Post project let down

It happens with weddings - post nuptial depression is a "real" illness, or at least a real situation that many brides find themselves in after the Big Day.

I have been thinking that in a lot of ways, there is something to be said for the postproject letdown that comes with getting to the end of a pregnancy, and getting through birth, and getting to the end of that first newborn phase. It's a time of changing definitions of myself, and of looking around and going "now what?". It's probably a lot of the reasons that there are challenges in redefining our marriage, living arrangements, personal space, image, routine, budget and so on.

How to address it? I'm not sure. I need to redefine myself and it's being done for me in a lot of ways which in itself is hard and really confronting. But in a relationship, a friend gave someone else the best bit of advice:

"Also, keep in mind there's always "post project" let down. You did this huge thing together and now you're sorta in maintenance (survival!) mode. Keep looking for the next "big project" you can do together. Stay focused on you and hub as the core of your family. It will be ok!"

So what other big project can we tackle together? So many things still have to happen - are still happening.

Cleaning out the garage that is rapidly becoming "a great Aussie shed";
Finalising my insurance claim - 3rd anniversary coming up soon;
Me finishing school;
TheHusband finishing his PhD;

and so on. But these aren't Big Projects. These are the day-to-day minutea that we all have to face. So dear readers - suggest me some Big Projects.

Famous last words

So my last post was Wednesday night... and Thursday morning at 2am I started to have contractions, and then by 7am on Friday I was a mama:






Sally (Salome for realz but Sally for short) Clio was born at 6:43am on 12 March 2010 into my hands in water. She was 7 lb 6.5 oz (3.36kg), had a 35cm head, and was 48cm long.

Short birth story: contractions started slowly at 2am Thurs, no idea when my waters broke, got more intense during day but ate breakfast and lunch so not too bad, and then contractions got closer together, midwife came about 8pm (I had said it would kick off at dusk and it did!), got in the pool at some point, started pushing about 3am, swore up and down to myself that she was going to be born by dawn and yep, 6:43am!

So doesn't even begin to cover it but that's the nuts and bolts. I'll get to writing a really detailed one soon.

10 things no one told me about pregnancy

It's nearly the end of this journey so here are 10 things that I wish I'd been told about pregnancy. This is something I've been thinking of the whole journey long but inspired by the great article over here I am writing them down:

1. Things change during pregnancy - but no one ever tells you that they change back and forth and no one can tell you when or how. Just because something is bad or hard or great or easy now, doesn't mean that tomorrow won't be different. I was surprised that, for example, my abdominal muscles separated really early. They came back together after a few weeks though. Other things that changed included my breasts getting hard and sore and then going soft again, my feet swelled and have gone down, my skin GLOWED and then has gone back to being a sulky teenager, morning/all day nausea came and went and came back again, and so forth.
   
2. Your breasts really can grow a LOT in the first trimester so be prepared to buy new underwear quickly if not immediately. It's not just a little bit of change at that stage - it can be a lot. For me it was a band size as well as a cup sizes.
   
3. It's also that your body changes shape. Your ribs spread - that means your tshirts stop fitting across the back, well before your bump stretches them. Your jeans stop fitting because your hips are bigger, not just because you're belly is. Be prepared to embrace these changes because they are hard, in our culture, to embrace.
4. That you slow down at the end because of lots of things, mental and physical. Pregnancy is a great time for you to cultivate judgement about whether you want to do something badly enough to get up and do it even when you hurt and feel like arse, or whether you can ask someone else to do it.
5. It feels good to cry when you want to cry and this can be liberating.
6. The same applies to naps. There is no guilt about napping during pregnancy, when the chance presents.
7. No one who isn't pregnant or recently so really gets how much hard work it is, but don't disappear up your own arse with being consumed with how much work it is. I wish I'd taken this advice more.
   
