Are Hopsital Births Now “Scarier” Than Home Births?

AP reports that home births are on the rise by a dramatic 20 percent, from 2004 to 2008, accounting for 28,357 of 4.2 million U.S. births. And lest you think it is only the tree-huggers or families who are uninsured and can’t afford a hospital birth, think again.

Sherry Hopkins, a Las Vegas midwife, has attended the home births of many well-educated, affluent, informed women, including a pediatrician, an emergency room doctor and nurses. Home births are the new “it” thing to do.

“I do think there’s a backlash against what’s happening in hospitals,” said Gina Crosley-Corcoran, a Chicago blogger and pre-law student, who gave birth to her third baby (a V-bac) at home. “Women are finding that the hospital experience wasn’t a good one.”

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The hospital birth experience does seem to be becoming increasingly invasive and drug-dependent.  There are relatively minor inconveniences such as being poked by needles, fetal-monitoring, and being told what position to labor in. Then there are bigger concerns such as cord-clamping,  inducement, soaring C-section rates, and brachial plexus injuries. And then there is the matter of comfort: birthing mothers want to feel at ease in their own surroundings, going at their own pace, without interference from doctors who want to speed things up so they won’t miss dinner.

Dr. Joel Evans, a board-certified OB-GYN who supports home birth, calls the medical establishment “resistant to change, resistant to dialogue, resistant to flexibility.”  For many women, hospital births have become a stressful, medicalized experience where every birthing woman is treated under the same protocols.

Home births are not for everyone, especially those who are high-risk. Emergencies do happen, so it is important to be close to a hospital in case you need to be rushed there. An informed decision, careful examination of the pros and cons, together with expert advice, is always the way to go.

Robbie Davis-Floyd, a medical anthropologist at the University of Texas at Austin and researcher on global trends in childbirth, says: “Women who are truly educated in evidence-based maternity care understand the safety and the multiple benefits of home birth.”

Read more: Home birth on the rise by a dramatic 20 percent

If you have had a home-birth of are thinking of having one, we’d like to hear about it! Please share your thoughts in the comment section below.

Brachial Plexus Injuries: A Preventable Newborn Injury- Please Read!

Three out of every 1,000 babies born in the USA suffer from injuries that could have been prevented. More children are inflicted with Brachial Plexus injuries at birth than suffer from Down’s Syndrome, or Muscular Dystrophy, or Spina Bifida.  The terrifying reality is that Brachial Plexus injury is a doctor-cause damage, occurring when a baby’s head is tugged or twisted in order to pull him out of the mother, damaging the delicate nerves in a newborn’s neck.

Symptoms may include a limp or paralyzed arm; lack of muscle control in the arm, hand, or wrist; and a lack of feeling or sensation in the arm or hand. The tragedy is that most of these birth-related injuries are preventable.  Like many of today’s problems, a little bit of education can go a long way.

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The problem is that a baby’s shoulders can become lodged behind the mother’s pelvic bones. Some practitioners panic and start pulling on the babies head. They call it “gentle traction” but it is hardly gentle.  In order to help shift the baby’s position, the mother needs to change positions, and this will help the baby to “slide out like a little fish.”

How? Laying flat on your back during labor is the WORST position for childbirth.  Although it is deemed most convenient for doctors, it narrows the birth canal by up to 30% and makes it much harder to push the baby out. Simply rolling over on your side, standing up, squatting, kneeling, or getting down on all fours will help. But never, never, never let anyone pull on your baby’s head.

C-section babies can also be injured.

Why aren’t more people aware of Brachial Plexus injuries?

