Post peak birthing

[mobbsey]

As I mentioned in another thread, we are expecting our first child next month and are planning to have the baby at home

Don't get hung up on it -- nothing went to plan for us three times in a row so just go with it and see what happens.

Anyhow, you're going to be so 'blissed out' with the screming, puking, shitting little brat that you only think of these things about a year or so later (when you begin having enough sleep to worry about such things).

[Little John]

I was born on a farm in the Yorkshire dales in 1963.

My mam was out in the hay barn collecting eggs. She went into labour. My dad wasn't about and my older sibling were at the neighbour's farm. She had to give birth to me in the barn.

Anyway, needless to say, it all went okay because I am writing this post.

[RenewableCandy]

That wouldn't be, first 3 months of 1963 would it? In the snow??

[Little John]

That wouldn't be, first 3 months of 1963 would it? In the snow??

It was in early May. There was still tons of snow about at the time

[sister of mercy]

Congratulations on the expected parenthood.
Hospital births have come a long way and most midwives will offer a personal care plan to take into account your preferences.
Most normal births require no intervention, however most obs prefer the first birth to be in hospital to establish an obstetric history.
In my case the first pregnancy was considered normal and was expected to be routine. I had all the scans and exams, however several hours into labour it became clear that the babe was breech, this was not known before. The point I am trying to get across is that each birth is individual and circumstances can change rather rapidly. If you live some distance away from a major maternity hospital then it may be wise to consider this when making your decision.
Post peak, I don't know, I think midwives will do what they have done for centuries, however we have greater knowledge to pass on now.
Opium is grown for pennies. Pain relief is always available.

[Adam1]

Most normal births require no intervention, however most obs prefer the first birth to be in hospital to establish an obstetric history.

I'm not sure why an obstetric history is required for a natural, healthy process. It is like saying that a mentally healthy person needs a psychiatric history. Like psychiatrists, obstetricians look for pathology, because that is what they are trained to do. Sometimes, their need to practise what they have trained for makes them find pathology where none is present.

I had all the scans and exams, however several hours into labour it became clear that the babe was breech, this was not known before. The point I am trying to get across is that each birth is individual and circumstances can change rather rapidly. If you live some distance away from a major maternity hospital then it may be wise to consider this when making your decision.

I agree that, if we were in a remote location, it would be better to be at or near a hospital. We are about a mile from our local hospital. A decent midwife should be able to recognise a baby going breech in plenty of time. I don't think it is physically possible for this to happen suddenly in mid stage-two labour. The key is a competent, calm midwife, confident in their own professional knowledge and not in awe of their obstetrician colleagues.

[MacG]

A decent midwife should be able to recognise a baby going breech in plenty of time. I don't think it is physically possible for this to happen suddenly in mid stage-two labour. The key is a competent, calm midwife, confident in their own professional knowledge and not in awe of their obstetrician colleagues.

I think this is a dangerous romantic view. In the 1800's, women giving birth died like flies. I visited a graveyard in Pajala in northern Sweden some years ago, and they have many graves from the 1700's and 1800's left in place up there. About one grave in 4-5 listed a woman in her 30's and a child born and dead on the same day. When reading CJL Almqvist from the 1820's, it is ASSUMED that a man will lose his wife, and he makes preparations for "the second" while his first wife is still alive.

[Adam1]

MacG, several factors have changed since the 1800s,

1) midwifery has progressed since then. The midwives I have spoken to don't refer to practices from 200 years ago. They seemed more evidence based in their practices than some obstetricians. Comparing midwives today with their predecessors 200 years ago is no more valid than comparing a surgeon today with one 200 years ago.

2) Women had no means to control their fertility back then. Many were subject to multiple pregnancies and many died early as a result.

3) General standards of nutrition and public health were much worse back then.

In the Netherlands, one third of women have planned births at home attended by midwives. In the UK, it's around 2%. In the US, midwives hardly figure at all - most are solely under the care of obstetricians and about a third of women have caesarians. Guess which country has the highest peri-natal mortality rates....the US.

In short, from what I have learned, planned attended births at home are as safe as hospital births (possibly safer for the mother). I haven't read the academic research on this, so can't back it up but I am convinced that birthing in hospitals under obstetricians is not the way to go for normal births. I would really suggest that you watch the film I referred to earlier in the thread (The Business of Being Born), it is to this issue what The End of Suburbia is to peak oil.

[sister of mercy]

Most normal births require no intervention, however most obs prefer the first birth to be in hospital to establish an obstetric history.

I'm not sure why an obstetric history is required for a natural, healthy process. It is like saying that a mentally healthy person needs a psychiatric history. Like psychiatrists, obstetricians look for pathology, because that is what they are trained to do. Sometimes, their need to practise what they have trained for makes them find pathology where none is present.

I agree that, if we were in a remote location, it would be better to be at or near a hospital. We are about a mile from our local hospital. A decent midwife should be able to recognise a baby going breech in plenty of time. I don't think it is physically possible for this to happen suddenly in mid stage-two labour. The key is a competent, calm midwife, confident in their own professional knowledge and not in awe of their obstetrician colleagues.