8. People will only talk to you about being pregnant, regardless of what you do for a living or for a hobby or how interesting you are. You don't have to be ok with this but it does help you keep #7 in perspective.
9. Having someone dance on your cervix is like being stabbed with a knitting needle through it. Even if you've never had anything else near your cervix, when it happens you'll know what I mean. And you'll be dancing on your toes until it passes.
10. That sleepless nights do start before bub arrives. Insomnia, hormones, nausea, I'M WIDE AWAKE AT 4AM, can't get comfortable, etc etc.
    

My blessingway - 37+3 weeks

Saturday just gone: I am a LOT pooplicated after a 4:30am wake up and a BIG day and LOTS of amazing things and then giving a concert then pancakes and home to bed by midnight.

My sister arrived early in the morning and helped me wind the skein of yarn that a girlfriend had dyed for me and sent over from Canberra. It was lovely to have my sister sit there with her hands out, holding the yarn, while we chattered and wound. People started arriving at 10am and by 11am there were about 20 women there including TheHusband.

It was a little unusual in that TheHusband was a part of it (most blessingways are female-only), but I am so glad that he did. It was a really special time for us and to have him also say "you are strong" meant a lot to me.

We cleansed the circle with some water with rose, lavender and kunzea essential oils, passed around and everyone flicked their fingers in and flicked water around. Kristin lit the blessingway candle (big chunky white one that belongs to the women's group I'm part of) and added it to the collection of candles that were there for people to take home later, and invited people to introduce themselves.


It was lovely that I got to add to that process and also reflect on the fact that I've known most of the women's group only a short while but these were some of my longest-serving friends ;). There were chorister friends who are now women's group friends, and midwife friends who are now women's group friends, and lots of choristers and women's group friends but enough cross-pollination to show me that I am in the righ place(s) in my life!

Then Kristin invited people to share thoughts and stories and experiences of birth. This was when the amazing women I call friends really shone through. Billie reduced a lot of us to tears with a poem (again! She's going to have a reputation for that!!!), and others spoke on their experiences, some very recent (Rose had her 3 week old with her) and some a little ways older (Emma had her 5 month old with her), and reminded me that I need to continue to trust the process and also surrender to it.

To hear people say that they thought I had courage, and was true and unwavering to my path, made me laugh a little. I am sure that my outspoken confidence shines through but at times I have my doubts as people reading here will have seen. I have gone forward on this path towards a homebirth, confident that my body is amazing and can do what it will, and the idea of giving birth actually excites and scares me all in one but mostly I am looking forward to seeing how amazingly well my body works. It has made me consider though that this confidence perhaps appears as arrogance, and I think I heard some people warning me of that in their stories - to be prepared to surrender to a path that is not the one I expect. I take their gentle reminders to heart though!

Then the circle was closed and blessed with yarn that I'd wound that morning, and cut and tied around each person's arm to wear until I birth. The candle was blown out and the blessing complete.

People were invited to hand over a bead to me with a chat, and I ended up with a lot of beads!!! Alice, Cassia and Ali set to work making a necklace for me which is surprisingly heavy and very lovely and balanced.


Billie then took me outside under a gazebo we have set up and took some photos of me - clad, unclad, draped in fabric and without my glasses! Then Kristin set to work on an AMAZING henna tree on my bump which made me so happy, and people took to the calico squares that I'd prepared and wrote blessings and thoughts on them for me to read during labour. I very sadly had to wash/scrub the henna off early for tonight as I had to wear a white shirt for the concert tonight, so I'm not sure how long it'll last.

Once the henna was done, people started to leave and took a candle and a crane with them. The cranes I'd made for the cupcakes that Billy had made (lavender/vanilla, and chocolate/chocolate ones) as I hadn't wanted to ask for 20+ vaginas to decorate them, and everyone took one home after eating their cake I hope! Billy and I went back outside for a few more photos, and this time Osk came out as well and we have some lovely couple ones as well.

My sister and Alice then tidied up, swept, packed the extra food into the freezer and let me nap a little. Then off for a concert and post-concert celebration and of course leaving me too tired not to snore, so Osk slept on the couch for the first time last night :(.

