Extremely negative reponse from a MW :(

[aob1013]

So, today i went swimming with my best friend and her baby. Her Mum dropped us off at the pool and sat with us after for some lunch. She's been a MW 20 years now so obviously knows her stuff, i'm guessing?

I explained that we will be TTC in June, possibly earlier and that this time i would like to try a homebirth, or at least a birth centre birth. She told me that there would be absolutely no way i would be 'allowed' a homebirth as i will be classed as a high risk pregnancy due to my previous premature birth and emergency section. She also said i wouldn't be 'allowed' to have the next baby in a the birth centre ............ Apparantly it was selfish of me to want a HB or BC birth!

I'm feeling so upset .... so i have no choice but to be strapped to a bed again, will probably be induced and then end up with another section?!?!?!?

NO NO NO NO NO NO!!!

Am i really high risk?!

 

[Bournefree]

20 years as a midwife and she said WHAT>>>??

I’M SHOCKED!

There is no LET or ALLOWED in childbirth! Your care provider (community Mws, PCT, NHS, them ultimately the secretary of state for health) have a legal duty to attend to you in labour. This can be anywhere of your choosing - let me say that again….. Anywhere of YOUR choosing!

Does your friends mum still practice, and if so I’d be even more surprised if she was a community MW or was seeing women in labour - however, I wouldn’t be so surprise if she was practicing in a high risk obstetric unit - their views can become very coloured by the “high risk” women they see everyday.. And the mediciallisation of how the births turn out there - it’s almost like negative feedback compounding their views - consultants often have this problem

So, you can give birth wherever you like - of course noone hopefully would go blindly into anything, and would full research what if any evidence there is for being “high risk”

So you have look at your presenting history. As for going before 37 weeks - you might not want to be too far from a Neo Natal Unit.. And I doubt that many would choose to birth in a stand alone birth centre or at home in this situation, You will know this at the time. Over 37, do as you please. Under it may be preferable to get to a hospital with a NNU (You can still birth in the MW lead unit - there is still nothing to stop you from doing this - the NNU consultants can be on stand by - they don’t have to be in the room the whole way through, and in fact even in the Obst unit - they won’t be!)
I don’t know the reasons why you had the c-section? I’m guessing that baby was in distress - you need to examine the reasons why baby was in distress - where you induced, epi, constantly monitored, unable to mobilise etc.

Certainly having had a previous c-section isn’t even an indicator for a routine repeat c-section. Vaginal birth is healthier for you and baby and you should be encouraged to labour naturally in the first instance.

Also please remember that even if you are “booked” for a certain location of birth - you can always change your mind right up into labour!

When you feel ready research all of this - prepare questions for your MW at the time, and your consultant (as you are most likely to be offered obstetric lead care)

In the end, the decision is YOURS and yours alone.

Xxx

 

[bobsiesgal]

you probably will be high risk if you went into premature labour in the past, but that aside, no doctor or midwife can force you to do something that you don't want to do, and they cannot ban you from a home birth, you do not need their permission. in fact they need your permisson to even touch you, and its classed as assult if they try and touch you without your consent (provided you are able to give consent) even if your baby or your life is in danger, so don't let them bully you.

tbh, i wouldn't worry about it now though, wait until your pregnant and then see how it goes from there, if there are no complications and you make it to 37 weeks (i think thats the limit for home births but i'm sure someone will correct if i'm wrong), then you should push for your home birth if thats what you want. oh and don't let people make you feel selfish, just make sure you educate yourself on the risks and make an informed choice based on how your pregnancy goes, there is nothing selfish about wanting a good birth experience.

 

[littleblonde]

im not sure anyone can tell you what you cant do when it comes to you giving birth. however you will be high risk. So you may have to fight for it. I had a section and im having a vbac in hospital this time. I was lucky that my consulatnts surports this. Not all do.

 

[aob1013]

Thank you all xxx

 

[Tasha]

I wrote a sort of similar thread before, I have never been 'allowed' a homebirth or one in a birth centre as I am too high risk. I have been told my HCP will let me know if I am allowed a VBAC or if it will be a section again. It has left me feeling like I have no choice in what they (although that should read I) do.

No advice really, but just wanted you to know you are not alone in feeling like you want something but cant have it.

I will say if you decide labour ward is the best place for you to have your next baby, then it doesnt have to be the way it was last time. With my second I kept walking and walking, then pushed her out with no pain relief, in the position I wanted and pretty similar with Honey.

 

[aob1013]

I wrote a sort of similar thread before, I have never been 'allowed' a homebirth or one in a birth centre as I am too high risk. I have been told my HCP will let me know if I am allowed a VBAC or if it will be a section again. It has left me feeling like I have no choice in what they (although that should read I) do.

