Planning to have your baby in the hospital? You might have to contend with some of the symptoms of an over-burdened healthcare system. Maternity wards can be over-crowded and under-staffed. Hospital stays are getting shorter. And if you happen to go into labour at the wrong time, you could be sent to another city’s hospital because all of the hospitals nearby are at capacity. What if our maternity care system could be over-hauled to relieve the burden?
What are the realities?
Fewer doctors and nurses
Besides the well-publicized shortage of nurses, Canada also faces a shortage of physicians who attend births. Between 1992 and 2004, the percentage of general practitioners who attended births fell from 28% to only 13% .
Rising Costs
Having a baby in these technological times is not cheap. The average cost for a vaginal delivery is $2,800 . For a caesarean, it is closer to $5,000 . This does not include the added costs associated with length of hospital stay or neonatal care. With every epidural, there is an added expense for the anesthesiologist and with a BC cesarean rate approaching 30% , costs are rising for maternity care.
Shorter Stays
An obvious cost-cutting measure is to shorten hospital stays. The average length of stay for a vaginal birth in BC has fallen to only two days. For a cesarean birth, it is less than four days . Women are being sent home to care for newborns within a couple of days of major abdominal surgery. What happened to resting and recovering from birth?
How would a new system look?
Midwives
Midwives are trained specialists in birth. They have usually completed four years of practical training. Their appointments run about 50 minutes (as opposed to the standard ten minutes with your family doctor). They often do home visits in the first week after baby is born to help initiate breastfeeding and to monitor mom and baby. Mothers report excellent continuity of care and higher levels of satisfaction with their births and their care .
The midwifery model of care tends to be cheaper than the current medical model. Midwives believe that birth is a natural physiological process. Though trained to spot and mitigate problems, midwives adopt a fairly hands-off approach as caregivers. Births attended by midwives show a lower incidence of epidural use, episiotomy, and cesarean section . The benefits are not just higher maternal satisfaction, but also much lower costs.
Homebirth & Birth Centres
In the last two hundred years, medicine has managed to pull birth firmly into its clutches. Contrary to all logic, with birth, we take women who are healthy and place them in the hospital as a preventative measure (in case something goes wrong) and then we treat them the same way we treat the sick and injured. Since when is pregnancy a disease?
Modern medicine can be thanked for the low incidence of infant and mother mortality associated with birth today. We know more about the human body, more about birth, more about infection. We know to keep wounds clean. We have antibiotics and other modern drugs. We can save moms and babies from situations that would have claimed their lives only 100 years ago. But that does not necessarily mean that birth belongs in hospital.
We can transfer our medical knowledge to other places, like the home. Recent studies show that with healthy pregnancies free of complications, planned homebirths attended by trained midwives are as safe as hospital births. For low risk women, we can achieve safe birth at home and reap a dual benefit because there are advantages to birthing where a mother feels safest and most comfortable.
We can also find a middle ground instead of polarizing between hospital and home. Imagine the power of a birth centre: birthing in a homelike setting with a midwife, a birth pool, medical equipment tucked out of sight and the potential of a quick transfer to hospital if need be. On the flip side, imagine the benefits for our rural and northern communities that don’t have hospitals have their own. Mothers would no longer have to travel to cities far from their families and support systems to have their babies. Birth centres could begin powerful partnerships between doctors/obstetricians and midwives.
Imagine if everyone birthed in a birth centre or at home with a midwife unless it was medically necessary to birth in the hospital. Imagine the resources (hospital space, staff and money) that could be diverted to caring for sick people. Imagine how different our medical system might look.
Imagine…
Sources
Canadian Institute for Health Information, Giving Birth in Canada: The Costs, 2006
BC Vital Statistics, Annual Report on Births, Deaths and Marriages, 2005
Canadian Health Services Research Foundation, Evidence Boost for Quality: Allow Midwives to Participate as Full Members of the Healthcare Team.
Outcomes of Planned Hospital Birth Attended by Midwives Compared with Physicians in British Columbia, Birth 34 (2), 140–147
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Monday, July 23, 2007
Inspiration
Interested in how you can help?
