Wednesday, December 16, 2009

Final Decision on Midwife

Ok, so we have decided on a midwife, her name is Christy Tashjian. She is wonderful. After interviewing around 7 different midwives, we have decided on her for many reasons. I found that the midwives were either very informative, very knowledgeable, and gave you a lot of information. This was great. It seemed to me that I had a better connection with the type of midwife who is more laid back, pro-Doula, and really wanted me to be in control of the birth. There were a few that I had a really hard time choosing between. It turns out that the ones that I didn't choose, but loved, also worked very closely with Christy, so there is a high chance that I will see them in the future. The one that I really loved, agreed that Christy was a perfect fit for me, and that she also works as Christy's assistant midwife during births.

A little background on Christy, she has two kids. Her son was born after a desired natural childbirth, prolonged labor due to his head being asynclitic, and then born by cesarean section. Yeah, sounds a whole lot like us. The second baby, was born at home with a midwife who she still works very closely with. HBAC (home birth after cesarean) is not something scary to her. When she was pregnant, she was more concerned about prolonged labor and getting "stuck" like last time. I can really identify with her on that. In case you were wondering, midwives now days, aren't little old ladies who don't speak english, and bring only a stick to bite on and a knife to put under the bed to "cut the pain". They also don't do voodoo, or witchcraft, and don't ask for hot water every two minutes like you see on old movies. They are trained for normal birth, and trained to support a woman through labor. The are also trained to screen and notice high risk issues that arise and all of them work with OBs as their back up for questions they may have. They don't do cesareans, they don't do IVs (unless positive strep B can't be controlled), they don't give epidurals, but they are all very skilled in hyro-therapy, maybe that is where the hot water comes in? If you have more concerns, look her up online, or ask me.

As far as VBAC (vaginal birth after cesarean) is concerned. Yes, it is safe. And yes, it is possible. No, you will not explode. There is a chance of uterine rupture, but that varies with the way a caregiver practices. Most OBs are "scared" of this, because it CAN be life threatening in a small percentage of the time. It is less common than other scary situations, like placenta previa, prolapsed cord and so on. When weighing the risks of VBAC compared to repeat cesarean, a mom is 4 times more likely to die with a RC (repeat cesarean), a hysterectomy is 2 times more likely with a RC, a blood transfusion is about 50% more likely, infection is almost 2 times more likely, Infant breathing problems are about 4 times more likely, serious problems with infant breathing are 4 times more likely, plus you couple in the expense, the postpartum depression increase, breastfeeding troubles, longer recovery (6 weeks compared to a few days) plus the fact that you are in a hospital, and have to deal with unwanted people. Also, bonding is severely postponed in a RC. Keep in mind, these so scary uterine ruptures also happen in moms who have never had a cesarean, let alone a baby. One midwife I spoke with has been to over 400 VBACs and never had any uterine rupture. If a mom is induced, or given stimulants such as Pitocin during labor, rupture then becomes a concern. Most Dr. aren't trained in supporting natural childbirth, so in that case, it is best to either find a Dr. who is, or hire a midwife instead or opt for a doula to be at your birth with the OB.

As far as home birth is concerned, it's been studied for years and years and every time proven to be as safe or safer than hospital birth. Interestingly enough, in my situation (HBAC) one study was taken where mom's opting for home birth were 89% of the time successful with a vaginal birth, only 6% needed a hospital transfer (non-emergency). Now, with the hospital study, 65% were successful with a vaginal birth. BIG difference. Otherwise, if you think about it, hospitals are for sick people, and sick people's germs. The rates of cesarean, episiotomy, Pitocin, need for anesthesia, infections, and complications are all higher in hospitals compared to home. We see birth as a natural, normal event, that is no more harder on a mom than digestion, elimination, and so forth, as long as she is HEALTHY. This is important. Exercise, diet, and nutrition are more important than prenatal visits. Yes, prenatals are VERY important, especially when planning a home birth, that should give you an idea of how important the others are. I am not against hospital births for everyone. Some women (high risk) need an OBs care. That is where they should go. If a woman feels "safer" in a hospital, that is where she needs to go. I do also feel that is homebirth was more supported by the medical community, it would be perceived differently by moms, and there fore, more moms would choose it as the safer option.

We also plan having a Doula at the birth for me and Phillip. We have narrowed it down to 2 or 3, but don't need to worry about getting that set in stone till we are actually pregnant. We picked a midwife prior to pregnancy, given the preparation that is suggested before conception. The two Doulas have TONS of experience, one trains Doulas for certification for DONA, she is the one who is going to be facilitating the training I am going to be taking in April. The other is the main spokes person for ICAN (international cesarean awareness network) here in Austin. She deals a lot with VBACs and emotional recovery for past births/experiences. I have very high hopes for both of them, and know I will be in good hands either way. From the midwifery community, it seems there are two of the best of the best out there in what they do.

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