Posted by Melissa Maimann on Aug 17, 2010 in
Birth,
Midwifery,
Normal Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
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MONA Vale Hospital’s new birthing unit will simply be a place for expectant mothers to have a home birth inside a hospital – but a long way from emergency care if a complication occurs – according to an obstetrician.
How anyone can consider a hospital birth to be the same as a homebirth is way beyond me! There is a very big difference between the comfort and familiarity of our homes, and a hospital environment.
Dr David Jollow, one of Mona Vale Hospital’s onsite obstetricians, said the new, midwife-run, Mona Vale birthing unit would mean women who suffer a complication during labour will have to be rushed to Manly Hospital instead of being treated by Mona Vale’s onsite obstetricians.
“The new unit is essentially a home birth that happens to be in a hospital,” Dr Jollow said.
“It would actually be safer to have a home birth in Balgowlah or Seaforth, because an ambulance ride to Manly would be quicker.”
It’s interesting that obstetricians oppose free-standing birth centres, yet we have the existence of midwife-run units where obstetricians are not available. Is ther a differnence? Is it merely a differing terminology to be acceptable to some?
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Babies, Birth choices, continuity of care, Home birth, hospital birth, intervention, Midwifery, Midwifery services, Public and private hospitals
Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
That I am pregnant again is an act of either incredible optimism or mind-blowing amnesia. As the sonogram technician squirts jelly over my abdomen for my 20-week checkup, I think it’s the latter. Watching this baby, who the tech tells me is a boy, I am not caught up in visions of his future; I’m caught up in visions of mine. All of a sudden, I know with a certainty I haven’t allowed myself to confront before: Somehow, I am going to have to deliver this baby.
Obviously, you say. But my first birth was traumatic, and although my son and I emerged fine, I lost a year seeking treatment for post-traumatic stress disorder and all the depression, fear and anger it brings. I imitated mothers who seemed normal to me, cooing and tickling my son. In truth, I was a zombie, obsessing about how I had ever let what happened happen.
What happened is this: In my 39th week, I am induced because of high blood pressure. At the hospital, I am given Pitocin, a synthetic form of the labor-inducing hormone oxytocin, and Cervidil, a vaginal insert used to dilate the cervix. Within two hours, my contractions are one minute apart. I had lasted as long as I could without an epidural because I had read that they sometimes slow dilation. That’s the last thing I need: I’m at a pathetic 2 centimeters. My doctor comes up with a solution for the pain: a syringe full of a narcotic called Stadol.
“I have a history of anxiety,” I tell the nurse who has brought in the syringe, as I always warn any medical professional who wants to give me drugs. “Is this drug OK for me?” “It sure is,” she says.
It is not. Within 10 seconds, I begin hallucinating. For five hours, I hallucinate that I’m on a swing that’s soaring too high, that houses are flying at my face. My husband has fallen asleep on the cot next to me, and I’m convinced that if awakened, he will turn into a monster — literally. I’m aware this notion is irrational, that these images are hallucinations. But they are terrifying. I buzz the nurse. “Sometimes that happens,” she says …
By noon the next day, 24 hours after I had arrived, I am only 3 centimeters dilated. The new nurse, a nice lady, tells me the induction isn’t working. “Your blood pressure isn’t even high anymore,” she says. “Tell the doctor you want to go home.”
When my OB comes in, I say, “I’d like to stop this induction, if that’s possible. I’m worn out. I hallucinated all night … I just don’t think this is working out.”
“OK,” he says. “Let me examine you. If you’re still not dilating, we’ll talk about going home.”
My previous dilation exams had been quick and painless, if not entirely pleasant. This one takes a long time. Suddenly, it hurts. “What are you doing?” I scream. “Why does it hurt?”
No answer.
“He’s not examining me,” I scream at my husband. “He’s doing something!” My husband grips my hand, frozen, unsure.
I scream to the nurse, the nice one who had suggested I go home. “What is he doing?” She doesn’t answer me, either. I writhe under the doctor’s grasp. The pain is excruciating.
The first sound I hear is the doctor’s directive to the nurse, in a low voice: “Get me the hook.”