No advice really, but just wanted you to know you are not alone in feeling like you want something but cant have it.

I will say if you decide labour ward is the best place for you to have your next baby, then it doesnt have to be the way it was last time. With my second I kept walking and walking, then pushed her out with no pain relief, in the position I wanted and pretty similar with Honey.

Thank you so much Tasha

At the very least i would like to be in the birth centre (which is on the same ward as labour ward) and try and go naturally. I think i had a pretty unnecessary induction and section last time xxxxx

 

[Tasha]

I think that you just need to push for what you want then hun. I think you just need to stand your ground.

I am not sure why you had an induction and section, will look for your birth story later.

 

[clairebear]

NO NO NO NO NO!

This is why so many women are fearful of home and natural births. Attitudes from people like her!

In my own experience i have found that there is another way.

My first birth ended in an emergency c section after long labour which was finally labelled failure to progress! ( i reached full dilation, pushed for 2 hours had a failed forceps and vountouse) Ended up with a section which made me feel like a complete failure as a mother.

Last August i achieved my VBAC. It was in hospital ( at the time i wasnt comfortable with the idea of a homebirth and we dont have a birth centre here) But it was sooooo different to my first.


IT CAN BE DIFFERENT

 

[helen1234]

what crap, times are changing, 6 months ago in my hosp they were pushing elec sections instead of vbacs.
but i'm having a mw led waterbirth. ad i'm sure if i'd have asked they'd tried to accomodate a home birth.

if baby starts to be a prem baby, you'll have to go into hosp, but if the pregnancy is progressing nicely then there's no reason why you cant be as natural as you wish and have a homebirth.

i've compromised i will have an hour monitoring when i arrive at hosp and have blood taken. then i will be 'allowed' to do as i wish. but will have regular bp and babys hb checked, but it will be when i'm ready

 

[nov_mum]

I think some MWs that have been working in areas where they see the 'complicated births' only see the negatives. It's like working in A & E, you start thinking that everyone who is ill is gravely ill after a nasty accident or major event like a heart attack or stroke. You never see the person coming in for their annual check up or prescription for the pill etc so you get a skewed view. I work in an area where people present acutely and sometimes we need reminding that the majority of people never find their way to us. The majority of people manage their care with their GP or community team.

Maternity is the same, if you work in a tertiary hospital where c sections are run of the mill, you will only ever see the ladies queued up to theatre. I would ignore her and her outdated practices. There are Drs fond of cutting and Drs fond of less intervention. Same with MW's it is just that we expect more from them

 

[NaturalMomma]

A previous c-section or premature birth doesn't make you high risk. It means they will watch you more closely, but it doesn't make you high risk. Plenty of people have a preemie first time and then full term babies next time.

 

[chuck]

You may not meet the criteria for admittance to a BC but you could fight that. I dont meet the criteria having had an EMCS but I'm having a HB.

Thankfully my MW's are supportive!

What an old trout!

 

[Pixxie]

Its your body you can do whatever the hell you want!

Even if something was really wrong they cant MAKE you go to the hospital (although you would anyway) As long as you go full term next time there is no reason why you cant have a birth center or home birth.

I was in the BC for my birth and I cannot rate it enough, I was examined once when I went in just to make sure I was in established labour and then was just allowed to get on with it! xx

 

[KandyKinz]

As mentioned in your other thread for those reasons alone they cannot deny you a homebirth but they can certainly make a fuss about it.....

As for being high risk.... Well your risk of another PPROM is higher then someone who has never had a PPROM though it is still relatively low and overall your chances of having another premature baby is much lower then someone who had went into labour spontaneously prematurely without having their waters initially break. As for the "distress" and emergency section issue. Well he was preterm. Preterm babies just don't cope as well with labour as full term ones. Once they're out they frequently don't transition to breathing on their own as well as full term babies. Some preemies do great, but overall when compared to their full term counterparts fully cooked babies do much much better. You just can't compare the two. Just because your little one ran into problems during your labour (and it was augmented right???) certainly does not mean that if you go full term next time around that the next little one will experience the same issues. Overall, "fetal distress" is one of those complications that is very unlikely to repeat itself even if it had occured in full term babe. So chances are should you get pregnant again you would very likely go to term and should you labour the chances of baby going into distress would be just as likely as any other baby who was being born at full term. So that in itself is definitly not a contraindication for homebirth and should not be a considerationa at all.

If you were intending to get pregnant and have a home waterbirth even if this next one decides to come preterm.... Well that's a whole other story.