Support Midwifery:
Learn more about homebirth:
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Support Midwifery:
- Donate to UBC's midwifery school
- Become a supporting member of your local midwifery association:
- Midwifery Association of BC
- Canadian Association of Midwives allied member
- Join an advocacy group:
- Share positive stories about your experiences with friends, family, co-workers
Learn more about homebirth:
- Talk to your midwife about whether you would be a good candidate
- Find books in the library
- Visit Sweet Home's homebirth page
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Sweet Home Reborn!
Sweet Home has a fresh new look and tons more content. Check out the new site and expanded education section. You'll find homebirth videos, info on midwifery, breastfeeding articles and free stuff! Keep checking back over the coming months as we continuously update our content and add new kits.
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Wednesday, July 18, 2007
July is Attachment Parenting Month
In honour of attachment parenting month, I'd like to share a couple of valuable links for those of you who are curious or who have questions about attachment parenting.
My sister, mother of four, sums it up like this: "Do whatever works." To me, that is the essence of attachment parenting. Responding to your baby's cues with whatever works for them, which often means feeding when they are hungry, holding them when they need to be near you, sleeping close by, and taking breaks when you are tired. Doing what works also means responding to your child as an individual: what works with one, won't necessarily work with the next one. And of course, do what works also implies trusting your instincts rather than listening to the baby trainers and constantly saying to yourself, "But the book says I should..."
For more info:
Dr. Sears' 7 Baby B's
Attachment Parenting International's 8 Principles of Attachment Parenting
And for all of you out there who think that Attachment Parenting is a couple of dirty words, I draw your attention to the concept of Balance in both of the above articles. Attachment Parenting is not about sacrificing yourself for the needs of your baby. It's about responding sympathetically and with love to baby's needs without forgetting to take care of yourself.
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
My sister, mother of four, sums it up like this: "Do whatever works." To me, that is the essence of attachment parenting. Responding to your baby's cues with whatever works for them, which often means feeding when they are hungry, holding them when they need to be near you, sleeping close by, and taking breaks when you are tired. Doing what works also means responding to your child as an individual: what works with one, won't necessarily work with the next one. And of course, do what works also implies trusting your instincts rather than listening to the baby trainers and constantly saying to yourself, "But the book says I should..."
For more info:
Dr. Sears' 7 Baby B's
Attachment Parenting International's 8 Principles of Attachment Parenting
And for all of you out there who think that Attachment Parenting is a couple of dirty words, I draw your attention to the concept of Balance in both of the above articles. Attachment Parenting is not about sacrificing yourself for the needs of your baby. It's about responding sympathetically and with love to baby's needs without forgetting to take care of yourself.
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Friday, May 18, 2007
Have your say!
Sweet Home wants to hear your opinion. We want to know what you think so that we can serve you better. We have a short 10 question survey for you. It'll only take a minute or two but will be invaluable for us.
Click here to fill it in!
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Click here to fill it in!
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Friday, April 13, 2007
Baby Talk Open House
We will be exhibiting at the Baby Talk Open House at the Roundhouse Community Centre in Vancouver tomorrow. Come by and say hello!
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Wednesday, April 11, 2007
Birth Choices - what is right for you?
Today we have more choices than ever about how we birth. We have the choice of using a doctor or midwife for our practitioner. We have the choice of birthing in the hospital or at home. We can choose who is present at the birth. We can choose to hire a doula. We can choose between a multitude of prenatal classes ranging from hospital-run classes to private classes in Lamaze, the Bradley method or Birthing From Within. We can enroll our older children in Sibling Preparation classes, we can take prenatal yoga or prenatal pilates, we can bring music, pillows and massage oil to the hospital. We can choose to labour in the tub or the shower or on a birth ball. We can play cards or go for a walk. We can birth squatting or standing or via elective cesarean. We can even write up elaborate detailed lists of all of our preferences and give this Birth Plan to our practioners.
Faced with all of these choices, how do you know what is right for you? How do you know that the choices you made before the big day will still be right when labour starts – especially if you are a first time mom?
Choice, in general, can be a double-edged sword. On the one hand, it is empowering and enriching to be given the opportunity to have a say in what happens to us. On the other, given too many choices or inadequate information to help in our decisions, the process of choosing can cause stress, anxiety and even guilt and depression. And when it comes to birth, it can give the misguided impression of control.
