Log In Sign Up

Prenatal Care... Necessity?


Forum: Natural Childbirth

Notices

Welcome to the JustMommies Message Boards.

We pride ourselves on having the friendliest and most welcoming forums for moms and moms to be! Please take a moment and register for free so you can be a part of our growing community of mothers. If you have any problems registering please drop an email to boards@justmommies.com.

Our community is moderated by our moderation team so you won't see spam or offensive messages posted on our forums. Each of our message boards is hosted by JustMommies hosts, whose names are listed at the top each board. We hope you find our message boards friendly, helpful, and fun to be on!

Reply Post New Topic
  Subscribe To Natural Childbirth LinkBack Topic Tools Search this Topic Display Modes
  #21  
October 18th, 2010, 02:43 PM
Aeterna's Avatar Super Speshil
Join Date: Nov 2006
Location: the edge of reason
Posts: 1,717
Quote:
Originally Posted by Sk8ermaiden View Post
I've seen a lot of people talk about how none of the things that used to kill people off in childbirth/labor apply anymore and it's really not based in historical fact. Sure, childbed fever really upped the stats there for awhile, but that's an anomaly in history.
An anomaly because we weren't aware of better hygiene practices and now we do? One of the most common childbirth complications is postpartum hemorrhage, which is typically managed with herbs or pitocin nowadays. Back then a poorly developed pelvis led to problems in the second stage (e.g., shoulder dystocia, arrest of descent, baby stuck or can't fit). Women and babies died due to this complication, one stemming from insufficient vitamin D.

If only 15-20% of pregnant women are truly high risk and birth left alone results in good outcomes then pregnancy overall shouldn't require a lot of management.

Quote:
Yes, the basic things checked on with a healthy pregnancy with a midwife are minimal. What you are paying for is their training at spotting when something might be going wrong. There is a good chance - a very good chance - that a woman doing her own prenatal care will have no problems or catch most of the huge ones. But there is also a reason that even among us weirdo "birth junkies" almost everyone will chose an experienced care provider. Experience will trump our basic and cursory knowledge (because that's what it is compared to someone practicing 17 years) almost always. You are paying for the small chance that you will need that knowledge and experience. I also think a small part of it is "fresh eyes" too. A lot of things that might seem small and unconnected to the mom add up to something big and wrong to someone trained in it.
All very true. I agree. As much as I fully support UP/UC, I enjoy the care and relationship I receive from a midwife.

Quote:
The thing that sums it up the most I think was the midwife who was talking about being "backup" for an unassisted birth and the mom retained placenta and nearly hemmoraged to death. EVERY woman I've met who went/is going UA believes that she would know exactly what to do in the situation. The mom in the story did too. What the extremely distressed dad said to the midwife on the phone was "we thought we knew it all from the books, but it is nothing like the books." Obviously things that go wrong in pregnancy are a lot less dramatic, but they can have the same results. The 4 years or so I have spent researching birth does not give the the qualifications and know how to diagnose many of the things that could go wrong in my pregnancy.
I'm confident could spot some things. For instance, I knew I had a significant case of polyhydramnios with ds1. I measured my fundus and palpated my uterus and could feel there was a lot of fluid. My measurement was the same as my midwife's. I was her first case of moderate-severe polyhydramnios. I also knew that I was at a higher risk for PTL due to my overdistended uterus and I was also aware I was at a higher risk for cord prolapse and I knew what to do in the event of PROM. We both did our research since she had no first hand experience in a case like that and we both came across much the same things on how to manage it. I had experience with polyhydramnios with my first so that is why I was able to spot it. I knew the severity of mine was associated with uncontrolled maternal diabetes and chromosomal disorders.

