Monday, June 20, 2011

You want to do a homebirth? what about the carpet?

Please view the AWESOME chart: http://vbacfacts.com/hbac/. It gives a personal perspective of the pros and cons for a home birth to a hospital birth.

I watched this video (see below) today, and thought *oh my Lord*. I actually said something a little more PG13 related, but seriously- oh my word!!!



I coworker asked why I am planning on doing a homebirth, and the majority of my reasoning comes from how my first was born. If the same thing happens again, and the cord is wrapped around Smiles' neck, then as his mother I will do whatever necessary to have him arrive safely. If that means going to the hospital and having a cesarean, despite my growing fear of that reoccurrence, if that’s what’s best for him- there are no questions.

I could have had an amazing delivery at Kaiser, filled with battery-operated calendars, dimmed lighting, a warm shower, and my husband there praying with me. The last part happened, the other three didn’t. And I think Scooby Doo was praying for him too. Putting him through that again…. To see husbands when their wives are in labor….

Here is where I come from: YumYum's Birth Story.

For Smiles, I have decided I want to deliver at home. Mainly because of the following reasons and questions that I asked of myself:

(1)    I’ve had Kaiser midwifes and an OB say that it may have very well not been necessary for me to have an emergency cesarean with YumYum.

The nurses never tried to reposition the baby upwards so the cord could loosen and hopefully untangle. Since my birth, two nurses at Kaiser asked me if they tried this with YumYum. I also think my blood pressure could have been lowered if I was calmer, and in a more comfortable laboring space. I labored in the regular delivery rooms for only 35 minutes. The rest was in triage, where women wait for the doctor to tell them they can be admitted since they are indeed in labor. I remember the room I was in for the four or so hours, being about the size of an eat-in kitchen, without the kitchen, just the eat-in part. Shove a hospital bed, a sink, a computer to monitor the baby, a nurse, a husband, an in-labor me, and the possibility of my mom or sister being there as well- it was crammed.

Mandatory Clause: At the same time, I know that from what we were told, having that cesarean saved my daughter’s life. I do not think that hospitals are evil. I am very grateful that the doctor on call that day did what she thought was necessary to keep the baby and I alive.

(2)    I have mixed feelings towards the hospital staff that day. I am angry that they stole something precious from me without my true consent, and I am grateful that they did what they thought was necessary in the moment. Should I have trusted their judgment? At the time, and still, I don’t think I know better than them as to what’s necessary or not. I don’t know what the breaking point is for how long a woman can be pushing before a c-section is needed, or what is considered too high of a blood-pressure. But I know my body. And no one else who acted on behalf of my body and my baby, did. I so appreciate them putting the baby first, but I need someone who can also consider what’s best for my health. This may sound selfish, but after the baby’s physical heath is secured, ultimately what is best for me, is also best for my child. A baby whose mother is detached, depressed, and unavailable is no kind of mom. I know firsthand. I LOVE my OB, but the chance of him being there when I deliver, I’ve been told, is “slim to none”. Normally when you deliver at Kaiser, you deliver with whoever is on staff that night. And I’m supposed to 100% whole heartedly trust this licensed stranger?

(3)    I do feel that a major contributor to my post-partum depression was the path that my delivery took.  I had a cesarean that I was completely put out for. I didn’t hold my baby for the first 5 hours of her life because I was still waking up from the drugs they gave me. I had trouble breast feeding her from day one because my skin-to-skin time with her was so late, and nurses have said that medicine that mom has during delivery can affect the babies ability to nurse. The stronger the meds and the form they are given- specifically the medicine they gave me to quickly put me out- also went to my baby girl. I did not want her to have that. I felt like a failure at the time. I hadn’t envisioned a perfect birth. I had hoped to hold off on pain medicine for as long as possible, and then deliver my baby “normally”. Why couldn’t have I had a normal delivery?

(4)    Many have said that I could have very well had an amazing first delivery at the hospital. What if everything would have gone fine with YumYum? Would I still want a home birth for my future kids? I don’t know. I don’t think there’s a non-bias way to answer that question because I think that you’re decisions are largely based off one’s experiences. I think the way I do because of my experience with YumYum.

(5)    What if the same thing happens with Smiles and a cesarean is necessary? Then that is what is necessary.

The first time they checked YumYum’s heart rate in the hospital, 4 ½ hours before she was born, the nurse said I would most likely have a cesarean because she was in distress. Her heart rate couldn’t keep up with my frequent and intense contractions, largely because every time I had a contraction the cord would get tight. If Smiles is in distress, we will know way ahead of time, that a cesarean could be possible and will take the necessary steps. I will labor at home as long as possible in an environment I am comfortable in, and then when the midwife says go to the hospital, I will. One thing I really like about my midwife is she is not anti-hospital. She believes that God has them there for a reason, and that Doctors and nurses who work for hospitals, can save lives. “They very well could have saved YumYum’s” she says.

