PLEASE don't attempt a homebirth just because you fear covid

Log in / Sign Up

List of Forums + New Post Recipe Box Usergroups Following My Posts Bookmarks

Private Messages Advanced Search Rules New User Guide FAQ Advertise Contact Us

Forum -> Coronavirus Health Questions

Previous 1 2 3 4 5 Next

View latest: 24h 48h 72h

banana123

Mon, May 18 2020, 10:43 am

amother [ Sienna ] wrote:

But that's not shoulder dystocia. If there are other complications, there are other signals and we can discuss those. But in this thread, where the infant died due to shoulder dystocia, it's irrelevant to discuss other complications. (And let's not forget that Hatzalah arrives sooner than EMT's in most places.)

In some cases you can c-section shoulder dystocia. They try to avoid it but sometimes there is no choice.

amother [ Sienna ] wrote:

Enough said.

HB MW's know what to do. They initiate transfer immediately. In fact, they can usually tell way before delivery that baby isn't in optimal birthing position and will be on top of it BEFORE you go into labor.

Some do. Some don't.

amother [ Sienna ] wrote:

Is it a wonder she ended up with shoulder dystocia? Do you guys literally not see the sequence of events?

I did see it and that was why I did not respond to FF's post.

Last edited by banana123 on Mon, May 18 2020, 10:50 am; edited 1 time in total

amother

Sienna

Mon, May 18 2020, 10:45 am

I don't know how to quote your post, but shoulder dystocia is not when a shoulder presents first. I don't know why you are saying that.

As for your response of some do and some don't. Do or don't what? Transfer? Or know the position of baby?

banana123

Mon, May 18 2020, 10:47 am

amother [ Coffee ] wrote:

Obviously. Did I say otherwise?

But dystocias DO happen less often when women are not forced into unnatural ways of birthing.

From March of Dimes:

"Conditions that are part of labor and birth also are risk factors for shoulder dystocia. These include:

Getting a medicine called oxytocin to induce your labor (make your labor start).

Getting an epidural to help with pain during labor. An epidural is pain medicine you get through a tube in your lower back that helps numb your lower body during labor. It’s the most common kind of pain relief used during labor.

Having a very short or very long second stage of labor. This is the part of labor where you push and give birth.

Having an assisted vaginal birth (also called operative vaginal birth). This means that your provider uses tools, like forceps or a vacuum, to help your baby through the birth canal. Forceps look like big tongs. Your provider places them around your baby’s head in the private part to help guide your baby out. A vacuum is a suction cup that goes around your baby’s head in the private part to help guide your baby out. This is the most common risk factor for shoulder dystocia."

So if you are truly concerned about shoulder dystocia, then home birth MIGHT be the better option.

All true. None of these things mean you can't deliver in a hospital that supports those values.

Your "might" depends on a number of variables and each person's situation.

amother [ Coffee ] wrote:

Um, that's why I mentioned being responsible. It doesn't take too much brilliance to choose a CNM over a DEM, or to choose the latter only after ensuring her training was extensive enough and that she is not a risk-taker.

In many states there actually ARE regulations, and those regulations generally limit midwifery care to CNMs.

I do agree that regulated midwifery care is safer, especially when said midwives are properly integrated into the rest of the medical system. It is a pity that the US does not follow that model. But that doesn't make a home birth automatically dangerous, it just requires more care in choosing appropriate providers.

(In general, taking statistics into account, almost ANY country is safer to birth in than the USA - both hospital and home birth.)

How do you define "if her training was extensive enough"? That's exactly what I'm talking about.

Yes, there are regulations in many states, as well as a whole host of HB midwives who practice illegally - and there is a market for them.

I never said homebirth was automatically dangerous. I questioned the professionalism of American homebirth midwives. And I explicitly said that in some countries, homebirth is as safe or safer than hospital birth.

