After thirteen years as a labor/delivery nurse, three cesarean sections and 17 years of teaching Lamaze, I saw birth from a new and holistic perspective when I attended home births. I observed the natural positions women assumed throughout labor. I increased my knowledge of comfort measures and realized the value of adequate nourishment. I also became aware of the spiritual nature of labor and birth.
Sometimes the laboring woman’s husband prayed for her during labor. Sometimes I was asked to pray. It was a blessing to feel pray to ask for God’s help.
When I returned to the hospital setting, I found myself between two philosophies of birth. Women in labor need to be nourished and well hydrated. Recently a young woman came to the hospital with a birth plan. We provided the environment for her to walk and change position, as she desired. I monitored the baby intermittently. Hydration presented a problem.
She did not want intravenous fluid unless necessary. The doctor okayed a saline lock (meaning the intravenous catheter was in place but was not attached to intravenous fluid). I encouraged her to drink clear fluids– we had apple juice available. In the home setting fruit juices, raspberry leaf tea, soups, broth and fresh fruit provided fluids and energy.
The doctor informed me (at the patient’s bedside) that the anesthesia department determines oral fluids and allows only ice chips. The doctor listened to my argument, but the issue was unresolved. Now the patient was reluctant to drink as much fluid as I thought necessary.
How do I do the best thing for the patient? As I discussed hydration with my patient she agreed to intravenous fluids. Her labor progressed well.
Almost all hospital practitioners have never seen labor and birth take place without medical interventions. A very interesting article on this subject has been posted at Science and Sensibility. Click here.
In the home setting, the laboring woman has more control. It is her environment and the attendants are guests. The problem with home birth in the United States is that we do not have a good bridge from home to hospital if a transfer is necessary. Distrust and animosity that often exists between home birth providers and hospital staff. They have different perspectives and ways of interacting with the laboring woman.
When a woman has complications that require transfer to the hospital, good communication between home and hospital is needed for a smooth process. Often the open communication does not exist. Transfer needs to take place at the right time, but it might be delayed if a good plan with a local hospital is not in place.
When a mom desires a homebirth, she should ask the provider a lot of questions. At what point in labor will the midwife/doctor arrive to provide care? Will she/he have an assistant, trained in infant resuscitation? What is the plan if complications occur?
The home birth staff provide medical supplies and a list of items needed for the birth. The mom should plan to have friends or family available to provide meals, fluids, emotional support, laundry needs and etc. A doula can be a great help.
A doctor speaks about her experience as a midwife and her view of home birth here.