midwifry in America seems to be that insurance won't pay for it. So instead of paying hundreds for a home birth, they pay thousands for a hospital delivery. And an episiotomy means it becomes a "surgical procedure", meaning instant thousands more dollars to the docs.

Then there is the woman next door who was induced so the doctor could start his vacation.

What a business...

[pgwenthold]

Being a little over the top there, aren't we..... There are advantages and disadvantages for both VBAC and repeat C-section.


I never said there wasn't. I just am pointing out the risks involved with a VBACS. As I said, the chance of complication is small, true, but that complication is very dangerous. Very severe bleeding where intervention is required in 10 minutes.

You can't be prepared for that in a home birth. As I said, you can't even always be prepared for that in a hospital!

[casebro]

I wonder if there is anything related to home births in Obamacare's 2500 pages?

[pgwenthold]

Except does mother really want him there, or she THINKS she wants him because that's what is expected of her?

Or perhaps they think that having their best friend in the room during that stressful time will make them feel better?

When I am in pain, I ask for my wife to help me feel better. Similarly, when my wife is in pain, she wants me with her to help her feel better.

Perhaps your marriage works differently...

[sgtbaker]

personally, I think some of the current culture is making people feel needlessly bad about any birth that is somehow not granola enough.


Ever have a conversation with a duola? If I didn't have three births in a hospital, I would have been terrified to go to one. Apparently they [hospitals] intentionally give you pactocin shots to make your baby retarded. They strong-arm you into getting an epi to ruin the whole experience. What I really didn't know was that hospitals love to skip over a simple procedure, like pushing, and forcing you into C-sections; apparently they love involving themselves in invasive procedures that put them at higher risks of lawsuits, for no particular reason.

[Professor Yaffle]

I never said there wasn't. I just am pointing out the risks involved with a VBACS. As I said, the chance of complication is small, true, but that complication is very dangerous. Very severe bleeding where intervention is required in 10 minutes.

You can't be prepared for that in a home birth. As I said, you can't even always be prepared for that in a hospital!


My apologies, I had a brainfart and didn't realise the VBAC was a homebirth - as i said in my ETA, that is not a good idea for a first VBAC.

[Professor Yaffle]

I think the problem in the US is that these issues have become too polarised, so both sides like to paint eachother as the devil. In the NHS they work quite happily with eachother and a reasoned decision can be made based on individual circumstances without one side making you feel like you are a reckless idiot.

[pgwenthold]

My niece and her husband recently had a home birth in a tub.

They recommend a book "The Business of Birth".

One complication with midwifry in America seems to be that insurance won't pay for it. So instead of paying hundreds for a home birth, they pay thousands for a hospital delivery. And an episiotomy means it becomes a "surgical procedure", meaning instant thousands more dollars to the docs.

Then there is the woman next door who was induced so the doctor could start his vacation.


Once full term has been reached, the only thing that happens is that the child grows bigger, making delivery more difficult. Given that early ultrasounds can provide very accurate determinations of when full term will occur, there is no reason that anyone should go past term.

Mother Nature is a cruel bitch.

[sgtbaker]

Or perhaps they think that having their best friend in the room during that stressful time will make them feel better?

When I am in pain, I ask for my wife to help me feel better. Similarly, when my wife is in pain, she wants me with her to help her feel better.

Perhaps your marriage works differently...

I think they do work differently. He wasn't around for the birth of our first, my best friend was and we had a blast. My second was also an epi so him being there or not, really wasn't for me. My third, there was no time for epi, I was upset, in pain, and he was annoying the crap out of me. The only peace I got was when he was trying to coach me on breathing and passed out from hyperventilating. Of course, we are divorced now so maybe that says more than I think :D

[ponderingturtle]

Ever have a conversation with a duola? If I didn't have three births in a hospital, I would have been terrified to go to one. Apparently they [hospitals] intentionally give you pactocin shots to make your baby retarded. They strong-arm you into getting an epi to ruin the whole experience. What I really didn't know was that hospitals love to skip over a simple procedure, like pushing, and forcing you into C-sections; apparently they love involving themselves in invasive procedures that put them at higher risks of lawsuits, for no particular reason.

Just like those vaccines they give to make kids autistic

[Mark6]

Or perhaps they think that having their best friend in the room during that stressful time will make them feel better?

When I am in pain, I ask for my wife to help me feel better. Similarly, when my wife is in pain, she wants me with her to help her feel better.

Perhaps your marriage works differently...
Probably. When I am in pain, I want professionals next to me, not a useless amateur, however well-meaning and sympathetic. And if the useless amateur is my best friend, I definitely do not want her next to me -- why stress her out for no good reason?

[pgwenthold]

Probably. When I am in pain, I want professionals next to me, not a useless amateur, however well-meaning and sympathetic.

