Childbirth at Home as Safe as Hospital Delivery: Study

[HuckleB]

Childbirth at Home as Safe as Hospital Delivery: Study

http://www.healthcentral.com/newsdetail/408/526372.html

"Women who choose to give birth at home with the help of a certified midwife have deliveries that are as safe as those done in a hospital, Canadian researchers report.

"Home birth is a reasonable option for low-risk women," said lead researcher Kenneth C. Johnson.

"In this low-risk group of women who had births with midwives at home, we found that the overall safety was similar to what you would find in a hospital in a similar low-risk group," added Johnson, a senior epidemiologist with the Center for Chronic Disease Prevention and Control at the Public Health Agency of Canada, in Ottawa.

Moreover, evidence from the study supports the American Public Health Association's recommendation that home deliveries with certified midwives should be increased in the United States, he said.

..."


This "study" actually confirms what the overwhelming portion of prior studies already showed. Still, so few people actually know this today that such information is incredibly welcome into the public sphere.

[patricia92243]

1. In other words, home delivery = money saved by insurance companies.

[HuckleB]

2. Perhaps.

But that's got nothing to do with this. Those of us who've followed home birth studies are well aware of the sources of funding, or the lack thereof, as well as the push by insurance companies and other providers to keep such information from the public. The acknowledgment of home birth safety by such a mainstream medical journal is a positive thing that helps to promote choice for mothers -- a valid choice, in fact.

[Skwmom]

15. Unless you have a complication in delivery. e/o/m

[HuckleB]

21. Wrong. -- Did you read the article?

Have you read the research on this matter?

[Skwmom]

25. Yes.

Masch is concerned that when complications set in, they do so quickly and need immediate attention. Women who appear to be at low-risk can fall prey to problems during birth that weren't anticipated, or may have conditions that were not known, which can affect the delivery. Being in a hospital allows these women to get immediate care, which can save their lives and their babies' lives, she said, adding, "There are examples that I see frequently."

Plus let me use COMMON SENSE. If a problem were to arise, where would I rather be. The hospital of course.

[HuckleB]

29. Again, that's not what the research shows.

Even when unanticipated issues arise, the safety of the child is not compromised. In fact, having noted the research across the spectrum regarding home births, including more specific, condition-based research, many of the "unexpected problems" are treated with more safety at home. And that doesn't even touch on the issues that result from unnecessary monitoring itself, in the hospital. Nor does it touch on the clear increase in unnecessary interventions in the hospital. These interventions are traumatic and sometimes dangerous to the mother and the baby.

I'm sorry, but I'll use the research knowledge as my common sense. Too often "common sense" doesn't take all the factors into play. Masch is clearly looking to cover turf here, and is not taking into consideration the actual results of the actual research.

[Skwmom]

58. The safety of the child is not compromised?

Hmmmm.... "only some of the unexpected problems are treated more safely at home." What about the ones that aren't?

Who paid for this so called "research?" You know the funny thing about research is that a lot of it is later debunked as invalid.

[HuckleB]

61. In other words, why do research?

This isn't one study we're talking about. We're talking about research studies en masse done over the past 30 years plus. Many of which were done by people who clearly hoped to find a different outcome. Further, these aren't the type of studies that are usually found to be wanting. Hypothesis is not the underlying factor here. For example, this is very different research from, say, that which leads to a serotonin hypothesis for depression that is found to be only part of the issue for part of the population of people suffering from depression. As for your first question, the point is that home birth is as safe, and in some cases safer than hospitalization. I don't know why this seems to bother you.

[AllyCat]

168. One thing to consider is that deliveries handled by CNM/CMs

are half as likely to involve Cesaerean births, episiotomies, and drugs as those delivered in hospitals by OB/GYNs. Sometimes these interventions are necessary, but when midwives can reduce the rate of these dangerous interventions that have complications and still deliver healthy babies, one has to consider the overall effect of the effort.

I'm researching this now expecting my first with advanced maternal age, and so far, no complications. As of yet, I have read nothing compelling to be in a hospital vs. at home. I plan to deliver in a hospital anyway, since our current temporary living situation is not really suitable for a homebirth, but that is the only reason so far we've been able to find.

If I can avoid some of the medical interventions done for, what I call, malpractice prevention (or CYA), then I feel safer with a midwife.

There are risks associated with both methods, but there are a different set of risks with each type and they have to be evaluated on the merits and potential benefits in each situation.

[Scairp]

124. Maternal deaths

In days of yore all women gave birth at home without any medical attention, and women died very frequently in childbirth. The baby often died as well. Sorry, I'm all for choices, but the idea that childbirth is just as safe at home as a hospital is crap.

[HuckleB]

125. Yeah, it's crap.

Screw the plethora of studies that show otherwise. They don't mean a thing!

:eyes:

[fleabert]

130. Infection and poor prenatal care are the root cause of much

maternal and infant death in our own history, and in the world today where advanced medical care is not available. good water supply is also a factor. Please do some research before making such statements. There are multiple studies that support this study's findings.

Homebirth, when coupled with professional midwifery care, is quite safe and is a viable option for most women and famlies. Those that choose it do not do so with a blind eye to safety or the welfare of their child/themselves.

[athenap]

137. Hospitals are safer?

My house may be a mess, but nobody ever got flesh-eating bacterial infections from visiting my house. Hospitals are filthy places, where a mother and a newborn infant are more likely to get exposed to all sorts of weird bacteria and/or viruses. At home, you're with your own germs, the ones you're used to, and unless your home isn't fit for human habitation, you aren't in any additional danger.

The "days of yore" argument is constantly brought up in defense of hospital birth, and it's a fallacy. Maternal and infant mortality rates were higher for many reasons, most having to do with poor prenatal health, poor diet and health in general, and too many or too frequent births (for the mother).

Certified midwives are trained to identify problems in labor, the majority of which are easily identifiable early enough on to allow for either treatment or a transfer to a hospital.

Hospitals, by necessity due to liability, must impose rules and regulations on all comers, but birth is an individual process, different for every woman, so the same standards can't apply across the board. Monitoring based on an arbitrary standard often lead to a cascade of increasing interventions, in an attempt to standardize and control something that is as individual as a fingerprint.

It's part of a larger effort to try to attempt to control something that's essentially just letting nature take its course. Women have been having babies for millions of years just fine without hospitals. And women even to this day still die in hospitals, with all the interventions in the world.

[oblivious]

148. Infections...that reminded me of this article in my local paper last week.

no url - pay to read

Saturday, June 11, 2005

Gut-eating disease hits three babies
Health team scrambles to find source of Chai Wan hospital's mystery outbreak

Health officials are scrambling to trace the source of a potentially deadly disease that has hit three newborn babies in a busy hospital within two weeks.

Two boys and a girl in Pamela Youde Nethersole Eastern Hospital have been struck by necrotising enterocolitis (NEC), a disease of unknown cause that kills intestinal tissue.

The babies, aged 12 to 16 days, are in isolation in stable condition, Centre for Health Protection consultant Thomas Tsang Ho-fai said yesterday.

The outbreak comes just under a year after the disease, which usually affects premature or underweight babies, killed one child and infected seven others at Queen Mary Hospital last June.

Also here:
http://www.news.gov.hk/en/category/healthandcommunity/050610/html/050610en05005.htm
http://www.thestandard.com.hk/stdn/std/Metro/GF11Ak01.html

[Cobalt Violet]

4. That was my first thought exactly. n/t

[Caution]

8. Got it in one.

Just another way that science is under attack. Doctors? Who needs em? All I have to do is drink my tonic (herbal concoction, inhale aromatherapy, seek spiritual healing, pray, etc, etc) and I'll be cured. Who cares that medical science has nearly tripled the life-expectancy over the last few hundred years and doubled it in the last 120?

