Would you give birth in a midwifery led unit?

[bellyjiggles]

Hi Hoobly.. interesting to hear another from the UK here!... good for you home birth an all.

Most would have dubbed my labour 'high risk'... but it was MY LABOUR, and very much my choice... but I would not have done it without the support of, and belief in, my fantastic midwife, who would have accompanied me to hospital had it been necessary (it definitely wasn't about staying at home at all costs)...

Unfortunately, even before nearing the end of pregnancy and the realisation that she was breach, my midwife was saying 'yes, we'll attend you at home, but will have to transfer the minute there's any indication of problems' and certainly wouldn't attend at home for a breach.. Although, by law, a midwife has to attend a labouring woman wherever she is. But not something you'd do really I think! I know one who has tho, whilst labouring with a Doula, and the midwives were kept in the back garden until safe delivery in the birthing pool indoors!!!!

The figures say that although women are now encouraged to labour at home, most (somewhere in the 70's %) get transferred anyway.. which wasn't encouraging for me!! whereas my midwife offered pretty much the opposite chances. Interestingly, when the 'community (or NHS) midwife' arrived, she got very concerned and starting trying to talk my partner into getting me to hospital, once again for a caesarian, which he knew I really didn't want but felt incredibly scared at the weight of responsibility having the decision that could be putting us at risk! The independent midwife continued to manage the situation after that and I went on to progress to a very straightforward breach delivery.

I just had complete faith in her YEARS of experience of birthing women at home, with twins, triplets, many breach.. needless to say she has an MBE for her services and dedication to midwifery.. she now lectures.. and YEP, I had to pay... well worth it!

[bellyjiggles]

... BTW.. don't think my post was clear.. most way through my pregnancy I was advised by a community or NHS midwife, who didn't hold out much hope of home delivery for first time mums, it was when they told me she was breach that i was told how it was gonna be in hospital, strapped up an all that! - terrified I sought out my independent midwife.. but at that point it was being consultant led.. don't think midwives would have been very involved atall.

[hoobley]

Yeah i had community team care, sounds like mine were a lot more supportive than yours! I was given the 70% figure too - you know that's 70% of those who DO transfer are first time mums, NOT 70% of homebirthers transfer. Sounds like they twisted that little statistic to scare you! About 20-40% of homebirthers transfer, the majority do so for analgesia options for a long labour which they don't have access to at home (epidural, pethidine etc. (my midwives had some morphine in my fridge but i didn't use it)). It's only around 8-14% who transfer for obstetric need (distressed baby, abruption etc.). Or at least this was the stats in 2005 when i was PG.

I don't know how i'd plan a breech to be honest. I have about 20 homebirthing friends and one of our more recent births was a catastrophic surprise breech at home and the babe ultimately died (very sad story - baby had no chin-to-chest reflex and got stuck with her chin up behind the pubic bone, and when they got her unstuck (more than 15 mins later) the placenta came right behind her head, and they think it might have detached before she got stuck, so clearly there was something going wrong before that point) and realistically a section at 39 weeks would probably have prevented all that, though to be fair at 39 weeks (and indeed at the outset of labour) she was head down and good to go, so they wouldn't have OFFERED a section. I have another friend who transferred from midwife centre to obs ward to have a section for a surprise breech. I don't know how i'd feel. Rationally i know women can birth breeches but when a baby you know has died of ANYTHING it changes your viewpoint of whatever it was, iykwim.

Sadly for most women the care in a breech case is only as good/experienced as the carer they have, and increasingly in the UK Obs and midwives do not see vaginal breech births and thus it IN FACT becomes more dangerous as the years roll on to attempt one. I'm so glad you could find a midwife who had the knowledge and experience and heart to care for you.

Bx

[bellyjiggles]

Hi.. yeah think I did say that she was talking about first time mums, as that applied to me.. but certainly can't comment on others situations.. some of which sound too distressing and awful to think about.. we do all know this stuff happens, in and out of hospital, but my point really was that the rates of ceasarian at 25% in our local hospital are recognised as being too high, and therefore obviously done all too readily - to prop up, I believe, a drastically falling level of experience amongst midwives generally to really manage these situations, as exposure to them during training and after is so rare and for the Ob even more so.. Wish I had a pound for every time I heard someone say they were told they would be hours and to go home, etc.,etc.