The back room is abuzz with energy from yesterday and I can see it becoming a birthing space now, not just somewhere we eat dinner.

I feel ready to birth now.

More photos care of Craftastrophies over on Flickr.

36 week update!

Wow I can't believe that I've reached 36 weeks already. Here are 10 things I want to note about this milestone:

1. In 1 week, or up to 7, we're going to have offspring. I'm going to miss having a Puggle under my heart but I am keen to meet them. Not so keen on the regular back ache and slight cramps and other feelings I'm having. Another 7 weeks of that, plus the agony of waking up with sore, will make me a very unhappy person.
2. I have started a "sentence a day" journal for Puggles. This is part of The Happiness Project Toolbox, which includes a Happiness Manifesto:

• To be happy, you need to consider feeling good, feeling bad, and feeling right, in an atmosphere of growth.
• One of the best ways to make yourself happy is to make other people happy; One of the best ways to make other people happy is to be happy yourself.
• The days are long, but the years are short.
• You're not happy unless you think you're happy.
• Your body matters.
• Happiness is other people.
• Think about yourself so you can forget yourself.
• "It is easy to be heavy: hard to be light."—G. K. Chesterton
• What's fun for other people may not be fun for you, and vice versa.
• Best is good, better is best.
• Outer order contributes to inner calm.
• Happiness comes not from having more, not from having less, but from wanting what you have.
• You can choose what you do, but you can't choose what you like to do.
• "There is no duty we so much underrate as the duty of being happy." —Robert Louis Stevenson
• You manage what you measure.
  

3. I am having my 2nd 30th birthday tonight. My birthday is actually in a month's time, but that of course is roughly when Puggles is due, so I celebrated early.

EDITED TO ADD: Kate from Craftastrophies completely and utterly outdid herself. She organised my friends (which is probably similar but a lot less fun than herding cats or nailing jelly to a tree) to buy me a Kitchenaid Artisan Mixer:


This is completely blowing me out of the water. I have a freakin' KITCHENAID in my kitchen! And I'm not afraid to use it! There will be LOTS more baking going on here!!

4. I have my blessingway next weekend. I am excited about this but it also feels a little like all my women friends are coming to wish me farewell and good luck on a journey only I can go on, alone. Oh wait - that's exactly what I'm doing.
5. Puggles is growing apace, bobbing in and out of my pelvis depending on what day it is, which is all kinds of fun.
6. My plan is to insist on a 10 day baby moon, where I stay in bed and not a lot else goes on. Gloria Lemay suggested how to ask for help during this period for this but I'm lucky to have friends who are not that intrusive!
7. I've been having some issues with my (low) blood sugar so my midwife encouraged me to get a blood glucose monitor. Easy done - just go to a chemist and buy. Or so I thought. Found the one I wanted and nope, the $35 prices was actually $65. Not ok in my book but my midwife is going to buy it off me so it's not really a matter of $$ at this stage. The consumables though - $55 for a box of 100 test strips!!! SHEESH! Then to get home and test drive it before I have to do a fasting one (first thing in the morning) only to discover that I was sold the wrong test strips. So now I'm waiting for the pharmacist to open so I can go back and sort this out.
8. I'm looking forward to my new body. Soft, squidgy, booby and stretch-marked.
9. The next set of 10 will be "10 things pregnant women won't tell you" because there are some lessons I want to share in the last few weeks of this pregnancy.
10. Happiness is handmade pasta and meatballs.

Busy bee

I have a new set of cramps, stretch marks, swollen feet/ankles and lack of sleep. And by "cramps" I mean I have to breathe through them and grimace a bit. Mostly from over-working at 32 weeks, and from being on my feet way too much. Only 4 weeks, and 17 shifts to go.