I've drawn up lists in the past on what to look out for--common complications and their presentation. I'm aware of very rare conditions like DVT, amniotic fluid embolism, HELLP syndrome, peripartum cardiomyopathy, and cholestasis of pregnancy. I fully recognize these conditions are rare, but it helps to be familiar with them if only for educational purposes. I asked my CPMs what the most common pregnancy complication they saw was and it was PIH. Since CPMs only take on low risk clients this makes sense. In birth it was postpartum hemorrhage. True shoulder dystocia is actually quite rare. The ones that typically UP/UC are low risk. I've not read a UP story gone bad, but I have read UC stories that don't end well. Same for hospital and homebirth. Being part of pregnancy and infant loss forums I've come across many stories that didn't end well and that goes for all manners and places of birth.

The are many cases where disorders and issues with the mom or baby go undetected while under the care of physicians and midwives or babies that die because of incompetent birth attendants. A friend of mine lost her daughter during a homebirth from a placental abruption. The midwife ignored all of the signs: spotting, hypertonic contractions/unusually painful contractions/cramping from the uterus trying to close off open blood vessels and tachycardia. That's just one story where a baby died because something went missed prenatally or during birth. My son's heart defects were missed completely. Had we known about them we could have made different plans.

I certainly understand not all are comfortable with UP for themselves. That's fine. I get that having a fresh pair of eyes can and does aid one's overall care. I needed a midwife with ds2 because I needed that support after having lost ds1. I was hyper-aware of my pregnancy. I overanalyzed almost everything and I needed someone to just tell me that everything was okay.

I'd like to point out that even under the care of a physician or midwife symptoms can pop up in between appointments, which in the beginning are usually 5-6 weeks apart. Typically, for UPers it's a daily thing. Something they're in tune with and do as part of their normal daily routine. If a UPer has elevated BP, develops visual disturbances and is spilling protein then she needs to get checked ASAP. That's just common sense. If she's doing this weekly or bi-weekly she has a better chance of 'catching' a problem at the onset, whereas as being seen every 5-6 weeks there's a chance the problem isn't new/just developing. The response to a problem is the same whether someone UPs or sees a provider. Something develops, call midwife or doctor. If it's something serious or rare like pulmonary embolism being under the care of a provider likely wouldn't make a difference. They don't ask you if you're experiencing symptoms of rare conditions. Conditions like these often pop up suddenly. A case of symptoms appear and you seek medical attention NOW! A friend of mine developed a pulmonary embolism in her last pregnancy. She experienced pain when breathing and shortness of breath. She went straight to the ER. It wasn't 'caught' by a medical professional during a prenatal visit. I was never once asked if I had any breathing issues, heart palpitations or areas of swelling or redness in my legs. It's just assumed the client or patient will disclose any concerns or call for help should something develop. It's no different with UP.

I tend to side with my last midwife. She has no objections to UP/UC for those that have had children already. She's attended UP births before/acted as the backup. Don't get me wrong, I understand where you're coming from. I just don't think UP is inherently unwise or wrong. It's not something I place such a strong value judgment on when the decision is an educated and informed one.

Anyhoo, enough of that novel. That's the most exercise my fingers have had in months.
__________________
Aeon, mama to Grace, 12/04; Evangeline, 11/06; Duncan, 11/08 ; Henry, 12/09; and Ruby, 11/14.




Last edited by Aeterna; October 18th, 2010 at 02:45 PM.
Reply With Quote
  #22  
October 18th, 2010, 02:55 PM
Mega Super Mommy
Join Date: Oct 2007
Location: Northern VA
Posts: 2,727
Quote:
Originally Posted by Vespertina View Post
Prenatal care for the 80% that are low risk is pretty basic stuff. Perhaps I've missed something, but how complicated is it?
Little condescending for a normally open-minded board, don't you think?

My point is, especially with a 1st pregnancy, inexperience could be dangerous. I was the epitome of low-risk. I was 26, very fit, very healthy & I had not 1 but 2 pregnancy complications that could've been dangerous to my health & future fertility. The molar was caught early because of routine bloodwork & an u/s. When my hcg came back over 250,000 at 8 weeks, my Dr knew something was wrong & ordered an u/s. I had exactly ZERO symptoms & even w/ a second or third pregnancy probably wouldn't have known there was something wrong, let alone my very first. The ectopic was much more obvious, stabbing pains & a trip to the ER.

