Saturday, September 24, 2011

Birth " back up" plan.

 Because birth is powerful and sometimes unpredictable, any woman planning to birth out of the hospital needs to know clearly what her "Plan B" is. Meaning, if sometime during her prenatal care and or during her labor, birth or after she or her baby require medical care which can only be received in a hospital setting she must ask her midwife...."Who, what , where and how?"
        Who will take over my care?
        What will I be transferred for? What are the barriers to getting there?
        Where will I go?
        How will I get there and How fast can I get there?

You need to have a good heart to heart talk with your midwife.  Know how she feels about transferring. Will your complete medical records go with you for continuity of care. Make sure she is not leery or fearful of transfer. It helps to choose a midwife who has a good working relationship with a Collaborative OB. For some of you....I know they are the "enemy" but you know what?  When you need the skills and expertise of someone who has seen the worse of the worse (severe high blood pressure, placental abruption, mal-presentation, fetal distress, hemorrhage,severe tears) and can get you and your baby through the emergent situation you might find yourself in.....this person could very well become your hero.

The chances of most of you needing that kind of care is rare.....but if it does happen to you you don't need to be worrying about "Who, what , where, and how".  Not then. And you need to have a midwife who is willing to make the call when her gut is telling her it's time.

And the final piece of your "back up plan" should be:  Does my midwife carry malpractice insurance? If in the event, either I or my baby are hurt by the poor judgement or neglect of my midwife ( remember- this is reality)....will we have recourse?  Is she accountable? Will I have funds available for on-going care if I or my baby needs it?  You wouldn't choose a physician without malpractice insurance, why would you not hold your midwife as accountable.  We make mistakes too. Some do. Because she seems like your friend? She's caring and kind?  She's willing to deliver you at home even though you have had two or three (or more) previous c-sections?  Your baby is breech? You have twins? You're 43 weeks.    Sometimes the best and safest place for a woman to birth her innocent child is not at home or not at a birth center.  Sometimes you need to be where intervention is just a whisper away.....

We all must keep our eyes on the PRIZE.......Healthy mom and healthy baby. Remember, you hire your midwife to help you arrive safely at your destination.

Birth safe....for now...Janet

I always say you need to have a "Plan B", know what it is, how you would initiate it and then set it aside.