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All of us wonder what would have happened if there was a home childbirth issue. Also see "You can't have a home baby because...", which deals with why individuals might be said to be unfit for home baby giving, e.g. the expectation of your first baby, a big baby, an earlier poor crack, a prior caesarian section, an earlier assistedbirth, an earlier severe sepsis, diabetic disease, a large multi parity, anemia, thrombocytopenia, and others.....
If you want to relieve your pains, what is it? If you had a posterior hemorrhage, what would happen? Supported childbirth - tweezers or ventous - what if you need one? If you need a C-section, what happens? If the string is around the baby's throat, what happens? Well, what if there was a string incident? Well, what if there's a Schulterdystokie?
If your baby needs a reanimation? If your baby is dying, what? If you want to relieve your pains, what is it? Various types of analgesia are available for home births. There are many ways of coping with your own pains that you can help, but there are also medications that can be used in home births to help the mom treat them.
Can' t have a home based anaesthesia - if you find at childbirth that you really want a home based anaesthesia, you would move to the clinic to get one. Waiting may be hard, but remember that a woman who is planning a childbirth in your clinic often has to spend some waiting around for an anesthesia.
PDAs must be given by an anaesthesiologist, and it is difficult to say when they will be available, as these physicians usually span all areas of a clinic and not just the delivery area. As soon as you choose to change your mother, your nurse could call you in advance in order to try to organise an anaesthesia as soon as possible after your induction.
Research shows, for example, that in general birth pains in the home are better controlled by females than in hospitals. If you had a posterior hemorrhage, what would happen? Homebirths' birth attendants wear the same medications that are used to eject the placenta and contraction the uterus as in the infirm.
Meanwhile, the nurse will take other urgent procedures, such as dispensing IV fluids and manual compression of the uterus, if the latter do not check the bleeding. It is much less likely, however, that you will have postpartum bleeding after a home baby than after a host baby, as the risks of PPH increase with procedures such as assistant childbirth and childbirth initiation performed only indoors.
Supported childbirth - tweezers or ventous - what if you need one? Nevertheless, there is an elevated risk of the baby (e.g. injury such as cranial injury or a complication such as Schulterdystokie ) and the dam (heavy tears and/or bleeding) being born with aid. When you need an assisted birth, e.g. due to poor second-phase advances, you would have to go to hospitals.
Occasionally a woman changes in this position and then gives spontaneous birth in Hospital, while others have supported childbirth. Usually it is not an emergenciesituation, but the transference for gradual advances in the second phase can of course be awkward and frustrating for the mom.
Below are some birthing histories of females who have been transfered for supported births: If you need a C-section, what happens? You need a C-section, you'd go to the infirmary to get one. Most of the unscheduled caesarian section is due to slower contractions in which neither mum nor baby are in immediate risk.
A cesarean section can appear after the mum has been hospitalized because of slower progression, perhaps an attempted elpidural anesthesia to find some peace, and a drop of Syntocinone (Pitocin) to accelerate her work. Occasionally it happens after a failure to give birth to the baby with tweezers or a vein. In fact, an "emergency C-section" means only one that was not intended at the beginning of the birth, regardless of whether the child or mum was in immediate risk.
Something that worries most humans is a "crash" or "real emergency" cesarean section in which the baby must be born desperately. A baby's HR may indicate to the obstetrician that the baby is in serious need. Maybe the string is around the throat - this happens in about a third of all babies born and usually doesn't cause a big deal of trouble, but in some cases the baby's baby is strongly deflated of it.
Possibly the string is compress inside the cervix. Mothers may bleed from partially separated placenta or, very seldom, from uterine rupture. During such an emergencies, the nurse immediately called an ambulance and called the clinic in advance, asking them to have the OR and OR staff prepared.
Medical teams took the mom directly to the O.R. During the wait for the ambulance and during the transferal, the nurse can apply an IV or Venflon IV syringe or needles so that a drop can be applied immediately in the ambulance or in the clinic. Historically, obstetrical "flying squadrons" were sometimes used to provide home delivery care.
In the United Kingdom, however, these have been gradually discontinued because, overall, they have proved less secure and efficient than transfers to hospitals. So, how much if you had to move from home, how much lost your life would be? Of course, it will depend on your proximity to the clinic and the transport situation, but even if you began in the clinic, the OR will have to be set up and an OR staff will have to be made up.
