What helped you over the mental hurdle...

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krazykat's picture
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What helped you over the mental hurdle...

to home-birth or HBAC?

I am definitely interested, but I am stuck. I am having trouble crossing over the "what if something goes really wrong; especially since I am a VBAC mom" mental block. I REALLY think I would be more comfortable at home. When I compare the hospital vs home environment in my mind, home wins hands down. But the numbers are just getting to me. I know the risk is very very small, but it is there and I am having trouble truly working through that. I know that the hospital has risks in and of itself. It is just hard re-programming this whole mind-set of "hospital = safe" that I have had for my entire life, mostly b/c my mom is an L&D nurse and has a PhD in pediatric nursing. She is obviously medically minded and against HBAC... and some of her points are truly valid. BUT I KNOW I would be more comfortable at home, which would probably ensure easier progression of labor.

I feel like when the student is ready the teacher will appear, so I am not very worried about finding a MW to attend an HBAC. I think that when I decide that I am truly ready, then the situation will present itself.

I appreciate ANYTHING you ladies have to add Wink

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I choose to homebirth because I know that when something goes wrong, it almost always goes wrong slowly with plenty of indication that things are headed down the wrong path. Because my midwives are trained to identify these indicators. Because it takes most hospitals 30 minutes to prep the OR for a c section and that is plenty of time for us to get to the hospital (with a phone ahead from my midwife).

I think that if I was planning an HBAC I would definitely be more nervous. I would want to talk to a midwife who was experienced in HBAC births for reassurance.

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I'm not a VBAC momma, but I know the biggest help for me with going with a natural birth (and this time, going with a home birth) is hearing success stories. Like this one: (also a VBAC momma, she used to be on here, not sure if she still is) http://thecaldwell5.blogspot.com/2010/02/our-eden.html . Man I read that and I wanted to get pregnant and have a baby at home right then and there!
I'm lucky, I have two older sisters who have had wonderful natural births and they convinced me this was something I could do. But now I'm taking it a step further with a homebirth and it's kind of fun to be the trailblazer ya know? BUt it does mean that I have to look for good homebirth role models elsewhere.

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"jooniper" wrote:

I'm not a VBAC momma, but I know the biggest help for me with going with a natural birth (and this time, going with a home birth) is hearing success stories. Like this one: (also a VBAC momma, she used to be on here, not sure if she still is) http://thecaldwell5.blogspot.com/2010/02/our-eden.html . Man I read that and I wanted to get pregnant and have a baby at home right then and there!
I'm lucky, I have two older sisters who have had wonderful natural births and they convinced me this was something I could do. But now I'm taking it a step further with a homebirth and it's kind of fun to be the trailblazer ya know? BUt it does mean that I have to look for good homebirth role models elsewhere.

Oh myyyyy, that was a beautiful story. TFS! I read birth stories ALL DAY sometimes... I think I'm obsessed!! I LOVE them and they truly are a source of inspiration and encouragement for me.

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Mine was four part in helping me.

First was that I was not happy with the mw at our local hospital and wanted to search somewhere else. Well my only other option is the city 45 minutes away. I decided I would rather have someone drive that distance to me in labor than vica verca.

Second was meeting with my mw and talking to her about all of my concerns. I had a list of what ifs and she talked me through what happens in all of those, and how I would be safe. She also talked to me about all she can and has to do, this really helped.

Third was reading tons of positive articles on hb. There are some really good studies out there about the safety of hb. Also what arty mentioned about the time frame for a c/s helped and knowing the hospital is literally right around the corner.

Fourth is a personal one. I have generalized anxiety disorder and hospitals and needles and all things medical tend to make me panic. I was worried that if I went with a hospital birth my anxiety would go up, which is not good for me or the baby. Also for me hoem is my safe place and deep in my heart I just knew that is where I wanted to be.

This was all with my first. After having one hb it was not even an option for me to have this one any other way. In fact my biggest birth fear is getting opted out of my hb.

kvo
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I am not giving birth at home (way too small, crowded, too many animals). If my home were bigger and more accommodating, I would hire a MW who had also delivered at a hospital where I was comfortable and one that my insurance covered in-network. I would take a tour of the hospital so that I would know what to expect if I needed to be transferred there. I would ask to meet the OB that worked with the MW in cases where c-section was required.

For me feeling like I know what to expect in all scenarios really help alleviate fears. HTH and good luck with your HBAC.

