I don’t want to completely throw my OB’s opinion out the window at this point, but some of the things he said yesterday were just so erroneous that it is hard to take the other things as seriously. It doesn’t completely discredit what he had to say, but it does call his credibility into question.
The sterile thing is just a big load of crap, obviously. This is for a lot of reasons. First of all L&D wards are not by any means sterile. You have people coming in and out (like dads, family and friends), eating snacks, going to the bathroom, etc. Nurses and OBs do wash their hands, but not like they do when prepping for a surgery. Also, Stephen’s point about super-bugs was very valid. The antibacterial soap they use to wash their hands is what causes the super-bugs because it doesn’t kill everything and what stays alive is stronger and resistent to the soap, etc. And what else is in hospitals? Sick people and diseases. Furthermore, if doctors were really concerned about home environments being sterile enough they wouldn’t let you bring your baby home 24 hours after the birth (sometimes less), or maybe not ever. We would all raise our kids in hospitals, wouldn’t that be fun?
Then the fact that he just went into the general homebirth is unsafe thing until we actually prodded him makes me think that he was just going to say anything he could to make me think I was making a dangerous decision. Plus the research at this point does not support the statistics he tried to throw at me. If that was the case the UK’s ACOG equivalent wouldn’t be trying to increase the number of homebirths. Countries where homebirths are something like 30% of the population wouldn’t be doing better than us as far as infant/maternal mortality is concerned.
As far as pre-eclampsia/eclampsia and stressed out heart rate concerns… those things don’t just show up suddenly in labor. Yes, hyperthyroidism does put me at a higher risk for them (if left uncontrolled), but we would know through monitoring whether that was an issue before the birth. Also part of the reason my midwife has me continuing my care with my OB is to have these things monitored if something serious does come up. And she assured me that if anything with either my heart rate or the baby’s heart rate was abnormal that would be immediate cause for transfer. She’s not going to ignore the signs of something going wrong. Plus, something I think I haven’t mentioned on here is that she’s also worked it out with one of the other licensed midwives in town to have her attend my homebirth as well. So I will have two trained women at my birth monitoring me and making the situation as safe as possible.
Baby breathing difficulties… my midwife was able to find one study last night that dealt with this issue. It was a really small study though. Out of 248 births, two babies had breathing difficulties. One was exposed to high levels radio-active iodine (one of the drugs used to treat hyperthyroidism, but you’re not supposed to take it in pregnancy) and had a goiter so big it caused the collapse of the baby’s esophagus. The other baby’s mom was treated with PTU and had some difficulty breathing upon birth, but there isn’t much information given about this case including the dosage of PTU that the mother was on. We could have a late ultrasound to see if the baby is doing things that are helping it to practice breathing too like swallowing amniotic fluid (something I’ve witnessed on our previous ultrasounds). Also the fact that she gets the hiccups all the time is another good sign that she’s getting prepared to breathe.
So after she found this study my midwife called me again and told me about it. Then she said that she was going to call my OB and talk to him about his reasoning for declaring my pregnancy high risk. She also wants to know what information/studies he is basing his opinions on.
I’ve also gotten several responses to a post I put on a message board about this and everyone from midwives to those with the same condition as me have said that thyroid issues do not risk you out of homebirth as long as your TSH levels are closely monitored throughout the pregnancy (which mine have been). Also hyperthyroidism is more of an issue if it is something you’ve had for many years rather than something that developed as a result of pregnancy. My midwife said if the former had been the case she would have told me that I needed to have my baby in a hospital.
It was very nice of my doctor to make the offer that he did as far as attending my birth. That has not gone unnoticed in my mind because that was actually a concern of mine. To go from a 1 in 10 chance to 95% is pretty good.
Also he did say that he wouldn’t run from caring for me even if I did decide to ultimately go ahead and homebirth. My midwife has had many patients with OBs that have refused to see them anymore for making this decision.
Stephen said he’d still support me in my decision, but he also thinks that based on what the doctor said the best of both worlds for me would be to go to the hospital and have our midwife as our doula.
At this point I’d say things are more up in the air. I’m just really anxious to see if my OB is going to be willing to talk to my midwife and what will come of that conversation. I’ll probably know more tomorrow. I just didn’t want to leave things hanging like I did yesterday. I covet your prayers and even little tidbits of information/research you come across (thanks Ruth!). I definitely have a lot to think about.