As it happens, one of the countries hardest hit by coronavirus is also the country with horrible homebirth regulations and high maternal and infant mortality rates.

banana123

Mon, May 18 2020, 10:51 am

amother [ Sienna ] wrote:

Some do transfer. Some don't.
Some do know how to help the baby out naturally. Some don't.
Some do know the position of the baby. Some don't.
Some do recognize shoulder dystocia on time. Some don't.
Etc. etc.

OBnursemom

Mon, May 18 2020, 11:05 am

amother [ Sienna ] wrote:

I am not sure why the baby didn't get oxygen at birth and till they got to the hospital.

I also don't understand how a hospital would have helped her. Shoulder dystocia is a problem at any delivery location. All the options to resolve the issue are available at home too.

This is a sad story but I don't understand the relevance to home birth.

The baby didn’t get oxygen because he wasn’t breathing.

OBnursemom

Mon, May 18 2020, 11:07 am

FranticFrummie wrote:

When DD's birth mom was in labor (40 hours!), we found out that DD had shoulder dystocia. DD's heart rate was dropping, and an emergency C section had to be done.

B'H, she scored straight 10's on her Apgar. Everyone was amazed. Off duty nurses and doctors came in to look at the baby who scored so perfectly after what she'd been through, and how close it could have been to tragedy.

I just have to comment on this. I’ve never seen a 10/10 apgar. None of the hospitals I have worked at give them at all. The best we give is 9/9.

OBnursemom

Mon, May 18 2020, 11:08 am

amother [ OP ] wrote:

If she would've been monitored at the hospital, they would've noticed the baby's large size and a c section would've been the way to go.

I realize I used the word would've 3 times in one sentence. Hindsight is not a chuchmah. If even one baby is saved because parents took the right precautions it is worth posting it.

Ultrasounds at term can be 2+ pounds off in either direction. Also many people get angry when you induce them for a macrosomic baby and the baby weighs 8 lbs- because again, it can be so off close to the due date.

banana123

Mon, May 18 2020, 11:09 am

OBnursemom wrote:

I just have to comment on this. I’ve never seen a 10/10 apgar. None of the hospitals I have worked at give them at all. The best we give is 9/9.

Why? I think my first got 10/10 on the second apgar. Don't remember what the others got.
What is 9/9? Did you mean 9/10?

amother

Seafoam

Mon, May 18 2020, 11:10 am

OBnursemom wrote:

I just have to comment on this. I’ve never seen a 10/10 apgar. None of the hospitals I have worked at give them at all. The best we give is 9/9.

The one I'm at is Max 9/10 for first minute because hands and feet are always a bit purplish

OBnursemom

Mon, May 18 2020, 11:11 am

banana123 wrote:

Why? I think my first got 10/10 on the second apgar. Don't remember what the others got.
What is 9/9? Did you mean 9/10?

No. 9/9 is 9 at 1 minute and 9 at 5 minutes. And I’ve never seen a 10/10 apgar in 20 years. Maybe liability reasons. In many places you can sue a midwife or OB for incidents at birth for 18 years.

OBnursemom

Mon, May 18 2020, 11:12 am

amother [ Seafoam ] wrote:

The one I'm at is Max 9/10 for first minute because hands and feet are always a bit purplish

Yeah. We always take off for acrocyanosis.

Refine

Mon, May 18 2020, 11:13 am

banana123 wrote:

No, not all midwives have zero standards, but at least in the US there are no regulations and it's a free-for-all. And unfortunately many people with no training open up shop as midwives. In addition, a large portion of mothers do not know how to differentiate between a quack midwife and someone who actually knows her stuff.

In Israel in order to be a midwife you first have to be a nurse. There are no exceptions. And home birth is much safer here.

I have to say, here doctors supervise, but from afar. Even in a hospital setting, the one who delivers you is the nurse midwife. The doctor is not usually in the room, unless there is a special situation.

You are correct that there is a wait between when the hospital decides to operate and when it actually happens. But (at least here) when there is an emergency c-section needed, wait time is usually no more than ten minutes. I doubt that even calling ahead, a midwife could shorten that.