Personally, I think its very possible to find a Dr or midwife who will support a minimalist approach. Why not have that if you can find someone you like?
__________________
Thank you Jaidynsmum for my siggy!
Reply With Quote
  #23  
October 18th, 2010, 04:54 PM
Aeterna's Avatar Super Speshil
Join Date: Nov 2006
Location: the edge of reason
Posts: 1,717
Quote:
Originally Posted by AmandaEliz View Post
Little condescending for a normally open-minded board, don't you think?
That wasn't my intention, but I'm curious, how so? It's true. Roughly 80% of pregnant women are low risk and the management of such pregnancies is fairly basic, especially if one sees a homebirth midwife.

I'm not sure how what I said was condescending, or anymore so than stating a pregnancy or birth choice is flat out wrong or unwise?

I support UP/UC when the decision has been weighed after much contemplation, soul-searching and research. I'd say that's pretty open-minded. You may not agree with my position, but I'd hardly call it close-minded.

Quote:
My point is, especially with a 1st pregnancy, inexperience could be dangerous. I was the epitome of low-risk. I was 26, very fit, very healthy & I had not 1 but 2 pregnancy complications that could've been dangerous to my health & future fertility. The molar was caught early because of routine bloodwork & an u/s. When my hcg came back over 250,000 at 8 weeks, my Dr knew something was wrong & ordered an u/s. I had exactly ZERO symptoms & even w/ a second or third pregnancy probably wouldn't have known there was something wrong, let alone my very first. The ectopic was much more obvious, stabbing pains & a trip to the ER.
But who is saying all women that UP forgo blood work and ultrasounds? It sounds like you're using your experience to argue that UP isn't wise because things can easily go unnoticed. A woman that UPs can also discover she has a molar pregnancy if she consents to these procedures/tests. Some choose to pay out-of-pocket for ultrasounds or go to lab testing facilities. They are just as capable of finding out the same information as another woman that sees an OB or CNM practice.

Having a care provider doesn't mean the mom will choose to a) have ultrasounds and b) have blood work done.

So, really, what you're stressing are ultrasounds and blood work. A homebirth midwife would not be able to do either of these and not all homebirth clients consent to these procedures. I know plenty that don't. I know a woman that didn't see a doctor or midwife at all during her pregnancy and she recently gave birth to her second child unassisted. Now, that's not something I would do, but I fully support her choice. I do advocate for at least some outside care (blood work and ultrasounds). Part of that is due to my history. Ultrasounds can provide useful information, but some aren't comfortable with them and I don't think negatively of them for it.

Quote:
Personally, I think its very possible to find a Dr or midwife who will support a minimalist approach. Why not have that if you can find someone you like?
I think it depends on the area one lives in. Not all areas have progressive birth climates. Some areas midwives aren't even given hospital privileges to attend births. I've yet to find a doctor that doesn't throw a fit if you don't consent to standard/routine procedures. When I declined the offer to take the OGTT with my first son at 10 weeks I was looked at like I had a third eye by a midwife (CNM). Granted, her experience was only in a hospital setting so many of the normal obstetrical procedures and tests are just a given. It's just expected that you'll consent.
__________________
Aeon, mama to Grace, 12/04; Evangeline, 11/06; Duncan, 11/08 ; Henry, 12/09; and Ruby, 11/14.



Reply With Quote
  #24  
October 19th, 2010, 10:43 AM
HappyHippy's Avatar Platinum Supermommy
Join Date: Dec 2008
Location: Pavia, Italy
Posts: 5,959
Quote:
Originally Posted by Vespertina View Post
That wasn't my intention, but I'm curious, how so? It's true. Roughly 80% of pregnant women are low risk and the management of such pregnancies is fairly basic, especially if one sees a homebirth midwife.

I'm not sure how what I said was condescending, or anymore so than stating a pregnancy or birth choice is flat out wrong or unwise?

I support UP/UC when the decision has been weighed after much contemplation, soul-searching and research. I'd say that's pretty open-minded. You may not agree with my position, but I'd hardly call it close-minded.

