My midwife homebirthed 5 of her 7 babies (twins were high risk, she had them in hospital) and was highly trained.
Ah... the whole risk assessment thing... only low risk women should be afforded choices... blah blah. Let's talk risk then...
I am considered too "high risk" to birth in a birth centre.
The ONLY REASON I am high risk is because I have had a previous caesarean. Recent bloods indicate that as a non-pregnant woman, I am healthy. I am overweight, that's about it for health issues. The SOLE reason I am considered high risk is because I've had a prior caesarean.
You wanna know how high of a risk I am? 0.5% chance that my uterine will rupture. If you had a 0.5% chance of anything else bad happening in life, you'd say the odds were on YOUR SIDE. Mind you, that's just the risk of rupture. The risk of a baby dying of that rupture is approx 1 in 10000. So a 1 in 10000 chance my baby is going to die as the result of me having a VBAC and my scar rupturing. I see that risk as pretty damn minor.
Now, let's just assume I am one of those unfortunate 0.5% who rupture.
How soon do you think that rupture will be noticed in hospital? Where numerous different midwives are flitting in and out of my room, leaving me alone for extended periods of time, dealing with other birthing mothers, etc etc.
How soon do you think that rupture will be noticed in hospital? We ONE WOMAN spends all her time in the same room as me, with no other concern but me and my labour.
Now, of course, at home, I'd have to be transfered to hospital. Given her focus on me, she is likely to pick it up sooner, call the ambulance and off I go to hospital, to a room which is waiting for me, because it's been told I am coming in with uterine rupture.
In hospital, when it's picked up depends on how long after it happens someone comes in and notices the signs. Then they have to get everything ready anyway... so it's not a case of them noticing the problem immediately and fixing it immediately simply because I am in a hospital. It may actually take longer to go from rupture to surgery than at home.
Of course, I am close to the hospital. I am not 100s of kms away. But then, a lot of women may choose to birth at home than travel 100kms to a hospital while in labour too... probably safer to deliver a baby at home with a midwife than on the roadside with a scared husband anyway.
So, IMO, it's actually far safer for me, and my baby, to just birth at home, with a midwife. Despite my "high risk," label.
Also, given that label, my birth would likely be hindered in hte name of hospital policy if I rocked up to hospital in labour. "8 hours and then c-sec," is likely what they'd say. I'd be laid on my back so I could be hooked up to monitors. Then my baby and myself are then subjected to the risks that come with all those additional interventions, and increasing the likelihood of me having a caesarean and exposing myself and my baby to all the risks associated with an emergency caesarean as well.
In all honesty, the choice for me is a simple one. IT's not about being a hero or hating doctors. It's about choosing what I believe it truly the safest option for me and my baby. As it is with every woman who births her way, regardless of what strangers who hardly know her tell her they know about her body and how things will go down.
ETA - Also consider that woman are shaped by their previous experiences. My experience has taught me that my best interests and my wants and desires aren't all that important when in a hospital. Now, that was just ONE experience, but it scared the sh*t out of me. Fear doesn't have to be rational.
I would ABSOLUTELY birth in hospital if I had faith that my wants and desires were important. If I could be given a room, with one midwife of my choosing (hell, I'd even pay for her, as I would my homebirth IM), and left alone... then I would be happy. It would actually cost the hospital very little to deal with me in that way... and then, if an emergency arose, there I am, ready to be fixed by those super well-trained OBs.
But I've been scared out of hospital. I've been in a situation where my wants and desires, and the best for both my daughter and myself has been ignored. I've seen my baby potentially need life-saving help from a paed, and not have the paed come. I saw her have to save herself, rather than get the medical attention she deserved, and what you would expect she'd recieve simply by being born in a hospital. I saw the other staff look on nervously, not knowing what to do, as she failed to breathe for 11 minutes and the paed they had called wasn't showing up. I saw them sigh, and shrug, and figure I should have a caesarean only because I was post-dates and not responding to induction DESPITE every test being done showing there was nothing wrong (the only reason she didn't breathe was because she didn't venture down the birth canal and have her lungs compressed - so a result of their decision to give me a caesarean). I was given that caesarean which wasn't even really necessary despite my objections... they used the "dead baby" line when it wasn't even relevant or a likely possibility at the time. I've been laughed at told to suck it up when having a cathetar inserted (in a ward, with another patient right there next to me) without anesthetic when I winced at the pain. I didn't feel looked after, or considered, or safe. I felt scared and afraid and bossed about by heartless people working through the factory that was that public hospital. A public hospital with a FANTASTIC maternity reputation too, btw.
So you know, if the hospital didn't scare me out of it, I would probably happily birth in one. But it DID scare me. It depressed me and screwed me up for years. So you know, I'm not keen to repeat that again, and have spent years looking into ways to improving my next experience, to hopefully avoid the times when I bath my baby and consider if life would be easier if I just take my hands away and let her slip under the water... because that's how I felt at times, and I have NEVER admitted that anywhere... IRL or here... but it wasn't motherhood that did that, it was the horrible experience I had in hospital, and the people who looked at me like I was insane for even feeling badly about that experience, who talked to me like I must not love my baby if I didn't like her birth, that I mustn't be a good mother if a "healthy baby," wasn't enough.
I don't want that sh*t again, so I am working to avoid it.
My experience wasn't even that traumatic compared to others, but TO ME it was traumatic and horrible and it's not something I will ever repeat willingly.
Last edited by SassyMummy; 19-06-2012 at 17:59.
Yes, there are pro natural obs. But look at intervention rates of private hospitals where care is provided by private obs.
This study is very interesting reading that shows low risk women birthing in a private hospital with a private ob are much less likely to have a spontaneous labour and twice as likely to have an episiotomy than the public patients.
Public hospitals are teaching hospitals. When I had my appointments with the dr's I'd ask them if they're ob's and no not one of them was. The anaesthetist told me they're all residents and if I was to need a c/s or wanted an epi a resident would be doing that too. That is not years of experience in my eyes.
You have to pay if you want a highly skilled and trained obstetrician to attend your birth in a private hospital. They're not all walking around the public hospitals and are waiting in the hallways while you're in labour. Again, false sense of security there, if they're so necessary and required, they'd be free and available at public hospitals. You would never see an ob at a public hospital appointment unless you were very high risk, otherwise, midwives look after you during pregnancy, delivery and post care. Ob's play little part, they're necessary for surgery and to manage high risk cases but in a normal, low risk birth, completely uneccessary. The public hospital system agrees obviously, I was suprsied to see the difference in my first private ob experience, to the public system.
Excellent post SassyMummy.
It is often forgotten that hospital policy (e.g. induction for 'post dates') subjects women everyday to an equivalent (or increased depending on the study you look at) risk of uterine rupture when they induce labour and start infusing women with pitocin.
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