The Business of Birth #2 - Hospital VS Home

Hospital vs Home?! What are you talking about?! Everyone knows that babies need to be born in hospital! Right? No. Not right. Although my parents generation seem to think that a baby that is planned to be born anywhere OTHER than a hospital is complete insanity!

But is it that insane? How is the hospital that much better (in cases that are NOT high risk)? Everything has a place, and a hospital is a place for "sick" or otherwise non-healthy people/babies. BUT, if you've had a completely normal pregnancy, with all normal results, and are "low-risk", they why do you have to be at a hospital? Why not be at home? In your own space, where you can be more comfortable... you have your own food (anyone who's ever spent any amount of time in the hospital can really appreciate having their own food!).

I've personally had 3 hospital births, and for my forth, I'm planning a home birth. It had never occurred to me to deliver at home before... but then I didn't have a midwife for my first 3 children either. I've done quite a bit of research about home births before making my decision. I like lists... so I've made a pro's and con's list of each option. Here's my list!

Hospital

Pro's

• IF anything should go wrong, you're right there and don't need to be transferred (except to another room)
• IF surgery is required, again, you're already there and only have to wait for a room.
• IF you need pain medication, they have it on hand (and in my opinion offer the pain meds WAY too often, even when you specifically inform them that you don't want any)
• The nurses are only a button push away if you have any questions after your baby is born (however, this is only good IF you have good nurses... otherwise it's of no good use)

Con's

• Not your own space, and you can feel uncomfortable and uneasy in the medical setting, which is not conducive to being relaxed and allowing your body to "do its thing".
• They tend to push pain meds that can lead you down a difficult road filled with interventions and ending in a cesarean section.
• They often try to rush things (this is dependent on the dr however, some are fine with taking the time needed)
• You probably won't get YOUR dr... and will have a complete stranger that you've never even met deliver your baby.
• Worse yet, the dr may be busy in surgery and not make it to your delivery (happened to me with my second - and the nurse who was delivering him had never delivered a baby before, and he wasn't breathing... so they had the resident dr's come in to help), so then you are in the hands of someone who not only do you not know, but they also aren't qualified.  
• They like to keep you on a time limit - one that's not always necessary.
• You often aren't allowed to eat - if you're having a longer labour you're going to need food to have enough energy to push that baby out - otherwise you might need the help of a vacuum or forceps during delivery.
• When you do get food, it's hospital food... gross. And they may not have anything you like. Also, what about your partner? What are they going to eat? Junk from the cafeteria? and how much is that going to cost?
• While speaking of costs, what about the cost of parking? ($16 for anything over 30 mins at our hospital)
• And cost of a private room? or will you settle for semi-private, or a ward?
• Breastfeeding isn't always supported by ALL nurses, and if looking for breastfeeding help, you will almost never get consistent answers. They also only help on their time schedule, not necessarily when the baby is wanting to nurse. These can cause all sorts of difficulties at the beginning.
• Lack of space in the delivery and  postpartum rooms, makes it difficult for support people or visitors.
• If you have older children, they are displaced for a few days while you're in the hospital. 

Home

Pro's

• In your own space, comfortable, familiar and everything that's YOUR'S is at your disposal.
• If you want to eat... you have everything you like right there.
• You don't have to worry about when you should go into the hospital, and if they will turn you away because you aren't "progressing enough" for them. 
• You can walk freely from room to room for a change of scenery without worrying if some stranger will see you half in the nude (I hate those hospital gowns!)
• Your support person will feel far more comfortable in their/your home.
• If you have other children, they can stay in the house... and their routines/lives won't be disrupted because of the new baby. I think it will make for a far better introduction to their new little sibling if they don't feel like they've been shipped off because of the baby's arrival.  
• You have the option of having a bath/shower whenever you like, for however long you like. (There were restrictions at the hospital I was at, and there were only 2 showers, no tubs, and it was way down the hall in a corner).
• Your doula/midwife have excellent options for pain management that are easier to administer without the interference of medical equipment (I find in the tiny hospital rooms you tend to be tripping over all of their equipment).
• You have a choice on what position you birth your baby. You don't have to be splayed out on your back working against gravity.
• Once your baby is born the midwife places your baby on you for skin to skin contact, that helps to calm your baby, pink them up, and it's a great start to your bond as Mommy and Baby.
• Midwives also usually let the cord pulse for longer than they do at hospitals, ensuring that your baby gets all the benefits from the umbilical cord.
• Your baby stays with you... the ENTIRE time... unless there is an emergency of some sort.
• After the birth, you get to stay/sleep in your own bed. This is a BIG DEAL. Hospital beds suck.
• Also, you don't have to be transferred to another room (love those trips through the hospital, just after birth, looking a little dazed as strangers stare at you).
• The midwife and/or your doula can and will stay with you for the first few hours afterwards. Then they go away and let you rest. And let you bond with your new little one without the constant interruptions of vitals, vitals again, questions, vitals... ect.
• You have a private room. FOR FREE. That's huge... with my last I was in a ward with 3 other women. Sleep didn't come easy... or at all for that matter.

