I just had one of the hugest learning curves and interesting experiences of my midwife life! I met some lovely people in the "brithing community" here and they asked me to be their midwife for a homebirth on their farm which is 2.5 hrs out of the city with a small government hosptial withing 20 minutes from there.
I ended up agreeing to attend the birth as a friend who happens to be a midwife. They had ultimate faith in the growth and birth of their unborn child, 15 years since number 2 had been born at home on the farm with a village (un-trained) midwife. They had no sonography, no blood tests and a few prenatals by me on times when we could meet up which was quite random because of our busy schedules.
On the day she went in to labour we had planned to meet and talk about what they wanted to happen during the birthing process and what did they want my role to be and I was going to suggest a blood test so at least we knew the blood group incase of emergency and a sonography if they were willing. I have attended hundreds of births before in the Philippines where no sonography was done as the women could not afford their food for the day, let alone a sonography. However having worked for the last 2 yrs in a city where most people have multiple sonographies in pregnancy I thought to ask for one at the end was an "ok" request from the midwife!
We ended up never having the discussion because she went in to labour and I was attending another birth at the other end of the big city! The husband went to a local private nursing home who said they would not help them at all with no blood tests or sonography and especially no HIV test which is mandatory here!
So I arrived to my lovely G3 friend , aged 42 and waited and checked heart tones and all vitals were normal... 22 hours later on a journey full of massage, love, comfort of their own home, encouragement, sensitivity, quiet, peace ... a tiny little girl arrived with waters intact! She was 2.1 Kilos and obviously IUGR ..... There was a velamentous insertion of the cord and I was completely in awe of how their bodies had worked together and how the waters had stayed intact protecting the baby from any danger of breaking the vessels and potential hemmorhage or demise! I was also very thankful that all were ok!
If they had had a sonography the velamentous insertion would have been detected. Then they would have been encuraged to have had a c section? It would have sewn a seed of fear or doubt in their beautiful faith in the process of home birth and the perfect workings out of it.
If we had gone to a hospital(without a sonography) the doctor may well have done AROM which is a very common procedure here, and that would have put the baby in potential or even fatal danger!
So was I stupid to attend this birth? It was the first I have ever attended as a sole midwife! I always work in pairs!
The family are total believers in health and organic farming and haven't been worrried about a thing. The baby seems to be thriving, breastfeeding well and has no jaundice and no anomalies that can be seen or heard! The family don't have a desire to see a doctor.
I am out of my box totally with all of this but in another way completely honour them and their choices. I can advice kangaroo care, increased breastfeeding, sunbathing and a doctor's visit but it's up to them what they do! They are a unique and beautiful family and it was an honour to be part of the whole process. The "fragile" situation of the cord and seeing such an IUGR baby shook me but the faith of these people has overidden these events!
I have been googling "velamentous insertion" and wondered if you have any studies on this .....
Thankful all was well at this HOME BIRTH!!