The United Brachial Plexus Network explains that the reasons are complicated and include the following:

* Since there is no mandatory reporting or tracking of this injury, the widely stated assumption that the injury is usually transient cannot be validated.
* Misconceptions exist regarding the life-long implications and disabilities associated with this injury.
* Birthing practitioners do not want to take responsibility for enabling these injuries through medicinalized labor protocols.
* Medical providers are resistant to the idea that this injury is often preventable.
* Birthing practitioners have succumb to the belief that brachial plexus injuries are an unpreventable and acceptable risk of vaginal childbirth.
* Patient’s guardians often feel the injury is minimized by hospital personnel and are usually told the injury will go away after a few days or weeks.

Please watch this 5-minute video and visit the United Brachial Plexus Network website for more information. A full-length 25-minute video is available there.

Contractions: Are These the Real Thing?

During the third trimester, some women experience “false” contractions called Braxton-Hicks contractions. This is a normal occurrence, and like real labor contractions, they may increase in frequency and intensity, making you worry that you are going into premature labor. But unlike true labor, these contractions don’t grow consistently longer, stronger, and closer together.

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How to tell if it’s preterm labor: True labor contractions show a definite pattern. Employ the 1-5-1 formula: if your contractions last at least one minute, are five minutes (or less) apart, and continue for at least one hour you are, most likely, in labor. (This would mean you should alert your health-care provider immediately.) Braxton-Hicks contractions come and go and don’t settle into a regular pattern. Don’t forget to practice relaxing and breathing with these trial-run contractions. (Dr. Sears)

If you are within a few weeks of your due date, but the Braxton Hicks contractions are making you uncomfortable, try these measures:

  • Change your activity or position. If you’ve been sitting or laying down, try walking around. If you’re been  moving a lot, resting may provide relief. (On the other hand, true labor contractions will progress regardless of what you do.)
  • Take a warm bath to help your body relax.
  • Drink water; these contractions are sometimes brought on by dehydration.
  • Relaxation exercises and slow, deep breathing may help you cope with the discomfort.

Should I call the doctor?

If you haven’t reached 37 weeks yet, and are having more than four contractions in an hour, or contractions are becoming more frequent, rhythmic, or painful, call your caregiver immediately.  In this case, it’s better to play it safe and don’t try to make the diagnosis yourself. Preterm labor is not something to take chances with. Other possible signs of preterm labor:

  • Abdominal pain, menstrual-like cramping, or more than four contractions in an hour (even if they don’t hurt)
  • Any vaginal bleeding or spotting
  • An increase in vaginal discharge or a change in the type of discharge — if it becomes watery, mucusy, or bloody (even if it’s only pink or blood-tinged)
  • Increased pelvic pressure (a feeling that your baby’s pushing down)
  • Low back pain, especially if it’s a new problem for you

Why More American Women Want to Give Birth at Home

When a pregnant woman decides that she wants a home birth, family and friends are usually shocked, and the first questions are often, “Is that safe? What if something goes wrong?”

In today’s age of medicine, pregnancy and childbirth are often as a disease or a problem that has to be “fixed” rather than the completely natural process it actually is, says Dr. Mercola.  For the 75 percent of women who have normal pregnancies, a knowledgeable and experienced midwife may be more qualified to attend birth than an obstetrician.  For some women, giving birth at home is preferable and possibly safer than doing so in a hospital.

“Safer than a hospital?” you may be asking suspiciously. The fact is thatobstetricians are trained to use surgical interventions that are often unnecessary in a normal pregnancy and delivery, and can cause more harm than good when used inappropriately. If you take a look at some statistics, you may start to see things differently.

99 percent of all U.S. births occur in a hospital, yet the United States has one of the highest infant mortality rates of any developed country (6.3 deaths per 1,000 babies born). In the Netherlands, one-third of deliveries occur in the home with the assistance of midwives, yet the infant death rate is  only 4.73 deaths per 1,000.

In terms of your own safety, maternal mortality rates rose more than 54 percent from 2000 to 2005 in the United States, while decreasing in other developed countries. One reason suggested for this scary fact may be the incredibly high rate of C-section in the United States, which accounts for nearly one-third of all births. It is actually the most commonly performed surgery in the US!