Con's

• If you need a c-section, then you have to be ready to be transferred to the nearest hospital. Keep in mind that if you were already at the hospital, you would still have an average wait time of 20 mins before being able to get into the OR. So the wait time isn't much different, but you now have to deal with the transfer.
• If you need pain meds, you will have to transfer to the hospital.
• If something goes wrong during the birth, you will sometimes have to be transferred to the hospital for observation.
• Pretty much all the cons are "if's" and deal with being transferred. However, in a normal, healthy pregnancy with no complications, it is unlikely for those "if's" to arise. 

All in all... the only reason to be at a hospital is IF you are having complications. In which case, thank heavens that we have the option for medical intervention. Without it there would be some miracle babies who would not have made it. BUT, if everything is healthy and normal, then why be at a hospital at all? That's just my personal opinion.

I have to say that I'm very excited about the impending birth of my fourth. I'm already more relaxed with my plan. I'm not stressed like I was last time about when I should go in to the hospital, if I'll make it there in time, what do I do with my other 3 kids if I'm here alone when it happens.... ect.

My parents generation in general seem to find this idea of birthing at home ludicrous. Purely insane, and primitive. I get the "but that's why we have hospitals!".... no, we have hospitals for emergencies. When was the last time you decided to go to the hospital for yourself as a completely healthy person? or take your healthy child there? unless you're visiting someone else, you don't. Because there's no need too. Pregnancy and birth are not sicknesses, and shouldn't be treated as one, unless complications arise.

I'm not saying you have to be for home births... I'm just saying keep an open mind, and do your research. You may be shocked by some of the things you find!

Vacations and LONG Drives

We recently got back from our family vacation, a 16 hour drive, one way. We have 3 little ones, 6, 4, and 2. For some, that kind of a vacation drive would seem like a nightmare!!

Between the "I'm bored's" and the "are we there yet's"... Madness takes its toll. But listen closely... Not for very much longer. I've got to keep control.... but I digress... and I have no idea why that quote from The Rocky Horror Picture Show came to mind... but it seems fitting.

So what do you do to keep your children entertained on long road trips?

I find that less is more, and more just creates more to fight/argue about. Some swear by dvd players - I'm not a fan. Why?

1. With 3 kids, they seldom to never agree on a movie, and I'm not playing several movies at once... they're a little young yet for headphones and the noise would drive me mental.

2. I'm also not a fan of having them stare at a show for 16 hours... there's so much more we could be doing with our time!

So what do we do then?

1. Each of our kids packs a backpack that they get to have beside their seats in our van. This generally contains a few books, and 3 or 4 of favourite toys.

2. I pack a "tickle trunk" (any Mr. Dress Up fans out there?!) I put a few inexpensive things in there and sometimes when we stop they get a little something from there. They don't get to pick, and they don't know what's in it. It can be anything from a new little truck, to colours and an activity book. They love getting the occasional little surprise and it buys a good 1-2 hours of quiet play.

3. We bring music that they know and like. It might not be our favourite, but they have a blast when we all have a sing along.

4. We talk about "interesting" things. We talk about where we are, the land, the people, the culture, the different kinds of jobs, and one that my kids seem to love - the geography - where we are, how far is it from home, what Province/State it's in, ect.