I'm not saying there aren't risk to hospital births. But what I am saying is that when homebirth is unregulated, it comes with risks - and a lot of them.

In some countries homebirth is as safe or safer than hospital births. In the US, that is not the case. But of course, the US doesn't have a sterling record in general for safety in this area.

The title of this thread - not to attempt homebirth solely out of fear of coronavirus - is spot on. Decisions made from fear are never well-researched and often turn out to be wrong.

Same thing as Canada and European countries. Many of the studies that the homebirth midwives rely on to show that home birth is safe come from countries that work very differently than the us. The standards are more uniform and higher for midwife certification and midwives are all integrated into the hospital system. So a midwife can call ahead and get a c section waiting and ready vs in the usa where the woman first needs to go through triage and have her blood type taken. And that's in a good case. Some midwives have such a bad relationship with the hospital that they will push off until too late chv or go to a further hospital. This is unheard of in canada, israel and europe.

ETA I see you posted this point later.

Last edited by Refine on Mon, May 18 2020, 11:22 am; edited 1 time in total

banana123

Mon, May 18 2020, 11:21 am

OBnursemom wrote:

No. 9/9 is 9 at 1 minute and 9 at 5 minutes. And I’ve never seen a 10/10 apgar in 20 years. Maybe liability reasons. In many places you can sue a midwife or OB for incidents at birth for 18 years.

Odd. Guess it depends on location.

They do take off for acrocyanosis here (not all of my babies had it).

Last edited by banana123 on Mon, May 18 2020, 11:25 am; edited 1 time in total

amother

Sienna

Mon, May 18 2020, 11:24 am

banana123 wrote:

Ok, whatever.

amother

Amber

Mon, May 18 2020, 2:37 pm

Refine wrote:

I know a couple of homebirth midwives with hospital privileges. They deliver both in hospital and homes.
The others I know work in tandem with specific doctors, and have access to their hospital privileges.
All frum homebirthers I know in NY/NJ use one of the above mentioned.
As with everything, do your due diligence.

amother

Amber

Mon, May 18 2020, 2:49 pm

What I find so sad about this is what pushed them to take the step of homebirthing. Separating babies at birth from parents is horrific, and unjustified in many (or all) corona cases.

Iymnok

Mon, May 18 2020, 2:57 pm

In some states in the US even a lay midwife is legal. IMO Using anyone less certified than a CNM Is irresponsible. That includes a certified midwife, a lay midwife, a doula, your mom, unassisted and your husband.
That midwife should have hospital privileges and a clear transfer protocol as well as all the emergency equipment possibly needed.

amother

Coffee

Mon, May 18 2020, 4:00 pm

So maybe you'd like to change your thread title to something like, "If you're considering a home birth, PLEASE only use a CNM."

Bashing home birth altogether makes your entire premise suspect. If you make a point like, "CNMs are a more responsible choice because it's too hard to judge the qualifications of a DEM or lay midwife," more people will be inclined to agree and you might get someone to choose a different care provider.

If you say, "Home birth is BAD! Because a baby DIED!!!" then it's unlikely anyone will take you very seriously. (Well, except for those that already think that home birth is equivalent to freebirthing while parachuting, but those aren't the ones you need to convince.)

Refine

Mon, May 18 2020, 4:41 pm

amother [ Amber ] wrote:

My friends who homebirth are frum and in NY.
One mother almost bled out and couldn't get back to herself for a long time. The midwife wasn't even the one who noticed and didn't transfer after the fact either (wouldn't fly in any other civilised country). Hatzala was shocked when they came.
The other baby got stuck but was way overdue and would have been risked out of homebirth in Canada for that.

amother

Amber

Mon, May 18 2020, 4:49 pm

Refine wrote:

I don't know what happened to your friends. I just know that the midwives I've been in touch with have a rigorous vetting process.
(And I also know that posting anecdotes is pointless. I can tell you horror stories about hospital births.)

Page 3 of 5

Previous 1 2 3 4 5 Next