Sadly, even though being seen by a few different midwives in a very major maternity hospital my breech presentation was not detected prior to going into labour.
It isn't always obvious when something is wrong and with newborns you don't have much time to put it right.
I personally would prefer to have the safety of a large maternity hospital with a neo-natal care unit and full obstetric theatre available should I need it.
I was not allowed to have my second child at home because of the problems with the first, that's whats meant by obs history. Some very serious things don't show until the last minute.

[tattercoats]

I was hugely inspired, Adam, by a book called 'Spiritual Midwifery'.

It's basically the account of the birthing practices of a very hippy/christian/buddhist community in America over a couple of decades - they were isolated enough on their farm that they decided they needed their own midwives, and had a battle royal getting their own folk certified to deliver at home on the farm (when of course many poor americans can't afford hospitalised births anyway!).

Basically they eveolved a very natural attitude and have very very good statistics. They avoid the intervention cascade where at all possible, but have back up on site, in their midwife kits, and in their own skills, where needed.

The hippy dippy stuff isnot everyone's cup of chai. It's not mine, but what was inspiring was to read many many accounts of natural births, to get a grasp of the vast spectrum that comprises 'normal'.

It's all risk assessment, isn't it? Goodness knows there are other areas of life where if we weighed the risks and probabilities the way births are managed, we'd never cook at home for fear of salmonella, nor cross the road for fear of being run over.

Hoping for a fine and healthy outcome for you and yours, and a baby who sleeps!

[emordnilap]

A situation I deplore is the centralisation of facilities that is happening/has happened in the republic of Ireland. Economics are triumphing over people. There are fewer and fewer people can actually claim to be natives of our county (Clare) every year because there have been no maternity facilities here for a such long time.

Home births are frowned upon because of the impossibility of getting specialised help if complications arise.

Apart from that, a further point concerning humanity's ensuing energy decline (apart from the happy logic of returning to more local hospitals) is that of breast feeding. No food miles! For the 'ethical' baby, breast feeding is de rigeur.

[Adam1]

I was hugely inspired, Adam, by a book called 'Spiritual Midwifery'.

It's basically the account of the birthing practices of a very hippy/christian/buddhist community in America over a couple of decades - they were isolated enough on their farm that they decided they needed their own midwives, and had a battle royal getting their own folk certified to deliver at home on the farm (when of course many poor americans can't afford hospitalised births anyway!).

Basically they evolved a very natural attitude and have very very good statistics. They avoid the intervention cascade where at all possible, but have back up on site, in their midwife kits, and in their own skills, where needed.

The hippy dippy stuff is not everyone's cup of chai. It's not mine, but what was inspiring was to read many many accounts of natural births, to get a grasp of the vast spectrum that comprises 'normal'.

It's all risk assessment, isn't it? Goodness knows there are other areas of life where if we weighed the risks and probabilities the way births are managed, we'd never cook at home for fear of salmonella, nor cross the road for fear of being run over.

Hoping for a fine and healthy outcome for you and yours, and a baby who sleeps!

The book sounds like it had the same effect on you as "The Business of Birth" had on me. I didn't really appreciate quite how profound giving birth was as human experience.

It so true about weighing up risks. Throughout the rest of our lives, until the day we die, we are going to be making decisions about probability of accidents and assessment of risk on behalf of our children.

I wonder if we were living an hour away from a maternity unit, emordnilap, whether we would be so relaxed about a home birth. The midwives where we are seem to be very well prepared for home births and we are doing a "Hypno-birthing" course, which teaches you auto-suggestion techniques to put yourself into a state of deep relaxation. Two of the community midwives have said to us that they were really surprised at how effective it is at easing births. Despite that, if a one in hundred problem arose which required a hospital admission, a one + hour journey would not be fun.

[RenewableCandy]

Move to Scotland. Fast. Their declining birth-rate means that they actually have enough Midwives to go round (unlike a lot of locations in England), their history (well, Glasgow at any rate) means they're mad-keen on getting your breast-feeding up-and-running (this often takes a lot of patience) because it's a shield against all sorts of bad health conditions in later life (TII diabetes, for example). My midwives cheered me on through the last 90 minutes like a winning football team, it was amazing.

[emordnilap]

Breast feeding's great for the mother too! Apart from the bonding aspect, a fine example was in a friend of mine who had terrible acne around her mouth. While breast feeding, she got back to a normal size quickly and the acne cleared up, enlightening her as to a possible reason she got it (and was a bit overweight) in the first place. The baby's feeding gave her an aha! moment.

She's now the epitome of a yum mum.

[SunnyJim]

As I mentioned in another thread, we are expecting our first child next month and are planning to have the baby at home

Don't get hung up on it -- nothing went to plan for us three times in a row so just go with it and see what happens.

Anyhow, you're going to be so 'blissed out' with the screming, puking, shitting little brat that you only think of these things about a year or so later (when you begin having enough sleep to worry about such things).

Amen to that! Neither of ours went to plan. We had the birthing pool set up at home and laboured all night, but had to give up and go down to the hospital in the morning. Shame, but there you go. We're still blissed out with the littluns.....

In a perfect world it would be great to follow your 'birthing plan' but few I know actually managed that!