I will now quote from the book: (I added bold-type and underlines)
"But what if there is an out of hospital birth and something happens?" This "what if" question reveals several false assumptions worth examining."
"The first assumption is that during birth things happen fast. In fact, with very few exceptions, things happen slowly during labor and birth and a true emergency when seconds count is extremely rare. Have you ever spent time in a hospital in a maternity ward? The atmosphere is not like the ER but rather, for the most part, quiet and peaceful. Regardless of what is seen in movies and television, nobody is running around. It's also important to remember that if trouble does develop, a trained midwife who is providing constant one-on-one care to the birthing woman has a better chance of anticipating it or recognizing it quickly than a labor and delivery nurse or doctor in a hospital who is responsible for several women in labor and can look in only occasionally."
"The second false assumption is that when trouble does develop, there is nothing an out-of-hospital midwife can do. This assumption can be made only by someone who has never observed midwives at out of hospital births. Again, with few exceptions, an out of hospital midwife can do everything that can be done in the hospital, including giving the woman oxygen. The condition known as shoulder dystocia (when the baby's head comes out but the shoulders get stuck) is another example. The only way to solve the problem is to maneuver the woman and baby, and that can be done just as well by a midwife in a birth center or home as it can be in the hospital. The most successful maneuver for shoulder dystocia that's been reported in the obstetric literature, by the way, is the Gaskin maneuver, named after the home birth midwife who first described it, Ina May Gaskin."
"The third false assumption revealed in the "what if" question is that if there's a problem, there will be faster action in a hospital. That might be true if the doctor happened to be in the room, but the doctor is not even in the hospital most of the time. If there's a problem, a nurse has to call the doctor, and the doctor's "transport time" to the hospital is usually as long as the woman's "transport time" to the hospital if she is in a birth center or at home."
"Within a hospital, even when an emergency C-section is indicated, it takes 30 minutes, on average, for the hospital to set up for the surgery, locate the anesthesiologist, and the like. In one study that looked at 117 hospital births where there were emergency C-sections for fetal distress, in 52% of the cases the time between the obstetrician's decision to do a C-section and the time the actual incision was made into the woman's belly was more than 30 minutes. So, when there is the need, during this thirty minutes, the out of hospital obstetrician or the out of hospital birthing woman, or both, can be in transit to the hospital. Again, this is why is it is important that an out of hospital midwife have a good collaborative relationship with the hospital, so when she calls to inform the hospital that she is transporting a birthing woman, hospital staff will waste no time in making arrangements."
As I said on facebook earlier today, the reason I am sharing this information is because....nobody ever gives a woman a hard time if she is choosing and planning to have her baby in a hospital. But if a woman says she is planning a home birth, people either freak out, tell her frightening stories, whisper behind her back about how "crazy" it (or she) is, etc. Not only that, but Midwives are not given enough credit, or respect for their education and training and experience with "normal", healthy birth. I personally would like to see that change.
Does it not seem strange that, in general, a C-section (or major abdominal surgery) for example, seems more acceptable and "normal" to the vast majority of people than delivering a baby out of the hospital? To me it does. And to take it even further, in some areas a woman can even ELECT to have a C-section even if it's not medically necessary. Yet not many people spread the fear mongering about those things in the way they do surrounding at-home, or out of hospital births. To me, it just doesn't make sense at all.
Here's a little more about my midwife, who is Kristin Eggleston (from her website) and her training.
She started Sunrise Midwifery in March 2009 after completing all the requirements to become a Licensed Midwife (LM) in Washington State and a Certified Professional Midwife (CPM) nationally. In obtaining her LM and CPM certifications, Kristin graduated from a three year, intensive midwifery education that included both classwork and clinical experience, as well as attending births in homes, birth centers, and hospitals in Washington, Idaho, and Texas. To become an LM in Washington, a midwife must complete her midwifery training, pass a comprehensive exam, and attend or manage 100 births that take place in an out-of-hospital setting. This means that the new LM has seen many normal labors and births from beginning to end, often having provided care to a woman for many months.
In comparison, a new obstetrician has often seen only cesarean sections, several vaginal deliveries, and almost no unmedicated labors and births. They do not usually provide care to the laboring mother(s) throughout her labor and birth, let alone her pregnancy. Most women feel safe and comfortable with the provider who knows her and her birth goals well as well as who has experience with normal, vaginal births.
Kristin's partial Curriculum Vitae
Education
2009 BA in Midwifery from the Midwives’ College of Utah
2006 Credits towards midwifery degree at Seattle Midwifery School (later Bastyr-SMS)
1996 BA in Anthropology from the University of Notre Dame
1995 Year abroad in Angers, France
Continuing Education
2012 40+ hours, encompassing gestational diabetes, MTHFR gene mutation, general midwifery and obstetrics
2012 5+ hours peer review with local midwives
Publications
Midwives and Uterine Rupture: What We Have to Offer. Midwifery Today, Autumn 2007.
2 comments:
Well-written and thoughtful. Thanks for sharing!
You look great! Awesome post that makes me look at things differently.
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