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The Current State of Home Birth and Emergencies

10/12/2011 1:07:24 PM

Tags: home birth, midwives, midwifery

Emergency Medical ResponseIn emergency medicine, OB calls are thought by most paramedics to be a Basic Life Support skill. Firefighters and EMT-B’s who receive basic level emergency training are taught how to catch a baby in an out of a hospital setting.  Paramedics who receive advanced training get to go watch a few babies get delivered in local hospitals. We can do IV’s and give drugs, intubate and many more advanced skills. Generally a birth is not problematic. There is a very small chance that the situation is going to become an emergency. Events like hemorrhages and babies born not breathing are very rare and many times, either in the hospital or at home, result in the death of the mother or baby. I’ve caught (not delivered), two babies in the field. They both were great, and neither needed to go to the hospital afterward. Due to protocol, I advised and pressured both to come to the hospital as a precaution.   

A midwife friend of mine recently attended a birth that surprised her. The woman wanted a home birth and was not interested in an ultrasound or any other tests before delivery. The woman delivered her daughter in the birth pool and then moved to the bedroom to deliver the placenta. Once in the bed she was continuing to have some cramping and back pain. The midwife went to check her out to see if there was a problem, only to find another head coming out. Needless to say, there were some surprised looks on the parents’ faces. Both girls were born 11 minutes apart at home. There was no emergency, both of the girls responded immediately and were pink and alert. The midwife and her assistant were able to check out both of them and make sure they were ok. 

Most hospitals I work with would have considered twins a high risk pregnancy.  Many hospitals would have either pressured or required the woman to have a C-Section. Most likely had this happened in the hospital she would have had an emergency C-section once the OB realized there was another child coming. This otherwise totally normal process of birth could have been made into an emergency for no reason.

I don’t mean to say that all hospitals would be the same. Some OBs would have let her have twins vaginally in the hospital, and some would have held off on a C-section and just let the second baby come out. I think in the world of birth we need to start talking about what an emergency is, when a situation becomes one and what the appropriate response is. Fathers and partners need to step up and educate themselves about birth issues and be the advocate and supporter their wife or partner needs. Doctors and nurses need to stop pushing and start listening to the needs of women in labor, and start believing once again that birth in its self is not dangerous. Midwives who specialize in out-of-hospital birth, CPMs, can work well with OBs so that if a transfer needs to happen it’s not about the midwife failing, but that the situation is heading toward an emergency and that a OB could handle.

I hope that in the future birth can be something we teach our children about. Maybe more women could get their education from family and not from Maternity TV shows who make birth out to be something only a trained OB can handle.

 I’d be a fool to suggest that no births are in fact emergencies. Some should be planned C-sections to avoid the death of the mother or the baby. For these reasons I am thankful for OBs who train as much as they do to prepare for those situations. I hope that if my wife finds her elf heading toward an emergency, our midwife’s training and my education will get us to a labor and delivery unit OB whose emergency skills we will openly accept.

Thanks for reading. I plan to get hold of some great birth stories in the near future and get them posted. Let’s keep the conversation going. All births are special and amazing achievements no matter where or how they occur.

Photo by Fotolia/Devilpup 

 



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Jade
9/19/2014 8:38:42 AM
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cristineduval
6/27/2014 6:33:15 AM
Also sometimes referred to as Diagnostic Medical Sonographers, an ultrasound technician (Sonographer) aids in the prognosis and diagnostic processes by the taking of ultrasonography diagnostic images of a patient’s interior. These diagnostic images are then used to help diagnose a variety of different medical conditions. What are the Duties of a Sonographer? Operating the ultrasonograhy equipment Adjustment of the equipment Maintaining the equipment Directing patients so as to ensure the best images are obtained Recording the medical history of each patient as it pertains to the ultrasound Performing the testing of certain areas as per the physician’s directions Maintaining the ultrasound records of the patient: http://ultrasoundtechnicianssalary.com/ Selecting the best and appropriate images for the physician’s use What else do Sonographers do? It goes without saying that a very important part of the ultrasound technician’s job description is maintaining the records of the patients that pertain to the examination, whether these are pathology files, charts, logs, imaging requisitions, and so on. Furthermore, the ultrasound technician is also responsible for ensuring that they can operate the complex equipment that is used. Interestingly, they also need to be physically fit as well, because sometimes they have to maneuver the patient in order to obtain the best images possible. They require good eyesight, because they need to choose the best images for the physician to use. It goes without saying that they also need to be personable, with a strong ability to interact with the patients that they work with. Sonography as a Career Since diagnostic medical equipment is improving continuously, this is a career choice that is becoming more popular as time goes on. The ultrasound technician might also choose to specialize in other areas, such as: Echocardiography Neurosonography Ultrasound technicians will find that they have employment opportunities in hospitals, clinics, physician’s offices, and in diagnostic centers. The ultrasound technician is trained to work with other professionals by carrying out diagnostic procedures that are important from a patient’s prognosis and treatment perspective. Most people encounter ultrasound technology when they are expecting a baby. The doctor makes use of the technology in order to render a picture of the unborn child, but more than that, it is used to monitor that the infant is growing normally and that the pregnancy is progressing as it should. The physician is also able to detect potential problems that would not be known about before the child is born. Most parents get to keep an image of the baby inside the mother’s womb, which obviously becomes the first baby picture. Summary: In general terms, an ultrasound technician is trained in imaging various parts of the body, with obstetrics being the main area where the technology is routinely employed. Some might also be trained in order to perform what is called Vascular Ultrasound. These ultrasounds are of the veins and arteries, helping physicians to uncover the condition of the vessels essential to the patient’s cardiac health.

Shelly
7/24/2012 1:44:53 PM
Great article! I can't wait for the birth stories!










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