You want to give birth at home with a mid-wife? Fine. Practice 15th century medicine on yourself and your children? Fine. If and when my fiancee decides she wants children, I'm happy to say that rather than going to someone who went to a weekend retreat for training that we'll go to a hospital and be treated by someone who spent years in an accredited medical acedemic institution followed by years as an intern in a hospital.

[meganmonkey]

9. Wow! Talk about a broad brush!

I know 2 midwives - one is a Certified Nurse-Midwife with a masters degree from Emory, and the other did a 2 year apprenticeship with a very experienced local midwife and is legally certified by the state. She has a great relationship with the OBs at the local hospital and anytime anything is atypical the birth takes place at the hospital. Even in those cases, she generally is the main person attending at the birth even though 'technically' she is there as a visitor - because the doctors know she is extremely competent and she knows the mother after working with her for months.


A weekend retreat? Get your facts straight. If I had more time I would get you a bunch of links but I have to get ready for work. Google is your friend.

Peace.

[shanti]

85. exactly

i had a cnm, and they have to follow high standards, and have an m.d. backup AND be close to a hospital. these aren't fly by night midwives.

[Ilsa]

14. I don't think you know how much training it takes to be a

certified midwife or a certified nurse midwife. That certification comes after extensive training, testing, and actual practice under supervision of another midwife.

Midwives, when doing prenatal care, take blood for tests, and make referrals to doctors for anything out of the ordinary.

But i think one of the best things they do prenatally is teach the expectant parents what to expect in labor and delivery and care of the baby. The mother can become a real partner in her healthcare instead of a passive "case" or a subject to be treated, ignoring her own body as the monitors get attached.

Being an active part of your child's birth is very empowering, which is a great feeling to have as you take on the role of parent, which can knock your confidence down to nothing in a hurry.

[HuckleB]

34. Hmm. Then why aren't you following the actual science?

The science clearly shows that birth at home for low-risk mothers is as safe, and in many ways safer, than birth in a hosptal. But you want to ignore that knowledge and force them into less safe scenarios in hospitals?

Also, your description of the training of midwives is ridiculous. It's clear that some education is in order here, and not for the midwives.

[MissB]

64. I'd never choose a home birth for myself

Anecdotal, I know, but there was this wonderful young couple who lived at the end of our block. They had an uncomplicated pregnancy and went with the midwife option. The hospital was less than 5 minutes away, and that was going normal speeds in a car and obeying traffic signals.

Something came up in the birth. By the time the midwife realized something was wrong and they called for an ambulance, it was too late. It was so damned sad - they'd waited so long for the baby and despite being so close to the hospital, nothing could be done.

Just another statistic in the other direction. I prefer hospitals for myself.

[HuckleB]

65. Thanks for sharing.

If the hospital was five minutes away, the complication that came up may not have had a different result in the hospital. As has been noted, many ICUs are quicker and easier to get to from home than from the birthing center of the hospital itself.

[fleabert]

71. I ask that you please conduct a little research before you slam an

entire profession.

Midwives are professionals, and the research regarding home birth and hospital birth is valid.

Hospital births in the US are not the reason mother/infant mortality rates fell in the early 1900's, hand washing and infection control is.

Sweden is consistantly in the top three of countries for mother/infant birth outcome, and most women give birth at home with a midwife, or at the hospital with a midwife as primary and ob as backup for high risk. Where does the US rank with a 95-99% hospital birth rate? 23-26th worldwide.

Interventions are a slippery slope, starting with continuous fetal heart monitoring, which often gives negative readings when no problems exisit. The US hospital c-section rate is nearing 30%, when people like Ina May Gaskin produce a rate of 1.4%.

a great place to start is "Ina May's Guide to Childbirth", and excellent resource for home birth statistics.

I am not saying you should have a home birth, it's not for everyone, but please don't slam those that do, nor insult the profession that provides such a service.

http://www.thefarm.org/
http://www.amazon.com/exec/obidos/tg/sim-explorer/explore-items/-/0553381156/0/101/1/none/purchase/ref%3Dpd%5Fsxp%5Fr0/104-7637372-6007117
http://www.childbirth.org/articles/laborbooks.html
http://www.mymidwife.org/about/what.cfm

[shanti]

87. thank you for mentioning ina may gaskin

her book was my bible during the late 70's when i was birthing my first child, who was not a home birth, btw. my second and third were tho. her book was invaluable because it was so very thorough.

[fleabert]

90. her new one was published in 2003, it's even better!

updated and stats galore. She is amazing. I wish I could go to the farm, but my dh has already said 'no way!' (if I could just get pg!)

[shanti]

99. yes, the farm!

i wanted to go there as well! i have their vegetarian/soy recipe book too:-) say, i notice that you are in sacramento like me. :hi: neighbor!

[fleabert]

103. hi there!

I am expecting another du'er from Sacramento to jump in on this thread soon too, it comes up occasionally!

[shanti]

84. your hubris is breathtaking

for lowrisk mothers, it's an extremely viable option. i know, i've had two of them. but stay in the dark if you feel better. :-(

[PunkPop]

95. Wrong! You are so wrong.

From a man who has been present through two midwife births and is about to go through another. Educate yourself.

"15th century medicine"? That's an ignorant comment. The whole post is a breathtaking example of ignorance as a matter of fact.

[fleabert]

138. the more times I read this awful post, the madder I get.

are you coming back to defend this crazy talk? I am really offended.

[HuckleB]

155. I wondered the same thing.

My suspicion is that the answer is no. The poster tossed off a tirade without having done any homework, and the no homework chickens came home to roost. It would be nice to see such a poster have the guts to apologize, but, even at DU, that seldom happens.

Salud.

[SemperEadem]

172. Don't knock it until you've tried it

You may be skeptical about homeopathic/new age approaches, but remember: you're not the one carrying the baby. If aromatherapy works for her, then it works for her... and her being comfortable and unstressed in her pregnancy is more important that you feeling affronted by the notion of alternative therapies.

[Ms. Toad]

10. Wow. I would suggest you do a little research

on what the hospital birthing process has done to dramatically increase the cesarean rate, and other delivery complications, before you jump to that conclusion.

Modern hospital birthing process in the US often involves birthing in a position that forces you to work against gravity, requiring inactivity to accommodate the monitoring equipment (slowing labor, which progress more naturally if women are allowed to move about), pharmaceutical intervention to either slow labor to wait for the doctor, which then may require additional pharmaceutical intervention to speed up labor (or the other way around) - both of which impede the body's natural labor progression, pain killing drugs given routinely rather than encouragement to find ways to work with the pain (pain killing drugs can impede the body's ability to push properly) and a myriad of other things designed to make the process easier for the doctors or less legally risky for the docs.

Personally, I don't recommend home birth - there can be major complications and I want hospital facilities close by in case there is a disaster. I did consider home birth, because there are no hospitals in my area that do not routinely require (or strongly push) all of the above interventions that hinder rather than support the birth process. The deciding factor for me was finding the only doctor in town willing to do prenatal care for women intending to deliver at home - and who was consequently also willing to be less aggressive in a hospital setting, and willing to permit me to give birth in the single LDR in our town which permits women to reject early monitoring, early bed restrictions, etc.

So - home birth is not for everyone, but this is a study that will be welcomed by many progressive people, and is not just a way for insurance companies to save money. In fact, insurance companies routinely refuse to pay for midwives - preferring to force women into using a traditional hospital setting.

(Insurance companies routinely, by the way, require more expensive options rather than less - It was only because of my doctor's willingness to go to the mat for me that I was able to use a home based treatment (cost $500) rather than stay a week or more in the hospital (which probably would cost around $500 a day, before you add in doctor's bills and medicine. They just pass the cost on for the more expensive treatment.)

