Let me tell you a story…
We recently attempted to assist a client to achieve a successful home vaginal birth after 2 previous cesareans. She was a little more than one week passed her due date, and she had tried to induce her labor with castor oil. The oil didn’t seem to do much, but her water broke and she was having contractions soon after. Her labor progressed quickly, but her baby remained high in her pelvis and it took a lot of maneuvering with Spinning Babies postures (Walcher’s Brim is a great one for this problem) and the baby finally began moving down into the birth canal.
Things take a complicated turn…
However, after hours of pushing, seeing the head and thinking that the baby was coming any minute, she began having some bleeding. It was significant enough that the midwives elected to transfer by 911 to the hospital. All of mom’s and baby’s vital signs were good, but unexplained bleeding in a mom with 2 previous cesareans is a potentially life-threatening sign. Our job is to recognize potential emergencies and get to the hospital before the train wrecks. This momma continued to push in the ambulance, and within minutes of getting into the hospital she pushed her baby out!
Hallelujah!!! The baby came through the door, not the window!
But wait…The baby was a bit shocked, but instead of allowing him to get his full placental transfusion and administering PPV (Positive Pressure Ventilation)* with a bag and mask to help the baby inflate his lungs, they immediately cut the cord and rushed him over to the warmer to tortuously stimulate him into taking his first breath. I had a hard time watching the video due to the roughness and lack of respect afforded this brand new being.
How does this impact our society?
For the nurses and midwives on duty, it is just another case, just another hour in their day. However, for that baby, it is his BIRTH. That happens to every one of us just ONCE in this life. We clearly do not appreciate the importance and significance of this event for our species. I am frightened to see the future generations coming up in the world when they have embedded in their primal memories this episode fraught with pain and fear and separation from the source of their sustenance. We are not building generations of people who will have love and trust as their core values. Else wise we must figure out how to overcome a beginning like this. Prolonged skin to skin contact with both parents initially and prolonged on-demand breastfeeding with baby-led weaning will both go a long way to repair the damage.
Hospital L&D should be a place that all women feel comfortable, respected, and supported… The other thing that really bugged me about this experience is that when the midwives showed up (they followed the ambulance), they were greeted by a seasoned L&D nurse who was shaking her head and clearly upset by the situation. She said something to the effect that the client is an RN at their facility, and that she should have known better than to attempt a home birth. Really!?!?! Excuse me, but maybe your facility should do a better job at supporting women with their choices so they wouldn’t see home birth as their only option.
We at Midwife360 would be happy to encourage our VBAC moms to birth in the hospital. We acknowledge that it is the safest place to be for someone with a complex physiologic pregnancy. We also believe that the way someone is treated during their pregnancy, labor, and birth will have far-reaching consequences for them, their baby, and their entire family. It can mean the difference between having postpartum depression or not. It can mean the difference between successful breastfeeding or not. It can mean the difference between having a vaginal or cesarean birth. On an individual level and ultimately on a societal level, these things matter!
What’s wrong with the NICU?
The next situation evolved because the baby had a ‘lesion’ on his head. It was in such a position that it was likely caused when he was trying to get under her pubic bone and the length of time that he was in the birth canal. Neither parent had a history or tested positive for herpes – which is what the hospital providers were worried about. They started the baby on an antiviral, and on an antibiotic, since mom was GBS positive and had received her antibiotics just shy of the 4 hours recommended by the protocol. The baby was not sick and had no abnormal WBC (white blood cell) nor a positive culture. They insisted on performing a spinal tap for this well-baby because they were sure he had herpes somewhere that was gonna kill him. The mom knew her baby was fine, but every time she said she was taking her baby home, the nurse practitioner would tell her that her baby could die. This baby spent 10 excruciating days in the NICU and received multiple doses of antivirals and antibiotics, with multiple IVs in his little body, and endured a spinal tap – FOR NOTHING! A huge NICU bill later for a normal baby with a skid mark on his head. I believe we can do better in our hospitals.
What can we do?
Expose the neonatologists who up-sell services for healthy normal newborns and get evidence-based care into standard practice. We must not stand for this any longer! This family was so relieved and ecstatic for the vaginal birth they knew was possible, only to be traumatized and beaten down by having to advocate and protect their new baby. It doesn’t have to be this way! It’s up to individual parents who have these types of experiences to write letters and submit evaluations of their experience to the hospital and local media. Also, seek out respectful maternity care and demand respectful newborn care as well. We as a society can do better for our pregnant people and newborn babies!
*This is giving the baby breaths with the bag and mask and is the first step in neonatal resuscitation. 5 long slow breaths.
