Crash Course In Homebirth

10 - 15% of babies pass some meconium before birth. Only small number of these will develop MAS if baby inhales either before or after birth. True meconium aspiration is often a prenatal/prelabour event. There are several documented cases where babies were born with MAS after elective c sections. Risk Factors: overdue diabetes high blood pressure difficult labor or delivery fetal distress decreased oxygen Both the meconium and the aspiration are usually related to hypoxic events in utero. The baby, if subjected to severe enough an hypoxic insult in utero, will gasp (sort of a last-ditch reflexive effort to get oxygen) and will then get the meconium down below the vocal cords. Many babies, despite lots of mec at birth, will be vigorous with no problems. The presence of mec. and a truly sick baby are extremely rare in the home due to the lack of so many interventions incurred in the hospital setting the aggravate or even precipitate mec. I have had a lot of success by having someone hold the baby by it's feet upside down while I suction with a 3 oz. bulb syringe......works great. It's amazing how much you can get out with the help of gravity. No Deep Suctioning for Mec Reduces Caustic Pneumonia. **If baby is born through thick meconium then only the mouth should be gently suctioned (which can easily be done at home). Deep suctioning should only be done if the baby is depressed, eg having trouble breathing, as deep suctioning can cause more problems than it solves. It is estimated to occur in 11-58% (mean 35%) of live births with mec -stained liquor, approx. 4% of all live births. MAS occurs in only 5-10% of infants with mec below the vocal cords.

There has never been a study that proved without a doubt that suctioning the trachea prevented meconium aspiration. Ninety-five percent of infants with inhaled meconium clear the lungs spontaneously.

NO CUTTING THE CORD UNTIL THE PLACENTA DELIVERS mother nature has her own way of suctioning, the pressure of the walls of an uncut vagina squeezes the baby’s shoulders and chest causing fluids to burp out of the baby easily and naturally. In the squatting position you are less likely to tear there is more than enough room to birth any baby whether it is breech, large baby, etc. Women were designed to labor and birth in an upright position. Most hospitals will not let you birth in the squatting position. Patience, privacy and no interference either physically or mentally are key to a safe birth; you will not get that in a hospital or with a midwife. Even animals know this; they know any interference will kill them that’s why they seek privacy. Birth is a matter of letting it happen rather than making it happen. There are 28 countries that have better infant morality rates than the US - what do they have more of HOMEBIRTHS!! I encourage you to have an unassisted pregnancy and birth. Well actually to be honest with you the mec. is caused by stress and artificially breaking your membranes causes more stress on the baby because it does not have a soft cushion surrounding it, as well as other problems such as cord prolapse, malpresentation(breech,postier etc.), stuck shoulders, fetal distress-fetal heart rates to drop, mec. in water, and infection. Also since you probably had a episiotomy, or a c-section your body was not able to suction the baby the way it was designed to. You can suction the bay with your own mouth. Since you were in a hospital, you were stressing out you did not have any privacy your labor is going to slow down, and artificially rupturing your membranes is another dangerous intervention

which forces your labor to speed up. Sometimes the water dosen't break till a few moments before the baby is born, and sometimes babies are born in the caul(bags still intact). You just have to trust your body, your body knows what it is doing. It is also extremly dangerous to stick things up there once your waters have been broken due to infection. So don't play the "oh I was glad I was in the hospital" game because more often than not those complications were caused by the hospital and interventions. It's better to trust your body than some doctor or machine. Yeah the truth hurts sometimes. Hospitals are not the way to go unless it's the rare but extreme emergency. www.empoweredchildbirth.com/html has a great article about why mec. happens. What if you had a postpartum haemorrhage? Midwives at home births carry the same drugs ** which are used to expel the placenta and contract the uterus as would be used in hospital. If these do not control the haemorrhage, the midwife would call an ambulance to transfer you to hospital, and undertake other emergency measures in the meantime, such as giving intravenous fluids and manually compressing your womb. (**Wood Betony tea, etc. ALSO causes contractions to expel placenta ... always a natural remedy for the sorcery of pharmacy.) However, it is significantly less likely that you would have a post-partum haemorrhage after a home birth than after a hospital birth, because the risk of PPH rises with interventions such as assisted delivery and induction of labour, which are only carried out in hospital. What if you needed an assisted delivery - forceps or ventouse? Assisted deliveries involve increased risks to the baby (eg injuries such as head trauma, or complications like shoulder dystocia) and the mother (severe tearing and/or bleeding). What if you need a caesarean? If you needed a caesarean, you would tranfer to hospital to have one. The term 'emergency caesarean' can be confusing, because in fact an 'emergency' caesarean just means one which