I know the hook is for breaking my water, to speed my delivery by force. I scream, “Get off of me!” He looks up at me, as if annoyed that the specimen is talking. I imagine him thinking of the cadavers he worked on in medical school, how they didn’t scream, how they let him do whatever he wanted.
“You’re not going anywhere,” he says. He breaks my water and leaves. The nurse never looks me in the eye again.
Eleven more futile hours of labor later, I am exhausted and terrified when the doctor comes in and claps his hands together. “Time for a C-section,” he says. I consider not signing the consent form, ripping off these tubes and monitors, and running. But the epidural I’d finally gotten won’t allow me to stand up.
It’s nearly midnight when I hear a cry. My first emotion is surprise; I had almost forgotten I was there to have a baby.
I was desperate to find someone who could tell me what had happened to me was normal. To say, “You hallucinated? Oh, me, too.” Or “My doctor broke my water when I wasn’t looking. Isn’t that the worst?” Nothing …
Now, I’d never loved my doctor … I’d found him patronizing — “Normal!” he’d shout at me, when I asked a question — I thought his assuredness might be a good antidote to my anxiousness. It seemed to work, until it didn’t.
… I also didn’t have a birth plan … Sure, I had a plan for the birth: Have a baby using whatever breathing method I’d learned in the hospital’s birth-preparedness class, maybe get an epidural. But I didn’t have the piece of paper that so many of my friends have brought to the hospital with them … in my opinion, the very act of creating such a contract was to ignore what labor is: something unpredictable that you are in no way qualified to dictate.
… people who hear my story ask … Did I consider a home birth? A midwife instead of an obstetrician? … The answer is no. I am not holistically minded. My philosophy was simple: Everyone I know has been born. It can’t be that complicated.
The women who ask me about my preparations for my first son’s birth — who imply with these questions that I could have prevented what happened to me if I’d been more diligent — are part of an informal movement of women who are trying to “take back” their birth — take it back from the hospital, the insurers and anyone else who thinks he can call the shots.
But hospitals aren’t so interested in giving women back their birth … stipulations dealing with labor and delivery (“I want only one medical professional in the room at a time”) garner barely a glance. University OB/GYN in Provo, Utah, even has a sign that reads, “…we will not participate in: a ‘Birth Contract’, a Doulah [sic] Assisted, or a Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care.”
… This question of whether I could have prevented my trauma has lingered in my mind since that day; now that I am pregnant again, it has become deafening. I have a chance to do it all over. Would I benefit from thinking more holistically? Should I bother taking back my birth?
During my pregnancies, friends gave me two books; their spines are still barely cracked. The first is called “Ina May’s Guide to Childbirth.” … The other book is “Your Best Birth” by Ricki Lake and Abby Epstein; it’s an offshoot of their 2008 documentary, “The Business of Being Born.” Their urgent message is that women who want to deliver vaginally can do so if no one intervenes. Instead, doctors and hospitals are doing all they can to “help” the laboring woman along … and failing. Inductions like mine, epidurals given early in labor, continuous fetal-heart monitoring — all of them have been associated with a higher risk for cesarean section. The result is an epidemic — 32 percent of U.S. births were C-sections at last count, the highest rate in our history. Individual surgeries may be medically necessary, but as a matter of public health, the best outcomes for mothers and babies come with a rate of no more than 15 percent, according to the World Health Organization.
Sam … was five months pregnant when watching “The Business of Being Born” convinced her that hospitals could be dangerous and a home birth would be more meaningful. She and her husband found a midwife … and spent the rest of the pregnancy preparing.
After 24 hours of labor, Sam’s contractions were two or three minutes apart, yet when her midwife examined her, she was only 3 centimeters dilated. The midwife gently told her that she was nowhere close to delivering, despite her contractions, exhaustion and pain. Sam asked to be taken to the hospital.
The change of scenery did her good. “At that point, I had been in labor for 40 hours,” she says. “I entered the relaxed zone. The epidural took the edge off … It was a sacred space.”
After her son’s delivery, Sam passed out, having lost 50 percent of her blood volume in a postpartum hemorrhage. Needless to say, she was relieved that she was in a place where blood transfusions were readily available … she believes she will want midwife care at a hospital next time.
