Birthing outside the system - perceptions of risk

http://www.ncbi.nlm.nih.gov/pubmed/22300611

The authors interviewed women (in Australia) who had free-birthed or had homebirths despite being "high-risk" to explore their perceptions of risk.

The women interviewed described their understanding of the risks of giving birth in hospital, particularly regarding interventions and lack of privacy, and sought to protect themselves and their babies from those risks through choosing to give birth at home.  They were found to have given this matter considerable thought.

The same considerations were found in Iran where women also perceive that there are risks attached to hospital birth.

http://www.ncbi.nlm.nih.gov/pubmed/22172740

Perhaps the DoH would like to produce one of their nice little leaflets (see their annual flu vaccine leaflets for example of same) expounding the risks of hospital birth to women?  Doubtless midwives would be required to tick a box in triplicate to confirm the leaflet had been given but it would be worth it for once.  It isn't just women's perceptions - both the Birthplace study and the PPH study done by the University of Southampton (see last posting) give quantifiable examples of the actual risks.

Postpartum haemorrhage

A review of 273,872 births by a team at the University of Southampton has shown that the rate of PPH is lower for women having homebirths, and concludes that the excess PPHs in hospital births is in part caused by medical intervention (e.g. use of syntocinon to speed labour, episiotomies, Caesarean sections).

The researchers advise "Women and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home."

And this is despite there being likely to be more physiological third stages at homebirths!  Once again, a clear demonstration that women's bodies nearly always do the job best if left to get on with it in their own time in a supportive and calm environment, and the hospital maternity services are unable, for the most part, to improve on physiology. 

The article can be found here:

http://www.biomedcentral.com/content/pdf/1471-2393-12-130.pdf

Tying and cutting the cord

For those who do not want a lotus birth (more of that on a later post maybe), what to do with the cord?  A plastic clamp?  A sterilised piece of string or plaited embroidery thread?  I much prefer the latter, the cord seems to dry out better.  Of course, the ties may become loose during that process and at this stage may need to be replaced (or not).  Clamps used to be cut off after 2 or 3 days but the clamp-cutters, at that point re-usable, were thought (probably rightly) to be an infection-risk.  Disposable clamp-cutters are available but are costly and unecological. This means that once a plastic clamp is on the cord, it can rarely be removed whilst the cord remains attached (4 to 10 days).

Cutting - scissors or knife or razor blade?  All should be sterilised as well as possible, usually by sterilisation tablets, baking or boiling, depending on what is being sterilised - see http://www.ific.narod.ru/Manual/Clean.htm  for useful discussion of the various methods.

Of course NHS midwives are supplied with sterile supplies and independent midwives also have their own supplies, also usually sterile pre-packed.   Animal suppliers also sell sterilised plastic cord clamps in small amounts.  These can be ordered via the Internet.  Paramedics have fantastic little birth packs which also contain a plastic clamp and sterile scissors (disposable).

If the cord is left until after the birth of the placenta, it is thin, its vessels have collapsed, and it is easier to cut through.  To those who haven't cut a cord before, it can occasionally feel quite hard to cut through.  Definite and determined cutting will always succeed.

I am quite sure that thinner cords would stay tied if simply knotted.  But I have never done this.  Has anyone?

Update 8.1.14 - here is a link to a lovely You Tube photo-montage showing cord-tying following a ?freebirth: http://www.youtube.com/watch?v=1lOden_xbt4&feature=youtu.be

Welcome to The Undercover Midwife's blog.

Welcome to my blog which is primarily for women making radical and difficult choices in the face of the demise of independent midwifery, the absence of services that meet their needs and preferences, and the inability of maternity services to approach birth from other than a medical viewpoint.

I am a midwife with more than 30 years experience and believe women and families need support to give birth and raise their babies within the context of their lives, relationships, beliefs and path through life.  Homebirth, attachment parenting, a community and familial approach to birth such as local birth centres and breastfeeding support, and the right to choose and get to know your birth attendant(s) are all important to me.  

Many women are choosing to "freebirth" too, often as a last resort rather than a first preference, though this choice is also a positive one for many too.  I hope that this blog will enable me to give some e-midwifery support to freebirthing women especially, and enable us to explore issues together.

Below is a link to an Australian news item:

http://www.abc.net.au/news/2013-02-08/free-birthing-on-the-rise-despite-danger-warnings/4509420