Question for women in the U.S.

[MillieJoan]

I asked a similar question in the Natural Parenting section awhile ago, but just now found this section. Oops!!

I had a hospital birth attended by midwives with my DD, who's now 6 months-old. I planned on a water birth, but the tub rooms were full and for a variety of reasons I ended up with an epidural, which I still regret (nothing went wrong, I just wish I'd managed without it!)

I know I want to have at least one more baby and I'm thinking a home birth might really be a better option for me than another birth in a hospital. However, I do have a *few* concerns...

One of the main reasons I got the epidural is that I found it really, really hard to deal with contractions in front of other people at the hospital. I spent 2 hrs in a waiting room because even triage was full when I got there, and there were 2 other women in there waiting for inductions, plus a man and his 2 kids who were waiting to see their mom. I spent those 2 hrs trying REALLY hard not to cry/swear/make any noise, really so I would scare the kids (and ended up breaking a load of blood vessels in DH's hands! ), and by the time I got a room, I couldn't face doing laps around the ward. I felt very on display and vulnerable, if that makes any sense.

I also didn't want anyone to touch me. DH really wanted to help, but when he tried to massage my back he was wayyyyy too tentative, and it irritated me without helping at all, so I didn't want him to touch me, period, so I wouldn't snap at him. I wish he'd been a bit more forceful, both in being my advocate for no pain relief (we'd discussed this previously, as I knew that, with bad enough pain, I was bound to cave if someone offered it!) and in helping me physically. Don't get me wrong, he was wonderful and emotionally supportive and everything, he just didn't know how to help me. Also, my contractions went into my legs, so even if I'd wanted to walk around the ward, I physically couldn't walk while having a contraction. I'm scared that if the same thing happened, I'd be entirely unable to cope during a home birth, as I wouldn't have access to pain relief. Or would having a tub available make a big difference?

Also--the midwives I used for DD's birth are CNMs. I liked that they had a natural approach to birthing, but also had medical knowledge. Where I am, only CPMs do home births, and I'm wondering if anyone can tell me what the prenatal care is like with a CPM. Do you get all the same tests done? Can they prescribe medication, if necessary?

Sorry for such a long question! I can't seem to get DD's birth out of my mind, even 6 months on. Even though we're both perfectly healthy and everything went smoothly, I feel in some ways like I failed because I took the epidural--and yet I'm scared of not having access to one next time around!

 

[MindUtopia]

I'm originally from the U.S. and from what I've read, it seems to vary from state to state what CPMs are allowed to do. You might want to try looking up what's legal in Maryland, or probably even easier, making an initial appointment with someone and asking them because they'd probably be able to explain it much more clearly. Care with CPMs tends to be less medicalized than with CNMs, and taking a more natural perspective, and obviously they are usually more experienced in home births because they only do out of hospital births. I don't think they have prescribing rights, but if you developed a condition that required medication, they would refer you to an OB to be seen for that anyway. They'd do the same with any testing they couldn't provide. But I would definitely look up what's legal for them to do in Maryland, because even if they're trained in certain things, the current legislation might prevent them from actually doing it.

 

[Cjackord]

I completely agree with mindutopia... Except, i wanted to add, my vists with the cpm have included everything that I did with my ob last pregnancy. Also, that I've been offered all of the same testing. My cpm does labs and referred me to a wonderful specialist for the diagnostic ultrasound. She will also do all of the same testing as the hospital after the baby is born. I think the only thing she doesn't offer is circumcision. Another issue is testing for gbs-- I'm pretty sure (I'm checking on Wednesday, in case I am positive) that she can administer iv antibiotics, but I know that it's more rare for them to be able to do so by state.

As far as not being able to handle the pain-- that's my fear too! But I've been told repeatedly that laboring at home is just not comparable to laboring on your back in a hospital. Hth!

 

[aliss]

I talked about the pain with my midwife yesterday (sorry I'm not in the US haha). I had an epidural with my first after about 24 hours of Pitocin.

She said that the pain for women in home birth is much more reduced than the pain in the hospital (without Pitocin, obviously it's more with). Transfer for pain relief in 2nd time mothers is much more rare than 1st timers.

Remember back when we were younger? Having period pains in class? Compared to having period pains while resting in your own hot shower? 1st time was worse than the other... but it was still the 'same pain'. Not that I can compare contractions to periods, LOL, I wish. But you get the idea.

Have you read Ina May's Guide to Childbirth?

 

[Cails]

I'm pregnant with my first- so I don't have any previous knowledge or wisdom to draw on. But I still wanted to encourage you on your quest to finding a better way to birth.

I hate that you still feel bad feelings about your first birth. How awful to be stuck in triage during labour! I'm sorry that happened!

From the reading I've been doing I can tell you this- your pain experience could end up being totally different for your next baby so long as you are looked after well by your care-providers during labour (having no rooms available is not being looked after well). Obviously if you labour in the privacy of a birth center room or in your own home you will feel way more comfortable dealing with contractions in whatever way your body wants to deal with them. You can make all the noise you want, rock back and forth, get in the tub... This really will change your perception of the pain and also your ability to cope with the pain!