The World Health Organization states that no country is justified in having a cesarean rate greater than 15 percent, but the rate in the United States is nearly 32 percent, which even worries The American College of Obstetricians and Gynecologists.

A C-section should be used only as a last resort.  One study found that a woman’s risk of death during delivery is three to five times higher during cesarean than a natural delivery, her risk of hysterectomy four times higher, and her risk of being admitted to intensive care is two times higher.

Obviously, C-section rates are lower among home births, as well as midwife-attended births. Women who delivered at home also have fewer interventions and greater freedom in choosing their birthing style. As long as you have experienced a healthy pregnancy, a qualified midwife is a very safest birth attendant, and your home may very well be the best place for you to deliver.

If you are planning a home birth, it may be challenging to find a birth attendant you feel comfortable with. It is rare to find an obstetrician that will agree to a home birth in the United States. Certified nurse midwives (CNMs) can legally attend home births in any state, but most choose to practice in hospitals instead.  Only 27 states currently license or regulate direct-entry midwives– or certified professional midwives (CPMs)– who have undergone training and met national standards to attend homebirths. (Find the legal status of CPMs in your state here.)

In the other 23, midwife-attended births are illegal.  A campaign is currently underway to expand state licensing of CPMs so that women who want a home birth can choose from a qualified pool of applicants, but until that happens you have a few legal options for homebirth:

  • Find a certified nurse midwife (CNM) who attends homebirths in your state or in a nearby state (then travel to that state to give birth)
  • Find a CPM who is either licensed by your state or in a nearby state (then travel to that state to give birth)
  • Use a CNM but give birth in a hospital or birth center (a compromise)

To find a midwife in your area, try:

  • Midwives Alliance of North America
  • Mothers Naturally
  • American College of Nurse-Midwives
  • Midwifery Today
  • BirthLink (Chicago area)

For more information: Should American Women Learn to Give Birth at Home?

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In the Nick of Time: Mom gives birth in hospital lobby

Many people treasure the videos of their child’s birth, but they’re usually taken by a proud dad… Not by a surveillance camera!  Last week a British woman gave birth to a baby girl just inside the hospital lobby! It was a very cold mid-night drive and Dad just wanted to get indoors so he wouldn’t have to deliver the baby by himself on the roadside… They got there with 10 minutes to spare, but Mom fell on her hands and knees and couldn’t go any further! Baby Alice was delivered shortly thereafter by Dad and two midwives.

You can watch the family’s CBS News interview here!


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Did you have a birth that progressed so quickly that you couldn’t make it to your planned destination? Tell us about it!

What NOT to Do While Your Wife is in Labor

Hey Dads! Feeling a little nervous as the birth of your baby draws near? Wondering how to be a helpful and supportive partner during the labor and delivery? Well, what you DON’T do might be just as important as what you DO do!  Even things you might not see as being an issue… let’s just say that women are even more sensitive during labor than they normally are!

As the experts at theCradle point out, “Something you wouldn’t think twice about doing under ordinary circumstances will be remembered as appalling if you do it during labor. No one wants to be the guy that’s remembered for taking a call from his stockbroker while his wife was in labor.”

Here are some tips from the authors of Don’t Just Stand There: How to Be Helpful, Clued-In, Supportive, Engaged & Relevant in the Delivery Room (via theCradle).