[fleabert]

72. no.

insurance companies will not pay for home births usually. cost of most home births are paid out of pocket. last time i checked, it was around $6000.00 total including pre-natal, labor, birth, and post-partum.

[HuckleB]

75. Indeed.

Most companies won't pay for the birth at home, itself. They do usually cover pre- and post- care, however. Alas, this does show the bizarre nature of insurance, which refuses to cover a safe method of birth that costs less than hospitalization. How many similar practices contribute to the high flying costs of health care?

[fleabert]

81. crazy isnt' it?

btw- you are doing an amazing job.

YEA HOME BIRTH!

[HuckleB]

128. Thanks.

And thanks for all your wonderful additions to the thread!

Salud!

[Ms. Toad]

102. They will cover pre natal care...

If you can find a doctor willing to provide prenatal care for someone intending to give birth at home. Most doctors refuse - as a result, women who intend to give birth at home sometimes pretend to be getting ready for a hospital birth in order to get prenatal care. As a consequence, these women do not necessarily receive an honest evaluation of whether they have any peculiarities that would make home birth not advisable.

[HuckleB]

119. Most midwives give the prenatal care themselves.

And most are covered for this by insurance, in my experience. At least the CNMs are. The midwife giving the prenatal care is very much a necessity for safe home birth, in fact.

[Ms. Toad]

152. Unfortunately, not everywhere is that enlightened.

It does look as though Ohio has made progress since I last did any research - but it still appears on a quick glance that CNM assisted birthing outside of the hospital setting is extremely rare.

Most women in Ohio who want to deliver at home are forced to use direct entry midwives - and although it is not ideal for prenatal care to be done by a physician rather than the midwife, it is better than relying solely on a direct entry midwife does not necessarily have the medical training or experience necessary to evaluate whether home birth is a safe option for a particular woman - but not necessarily much better if the woman cannot be honest about her intentions with her physician.

[HuckleB]

154. Yeah, I sometimes forget just how good we've got it out here in the west.

:(

Salud.

[merbex]

3. Frankly, after giving birth twice those midwives better arrive at

a home with drugs.

I gave birth naturally the first time and it felt like I had been hit by a semi when it was over

Second time,epidural from the gitgo

Easy as pie

[wakeme2008]

5. no to the Drugs....

:)

But you are in a different position.....

[fleabert]

74. unmedicated birth in the hospital is usually described as much

more painful than unmedicated at home, by those that have experienced both. Less interventions, no rules about eating, drinking, movement, monitoring, internal exams, etc... make for a much more comfortable mom, usually.

Not saying home birth is the choice for you, just saying that women who do choose home birth are not choosing a more painful path, necessarily.

Personally, I have attended 8 births as a doula, 7 in hospital, one at home. The home birth was much smoother, and it was twins.

[HuckleB]

78. Did they know that the mother was going to have twins?

Most midwives wouldn't birth twins at home.

Dang.

[fleabert]

88. yep!

she's very active in the birth field. doula educator, doula, midwife, etc... Her main midwife said that if she went to 36 weeks, she was comfortable with a home birth. She had dual care with an ob/gyn for check ups and ultrasound. babies #2 3 and 4 were born at home too. #7 is on the way.

It was incredible.

[shanti]

91. wow

it's unusual to hear of a twin home birth. if that had been a hospital birth, most likely they would have sectioned mom. hospital are VERY quick to do that. as an aside, i wonder what the ration of c-sections is by racial breakdown? i enjoy watching the birth shows on cable, and it seems like a high percentage of minority moms are given c-sections.

[fleabert]

92. I'd have to pull out some books, but I remeber reading that

more minority women do end up with more interventions in general, up to and including c-sections. I'll have to come back to the thread tomorrow, I have to get ready for work!

Her OB wanted to schedule a section before baby turned, but she said no, as long as they are healthy and doing well, I will stay pregnant. She is a very highly educated and strong woman!

[shanti]

89. lol, i was just the opposite

military hospital/epidural/forceps/episiotomy the first time, unmedicated home birth second and third times, and hospital labor room (!) unmedicated the last time. i HATE needles. i could handle labor because i knew there was an END to it, unlike other types of pain, but i'm thankful that i'll never have to do it again.;-)

[tavalon]

6. Duh

Of course, it is awfully rare that you actually here that. In most cases, it is actually safer.

[Archae]

7. I was born at home.

Back in 1959.

[fleabert]

97. planned or accidental?

that was a time when women were getting 'twilight' births handed to them without any say in the matter.

[Archae]

104. Planned.

Milwaukee hospitals had a staph infection epidemic, lot of babies were infected.

[fleabert]

106. what an awesome mom you have!

staph is still a huge problem at hospitals, and one of the risks of giving birth in a hospital that should be considered by all pregnant women.

[GoddessOfGuinness]

171. So did Denver...

I was born in the midst of it in 1958, and damn near died.

[UpInArms]

11. I was probably not "low risk"

and I and my son would have died during a home delivery.

I'm glad I opted for the doctor and the hospital, but then it is a very personal choice.

[Maeve]

19. Hospital "birthing rooms" are a reasonable compromise

And they were created to give the "home like" experience so many of us wanted. Only one of my four was born in an old-style delivery room and that was the worst--I was semi-ignored until Hubby insisted "yes, the baby is crowning, get in here!", then transported in mid-push to a cold room, baby taken away to the nursery and given a bottle despite insistance that there were to be no artificial feedings (kid took a week to get straight on nursing after their "help" and we left the hospital before she was 12 hours old). I didn't have the option of a birthing room at the time (small hospital), but you better believe I went elsewhere for the next child!

Compromise situations have to be available, but let women decide. Some want the meds, some of us do better without; some need white coats to feel secure, some need family members. Some need intervention, some of us manage just fine without.

[UpInArms]

20. although I went to a small hospital

they had a birthing room with a birthing chair - it was a natural childbirth (no drugs) but after 36 hours of labor (do I really have to remember all that?) they were about to "life flight" me out of there.

[HuckleB]

32. Great post.

Salud.

[Ms. Toad]

153. Great options - BUT...

When I gave birth nearly 15 years ago there was one room available in my community of >100,000. If it was full, you were out of luck. I am not aware that it has improved since then.

[bleedingheart]

12. What was the NUMBER ONE KILLER OF WOMEN about 100 years ago

CHILDBIRTH

For women who are healthy and who have had trouble free pregnancies and babies in the perfect position for natural delivery...a home delivery is possibly a wonderful experience.

But for women like my sister, my sister-in-law and myself...we would have all died in childbirth.

[HuckleB]

22. Did you read the article?

:shrug:

[bleedingheart]

36. yes and to be honest I am very much against promoting this for everyone

it isn't for everyone.

One of my coworkers had a wife who was insistent on having a midwife and they finally negotiated having her deliver at a "birthing center" that was across the street from a hospital. Luckily she did, her child was born with bizarre birth defect, she had no diaphragm...and needed immediate attention after birth. After this incident, she felt that had she delivered at home like her mid wife coached to her to do...her daughter would have died.... luckily both mother and daughter were fine.

It isn't that I don't think the midwives are good at what they do, but there are just too many things that can go wrong and having a hospital to back you up is a whole lot better.

And...what about the mandated tests for these kids...like the PKU test ? The tests for other disorders that are done routinely once the child is born? Once again...a parent might forgo those tests and end up having more problems...some of those disorders can be handled by just altering the child's diet.

[HuckleB]

37. The necessary tests are done.

Both prior to birth and after birth. And many of the unnecessary tests and interventions are not used, which helps prevent complications in itself. Anecdotal cases are scary, but they do not make home birth less safe than hospital births. The death rates are the same, and may actually be lower for home births, all things considered.