.. as for what the mum needs.. she needs to be in the place she feels most relaxed and confident, under a bush or in a high tech hospital unit! cos I think thats the key to helping reduce difficulties during labour, along as the staff can be trusted to not intervene unnecessarily! - which I couldn't do!

[Julie Doula]

Originally Posted by AnnaT

I also just want to say that I have never seen Kelly or any of the mods berate or belittle a person for choosing OB care and intervention. BB and a majority of women using it are all about INFORMED CHOICES not bullying people into having natural births.

I've seen Kelly get flak for supporting women women who choose/prefer obstetric care. And for supporting women who get bullied into obstetric care. Seems like she gets it from all sides! What she has done is create a forum community that supports informed choice, and people's individual journeys towards more informed choice. Birth is always going to be a hotly debated topic, but to go against the tide of mainstream opinion in a medicalised culture takes some courage. I don't think Kelly or any of the other mods here would say there is only one right way or best way. But opening up the menu a bit, sharing stories, and making the info & knowlegde out there that much more acccessible is all good. It takes guts to open up discussion where there are naturally going to be many & varied opinions.

[DisGirl]

I went through my local hospital, but in a program where I was looked after the one midwife and a backup. I had them both all through my pre-natal care, one was with me through my entire labour (well once I went to hospital) and then they alternately came to visit me at home for two weeks after the birth. I had complications and an ob came in to help get DS out (cord wrapped around his neck twice constricting the cord with each contraction and not letting him progress) in the end, but my midwife did a wonderful job monitoring me and keeping me informed and calm throughout it all.

I'm in the same program again with this bub and wouldn't have it any other way, but knowing that the OB will be nearby is a reassurance to me.

[buliej]

Hi

I replied earlier that I wanted an OB because I am over 40, it would be if things work and IVF pregnancy (although I've read that shouldn't matter), and it could be a multiple pregnancy (I'd obviously know this in advance, but it would be a factor). However, I've found reading these posts interesting and informative - especially the recent one about having some follow-up visits - this is very appealing. If there was a program that combined both OB and mid-wife care, I'd definitely explore - my sister in the US had a doula and she loved it - but I have no idea how to explore this here and my Aus network is somewhat limited (I'm an American ex-pat) and I am reluctant to use anyone who doesn't come highly recommended from a "trusted source"...so I guess this leaves me ...confused!

[sasha]

Interesting to see that when I voted it was over 70% in favour of midwife care I chose that for my first birth and am heading there for my second (any day now would be good, not that I'm over being pregnant at ALL). I loved the fact that in the room were me, my partner, the midwife and then our baby. So simple. I felt really lucky to have this choice, knowing that if needed I could be transferred to the hospital where I would get any specialist care I needed. It worked really well for us.

[sushee]

buliej,

my youngest son is an IVF baby, my first 3 were not and yes, in the end, it didn't make any difference to my pgs or births.

[Loqua]

I voted 'yes'.

Wouldn't choice be a lovely thing?

What we'd truly like is a home waterbirth, with a midwife. Not sure if we'd be able to afford that, though. So, next preference is for a birth centre with midwives. (Hopefully still in water!)

Mind you, hubby and I are still a little while off TTC... we're still sorting out a visa so that we can be in the same country! (Distance does get in the way somewhat.)

[Jennifer13]

I voted undecided.

I used a private ob in a private hospital for the birth of my DD. Due to placenta praevia I needed a c/s, but we were given until 37 wks to see if a vb was possible. Because I went that far along in the pg without knowing I would wonder how I would have fared finding and trusting an ob in such a short space of time. And I loved my ob and the hospital we went too, so I would choose him again.

HOWEVER the world is not perfect and if he were unavailable for my 2nd child I would look at all options, including midwifery-care.

[DaniellyBelly]

I can't imagine giving birth any other way! Midwifery-lead care is extremely undervalued and underestimated! Not to mention misunderstood. I've come to realise that many of my family and friends are under the impression that Midwives are not medically-trained proffesionals and that they feel more 'safe' under the care of an obstetrician. It's sad, since the intent of obstetrics is really to manage high-risk occurences, NOT normal birth! And we ask ourselves why women feel disempowered after a highly managed birth where they are no longer the ones in control? There IS a better way for normal, uncomplicated birth, and it's definitely Midwifery-lead care!