was not planned at the start of labour, regardless of whether mother or baby was in immediate danger. What most people worry about is a 'crash' or 'true emergency' caesarean, where the baby needs to be delivered urgently. This is more rare. In a dire emergency situation like this, you would call an ambulance immediately, and would telephone ahead to the hospital and ask them to have the operating theatre made ready and the surgical team assembled. The ambulance team would take the mother straight to the operating theatre. So how much time would you lose by having to transfer from home? Even if you started off in hospital, the operating theatre would have to be prepared and a surgical team assembled. The target for delivery by emergency caesarean is 30 minutes from decision to delivery, but research suggests that this target is not usually achieved. What if the cord is around the baby's neck? It might be looped around once, twice, three times or more. Although it can be frightening at the time, it is not usually a major problem; some babies need some resuscitation such as rubbing the skin, giving air by bag and mask, or oxygen, but most are fine. If the baby does not show distress earlier in labour and its head descends, then the situation would be managed in the same way, wherever you gave birth - after all, there would not be time for a caesarean in hospital if your baby showed signs of distress only in the last 10 minutes of labour. What if there was a cord prolapse? Cord presentation occurs when the umbilical cord presents in front of the baby's presenting part (usually its head, unless it is breech). As the head descends, the cord is compressed and this can restrict the baby's oxygen supply. Cord prolapse is the next stage - when the cord protrudes from the uterus in front of the baby, and can be felt in the vagina. Sometimes you can push the cord up and out of the way, holding the baby's head up while

you do it. If a cord prolapse occurred at home, you would probably go on all fours, with your head lower than your body and your bottom stuck in the air. This would take the pressure off your cervix and hopefully off the cord, holding the baby's head up and off the cord by hand, while waiting for the ambulance to arrive. Cord prolapse is a complication which could be fatal in home or hospital. In the home and hospital groups totalling 10,695 women, only one cord prolapse occurred, in the home birth group - but no fetal death was reported*. Of planned home births reported on the incidence of cord prolapse, cord prolapse occurs on average once in every 900 deliveries (cord presentation once in every 300), but is much more likely in certain high-risk categories: breech or transverse lie, small babies, polyhydramnios (excessive amniotic fluid). Very few women planning a home birth have pregnancies which fall into these categories. Babies sometimes die from this condition, wherever the mother is labouring - but the worry is that if it happens when she was at home, somebody, somewhere will blame the fact that it was a home birth. If it happens in hospital, it will be "just one of those things". What if there is a shoulder dystocia? Change the mother's position to one which allows more space for the baby to move through her pelvis. What if your baby needs resuscitation? stimulating the baby by vigorously rubbing its skin Suctioning of the nose and mouth with, for example, a bulb syringe or a suction machine to remove mucus etc.. which may be obstructing its airways Ventilating the baby - giving air or oxygen under pressure. This is done either with an ambubag or 'bag and mask', which is operated by hand, or by intubation, where a tube is passed into the trachea and which may be attached to a ventilator. What if your baby dies? How will you feel then?

Rarely, a baby may die after a homebirth, when he or she might have survived after a hospital birth. Perhaps a crash caesarean is needed, and transfer to hospital is delayed. And the converse is true - sometimes babies die after hospital births, when they might have survived after a homebirth. This could happen because of breathing difficulties after caesarean section, hospital-acquired infection, birth injuries from assisted delivery, severe reactions to drugs given to the labouring mother, or stress or injury resulting from labour being induced or augmented.