[fleabert]

77. Midwives are trained in infant cpr and bring O2 to every birth.

They are not simply women who decide they want to see babies born, they are birth professionals.

all of those tests are done by pediatricians, not OB's. Once the baby is born, the OB/GYN is gone, except for checking on mom. they have nothing to do with the infant's care. Midwives do postpartum visits for mom and baby. If a state mandates a test or shot, it's done.

There are too many things done to women in hospitals during labor that can cause things to go wrong, imo.

[gollygee]

93. Anyone opposed to home birth should read

The Thinking Woman's Guide to a Better Birth by Henci Goer

The introduction is available here: http://www.hencigoer.com/betterbirth/intro/

[fleabert]

96. and A Good Birth, A Safe Birth, by Korte and Scaer...and

http://search.barnesandnoble.com/booksearch/isbnInquiry.asp?userid=wK4hThEB3W&isbn=1558320415&itm=1


Birthing from Within by England and Horowitz
http://search.barnesandnoble.com/booksearch/isbnInquiry.asp?userid=wK4hThEB3W&isbn=0965987302&itm=1

[gollygee]

100. Oh did I put that as a reply to your post?

whoops! I meant to reply to the OP.

But yeah those books too! :)

[conflictgirl]

179. I don't think people are promoting homebirth as right for everyone

But I hope like hell that people aren't saying that hospital birth is right for everyone, either.

When it used to be routine for women to die in childbirth, it wasn't because they were birthing at home with midwives - it was because antibiotics weren't available, washing hands wasn't standard practice among any medical professionals, women were too far from the hospital for a Cesarean should they need one, etc.

But the hospital is NOT the safest place for all births. Ask the man I know whose first wife died to an antibiotic-resistant staph infection contracted in the hospital after her C-section. How about the very good friend of mine whose child got cerebral palsy because her OB was in such a hurry to get out of the hospital and botched the delivery?

BTW, I used a homebirth midwife with my second pregnancy. My first birth was a C-section. And the baby was 10 lbs 4 oz at birth. No drugs. No episiotomy. Obviously neither the baby nor I died as a result. Birth as a whole is much, much safer than the medical community wants women to believe. And again, any woman who wants to birth in a hospital should be allowed. Any woman who wants to take pharmaceutical drugs for legitimate medical conditions during pregnancy should have that access (even though sometimes those drugs later have disastrous effects - think DES). But don't take away the rights of those of us who have researched it and know that homebirth is safe and so is natural medicine instead of pharmaceuticals.

[fleabert]

79. INFECTION

usually a result of lack of hand washing from birth to birth...and a lack of penicillin once infection took hold.

no one promotes homebirth for everyone. In fact, the midwifery model of care is just the opposite. It is women-centered and strives to support womens educated and empowered decisions. I don't approve of saying all women need to give birth in a hospital, nor should all women give birth at home.

A good midwife would not take on a high risk birth at home, and a good OB/GYN should refer low risk out to midwives (for hospital/birthing center/home birth) OB/GYN's are surgeons, first and foremost. If I don't need surgery, I don't want a surgeon caring for me, I want them as back up.

[bleedingheart]

113. I had all the appearances of low risk...

until the end...then my case spiraled out of control...

[fleabert]

131. I cannot comment on your situation, but research shows that

maternal and infant outcomes are at least as good, if not better, in a well planned, attended homebirth.

I recommend 'A good birth, a safe birth' as a starting place for researching homebirth. Then Ina May Gaskin's newest book. Dr. Sears is also a great resource for pregnancy, labor, birth, and child rearing issues. 'Birthing From Within' is an awesome, fresh approach to childbirth. Links are up earlier in the thread, except for Dr. Sears, here he is (they are):

http://www.askdrsears.com/

I am sorry you had a tough birth experience, and I am glad you had good care to help you through it.

[SarahB]

185. Most deaths were due to infections.

Women who gave births in hospitals 100 years ago were far more likely to die. Many women need a hospital (I'm one of them as well), but for low-risk women, homebirth with an experienced trained midwife leads to fewer interventions and are more safe.

[Ilsa]

13. Death during childbirth was also due to infection because there

were no antibiotics 100 years ago, or ambulances to rush them to hospital if they were bleeding excessively. Blood transfusion science has progressed alot since then also.

Modern certified midwives are well aware of their limits and when a birth needs to be attended by a doctor. I even know a midwife who was taking a mom to the hospital because the baby had turned again and was breach during labor. The midwife ended up delivering the baby anyway, breach, and all turned out well. They went to the hospital and the doctors checked out mother and baby and sent them home.

Homebirth isn't for everyone, but for many, it could be a much healthier experience than going to a hospital. Even hospital nurseries sometimes have infection problems.

[BiggJawn]

16. I find it odd that something so natural is treated like a major emergency.

We are the only species in the world that require the intervention of highly trained professionals and millions of dollar's worth of facilities to finish our reproduction process.

I wonder why that is?

[HuckleB]

24. Exactly.

Of course, the reasons are multiple. But good-old turf wars are among them. And certainly, birth is a great example of how medical practice fails to note and adjust to actual research.

[Danmel]

62. Because Eve ate the apple

Most mammals give birth easily adn without pain. For whatever reason, humans do not. TO say that it is natural and medicine should not be ivolved is simplistic. Prenatal care saves hundreds of thousands of babies and women from serious problems.

[HuckleB]

63. Indeed.

But then, some practices, most noted in hosptal birth, may actually increase the pain.

[BiggJawn]

123. I thought Eve's apple gave us mensturation?

Yes, it may be simplisitc, but I can't help but wonder why Mice don't have little mousy OB wards to go to, and why you don't usually have to call the Vet to deliver puppies.

You could almost come to the conclussion that Man is defective, and we should have gone the way of dinosaurs but for the acquired skills of the Obstetrician...

[shimmergal]

178. Humans do not because of our large heads and

the fact that we walk upright, altering the angle of the woman's pelvis. At least that's what I've always understood.

[muriel_volestrangler]

109. There was a good natural history programme on British TV recently

saying why childbirth was more traumatic for humans. The large brain of the baby doesn't help, but the real problem is the mother's pelvis, designed for walking upright. That doesn't go well with the mechanics of birth. As it is, a human baby comes out more helpless than other animals, and in many ways could do with a bit more development in the womb. However, human evolution has compromised. Nevertheless, all societies have a tradition of others giving help, whether it's other mothers, midwives, or doctors. And it's a reasonable conclusion that it's been like that since before language developed.

My father was a GP, and he says you should always have a midwife in charge, if it's a low-risk birth. They're the experts at it, and will also normally know the mother better, which helps. Of his 3 children, one of us was born at home - but he wouldn't have done that without a midwife there.

[fleabert]

132. Kudos on a great post, and an amazing father!

that's the kind of Dr. I'd like to find.

[DemExpat]

140. So true.....and this is something I resisted when I was pregnant.

It is good to have medical controls during pregnancy, and backup for in case something goes wrong, but I had both of my babies at home - soaking in a warm bathtub to help me relax during the worst of the contractions until time to deliver - in my own bed.

DemEx

[all.of.me]

17. it is safer emotionally, spiritually and mentally for all couples.

[gate of the sun]

18. I had three children at home

and the last one at 41 almost 42. I did have a hemorrhage after the last one and had to be transported to the hospital and even knowing it would have happened I wouldn't have given up having my child at home. My daughter though just had a baby and she wouldn't have been able to deliver at home she had alot of complications yet even in this situation she would have had plenty of time to be transported.

[Kittycat]

23. The article focuses on Low-Risk groups, but

Doesn't take into consideration, the IDIOTS that try to deliver at home anyway - like my Cousin-in-law's wife that lost her child! She had Pre-e, and the midwife said she wouldn't deliver the child, she told her to do it - or she would have it alone. When the time came, the midwife was there, and the babies head got stuck in the birthcanal and died :(

Had they been at a hospital, in a nice comfy L&D room (like many hospitals today have), that baby would be here. I hate her for that idiotic decision!!!