But who is saying all women that UP forgo blood work and ultrasounds? It sounds like you're using your experience to argue that UP isn't wise because things can easily go unnoticed. A woman that UPs can also discover she has a molar pregnancy if she consents to these procedures/tests. Some choose to pay out-of-pocket for ultrasounds or go to lab testing facilities. They are just as capable of finding out the same information as another woman that sees an OB or CNM practice.

Having a care provider doesn't mean the mom will choose to a) have ultrasounds and b) have blood work done.

So, really, what you're stressing are ultrasounds and blood work. A homebirth midwife would not be able to do either of these and not all homebirth clients consent to these procedures. I know plenty that don't. I know a woman that didn't see a doctor or midwife at all during her pregnancy and she recently gave birth to her second child unassisted. Now, that's not something I would do, but I fully support her choice. I do advocate for at least some outside care (blood work and ultrasounds). Part of that is due to my history. Ultrasounds can provide useful information, but some aren't comfortable with them and I don't think negatively of them for it.

I think it depends on the area one lives in. Not all areas have progressive birth climates. Some areas midwives aren't even given hospital privileges to attend births. I've yet to find a doctor that doesn't throw a fit if you don't consent to standard/routine procedures. When I declined the offer to take the OGTT with my first son at 10 weeks I was looked at like I had a third eye by a midwife (CNM). Granted, her experience was only in a hospital setting so many of the normal obstetrical procedures and tests are just a given. It's just expected that you'll consent.
To the first bolded, yes, most pregnancies will be uncomplicated. But how would a first time mom, with no training, and only read pregnancy books which have a lot of facts wrong and don't tell everything, going to know if there is a problem? Especially when it isn't an obvious problem. When I was still in my apprenticship phase of Midwifery I was suprised at how little I actually knew. When only reading books you don't get the full picture.

To the second bolded. A homebirth Midwife who is licensed or certified (and in some states they don't have to be either) normally has access to blood work and ultrasounds. I had a homebirth 6 months ago, I had blood work done and an ultrasound. My Midwife did some of the blood work, but some of it was done at my local clinic because it was just easier for me. I didn't do all the tests that you can get done in a pregnancy, but I was having regular prenatal appointments with a Midwife who did take my blood pressure, urine, did palpatations, and so on on each appointment. Yes, women can do that themselves, but they have to know what their looking for. Many women who use a doppler or fetoscope will hear the placenta and not the baby, or interperet (sp?) it wrong and think the baby is ok when the baby is really in distress.

Like I said earlier, I do support women who have UP/UC, but I do have to recommend against them, and provide as much evidence-based information as I can. I think using a OBGYN or Midwife for atleast back-up care is a wise choice. You don't have to see them for every recommended appointment.
__________________
Mama to G, L & twins F & M
Started off 2013 homebirthing suprise twins Fia Celesta & Maddalena Isabella
Reply With Quote
  #25  
October 19th, 2010, 11:30 AM
moon~maiden's Avatar Cheryl~ birth truster
Join Date: Jul 2007
Location: south eastern Mass
Posts: 13,088
great conversation ladies!!!
__________________
Reply With Quote
  #26  
October 19th, 2010, 01:06 PM
mgm78's Avatar Zoe's mom Meredith
Join Date: Aug 2008
Location: PA
Posts: 17,089
Send a message via Yahoo to mgm78
I would opt for prenatal care. I loved the prenatal care with my midwives at the birth center. Not only did they check me, but they spent about 30 minutes with me each appointment talking with me and educating me on different things, everything from healthy sex during pregnancy to nutrition to preparing for childbirth. They were very hands off and I weighed myself and dipped my own pee with them. It was nice to feel their support during my pregnancy.
__________________