  • Don’t chat on your cell phone with your friends.
  • Don’t return work calls.
  • No checking your stocks, surfing on the wireless, or checking your email.
  • Blowing bubbles and chewing gum is generally not a great idea.
  • You may have had a really long, hard day, but let her have the bed.
  • Don’t fight her for control of the remote – make sure you TiVo all important ballgames at least 48 hours in advance as you come down the stratch to the due date.
  • Reading a newspaper is a bad idea in general, even if you give her first choice of the sections.
  • Don’t flirt with the nurses.
  • Don’t take inappropriate photos – you’re not making a documentary for the National Geographic Channel. Remember, anything you shoot should have a “PG” rating.
  • Don’t let your mother or other relatives into the room or within earshot, unless your partner is totally fine with it.
  • Don’t socialize too much with the labor partner in the next delivery room.
  • Don’t mention the success of other laboring women on the floor – that’s not going to inspire her.
  • Don’t ask the doctor to bring you coffee.
  • Cool as it is to watch, don’t pay more attention to the contraction monitor than to her.
  • Avoid the subject of personal-injury law when conversing with the medical staff.
  • Don’t pass out and need to be taken down to the emergency room to get stitches.
  • Don’t scatter your stuff around the delivery room and then ask her if she’s seen your car keys.
  • Don’t discuss real estate or golf with the doctor while she’s having contractions.
  • Don’t eat onions, garlic, or other obnoxious food, like Doritos or Cheetos.
  • Don’t tell her to go back to sleep if she wakes you up with contractions.
  • Don’t tell her that you heard it doesn’t have to hurt.
  • And finally, whatever you do, don’t do what I did – lie in her bed the morning after, eating her breakfast, while she packs the bags. Unfortunately [my wife] has the photo to prove it.

Choosing a hospital to give birth

When you choose your obstetrician, you are also choosing the hospital at which you’ll give birth, More 4 Kids points out. Your doctor will have admitting privileges at a certain hospital, so you have to start thinking about which hospital to deliver at before selecting your obstetrician. You may have to switch doctors in order to deliver at the hospital you want.

You can start your research by asking your current gynecologist about good hospitals. It should be less than an hour away, and easily accessible by car. It is especially beneficial if the hospital is easily accessible by the interstate system, since you will not want to experience traffic while you are in labor. If you have a high-risk pregnancy, you should make sure that your hospital has a neonatal intensive care unit. Hospitals that use the latest neonatal-care technology are also a plus, in case of complications. The comfort and privacy of the delivery rooms, infant care, visitor rules, and other services may be factors to consider.

The questions you ask should be tailored towards your needs, and should always serve the purpose of opening up the lines of communications between you and your birth team. Some of the answers might be dependent upon your practitioner, while other policies will be determined by the hospital or birth center. These policies can have serious impact on how you labor or give birth, including your postpartum stay. Here are some questions from About.com to help get you decide what you need to ask of your place of birth:

Labor & Birth

  • Do you offer any type of classes? Who teaches them? What is the cost? Do you have specialty classes?
  • Where do I go when it’s time for labor? Is there a different place at night?
  • What paperwork needs to be completed prior to admission for labor? Is there other paperwork to be done? Can it be done prior to labor?
  • What will I need to bring with me when I’m in labor? Will my chart be sent over or will I need to hand carry it?
  • Do you have a triage system? How long does one usually stay in triage?
  • What types of birthing rooms are available? Can I labor, give birth and recover in one room?
  • What types of comfort measures do you encourage? Is there a tub or shower in the birth room? Do you have access to birth balls, music, squat bar, etc.?
  • What type of food or drink is allowed? Is there a kitchen area for myself or my family? Am I allowed to bring food or drink from home? Do you provide clear liquids like popsicles, broth, Jell-o®, etc.?
  • Are IVs required? What about a saline lock to provide access to my veins instead? Who would make this provision if it’s not a standard policy?
  • What type of medications are available should I choose medication? What IV medications are used? Do you offer epidural anesthesia? Is there a special class to take for the epidural? Do you have anesthesiologists who only do obstetrical anesthesia? Do you have 24 hour anesthesia available on site? Can I have a pre-labor consult with the anesthesia group if I have special concerns?
  • Do you have visitor policies in labor? Do you have policies about siblings?
  • Are cameras and film equpiment allowed? Are there any parts for which we should turn it off?
  • What type of fetal monitoring do you offer? External? Internal? Doppler/fetoscope? What are the hospital policies on monitoring in labor?
  • How often do you experience an overflow of patients? What happens if all of your birthing rooms are taken?
  • Do you utilize students or residents in any way?
  • What is your hospitals induction rate? How many patients receive augementation in labor? What is your episiotomy rate? Epidural rate? Forceps/vacuum rates? Cesarean rates? VBAC rate?
  • Do you have doulas on staff? Do you have a listing of doulas?
  • To whom should I send my birth plan? Does it need to be signed by my doctor or midwife? My pediatrician?