[HuckleB]

26. I don't know any midwife who would have done that.

Pre-eclampsia usually means big time health care, as the mother is often in serious danger. The whole situation sounds incredibly odd. Still, the research includes all negative outcomes in home births vs. hospital births, so, if such incidents are even remotely common (something I do not suspect to be true), the safety for low-risk mothers would be even greater.

[Kittycat]

33. Believe it or not...

She had mild Pre-E the week that she delivered, and refused to go to the hospital. The midwife felt that someone should be there when the time came. CIL's wife used to tour the Midwife circuit lecturing on the Home births, etc, etc, other crunchy stuff, etc... After she lost the baby, she continued to tour for another year. She ended up having some sort of a breakdown, and now won't leave her house. She has some fear of smells & chemicals now... I said she wasn't normal.

She sent me an email encouraging me to consider home birth for my TWINS!!! She's nuts - I had mine in the hospital, and still lost one. It's hard to have sympathy for her - when this could have been prevented. I don't promote home births as safe for anyone, unless they've already had a successful, non-complicated delivery & their current PG is without complication. Until that child comes out - you never know what is going to happen. And if it's your first, and they get stuck - how could you live with yourself after that :(

[HuckleB]

35. Sounds like a truly bizarre case, all the way around.

In truth, some babies do "get stuck" on the way out, but the mothers make their way to hosptial, and those babies survive at the same rate as the babies with the same conditions as in the hospital. The issues with the pre-e likely promoted the death of the child, in this case, though, obviously, I am not privy to the details.

You're right. You never know what's going to happen until the child comes out. But the research is clear in showing that, even with that knowledge, birth at home for low-risk mothers, nullparous or multi, is as safe as in hospital, and, in some ways, safer.

[bleedingheart]

43. my first got stuck in the birth canal...and luckily the hospital had a

vacuum device to help me deliver him...on the second try he emerged..looking a bit like a cone head but healthy.

However if the second try didn't work they were getting an OR prepped to deliver him C-section since my condition was degrading after two hours of pushing...I also ended up with a case of congestive heart failure as a result of preeclampsia...

Second pregnancy was a c-section (due to breach) at a fine women's hopsital in Pittsburgh...

[HuckleB]

48. I don't know the details of your case.

First, if you had pre-e, the midwife would have sent you to the hospital straight away. Second, many babies get stuck in the canal, and midwives do quite well with them at home, sending patients to hospital if necessary, with plenty of time. In fact, in many cases, the ambulance or car ride to the ER is shorter than the elevator ride to the ER from the birthing center.

Salud.

[bleedingheart]

55. I had atypical pre-eclampsia

didn't drop protein, didn't have any blood pressure issues ..just swelling...which a lot of normal pregnancies have.

In fact my cardiologist (assigned to me after the case) stated that in his review of the myriad of tests done prior to the birth...he felt that I was one of those 1% that don't match the "norm".

[Skwmom]

27. What about the issue of undetected problems because

women and babies are released too early from the hospital?

[HuckleB]

30. Most midwives follow-up with home visits for three days in a row,

following birth. With a hospital birth, the mother goes home and comes back a week later. Which population do you think would be best served in regard to the proposed "cases"?

[triguy46]

117. Kinda depends on the qualifications of the practitioner

[HuckleB]

120. ?

:shrug:

[ninkasi]

28. I was born at my grandmother's house

but it was 1943, and many babies were born at home then. Two of my aunts, my mother's sisters, also had babies in that home.

My stepdaughter chose a home delivery for her youngest, and her mom and aunt, her in-laws, and I were all there. The midwife said she had never seen so many grandmas together for a birth before, and was impressed that we all got along so well.

We were all thrilled at being there, and giving our daughter love and support. I stayed most of the next day taking care of the older two children, then was relieved by her mom, who was then relieved by her mother-in-law. She had much, much more care and attention than she would have received in a hospital.

Of course, we were all alert to any hint that something might be going wrong, in which case the midwife had a doctor she could call in case we had to get my stepdaughter to the hospital. For our family, it was a beautiful, spiritual experience, but the health of mother and baby come first.

[msanthrope]

31. I gave birth to my daughter at a birthing suite,

connected to a hospital. Had I needed it, I was three minutes away, by stretcher and underground corridor, from the emergency room. My midwife came from a doctor/midwife practice, and would have stayed with me, even through an emergency c-section.

My Midwife did an excellent job, and I only had 20 minutes of pushing. No drugs, no rips.

The practice itself had a very sane approach: If you went into labor before 35 weeks, hospital. At 35 weeks, your chart was carefully reviewed by a committee of doctors and midwives to make sure you qualified for the birthing suite. If you didn't, hospital. If you went to the birting suite, and had complications? Hospital. Your midwife stayed with you, so you always had an advocate there.

[HuckleB]

38. MORE: Caretakers of Homebirth: Doctors Who Come to You

http://www.mothering.com/articles/pregnancy_birth/homebirth/caretakers.html

"...

Indeed, according to the National Center for Health Statistics, after falling steadily from 1989 to 1996 the rate of cesarean delivery increased again in 1999 to a national average of 22 percent, up 4 percent from 1998.1 According to a 1999 Reuters report, in a study of more than 1,200 women, researchers at Brigham and Women's Hospital in Boston found that first-time mothers who develop a fever during labor are three times more likely to deliver by cesarean section than those who don't. Ninety percent of the 301 women in the study who developed a fever during childbirth had been given an epidural, suggesting a link between the two.2 Studies at the University of Houston Medical School showed two to three times more cesareans for dystocia in first labors in the epidural group than in the group of women without anesthesia.3

In spite of these and other related studies, the rate of epidural anesthesia use continues to rise. Comprehensive reports from many hospitals indicate that almost all (80 to 98 percent of birthing women, depending on the hospital) receive (oral) medication, anesthesia (epidural analgesia), or both. In contrast, 90 percent of Homefirst mothers succeed at having uncomplicated and nonmedicated homebirths, and of the 10 percent who are transferred to the hospital half still have a vaginal birth.

Eisenstein minces no words when he declares that homebirth is safer than hospital birth for those 90 percent of mothers who are low risk. The problem is that obstetricians treat all women as high risk. "Obstetrics, which is really a combined philosophy, business, and religion, does not have science as its base," Eisenstein says. "Obstetricians practice much more philosophy than science. Pregnant women are tested, medicated, and operated on to excess every day by this profession in an unethical and dangerous way. This unscientific medicine is dangerous to us as a nation. Our maternal and infant mortality rate is unacceptable for a society as sophisticated as ours. We produce more premature infants than any other country with our interventionist technology and then praise ourselves for saving some of their lives."

Support for the safety of out-of-hospital and nonintervention births is abundant. According to a 1994 study, after "reviewing the full spectrum of literature from the United States and abroad, the literature shows that low- to moderate-risk home births attended by direct-entry midwives are at least as safe as hospital births attended by either physicians or midwives."4

...

[kanrok]

39. Yep, safe, unless you are in the unfortunate 5% of women

who have complications during labor. Then you're screwed, or more pointedly, your child is screwed. There is no continuous fetal monitoring at home. There is no access to an obstetrician should the baby get in trouble. There is no neo-natologist available to treat the child immediately after birth, should the need arise. There is no operating room down the hall in case a C-section is needed. Even if the mid-wife is the best trained mid-wife in the world, she (or he) still does not have the training necessary to treat the most potentially catastrophic injuries that arise when complications occur. If something does happen in utero, during the intra-partum period, calling 9-11 won't solve it. Seconds matter when the child is being deprived of oxygen. True, in the majority of births, the obsterician is there merely to catch the baby. But you get the best doctor you can for the most important moments of your child's life. To do otherwise poses too many risks, IMHO. No slight on mid-wives. They do great work. Let them do it in a hospital setting, where there is immediate access to life-saving equipment and talent.