5. We play strange homemade games... like the license plate game: spot a license plate that is from somewhere OTHER than the Provence/State that you're in and gain points based on how far away the plate is from.

6. We play age appropriate trivia, and "I spy".

Between all these things and stops for gas and for meals we NEVER ONCE heard an "are we there yet?" or an "I'm bored".

And for meals... if at all possible, PACK PICNICS! The kids want to get out and run, play and stretch. Heck, I want to run, play and stretch after sitting for so long! Picnic's are a great way to do this. No wasting time sitting in a restaurant and waiting.

We also have Van Rules. This is a list of things you are allowed to do. We don't bother going over what's not allowed... they pretty much know what is not allowed, and I don't need to remind them, especially if that's the last thing they hear... what do you think is going to be fresh on their mind? Perhaps they can't think of stuff they are ALLOWED to do... so they will often do what's on their mind. Wow... hope I didn't lose you there... haha!

So our rules... here they are.

Van Rules:

1. You can play with the toys/books you packed.

2. You can look out the window.

3. You can be bored... yes... it's okay to be bored. If you complain to me that you are bored, then I will be happy and say "Great! That's one of the things that you're allowed to do!"

4. You can sing songs.

5. You can participate in the van games (license plate game, trivia, ect)

Pretty simple!

We had a great trip, both ways. Our kids didn't complain... not even once. No fighting (okay, there was a couple of times where one kiddo got a little over zealous with their toy and ended up bumping the one sitting beside them.... but it was a mild altercation and easily resolved!).

I've had people tell me that we're just lucky that we have such good travelers. Perhaps that's true. Perhaps my kids are just good travelers. BUT, I'm not going to give them any reasons to start becoming a spoiled, I want what I want right now, kind of traveler. My kids are well prepped, and know my expectations, and they know what to expect of the trip. There are no surprises for how long it will take, and we break it up in stops so they know just how much longer we have. It works for us.

Happy Travels!!

How to Calm Down the Crazies

I know we all have them... the crazy weeks, the ones where every minute seems scheduled, planned, or just plain rushed.

That was my week last week. Pure insanity.

Today is the last day where 2 of my kids extracurricular activities over lap - so it will be nice to get by tonight so that we only have one sport to attend on Mondays for the rest of the summer.. Last week saw sporting events, school trips, birthday parties (one for my princess, and one to attend), party prepping, meetings, and every Mom's never ending cleaning/laundry/cooking routine.

What do you do after a crazy week? 

I'd like to take a week and calm it down. No plans, just having fun playing outside with no commitments of having to be here, there, or anywhere. Time to just be together as a family, and enjoy each others company.

Sadly, it's going to be a busy couple of weeks coming up too... as we prepare for vacation - our first in a few years. It's about an 18 hour drive with 3 kids and 2 adults (it can be done in 15 with just adults and only stopping for gas). But with the kids we like to stop and give them some time to run and stretch.

So we have planning, prepping, and packing for vacation. Soccer games and practices, final swimming lessons, the ending of school, vehicle checks, food/meal planning. Lots of stuff to fill my days, never mind the regular cooking/laundry/cleaning routine with three little ones. And of course finishing a crochet blanket for a friend of the family, and trying to get ready for our new baby that should be arriving in September. Just lots to do.

I'm hoping vacation will be a good time to just relax and enjoy our together time. I'm even looking forward to the 18 hour drive - that might make me crazy - but I can't wait to just sit there and not have to do anything for 18 hours!!

Speaking of long drives.... what do you do for your kids on long drives?

3D Ultra Sounds, Ye or Ne?

This being my fourth pregnancy, it's been a pregnancy of firsts.

I've never been one for 3D ultra sounds. Why not? I found that it ruined the surprise of seeing what they looked like when you got to hold them and look at them for the first time. I never wanted to get one with my first three.

But now?! Well, everything seems different this time around. I don't know if it's because it wasn't planned this time or what, but I seem to be doing everything different!

I had a 3D a week ago... we wanted to confirm the gender (which I couldn't wait to find out this time - and didn't even want find out at all with our last). I was actually excited about seeing our little one in there. It was amazing!

