I just read a really sad blog. The woman writing it was using her blog as a pregnancy journal. She decided late in her pregnancy that she wanted to have a homebirth, so she consulted with a midwife to see if she was low risk. The woman has hyperthyroidism and has been on thyroid medications during this pregnancy. She went to her OB and told him of her decision to pursue homebirth, but that she wanted to make sure she was low risk. He disagreed with her decision and said she was too high risk for homebirth.
My first instinct? The doctor is just saying that because he doesn't want you to leave his care and he has a bias against homebirth.
So, I picked up Heart and Hands and checked out hyperthyroidism. Sure enough, it is a contraindication to homebirth, especially if the woman has been taking thyroid medication. DARN! I really had wanted to post a "go for it" encouragement on this woman's blog, but I just can't do it.
It is so hard sometimes to see women have to choose a hospital birth with an OB when they really want a home birth. I think one thing that makes it especially difficult is that there are so many women out there who are truly low risk and who would be great homebirth candidates, but end up going with the hospital birth because they are either misinformed, uninformed, or just plain scared. To see a woman who really wants it to not get it is tough for me.
I think one of my greatest fears throughout both of my homebirth pregnancies was that I would be risked out at some point. It didn't happen, but the fear was always there. I would get really nervous at my prenatal appointments, thinking, "OK, this is it. Today is the day I get risked out." I especially had that fear with my last pregnancy. I was older (40) and obese, but otherwise in excellent health. Plus, I had already given birth vaginally to four other children. I kept thinking I was going to end up with a hospital birth, and would leave every prenatal appointment with a sense of relief that I had somehow managed to squeak by again!
I would have been so sad to have been risked out! I know the pain this woman is going through! I wish there was some way her prospective midwife could wave a magic wand and make her low risk. Maybe there is some way for her to have a homebirth. Maybe there are things she could do to get herself well enough to still have a homebirth. I really don't know, but I sure do hope so.
Tuesday, July 29, 2008
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5 comments:
Hi... not sure if this blog is about me or not, but if it isn't it is a pretty crazy coincidence.
My SIL found this post when she was trying to do a little research for me about hyperthyroidism and homebirth.
Thanks for the information about Hearts & Hands. Let my midwife know about it.
If we read the same blog it is important to not that the OB first expresses a general prejudice against homebirth.
It is also important to note that there is a difference between controlled and uncontrolled hyperthyroidism.
Though this condition generally requires more frequent testing and may need some consultations with an endocrinologist, controlled hyperthyroidism is not a barrier to homebirth.
It is also important to compare the rate of breathing difficulties due to hospital interventions (vaginal and c-section) to that of an unmanaged birth of a mom taking medication to control hyperthyroidism. Hospital interventions can actually compound potential breathing difficulties that a baby born to this may have.
Yes, this was about Lisa's blog. The information I found in Heart and Hands is on page 19 in a section called, "High Risk Factors in Pregnancy." Here is what it says about thyroid disease:
"Thyroid disease. Particularly hyperthyroidism. Slight enlargement of the thyroid gland is normal in pregnancy, but persistent tachycardia or elevated levels of circulating thyroid hormones are symptoms of disease. Dangers: Thyroid medication has potential for causing severe fetal complications. Hyperthyroidism can cause miscarriage, premature labor, and fetal anomalies. Untreated hypothyroidism can lead to cretinism in the newborn."
As with just about every health condition in pregnancy, there may be gray area, just as Kristina's comment says. I'm not an expert in hyperthyroidism, so you need to research this for yourself and discuss your findings at length with your midwife.
My blog post wasn't really about hyperthyroidism, otherwise I would have put a lot more research into my post! My blog post was about how I want everyone to have a homebirth, and how hard it is for me as a student midwife when it doesn't work out for them, especially when they want it as much as Lisa does.
Lisa -- I hope you find the information you need in order to make the best decision for you and your baby. And, I really, truly hope that decision is to continue with your homebirth plans!
Kim
Well, talked to my midwife today and I think our research is leading us in the same direction which is to continue as planned. Need to talk to my husband though and make sure he's still on board. Anyway, thanks again for tidbit of information. :)
That's great news Lisa! I hope you have a really wonderful, beautiful homebirth!!!
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