So yesterday I was 36 weeks exactly, and I had my appointment with my midwife Beverley for my homebirth set-up. I was left feeling a little rail-roaded if truth be told. The usual antenatal checks were fine, with 90/60 BP (my highest isn't usually more than 115/75), clear wee, nice head down position on the baby, heartrate fine, measuring bang on for dates, and so on.
This was all done towards the end of the session. She went through the stuff like how is the access, where I was planning on birthing, is there hot water available, clean warm towels and clothing for baby, etc. And then came the "this is what will happen in xyz situation". Birth must happen between 37 weeks and 41+3 weeks or I'll have to go to hospital. Birth must happen before 42 weeks or I'll be induced. Birth must happen within 24 hours of my waters breaking or I will be induced (with a drip). If my waters break and there is muconium present I must birth in hospital. I must have 3-4 hourly vaginal examinations during my labour to assess the progress of labour. Oh and even if none of these happen, if the midwives are already out on a home birth, I must go into hospital.
Some of the emergency things - fine. Cord prolapse, hemmorage, fetal resuscitation (been there), severe tearing, so on. I just felt like I was tensing up though during the situations I "must" give birth in hospital, I did stand my ground (to an extent) with some of them, but others I just nodded along. I, of course, want a healthy baby at the end of it, and I would of course transfer in a true medical emergencies, but some of them seem to be just for the staffing's convenience, or fear of litigation.
I asked what would happen if my waters broke, showed some muconium, but I gave birth shortly after? Would the baby and I have to transfer? And she said they would do observations on the baby 4 hourly if baby seemed well. If baby seemed to be having trouble breathing then we would transfer.
The whole manner in which this was all delivered seemed rather like it happened quite often, and that I'd be damned lucky to get a home birth. It made me feel less confident in a home birth (I wonder if that's the point??), but right now, as someone said to me, take everything they've said and stick a "It's policy to" in front of it - and that I have the right to go against the policy if I choose to. For example, it's policy to be induced if labour hasn't started within 24 hours after waters have broken, or it's policy to offer vaginal examinations 3-4 hourly during labour. I hope I can find the strength within myself to do this - and to do it right. And to trust myself to differentiate my wants and my needs, and listen to my needs and the needs of my baby if they contradict my wants. I hope they won't - I hope my wants and my needs co-incide and that I get the birth I have always wanted.
I have a love/hate thing with the home birth assessment. It's SO exciting! But kind of stressful with all the stuff they have to cover. Sounds like you did great standing up for your choices! :)
ReplyDeleteYou, of course, have every right to say NO to any of the things they said you "must" do. They tell me that I must go into hospital if there are no midwives available, but they are actually legally REQUIRED to send someone out, even if that means bringing in an independent midwife (which they must fund) due to genuine unavailability. It's amazing how you can say, "Well, my contractions are really hotting up, it's my 3rd baby, and I'm staying here." and hey presto, they manage to rustle up a midwife to come out to you. I always nod and smile at that point when they say that, but do not ever intend to go in for a hospital birth if they tell me they can't find a midwife to send out.
My waters had meconium in them with Benjamin (born at home). I knew the policy, and it's a good one, where meconium is concerned, to go in if that happens. My waters broke as his head was crowning and the meconium was obvious, but there was no time to do anything, obviously! They did check him afterwards. No 4-hourly obs though, BUT I was already doing 2-hourly obs myself for the first 24 hours since I knew I was GBS+. Elijah's last little bit of waters that hadn't already broken had a little meconium in, but they were fine with that since he was obviously well and I was doing the obs for 24 hours again.
Different hospitals have different policies re. waters breaking. I can't remember mine, but I know we totally ignored whatever it was with Elijah, going close to 48 hours after my waters broke, and with GBS as a likelihood as well. They didn't particularly "let" me, I just said NO. I have been so blessed to have a doula because it's really hard to stand up for what you want when you're compromised by pain or hormones or tiredness, but a doula will do that all for you - I wish you had one so that everything would be as unstressful as possible for you! Research the risks thoroughly and make your own choices, and Heather would say, state them in writing, in a birth plan.
I really hate internal examinations during labour, it just messes with me physically and also my state of mind as it's like a "test" to see how well I'm doing, urgh! So when Heather started to be my doula with Benjamin and I told her this, she said I should state in my birth plan absolutely NO internal examinations whatsoever, unless medically ESSENTIAL, and even then after discussion with me and with my consent. I had some pressure to have one to assess whether or not I was really in labour with Benjamin, but I said no, and referred them to my birth plan, and that was that. They said they didn't think I really was in labour and had no way of knowing without an internal, etc, and they might have to go if I wasn't really in labour yet. Pfthth. You know your body better than they do. Benjamin was born 6 hours later (ha!). I have had 3 babies without internals now! :) You absolutely do NOT have to have those ("policy" or not) and can say no, even if they are pushy. They have no right to insist upon one. But it helps to have that written down so they can just be handed a piece of paper and read your statement on what you will and won't accept (well, best to word it less stubbornly than that, lol!).
My lovely head of clinical midwifery at the hospital, who stood up for me a lot and delivered Elijah, said that everything is about "it's policy to..." but it's perfectly fine (even if the consultants disagree) to ignore policy and choose something else. It's their job to support your choices, even if they don't go along with "policy".
You can totally do this! I hope it goes wonderfully for you and you get all the support you need! :)
Wow! This babe is going to be here before we know it! Hoping all goes well and smoothly for baby.s birth and that you are both healthy! No matter how he arrives. Although I'm rooting for your home birth! :)
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