… Bialik’s first birth didn’t go the way she wanted. After three days of labor at home, she stalled at 9 centimeters, one short of the goal. Her midwife suggested they go to the hospital, where after a natural childbirth, Bialik’s son spent four days in the neonatal intensive-care unit. “My son was born with a low temperature and low blood sugar, which isn’t unusual in light of the fact that I had gestational diabetes,” she explains. “I understand doctors need to err on the side of caution, but there was nothing wrong with my child. All of our plans for bed sharing, nursing on demand, bathing him — gone.”
The experience was scarring. “I felt a sense of failure that I had to call my parents from the hospital,” Bialik continues. “Yes, I know vaginal birth in the hospital is the next best thing to a home birth.” …
I point out that natural childbirth in the hospital — her “failure” — was my best-case scenario. But I also understand when she says, “Everyone is allowed her own sense of loss.” She realized her vision when her second son was born at home.
The second time around
I don’t consider myself a candidate for a home birth. The risk of uterine rupture from an attempt at vaginal birth after cesarean (VBAC) makes it unthinkable … I’m also not really interested in a home birth … But I’m also not interested in another C-section …
So I’d like to attempt a VBAC, but I know that it doesn’t always succeed. I have a new doctor — the 10th I interviewed following my son’s birth — at a new hospital, and he has agreed to help me try. But my primary goal is more modest: not to be retraumatized. Even now, my heart pounds at the sight of hospital receiving blankets, the antiseptic smell of the maternity ward.
The common thread in Bialik’s and Sam’s stories that impressed me was how supported and safe they felt with their midwife …
In an e-mail Bialik sends after our meeting, she goes back to my idea that some women weren’t meant to have babies the holistic way. “There are those among us who believe that if the baby can’t survive a home labor, it is OK for it to pass peacefully,” she writes. “I do not subscribe to this, but I know that some feel that … if a baby cannot make it through birth, it is not favored evolutionarily.”
I think about my appendectomy, back in 2003. Had I not made it to the hospital in time, I would be dead. What would it be like to refuse medical intervention? I’d call my family, say my good-byes. “I’m sorry,” I’d say. “But I’m not evolutionarily favored. It’s time for me to go.”
This attitude, that everything was better back when there were no doctors, seems strange to me. C-sections, although certainly done too often, can save lives. Orthodox Jews still say the same prayer after childbirth that those who have been in near-death experiences say — and with good reason. A birth that leaves mother and child healthy may be commonplace, but it’s also a miracle every time.
As the weeks pass and my belly grows, I can’t stop thinking about Sam. Her pregnancy was a sacred time, and she had truly looked forward to labor. Is that what I should try for — a meaningful birth, as well as an untraumatic one? At what point had people like Sam and me learned to feel entitled to a meaningful birth?
“I think that birth should be a beautiful experience,” says obstetrician Kimberly D. Gregory, M.D. She’s the vice chair of women’s health care quality and performance improvement at Cedars-Sinai Medical Center in L.A. “It should be exactly the way you want it, and doctors should intervene only to preserve the health or life of you or your baby.”
Naturally, one would assume that Dr. Gregory advocates birth plans. When I ask her this, she laughs. “We always say, ‘If you show up with a birth plan, just get the C-section room ready,’” she says. “You get everything on that list that you don’t want. It’s like a self-fulfilling prophecy.” Dr. Gregory led an unpublished study that compared women who took traditional hospital birth classes with those who employed Bradley-like training and a birth plan. The birth-plan group trended toward a higher C-section rate and more interventions. “There’s a certain personality type that tends to be more anxious. Maybe the anxiety hormones themselves put them at risk,” Dr. Gregory theorizes. “It seems that being open and honest and choosing the right doctor is probably a better option than writing everything down. Walking in with this list appears to set up an antagonistic relationship.” …
… In the past three weeks, I’ve had the same dream. I’m in a field (I believe at Ina May Gaskin’s Farm), and women in braids are dancing around me as my baby is born, painlessly, joyously. As I reach down, I notice my C-section scar is gone.
I wake up upset. Am I truly under the impression, subconscious though it may be, that taking back this birth will undo the damage of the last one?
