Home Birth Questions Answered--Safety, Etc...

Part I; Part II; Part III; Part IV; Logistics

I think this is the fun part--the hows, what-ifs, and whatnot of natural and/or home birth. In my pre-childbearing days the only thing I envisioned about home birth was crunchy hippy-types with flowers in their hair, talking about the beauty of placentas & stuff. There was no way I'd do anything that freaky-deaky. The thing is, once you know more about home birth, it loses most of the freaky-deaky and often sounds completely reasonable, even if it's not something you'd want to do.

Q--Are you nuts?
A--No, just a little outside the mainstream when it comes to the birthing.

Q--What's the deal with midwives? What's their "thing"?
A--The midwives model of care is based on the assumption that normal, low-risk pregnancy & birth are not medical events, and the majority of the time they will go just fine when allowed to proceed on their own. The goal is to empower women to trust their instincts and believe in their bodies' abilities to do what what they were designed to do--birth babies.

Q--Who delivers the baby?
A--Ah, a distinction in terminology here. The mother delivers the baby. Birth attendants, such as doctors and midwives, catch babies. Or depending on their wishes, sometimes moms & dads catch the babies.

Q--Really? People care that much about semantics?
A--Some do, some don’t. Depends on what helps them feel empowered.

Q--What about prenatal care?
A--I have all the same appointments as I would with an OB, and all the same screenings and such are available to me. My blood is Rh-negative, so I need an extra shot or two, and in my case the midwife gives them to me.

Q--Where do you have your prenatal care?
A--Some midwives, even home birth ones, have offices. Mine comes to my house. She brings all her necessary supplies with her. It's fantastic!

Q--Did she do an ultrasound?
A--She referred me to the hospital to have it done.

Q--What if something goes wrong?
A--Totally depends on the situation.

Q--Nice one, Snarky McSnark. What if the baby is breech?
A--Depends on the parents' & midwife's comfort level with a breech birth. In my case if we tried all the 'tricks' and the baby just wouldn't turn, I would go to the hospital & have a c-section.

Q--Would the midwife do the c-section?
A--No, an OB would.

Q--What if you have a failure to progress?
A--As long as the baby and I were both fine we would let the labor progress at its own pace. I would probably do a combination of different things, such as changing positions, walking around, and the like. Or if I were tired I might rest for a while to conserve my energy for when things picked up again. I would also eat (lightly) and drink to keep my energy up.

Q--Indefinitely?
A--Probably not. If things were going so long that I was becoming exhausted, or if the midwife recommended transfer, I would go to the hospital. Most likely though, the baby will come on his own when he's ready.

Q--What else might send you to the hospital?
A--To name a few: premature labor, problems with the placenta (abruption, previa, etc), signs of distress in the baby, signs of shock in me, thick meconium (poop) stained fluid, cord prolapse, or pretty much anything where we or the midwife feel it’s necessary.

Q--Who decides if you go to the hospital?
A--In most cases, the midwife would consult with the doctor on call at the hospital first. If at all possible it would be a joint decision between us, her, and the docs, but there are some cases where she & the doc would make an executive decision, regardless of what we think. Knowing that she’s going to do her best to help us have an intervention-free birth, if she thinks we should go, I’d likely be quite inclined to agree.

Q--How closely does the midwife watch you during labor?
A--Once the midwife and her assistant are here, it's pretty much continuous support. She takes my vital signs every so often, and keeps an eye on me in general to make sure I'm staying healthy throughout labor. There's a protocol she follows, but I don't remember what it is.

Q--What about fetal monitoring?
A--The midwife brings the doppler-thingy and listens to the baby's heartbeat, according to a specific protocol. If I remember right it's every hour during early-active labor, every half hour during active labor/transition, and every 15 minutes during pushing. As with me, she keeps an eye on the baby to make sure all is well.

Logistics next time! Any more questions, put them in comments or email me: skerri_bATyahooDOTcom...