An interesting chart is available in the Tuffnell et al document (see references below), which lists the stages from making the choice to delivering in a C-section. When you were working at the infirmary when your baby was in need, you may be amazed at how long it could take from "call to cut," i.e., how long it took for the plastic surgeon to actually start the surgery.
However, research shows that the British goal for childbirth by cesarean section is 30 min from making the choice to childbirth, but this goal is usually not met. Nine minute at her big Oxford training clinic. Inevitably, the transfer from home for a Cesarean section usually results in a loss of a certain amount of patience in comparison to a scheduled outbreak.
Dependent on your transfers, however, the discrepancy may not be as large as you would like. However, the problem for most people is how likely it really is that they would need a "crash" C-section. Below are some childbirth histories of a woman who changed from a home delivery to a C-section: the first one is a c-section:
About 1 in 3 infants are conceived with the string around their neck. Though it can be scary at this stage, it is usually not a big deal; some infants need revitalization such as friction of the skins, supply of breath through pouches and masks, or breathing fresh blood, but most are well.
Sometimes it can be more serious no matter where the baby is conceived. In almost all cases it would be treated at home in the same way as in hospitals. When the string is very narrow, the baby's baby's skull may not drop and its HR may almost certainly show symptoms of stress if the string contracts during contracting when the baby's skull is pressed down.
Home maternity staff would monitor the baby's HR on a regular basis, and if this showed evidence of need, you would go to the clinic. Usually, if the foetal need continues. In most cases, however, the string is so slack that the baby can be conceived in the vagina.
Unless the baby is shaken sooner in labor therapy and his mind sinks, the situations are handled in the same way wherever you were born - after all, there is no room for a cesarean section in hospitals if your baby shows evidence of shaking only in the last 10 min of labor.
Once the baby's baby starts to have a baby, if the string is slack enough, the baby's birth baby's baby could be given a headloop by the baby's baby's head, or she could hold the baby's baby's baby's head near the dam while his baby's baby is still being conceived, and "roll over" it so that it is conceived through the string bow. Rebecca's history is an example of how to untangle a baby without severing the string, while Willow's baby was also conceived with the string around his throat.
When the string is very narrow, it could jam the string and trim it as soon as the baby's baby is born-for example, see Nicolas' history, Suzannes, Rosie Taylors or Doris' history. A lot of skilled mothers think that in this case it is almost never necessary to sever the string, because when the womb shrinks and the baby's stomach goes down, the string will come loose.
According to one of the midwives, the most serious case is when the string breaks when the baby is delivered; what is the difference to shearing? Christy's history is an example of a string that was too narrow to be loosened, but still enabled the baby to be conceived. There are two major factors why early cable trimming is best to avoid.
First, if the baby's shoulder gets caught after the string is severed, it has no air until it is delivered. Secondly, the early trimming of cords removes a considerable amount of the baby's own bleeding, which is usually transferred from the placenta a few moments after delivery, and string bleeding, and today there is much research suggesting that this is associated with an elevated chance of infant anemia and other issues (see Third phase of birth).
When the baby is not in good shape at the time of delivery, the baby is resuscitated by the nurse, and the home procedures are at least primarily the same as in hospitals. What if your baby needs CPR? Well, what if there was a string incident?
The prolapsed string is one of the emergencies a midwife dreams of. Cords are displayed when the navel is in front of the baby's display part (usually the baby's neck, unless it is a closure). Lowering the baby's bowl compresses the cable, which can limit the baby's ability to oxygenate.
The prolapsed string is the next step - when the string sticks out of the womb in front of the baby and can be felt in the sheath. Occasionally a nurse or physician can slide the string up and out of the way and hold the baby's baby's baby up while they do it.
Often, however, an incision is necessary. At home, if a string incident occurs, your birth attendant would probably ask you to go on all four, with a bowl deeper than your own torso and a butt in the wind. That would take the strain off your neck of the womb and hopefully the string as well.
Your nurse could hold a palm in your hands and hold the baby's baby's baby up and off the string while she waits for the arrival of the ambulance. You could stay in that spot while the paramedics took you to the morgue. Interesting sights for the neighbors - but potentially life-saving for your baby.
There is no question, however, that this is a complicated situation where any delays could turn out to be deadly; there is no question that the best place for a string incident is the clinic. Problem is, how likely is it that a cable incident will happen? The prolapsed string is a complicated condition that can be deadly at home or in hospitals.