“I don’t understand this phrase ‘take back your birth,’” nurse-midwife Pam England, creator of “Birthing From Within,” … tells me. “Who took it? What would a woman tell herself it meant about her if she failed to meet the criteria she made up for ‘taking back’ her birth? I am concerned that this phrase, meant to generate action and a feeling of empowerment, may actually be generated by or feeding the victim part of her.”
England is right: Having a childbirth that I deem successful this time will not change what I haven’t overcome from the first. I try to find a way to make what my doctor and nurses did to me OK, but my mind rebels. I feel loss — no, theft — of an opportunity for me to have a baby the way so many other women do: a carefree pregnancy, a labor that could still go any way.
Maybe I’m not so different from the women I spoke with, after all. Bialik had a successful natural childbirth but felt like a failure because it was in the hospital. Women who had a C-section also used words like failure. Perhaps part of the problem is that our generation of women is so ambitious, so driven, that we don’t know how to do anything without quantifying it as a success or failure.
According to Dr. Gregory, women are now requesting a C-section for their first birth, even without indication. “A lot of people are uncomfortable with the unknown,” she says. Plenty of people are wary of C-sections by choice, from holistic moms to obstetricians. But isn’t this, too, taking back your birth? Refusing to be out of control seems to me the epitome of taking it back. You don’t have to have an unattended birth in the woods to be considered a real woman.
Deciding that you can’t control the uncontrollable — and committing to that decision when you are, in fact, out of control — is also taking back your birth. It’s what your grandmothers did. It’s what their grandmothers did.
With this, I realize that I have already taken back my birth, but not as part of any movement. I have stopped judging women who take extra precautions as defensive and started to understand that everyone has to find her way.
I don’t know how this story ends. I’m still not convinced my body was made to deliver vaginally. But here’s what I do know: I will insist on kindness. I will insist on care. And I hope I will be open to being treated kindly. It’s harder than it seems.
I have another hope, too. I hope there will be a moment when … I will look down at my baby — whether he is handed to me on my belly or from behind a curtain as my body is sewn shut — and I will remember what I’ve known from the beginning, when I looked down at that plus sign and we were alone together for the first time. Before these questions wrapped around my neck, choking me for answers. I will know that I am his mother and he is my son. And maybe, in that moment, I will be ready to say that the only success and failure is the outcome of the birth, that we are healthy …
I’m concerned that birth is defined in terms of success and failure, and that after this author’s journey, she has determined that health is the only important factor. In this day and age, it is entirely possible to have a safe VBAC – a safe birth experience as well as a satisfying one. The vast majority of women who choose VBAC will be successful provided that they choose the right care provider.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: birth, Birth choices, birth debriefing, Birth trauma, Caesarean, Complicated pregnancy or birth, continuity of care, CTG, Epidural, fetal monitoring, Home birth, hospital birth, intervention, midwife, Midwifery, Normal Birth, Obstetrics, Public and private hospitals, VBAC
Posted by Melissa Maimann on Jul 14, 2010 in
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
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Pregnant women who develop gestational diabetes during their first pregnancy are at increased risk for developing this condition in their second or third pregnancies …
… gestational diabetes … affects about 4% of all pregnancies, according to the American Diabetes Association.
In the new study of 65,132 pregnant women, those who had gestational diabetes during their first pregnancy had a 13.2-fold increased risk of developing gestational diabetes in their second pregnancy.
Those who had gestational diabetes in their first pregnancy but not their second had a 6.3-fold increased risk for developing this condition during their third pregnancy, and those women who had gestational diabetes in their first and second pregnancies had close to a 26-fold increased risk for developing gestational diabetes in their third pregnancy, the study showed …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, Preconception care
Posted by Melissa Maimann on Jul 7, 2010 in
Birth,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
A question I have often wondered.
Through my practice, I have a lot of women coming to be because although they have chosen an obstetrician, they really want a natural birth and it has recently occurred to them that their obstetrician will only “deliver” their baby if they’re on their back in bed / do an episiotomy / induce by 41 weeks / insist on continuous monitoring etc, and this is not what they want.
I often ask the question, “What was it that made you decide to have an obstetrician?” or, “What was it that made you decide on this particular obstetrician?”
And the responses are generally very interesting.
• My GP referred me
• My mother / sister / friend / neighbour used this doctor and she said he’s wonderful
• Well, when I got pregnant I went to my GP. She asked me if I have private health insurance and I said yes, so she wrote a referral to Dr XX.
