Childbirth Options

Begin at the Beginning

Posted on Nov 9, 2010 in Childbirth Options, Featured, Parenting | 9 comments

Begin at the Beginning

Forgive me for being a bit obvious here: Natural Parenting came pretty naturally to us. When I look at the list of principles that make up the natural parenting philosophy, I identify with so many of them that it’s hard for me to think of just one that might resonate more than another. I can’t even really pinpoint how or when I came to incorporate them into my life. Sometimes I end up in a situation (like the sign-in sheet at La Leche League meetings) when I am asked where I first heard of La Leche League or co-sleeping, or when did I first become interested in homeschooling or midwifery, or when did I decide to breastfeed and to leave my son intact, and I just can’t say. I don’t remember a time when I didn’t know about those things, yet the truth is that somewhere in my twenties I must have started absorbing the Natural Parenting principles from somewhere, little by little. I have a feeling that the process was very organic, each of these ideas meshing with some part of who I was already. There were no epiphanies; just a feeling that “hey, this makes sense—how could I do it any other way?” If I had to say what opened the door for natural parenting in my life, I’d have to start at the beginning, and for me, that is homebirth. I was born at home and thus, all my life I’ve understood homebirth as a legitimate option. In grade school, I was more interested in the fact that I could wow my classmates as the only one not born in a hospital. I didn’t give much thought to the significance in terms of birth options or maternity care reform, but subconsciously I must have realised that I was proof that hospitals were NOT a vital part of the process of birthing a baby. In University I took a class on the Psychology of Health where one section looked at maternity care around the world. I was instantly enraptured by the system in the Netherlands. In the Dutch system, prenatal care is delivered by midwives and general practitioners, unless the patient is deemed high risk and transferred to the care of an obstetrician. Thirty percent of Dutch births take place at home and every new mother receives free daily in-home post-natal care visits by a nurse who helps with chores and gives assistance establishing breastfeeding. Sitting in this class in my early 20’s I knew that I would be seeking midwifery care for my own pregnancies. Midwifery care was attractive to me in the beginning primarily because the midwifery model of care is so strikingly different than the medical model. For a really in depth explanation, I highly recommend Ina May Gaskin’s Guide to Childbirth, but in a nutshell, the midwifery model of care views pregnancy and childbirth as normal, natural parts of life.  The midwifery model believes that birth unfolds best when left alone and that the fewer the interventions the better. Even though I’d never been pregnant before that rang true for me; I didn’t believe that pregnancy was a disability or that birth was an emergency waiting to happen. I guess what it came down to is that midwifery validated what I’d known deep down my whole life—that birth is a safe and normal part of life. Nevertheless, when I was pregnant with my first my attitude toward homebirth was “we’ll see.” I thought we’d explore it, talk it over with the midwives but that it was more likely we’d have a homebirth with our second baby. I thought back to my mom saying that one of the reasons she had me at home was because she’d already given birth twice before. She talked about it like it was no big deal, but there was always the underlying explanation that she had experience. And me? In my first pregnancy? Of course, no experience. Over and above the fact that many studies have been done recently that verify the safety of homebirth, a few things...

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A Quiet Example

Posted on May 9, 2010 in Birthing, Childbirth Options, Featured, Maternity Care Options | 13 comments