National Birthday Trust Fund's survey of home delivery plans in the United Kingdom covered the frequency of line prolapses. The home and clinic groups, with a total of 10,695 females, had only one prolapsed line, the home delivery group - but no foetal mortality was reported*. According to the author, the prolapsed string occurrence appears on one occasion per 900 pregnancies on avarage (presentation of the string once per 300), but is much more likely in certain high-risk categories: occlusion or transversal position, small infants, polihydramnios (excessive fruit water).
Only very few females who plan a home delivery have maternities that fit into these classes. Notice: I was approached by a woman who took part in this trial. Initially she was reserved for home delivery, but at the end of her gestation she opted for home delivery. Upon her entry into labor at the infirmary, she was diagnosed with a prolapse of the string and her baby die.
Since she was initially contracted for home delivery, the deaths of her baby are considered deaths in the intended home group. Notice that she was not at home or traveling when this happened - she was in a clinic. Sometimes infants sometimes end up dying of this state wherever the mom works - but the concern is that when it happens, when she was at home, someone somewhere is to blame for it being a home born.
When it happens at the infirmary, it'll be "just one of those things." Rope incident is an example of a hazard affecting a relatively small part of the birth rate, which distorts overall security statistic. A string chart at 300 mean birthrates may sound rather frightening considering it is a life-threatening condition, but for normal pregnant woman with low-risk gestations the risks are many fold lower.
This is a sad case of a string incident at home. Once the obstetrician had recognized the incident, the mum went to the infirmary and the obstetrician lifted the baby's baby's baby from the string by hand. From the time the baby was diagnosed with obstructive pulmonary disease to the time it was born with a cesarean section, which passed three and a half years later, 56 min. passed.
In this Daily Telegraph articles, Traci Relph, the mom, herself a birth attendant, tells us why she still helps home mothers. In her opinion, the result would still have been terrible if she had been in prison at the time of the incident, because her boy might have still been dead or alive but seriously handicapped.
Surely she would have had the C-section much quicker if she had been in the infirmary; in such an emergency, most clinics would have been able to have the baby within 30min. Well, what if there's a Schulterdystokie? The term'shoulder dystocia' means that the baby's baby's scalp was conceived, but itshoulders are still inside the mum and are not conceived immediately with the next contract.
It' s life-threatening for the baby as the baby can only breath after the baby is born and there is no room to blow up the lung but the cable can be squeezed after the baby's baby is born and the baby's baby can only breath after the baby is born and the baby can only blow up the lung. It' a situation that can be frightening for both the obstetrician and the mom wherever it happens.
In the UK, all UK midshipmen should be given training in the provision of urgent care for Schulterdystokien, and these relief manoeuvres can be performed at home or in hospitals. This includes moving the mother's posture to a posture that gives the baby more room to move through her hips, the McRoberts maneuver of pushing the female on her back and her legs up under her arms, and the single-handed delivery of the baby's strapped shoulders to the nurse.
Only one manoeuvre can be performed in hospitals but not at home, and this is practically unknown in the UK - the Zavanelli manoeuvre, in which the baby's baby's face is pressed back into the mother's womb and the baby is caesarean-sectioned. If your baby needs a reanimation?
UK midshipmen usually carry reanimation devices with them to home deliveries, and all must be educated in the reanimation of newborns. The majority of reanimation techniques used in hospital are also available at home, all of which are most likely to be needed after a sudden delivery.
Ventilation of the baby - release of compressed or pressurized fresh blood or fresh blood. When the baby's respiration is impaired because the baby's maternal pethidine or other opioids were given during labor, the remedy naloxone (narcan) can be given. It can also be done at home if the nurse is qualified, but since this method can be hazardous for the baby itself and can cause or aggravate airway problems, it is usually only done in hospitals and then only in severe circumstances.
When a longer reanimation is required, a midwife is usually ventilated with a pouch and face shield until the baby is taken to the hospital. Keep in mind that this is the preferred type of ventilation, primarily wherever the baby is conceived. Usually there are two mothers present at a home delivery in the UK, so in the unlikely case that both the mum and the baby need help after the delivery there is a specialist available.
This is a commentary from a middlewife who has experience in the care of home and home births: The thing I have for a home birthing neo-natal residual is: Mom and Dad asked for several hand tissues to keep us hot when we expected the baby to come. Anything I don't have is in that room at the hospital:
But if I've ever been to a home birth where the baby didn't breath in the first moment, I'd ask someone to call a paramedic who has a mechanic aspiration, laryngoscopes & ET tubing, probably also medication. Midwifery has more discussion of home and institutional reanimation on the UK Midwifery archives page on neonatal reanimation.