Man, I feel sorry for your child.

When your child cries, do you say, "There's nothing physically wrong with you" and leave the room? Because there is nothing the doctor can do, so what can you do? He'll get over it.

[Mark6]

When my child cries, I comfort him. I am not useless. When I was a child, I too wanted my parent next to me. When I grew up, I no longer wanted to. There is a difference.

Also, if I cry because I am SAD, as opposed to being in severe pain, then I want my wife next to me. As she does for me.

[pgwenthold]

When my child cries, I comfort him. I am not useless. When I was a child, I too wanted my parent next to me. When I grew up, I no longer wanted to. There is a difference.

Yeah, now I want my spouse instead of my parent.

(btw, I don't know about you, but pain makes me sad; it definitely makes my wife sad, too)

[Mark6]

I guess we are just different. :)

[Lucian]

Help? I stayed in the Splatter-Free zone and let the people do what they were paid to do. I don't know why on TV they tell husbands to boil water. They should tell them to get a wet-dry vac, a shovel, and a garbage bag.

Good God, man, what did you do with those babies?

[ysabella]

Hospitals have been so successful in lowering maternal mortality that people forget just how dangerous being pregnant can be. It seems to me to be a lot like the anti vax movement, if measles was killing kids left and right no one would be anti vax, but the very success of it has let people question its need.

There are people who are very actively anti hospital.

You're spot on. The same gal is actually anti-vax. She's one of the ones who believes that it's all increased hygiene and health making those diseases go away. :rolleyes:

[ysabella]

HOLY SMOKES!

There are friggin DOCTORS who aren't willing to do a VBACS because of the risk involved. The problem is that, if complications were to occur with the scar tearing, surgical intervention is required within 10 minutes. Our doctor won't do it because anesthesiology can only guarantee intervention within 30 minutes.

The chance of type of problem happening is not high, but when it does, it is lethal without that intervention.

Your friend was playing with disaster. I'm glad it went ok, but that does not make it a good choice.

Unfortunately, she's had some ongoing complications and pain. This has been since she went to the hospital. She's not giving a lot of details but says that someone made a mistake, but another doctor realized what was happening. Kind of mysterious. I'm guessing it has added to her confirmation bias about those eeevil hospitals, though.

[ysabella]

Ever have a conversation with a duola? If I didn't have three births in a hospital, I would have been terrified to go to one. Apparently they [hospitals] intentionally give you pactocin shots to make your baby retarded. They strong-arm you into getting an epi to ruin the whole experience. What I really didn't know was that hospitals love to skip over a simple procedure, like pushing, and forcing you into C-sections; apparently they love involving themselves in invasive procedures that put them at higher risks of lawsuits, for no particular reason.

:eye-poppi

I do hear that stuff from people. I mean, c'mon, you can take a tour of the birthing center. You can talk to your OB. Find out if it's really true. I gather that there are places and doctors who are bossy and not nice, but in most places they want to let you have the birth the way you want it.

[ysabella]

I think the problem in the US is that these issues have become too polarised, so both sides like to paint eachother as the devil. In the NHS they work quite happily with eachother and a reasoned decision can be made based on individual circumstances without one side making you feel like you are a reckless idiot.

Another important factor in the US is that midwife licensing varies by state. In some states they have to be nurses, in others there's just about nothing required. So the quality is pretty variable. There are some independent certification bodies, though, and midwives certified by them have to uphold some standards, so that helps the situation.
The OBs I had, by the way, had no problem with midwives or doulas if I'd wanted to pack the delivery room with them.

[Professor Yaffle]

Another important factor in the US is that midwife licensing varies by state. In some states they have to be nurses, in others there's just about nothing required. So the quality is pretty variable. There are some independent certification bodies, though, and midwives certified by them have to uphold some standards, so that helps the situation.
The OBs I had, by the way, had no problem with midwives or doulas if I'd wanted to pack the delivery room with them.

Ah, I see. In the UK all midwives have either trained specifically to be midwives (a degree in midwifery equivalent in level to the nursing degree), or have trained as nurses and then have done additional training to become midwives. Even if you have a consultant led birth here, he/she will be assisted by midwives and they will mainly look after your post natal care, both in hospital and once you go home.

[The Drain]

One of the most moving moments for me at the birth of our first child (in a national health service hospital) came before the birth itself when the staff in the maternity ward set up an incubation cot on the other side of the room... and I realised that what we have here - this thing we call 'civilisation' - was preparing to welcome another member to its ranks on an equal basis.

I had already been put to work by the senior midwife monitoring a machine that goes beep - it was the baby's heartbeat - and I strongly suspect it was just to keep me occupied; but I loved the fact that the wee mite, even before birth, was already the beneficiary of the very best technology that human society could muster.