I don't regret not doing it with the other three, but I am happy that I took the opportunity to do it this time.

How do you feel about 3D ultra sounds? Ye or Ne?

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Separation Anxiety?

Separation anxiety.... for the parents?!

So the grandparents call and ask if they can have the kids for a sleepover and you, as the parent, think... well... maybe.... but your not over the moon about it?

WHAT'S WRONG WITH ME?

Almost all the parents I know would be over the moon to have an evening and half the next day to themselves. So why do I feel so lost without the noise, the fighting, the shear craziness? Because I also miss the kisses and hugs, the story time, the snuggles.

I know that it's important for them to have some "special grandparent time".... and they LOVE it! So do my parents. I just have a hard time letting go.

My kids have only ever had a sleepover with Grandma and Papa - and even that is only occasionally. Perhaps as they get older I'll feel more at ease with it... but at 6, 4 and 2.... well.... I just really miss them.

Does anyone else feel this way? Or am I just crazy?

What's your first reaction when sleepovers are requested? 

How old were your kids when they had their first sleepover?

This Business of Birth #1

I put #1 because I couldn't possible fit everything about birth in one post... so there will be a few "birth" posts and they will be easier to keep track of if they are numbered.

This business of birth and all that surrounds it, the magic, the myth, the medicine, the midwives vs doctors.... but most of all the shear miracle of it. Through my posts I'm sure I will touch on all of these things - certainly not in sequence, and I may overlap them sometimes. But I think it's a very important topic that women need more information about, so that they can make informed decisions about their bodies and for their baby. Also, I will incorporate my varied experiences I've had with my first three children, and I'll update about my fourth as I go along (I'm due in September - so I'll have a full update of how things went after that - until then I'll post about my intentions this time around.

So where to start? There is so much that can be covered on this topic!

I guess I will start at the beginning... my beginning that is.

I had trouble getting pregnant, was seeing a fertility specialist... ended up getting pregnant, but started to miscarry - or so I was told. This "specialist" had missed the fact that I had an ectopic (or tubal) pregnancy. VERY dangerous! 3 days later I was in major pain and ended up in the ER. I won't go on about this (perhaps another time) but I'm including it simply because it led me to the OB/GYN that I used for my first three children. She was great. Very efficient, and blunt which I liked. I wanted to know what was going on, and not have things sugar coated just to make me feel better.

I was with this Dr when I got pregnant with my first baby (technically my 3rd pregnancy though). I had considered going with a midwife after I got pregnant, I called the only midwifery group in my area but they were booked. I went on the waiting list, but didn't hear back. I stuck with my Dr. Now I'm going to gloss over this a bit, but I went into preterm labour at 24 weeks and spent a month in the hospital on bed rest, was released and allowed to go home on bed rest at 28 weeks. I was told I would NEVER (all of the "specialists" opinions, and there were many who had a hand in my case) make it passed 32 weeks at best. I made it to 37. Dr's don't know and can't predict everything. I'll get into my love hate relationship with dr's after.

Fast forward to the birth. 10 hours and 10 minutes long total. I went into the L&D around 6:30 pm with my contractions 2-3 minutes apart. I got checked in, monitored, they made me lay on my back for monitoring - those of you who have had back labour can sympathize with this. I was in AGONY, but they said they needed a 30 minute "strip". I was never so happy to be able to get up when they finally finished that! I got moved to a room, finally, around 8:30.

This is when the constant barrage of options and opinions started flowing in from nurses and the dr. It was highly recommended to me to get an epidural. I refused. It was written in my birth plan that I did NOT want any interventions, unless medically necessary. And since an epidural wasn't a medical emergency.... well... there was no reason for them to even mention it, let alone try to push it. Upon refusal I was given other medicinal options, I can't remember them all, but they were injections to help lessen my pain. I repeatedly informed them that I was doing fine and didn't need it. They told me "oh but you will, and then it will be too late".... gee thanks, way to support a first time mom in labour!! Non the less, I held out. I requested a ball and spent most of my time on that... what a wonderful thing for back labour! It was the only thing that gave me some relief.