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I planned a homebirth both times but the first ended in a c/s. My sister was born at home and it is one of my first memories. To me it just felt right and natural. Honestly I hadn't really thought of the risks until my third trimester when a lady on this board or the hb board lost her baby and was dealing with some negative attitudes because she homebirthed. I had a long talk with my mom and dh about the risks then. I had done my research about hb and we basically talked about it again and I realized again that hb was just as safe, I was close to the hospital if needed and I had chosen competent midwives. But I also knew that if something happened I didn't have the easy way out of blaming the doctor or hospital. I had to know that if something happened that it was most likely going to happen in a hospital or at home. For my hbac, I was a bit more scared but I knew the right place was at home. I knew that for the birth I wanted it needed to be at home. I was a bit nervous because the risks are higher but I was confident that I could birth a baby and I had an excellent support system. There was a point in my labour that was exactly like my first birth and I was terrified but I had my SIL who had had a vbac that helped me through it.

IDK - I think for me it was my support team and they really believed in my and what I was doing. And dh and I talked and we agreed at the slightest indication of something going wrong we go in.

Good luck!

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A couple of really great homebirth story collections are "Adventures in Natural Childbirth" edited by Janet Schwegel and "Baby Catcher" by Peggy Vincent.

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"MamaArty_RMT" wrote:

A couple of really great homebirth story collections are "Adventures in Natural Childbirth" edited by Janet Schwegel and "Baby Catcher" by Peggy Vincent.

While I loved Baby Catcher, it has a LOT of emergency/transferred to hospital stories... I actually found myself less optimistic about homebirth after reading it, though it DOES show that a good midwife can get you to the hospital in time.

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As of right now I am still planning to HBA2C this fall. I don't know that I've truly gotten over the mental "what if's" game I've been playing with myself. I've been reading, reading and reading. I ordered a bunch of books about the maternity system in general and how destroyed it is and I also ordered some from Ina Mae Gaskin about natural birth. I've also become a birth story addict Smile If I come across something that I think really helps me I will PM it to you!

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This is my third birth and we are having a HBAC. My first (planned natural hospital birth) ended in a C/S, my second was a hospital VBAC and this is a planned HBAC. I am almost 32 weeks along now and have had another healthy, uneventful pregnancy.

For us the decision was easy. I feel confident of my inability to have the sort of VBAC that I want in a hospital setting. Around me they are allowed, but there are a ton of "rules" in place surrounding post dates, constant FEM (and my hospital did not have telemetry units, so I was stuck in bed) and no options to waterbirth or even labor in the shower or tub.

I felt blessed in that we have a great midwife who is passionate about HBACS and very experienced in them, and who lives only 10 miles from me. We also live only 1.5 miles from a hospital, a stat that brings me comfort in the unlikely scenario in which some sort of emergency came up. Having a VBAC under my belt is also a great comfort to me ~ I have faith in my bodies ability to birth vaginally as I did two years ago.

Honestly while I know that there is a very slightly elevated risk for HBAC Mama's , to me they feel WAY offset by the hugely elevated risk of another birth gone awry as my first birth did due to hospital procedure and restrictions.

Congrats on your pregnancy and good luck with whatever you decide! If you want more info feel free to PM me.

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"momW" wrote:

As of right now I am still planning to HBA2C this fall. I don't know that I've truly gotten over the mental "what if's" game I've been playing with myself. I've been reading, reading and reading. I ordered a bunch of books about the maternity system in general and how destroyed it is and I also ordered some from Ina Mae Gaskin about natural birth. I've also become a birth story addict Smile If I come across something that I think really helps me I will PM it to you!

Share with us all if you can--good birth stories are so helpful!!

I've started reading Sarah Buckley's Gentle Birth, Gentle Mothering and it is AWESOME AWESOME AWESOME. Foreword by Ina May Gaskin Smile

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The disclaimer to my post is that I'm not a VBAC mom, and haven't done much reading or research in regards to VBAC/HBAC risks and whatnot.

Getting over that mental hurdle, for us (DH and I) was mostly a statistical thing. I kept looking for facts and kept coming up with the same result: for low-risk moms and babies, with uncomplicated pregnancies, homebirth with a skilled midwife is as safe as, or safer than, a hospital birth. Period. End of story. That was it for us. Studies with thousands of moms in home vs. hospital have proven this.

Something else that really motivated me is that I knew that the moment I walked into a hospital to give birth (emergency or not), my risk of a c-section goes up drastically. I am terrified of the thought of a c-section and choosing a homebirth is my biggest way of avoiding a preventable c-section.

And all the scary what ifs in terms of a baby emergency - well I know that the risk level of many of those complications can be significantly decreased by staying out of the hospital in the first place.

DH and I, not that many years ago, were firm believers that homebirths were irresponsible and dangerous. We have done a full 180 from that point of view. So it really was a big hurdle for us. It is amazing what can happen when you educate yourself!