So a day off today saw us clean the house thoroughly and then I made spring rolls, and a banana cake, and a roast chicken, and smashed potatoes, and roast pumpkin. zomg the chicken was perfect, and the Crash Hot Potatoes were very successful.

Is this the nesting phase of pregnancy? I don't know. I do know that I also cleaned the pantry out, and the fridge, and did some crafty, and washed the dishes, and now need a nap.

Planned home and hospital births in South Australia, 1991–2006: differences in outcomes

The Medical Journal of Australia has released a paper and is claiming wildly increased rates of deaths among home births in South Australia. Read the synopsis - complete with 27 times higher! 7 times higher! bad APGARs!! - and then read the study and LOOK at the contradictions. It is appalling that this stuff ever gets published. And what's with the random throwaway inclusion of SIDS in there? I don't even begin to understand that inclusion...

Edited to add: and interviewed for on NewsRadio!!
Mon 10:45 - Babies are seven times more likely to die during a homebirth labour than a hospital labour -- according to a new study ... (audio)
Mon 10:50 - Homebirth advocates have accused the AMA of conducting a scare campaign ... (audio)

So let's take it apart as Joy has done, just for kicks - cause we all know that the "dead baby" card is a winner, regardless of the facts. Lisa has written a great summary of this as well.

• Although presented as research, it is not - it is a report on the statistics that were available. In research terms, this is the lowest of the low and has no control for biases and no statistical power which is interesting as I am (a) hopeless with statistics and (b) unschooled in them. The conclusions drawn are not backed up by solid numbers so are no better than opinion which is interesting because if you listen to the above interview (first one) the guy is not actually saying what is being reported. He clearly says that homebirth is safe.
• The planned homebirths that are reported are confounded three ways - no one can tell whether they were under the care of a registered and experienced midwife, or were unattended births, or under the supervision of a hospital-based program; the "planned homebirth" number is ~1000 and the actual number is ~300 so we're not talking about actual homebirths - just those that at the first antenatal appointment said they'd like one; and lastly - the way statistics are gathered changed during the time period reported.
  
• The title tells us something - it was about planned hospital and planned homebirths, at time of booking. This is a LONG way from the actual outcome, some 8-9 months later and the study author clearly states that they are unable to separate planned homebirths to actual homebirths out. Lots of planned homebirths don't eventuate for lots of reasons, and not all of them have anything to do with the pregnancy or maternal health. Having filled in the form that is being used here, I can tell you - the midwife looks at the Handheld Record and writes something down. No discussion is entered in to about the whys and wherefores of what changed those plans.
  
• There are probably only 2 situations in all those years where someone's baby died and it was at home and they planned to be there. 2. In 16 years. 1 had known high-risk indicators as it was a twin pregnancy. So we're down to 1 surprise death. In 16 years. That's pretty good odds.
  
• There is no way to look at such a rare outcome of intrapartum death with a small sample. Someone else has pointed out that with those odds you'd need 10,000 births at home to demonstrate this. I'm not a statistician so can't comment on those.
• I've listened to an interview with the author and he does say quite clearly that homebirth is a safe option as long as the woman is prepared, is assessed for risks, and is close to a hospital.
• I agree with Hannah Delaney (as Joy quoted her): I find it amazing that in a broken system, with uninsured midwives with no rights in hospitals, the death rate is actually no different.
  
