Posts Tagged "birth centres"

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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Rebirth: Maternity Care Alternatives

Posted on Feb 3, 2009 in Birthing, Childbirth Options, Featured, Maternity Care Options | 0 comments

Rebirth: Maternity Care Alternatives

Planning to have your baby in the hospital? You might have to contend with some of the symptoms of an over-burdened healthcare system. Maternity wards can be over-crowded and under-staffed. Hospital stays are getting shorter. And if you happen to go into labour at the wrong time, you could be sent to another city’s hospital because all of the hospitals nearby are at capacity. What if our maternity care system could be over-hauled to relieve the burden? What are the realities? Fewer doctors and nurses Besides the well-publicized shortage of nurses, Canada also faces a shortage of physicians who attend births. Between 1992 and 2004, the percentage of general practitioners who attended births fell from 28% to only 13%. Rising Costs Having a baby in these technological times is not cheap. The average cost for a vaginal delivery is $2,800. For a caesarean, it is closer to $5,000. This does not include the added costs associated with length of hospital stay or neonatal care. With every epidural, there is an added expense for the anesthesiologist and with a BC cesarean rate approaching 30%, costs are rising for maternity care. Shorter Stays An obvious cost-cutting measure is to shorten hospital stays. The average length of stay for a vaginal birth in BC has fallen to only two days. For a cesarean birth, it is less than four days. Women are being sent home to care for newborns within a couple of days of major abdominal surgery. What happened to resting and recovering from birth? How would a new system look? Midwives Midwives are trained specialists in birth. They have usually completed four years of practical training. Their appointments run about fifty minutes (as opposed to the standard ten minutes with your family doctor). They often do home visits in the first week after baby is born to help initiate breastfeeding and to monitor mom and baby. Mothers report excellent continuity of care and higher levels of satisfaction with their births and their care. The midwifery model of care tends to be cheaper than the current medical model. Midwives believe that birth is a natural physiological process. Though trained to spot and mitigate problems, midwives adopt a fairly hands-off approach as caregivers. Births attended by midwives show a lower incidence of epidural use, episiotomy, and cesarean section. The benefits are not just higher maternal satisfaction, but also much lower costs. Homebirth & Birth Centres In the last two hundred years, medicine has managed to pull birth firmly into its clutches. Contrary to all logic, with birth, we take women who are healthy and place them in the hospital as a preventative measure (in case something goes wrong) and then we treat them the same way we treat the sick and injured. Since when is pregnancy a disease? Modern medicine can be thanked for the low incidence of infant and mother mortality associated with birth today. We know more about the human body, more about birth, more about infection. We know to keep wounds clean. We have antibiotics and other modern drugs. We can save moms and babies from situations that would have claimed their lives only 100 years ago. But that does not necessarily mean that birth belongs in hospital. We can transfer our medical knowledge to other places, like the home. Recent studies show that with healthy pregnancies free of complications, planned homebirths attended by trained midwives are as safe as hospital births. For low risk women, we can achieve safe birth at home and reap a dual benefit because there are advantages to birthing where a mother feels safest and most comfortable. We can also find a middle ground instead of polarizing between hospital and home. Imagine the power of a birth centre: birthing in a homelike setting with a midwife, a birth pool, medical equipment tucked out of sight and the potential of a quick transfer to hospital if need be. On the flip side, imagine the benefits for our rural and northern communities that don’t have hospitals have their own. Mothers would no longer have to travel...

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