Relinquish Control (even those subconscious thoughts…)
The first thing you can do on your journey towards the right birth for you is to forget about those fantasies of your ideal birth. We all do it: we all have a vision in our heads of the way we hope our birth will proceed. These visions are rarely realistic (unless you imagined in your ideal birth that you would be half-naked on your hands and knees in a roomful of strangers). Birth is a dynamic process and we cannot control what happens. The woman who is determined to get her epidural before she’s finished with the hospital admitting desk may deliver baby at home in the bathroom attended by her partner. The woman who preaches natural birth from before conception may end up with a complication, or labour induction and a cesarean delivery. We’ve all read these stories and hoped it wouldn’t be us. But it could be. So the first step is to let go.
Read everything you can get your hands on
Knowledge is power. If you aren’t a reader, ask questions. Ask all the mothers you know what their experience was like. Ask your practioner all those nagging questions you’re afraid to speak out loud. Explore all the birth possibilities there are. Don’t shy away from those topics that you hope you won’t have to face (like having a long, drawn out back-labour or requiring a cesarean). Don’t write off ideas that are new to you (like homebirth, or hiring a doula). The more you can understand about the way labour progresses (or sometimes doesn’t) and the way labour is managed (or sometimes mis-managed), the better the chance that you will be able to play an active part in the process.
Be Flexible (but know your limits)
That is, be prepared to change your mind. Something that seemed right before birth may no longer be fitting during birth. Hell, something you asked for during one contraction, may not be what you want during the next. Accept the fact that you may need to revise your thinking in the face of new information. However, if at any time, you are uncomfortable with the care you are receiving, be confident that it is okay to assert yourself or have some intervene on your behalf. By trusting your instincts and your birth team, you’ll know when to stand your ground and when to adapt.
Gather good people around you
The people who support you and care for you during labour can make a huge difference. Consider carefully whether you want a doctor or a midwife, whether you will hire a doula and which friends and family members you would like present. Ask your care-givers questions and reserve the right to change your mind if you don’t feel comfortable. The time it takes at first to find good people could make the difference in how your birth unfolds or at least in how you feel (even when things don’t go as planned). Good people will give you information and not rush your decisions, will help keep you focused, will make you feel supported and empowered, will be positive and encouraging and will inspire trust.
Face your Fears
We all go into labour with a mixture of elation and apprehension but it’s good to ask yourself what it is you are afraid of before your water breaks. Hopefully a few weeks before. It’s hard to know how to manage a nebulous, nameless fear. But if you can seriously explore what scares you about birth (and motherhood) before the throes of labour send you into panic mode, the odds are you’ll be better equipped to deal with whatever comes your way. Try, if you can, to go a little deeper into your fears than the obvious like fear of pain or fear of a long labour. What about the pain scares you? Fear of not being strong enough? Fear of losing control? What about a long labour scares you? Facing your fears is emotionally exhausting but it would be a shame to let fear hold you back from the possibility of a truly rewarding experience.
Know yourself, know your situation
This is the easiest part because it might be decided for you. Are you a home-body who feels most comfortable with a few close friends rather than in the middle of a party? Maybe homebirth is an option for you. Are you an analytical person who is comforted by procedures and technology? Are you someone who always wants to be prepared for the worst case scenario? You might feel strongest birthing at a hospital or birth center. Are you totally against medicated birth? Perhaps a water birth is right for you. Is your baby breech? The safest bet for you and your baby could be a cesarean. Was your pregnancy a textbook case or did you suffer from multiple complications? Your health practitioner will be able to explain what your options are based on your personal situation and with a bit of self-analysis and thought, you’ll find the answers you’re looking for.
Often as labour day unfolds, it doesn’t come down to choice at all. We don’t choose when our babies will come or how they will make their entrance. Sometimes, circumstances arise that take the power from the mama and she needs to stretch and bend around the situation she is given. And sometimes, with trust, in our instincts, in ourselves, in our babies, in birth itself, our babies come just the way we knew they would. We do what we need to do and the most right thing of all is that they are safe.
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
Faced with all of these choices, how do you know what is right for you? How do you know that the choices you made before the big day will still be right when labour starts – especially if you are a first time mom?
