Monday, May 31, 2010

"Do You Feel Like Pushing?"

When I hear that a woman has hired a Midwife to attend her birth in her home, and then hear of all of the unnecessary interactions or interventions that were done, I want to cry and scream and throttle someone all at the same time. I'm not sure if Midwives have had the Medical model ( as opposed to what they should have - the Midwifery model ) drilled into their training, or if they haven't learned how to sit back and simply observe. But either way, it is robbing women of the experience that they could have in a home birth.

Recently I have heard several times of Midwives asking their clients, who are busy in transition, "Do you feel like pushing?", and I want to scream. If you have to ask your client whether or not she feels like pushing, you have your answer. If she's not beginning to grunt and push, then NO! She doesn't feel like pushing. I'm not sure whether some Midwives believe that certain clients will be an anomaly and never get the urge to push, keeping baby inside forever unless the Midwife does not step in and save the day by asking. I'm not sure what the reason behind this is. But it is not only unnecessary, it is interfering with mom's groove in labor. Now you have a client who is thinking, "Do I feel like pushing? Maybe I don't know when to push." You have now taken her out of her body, where she was happily laboring ( okay, maybe not all "happily", lol ) and into her head with concern or questions.

Guess what? You can learn so much by simply sitting back and observing. This goes for vaginal exams, pushing, whether or not baby is okay ( without touching, rubbing, suctioning, talking, etc ), and any other unnecessary interference in labor.

And ladies? If you have a Midwife who asks you this question, please tell her that YOU will let her know when you are ready to push, and to please stop interfering. Though, I would recommend finding out prenatally how your Midwife practices. Ask to get in contact with previous clients. Ask them how the Midwife was during their birth. Make sure that you have a truly "With Woman" Midwife, and not one that is fearful of birth or who over medicalizes it. Out of the last 10 clients, how many have ended up in the hospital? Make sure you have a Midwife who respects and honors your wishes. If you ever find out that your Midwife does not ALLOW ( or even has PREFERENCES ) you to birth in a certain way, such as on your bed or in water .... find someone else. This is a violation of your rights, and shouldn't be imposed on you.

Thursday, May 20, 2010

What Happens in a Home Birth?

Many times I have people wonder what's so different about a Home Birth. How is it different than giving birth in the hospital? How is it better?

I have listed my 10 reasons for giving birth at home before (added below), but it doesn't walk you through what a Home Birth can really be like, step by step.

First of all, my prenatals usually last, on average, an hour long. I use the time to really get to know the family. Birth is such an intimate time in a family's life. If I am going to be a part of it, I want them to feel like they really know me, and vice-versa. We not only go over the clinical diagnostic that are done at an OB office (Blood pressure, fundal height, baby's heartbeat, check urine), but we also go over nutrition (which is vital in preventing things in pregnancy), as well as the emotional well being of mom. I want to make sure that any concerns or questions are fully addressed in each and every prenatal. As we get closer to 40 weeks, we will go over any specific birth wishes (candle light, waterbirth set up, music, etc) and make sure that all supplies have been gathered and are ready. We speak about when to call me in labor, and what the family wants my roll to be. Am I catching, or is dad or a sibling? I have absolutely no problems with someone else catching. And unlike some Midwives, I do not require a "three handed catch". I trust that dad will catch baby perfectly fine without my help. ;)

There are some Midwives in the area who do not "allow" clients to birth on their own bed, or "allow" clients to birth in the water. I see this as a gross violation of personal choice in birth. I am happy to catch baby (if I am even the one catching!) in whatever place mom chooses for her birth. My desire is to see women take charge of their births, and not ask me for "permission" with what they can do with their body and baby. I am simply there as a lifeguard of sorts - to make sure that labor and birth progress safely.

At the last birth I attended, I was called in the afternoon to be given a "heads up" that mom was in labor. She and her husband were going to try to go on about the day as normal, and call me when things really picked up. I got a call back at about 10pm, with a request to come soon. I gathered my supplies and headed out. When I arrived, the birthing room (in this case, the bathroom) was such a beautiful scene. Mom was laboring in her tub. Lights off, candles lit around the tub and bathroom. Dad was playing his guitar and singing to mom. It was such a sweet setting. Mom was smiling, excited for the day to have arrived. With her permission, I checked on baby's heartrate, and asked how she was doing. (In between contractions, of course.) When I knew everything was good, I retreated downstairs, telling them to call if they needed anything. They had it all under control, and wanted the intimacy of the two of them laboring alone. I only went back up every so often to check on baby, and retreated back downstairs. I don't do any vaginal exams unless I feel there is something going off that needs this tool. And it isn't often that I feel this way. ;)

At about 2am, mom decided to try to get some rest. Contractions were slowing down and she was tired. We all fell asleep for a bit, until I was woken up at about 2:50 with sounds of her starting to push. They called me back upstairs. From the time that mom's body got serious about pushing, to the time baby was born, was a mere 6 minutes. She did BEAUTIFULLY! She caught her breath, gathered up her baby, and snuggled her. I made sure baby's color and tone were good, and then didn't touch baby again for an hour. Because baby was breathing perfectly, crying quietly, and her tone was great ... I didn't need to interfere with touching baby. This was mom and dad's time, and didn't need to be interrupted. An hour after birth, I did the full newborn exam and checked mom for tears. Not ONE! :) I made sure mom and baby were nursing without any problems, cleaned up everything from the birth, and left the new family to snuggle up together and sleep.