I ask these women if they considered any other options. “What options?” comes the response.
I’m amazed that with the marvels of modern technology, internet etc, that women don’t know they have other options. It seems to be to be an interesting handing-over of responsibility and I’m curious why it happens with pregnancy and birth, but not in any other aspect of life. Do we buy a particular computer – that can’t meet our needs – because it was recommended and we didn’t know there were other computers on the market? Do we buy a large house when we need a small house because it was recommended by the real estate agent?
In most other situations where choices are involved, people will engage in a process of assessing options.
We might list all the possible options and then assess each option across a range of qualities.
We might seek the recommendations (note: plural, not singular) from significant others.
We ask questions.
We consider what it is that we really want, and then match it to what’s available, seeking the most satisfactory choice.
But sadly, this does not happen with pregnancy and birth. Countless women come to see me, having chosen an obstetrician, but really desiring a natural birth that the obstetrician states openly he will not have a part in. There might be a birth centre in their local area, private midwives who could attend them, or even a public hospital caseload midwifery program. Sadly, these options were not explored by the family.
The next question, then, is why, having chosen a care provider who is truly not suited to our needs, do we stay with that care provider?
I always applaud women who make the courageous change. Many women who come to me describing their “predicament” will re-appraise their options and make choices that are aligned to their preferences. Others will remain with their original decision but will ask me to attend them throughout their pregnancy and birth in attempt to act as an intermediary between them and their obstetrician. I don’t consider this to be the most advantageous position, either for the woman, the obstetrician or myself. However, surprisingly, it seems to work well and all the births I have attended in this capacity have occurred on the woman’s terms. I am in awe of those women for having the courage of their convictions to remain with an ill-suited care provider and find the resources that will help them to still have their birth on their terms. They come away elated, feeling they have truly achieved the best of both worlds: an obstetrician they know for if something “goes wrong” and a private midwife who is an expert on natural birth.
Ideally, women will see a midwife for a pre-conception consultation where birth options can be discussed. Some women will ultimately benefit from – or desire – an obstetrician for their pregnancy and birth and this should not be denied to those women. However, a large majority of women simply want a “natural birth” and assistance to avoid tearing and a long labour. They want a healthy baby, a satisfying experience and they really want continuity of care. These women need to know – even before they become pregnant – the options that are open to them. It’s never too early to meet with private midwives and choose the one who is suited to your needs.
Ultimately, if the maternity reforms work to women’s advantage and if obstetricians and midwives are able to put The Birth Wars aside, women ought to be able to have continuity of midwifery and obstetric care: one midwife and one obstetrician who provide the woman’s care so that she benefits from a natural birth expert and an expert in things that “go wrong”. Place of birth could be home, birth centre or hospital and waterbirth would be a supported option.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, continuity of care, midwife, Midwifery, Midwifery services, Obstetrics, Preconception care, Public and private hospitals
Posted by Melissa Maimann on May 31, 2010 in
Birth,
Home birth,
Midwifery,
Normal Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
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Aromatherapy is being offered to women in labour at Southmead Hospital as a natural pain relief … midwives have been trained to mix a range of oils to ease symptoms for women giving birth at the hospital and in their own homes.
The oils … have been found to have therapeutic effects and are used in massage, in a bath or dropped onto a smelling stick.
Bergamot, jasmine, lavender, peppermint, grapefruit, clary sage and frankincense are being used by the midwives to ease symptoms such as nausea and back pain.
… being more relaxed during labour generally helps the birth progress more smoothly.
… a woman who had planned a natural birth and opted for the essential oils could turn to an epidural afterwards should they need it.
… It is hoped that offering women aromatherapy will support the drive from the Department of Health for more women to give birth naturally.
The oils will generally be used in lower risk births … which is generally the criteria for women giving birth in their own homes or in the birth suite at Southmead, which is run by midwives rather than doctors to make it a more relaxed environment.
Previously midwives had only been able to offer women gas and air in their own homes but the aromatherapy provides more options.
Essential oils costs less than 50p per person …
It would be great if this could be implemented across Australian hopsitals – public and private. It seems that the UK has a huge drive at present to increase the rates of normal, natural birth. What is preventing Australia from following suit?
