New Beginnings Doula Training

New Beginnings Doula Training
Courses for doulas and online childbirth education

Monday, October 24, 2011

Birth Center visit and stats-we need more mother centered care

I went to meet with a local birth center here in town to try and set up a connection that I can hopefully use for training and volunteer work at.  It was interesting to see this place.  I had actually given birth with this same group almost 11 years ago, but it was at a different location and different set of midwifes, so it was fun to see how it had grown.

The first thing I noticed when I walked into their birth rooms was the complete lack of technology.  It's there, you just can't see it.  It was obviously centered on the work that the mother would be doing, not the medical staff.  And after working in the hospital for 5 years, it was like a breathe of fresh air.  Really, I think I would cry about it if I was in the mood.  To me, this was what birth should be.  It's not really about whether or not we want pain control, or the efm, or the birth's about creating a space for women to birth that was theirs.  I know this is the whole philosophy behind homebirth, but for women who don't want to do that(I myself prefer to know that my care provider can have a c-section room ready to go in 5 min without fighting the system), this is the perfect place that can provide that care.  I really wish we could have this in hospitals too.

For those nurses or women who don't get the difference, you need to experience it to see.  Very different.  In the hospital, you are never on the women's turf...can we change that?  I would like to try.  Because for women who want epidurals or need more interventions, they deserve to have their own space too.

Some interesting stats...the birth center transfers about 50% of the women who want to birth there to the hospital before labor even starts.  This includes women who have twins, are a vbac, and have other medical issues.  Those I kind of get, but the one stipulation that bothered me was the time constraint of 41 weeks. It's something that I need to do some more research on my own, but from what I have seen, I am becoming convinced that a late a baby is either one of two things...natrually late and totally fine, or IUGR and needs to be out sooner.  When I get back into school, this is going to be my thesis:)

OK, so past that stat, they transfer about 30% in labor.  Usually for maternal fatigue or mother is requesting an epidural.  Cool.  No time limits on how long labor can be either(yea!).  And their c-section rate is 13%.


kami said...

I am surprised their stats are so much different than home birth. My home birth midwife's stats are something like a 2% c-section rate and 5% transfer rate (usually for pain relief). Another local home birth midwife is similar...3.5% c-section rate and a similar transfer rate. I wonder what makes theirs higher? I like that the technology can't be seen.

I'm interested in the 41 week rule as well, considering I'm approaching 42 weeks as we speak (and going crazy). Pretty sure my due date is wrong (we have another one to go off of...Nov 4th) and baby is fine but it's hard to know when to intervene. I don't want to cause unnecessary problems through intervention but I also don't want to go too long either.

Rachel said...

I think part of the difference is that women who do homebirths are way committed to not transferring. Birth centers are similar, but women have given themselves the option of being able to transfer. In other words, I think the transfer rate has more to do with the mindset of those who choose these options.

For instance women who chose to birth in the hospital but want to try to go natural, probably get epidurals 80% of the time. Some of this is due to the way physiological birth is not supported, but some of it is their own mindset, they were not committed.

I'm not too freaked out by overdue babies, but I do like to get NST's and biophysical profiles. There is an increase in problems after 42 weeks, but it's about the same as at 37 weeks, and like I said, I think(just by looking at the data) that these are babies that are have not been getting the nourishment from the placenta all along. That's just my own hypothesis though.

Birth is a Journey: Does it have to be life changing?

  • One woman might have to climb on an overfilled boat, risking her life and nearly dying as she escapes over the ocean to come to this land. This experience could certainly be life altering. It may very well color the rest of her life, positively or negatively. (I overcame this amazing struggle and here I am triumphant! OR Holy crap, that was SO hard I don’t know if I can go on! By the way, neither response is “right”. No one would judge the woman with the 2nd response.)
  • One woman may buy an airplane ticket, sit on a comfortable 747 and fly to America with a nice smooth flight and landing. She is happy to be in America. Those welcoming her are glad she is here safe and sound. She may only travel by plane 2-4 times in her life, so it is pretty memorable. But the journey itself probably wouldn’t be life changing; it would simply be a journey.
  • One woman may learn to fly an ultra-light plane to lead a flock of geese into America teaching them to migrate. This experience could certainly be empowering and life altering.