A Quiet Example

Welcome to the May Carnival of Natural Parenting: Role model This post was written for inclusion in the monthly Carnival of Natural Parenting hosted by Code Name: Mama and Hobo Mama. This month our participants have waxed poetic about how their parenting has inspired others, or how others have inspired them. Please read to the end to find a list of links to the other carnival participants. *** In 2005, we had a baby. We used midwifery care. We had a home birth. We had a son and we did not circumcise him. We used a cloth diaper service. We breastfed. Aaron and I were the first in our group of friends to have kids. At first it was kind of strange and we felt like outsiders among them. Life had changed in that instant, punch-in-the-face kind of way that seems normal among first time parents, and we found ourselves withdrawing from our childless friends. Out of necessity, we hunkered in and learned to parent. Along the way, one-by-one our friends joined us in parenthood. Five years later, nine of the couples that we regularly associated with back then either have kids or are pregnant. In this group of nine couples, seven used (or are using) midwifery care. The two couples that didn’t were pregnant with twins. Only one birth was by cesarean (and it was one of the twin births). Two couples had their babies at home and two more couples are currently planning home births. Surrounded by these people, I often make the mistake of thinking that midwifery care and home birth are more widespread than they are. But when you look at the data, a different picture emerges. According to the most recent reports from the BC Perinatal Health Program, only 5.8% of births in BC were attended by a midwife (versus 78% in our friends), and 29.3% of births were by cesarean section (versus 14% in our friends). In 2007/2008, there were 671 home births out of a total 43,505 births which gives us a home birth rate of 1.5%. If all goes as planned, the home birth rate among our friends will be 44%. Why is it that our group of friends has this vastly different set of statistics for their births? I suppose it is partly demographic. Perhaps we share similar mentalities that would predispose us towards these kinds of choices: cloth diapering, eating organic, and so on. We are friends for a reason. But it’s not like our friends are hippies. Overall, most of our friends are regular people, professionals, home owners. Aaron and I were probably closest to the home birth “type” – you know, living in a bus and sporting dreads and all. When I look at the numbers though and realize how different our group is from the rest of the province, I would like to think that maybe we were a positive example to our friends. I tried not to be preachy but I answered questions when they came our way. I only remember a few conversations and no one has ever said that we influenced them. I don’t take credit for their decisions. After all, I don’t think anyone chooses home birth because their friends did. You have to make that choice for yourself and you don’t make it lightly. You ask questions. You read. You talk to your caregiver. Yet, even knowing one person who has actually had a home birth can demystify it for you. Every single person who uses a midwife or has a baby at home helps to normalize birth options for everyone they know. Even if you never really talk about it you become a shining example that there is another way, that there are choices. So in some small way, I like to think that we did have a role to play, that we were a positive influence among our friends. Maybe when they walked into their first appointment with a midwife and she offered them a choice of birth place, they didn’t brush it off as quickly as they might...

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First Baby First Homebirth

Posted on Dec 12, 2009 in Childbirth Options, Featured | 3 comments

First Baby First Homebirth

I was born at home so I’ve known all my life that there was a possibility that it wasn’t all about the hospital, that there were options. Even so, when I was pregnant with my first my attitude was “we’ll see.” I thought we’d explore it, talk it over with the midwives but that it was more likely we’d have a homebirth with our second baby. I was unsure and I thought back to my mom saying that one of the reasons she had me at home was because she’d already given birth twice before. She talked about it like it was no big deal, but there was always the underlying explanation that she had experience. And me? In my first pregnancy? Of course, no experience. I recently read this post by @heartsandhandss from twitter where she talks about whether or not homebirth is for you. What struck me so much about her post was the idea that as a first time mom, even those who are drawn to homebirth often feel this ambivalence about homebirth. You say that with your second baby you might consider a birthing center or a homebirth because it won’t be as scary as with your first baby. Her argument is that you might as well have a homebirth while you still qualify for one, while you are still low risk. With cesarean rates hovering round 30% (depending on where you are), you have a 1 in 3 chance of coming home from the hospital with the prospect of trying for a VBAC next time. Again, depending on where you are, you might not be eligible for a homebirth anymore after that. This point of view really stuck with me. To me the tricky part is being able to balance that kind of rationale with the fact that first time moms often haven’t got the experience to TRUST birth yet. Interestingly, for so many the experience they gain in the hospital does the exact opposite: it doesn’t teach them to trust birth at all. Or you find that experienced mothers turn to homebirth only because they’ve had such a terrible hospital experience that they go looking for anything, any alternative must be better than doing THAT again. A few things helped change my mind about having a homebirth for my first baby. The first was that in my family it was treated like a normal and acceptable choice. I had support for my decision and it was something I’d known about my whole life. The second factor was the trust I had in my midwives and when I told them that I thought maybe a homebirth the second time around, they were able to put whatever nebulous fears I had to rest. In fact, I can’t even remember what their answer was. I just knew after that talk that we’d be planning a homebirth. And lastly, I read books books books until I trusted birth at least logically if not from experience. For me, it ended up being the natural path to take, perhaps because that’s where my path started in the first place. For others, I really think that @heartsandhandss makes a compelling and logical argument. If you want the best chance of staying low risk, staying eligible for homebirth in the future, at least explore it as an option the first time. Or make the choice to birth with a midwife in a hospital or birth centre. Otherwise, the choice may never be yours. photo credit:...