[HuckleB]

40. Thanks for the opinion.

However, the research shows a very different reality from your opinion. Where do you get your 5 percent from, anyway?

[jayfish]

44. On A Strictly Anecdotal Note:

If they were born at home, my wife would have probably died during the birth of both of my children.

Jay

[HuckleB]

47. Obviously I don't know the story.

But I suspect that your wife would have been told by the midwife that she needed to have the birth at the hospital.

[jayfish]

49. No, These Were Post Delivery Problems.

For our first child, the placenta would not detach and required surgery to remove. Which, in-turn, led to hemorrhaging. For the second she just out-right started to hemorrhage (not related to the first problem) after the baby was born. I'm sure they were both flukes but I'm just say'en.

Jay

[HuckleB]

50. Those do happen in home births.

And the research to date shows that the safety of the mother is not compromised. Believe me, I am a pediatric and psychiatric NP who was very cynical about home birth until I did the research, prompted by my wife's curiosity about using the option. If the research showed that the mother's health was at all at risk by comparison, I would not have gone along with such a plan. Obvioiusly, she could have vetoed me, but she wouldn't have gone along with such a plan either.

[jayfish]

53. My Situation Was Just The Opposite.

I was open to home birthing but my wife was adamantly against it (her mom and sister are in the health-care industry). Anyway, as I implied, I'm sure it's not an indicator of anything. I just wanted to share.

Jay

[HuckleB]

54. I appreciate it!

Thanks for the constructive conversation.

Salud!

[athenap]

147. Four weeks ago, I had my daughter at home

My placenta took its time to detach, *and* my quirky uterus did this weird thing where the bottom part, and my cervix, closed up before the top. My midwife, midwife-assistants, doula, and I calmly called 911 for ambulance transport to the hospital (the ambulance was called for two reasons--one for ER admit/insurance purposes, and the other was so that I could lie down and have the baby with me, nursing, to encourage my uterus to further contract and not have her strapped into a carseat), where my backup doc went through a fifteen-minute procedure my husband calls the "roto-rooter" procedure (eek!) - I was put under (a courtesy, because it's not something you want to be awake for) and my doc went in and pulled the placenta out manually. The whole procedure took less time than it did for my husband to fill out the paperwork to admit me.

Given the fact that I was ignored for two hours before starting checkout procedures, then ignored two more hours after checkout procedures had started, the idea that someone in the hospital would be more likely to notice if something was wrong is laughable.

Skilled midwives are trained to look for signs of difficulty like this, and they are trained to know their own limitations in their environment. Just as your family doc knows when to refer you to a specialist.

[DemExpat]

149. Congratulations, athenap!

Hope everything is going very well now for you and your baby.

:hug:

DemEx

[kanrok]

59. It comes from experts in malpractice cases

I am a plaintiff's personal injury attorney. I handle a substantial amount of obstetrical malpractice cases. I am currently litigating a home birth CP case against a family practice physician who failed to recognize the signs of HIE. Once the child was delivered (after a nearly 3 hour second stage in a primip) he couldn't get the child intubated, and there was an additional 30 minute delay getting the child to the hospital for treatment. Once at the hospital the neo-natologist intubated on the first try. Here, the physician advertised (as you say, the research supports) that delivering at home is "as safe or safer than delivering in a hospital." He claimed he had the same equipment they have at the hospital available to him at the home.

The reality you speak of hits close to home for me. I deal with the remnants of the specious claim that delivering at home is "just as safe" as delivering in a hospital. The child in my case was profoundly injured. (Ironically, she later died of injuries she sustained while hospitalized at a nationally renowned hospital because a nurse placed a heating pad in a micro-wave and put it on the child's leg causing 2nd and 3rd degree burns, leading to transefer to a burn center, then later to the development of infection and death. A tragic case, to be sure).

Now, let's be clear. I have no animosity against home birth advocates or midwives. Especially midwives. They perform a much-needed service, especially in under-served communities. And it is true that home births can be safe, if the patient is screened carefully. But IMHO you are playing with fire. If you want a natural birth, do it in a birthing center in a hospital. No sense stacking the odds agaisnt you.

BTW, the mom in my case was the picture of health and a good candidate for natural birth. No complications in the pregnancy, adequate pelvis, average sized baby by ultrasound, and wonderful pre-natal care, including exercise and diet. One case, you might say? One case too many for me.

[HuckleB]

60. So where are the studies to back up your claim?

You say that home birth safety is specious. The studies indicate otherwise. Your opinion that mothers are playing with fire just doesn't bear fruit across the population. In fact, one can argue quite well that a mother who chooses a hospital is playing with much more fire. Anecdotes are great for conversation, but not so great when it comes to making actual health care decisions. And anecdotes on the Internet? Do we need to go into that? And what do you do when you get a case where unnecessary intervention caused complications for the mother and/or baby? Do you ask why the baby wasn't delivered at home where the intervention would not have occurred? And, yes, I have been privy to many such cases. I've spent my life working with children with neurodevelopmental disabilities. Now, I grant that such info. is anecdotal, but it is also backed up by the research.

[kanrok]

66. If you want to have your child at home, be my guest

I don't need studies to show me how quickly bad things can happen during childbirth. That's not anecdotal. It is scientific fact. Can bad things happen in a hospital. You bet. Can Pitocin be a bad thing to give in certain cases? Yep. It's interesting how you pick out one line of my post and criticize it. You miss the point. I am dead set against home births, that is true. But, I am not against natural births. Have a mid-wife. Let him or her deliver the child. Go for it. They are a great supplement to healthcare. If there is an uncomplicated birth, let them catch the baby. Have a birth plan that states you don't want drugs, or EFM or any thing else your heart desires. Just do it at a hospital. If things go downhill, for the sake of the baby (and the mom), let the professionals take care of it. With all due respect, a midwife in a home setting is not capable of handling the myriad of problems which can arise in a seemingly uncomplicated birth. They just do not have the training to handle things when the shit hits the fan. All the research in the world is a cold comfort to a child with CP or the family of a dead baby. Under those circumstances you might as well give birth under a tree.

[HuckleB]

67. Umm. No, your opinion is not based in science.

Yes, bad things can happen quickly. However, the overwhelming evidence shows that they can be dealt with just as well at home as in hospital. Anecdotes don't change that.

You have chosen an opinion that is not based in the knowledge of the current body of research. You have the right to hold that opinion. However, you have offered but one anecdotal case that I cannot even confirm the details of as justification. The science shows that death is just as likely to occur in hospital as out, and that complications may be more likely to occur in hospital than out, when comparing like populations. All the hyperbole in the world doesn't change that.

Doesn't it scare you to be involved in such a case but to not have done a full review of the literature? Don't you read the literature used by "experts" to make the claims they're making? Wouldn't you be held liable if the "expert" gives false, misleading or unscientific information?

There are too many folks guarding their medical turf, despite research evidence, and often continuing practices not based in research, but in "tradition." Might some of these folks act as "experts" in court from time to time?

[kanrok]

73. Hmmm...I read the study

Luckily the BMJ is online and FREE! Interesting conclusion. I read it with skepticism and am not totally convinced, but it does make me want to research this more fully. It is prospective (good) and large enough to make it useful (good), but it's comparison numbers can be criticized (most of the studies it compares to are from the 70's and 80's...not so good, but explainable), the BMJ is HIGHLY respected (I know because I use it from time to time to make points in current cases...good). All in all it now forces me to re-think my position. Thanks. Really. (As an aside, it doesn't scare me that I'm involved in a home birth case without reviewing this line of literature. I'm not asserting it's not within the standard of care to have a home birth, just that this doctor did not adhere to his standard in the manner in which he delivered this baby. i.e., a person can decide to have a home birth, but the doctor (or mid-wife) still must meet minimum standards when executing the delivery plan, e.g., monitor the baby, make the right decisions when it's time to get to a hospital, tec.)