• The intervention rates are STARKLY different - c-section 9.2% in planned homebirth vs 27.1% in hospital births, episiotomy rates of 3.6% in planned homebirth vs 21.7% in planned hospital births (one sixth the rate!!!!! And CLEARLY shown to be a bad idea anyway. 3.6% is also for the "planned homebirth" women, 70% of whom birthed in a hospital so is not "of women who birthed at home" but includes a large number of women who were perhaps treated the same (ie were likely to have a 21.7% chance of an episiotomy anyway) so the actual % would be lower still).
• Lisa's comments about PPHs got me thinking: that the comparison of post-partum haemmorhage is ridiculous enough to call the whole thing in to question. The numbers are similar once the authors took out the know reasons for PPH in hospitals (episiotomies, induction and augmentation, surgery etc) and so the author concludes that oxytocic drugs are used with the same gay abandon at home as they are in hospitals. Um - no. You the author firstly don't ask if drugs are used, so you can't make that conclusion from the stats. And further you clearly have NO idea how homebirth works and that the calm nature of birth, along with skin-to-skin immediately, breastfeeding, bonding, known care provider and so on decreases the risk of PPH. Even something as simple as keeping the room warm is said by people such as Odent to help. And perhaps because you took out all the confounding factors that are iatrogenic to the birth process in hospital, and found the same number, there is always going to be a background level of PPH and that nothing can be done to avoid a small number of them. It comes down then to how they are managed.
  

Women will always choose this and my concern is that this is going to go even more underground than it already is. I've heard women saying now that these changes make them LESS likely to hire a midwife to birth at home. Not less likely to have a homebirth but less likely to be attended by a registered, trained and competent professional. They are saying they are more likely to freebirth or just hire a doula for comfort. This is going to make the outcomes worse, not better, and probably not change the numbers.

The authors state that ‘women's autonomy in choosing reproductive behaviour is a fundamental human right enshrined in Australian law'. It is about autonomy. Others have said "The excess mortality continues to be found in high-risk women and women need to be informed of this risk." but are missing the point - that even when informed of the risk, some women would rather birth at home and not go to a hospital. And there are some practitioners who will take on those at high risk.

This does give me pause for thought about my own practice. What risk appetite do I have? As a beginner practitioner, I am prepared to go with some known knowns - breech, grand multip, reasonable distance from a hospital - but not twins, or pre-term, or probably a few others. The unknown unknowns I am trained to deal with and know that I have a whole heap of midwives at my phone-tips to call and discuss with, and I can't assess those beforehand so just need to keep up my training and skills and calm to deal with them.

Lastly - this is about the babies. Think of the children!! But there is no measure made of the maternal mortality, and only a very crude analysis made of maternal morbiditiy. No measure of maternal satisfaction.

Hoyden About Town said:
"If this study had shown a substantial increase in fetal deaths with home birth, this would still not be a reason to place legal restrictions on reproductive choice. It would not be a reason to imprison women in hospital by State force, and it would not be a reason to stop women from making informed decisions about our own bodies. They are our bodies, and until a fetus is born, we get the final say in what happens to us."

And therein is the crux of this - it is about the women and their bodies. The fetus does NOT exist legally until it takes its first breath. So what we are talking about it restricting the rights of roughly half the population. Sure, they are rights that a lot won't exercise, and choices that many of them will never make but - just like I have the choice to smoke - I have the choice about where I have this baby.

Pregnancy and birth plan - what with 100 days to go!

In roughly 100 days I will have a baby, and I'll be a mother, and life will be different. I am enjoying this phase of pregnancy - I am round and gorgeous without being ungainly and uncomfortable, I am glowing without being exhausted all the time, and

So some plans for pregnancy and birthing:

• I will have one or two midwives throughout my pregnancy, birth and postnatal period - I would love to work with a midwife that I know and have a recently started midwife in independent practice "apprentice" to her for my pregnancy
  
• I will not have any screening tests as I know my blood group, and we do not want unnecessary ultrasounds
• I will labour at home
• I will birth at home
• I will spend a lot of time in water
  
• I will use hot water, massage, dance, noise, pressure, for pain relief
• I will eat and drink as I labour, as I want
  
• I will listen to music and have already had thoughts about music to listen to (suggestions welcome!)
  
• I don't want people to talk to me - entertain yourselves!
  
• I will have Osk there with me
• He will catch the babe and announce the sex
  
• I want to have the process videod
• I will breastfeed
• I will have a "lying in" for a month afterwards - a milky, cuddly babymoon
  
• Osk will take paternity leave
• We won't buy a pram but instead will use a sling and mei tai
• We will co-sleep
• We will not immunise immediately but will consider each
  

Yep a fairly definitive and bolshi list but hey - it's not a contact sport, it's not a spectator sport, and it's really important to me.