If I had the VBAC issue to consider, I can't honestly say what I would choose. My HBMW has done many HBACs. I would have to do a considerable amount of research to fully understand the risks and make a decision.

(Sorry this is so disjointed. It's late and I should be in bed ;))

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"Panonim" wrote:

Something else that really motivated me is that I knew that the moment I walked into a hospital to give birth (emergency or not), my risk of a c-section goes up drastically. I am terrified of the thought of a c-section and choosing a homebirth is my biggest way of avoiding a preventable c-section.

And all the scary what ifs in terms of a baby emergency - well I know that the risk level of many of those complications can be significantly decreased by staying out of the hospital in the first place.

See, this is exactly where I am at right now. I wish I could get an un-biased answer to one question: Are there more risks associated with a repeat c/s, or more risks associated with an HBAC? I also am TERRIFIED of a c/s even though I already have had one. I seriously think I would have a panic attack if they wheeled me into another operating room, which would mean I would have to go under general again, and that is the last thing on earth that I want to ever experience again.

DH and I were also against HB (well, I don't know if we were against, but it was just a non-issue; something we never considered). We weren't even that into the natural approach until recently. Education does work wonders. And we only really seriously began to consider HBAC when we began to see that support for VBACs just isn't there... even though the research clearly indicates they are safer for mom and baby than a repeat c/s. And there are OBs out there that support VBAC on paper, but when it comes down to it, they really aren't supportive. I feel like if I go to the hospital, I might as well put myself on the calendar for a repeat c/s.

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"krazykat" wrote:

See, this is exactly where I am at right now. I wish I could get an un-biased answer to one question: Are there more risks associated with a repeat c/s, or more risks associated with an HBAC? I also am TERRIFIED of a c/s even though I already have had one. I seriously think I would have a panic attack if they wheeled me into another operating room, which would mean I would have to go under general again, and that is the last thing on earth that I want to ever experience again.

I'm not terrified of a CS ~ The only thing that would truly terrify me in childbirth would be losing a baby, but I am PASSIONATE about giving myself the best chance possible to have the safest and most respectful birth with the least amount of interventions possible ~ for that, I personally believe that I am best suited to plan to birth at home. That said, if an emergent situation comes up and a CS Is the only way to safely deliver my baby, I will be forever grateful for the ability to get to a hospital and have a CS.

Here is a link and site which may help you some ~ there are lots of links to stats on this site.

http://vbacfacts.com/2008/09/06/homebirth-vs-hospital-birth-for-the-number-cruncher/

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"krazykat" wrote:

See, this is exactly where I am at right now. I wish I could get an un-biased answer to one question: Are there more risks associated with a repeat c/s, or more risks associated with an HBAC?

Okay, think of it like this....the risks are not really comparable for a VBAC (whether at home or in the hospital) vs a c-section. A repeat c-section comes with one set of risks that are more towards affecting the mother and future pregnancies. A VBAC presents risks for the baby. That is the gist of it actually. Now, with a homebirth, your risks aren't really any different than any other woman homebirthing. The risk of a rupture, which is probably the only thing about a VBAC that makes it scary, is at the highest estimate 1%.

Attached is a very good study summary. Now, I don't normally recommend reading summaries because you lack the chance to see the guts of a study and decide how well it was done for yourself. But this is the only way to see this one without paying for it, so it will have to do. http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937808010995.main-abr.pdf?jid=ymob

I don't remember if you said you had already read the NIH statement from their VBAC conference recently, but here is a link. Question #3 "What are the short- and long-term benefits and harms to the mother of attempting trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms?"
http://consensus.nih.gov/2010/vbacstatement.htm

For me, it's not so much knowing the risks of a RCS vs a HBAC, it's more knowing the risks of a RCS vs a VBAC in general. Then take what you know to be true about the safety of homebirths and apply it. Ask your m/w questions about how she knows when there's a problem. Does she do anything differently for VBAC moms, like extra monitoring? Does she know what problems to look for that represent a possible UR? Is she going to be able to talk you down when you start stressing about the scar giving way in the middle of labor? (I've heard this is a normal fear for VBAC moms in the pangs of labor)

And one last thing to consider is that you won't be in a hospital where there is always that risk for unnecessary intervention that leads to RCS, but you will have a hospital transfer as an option. From where you will be delivering at home to the hospital what is the transport time?

Here's a study related to maternal and neonatal mortality related to UR. Keep in mind that this particular study does not differentiate between UR and scar dehiscence and there's a BIG difference so I would say their true UR rates are inflated because of them keeping dehiscence in there but it's still a good study. http://www.ajog.org/article/S0002-9378%2801%2970170-6/abstract