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Home birth, hospital birth, midwife, Midwifery services, Normal Birth, Public and private hospitals
Posted by Melissa Maimann on May 29, 2010 in
Birth,
Caesarean,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
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A recent study showing that the rate of cesarean sections performed at hospitals across … Canada, varied between less than 15% and more than 27% — with only 2% requested by the women — prompted researchers to recommend “revising the current guidelines” on when it is appropriate to perform a c-section … Difficult labor was found to be the most prevalent cause for a c-section …
It will be interesting to read what the new guidelines say. Certainly, some factors promote vaginal birth such as staying at home for as long as possible in labour, planning a homebirth, receiving midwifery care, being well prepared – emotionally, mentally and physically – for birth, reading widely about pregnancy and birth to be well-informed and more comfortable with the process and having the continued support of a midwife who is experienced in supporting women through natural birth.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: birth, Caesarean, Complicated pregnancy or birth, Normal Birth, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on May 28, 2010 in
Birth,
Home birth,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
framework for privately practicing midwives
The Quality and Safety Framework is not out yet in its final version. A final draft has come out and it is now in the hands of the Nursing and Midwifery Board to accept or reject the Framework in whole or in part. I will update this blog once I know more details about the QSF.
Midwifery in the home nsw legal
Yes, midwifery is – and will remain – legal at home.
Private health insurance, private midwifery care, australia
Yes, Private Health Insurance may cover the cost of private midwifery care. Some health funds are more generous in their benefits than other funds so it’s worth doing your homework before becoming pregnant so you can get the cover that’s most advantageous.
Private midwife vs obstetrician
The role of the obstetrician is to provide care for women with complicated pregnancies and births, so they’re called in to manage things that are not seen to be progressing normally. The role of the midwife is to take care of healthy, well pregnant and birthing women (and their babies) and to refer to obstetricians when it’s necessary. Private midwifery care is holistic in nature, so women can expect that their midwife will be interested in getting to know them, they can expect their pregnancy consultations to be very thorough and to last for 1-2 hours. Private midwives attend the whole labour and birth, we do not just attend for the end of birth. Private midwives take on a much lower caseload – you’ll be hard-pressed to find midwives with more than 4 births a month, so we’re more available to our clients.
Water birth experts australia
That would be a midwife! More specifically, a private midwife or birth centre midwife. We regularly attend waterbirths.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: birth, Birth choices, continuity of care, Home birth, hospital birth, Maternity Services Review, midwife, Midwifery, Midwifery services, Normal Birth, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on May 22, 2010 in
Birth,
Home birth,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Exorbitant prices with Sydney obstetricians, alternatives?
There’s a great alternative: private midwifery care. While private midwives may not be cheaper than private obstetricians, the service is experienced by women to be more personalised, thorough, caring and supportive. Consultations are one to two hours in duration, so there’s plenty of time you to get to know your midwife and to talk through all fears and anxieties. All questions are answered thoroughly and there’s time for things like birth planning, childbirth education as well as the clinical things. Of course, if any problems are detected, midwives refer to obstetricians who can provide obstetric care.
How much will it cost me to access a private midwife as my care giver
The fees vary and in Sydney you’d be looking at anywhere between $4000 and $6000.
Refusing to be induced at hospital
All women have the option to accept or decline interventions. The hospital will want to ensure that you understand why they want to induce you, the risks of not inducing, and that you’re accepting responsibility for your decision. You’re perfectly within your rights to refuse interventions and to birth at your chosen birth place with support.
How to have a baby naturally in a hospital
In short, take a private midwife with you! the most important decision you will make in your pregnancy will be choice of care provider. Typically, midwives have lower rates of intervention than do obstetricians. Private midwives have even lower rates of intervention than do hospital-employed midwives. Safety is never compromised.
Home birth fetal auscultation
Yes, this is common-place in homebirths. Your midwife will have with her a doppler which may be used in the water if you are planning a waterbirth. It is common place for midwives to check your baby’s heart rate every 30 minutes in labour and more often if they feel that there is a problem. If your midwife suspects that your baby is distressed, she’ll arrange for you to be transferred to hospital where she will remain with you every step, providing advice, reassurance and support.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: birth, Birth choices, Complicated pregnancy or birth, continuity of care, fetal monitoring, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery services, Normal Birth, Obstetrics, Public and private hospitals, waterbirth
Posted by Melissa Maimann on May 17, 2010 in
Birth,
Home birth,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Can my private midwife go with me to public hospital?