Henna and bellies and exams, oh my!

I have a heap of photos to share but because our internet is dicky at the moment I can't rely on it to stay up long enough to link to them. So I'll do it in dribs and drabs, ok?

Here are some from yesterday, where I hung out with a whole heap of people from Joyous Birth and did a heap of things including having some henna on my hands and belly. Belly shots are to come so here are the hands:


This is the mixture on my hand - it's now a lovely chocolate woody brown and will darken over the new day or so.

Here is my belly cast - Alice did it for me at 23 weeks because I wanted one roughly halfway through, and then at the end. I'll upload a how-to soon!

Here's the bump:


And lastly a photo of the photo we had printed and framed for my FIL's 60th birthday last weekend:

Almost to the end

I had plans for Friday morning but instead ended up making sweet sweet love to my LAST ASSIGNMENT FOR THE YEAR and then went to my LAST SHIFT FOR THE YEAR at a hospital and shared an amazing empowering birth with a woman whose previous birth was traumatic and this one was amazing (her words, not my judgement).

I now only have 18 units of my degree to go (oh and two exams and a portfolio but *meh*). I am struggling a bit to just. keep. going when I want to be focused on work and nesting and being pregnant. I have two solid subjects next year to get through, including big placements

Today is a delicious day off. TheMan has gone to the gym to do a double class - RPM then pump. He is bringing coffee home for us though.

Then we need to tidy the house. It is clean, just not tidy. It's the effect of spending 6 months doing 99% of things and discovering that at the end of 6 months, that means there is stuff and things around the house waiting to be put away.

The study is slowly turning into Puggle's Room. I refuse to call it a nursery as I don't plan on nursing in there, and s/he won't be in there by themselves for ages. I will take some photos shortly to show!

The shopping list is shrinking:

Need:

• Nursing and maternity clothes for moi
• Reusable cloth pads for moi (12 x Regular and 6 large)
• Mattress protectors x 2 (for our bed)
• Sheet set x 2 (extra for our bed)
• Nightlight (actually yes I want a touch lamp for beside the bed and these are hard to find!)
• Lambskin baby rug
• Singlet suits x 10
• Knitted hats x5 (have new book for these! Now to buy some yarn to make them with :)
• Baby wipes (both disposable and washable)
• Nappy bucket(s)
• Thermometer
• Steriliser (bottle/pump) (want a microwaveable one)

For later:

• Storage containers for milk/food
• Training cups
• Bowls, plates, utensils
• Teethers/teether toys
• Teething gel / Razberry
• Non-slip bath stickers
• Safety gate
• Powerpoint plug guards
• Cupboard & appliance latches
• Potty
• Toilet training seat

And a few big things that we want:

• Chest freezer
• New car (we have a 3 door hatch at the moment and are going to have to upgrade to a 5 door at some point soon)

How's the pregnancy going?

I get asked it a lot and I guess you, my loyal blog readers, should hear some more about it.

I am now coming up to 21 weeks pregnant. That is pretty much set though I'm measuring 1cm in front of that "guideline" by fundal height, so who knows what that means. But in terms of due date:

"Recent research offers a more accurate method of approximating gestational length. In 1990 Mittendorf et Al. undertook a study to calculate the average length of uncomplicated human pregnancy. They found that for first time mothers (nulliparas) pregnancy lasted an average of 288 days (41 weeks 1 day). For multiparas, mothers who had previously given birth, the average gestational length was 283 days or 40 weeks 3 days." Source

So 41 weeks and 1 day puts my due date at 25/03/2010 rather than 17/03/2010. Now for me, it matters not when bub arrives - I am comfortable knowing that sometime before Ostara next year, we'll be a family of 3. Which I what I'm telling people - either that bub is due in March sometime, or else "before Ostara/Easter".

