Friday, July 15, 2011

Hospital vs Out of Hospital, A Tale of Two Births

On the fence about where to have your baby?

Another local doula shared this with me yesterday, and it was such an amazing illustration of the difference between birth in or out of a hospital, I just could not keep it to myself. So, with her permission, and with all names and birth places removed for HIPPA reasons, here is her story.

Hi, All,

I posted a cryptic note on Facebook. Someone asked for my stories . . . Sharing here. With great disappointment for Mom “P”, and relief and joy for Mom “S”.

I can’t post this on Facebook — because I don’t want one of the moms to see my experience and feel bad about hers. I would never want to take her birth from her. She chose it. But, she has NO IDEA what she chose. I have rarely (if EVER) seen such a clear linear comparison between birth choices.

2 moms. . . Both due 7/7 with 2nd baby. Both have a 2-1/2 year old son born in a hospital.
“S” was concerned about getting the birth she wanted in the hospital the 2nd time around, so transferred to a midwife at the BC [birth center]. (Very cool in and of itself because Dad is an MD resident in OB at the hospital where she would be birthing.) Saturated with medical mindset, never seen a midwifery birth. Open and participating because it’s what S wanted.

S went into labor spontaneously at noon. Called me as she went to BC. She was 7 cm when she got there. Climbed in hot tub, then moved to the labor ball. On hands and knees on the bed when her water broke. Followed shortly by an urge to push. Encouraged to stay how she was, not necessary to check dilation, allow her body to release the baby when the baby was ready. Baby emerged between her legs, with dad’s hands on it. Dad handed baby up to mom. Baby was a bit floppy and did not breathe for what felt like an eternity. Midwife did appropriate observing and stimulation, but baby was pinking up even without apparent breathing. Midwife pointed out that the umbilical cord is still pulsing. Baby is getting all the oxygen she needs. She will breathe . . . Soon. Our goal is to let her hear mom’s heart, have her back and feet rubbed, and make sure her heart is doing it’s part. It was. She’s pinking up, just not breathing. 1min 45sec later baby begins weakly crying. Cord is still pulsing. Placenta still attached. Baby is nuzzling breast. 30 minutes after birth baby is breathing fine, has cried a couple of times but not vigorously. Baby self-attached [to the breast]. (a miracle because older brother struggled for WEEKS to nurse and it was agony for mom). 45 minutes after birth, placenta finally detaches and emerges. Clamp & cut by dad. Herbal tea bath and quiet time as a sweet family. Back to the room to swaddle perfectly organized baby who goes to sleep on bed when a meal is brought in for mom and dad to enjoy sitting on the bed together. Older brother comes to meet baby sister. Whole family is home before bedtime happy and content on every level.

2 days later, P went into spontaneous labor at noon. Called me to come to the house. She was clearly laboring so we headed to [hospital] and arrived there at 2 pm. Mom has to stand at admissions desk for 15 minutes, doubled over, getting hip squeeze from me while dad-in-a-panic signs paperwork and stress wafts over to mom while I squeeze squeeze squeeze. Tried to make her sit in a wheel chair. Too uncomfortable. Standing and walking to the LDR [labor delivery room]. Require her to change into hospital gown. She can’t do it herself, so nurse does “skin the bunny” and takes her clothes off of her. Mom asks if she can PLEASE check her without getting in bed. No, that’s impossible. Mom is checked — 7 cm. Bounces up out of bed to labor standing up again. Nurse screams “I need a delivery cart. Get the doctor. Have to get the IV and lab work done stat.” Room fills with busy nurses bustling and requring dad and me to dance around them. Stress level in room raises. No time for soft music, massage, etc. Mom’s water breaks with a splash all over the floor. Mom is clearly grunting, and ready to push. NO, don’t push. Wait till we check you. Mom’s back in bed and they confirm baby is visible. Nurse pulls out stirrups. Mom says no, don’t move me, I want to sit up and push sitting. I start to raise the head of the bed and am commanded to not move the bed, she must lay down. Mom begs please let me sit up. Doctor tells the nurse to disassemble the bed. Nurses grab mom’s legs while she says no, and force her legs in the stirrups. Baby is emerging. Doctor catches, immediately clamps the cord and cuts it. Baby is floppy and stunned from a short labor and fast birth. NICU team is called. Nurse confirms baby’s heart is beating. Is pink and strong pulse. But, too limp for their comfort. Suction aggressively. Then, bag mask.

Dad is pacing with hands in his hair. Mom is crying. 2 minutes after birth, baby is crying and pink as any other newborn. But, “not transitioned smoothly enough to be reassuring.” This is what happened to Baby A [their first child] who had to go to NICU. “Apparently, this is how our babies just behave at birth.” NICU doctor tells mom & dad that he wants to be able to look in their eyes and tell them baby will be ok, but he can’t do that right now. HE needs to take the baby to NICU for minimum of 6 hours. Baby may not breastfeed because it’s too stressful for babies to breastfeed when they are having difficulty with transition breathing. Mom gets to give baby peck on the cheek and baby goes to NICU. I offered to come back to help breastfeed and take photos of siblings meeting. No thanks. I can go.

Side by side in my mind . . . Nearly identical in every way. Even the size of the babies, gender, gestational age, multip, etc. Clamp and cut vs. gentle birth.

I NEVER want to do a hospital birth again. The nurses and doctors (and parents) are left with the sensation that it was the technology that saved the baby’s life. THIS, (in their mind) confirms their deep belief that birth is fraught with danger, and hospitals are the best place to birth. I am going to pursue CPM not CNM as my future career. It is crystal clear to me . . . I do not want to work in that setting.

Best,
M


2 comments:

  1. Wow and Wow! I struggled at first to decide if I wanted to try and VBAC in a birth center for my 2nd but finally came to a decision to use the BC. This only confirms and makes me more confident!

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