There are so many awesome things about home birth! I think as you research you'll discover that you have an innate ability to deal with the pain, so long as you are in the right environment.

Like the lady above mentioned read Ina May Gaskin's Guide to Childbirth. You should also watch Ricki Lake's The Business of Being Born. Try reading some Lamaze books too (its not really about the breathing anymore).

Good luck! I hope you find the birth thats right for you and your future baby!

 

[MillieJoan]

I talked about the pain with my midwife yesterday (sorry I'm not in the US haha). I had an epidural with my first after about 24 hours of Pitocin.

She said that the pain for women in home birth is much more reduced than the pain in the hospital (without Pitocin, obviously it's more with). Transfer for pain relief in 2nd time mothers is much more rare than 1st timers.

Remember back when we were younger? Having period pains in class? Compared to having period pains while resting in your own hot shower? 1st time was worse than the other... but it was still the 'same pain'. Not that I can compare contractions to periods, LOL, I wish. But you get the idea.

Have you read Ina May's Guide to Childbirth?

I like that analogy, b/c I definitely know what you mean about dealing w/ cramps. And no, I haven't read Ina May's Guide to Childbirth, but I have seen interviews with her. I'm going to request her book at the library asap

 

[SarahBear]

One of the main reasons I got the epidural is that I found it really, really hard to deal with contractions in front of other people at the hospital. I spent 2 hrs in a waiting room because even triage was full when I got there, and there were 2 other women in there waiting for inductions, plus a man and his 2 kids who were waiting to see their mom. I spent those 2 hrs trying REALLY hard not to cry/swear/make any noise, really so I would scare the kids (and ended up breaking a load of blood vessels in DH's hands! ), and by the time I got a room, I couldn't face doing laps around the ward. I felt very on display and vulnerable, if that makes any sense.

Simply eliminating all these stressful factors will make a world of difference. You weren't given a chance to relax, no wonder you were so miserable! The epidural isn't a failing on your part, it's a failing in the setting of the hospital. If you were at home, you wouldn't feel on display and you'd have the freedom to make as much noise as you needed. Making noise and being able to relax in privacy are both stress reducing factors that contribute to one's ability to cope with labor pains. You also won't have to deal with feeling vulnerable.

I also didn't want anyone to touch me. DH really wanted to help, but when he tried to massage my back he was wayyyyy too tentative, and it irritated me without helping at all, so I didn't want him to touch me, period, so I wouldn't snap at him. I wish he'd been a bit more forceful, both in being my advocate for no pain relief (we'd discussed this previously, as I knew that, with bad enough pain, I was bound to cave if someone offered it!) and in helping me physically. Don't get me wrong, he was wonderful and emotionally supportive and everything, he just didn't know how to help me.

He might not have been the one giving birth, but I'm sure the stress of the hospital didn't help his nerves either. Also, if he didn't know how to help physically last time, perhaps this time, you can prepare together for how he can support you. You can also practice so that in the moment, he knows exactly what to do. If you have a home birth, you won't have to worry about his forcefulness with the pain relief. If you do go with a hospital, perhaps investing in a doula would be best. Remember, even if he's not giving birth, it is an emotional time for him as well and perhaps he's not the right person to advocate for you.

Also, my contractions went into my legs, so even if I'd wanted to walk around the ward, I physically couldn't walk while having a contraction. I'm scared that if the same thing happened, I'd be entirely unable to cope during a home birth, as I wouldn't have access to pain relief. Or would having a tub available make a big difference?

It's hard to say how this time will be compared to last time, particularly since you had a number of factors contributing to your inability to cope that would be eliminated in a home birth situation. It might be that had you had privacy and the ability to vocalize earlier, you wouldn't have been in so much pain later.

Also--the midwives I used for DD's birth are CNMs. I liked that they had a natural approach to birthing, but also had medical knowledge. Where I am, only CPMs do home births, and I'm wondering if anyone can tell me what the prenatal care is like with a CPM. Do you get all the same tests done? Can they prescribe medication, if necessary?

With a midwife who is not a nurse-midwife, the prenatal care is pretty similar. The pattern of when and how frequently you have appointments is the same. They check your urine, blood pressure, and weight, like they would other places as well as measure your fundal height and listen to the baby. The tests offered are the same, but you have more freedom to turn down the ones you don't want to do. You can also get ultrasounds. I'm not sure who does the ultrasounds because I have turned them down. I'm guessing you get referred to someone. As for the things that require blood draws, my midwife conducted the draws and sent the blood to "the lab." These midwives cannot prescribe anything. You would have to go to your doctor for that. If your pregnancy becomes high risk, you will also be referred to a doctor as midwives are only trained to handle low-risk pregnancy and birth.

Good luck in your future birth. Please look thoroughly into your birthing options before making a decision. Your experience is a result of your situation, not your personal failing.