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Old Jan 15th, 2010, 14:09 PM   51
Joyzerelly
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I think that's what I need to do. I honestly thought, because of the way he is, that he'd want a fully objective and 'factual' type view. I've inadvertently made him more anxious. He is so not an ignorance is bliss type of man so I gave him the homebirth.org website and let him read the lot. He's now talking about prolapsed cords and all sorts that he was unaware of a week ago!

We see the MW a week on weds and ATM he's saying he doesnt need to discuss it with her and I should just plan it. I'll leave it for a few days and then a bit closer to the appointment I'll maybe dig out some good accounts from fathers. I'm know he'll come to the appointment if I ask him to.
I would usually agree that it's best for people to have all of the information possible to make an informed choice. In the case of births though, I think it's better just to concentrate on the positives. The last thing you need is to be filling yours and your partner's heads with all of the dreaded details of what can but probably won't go wrong. This is likely to create a more stressful and less relaxed atmosphere in the birthing room, making you more tense and your birth more painful. I'd have just shown him the mainly positive stuff, bearing in mind, that if anything were to go wrong, the midwives would be there and they would take over and do their jobs. It's much more important that your man is relaxed and confident and therefore filling you with confidence in your hour of need and the worrying is left to the midwives. Just my opinion.



 
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Old Jan 15th, 2010, 14:19 PM   52
Mervs Mum
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Thanks Joyz. I agree with what you're saying in theory but because I know how he works (he's a teacher and is very 'fact' and 'research' orientated) if I just gave him the positives, he would go away and find both sides of the story.



 
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Old Jan 15th, 2010, 14:31 PM   53
gina8177
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Thanks Joyz. I agree with what you're saying in theory but because I know how he works (he's a teacher and is very 'fact' and 'research' orientated) if I just gave him the positives, he would go away and find both sides of the story.
When he's researching he's facts, he sould research both sides of giving birth in a hospital. I think those are the facts that eased DH a bit and helped him put it into perspective.



 
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Old Jan 15th, 2010, 14:35 PM   54
Mervs Mum
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Originally Posted by Mervs Mum View Post
Thanks Joyz. I agree with what you're saying in theory but because I know how he works (he's a teacher and is very 'fact' and 'research' orientated) if I just gave him the positives, he would go away and find both sides of the story.
When he's researching he's facts, he sould research both sides of giving birth in a hospital. I think those are the facts that eased DH a bit and helped him put it into perspective.
Good point! That's what I need to tell him to do to make a comparison against the same stats for complications in hospital.



 
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Old Jan 15th, 2010, 15:21 PM   55
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I was away to suggest exactly the same. There are a lot of things that can, and do, go wrong in hospitals (the cascade of intervention is a biggy), and doctors will say things like 'what about shoulder discocia' but the fact is that they wouldn't do anything differently in hospital then they would at home.



 
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Old Jan 15th, 2010, 19:29 PM   56
ryder
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sorry for sneaking in, I cant remember how I foudn this, but its interesting to read.... I hear alot of you UK girls talk about medical interventions etc and from the midwives? Im just curious, because our mw's here who deliver in the hospital are only there for you and they really push for no medical interventions at all, even including fetal monitoring etc.



