Monday, November 09, 2009

Inquisition Monday: Birth Plans

Brittney asked, "I have a question for next week: With all you know about birth, and with doing an unassisted birth, what is your plan for the next baby? Do you think you will have someone around to do some "after-care" or more support/pictures during the birth?"

This entirely depends on where we're living and how pro-active I feel at the time. Right now, the basket that holds all our eggs is the "McKay will get a job after graduating in April and we'll move in May/June" basket. Unless we have a micropremie in the next 6 months, it's highly unlikely we'll have another baby while in Utah. And of course, if we were in a premie situation, we wouldn't UC.

I originally thought we might ask a midwife if we could pay a small fee just for being "on call" for things like stitches around the time of the birth: no prenatal care or extra postnatal care. I know of a couple midwives here in Utah Valley that I could discuss that with, but if we're not going to be in Utah Valley, I guess that doesn't matter. Would I be able to find UC-friendly midwives? Possibly.

Last year when I read Rixa Freeze's PhD dissertation, Born Free: Unassisted Childbirth in North America, I became a little more aware of the plight of the midwives. I hadn''t realized that midwives and UCers could be at odds with each other. Many UCers would love a la carte care like I described: stitches, or just an ultrasound, or just rhogram, etc., but many midwives find a request like that to be contrary to what they want to accomplish as midwives: the development of a trusting relationship. Asking for a la carte care isn't particularly relationship-building. I had never considered that side, but it could definitely affect the ability to find a UC-friendly midwife in the future.

However, the place we'd like to move is very very crunchy. Midwives left and right. Would I be able to get a la carte care? It's possible. So I might look for a UC-friendly midwife next time, or I might not. We were very close to not having a waterbirth last time because I didn't really feel like going and finding a tub. We did get one "just in case," but I didn't think we'd actually use it, and we probably wouldn't have if the labor had been less than 12 hours. Would I be just as "on the ball" with finding a midwife? I don't know.

I don't think I'd hire a photographer unless I felt very comfortable with them. I really want to limit the number of people there. Our laptop has a time lapse video feature though, and I thought that would be fun. Maybe we'll do that.

Aubrey asked, After you had a home birth...what do you do with the water in the birthing pool? Where it is in the middle of your living room, how and where do you drain it? Is it safe (legal?) to drain in outside, with it being a bio-hazard?

McKay did an amazing clean-up job. There wasn't a lot in the tub: a little bit of mucous plug and blood. I think we flushed the plug in the toilet. As for the water, during the birth we heated water on the stove in a large stock pot. That stock pot was re-assigned to water removal and McKay took the water out of the birth tub potful by potful and dumped it in the bath tub to drain out. It was tiring for him, but I think it was therapeutic for him to process the long labor and resultant baby. We might considering making a siphoning system next time, but that depends on if I get "on the ball" again and get a pool next time.

Because we live halfway under the ground on the bottom floor of our complex, carrying a tub full of water outside and up the stairs wouldn't have been very feasible for us. If we owned our own house and the ground is level with the birthing place, we might have just dumped it outside.

I think you risk bio-hazard issues only when you throw things away. You shouldn't throw human waste in the dumpster (even inside diapers) because of the possibility of a sanitation worker handling it. I'm pretty sure human organs (including placentas) are included in that. However, I know many people who have buried their placentas in their yard under a tree or bush. Since it's ok to do that, I'm sure dumping some diluted blood (it looks like more than it really is) on your lawn is fine. It's only an issue if it's thrown away and handled by other people.

Thanks for the questions! Heatherlady, I'll answer yours next week!

11 comments:

  1. With my water birth, we had a hose that went from the birth tub to the toilet and when my midwives cleaned up(it was nice to have other people take care of that) it just continually flushed down the toilet till it was all gone. Then we had a liner that was int he tunb that was just balled up and put in the dumpster.

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  2. I used a smaller bucket to remove the water. The stock pot would have been too heavy full of water.

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  3. Wait a minute, are you saying you are not planning on receiving pre-natal care?

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  4. Sorry I got that wrong, McKay. Thanks for doing the clean up!