Mrs Drain, however, had made me promise beforehand that whatever happened at or after the birth I was to stick with the baby and not let my eyes off it for one second. She had a strong fear of mistaken baby swapping. (I blame the Daily Mail). So when the lad was born, and I was asked to cut the cord (wow!), the team split in two and I and one of the midwives attended to baby while the obstetrician looked after herself. The fact that there were now two teams blew my mind away.

The most moving moment of course, was seeing the little blighter in his Mum's arms with his eyes wide open having a good look around. And that was before the cord was cut. I wouldn't have missed that for the world.

To any first time Dad-to-be reading this thread I would say; Please, if she'd like you there, then be there.

[Uncayimmy]

One complication with midwifry in America seems to be that insurance won't pay for it. So instead of paying hundreds for a home birth, they pay thousands for a hospital delivery. And an episiotomy means it becomes a "surgical procedure", meaning instant thousands more dollars to the docs.

I'm not sure what you mean by insurance won't pay it. Different plans have different requirements, and we're talking about a birthing center not the village elder who's been around a lot of births. You'll need to be more specific.

Then there is the woman next door who was induced so the doctor could start his vacation.

I'm pretty sure that's a misstatement. I'm thinking there was a woman next door who chose to induce rather than risk having her baby delivered by somebody else should it arrive while the doc was on vacation. What's wrong with that?

What a business...
It is a business. A business that offers a much healthier and safer way of delivering babies. Basically, a woman trusts a OB/GYN to monitor her womanly hydraulics. When she becomes pregnant, she trusts the doc to monitor her own health and that of the baby. If the OB/GYN says everything is good to go, some women say, "Okay, doc. I'm gonna go somewhere else to deliver the baby. I don't like hospitals, and you're too expensive. But I want you and the hospital be there just in case we need your far superior experience and equipment. After all, one in six women like myself end up in the hospital anyway."

If that's what women want, no skin off my nose. I do know that in other businesses when people pull that kind of stunt, people at the business get a little irritated if not insulted.

[Miss_Kitt]

Ever have a conversation with a duola? If I didn't have three births in a hospital, I would have been terrified to go to one. Apparently they [hospitals] intentionally give you pactocin shots to make your baby retarded. They strong-arm you into getting an epi to ruin the whole experience. What I really didn't know was that hospitals love to skip over a simple procedure, like pushing, and forcing you into C-sections; apparently they love involving themselves in invasive procedures that put them at higher risks of lawsuits, for no particular reason.

sgtbaker -- I think you are painting with a very broad brush here. My doula would have strong-armed me into an ambulance had I not been willing to go to the hospital early in labor. "Doula" is not a legally protected term, so there are people who call themselves that that are rabid anti-medicine "granolas"; but my doula was an RN!

Like most medical issues, there is an unhealthy amount of exaggeration on both sides of the debate. Not all midwives or doulas are anti-hospital or anti-medicine, but some are; not all doctors or hospitals manipulate their standard labor/delivery procedures with an eye to speed of throughput or maximizing payment from insurance, but I would believe that some do.

It is demonstrably true that the US has higher c-section rates than most other developed nations. This is at least partially because of the horrendous jury-awarded settlements to parents of babies born with cerebal palsy based upon the argument that CP was caused by birth-related oxygen deprivation and/or trauma, and a c-section would have resulted in a normal child. It is worth noting that, while the number and percentage of c-sections has increased dramatically, the rate of CP has not dropped. Yet, now that doing a caesarian in certain situations has become the "standard of care", any doctor who does not do so is leaving himself open to a charge of malpractice.

There are also--incredibly, to me--women who actually want a c-section so they can plan when to have the baby. Had I not personally known a woman (one of my daughter's classmate's mom) who told me blithely that "I'd never have a baby naturally, that's too hard to schedule around" I would have thought it an urban myth. Yet she has had three kids, and all were c-sections even though she was told she was an excellent candidate for VBAC.

It takes all kinds to make a reality, MK

[ponderingturtle]

sgtbaker -- I think you are painting with a very broad brush here. My doula would have strong-armed me into an ambulance had I not been willing to go to the hospital early in labor. "Doula" is not a legally protected term, so there are people who call themselves that that are rabid anti-medicine "granolas"; but my doula was an RN!

And those are not exactly incompatible. How was her continuing education on therapeutic touch?

[Miss_Kitt]

And those are not exactly incompatible. How was her continuing education on therapeutic touch?

She doesn't hold with BS like therapeutic touch, thank you for that cheap shot. As stated in an earlier post, she is currently working at the NICU in a hospital. She is a medical professional; however, the term "doula" is not restricted; people with no medical training or certification at all market themselves as doulas.