Reply With Quote
  #27  
October 19th, 2010, 06:15 PM
bostoncreampie's Avatar Platinum Supermommy
Join Date: May 2007
Location: outer space
Posts: 22,681
Send a message via AIM to bostoncreampie
When I hear the argument that women have been doing this for the entire history of mankind, I can't help but roll my eyes a little. Because I'm sure the infant death rate was a lot higher too. Less is more, but I do think there is an important line between less and nothing. There are risks that exist that while rare, can be treated with the help of professionals. I think a good middle ground is having professional, hands off care. I felt that the birth center where I delivered my son was a good middle ground. You just never know if you are one of the women who have a rare risk, I would hate for something to go unnoticed by an untrained eye, and end in tragedy.
__________________
mama to 5 yr old DS1 , 3 year old DS2 , and nursling DD .
Reply With Quote
  #28  
October 19th, 2010, 07:47 PM
Caelen's Avatar Platinum Supermommy
Join Date: Nov 2009
Location: Hurley, WI
Posts: 8,572
I didn't read the other posts, so if I repeat something, sorry!

My opinion is that the doctor/midwife only does so much care. They administer the few tests we need (blood work, u/s etc) then all they're doing is providing guidance and WE, the client, are providing the actual care. After all, we are the ones pushing ourselves to eat right, to exercise and all that good stuff. So I guess my opinion is that you already have a lot of control over your care. Find the right doctor along with that who shares your philosophy on things, you'll probably be set.

I love the idea of a home birth, but I don't think I could EVER go unassisted. Of course there's the odd chance that things could go so fast that with where we are if its winter, I may very well end up going unassisted. I don't think I would ever actively choose that route though. I really feel strongly that its a good idea to have a doctor or midwife involved because they are trained to know when there's a problem and what to do when that problem arises. I'm more comfortable with that because if something goes wrong it could be mine or my kiddo's life at stake.
__________________
‎"That which offends you only weakens you. Being offended creates the same destructive energy that offended you in the first place- so transcend your ego and stay in peace."

Stay at home mom to two:
Jacob 03/17/2009
Benjamin 03/18/2011
Reply With Quote
  #29  
October 19th, 2010, 07:54 PM
Caelen's Avatar Platinum Supermommy
Join Date: Nov 2009
Location: Hurley, WI
Posts: 8,572
Quote:
Originally Posted by AmandaEliz View Post
Personally, I think its very possible to find a Dr or midwife who will support a minimalist approach. Why not have that if you can find someone you like?
I was lucky enough to find an OB who is like this. It may not be his normal approach, but he's been happy to follow it with me. Its kind of refreshing after the craptastic experience I had during my pregnancy/labor/delivery with DS. So yeah, its very much possible. You just might have to do some searching and be sure that you can communicate what you want. Sometimes its good to be open to alternatives as well.

Not so much telling you this, Amanda, as saying it so a few first timers that might read this will get it .
__________________
‎"That which offends you only weakens you. Being offended creates the same destructive energy that offended you in the first place- so transcend your ego and stay in peace."

Stay at home mom to two:
Jacob 03/17/2009
Benjamin 03/18/2011
Reply With Quote
  #30  
October 20th, 2010, 07:16 AM
Aeterna's Avatar Super Speshil
Join Date: Nov 2006
Location: the edge of reason
Posts: 1,717
Quote:
Originally Posted by JennTheMomma View Post
To the first bolded, yes, most pregnancies will be uncomplicated. But how would a first time mom, with no training, and only read pregnancy books which have a lot of facts wrong and don't tell everything, going to know if there is a problem? Especially when it isn't an obvious problem. When I was still in my apprenticship phase of Midwifery I was suprised at how little I actually knew. When only reading books you don't get the full picture.
In my earlier responses I clearly stated that UP makes sense for multiparas. I've said that quite a few times. Most of the UPers I know have kids. I'd say virtually all birthed previous children at home.

Quote:
To the second bolded. A homebirth Midwife who is licensed or certified (and in some states they don't have to be either) normally has access to blood work and ultrasounds.
Both my midwives are certified and licensed and they could not perform/order ultrasounds or blood tests. They are CPMs. The client has to have blood work done either at a lab testing facility or an OB/CNM practice.

