Posts tagged ‘lay midwife’

OB Docs and Nurses Scoff at Homebirth

My community hospital’s views have never been in favor of any type of home-birth… whether it’s with a skilled professional  practitioner or a skilled lay midwife. There could have been some free unassisted births going on but we were not aware….  As I grew-up in this profession, I learned first from my experienced counterparts…then I began to educate myself and learned a lot from mothers and babies.  The doctors and nurses I worked with were all stagnant in their knowledge in my early years. They were satisfied with how things were.  I was young, I had an open-minded philosophy and an eager quest for knowledge.

In the later 70’s, just when we began to have mothers speak out and request a more natural childbirth, I had a few friends who enlisted the aid of some lay midwife in the region and arranged for homebirths. They all had a really nice birth experience without a single complication. Perhaps that was why I was open to the idea even though I was not personally involved. Besides some of the truly prepared couples who came in and had incredibly beautiful births….. that had been my first exposure as an alternative option to the knock’em out–pull’em out births I had been working with on the job. I knew my friends were very low-risk and had done their homework. 

   However, the hospital’s exposure to a homebirth in those days was only if the homebirth went awry for some reason or another and they came in our doors seeking help…  here’s what the docs and nurses would say to one another :

• “Can you believe she planned to deliver at home???”
• “How could she take take a chance like that with her baby?”
• “The reason people started coming to hospitals to give birth was because mothers and babies were dieing at home….she must be crazy or totally insane!!”

   We’ve had planned homebirths come in for various reasons, as I am sure other facilities did…. (keep in mind that in my area, the usual birth attendant was a lay midwife). The situations bringing the mother to the hospital were often scary and upsetting for her. The most common were:

• Fetal heart rate decels with or without meconium stained fluid 
• Lack of progress with pushing mostly after many hours..
• Higher than normal bloody show or bleeding–possibly abrupting
• Breech, brow or face presentation
• Retained placenta

Often the OB’s didn’t handle themselves well.. certainly not professionally. We had this one OB who would call for the OR to be opened before he even examined the patient or evaluated the situation…..regardless of why they came in.  And he often actually yelled at the mother, in the middle of her scary situation.

“Your baby will die if we don’t do an emergency C/S right now, why did you let this happen!”

Most often the backlash was directed at the midwife who cowered in the hallway- uninvited by the staff, left alone detached from her patient. She never left the unit though until she was afforded the opportunity to visit and speak to her patient. 

The two significant situations I remember which would fall in to statistical data for morbidity were:

1.  An abruption which resulted in a crash C/S upon admission and a neonatal resuscitation with good response….(final apgars 3@one min then 7@ five min) positive overall outcome, no long term sequelae.
2. A birth where the father (a chiropractor) was the birth attendant for his wife, a multip, encountered a shoulder dystocia and the baby ended up with a displaced fractured left humerus. That baby was in a crib with traction to realign the bone. The child went on to be an honor student at a local university after homeschool.

I feel that instead of the midwife or mother receiving hostility (or even the mother being wisked away to the OR without a trial of something if the baby was deemed stable..)~ the staff should have behaved in a compassionate professional manner, acting on any urgent situation with consideration that this mother is now experiencing not only labor but fear and grief over the loss of her beautiful planned birth.

Despite all the negativity from the staff, we never had a seriously bad outcome from attempted homebirths arriving on our doorstep.  We still have attitude problems, probably always will~ just as we do with breastfeeding.  I wish they could  look at it from my perspective. Those who choose homebirth today have better information to hopefully make an educated informed decision about their birth options and choose wisely. I really like Ricki Lake’s “The Business of being Born” among other’s. I hope those choosing homebirth are truly investigating all these options, deciding what is best for them and not making any decisions out of “anger at the system” or any sort of revolutionary zeal.  

  There is so much out there for medical professionals to be aware of other than what goes on in their tiny little realm, their little part of the world. My co-workers and doctors need to be better informed.  

Any one bad outcome (which most certainly happens in the hospital)  does not mean that every homebirth is a bad idea.