Cesarean Birth

  • Can my partner stay with me for a cesarean birth? My doula?
  • Can we have photos of the birth?
  • Will I be able to watch the surgery via mirror? Could the drapes be lowered?
  • What is the policy about pre-operative medications? Post-operative pain relief?
  • Will the baby be available to me during the surgery time? In the recovery room? When can I begin nursing?
  • If the cesarean is planned, what is the admission procedure?
  • Will my partner be able to go with the baby, should s/he need to leave the room?

Postpartum

  • Will I have the same room postpartum that I did for labor and birth?
  • Are all your postpartum rooms private? Will I ever be moved from my room?
  • Do the rooms have showers or tubs? What about sitz baths?
  • Can members of my family stay over night? Is there an extra charge for this?
  • What pain relief options are available postpartum? Does that differ if you’ve had a cesarean birth? What about nursing moms?
  • What is the average length of stay for a vaginal birth? A cesarean birth?
  • Is there a policy for early discharge?

Baby Care

  • What is your policy on rooming in? Are there times that the baby cannot be in our room?
  • Do pediatricians do their visits at the bed side? When would this not be appropriate?
  • Do you have a lactation consultant? Is she available seven days a week? What are her hours? Does she see every nursing mom? Is she certified?
  • What are the policies about breastfeeding babies and bottles/pacifiers?
  • Are their sibling visitation policies?

image: The Brooklyn Hospital Center

Obviously, the level of care and sensitivity of hospital staff should be your first priorities. But beyond that, there are many other perks that you might want to look into. Some hospitals offer private suites (for those who are willing to pay) rather than a room that holds several women. Some private suites even offer amenities such as whirlpools and HDTV. Often, these suites also permit you to spend the entire duration of your labor and delivery in the same place, which is known as a Labor Delivery Recovery Postpartum (LDRP) room. You may also be cared for by one or two nurses who have no other patients, and so you will receive more personalized care. It is important to reserve a private room as early as possible in order to raise your chances of having it at your date of delivery.

Hospitals offering private suites also offer premium services such as:

  • lactation (breast-feeding) consultants
  • 24-hour anesthesiologist care
  • a private nursery for keeping your infant near you after the birth
  • 24-hour room service (new mothers can be hungry at odd hours of the day and night!)
  • permission for siblings to watch the birth
  • 24-hour visitors (unless the mother or infant is in need of more medical attention)
  • massages that last from fifteen minutes to two hours
  • free parking for visitors
  • new-parent classes for parents to learn about infant care.
  • special support groups such as new mothers groups, new fathers groups, and even new siblings groups.

After you have made a list of hospitals that interest you, it is a good idea to schedule visits with them. Many hospitals offer group or individual tours for their maternity centers. During your visit, scrutinize the facilities for cleanliness, because hygiene is essential when your baby is born and is vulnerable to infection. You should arrive at your tour with a list of questions, though it is likely that many of these questions will be addressed during your tour. In addition, you should ask for a brochure or pamphlet of the hospital’s policies and regulations for maternity patients, so you can brush up on them before your delivery date. During your visit, be careful not to be taken in by the luxury of the facilities—make sure first and foremost that the hospital has the resources to successfully treat your infant in case of emergencies.

For more information visit More 4 Kids and About.com: Pregnancy & Childbirth.