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Preparing The Nest – getting ready for your homebirth

Posted on Nov 12, 2009 in Birthing, Childbirth Options | 0 comments

Preparing The Nest – getting ready for your homebirth

Having a home birth can be an amazingly empowering and rewarding experience, not just for mom but for the whole family. In a world dependent on technology, enamored with science, it is indeed a rare accomplishment to birth a baby at home far from epidurals and laughing gas. There is also something magical about going through the birth experience in the place you live day to day, in your own private space where you feel safe and comfortable. Imagine how lovely it is, a year or two later, to look up from where you are sitting and think “wow, this is where we were when this sweet child joined us for the first time!” A home birth is not particularly more complicated than a hospital birth. In fact, in many ways, it can be much simpler. No forms to fill out, no nurses coming and going, no shift changes, no electronic fetal monitoring—just you, your team and your space. However, you will need to cover a few basics: Mindset Try not to fixate on the idea of being at home. Prepare for the possibility of needing or wanting to transfer to the hospital not because you doubt the process but because there is always an element of unpredictability with birth. In the event of a transfer, you will need to remain focused on your birth and your baby rather than being disappointed about ending up at the hospital. Telling everyone in the weeks beforehand that we were “planning a home birth” rather than “having a home birth” helped me to mentally leave the door open for the possibility of a change of venue. Cleaning Several weeks before your due date give the place a serious clean. Afterwards you will only need to maintain with spot cleaning/maintenance. No need to feel embarrassed by the state of your housekeeping when welcoming your birth team. Supplies Your midwife will give you a list of supplies that you will need to have on hand for your birth. Every midwife tends to have a slightly different list but the basics are all the same. Some items can be found around the house; others will need to be picked up specifically for your birth. If you order your supplies online, keep them in the shipping box in a place that is relatively handy. Add a good pile of old clean sheets, towels and wash cloths. Choose linens that you don’t mind staining. You can also put everything in a laundry basket for easily carting to a different room when labour starts or if you are compelled to move around. Remember to pack your hospital bag and keep it by the door in case you end up transferring to the hospital. Food Shop beforehand for snacks for yourself and your birth team. Good ideas are fruit, popsicles, juice, miso soup, crackers. You can also make up a batch of Labourade or drink Emergen-C. If your labour is long you may get hungry and you definitely need to stay hydrated. Stock your freezer with healthy heat-and-eat meals to make those first weeks with a newborn a little easier. You can use up some of that late third trimester nesting energy making your own or enlist your family and friends to each donate a meal for your freezer when they ask, “What do you need?” Siblings You can choose the level of involvement for older children: whether they go to friend’s house, stay in the next room or wander in and out at will. Try to bear in mind the individual personalities of your little ones as you make this decision. You can prepare them for what to expect with classes, books or even colouring. Talking with kids ahead of time about what will happen during labour and birth will help them take it all in stride. If you plan on having your older children present, it is a good idea to have an adult there whose main role is to attend to them. Pets Dogs especially can find the commotion of birth slightly upsetting. Try to have...

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Open Letter to BC Homebirth Study Critics

Posted on Sep 3, 2009 in Birthing, Childbirth Options, Maternity Care Options | 3 comments

Open Letter to BC Homebirth Study Critics

Dear Uniformed Commenter After reading the newest study on the safety of homebirth, I sat back to read some reactions from the press and the public. I had a look at the CTV coverage and the CBC coverage and I read over the comments in reply to each story. Imagine my dismay when I read some of your reactions! I was rather glad that the comments were closed because I was too upset to post anything coherent or cool-headed. Frustrated, I can not stop thinking about your replies. First, I shake my head as it appears that you’ve neither read the study nor understood the very article you’ve responded to. You seem to have missed the point entirely. Your arguments fall into one of several categories: 1. The Personal Anecdote Rebuttal This is some variation of “I can only imagine how horrible our child’s birth would have turned out if we had tried to have a home birth” and then launching into your personal story where everything was touch-and-go but thankfully the medical staff at the hospital saved your baby. First of all, this is not a logical rebuttal to a scientific study. This is an emotional reaction known as a pathetic appeal. You are rejecting “a claim based on how it makes you feel without fully analyzing the rationale behind the claim”. You are appealing to people’s very real emotions about the health and safety of a tiny baby at the expense of being able to actually hear what the study’s authors are trying to tell you. While it is totally understandable that this is an emotionally sensitive topic for many, the problem is that you are overemphasizing the emotional component at the expense of the message (the logical component) – this is a flawed argument. Effective, yes – ad campaigns do it all the time, but flawed nonetheless. Secondly, while my heart goes out to you that you had a difficult and scary time at the birth of your baby and while I’m glad that modern medicine was able to save your baby, we can’t actually compare your situation with that of the study subjects. We have no way of knowing with the few details you’ve given if your particular circumstances would have made you an eligible sample for the hospital group. Perhaps you had complications or a high-risk pregnancy that would have excluded you from the study. Therefore, sadly, your situation is not a relevant point of comparison for a study that was looking at births fitting very specific criteria. If that is the case, even the study’s authors, home birth advocates, the BC College of Midwives etc. would all agree with you: your child’s birth should not have occurred at home because it did not meet the criteria to have a home birth safely. 2. The What If Question This argument boils down to “Yes, homebirth is fine as long as nothing goes wrong. But why chance it?” You have missed the point completely; the study concluded that home birth is as safe as hospital birth because in all the cases studied, virtually nothing did go wrong. The perinatal death rate was the same as for both hospital groups (in fact, it was marginally lower in the homebirth group). This what-if-something-goes-wrong argument was essentially what the study was trying to find out – how often does something go wrong at home? And the conclusion was, provided certain guidelines are followed: no more often than something goes wrong in the hospital. 3. The Get With The Times Blow Off This argument is the most uninformed of the bunch. You demonstrate your complete lack of understanding of maternity care and midwifery with variations of “Midwives are old hippies with no training and would be useless in an emergency” or “Stop being so full of yourself and your need to prove something – modern medicine is here for a reason, use it.” This brand of reaction is intended to silence anyone supportive of homebirth by insulting and denigrating but it only demonstrates your own ignorance. Midwives, in BC...