While there are some RNs who support baseless notions like TT, and some MDs who support the nonsense that autism is due to mercury poisoning, I think it's unreasonable to act as though the majority support that. The mindset of medical practice discourages, though does not eliminate, blatant irrationality in the profession.

[ponderingturtle]

She doesn't hold with BS like therapeutic touch, thank you for that cheap shot.

It is a technique that provided continuing education credit and as such is clearly with in common nursing techniques. Being a nurse does not make her not a woo, just like being a surgeon doesn't mean dr. Oz isn't full of woo and killing people with his show.

While there are some RNs who support baseless notions like TT, and some MDs who support the nonsense that autism is due to mercury poisoning, I think it's unreasonable to act as though the majority support that. The mindset of medical practice discourages, though does not eliminate, blatant irrationality in the profession.

Some? Enough to get it broadly recognized as continuing education if you take a course in it. I haven't heard doctors getting continuing education benefits for attending autism is caused by vaccines classes.

[Chris Haynes]

Another important factor in the US is that midwife licensing varies by state. In some states they have to be nurses, in others there's just about nothing required. So the quality is pretty variable. There are some independent certification bodies, though, and midwives certified by them have to uphold some standards, so that helps the situation.
The OBs I had, by the way, had no problem with midwives or doulas if I'd wanted to pack the delivery room with them.

Many of those laws come about due to tragic events.

Over twenty years ago a Seattle birthing center shut down after the death of a first time mother and her baby from the effects of extreme hypertension due to preeclampsia.

This was the same birthing center that almost ten years before that a college friend went to for the birth of her daughter. The birth went fine, but a day later the parents noticed something odd about her breathing. They took her to an actual doctor and find a minor birth defect that was corrected surgically, but completely missed by the mid-wives (aagh... that child is now close to 30!).

I tried to find an online reference to that birthing center tragedy, but failed. Even though the father/husband was a columnist of a small neighborhood newspaper where he wrote some stories about the incident (including his lawsuit). I just checked and that paper's archives only go to 2001.

Apparently his wife was afraid of hospitals because her mother died in one due to preeclampsia. She never told the birthing center this very important bit of information. They also did not monitor her blood pressure very well. When she crashed, she crashed very fast and was dead by the time the ambulance got there. The same with the baby.

Since then there are more stringent requirements for mid-wives, including giving more attention to the screening of the mothers. I knew someone who was going through the training, and it was very intensive and lasted a long time.

The timing was such that if I had wanted to use a birthing center I could not because it was closed. But that incident did frighten many of us enough to be sure to stick close to a hospital. Those I know who did a home birth only did after their first was born in a hospital.

The irony is that my oldest son and I would have possibly died without hospital intervention (after his second day he was transferred to Children's Hospital, he was a a bit over a week old when he came home), but my second and third could have easily been born at home (the third was almost born at home!). Though I feel the same as Betty McDonald did in her book The Egg and I (http://www.amazon.com/Egg-I-Betty-MacDonald/dp/0704102471/ref=ntt_at_ep_dpt_2), the hospital feeds you, cleans up the mess and the only thing that is required from the mom is that she hold and feed the baby (her book Anybody Can Do Anything (http://www.amazon.com/Anybody-Can-Anything-Betty-MacDonald/dp/1888173289/) starts out with her leaving her husband and moving back with her mother and sister).

(oh, wow! I bought the paperback reprints of McDonald's autobiographical books ten years ago from Amazon. I think it was part of her 100th birthday aniversary, though she died just before her 50th birthday. An unused copy of the Anybody Can Do Anything paperback reprint is going for over $200 from a seller on Amazon! Wow. This is not a book that is coming to the "bring a book, take a book" part of the Seattle Skeptics Meetup!)

Gah! Lots of edits. I blame that on having to be onsite for youngest at Sakura-Con (http://en.wikipedia.org/wiki/Sakura-Con)!

[ysabella]

Many of those laws come about due to tragic events.

Over twenty years ago a Seattle birthing center shut down after the death of a first time mother and her baby from the effects of extreme hypertension due to preeclampsia.

:(

I've got nothing against the idea of midwives, and they could even have an important role in better future birthing experiences for American mothers. I just want a way for people to be sure a given midwife is qualified. I mean, once you're pregnant you only have so much time to decide who you're having provide your care.

There really is an almost competitive culture out there currently, where you're somehow better and more womanly/motherly if you have an easy birth, and if you don't you have to assign blame (including some to yourself). It means you were scared or you let THEM intervene too much or whatever. Breastfeeding should also be easy and loving and perfect, and if it doesn't happen that way, you're somehow in the wrong.

I'm happy to say I didn't buy into that. I guess I'm a happy slacker mom.