Posted by: Crystal | January 11, 2010

Decision Made For A Home Birth

Everyone knows that Mike and I are expecting our third baby this coming April.  With every baby, a family has to make a decision about where to have the birth and with what care givers.  In our case, we have been with The Pearl Place Midwives with the birth of both Henry and Helen.  We’ve had them at St. Joseph’s Hospital in Tacoma, and been very pleased with the level of care that we were provided with.  In Henry’s case, they were very hands off, just letting my body do what God made it to do.  I was very grateful for everyone that helped us to achieve the un-medicated birth that we had planned for.  In Helen’s case, I never went into labor.  Over a weekend, I developed a fever of 103 degrees, and a routine stress test revealed that the baby was non-responsive with a heart rate close to 200 bpm, and that my fluid levels were at a 4 (VERY low).  This made us to make the difficult decision to undergo an emergency cesarean section.  It was a good decision.

In the case of this baby, however, we are running into some big problems.  The midwives, that I love, have birthing privileges at St. Joe’s…a hospital that has jumped on the bandwagon in Washington State and has now banned VBAC (vaginal birth after cesarean) births.  Their reasoning is very simple.  While the risk is very small (especially when compared to other obstetrical complications), the resulting lawsuits that are allowed in this state have made it not worth it for the hospitals to allow.  This is because they do not have the ability to have an OR/emergency room staff “immediately” available vs within the regular 30 minute time frame.  Rather than risk the liability, no matter how faint the possibility, they simply ban VBACs.

This is a horrific problem.

The average cesarean can cost in excess of $30,000.  It is the number one most commonly performed elective surgery in the United States.  The cesarean rate in the US is currently at an embarrassing 32% compared to the recommended 15% (with 10% being closer to ideal), and yet we have the 21st highest infant/maternal morbidity (death) rates in the world.  The system is broken.

A cesarean section can be life-saving.  (This is rarely the case, as even life-threatening conditions are most commonly caused by hospital intervention), but it can’t be argued that a c-section is a wonderful tool when used properly.  I can personally vouch for this, as seen with our experience with Helen’s birth.  So many people have said to me that being in a hospital saved their baby’s life…but they don’t know what to say when I point out to them that their baby’s life would never have been in danger in the first place if X, Y, or Z hadn’t been done to them.

We have amazing technologies in this country, but we overuse them.

When I ask people how much their doctor’s visit cost them, their reply is always “Zero dollars!  Insurance paid it!”  This mind set completely flabbergasts me.  How can we hope to control health care costs in this country if no one even bothers to check how much things cost in the first place?  Trust me friends…you paid for it.  I paid for it.  Americans all over this country are paying for it in the form of outrageous health care premiums.  The current administration thinks that we need a public option to fix this.  Nonsense!  We need patient accountability.  If more people started finding out what a procedure cost, and then either refusing it or going elsewhere if it was too much, we would see health care costs come down in this country.  And while we are at it, how about we become educated about our own health care?  Should we simply accept everything like little babies that can’t possibly think for ourselves?  I appreciate the vast amount of knowledge/experience that my care giver provides.  However, what they say is not going to become my gospel truth.  I use them as a way to educate myself and then make my own informed decisions.

Which brings me back to the subject.  How can I believe so passionately about the sad state of affairs this country is in regarding health care, and yet then blindly subject myself to that broken system?  Should I simply schedule another cesarean, despite the fact that it is neither the safest nor most cost-effective option?  Should I allow my body to be subjected to what amounts to assault simply because I have no other option?  Should I subject myself voluntarily to a procedure that is so painful and invasive because a paper-pusher somewhere says that I have to?

No matter how many times I go around and around about this, the answer is always the same…NO.

So I have educated myself.  I have used the many resources at my disposal…obstetricians, midwives, the internet, books, personal accounts and birth stories.  I’ve taken all of this (sometimes conflicting) information and I’ve used the brain that God gave me to make an informed decision.  (BTW – if someone makes a different decision, but does so in an informed manner, I totally respect that!)  The conclusion that I’ve come to is that the only way to have the chance to achieve the birth I want (Remember that they are all different, and things do occasionally happen that are unforeseen) is to plan to have a midwife-attended home birth.

Phew!

Making a decision is like having a huge weight lifted!

But wait…insurance companies don’t insure midwives to attend home birth VBACs for the same reason that the hospitals are so afraid.  Legal retribution.  Thankfully, the midwife community is trying to fight these absurd  rules and regulations, and after many many phone calls with almost as many dead ends, I have finally found a group of midwives that are willing to interview me to determine whether I would be a good candidate for a home birth.  I will share more about this after I speak with them.

I have some hurdles to jump through first, so while I’ve made the decision, something might still prevent me from it.  But at least I’m trying.  Maybe I’m just one person that is fed up with being treated like a mindless animal by the health care community, but at least I can rest my head at night knowing that I am doing what small things are within my power to stand up and say to whomever will listen that this is wrong.

More to come later about this, but I encourage anyone that wants to debate this decision to attempt to become educated about the facts before launching out from an emotional viewpoint.  Maybe we will still come to different opinions, but we will both be able to say that we are informed decision-makers.  Now let’s change America!

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