(6)    You had a cesarean before? Is it safe to a regular delivery after that? For me- yes. Because I didn’t have a cesarean because of problems progressing (30% of all births), or too big of a baby, or a breech baby (3% of all births)- there’s no reason to automatically bypass the opportunity to have a vaginal delivery. Fetal distress (happens with cords wrapped) happens in roughly 9% of all pregnancies. It does not mandate a cesarean, but can lead to one. Having fetal distress in one pregnancy does not affect the likelihood of reoccurrence.

(7)       What about your chance of uterine rupture? My midwife at Kaiser said that because I have had one previous c-section, and YumYum was born less than 18 months ago, the chance of me having a uterine rupture is less than 1%. If this does happen, we are in trouble. However, she did say because I am within a 7 minute drive to the hospital, this is good- but it is still an extra 7 minute drive that, when in an emergency, no one wants to take.
Here are some other statistics I read:

"The risk of maternal mortality with repeat cesarean and VBAC is very low, but the risk is higher with a repeat cesarean: 0.04% vs. 0.02% per a National Institute of Health Study of 18,000 women. (Landon 2004: http://content.nejm.org/cgi/content/abstract/351/25/2581) That same study found the rate of infant death to be 0.01%. They also conducted a review of 880 uterine ruptures in a 20 year period, resulting in 40 infant deaths in 91,039 VBACs which is a rate of 0.04%. They found the combined risk of infant death or brain damage to be 0.05% or 1 in every 2000 VBAC labors."

Facts about HBACs (Home Birth After C-section): http://vbacfacts.com/hbac/

"It’s one thing to understand the risks of VBAC, but they must be countered with the risks of repeat cesarean, otherwise the patient is left with the false notion that repeat cesareans are risk free."

"Women who have a low transverse incision (side-to-side) have a rupture rate of 0.02 percent to 1.5 percent." (This is me)



So there are some answers to some questions some of you may have. But I mainly just write for me. :) That's all for today,

Love,
007

Interesting Links:
The Unnecesarean Blog (You’re not a bad mom if you want a cesarean… again.)
Fair comparison between VBAC (vaginal birth after cesarean) and RCS (repeat cesarean): http://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/weighing-the-pros-and-cons/ 

*Note: this is a blog in progress. I’m just writing thoughts as I go…. Blessings, 007

2 comments:

  1. I like this blog posting mainly because you are open minded to what your body can do--either in a hospital or at home. And I mean it in both senses...you are open to saving your baby's life (obviously) by doing another C-section if needed, but also you are open to having an amazing birthing experience as the family of 4 you're becoming (if possible). I love that you didn't hate on doctors. but I also love that you stood up for yourself. This is YOUR decision. God will guide & protect you the entire time you're in labor. We're doing a home birth too, and I'm actually looking forward to it, believe it or not. :) I've been told it's the best reason to be in the worst pain...all for the love of your family. :) love you!

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  2. As usual, I love your blogs...just a couple thoughts though. Obviously, I had a c-section as well that was unplanned and I do feel robbed of many things because of that-especially since I was knocked out too-that is why I am also planning ...a vbac for Jillian. However, my concern for you isn't really about the same complication but for uterine rupture. The risk is extremely low, like 1% for a uterine rupture. But, if this does happen there can be catastrophic consequences. This is why many Doctors recommend only doing a vbac if there is a 24 hour anesthesiologist and a 24 hour O/B on site where you are delivering so that in the event a rupture occurs your life and your babies can (hopefully) be saved. If you are at home you may be too far away from a hospital to get the life saving expertise you need-have you researched this?? Also, have you considered using a midwife at Kaiser instead of a Doctor? My Sis in Law just went through a 42 labor with her baby with a midwife at Kaiser Roseville and they treated her with the utmost respect for her wishes-basically until she told them she wanted the c-section. As far as the drugs during your c-section-the medication for general anesthesia doesn't have time to get to the baby. I asked about this before my c-section because I was so anal about drug exposure-which is why I was drug free, even refusing pitocin, up to that point. When you are knocked out the entire prep process is complete (as yours was since you were feeling the scalpel) before they knock you out and they have the baby out within 15 seconds of cutting so the meds can't hit the fetus. However, if you had an epidural for a while prior to your c-section that could have affected Emelynn's ability to nurse because the longer they are exposed the harder it is (sometimes) for them to nurse-so I wouldn't even worry about that aspect if I were you. Anyway, these are just some of my thoughts...I always recommend women to educate themselves thoroughly on all their options prior to giving birth so that when the time comes they can make educated decisions. I would recommend "The thinking woman's guide to childbirth" and "The business of being born" documentary to anyone who wants to be better educated on all things birth. Good luck lovely! I will be right there with yah! -Allison

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