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Re: Homebirths (long)From: Jamie (ajfields@pine-net.com)Mon Nov 21 10:00:14 2005
Gail, there is a small set of women who do want homebirth. Some of them "settle" for birth center or attempt low intervention hospital births. That's hard to accomplish, given the medmal situation here. Some end up with unassisted births d/t being unable to find a provider. Having had 2 of my babies present with nuchal arms, needing a little maneuvering by the mw to get out, I'm not a fan of UC. Sure, most of the time things are fine, but the mw's job is to know when it isn't and do what needs to be done-and to know when it's time to seek medical care. For those women who want homebirth, availability is spotty as you found. In some areas, OBs have actively fought the legalization of homebirth assisted by midwives. My state is one of those in which there is no law regulating direct entry midwives as all, as I mentioned in a PP. There are CNMs but they are forbidden to attend homebirths. That leaves homebirth desiring mothers with the choice of an UC or finding a mw who has been educated and credentialed elsewhere, and who is willing to face the risk of being charged with practicing medicine without a license. There is no law in our state forbidding direct entry mws from attending home births, however, which puts us one step above a few other states. There just isn't one that expressly allows it, either, which would allow for protection of mws and regulation of practice. I resolved my personal dilemna when I moved here during my 3rd pgcy by searching for 3 weeks until I found one in a neighboring state. She is licensed in her state, and has a backup physician (very rare). Most of the people I asked thought midwives no longer existed. That subset is pretty small, though. The majority of women I know want to be rescued from birth, to be honest. Their reading generally consists of What To Expect (which, btw, condemns homebirth as a foolish and dangerous idea, just in case someone might be considering it). They request induction at 38 weeks and assume that b/c the doctor agrees it must be safe. When they have complications from being induced 2 or 3 weeks early, or from AROM at 3cm with a floating baby, or from cytotec or high dose pit, they firmly believe that being in the hospital saved their babies' lives. The typical birth in the hospitals where I've worked was enter the hospital with piddly contractions, or come in to be induced, epidural or intrathecal no later than 4 cm, slow progress, augmentation, directed pushing for a couple of hours. At any point in the merry-go-round, several women are detoured to c/s for FTP. Most of them don't question the process, they decide their bodies are broken. I think the desire to be rescued from birth is ingrained into our society to some extent, and I think that lack of responsibility is a huge part of the reason for the litigious atmosphere that limits choices for those who DO want to take responsibility. jamie
At Mon, 21 Nov 2005, GA12L@aol.com wrote:
>
-- JFields, RN, BSN
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