    Elita- I do my own prenatal care. I'll regularly check things like the heartbeat, my blood pressure, weight (if I get access to a scale). I also check for protein and glucose in my urine as I get closer to my due date.During my pregnancy with Margaret, when there were problems I first tried to change my diet and I would re-test a few days later. For me, diet fixed everything I came across (glucose, protein, even a UTI). If there had been a persistent problem, I would have sought more help.

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  5. Very interesting post.
    I can only imagine UC next time though I have pondered having a mw on call. Saying that, we wont have that option in Australia it seems after next year.

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  6. Those complaints from the midwives sound a lot like the comaplaints OB's make concerning transfers - that they inherit someone else's problem, etc.

    Both midwives and obs should be willing to meet with a woman once and then let her decide on her own care, and if it turns out a midwife is needed, or a transfer is required, the correct response is to simply help. No one gets mad at the heart attack victim for not planning their attack in advance, or the person who comes in with a toothache for not checking in every month. But when something such as sacred and important as a birth takes a turn for the worse, there is anger and resentment from the person who should instead be calm and healing.

    We don't have to know someone to treat them with gentleness and professionalism.

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  7. Wouldn't it be great to have the midwife available, but not actually there?

    So where is this very very crunchy place you want to move to? I live in a crunchy-town (Portland, OR), and I love it.

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  8. I was fortunate to find a midwife who was supportive of my plans to UC and was willing to show up after the birth if wanted/needed or for any desired tests during pregnancy. Because of the trust relationship, I had to compromise a little bit in order for she and I to work together. I ended up seeing her for more prenatal appointments than I had originally planned. I felt it was necessary to have the type of supported I felt was important. The relationship we developed was a very nice one to where I genuinely wanted to call her after the baby was born and was glad for her visit. I tell you all of that because you might find that you need to strike a balance in a way like that for a midwife to be willing to work with you.

    On the birth clean-up, my husband said it was a disgusting experience. We had attempted a siphon system but it didn't work how he had intended. He really did not like that part of the experience and for that I'm sad for him but grateful he dealt with it.

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  9. I was very grateful to my mum for cleaning up after my home birth. We didn't have the problem of emptying a pool, but there were a lot of bloodstained towels and sheets (more than I realised). She took everything away in a black bin liner and brought it back 24 hours later, clean and dry. Thank god for tumble dryers.

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  10. We used this siphon system with a hose just long enough to reach to the kitchen sink. It's for aquariums, so you can find them at pet stores. It was a little leaky, but only at the sink end, so it leaked into the sink. It came in handy for pulling out some of the cold water so we could add hot water back in as the pool cooled. I didn't end up birthing in the pool, just laboring there, so it was just water that we had to siphon out, but I think it would have worked fine regardless. We also bought a little fish scoop net that we never got to use, in case we had to swipe out anything solid.

    I love the time lapse idea. We got so into the labor and then kind of discouraged by the length of it (42 hrs) that we ended up not taking many pictures during. It somehow felt like we would be jinxing it, as strange as that sounds now. We didn't do UC, so our midwives snapped off a bunch at the end, and even some video, so that was helpful. I think next time I would keep the cameras accessible and try to remember to take more throughout.

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  11. I have had 5 kids, 4 homebirths, and 2 uc's (my 2nd and 4th homebirths). I don't think I'll have another though.

    On the midwife issue I do know some midwives who are supportive of uc and some aren't. The reasons vary from believing that homebirths are safer with midwives to the liability concerns. That seems to be the biggest issue with midwives I know and as a student midwife and supporter of uc it's something I have thought of as well. If I support a woman in various ways or contractually agree to possibly support a woman - where is my responsibility and what am I liable for?

    We've always used a pump to get the water out of our birth pools. This last time we didn't have a pump so we used one of those siphon things for aquariums you attach to a hose. All the water went down the sink. Previously using the pump we drained it out into the toilet. Worked a lot better and used much less water since the siphon also drained our sink water. It's probably better to drain into a toilet anyway since that's where human waste is supposed to go!

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