[HuckleB]

76. I appreciate your open mind, and your explanation regarding lit review.

Salud.

[fleabert]

82. you have a very open mind, I am impressed and

a little humbled.

If you would like more reading, please check out Ina May Gaskin's, Guide to Childbirth. She provides the outcomes from 2028 pregancies from 1970-2000, includes all that came to her, no screening out high risk or otherwise. Appendix B, 'evidence based care' is also very revealing.

http://search.barnesandnoble.com/booksearch/isbnInquiry.asp?userid=wK4hThEB3W&isbn=0553381156&itm=1

[kanrok]

141. Thanks. Will do.

[fleabert]

80. anecdotally...

the last birth i attended as a doula was a home birth. Twins. 40 and a half weeks, 8lbs and 7.9 lbs. Baby b was breech until 38 weeks, turned on her own. totally uncomplicated birth in her bedroom with four other kids looking on, it was wonderful. Three midwives in attendance, one for mom, and one for each baby.

Babies are now 2 and a half, and very healthy.

Does this mean I say every mom with twins should have a home birth? NO. it's anecdotal.

[kanrok]

144. I hear you.

I have a pretty good grasp on the definition of "anecdotal."

[Ayesha]

115. A hospital is no guarantee

...that these kinds of things won't happen. I have CP due to medical malpractice and I was born in a hospital. Just one of the MANY mistakes the OB/GYN made was that I was breech and he failed to use a fetal monitor until it was too late. And yes, my parents did sue and received a settlement.

I agree with you on the birthing center. I do think natural childbirth is best when possible, but being close to the hospital gives the mother the best of both worlds. But I also feel strongly that hospitals can and do make mistakes on a regular basis, and thus there are probably some babies that have fared better due to being born naturally.

[kanrok]

142. You are absolutely correct.

[GoddessOfGuinness]

173. As your story demonstrates, incompetence can occur

in any location.

[shanti]

94. 5% failure rate

is good enough for me. hospital births don't always work out either.

[HuckleB]

41. I have to go.

So I wont' be responding for a few days, likely.

It is interesting to note the responses to the actual (extensive) body of research showing the safety of home birth. "Yeah, it's safe except for X..." Etc... Even though that's not what the research shows. Are we this emotionally tied into believing that there is one way to do things? This tied into the perceived knowledge of some higher authority, even though that higher authority has gone on its way for decades, using unproven techniques and ignoring much research itself? I don't know. I guess I didn't expect to see such vehement responses here. It is interesting.

[Ilsa]

42. I find it odd that with all of our medical advances,

we still have one of the worst infant mortality rates in the world compared to other industrialized nations. Those industrialized nations that use midwives more seem to have better outcomes, from what I've read.

Now I need to go find some links to back this up...

On edit: Here's the infant mortality rate. We're at #36.
http://www.geographyiq.com/ranking/ranking_Infant_Mortality_Rate_aall.htm

Here's another site where we're 40th:
http://www.nationmaster.com/red/graph-T/hea_inf_mor_rat&int=-1

[HuckleB]

45. The Netherlands, with 35% of births at home is one.

"In the Netherlands, where the perinatal mortality rate is one of the lowest in the world, approximately 35% of all births take place at home. An integrated system of home birth services includes well-trained midwives who carry emergency equipment, and a well-established system for emergency transport and the reception of home birth transfers in hospital.(2) "

http://www.cmbc.bc.ca/docs/homebrth/homebrth.htm

[DemExpat]

145. Yes, I had both of my babies at home here in Holland in the '80s....

With excellent pre-natal controls, midwives, emergency system in place, etc. and first class post-natal check ups throughout the first year.

With my first birthing I tore my perineum clear through with my 10 pound baby girl....so was rushed to the hospital for surgery to sew me up.

My second home birth went without a hitch or a stitch...:-)

I respect that it might not be for everyone, but I certainly wholeheartedly support the choice being availabe for those who want to give birth at home!

DemEx

[bleedingheart]

46. I believe that the infant mortality stats may include more data today

the problem is this...

20-30 years ago, women who went into labor at 5-6 months were miscarrying and I don't think that it was considered in the infant mortality stats. Today that same child would be delivered, placed in a NICU and then if the child dies...it is added to the infant mortality stats.

So is miscarriage included in infant mortality today? Was it 30 years ago...and has the definition changed? and has the technology affected the stats..???

[Ilsa]

51. Very true. The stats may be convoluted

and unreliable. But I have some doubts that it is just preemies/NICU deaths that sent us to 40th.

[bleedingheart]

52. I think it is also are abysmal healthcare system

basically we have millions of uninsured women out there that receive no gynecological or obstetric care until they "really really need it"...

Same is true for other conditions as well, many men are walking around with prostate cancer and probably don't even know it.

[jhain]

118. BINGO!

and the incidence of idiopathic problems in both mother and baby is a statistic frighting enough to have propelled me to the homebirth choice.
The current C Sec percentages are staggering.

I had hospital births and homebirths.
My midwifery care in conjunction with my homebirths was BY FAR the best medical I ever received.

This study is a welcome bit of info.

[fleabert]

134. hear hear!

I cannot explain more clearly to women the difference between the midwifery model of care, and the gyno/obstetric model. I have been blown away by the difference in how I am treated, how I am spoken to, how I am touched, and how I feel after switching to a midwife for ALL my well-woman care. They care for women from puberty to menopause,not just during pregnancy and birth.

No way I would go back to a surgeon unless I need surgery.

[HockeyMom]

56. My first daughter was breech

This 26 years ago. The hospital staff wanted to do a C-section, but my doctor, who had been practicing over 20 years, told them no. I was given xrays and a mild epidural which only dulled the pain, but not all feeling. The entire obstetrics staff was there to watch this. They had never seen it before? The room was so crowded my husband was complaining they pushed him aside. My doctor said to me that this would require "a LOT" of work on my part, but if I was willing to do this, he would work to make it happen (baring any unforeseen complications). When she was delivered about up to her chest, he just reached in and delivered her head with his hands - no forceps. When my daughter was delivered, the rest of the staff there applauded. Unbelievable.

Obviously, none of this could have happened at home. Even though I didn't need a C-section, everything was there and waiting for it in case something did go wrong.

[HuckleB]

57. What a great doc!

He clearly showed, anecdotally -- of course, that the usual interventions are not always needed.

Thanks for your story.

[Danmel]

68. You don't always know who is low risk

When I had my first child, I'd have been considered low risk. I was 30 years old, in good health, no pregnancy complications, good prenatal care, I ate well, didn't smoke or drink.

I was in labor for almost 24 hours and had not progressed beyond 4 centimeters. I just did not progress at all. I walked, I talked, I did it all- nothing. (And I did not have an epidural so nothing was slowing things down.)

Finally, I had a section- I don't know what would have happened had I been at home- would I have labored for 30 hours, 40 hours? Would the baby have been compromised in some way? Hard to say, but it sure as hell didn't look like I was progressing- after 24 hours I was given pitocin- 2 hours later I was at 5 centimeters- then I got the epidural and the section. I'm fine, my daughter is 14 and an honor roll student. Would it be worth the risk to damage her? I don't think so. Plus it was January and it snowed heavily the day she was born. Had I delivered at home and had she (or I ) needed immediate medical attention, we'd have been stuck.

With my son, I had a sono at 38 weeks because I was VERY large and had only gained 22 pounds- they calculated the fetal weight at about 9 pounds and scheduled me for a section- (since I had had one before, they didn't want me to risk passing such a large baby) (I am only 5 feet talland weigh 120 when I'm not with child.)