Around 9 pm the dr came back in. Upon learning of my refusal of meds he shook his head and came to talk to me. He checked me and I was about 8 cm dilated. He said "well, lets speed things up and have this baby tonight. I'm going to break your water, ok?" Again, as a first time mom I thought that this is what "had" to happen... so I said ok. OH MAN!! That's when the real pain started! I was still having back labour and they gave me gas (the only thing that I had "ok'd" on my birth plan) to try and help me with my breathing. I was getting no breaks between the contractions. This went on for 30 minutes approximately.

Now I think it's interesting to note a couple of things at this point. The Dr said "well, lets speed things up and have this baby tonight. I'm going to break your water, ok?" While that is technically a question, it certainly doesn't come across like "would you like me to break your water to speed things up?". He didn't say it like it was an option. And I didn't think it was an option. It was just what HAD to be done. Now however, I think what was the rush? Did he want to make sure that he got paid for another delivery before his shift was up? I don't understand what the rush was. I hadn't been in labour for very long, the baby was doing fine, and I had only been at the hospital for a few hours - so why the rush? Very curious.

Anyway, around 10 pm I was ready to start pushing. This took me some time... 1 hour and 10 minutes to be precise. I was working hard - my body was working hard with the contractions to push my baby out. And again, in comes the Dr. - by the way, I didn't know this Dr and hadn't met him before - he's there at the end of the bed waiting for more action to happen. Things slowed down as she started to crown, but everything was still fine with both baby and me. However Dr. Rushy-rush had a "suggestion". He said "I'm just going to give you a little incision to help speed things along". Now I was somewhat more prepared for this, and was adamant that I was NOT going to have an episiotomy unless my baby was in distress and it was necessary to get her out now. My baby was fine however, and there was no need for "a little incision" as the Dr said, especially if it was just to speed things up. Since when is birthing a baby a race? I didn't understand the rush.

I spent the next several minutes - I can't say how long exactly, if you've ever been in labour you can understand how time can cease to have any meaning - arguing with the Dr between contractions/pushes. I asked him point blank why he wanted to give me an episiotomy, again he repeated that the incision would just help speed things up. This confirmed that I had not been hearing things the first time. And I don't understand why he wouldn't say episiotomy, he just kept saying "a little incision", like that somehow made it more acceptable and friendly? Anyway, I flat out told him NO. We argued about it for a while. He said, well you're going to tear... like that was scarier than being cut. Not for me, I had done my homework on that and I knew that tears heal better and faster than "little incisions". Arguing with the Dr really makes for a memorable delivery though!

Finally my daughter was born, with no meds, no episiotomy.... and (mostly) in her own time. 

So again... why the rush? I found out some interesting information about that night though. There were 9 women in labour that night. I was last one in, the first one out, and the ONLY one not to get an epidural. Of the other 8 who all got epidurals, 7 of them ended up with cesareans. I didn't get the chance to talk to all of them after the fact, but I did get to talk to 5 of the 7 c-section ladies. They ended up with the cesarean because their labour's had stalled out after the epidural, then they had pitocin, then another epidural and more pitocin.... a vicious cycle that ended up with the baby being in distress and then having the cesarean as a result. I wondered if that would have happened if they had not had an epidural? I don't know if they asked for the epidural in the first place, but if that was the first thing the nurses had asked me... well... there's a good chance that it was the first thing they asked them too. And it's hard to refuse a carrot that's being dangled in front of you.

Anyway, I found that a very interesting fact. That's when I started to become more interested in the how's and why's of birth, and birth in the hospitals.

Why was the epidural being pushed so much? Why all the rush? Why did the dr not make my options actually appear to be options? How could this have been a better experience? An experience that didn't feel as though I had different expectations of the staff, an experience where we were all on the same wave length and could work towards the common goal of a healthy, natural birth. Not an experience where medical interventions were offered and in some cases pushed when there was no need for it.

In closing, options are GOOD. But informed decisions are BETTER. Know what you're agreeing too, do your research. This is YOUR body and ultimately your decision.

Please let me know if you have any questions or comments. And let me know if there is a particular topic that you'd like to discuss.