What is amusing is if I tell people I'm 21 weeks, they'll go "ahuh", like it means something to them. If I say "5 months", then the assumption is that I have 4 left to go. If I say "March" invariably people go "wow you're big/small for that!", like they have any idea of what I should be now.

By the way I've updated my 101 in 1001 days list and need to get my bum into gear as it's now less than 2 years to go!

How does it go?

blah blah blah state of the world etc etc and btw i'm pregnant

congrats. where are you having it?

at home

oh

is that safe?

well yes - i have a private midwife and am well supported with my husband and friends

oh

but it's not safe to do it at home! think of the children!!!

************************************

I have to bite my tongue because:
(a) it's none of your business where I have my baby
(b) not safe based on what? Have you looked at the research? Because in making an informed decision, I have done a lot of research. Have a look at Wikipedia or a recent Canadian Medical Association Journal article for easy understanding:
Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician.
(c) not safe compared to what?
(d) still none of yur business
(e) I don't think that FOR ME, birth in a hospital is normal, natural or safe and to have a normal vaginal birth in a hospital without unneccesary interventions is a miracle rather than the norm and those interventions cause problems. There are lots of potential downsides to birthing in a hospital - they're used for treating sick people, there is little to no continuity of care or carer, there are clocks everywhere, they are a business and fast turnover is of the essence, the definition of normal is very narrow and anything outside of it is scary to care providers, and the outcomes are no better for all the interventions.
(f) I am a fit young healthy woman and have no need to hire a surgeon for a natural life process, I have hired a professional and expert in normal birth, and am quite prepared for a natural birth, "pain" and all.
(g) There is no pain free way of giving birth, and I am prepared to work with the sensations rather than against them, so don't need to plan my pain relief now beyond having a spot for a birth pool and knowing that we have unlimited hot water.

Same goes with having ultrasound scans, or blood tests, or xrays, or pelvimetry, or combinations thereof.

Informed choice does not mean agreeing with you.

I don't have to agree with you and you don't have to agree with me.

How do I marry these opinions with being a student in the health care system though? I am quite capable in a professional capacity to offer you choices (or are they decisions between two options? A topic for another post I think), discuss them with you, note which you've chosen and go from there. It is none of my business what you do with your body or baby, except from a point of view of a professional discharge of my duties. When in a traditional care situation (hospitals) I can't care for the outcome of your pregnancy from anything other than a professional point of view, because I would burn out. And if I believed in ethical practice, which I do, I also believe in autonomy and the right to self determination in health care. And by the time I see people on a postnatal or labour ward, they've made their decisions and chosen their care path and it is none of my business to judge those decisions. I don't have to agree with yours and you don't have to agree with mine.

And yes, I could just say "local hospital" or "random doctor" and lie about where I'm birthing, to avoid these conversations and having to justify myself. Instead I just smile and say "I've hired a private midwife to undertake my care" and leave it at that. Which is hard and harder at the moment when I'm in a private hospital on placement. I just try to choose who I discuss these things with.

************

And the upsides of birthing at home? Here are 10:

1. I know where stuff is, and so does my hubby. That means we have some of the power back in this situation cause mw Julie will have to ask where things are!
2. The house is colonised with our bugs already. I doubt there's anything nasty hanging around (dust bunnies not counted here).
3. I don't have to go home after giving birth.
4. I don't have to be alone unless I want to be.
5. I don't have to ring a bell and wait for anything or anyone.
6. There are no machines that go ping. Except for the microwave.
   
7. There is not going to be a trip in a car in labour.
8. I get the absolute and final say over who is going to be at my birth.
9. I will not be up on a bed at a convenient height for my birth attendant.
10. My babe will be born where they were conceived.
11. I don't have to have a change of care provider mid-labour, or explain my birth plan, or decline drugs, scans, CTGs, vaginal exams, etc etc, at every turn.