By Rich Monetti
To those of us not familiar with Home Birth, the image that can easily emerge harkens back to a hippie, communal ritual that somehow survived the 60's. They see midwife, home birth and it's tie dye, brownies and chanting candles, says Midwife Susan Rannestad of River and Mountain Midwives in Gardiner, New York but in reality its application qualifies as a distinct branch of medicine with a different model of care than the birthing process we find in hospitals.
Aside from the university based degree which New York State requires in midwifery, the at home intervention is an
Many women move forward on a Home Birth in hopes of diminishing the need for the more invasive methods that more commonly come of a hospital planned birth. "They desire a natural birth with a low level of intervention so that their body can work on their own accord," she says.
In other words, for one, comfortable surroundings, the easy opportunity to move about your own home and a say in the goings on can make the labor pains much more palatable. In turn, even with the option to transfer to the hospital where an epidural awaits her spinal chord, most mothers defer on drugs that she feels the medical community takes for granted.
More alarming is the 29% national Caesarian rate, according to a 2004 CDC study, which stands about 25 percentage points above the home birth ratio. Women still die in this country from C-sections, she says, because of anesthesia, infection and other related surgical complications.
She attributes the difference to provider management that goes hand and hand with habit and proximity. “The connection is that you’re more likely to get a Caesarian if you’re in a place that gives Caesarians,” she says. In turn, she points to higher rates of autism, asthma, learning disabilities and behavioral problems for children delivered by C-Section.
Of course, in the event of a home birth that requires a C-Section, an emergency transfer is initiated. Over the years, she approximates that about 6% of her homebirths have ended up in a hospital, but she would only count five of those as emergencies.
The others she would prefer to identify as “complications” and flashing lights and sirens are not always needed to resolve them. So staying put or not, situationsare dealt with in the same competent manner as in a hospital. “Midwives and doctors have to be able to handle complications,” she says, and that possibly means a midwife provides oxygen, administers drugs to stop a bleed or performing a neo-natal resuscitation.
Regardless, if you’re having a homebirth, it’s not necessary to register with the town and map out some sort of special emergency evacuation procedure. Home or hospital birth, she says, every family has an emergency care plan that has all the contact information for their local 911 and directions to the home.
Nonetheless, husbands sometimes need a bit more convincing. “What do you mean you want to have a home birth,” she says her husband queried her in a panic. Reminding him with just the right amount of tact required of a wife, she says she told him, Duh, I’m a midwife.
From that, the wife and midwife realized that many men are just plain afraid of birth and subsequent trips to their midwife made it all easier. “Oh, there’s actually people that are helping us through this and they do it all the time,” she says he came to the realization.
Sealing the deal, she put his fears to rest with some simple maternal common sense. “We’re mommies and we would never hurt a child,” she also made him realize, she says.
Joking aside, some studies show a higher mortality rate in homebirth scenarios but she feels those numbers are skewed by including miscarriages that occur at home, which were never planned to be homebirths.
In contrast, she would direct you to www.mana.org for results of planned home births. Otherwise, she can quote some anecdotal evidence that goes along way with or against the numbers. “They turn to their husbands and mothers and say thank you for being here with me,” she concludes.
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