Sunday, March 16, 2008

Of This, You Can Be Sure

Recently, someone considering a homebirth asked me, if indirectly, for assurances. Of course I can give none. The person had been inflicted by horror stories that made them rethink their course of action. Well, I got horror stories too. I've seen illegal shit, immoral shit, unethical shit, and shit that was plain just wrong. You don't know how far a person will go when they think their liscencsure and livelihood are in jepardy. They will do anything to cover their asses, anything. Of that, you can be sure. My assurance in choosing a homebirth, if any, was that I would be in control of my environment, and I would choose my caregiver. If the shit did hit the fan, I'd be the determiner of which shit- mother nature shit, or iatrogenic shit. And nothing I saw during my years on L&D gave me any confidence in medical 'management' of normal childbirth. I just saw a lot of shit hitting a lot of fans.


Midhusband said...

Well said, Laborpayne.

It is sad that there is so little straight up-ed-ness in the discussion and in the care that women receive (particularly in hospital).

- There are no guarantees with planned, attended home birth, but the risk of a bad outcome is very low.
- There are no guarantees with planned hospital birth, and advanced problem solving is close by, but the likelihood of someone doing something to you that is not necessary and not helpful is really high.
- It is perfectly fine to plan your birth at home and we should all work to support you.
- It is perfectly fine to plan your birth in hospital and we should all work to support you.

I think we need to start over. Let’s deploy a bunch, and I mean a bunch, of midwives to serve women in all settings. Let’s address the awful environment in which obstetrics is practiced.

…and, most importantly, let’s support mothers as best we can with the best information, care, and respect for their decisions.

I look forward to the day when there are no women who choose home birth because “they ain’t gonna do it in the hospital ever again”.


TFJ said...

MH, do you think that is possible?

I am so straight up, sometimes it makes people shake their heads. But that is ok, I just told a couple that I have no secrets. Let's hear the hospital staff say that :) How about some stats!

I would hope that ALL care providers are straight up- I have seen it in others (especially emergency room docs), but never in conventional maternity care, never. Usually when the secret does come out, it is shocking (oh my inlaws were coming in town, so how nice you had the c/s today instead of waiting for labor.)

!!!!! true story

Laborpayne said...

First of all,
Russ, will you marry me?
This is a great discussion. It touches on an important truthfulness and it's flip side trustworthiness. I think women have done a fine job of trusting their caregivers, they just haven't proved themselves to be trustworthy. Women tend to get pissed when they hear in my message, "don't trust your doctor" But that's as straight up as I can get.

Anonymous said...

Even if your provider can be trusted, can the staff at the hospital? I get the feeling my nurse was the one causing the issues in my labor and birth. She contradicted the OB's when they said I could get out of bed, said to labor down rather than push at 9 cm, and when I was told I could get off the monitor she insisted it stay on. When I was told by the OB directly that he didn't want to break the bag of waters because it would possibly get the baby's head stuck in a bad position and he didn't want to have to turn my baby when we could probably do that with position changes, she actually called him in to break my water because with all my movements to move the OP baby she couldn't get me on the monitor (she kept saying I wasn't getting credit for my contractions...what?). She insisted he come and called him to break the water and get that line screwed into my baby's head and another nurse said, "but the baby could get stuck in a bad position." Just after she called him my little Jillian moved, I felt it, and then suddenly had the first urge to push. She came out in the bag of waters (intact). My family doctor came and checked on my baby and I told him the story. He said, "man, sometimes when I would come for births I fought with the nurses here who insisted on all these interventions...the nurses were more of a problem for me." He quit catching babies. I know there are times when nurses advocate for their patients (atyourcervix), and times when they intervene. You roll the dice when you go to the hospital. First of all, my provider never can make it. It's either her day off or she's not on call because it's after hours. Out of six babies I have had MY provider there one time for the birth, and only there three times for the placenta. So, if they had gotten there on time, I would only have my provider half of the time for the birth. Hardly there for the labor, just hospital staff. Do women realize this when they have their first baby? They might have discussed a birth plan with a provider who is on board and totally supports them, but the staff at the hospital really actually determines the care. I've had great nurses and bad ones. At home, at least you'd be with your provider or a loved one...and if you trust the person who is good, you will go to the hospital only in need.

Still, I'd love to see a midwife model in the hospital. I want midwives in charge of l&d units, and for them to be there with the woman...and for OB's to catch babies only for very high risk or to do surgery. If an OB wants to catch he/she should be a dual Midwife/OB. They should have to stay with the patient longer. Less patients, more care. That's just my opinion. But what do I know, I've only birthed 6 babies?