Midsummer Lisa Barrett has an article on home reanimation on her blogs, along with a series of photographs showing a non-breathing baby being revived while still with her mom. National Birthday Trust Fund's home delivery survey in the United Kingdom found that home born infants were less likely to have some kind of reanimation than infants who had intended to have a home delivery but had a similar likelihood.
Infants conceived in hospitals after the postponement of a scheduled home delivery are more likely to have had to be resuscitated, but many of them will have been hospitalized for childbirth related problems. And, of course, since these infants were hospitalized, the fact that their mother had initially been planning home deliveries did not influence the accessibility of CPR for them.
These are some birthing histories where a baby needs revival or was conceived at the time of delivery in bad state. Default setting of "bad condition" is that the APGAR value at delivery is below 7, out of 10 possible. Anna-Luise's daugther had an undiscovered bifid disorder; she did not breath at childbirth and needed mouth-to-mouth ventilation at home.
When she breathed, she moved to the infirmary, where she was operated shortly afterwards. "Danielle's baby had his string around his throat when his baby's baby's head on. Hebrews severed the string and "pulled" him out, but he did not breath alone until they made the CPR. Approximately a moment later I consented that Richard would slit the string so that they could make it breath and then be returned to me in the pool.
Because of the high sides of the swimming pools I could not see what they were doing and I tried to loosen up by a few slight contracting movements. When Sarah came to the infirmary, her second phase was very sluggish and Baby Aidan had his string around his throat. After passing through Maconium, he was suddenly conceived.
Although he was hospitalized, his care is pertinent; was there any particular part of this reanimation that was not possible at home? Petas Baby's baby's shoulder was clamped for six moments after the birth of her baby's baby and she came in blank and didn't breathe. Refreshed with a pouch and face shield while lying next to her, with a string appended, she was later taken to prison for worrying about her respiration.
While Christy was alone at childbirth, her baby had the string around her throat and was slowly breathing, but Christy handled the circumstance beautifully and baby and dam were kept in good form. Claire's baby was hospitalized after she was put into labor, and she had an Apgar of 4 at delivery; her string was immediately severed and taken out of the room for revival, which Claire found very traumatic.
Aida' s baby, Maia, did not breath at childbirth and had an Apgar of only 2. Her reanimation was performed at home safe and gentle, and her string was not severed. Suzanne' s baby, Jamie, had the string tight around her throat and was light gray at delivery, with a 1-minute Apgar value of only 5, he was revived at home with pocket and face shield and taken to the infant care center for control after delivery.
Kira had the string around her throat and was "very blue" at delivery. Helen's second baby, Jesse, was revived at home for ten moments when he couldn't breath alone. Jessica's baby needed revival when she was conceived 18 working days past childbirth and weighed 10 pounds 3oz.
Oddny's boy, Anton, was an unanticipated breech-born, and like most breech-births he initially needed some help to breathe. Doris' 7th baby, Gabrielle, had Schulterdystokien and needed for about five minute after the delivery a Reanimation. If your baby is dying, what? Occasionally infants are killed after or during a baby childbirth.
Mortality may be due to innate malformations or to things that would have occurred where the baby was born. Seldom can a baby starve to death following a self-birth if it could have lived after a host family. Maybe a crash-caisersection is necessary and the relocation to the infirmary is retarded.
The opposite is the case - sometimes infants are killed after childbirth in hospitals if they may have lived after a home bird. These can be respiratory problems after cesarean section, hospital-acquired infections, childbirth trauma from assistant childbirth, serious responses to medication administered to working mothers, or due to distress or trauma resulting from childbirth initiation or extension.
However, what we can do is look at the results of a large number of scheduled home births and ask if more infants are likely to be dying or hurt at home or in hospitals. Most of this website is devoted to this issue, and the overwhelming view of the experts is that infants will no longer be killed, and infants and mother are less likely to be hurt if they plan to give birth.
On this page there are two natal histories of a family that let a baby go after a home bird. The baby was unable to breath alone in both cases and, despite immediate reanimation and quick hospitalisation, both were killed. On both occasions, the next baby was born at home.
To commemorate the kids they sacrificed and to celebrate the baby's remains, please see the natal histories of Nicky and Megan.