[richsaralex]

Originally Posted by DaniellyBelly

And we ask ourselves why women feel disempowered after a highly managed birth where they are no longer the ones in control?

I totally agree - women are disempowered in birth - majorly!! Why are we not more confident in the abilities of our bodies to do what is only natural? Weve been doing this for thousands of years afterall... why do we need a doctor to tell us what to do?

[Karina]

I too felt my hospital wasnt a particularly empowering place to be. As soon as I rocked in when I was in labour, I felt like i was spoken down to by the random midiwfe who was on duty. Midwife was being an arse and when I was squatting when I had contractions (because its what felt good at the time) the midwife told me "what are you doing, why are you doing that, get up on the bed". It was more her tone that made me feel little. It was in the regular labour ward as the bookings person pretty much told me to use the labour ward not the birth centre (another disempowering moment from them).

On a bit of a side note, when I told people I was pregnant, one of the first things people asked (after when the baby was due) was: "oh are you going to XXX private hospital? I've heard its really nice" as if its just normally expected to go to a private hospital under the care of an obstetrician (no offence intended to people who choose this option, it was just wierd that everyone seemed to expect me to do it). People thought it was a bit strange that I didnt see a doctor at all for my pregnancy and saw (and planned to see) midwives only.

[richsaralex]

Karina - I had exactly the same experience as far as people's reactions to my choices. People couldnt beleive I hadn't seen an Ob, or that i hadnt even seen a GP. They actually made it sound like I was making an irresponsible decision!! The fact that i was a young mum (I was 24 when my little boy was born) meant that alot of people didnt take me too seriously either, and felt it was their right to tell me what I was doing wrong - very frustrating!!

And when I say I had a water birth I get a mixture of incredulity and (sometimes - rarely) jealousy (from those who didnt know it was even available!). Also, the fact that I was only in the birthing suite with my midwife for half an hour before my son was born (so therefore no time for pain relief!) people almost fall over with shock! Apparently i'm incredibly irresponsible for staying at home so long (shock horror!)

Trying to explain my decision was like hitting my head against a brick wall - people are so brow beaten and terrified by the medical profession that I eventually just gave up trying to explain myself - all I hit up against was peoples judgements and fears. With this baby I think i'll be much more prepared for peoples reactions, and maybe i'll manage to bring a few people around to my p.o.v. - you just never know!!

[hoobley]

I had a homebirth and still get raised eyebrows and "Well, i guess you were among the lucky ones" when i mention it. I tell people "I didn't base my decision on newspaper stories or other people's fears, i looked at peer-reviewed medical research. It seemed a more intelligent way to assess risk." and leave it at that. There are no papers proving how dangerous homebirth or midwifery-led care is, because it isn't. It might be cruel of me, but i'd rather they realised they are being irrational than let them go on thinking i am.

Bx

[BellyBelly]

*bump*

I am putting this in my submission to the government shortly, any other votes/comments?

[sunshine_sieben]

Not only would I choose midwifery led care again, but when I recently found out that I was pregnant again, my first call went to my midwife (well after telling family and a few friends). And I am ecstatic that most likely, I will have the same midwife looking after me that was with me all through my first pregnancy, DD's birth and after.
When I tell people about the post natal support I got from my midwife, their jaws drop. They can't believe that it is possible for your midwife to spend 4-5 hours with you every day (in your own home) to make sure that BFing is working out and to help wherever necessary. If more women got this type of support, not only would we reduce the incidence of unnecessary c/s, but also increase the success of BFing.
I cannot imagine giving birth any other way.
OBs are wonderful and necessary for complicated births and emergencies. Midwives specialise in "normal" births, which is the vast majority of births. But when you talk to people around you who have been through the normal hospital system (especially some private hospitals), you could get the impresion that most births are high risk and very complicated, life threatening even. I wonder what these people think has happened in our evolution to warrant that view that we have lost the ability to birth our own offspring.
I am looking forward to having the same people attend to this birth that were there for Maya's birth: My midwife, DH & my mum. Just this time, DD will be there, too. I am actually really looking forward to the labour and birth part. The way I have experienced it, it was amazing. Painful, yes, but magical.

Sasa

Sasa