Quote:
Yes, women can do that themselves, but they have to know what their looking for. Many women who use a doppler or fetoscope will hear the placenta and not the baby, or interperet (sp?) it wrong and think the baby is ok when the baby is really in distress.
Women that have had children before and quite possibly homebirths are usually pretty familiar with the sounds of the placenta and fetal heart tones. I'm pretty familiar with the sounds the placenta makes and fetal heart tones, but after four babies and 7 years spent as a birth junkie that would make sense. I was able to tell I had an anterior placenta with both my third and fourth baby.

Now, a first time mom may not being able to distinguish the sounds of the placenta from fetal heart tones. If a woman that hasn't been pregnant is interested in UP she should do all of the necessary research and get in touch with a homebirth midwife for tips or advice. My midwife with ds2 did this for a couple that were chiropractors.

I think it's important to remember the demographic/individuals choosing to UP. It's rare to find a UPer that hasn't birthed at home with a midwife in attendance.
__________________
Aeon, mama to Grace, 12/04; Evangeline, 11/06; Duncan, 11/08 ; Henry, 12/09; and Ruby, 11/14.



Reply With Quote
  #31  
October 20th, 2010, 08:31 AM
FusionGirl's Avatar Formerly TTC#1inNC
Join Date: Jun 2009
Location: North Carolina
Posts: 5,154
Quote:
Originally Posted by kristenpie View Post
Less is more, but I do think there is an important line between less and nothing. There are risks that exist that while rare, can be treated with the help of professionals. I think a good middle ground is having professional, hands off care. I felt that the birth center where I delivered my son was a good middle ground. You just never know if you are one of the women who have a rare risk, I would hate for something to go unnoticed by an untrained eye, and end in tragedy.
I feel the same.

It has been interesting for me to read this because my SIL is pregnant with her 2nd. She has a 7 year old son. She is possibly due in May - that is just my guess. She is not planning on any prenatal care at all until she is at least 5 months pregnant and when I spoke with my brother yesterday he was with her so I asked when she was due and she doesn't have a clue. I have no idea how she is going to determine she is 5 months along and its finally time to get checked out. I am glad she lives in a different state because I don't think I could even look at her.

This thread has opened my eyes a bit to going through your pregnancy with minimal assistance and the thing I see repeated over and over is that you have to be educated and know what to look for. I know my SIL is not. Don't take anything I said above the wrong way, I am all for home births and MWs and minimal assistance but I feel my SIL is taking a way to minimal approach to he pregnancy.
__________________
Reply With Quote
  #32  
October 20th, 2010, 09:36 AM
BobbityBoo's Avatar Platinum Supermommy
Join Date: Aug 2009
Location: The Left Coast
Posts: 816
Quote:
Originally Posted by Uma View Post
I think it's important to remember the demographic/individuals choosing to UP. It's rare to find a UPer that hasn't birthed at home with a midwife in attendance.
I don't think the OP falls into this category so I think that accounts for a lot of the views presented in the thread originally.

On a another note what is the difference between all the acronyms? UP, UC, UA? A PP (maybe it was even you) made a distinct difference between UPers and UCers.
__________________


Thank you Kiliki for my wonderfull siggie!
Reply With Quote
  #33  
October 24th, 2010, 05:53 PM
Tiny Loves
Join Date: May 2010
Posts: 1,123
UP- is unassisted pregnancy (prenatal care)
UC- is unassisted childbirth (and more oft than not they UP too)
__________________





Reply With Quote
  #34  
October 25th, 2010, 08:02 AM
BobbityBoo's Avatar Platinum Supermommy
Join Date: Aug 2009
Location: The Left Coast
Posts: 816
Quote:
Originally Posted by hellolove View Post
UP- is unassisted pregnancy (prenatal care)
UC- is unassisted childbirth (and more oft than not they UP too)
Thank you! I'm guessing UA is just unassisted in general?
__________________


Thank you Kiliki for my wonderfull siggie!
Reply With Quote
Reply

Topic Tools Search this Topic
Search this Topic:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off



All times are GMT -7. The time now is 02:55 AM.



Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
Search Engine Optimization by vBSEO 3.6.0