In terms of VBAC, technically speaking it does increase your risk of rupture. Whether it's "high" risk or not is really a subjective statement and is completely and entirely dependant on what level of risk you deem acceptable. What one woman regards as a highly risky practice may seem like a perfectly acceptable choice to someone else. Ultimately, this is where you have to do your research and determine what risk you are willing to take. The overall incidence of rupture tends to vary depending on the studies looked at and what factors were excluded etc etc but it tends to vary between 1/1000 to 15/1000.... Not all studies are created equal so it's definitly good to dig into the reasearch a little to get a real good understanding of that risk and how it specifically relates to your circumstances.

Also, of note there is research out there suggesting that the risk of rupture is increased if the due dates between the previous cesarean and the next baby is less the 24 months apart... Some suggest a minimum waiting time of 18 months.... Again, different studies yield different results but it can be worth looking into.

Another factor is your distance from hospital. You said it was around 45 minutes right? That can be quite substantial if a uterine rupture were to occur and most midwives I know would be shaking in their boots if they were to have a client planning a VBAC such a distance from home. It wouldn't be forbidden but it would likely result in some lost sleep. Uterne ruptures are SCARY! They happen fast! With many obstetrical emergencies there tends to be a slow progression to the emergency and more often then not there are signs along the way that say HEY HEY HEY things aren't going as intended and this tends to be especially true with things like fetal distress....... While with ruptures they can just happen! Occasionally, you can get a rise in the mothers pulse as things start to seperate but often when it does happen it can go from calm to chaotic in seconds. Everything can be perfectly fine one minute then the next contraction mother is screaming in pain on the floor and the baby's heartrate drops considerably and won't recover. And the faster you get that baby out the better the chances of that baby surviving and that mom surviving. There's only so much a midwife can do to stabilize that woman during transport. She'll get an IV in and catheterize and give supplemental O2 and ensure everyone is all set up in the hospital for a crash section but that woman is going to be bleeding internally and that baby is going to be deprived of oxygen the entire way to the hospital and there isn't anything the midwife can do to slow down that bleeding. So 45 minutes can feel like a long time...... And yes the ambulance will get you to the hospital faster then one could get there just driving on their own.... But that ambulance also has to get to your house and it has to get you out of the house and that takes some time as well....

So with VBACs distance from hospital can be factor.... There's lots of emergencies that can happen at home, fortunately with many of those there are things in which a midwife can do to stabilize the mom and baby until they get to the hospital. If baby is having a difficult time breathing the midwife can provide bag and mask ventilation until they get to the hospital where intubation can occur. It's certainly tiring to do that for a prolonged period of time but it can be done. If there's a prolapsed cord, any oxygen deprivation the baby can experience can be eliminated by getting the mom in a hands and knees position then manually pushing the baby's head away from the cord. Not fun stuff but baby is A-Okay as long as someone's holding up the baby and preventing it from squishing the cord.... Then there's postpartum hemorrhages... Definitly not fun stuff but there are things in that situation in which a midwife can do to stop or slow down the hemorrhage.. If it's from a complicated tear and bleeding blood vessels she can put pressure on the area and clamp the vessle shut until it can be repaired.... If it's from uterine atony there's anti-hemorrhagic drugs she can administer, there's uterine massage to keep the uterus contracted and if worse comes to worse she can provide bimanual compression until they arrive to the hospital. Ofcourse no one wants to ride to the hospital with someone's hand in their uterus but it is a highly effective way of controlling the amount of blood lost until a person can get into surgery..... Then there's uterine rupture........

And I'm not against VBAC, but I do certainly understand why many care providers are scared of doing them at home. Personally, if I were in your situation I would definitly be opting for a VBAC but I would be waiting a little bit longer to ttc just to be on the side..... and being that I am also 45 minutes away from the hospital I would not feel comfortable labouring and birthing at home.... but hospitals are certainly not my cup of tea either so I would likely find myself a nice hotel in the city within 15 minutes of the hospital and birth there.... Preferably one with a nice jacuzzi/whirlpool tub so I could have a waterbirth.... and obviously since I'd be out of hospital continuous fetal monitoring wouldn't be an option, but I would be fine with that and would prefer intermittent auscultation anyways so that wouldn't be an issue. BUT I would opt for and agree to a having a saline lock in place just in case as inserting an IV in someone experiencing blood loss can be a difficult thing. But that's me.... Now it's your turn to decide what's best for you.... And it seems like you've already decided... Now you just have to get past the searching for approval stage, cause it really doesn't matter what others think and if they approve... It's your birth.