It may not sound like I did much. I usually don't. When a mom is healthy and has had a healthy, low risk pregnancy, the best thing to do is as little as possible during labor and birth. Interrupting the process continually can hinder the birth. Vaginal exams are unnecessary the vast majority of time, and should be avoided. Unless mom and dad need the extra support, they should be given as much time as desired to be alone. They created the baby alone, they should be given the opportunity to labor alone. Now, I have had families that have wanted me more involved. I have kept mom company, rubbed many backs, and have even slow-danced in labor with mom. I am happy to fill whatever roll the family wants me in - even if that means doing nothing at all.

This is the difference of Home Birth. There aren't unknown people (nurses) walking in and out of your room without permission. There are not beeping machines or an uncomfortable bed. There aren't any IVs, or limited spaces in which dad is allowed to go. There aren't any restrictions to how/where mom births, or how many/little people in attendance. All newborn exams are done on the bed with mom, not across the room or in a separate area. Baby never leaves mom's site (unless dad is showing baby off to family that may be in another room).

Birth should be a beautiful, intimate time for a family.

Ten Reasons (and there are many, many more than ten!) To Birth At Home:

10. You remain an autonomous woman throughout labor and birth. You're not treated as a sick person, you don't have to put on a hospital gown, and you're not told what to do.

9. Your husband/partner can take breaks as needed, and he's in his own home. He doesn't have to wander the halls to look for a vending machine or a cafeteria. He can even play video games. ( The big plus to my husband )

8. You can eat and drink as you wish. You are not restricted to ice chips, you are actually encouraged to eat healthy, protein-filled snacks and meals.

7. You don't have an IV. In a home birth, you drink as your source of hydration. There is no IV placed in your hand, and you are free from that cumbersome IV pole.

6. There are fewer complications at home. This is from multiple studies done over multiple decades. At home, fewer ( next to zero ) episiotomies are done. In the hospital, some have a nearly 80% episiotomy rate. At home, fewer babies need help breathing at birth ( 17 times LOWER risk at home ). At home, shoulder dystocia is less likely, even for those HUGE babies. ( even though the HUGE babies are not the ones at more risk for this, despite the myths ) At home, fewer moms hemorrhage. At home, fewer moms tear.

5. There is never a risk of mixing up babies. There is only one brand new baby at home ( well, 2 if twins ), and you know he's yours.

4. There is never a risk of mixing up medications. There are no medications, but even if there were there would be no possibility of getting someone else's meds, and dying.

3. There are no drugs. Now, this may seem like a bad thing to some women, but it's a good thing for EVERY baby. A baby born without drugs, is a healthier baby. You don't put baby at risk for drug-related conditions at birth, when there are no drugs to begin with. And without an epidural, you're not at risk for the myriad complications to both mom AND baby that come with one.

2. As many, or as few people can be in the room with you when you birth. From children to grandparents and anyone in between. And, anyone you wish can catch the baby. It makes birth what it should be - a family event.

1. You are giving your baby the greatest gift of all - a non-interventive, drug-free, peaceful, safe birth...and on your terms, not a surgeon's. There are no birth do-overs, so why not give your baby the best birth possible?

Just reduced fees

I firmly believe that having a Home Birth should be an affordable option for all women who desire to have a safe, gentle birth on their terms. With the way that the economy is, and seeing that so many women rely on Medicaid in Southern Utah ... I wanted to make Home Birthing an even more affordable option.

My full home birth fee is now $1500. I give an additional $200 discount for women who can prove eligibility for Medicaid, bringing the fee down to $1300. I also offer up to $400 in trade/barter services. Which means, if you qualify for Medicaid AND have something to trade or barter, ( Do you sew? Do you sell tupperware/candles/etc? Is your husband a mechanic or handyman? ) it brings the cash price down to $900.

What do my services include?

* Full prenatal care
* Available 7 days a week for questions/concerns
* All In-Home prenatals ( if you live within 50 miles of me )
* Waterbirth tub at no additional fee
* Book lending library
* Labor / Birth and up to 4 hours with you after birth
* Post partum visits at 24 hours, 3 days, 7 days, 2 weeks, and 6 weeks
* FULL 24/7 breastfeeding support

I "specialize" in VBACs, as this is very near and dear to my heart, being a VBAC mama myself. I also will attend twin births, as long as the pregnancy has been healthy and normal.

Initial consultations are FREE. Give me a call and schedule one today!

Joyful Birth Services Website