 
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Old Jan 16th, 2010, 02:11 AM   57
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I think it's quite a complex thing. On a basic level, MWs differ from consultants (doctors or obgyn I think you'd say) in that they dont get involved in certain procedures. But then you have MWs who work in a hospital setting and those who work in birth centres or as community MWs - ie the ones who care for women with 'low risk' pregnancies. I've dealt with them all to differing degrees. With my eldest I was being looked after by the community MWs but when I went over due, they then passed my care to the consultants as MWs dont induce women. Yes they can do sweeps but they dont make a decision here to medically induce - that's the consultants area. When I was induced, I was monitored as you would expect but cared for but hospital based MWs being managed by consultants.
Over Christmas I went to the hospital with a suspected UTI. The hospital MWs monitored me and the baby. If I were to choose to give birth in the hospital I could expect more intervention. More monitoring and more examinations to check 'progress'. In the birth centre the only real monitoring is them checking the babies HB with a doppler and the odd internal. They dont really get too hung up on how long you've been in labour where as they do in the hospital. You need to be progressing and they will intervene if you dont in accordance with their guidelines. This is where things tend to snowball. I didnt make 'adequate progress' with my first so they tried to speed things up with a drip. To cut a long story short they ended up cutting me (more intervention) and using forceps to pull her out. In the BC unless you'd been there much longer, they type of thing they would use to try to get things going would be moving you around, getting you on a ball etc. They also didnt 'tell' me when I was 'allowed' to push. They told me I was 9cm and when ever I felt the urge to push I could. When I was my sisters birth partner (in our hospital because she wanted an epidural) they wouldnt allow her to push until she was the set 10cm....she didnt get the job done quick enough and ended up with a c section.
Birth centre and community MWs as a general rule seem more supportive to the idea of home birth. They chose to work in that role rather than with the consultants (in this area) and so they have a certain out look. The MW's in the hospital environment are very much working 'for' the consultants and so even if they themselves have a preference for less intervention, I guess they dont have the ultimate say so which means they end up being involved with more of that kind of stuff by default.

As with anything there can be massive variations locally - this only really reflects the way it works in my area. Some areas dont have a BC and have community MWs who are really pro home birth because that's the only alternative to hospital. Some areas the community MWs are very much in favour of things being more like he hospital model I described so it's pot luck really.



 
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Old Jan 16th, 2010, 06:20 AM   58
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I'll describe it from the point of view of a nurse and an American living in the UK:
Our midwives are the equivalent of your L&D nurses. When you train over here, you train as either an adults', children's, mental health or learning disability nurse or a midwife. In the US (and I believe Canada is similar), you train as a general nurse and specialise after qualification. And I don't believe midwives in the US/Canada need to have nurse training. So, if midwife went to work in the US, she'd probably have to take a few extra courses and would then work as a L&D nurse. If a midwife came from there, she'd probably have to start from scratch. If a L&D nurse came from there, she'd probably take a nurse-midwife bridge (18 months) and work here as a midwife but would also be able to work as an adult nurse.

Also, our midwives enjoy a lot more autonomy here than the L&D nurses in the US/?Canada (as a nurse, I can say the same goes for nurses a lot of the time). Pregnancy, labour and delivery are not seen in such a medical light here; it is seen as the natural process that it is. Therefore, while we have obstetricians aplenty, a woman with a normal pregnancy and delivery would never see them.



 
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Old Jan 16th, 2010, 07:17 AM   59
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Great explanation Manda! I wasnt sure how a MW and a L&D nurse compared. I'm hoping to take a doula course this year before I start a 2 yr foundation course with a view to possibly taking the 3 yr MW degree. I'm still not 100% sure it's the way for me to go but I thought the doula qualification and foundation course would help me to decide and while I am a SAHM if will give me something outside of the kids to do for 'me'.

Manda - do the L&D nurses deliver babies in hospital in the way they do here? Like at m hospital, even in the consultant led wards, the MWs generally deliver the baby unless there is a particular reason for the consultant/obstetrician to be there.



 
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Old Jan 16th, 2010, 08:32 AM   60
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MM, from the US births I've been at (and a few of my aunts are L&D nurses), the nurses seem to manage everything, but the woman's obstetrician is aware and there (or due to be there for delivery) or whoever is on call from that team. When I compare the two, I think it's silly that they have doctors over there to essentially just "catch" the baby. I think I'd be very frustrated as a L&D nurse - they're incredibly capable and knowledgeable professionals but, it seems to me, aren't allowed to explore the full potential of their role. I much prefer our system of only involving doctors if there's a problem. I think it's ideal the way we have it here, as doctors solve problems, diagnose and treat. Midwives and nurses provide more holistic care, and as long as it's a normal delivery, are better caregivers for the women, IMO. And, since midwives (the same for nurses) in the UK are trained in this holistic way and know the importance of evidence-based practice, I think we're allowed to pursue a more "normal" labour and delivery, which includes home birth for those of us that are low-risk and wish to do so.

I've had consultant neonatologists turn around to their junior doctors and medical students on the ward round and tell them that they should never underestimate the nursing view and diagnosis, as they as doctors only get a snapshot, whereas we spend our entire shift with our babies.



 
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