Newborn baby: Tests, shots, and other hospital procedures

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Right after the birth of you baby is a very special time! You will cradle that bundle of joy in your arms for the very first time and, with the labor behind you, bask in the amazing feeling of motherhood. Although you probably want to enjoy this time uninterrupted, the doctors and nurses may whisk your baby away to perform several important tests and procedures.

You can request a little more time to bond with your baby. But here’s an overview of the care you can expect from the hospital staff, from WomensHealth.gov:

Apgar Evaluation

The Apgar test is a quick way for doctors to figure out if the baby is healthy or needs extra medical care. Apgar tests are usually done twice: one minute after birth and again five minutes after birth. Doctors and nurses measure 5 signs of the baby’s condition. These are:

  • heart rate
  • breathing
  • activity and muscle tone
  • reflexes
  • skin color

Apgar scores range from 0 to10. A baby who scores 7 or more is considered very healthy. But a lower score doesn’t always mean there is something wrong. Perfectly healthy babies often have low Apgar scores in the first minute of life.

In more than 98% of cases, the Apgar score reaches 7 after 5 minutes of life. When it does not, the baby needs medical care and close monitoring.

Eye Care

The Centers for Disease Control and Prevention (CDC) recommend that all newborns receive eye drops or ointment to prevent infections they can get during delivery. Sexually transmitted diseases (STDs) including gonorrhea and chlamydia are a main cause of newborn eye infections. These infections can cause blindness when left untreated.

Silver nitrate, erythromycin, and tetracycline are the three medicines used in newborns’ eyes. These medicines can sting and/or blur the baby’s vision. So you may want to postpone this treatment for a little while.

Some parents question whether this treatment is really necessary. Many women at low risk for STDs do not want their newborns to receive eye medicine. But there is no evidence to suggest that this medicine harms the baby.

It is important to note that even pregnant women who test negative for STDs may get an infection by the time of delivery. Plus, most women with gonorrhea and/or chlamydia don’t know it because they have no symptoms.

Vitamin K Shot

The American Academy of Pediatrics recommends that all newborns receive a shot of vitamin K in the upper leg. Newborns usually have low levels of vitamin K in their bodies. This vitamin is needed for the blood to clot. Low levels of vitamin K can cause a rare but serious bleeding problem. Research shows that vitamin K shots prevent dangerous bleeding in newborns.

Newborns probably feel pain when the shot is given. But afterwards babies don’t seem to have any discomfort. Since it may be uncomfortable for the baby, you may want to postpone this shot for a little while.

Newborn Metabolic Screening

Doctors or nurses prick your baby’s heel to take a tiny sample of blood. They use this blood to test for many diseases.

All 50 states require testing for at least two disorders: phenylketonuria and congenital hypothyroidism. But many states test for up to 30 different diseases: All of these problems are impossible to spot without a blood test. And if left untreated they can cause mental retardation and even death. The March of Dimes recommends that all newborns be tested for at least 29 diseases.

Hearing Test

Many hospitals offer newborn hearing tests. Tiny earphones or microphones are used to see how the baby reacts to sounds. Newborn hearing tests can spot hearing problems early. This can help cut the risk of serious language and speech problems.

Hepatitis B Vaccine

Most hospitals now suggest that newborns get a vaccine to protect against the hepatitis B virus (HBV). HBV can cause a lifelong infection, serious liver damage and even death.

The hepatitis B vaccine is a series of three different shots. The American Academy of Pediatrics and the Centers for Disease Control (CDC) recommend that all newborns get the first shot soon after birth or before leaving the hospital. If the mother does not have hepatitis B, the first shot can wait for 2 months. The second and last shot should be given before 18 months of age.

Complete Check-up

Soon after delivery most doctors or nurses also:

  • Measure the newborn’s weight, length, and head.
  • Take the baby’s temperature.
  • Measure his breathing and heart rates
  • Give the baby a bath and clean the umbilical cord stump.

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