Yes. Private midwives attend women wherever they are giving birth. Many women who seek out the services of a private midwife will be planning a homebirth, but may other women want a private midwife to be by their side in a planned hospital birth. This may be because the woman wishes to have all her pregnancy and postnatal care requirements met by her midwife, with the option of birthing at home or labouring at home as long as possible before heading into hospital. Once in hospital, although the woman will be assigned a hospital midwife, the woman’s private midwife will be by her side providing emotional and physical support, encouragement and most of all continuing the safe and trusting relationship that has been developing over the months.
This is truly a great way of getting continuity of care within the hospital system and maximising the chance of a natural and healthy birth.
Difference between midwife and obstetrician
A midwife is a specialist in normal pregnancy, birth and postnatal. Midwives are qualified and educated to care for women and babies on their own authority while ever women and babies remain healthy and well. the other part of the midwife’s role is to detect complications in the pregnancy and to refer to an obstetrician in a timely manner. Some women will consult with an obstetrician once or twice if there are problems, while other times the obstetrician will continue the care of the woman. Obstetricians are surgical specialists who have degrees in medicine, surgery and obstetrics. While they are certainly qualified to care for healthy pregnant women, their specialty is in pregnancies and births that are complicated. An obstetrician can perform surgery such as a caesarean, and they can perform assisted births such as forceps and vacuums.
Both obstetricians and midwives are essential in our maternity care system.
Average cost parking at hospital
It can be expensive! Some hospitals offer free parking, while other hospitals may be around $30 per day. Remember to carry lots of change with you as some hospital car parks take coins only.
Can you have midwives deliver in private hospitals?
Generally speaking, no. you’ll be admitted under the care of an obstetrician and the midwife who is looking after you in labour will call your obstetrician when your baby is close to being born so that your obstetrician can “deliver” your baby.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Complicated pregnancy or birth, continuity of care, Home birth, hospital birth, midwife, Midwifery, Midwifery services, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on May 11, 2010 in
Birth,
Home birth,
Midwifery,
Normal Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
There is no standard of events for women who give birth at home. Homebirth care is always individualised to the needs of the woman and family.
The following information can help you to understand what may happen in labour, to give you a sense of your options and lessen any surprises. When you birth at home, you can expect to:
- Wear whatever you like in labour
- Have vaginal examinations when / if you want them. Your midwife may suggest an examination if she feels it is needed, which is not very often as we know that babies are born whether vaginal examinations are performed or not and many women prefer to avoid them wherever possible.
- To have your temperature, blood pressure and pulse taken when it is necessary to do so – sometimes this is not done at all
- Have your baby’s heart beat listened to with a hand-held doppler that allows you to remain in the bath or shower.
- If additional fluids are needed, you can expect your midwife to offer you lots of drinks – this will also help to keep up your energy levels. In fact, your midwife will probably offer food and fluids regularly throughout your labour anyway.
- We don’t use ID bands at home. Not for Mum, not for baby. No chance of anyone getting lost, everyone knows who’s who, and no mother is handed the wrong baby!
- Your waters are very unlikely to be broken at home.
- You can expect to give birth in the position that’s most comfortable to you at the time. For many women, this is kneeling (so you can catch your own baby) or all fours (and your partner can catch the baby).
- Waterbirth is a common birth method at home.
- While “pain relief” is not offered, your midwife will make suggestions to assist your level of comfort such as position changes, hot packs, bath, shower, massage and so on.
- You will find that your body will push instinctively when the time’s right.
- Many women will not tear and episiotomy is very rare at home.
- Placentas usually come of their own accord, in their own time provided that the blood loss is not excessive.
- Your baby’s cord will be cut after the placenta is born, and some women prefer to leave it intact and have a lotus birth.
- There is no separation of mother and baby.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: birth, Birth choices, continuity of care, fetal monitoring, Home birth, midwife, Midwifery, Midwifery services, Normal Birth, waterbirth