Choice, in general, can be a double-edged sword. On the one hand, it is empowering and enriching to be given the opportunity to have a say in what happens to us. On the other, given too many choices or inadequate information to help in our decisions, the process of choosing can cause stress, anxiety and even guilt and depression. And when it comes to birth, it can give the misguided impression of control.
Relinquish Control (even those subconscious thoughts…)
The first thing you can do on your journey towards the right birth for you is to forget about those fantasies of your ideal birth. We all do it: we all have a vision in our heads of the way we hope our birth will proceed. These visions are rarely realistic (unless you imagined in your ideal birth that you would be half-naked on your hands and knees in a roomful of strangers). Birth is a dynamic process and we cannot control what happens. The woman who is determined to get her epidural before she’s finished with the hospital admitting desk may deliver baby at home in the bathroom attended by her partner. The woman who preaches natural birth from before conception may end up with a complication, or labour induction and a cesarean delivery. We’ve all read these stories and hoped it wouldn’t be us. But it could be. So the first step is to let go.
Read everything you can get your hands on
Knowledge is power. If you aren’t a reader, ask questions. Ask all the mothers you know what their experience was like. Ask your practioner all those nagging questions you’re afraid to speak out loud. Explore all the birth possibilities there are. Don’t shy away from those topics that you hope you won’t have to face (like having a long, drawn out back-labour or requiring a cesarean). Don’t write off ideas that are new to you (like homebirth, or hiring a doula). The more you can understand about the way labour progresses (or sometimes doesn’t) and the way labour is managed (or sometimes mis-managed), the better the chance that you will be able to play an active part in the process.
Be Flexible (but know your limits)
That is, be prepared to change your mind. Something that seemed right before birth may no longer be fitting during birth. Hell, something you asked for during one contraction, may not be what you want during the next. Accept the fact that you may need to revise your thinking in the face of new information. However, if at any time, you are uncomfortable with the care you are receiving, be confident that it is okay to assert yourself or have some intervene on your behalf. By trusting your instincts and your birth team, you’ll know when to stand your ground and when to adapt.
Gather good people around you
The people who support you and care for you during labour can make a huge difference. Consider carefully whether you want a doctor or a midwife, whether you will hire a doula and which friends and family members you would like present. Ask your care-givers questions and reserve the right to change your mind if you don’t feel comfortable. The time it takes at first to find good people could make the difference in how your birth unfolds or at least in how you feel (even when things don’t go as planned). Good people will give you information and not rush your decisions, will help keep you focused, will make you feel supported and empowered, will be positive and encouraging and will inspire trust.
Face your Fears
We all go into labour with a mixture of elation and apprehension but it’s good to ask yourself what it is you are afraid of before your water breaks. Hopefully a few weeks before. It’s hard to know how to manage a nebulous, nameless fear. But if you can seriously explore what scares you about birth (and motherhood) before the throes of labour send you into panic mode, the odds are you’ll be better equipped to deal with whatever comes your way. Try, if you can, to go a little deeper into your fears than the obvious like fear of pain or fear of a long labour. What about the pain scares you? Fear of not being strong enough? Fear of losing control? What about a long labour scares you? Facing your fears is emotionally exhausting but it would be a shame to let fear hold you back from the possibility of a truly rewarding experience.
Know yourself, know your situation
This is the easiest part because it might be decided for you. Are you a home-body who feels most comfortable with a few close friends rather than in the middle of a party? Maybe homebirth is an option for you. Are you an analytical person who is comforted by procedures and technology? Are you someone who always wants to be prepared for the worst case scenario? You might feel strongest birthing at a hospital or birth center. Are you totally against medicated birth? Perhaps a water birth is right for you. Is your baby breech? The safest bet for you and your baby could be a cesarean. Was your pregnancy a textbook case or did you suffer from multiple complications? Your health practitioner will be able to explain what your options are based on your personal situation and with a bit of self-analysis and thought, you’ll find the answers you’re looking for.
Often as labour day unfolds, it doesn’t come down to choice at all. We don’t choose when our babies will come or how they will make their entrance. Sometimes, circumstances arise that take the power from the mama and she needs to stretch and bend around the situation she is given. And sometimes, with trust, in our instincts, in ourselves, in our babies, in birth itself, our babies come just the way we knew they would. We do what we need to do and the most right thing of all is that they are safe.
Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!
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