Reply to Evelyn Muhlhan - another homebirth midwife bites the dust?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]"I've been musing about what I would do if I were to go into preterm labor. The answer is obvious if the baby were 30 weeks: go to a hospital with a good NICU. My own cutoff for an out-of-hospital birth would be around 36-37 weeks, depending on the particular situation, access to oxygen and a midwife skilled at recognizing signs of respiratory distress or other prematurity-related complications."

"But what about 28 weeks? 26? 24? 22? At what point would I allow the baby to pass on peacefully, rather than attempting heroic efforts at resuscitation with a small chance of survival and high likelihood of major disabilities if the baby were to live? My own gray area is between 24-28 weeks. By time a baby hits 26 weeks gestation, survival rates are between 80-90%, and about 15% of those surviving babies will have major disabilities as a result of prematurity. I think this would be the earliest point at which I would consider intervening."

"Still, survival rates and even major disability rates are not the only practical or moral considerations that I would have to account for. Having a very premature baby, in my own family setting, would mean I would have to commute to a hospital with an advanced enough NICU: probably 40 minutes away and most likely an hour or more. The stresses on our family, the realities of trying to spend my time in a NICU while caring for a nursing toddler, and the emotional and financial drains that an extremely premature baby would entail are all things I'd have to carefully think about."  -From a natural birth blogger

Late to the conversation here. I started my pregnancy under the care of very good CNM and then was transferred to OB/hospital care when my pregnancy got very complicated.  I'm very sympathetic to natural birth and I believe strongly in a woman's right to choose or decline her own medical care.  I'm also the mom of a 29w preemie who is everything to me.  When I read the quote above on a blog it just made me sick to my stomach that someone (and someone who obviously loves and want children) would consider withholding care from a 28w preemie.  I don't quite know where I'm going with this-I guess I do believe in the right of women to choose their own standard of care, but I'm also personally pretty horrified by what some of hose choices look like.[/quote]

I wonder if she'd think differently if she was actually in that situation? It's one thing to ponder something, but a lot different if you're actually facing it! [/quote]

I think the point of pondering something is to try to figure out what you would think if you were actually in that situation. I think we could all stand with a bit more reflection on our choices and motivations for things. Even if you come to exactly the same conclusions you have now, it's a good self-awareness exercise.[/quote]

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