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Birth Plan Basics

Posted on Aug 23, 2009 in Birthing, Childbirth Options, Featured | 3 comments

Birth Plan Basics

Once unheard of, it is now routine to hear “this is a copy of my birth plan” as a woman is admitted to L&D. There is a lot of info (and opinions) out there about birth plans. This post is intended as a primer to get you pointed in the right direction. Often explained as a document outlining how you wish your childbirth experience to go, the birth plan is much more: The birth plan is way to prepare for your birth: properly prepared, it will require discussion with your care providers and likely personal research and reading. It will allow you to seriously consider how you feel about medications, interventions, procedures, and yes, emergency situations should they arise. It will give you an opportunity to talk with your partner about his/her hopes and fears and to communicate about what is important to you both. The birth plan is a communication tool: hopefully it will clearly and succinctly spell out your wishes and expectations not just for your childbirth experience, but for the safety of your baby and yourself. It can function as a reminder to your care provider of things you may have talked about weeks before. The birth plan can have the power to speak for you despite staff shift changes, whether or not you have an advocate there for you (partner, family, friend or doula) and whether or not you are in a condition to speak for yourself. The birth plan is not a frivolous wish list: it is a simple one page statement outlining what you are ok with and what you are not ok with. Birth plan detractors seem to feel that a birth plan reflects a selfish mom’s over-attachment to her own experience. However, we all have the right to informed consent when it comes to medical procedures and your birth plan should focus on this aspect rather than getting caught up in small details like whether or not you want to have your ipod in the room. The birth plan unfortunately is not a legal document: there will be hospitals and staff members and births where the birth plan does not get followed. Make sure to go over it with your care provider ahead of time. Is your care provider comfortable with the plan? Find out if the points you’ve made are even possible at the place where you are delivering – does hospital protocol even allow everything you’ve outlined? Bring multiple copies with you to give out. Be prepared for shift changes. Remember that circumstances might arise that you didn’t consider ahead of time and some parts of the plan might not get adhered to. The birth plan is not a road map: no one can really plan out their birth. Birth is almost always surprising in some way. It is hard not to get caught up in your vision of the ideal birth but birth is unpredictable. Remember to account for things you hope will not happen. The birth plan should not become a way to cling to control. Carefully consider the points on your birth plan and thoughtfully write it out. And then, hand it to your partner and let go of the plan so you can embrace the unknowable aspect of birth. Resources Here are a couple of good online birth plans to check out. You can fill them out online to print and take with you, or just use them as a sample or starting point to write your own. Pregnancy Channel Childbirth.org Earth Mama Angel Baby And finally, a couple of great books to get you started on your research: Creating Your Birth Plan – The Definitive Guide to a Safe & Empowering Birth Marsden Wagner, M.D., M.S. Creating Your Birth Plan helps expectant mothers make informed decisions about the assistance they’ll require for childbirth. Designed to encourage collaboration between pregnant women and their caregivers, it includes information on: What to expect when delivering in a hospital, in a birthing center, or at home How to select an advocate to ensure expectant mothers’ wishes are honored...

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