Well he was 7-11, but when they took him out the cord was around his neck, chest and thigh. He was triple wrapped. Had I actually gone into labor and he had descended, he'd have strangled. Maybe he'd be a spastic quad, maybe he'd be retarded, maybe he'd have been dead. But he's a bright funny 11 year old and I'm fine.

So statistics can be what they are. Personally, I'm glad I didn't have home births. I probably wouldn't have lived through the first pregnancy to lose the second.

[HuckleB]

69. You do know who is low risk.

However, low risk should not be confused with no risk.

If labor goes too long at home, the mother is moved to the hospital. Further, midwives consider road conditions into the equation of when and where things are done. That's part of the reason why home births are safe, if not safer, than hospital births. As for the second case, that's actually more common than one would think, and such children are given birth at home without complication on a regular basis. However, in your condition, the midwife would have had you deliver at the hospital, anyway.

[athenap]

151. Long Labor

With my first, I had midwives and planned to deliver at a free-standing birth center. My labor with him took 4 and a half days (yes, that's right--days), as he was partially posterior. I put up with 10-minute-apart contractions for three and a half days, while my body went from 3 cm to 7 cm. If I'd had an ob and conventional hospital birth, I'd've been given pitocin, then an epidural, then a c-section due to "failure to progress." Not by my standards, but by the hospital's arbitrary timeclock.

But my midwives, who knew I wanted to have as little intervention as possible, allowed me to try different things. I rested, walked, did lunges, dined on Indian food, and generally let my body go at its own pace. I did have to transfer to the hospital when I was at 9.5 cm because my cervix started to swell. An epidural was needed for me to have a few hours' rest and give my body time to stop swelling, and the free standing birth center wasn't able to administer the anesthetic. After my epi, I finished dilating, and was able to push my son out with no further complications. My son is healthy, bright, and completely fine, and has been since birth.

[HuckleB]

70. LOL! -- Norwegian Princess speaks out on home births --

http://www.aftenposten.no/english/local/article1061009.ece

Norway appears to be more similar to DU than one might think!

:)

[shanti]

83. in some cases, safer

i delivered 2 of my four sons at home. it was a beautiful experience, but it's not for everyone.

[fleabert]

86. I find it very interesting that those that are in support of home birth

being an option are very supportive of individual choice in the matter, and are careful to say that it might not be the choice for everyone, while most that are opposed to home birth (for whatever reason) seem to be against it for anyone. As if, if one chooses home birth, one is putting themselves or the child in danger, and clearly are reckless. Even though the research and statistics plainly state otherwise.

why does it offend some so much that homebirth is a valid, safe choice?

I support women and families making choices from an educated and empowered position; all the facts on the table, then choose. Eliminate or reduce the fear and the choices one makes are that much more sound. If you choose an epidural and hospital birth, great! if it's homebirth and burying the placenta under a tree in the back yard, great! Just make the decision with a whole and happy heart, and with a head full of facts.

[Amaya]

98. I totally agree with you!

I've had two home births, both uncomplicated. I chose it because for me, it felt right.
It's not for everyone, tho.

[fleabert]

107. congrats on two happy, healthy births

I wish everyone knew someone who had given birth at home, it would make threads like this less 'hot'.

[Stuckinthebush]

101. It is a personal choice

and I support both those who choose home birth and those who don't.

It must be pointed out that this is one study and needs to be replicated.

In our case, our first child would have died if we chose the home birth route. Because we were at the hospital when the baby went into distress, my wife was immediately wheeled into the operating room for an emergency C-section. Any more time would have meant loss of oxygen to the brain of our child.

We now have a healthy 8 year old who will be starting a gifted program next year and are thankful we chose the hospital birth route.

There was no question on how we were going to have the next two children, and we chose hospital birth without hesitation. To us, the risk was just too great and it seemed to make no sense to have a home birth and risk not being around needed medical care.

[fleabert]

105. this is not the first study to produce these results

speaking in generalities, since i don't know the details of your experience, there is no way of knowing if fetal distress that occurs at the hospital would have occured at home since many interventions done at the hospital carry a risk of causing fetal distress. continuous FHM often shows fetal distress when none is actually occuring as well.

to say that "it seemed to make no sense to have a home birth and risk not being around needed medical care" implies that women who do choose home birth are making a decision that makes no sense and puts them and their baby at risk, and also insults the intensive training and planning that midwives put into their profession and home births, respectively. I find that less than supportive.

[Stuckinthebush]

108. As much intensive training midwives may have

Will never compensate for the fact that they are not at a hospital with the tools necessary to intervene in some very dangerous situations.

When I say it didn't make sense, I mean that for our situation and state of mind it didn't make sense. The pros and cons of both were weighed and there was no contest for us on which way to go.

Another person can weigh those pros and cons and come up with a different answer and that is fine. But for us, it seemed foolish after our serious near death experience with our first daughter. Even friends who had midwives opined that it was best we were at the hospital.

I have seen people get into near fist fights over the question of midwife or hospital, and I think that is ridiculous. What works for one does not work for another. Hospital or home...your decision. I just hope that everyone weighs all pros and cons of both and goes into EITHER situation with eyes wide open.

[fleabert]

110. at the base of our feelings we agree.

again, i was saying that i was not commenting on your experience, as I was not there and do not know the details. even if I did, I still would say that you made the decision that was best for you, and that's the way is should be.

[Stuckinthebush]

112. Exactly

That's the way it should be...for everyone.

[gollygee]

111. My daughter was born with a midwife at a hospital

so that happens too.

[Stuckinthebush]

114. Best of both worlds!

I like this solution.

[Pithlet]

165. That isn't my experience

Here and on parenting boards, I've been flamed for having a hospital birth. Hospital births are evil and dangerous, and home births are wonderful and safe. And anyone who thinks otherwise just has a close mind. It's happened even to others in this thread. Feh...

I would have died had I had a home birth with my first born. It just isn't worth the risk, to me. I believe that should be a personal choice, and I respect the choices of those who decide to have a home birth. But, it's not what I would choose, and I resent being told that hospitals are a less safe choice, and that I ignore the studies.

Want a home birth? Fine, have one. You loved the experience? That's great! Birth should be a positive experience. But, it IS possible to have a positive experience in the hospital, just as I did with my second born. I loved it, and I hate it that it is disparaged by the home birth crowd.

[HuckleB]

166. There a "fundamentalists" of all stripes.

Still, the majority of folks who choose home birth face a torrent of criticism from uninformed relatives and friends. It's not easy choosing home birth in this day and age, regardless of the evidence that supports its safety.

[triguy46]

116. birth 'em at home...

educate 'em at home, have live at home until they're 37. All very "progressive" ideas.

[HuckleB]

121. ?

:shrug:

:eyes:

You seem to have a need to criticize a practice deemed safe by scientific study, but aren't sure how to do it without meaningless one-liner comparisons. What gives?

[Amaya]

122. Don't be an ass

[fleabert]

133. mmmm-kay.

don't mess up a good thread dude/dudette.

[LeftyMom]

143. WTF?

Speaking as a DUer who homeschools and wants to homebirth my next kid- please kiss my progressive and stretchmarked ass!

Your comment is insensitive and uneducated- you clearly have no idea why progressive families choose to birth and educate thier children at home, and no desire to learn the truth or you would have asked nicely.

[HuckleB]

126. Physicians and Advanced Practice Nurses. Another sacred cow goes south?

Do physicians deliver better care than Advanced Practice Nurses?

http://www.nursingadvocacy.org/faq/apn_md_relative_merits.html

"he media sometimes suggests that physicians deliver better care than Advanced Practice Nurses (APNs). Is that true?

Not according to most scientific studies, which have found that care by APNs is as good as or better than that of physicians.

Some recent press articles have openly disparaged or devalued the care of APNs relative to that of physicians. And the government's slogan for their "Take Your Loved One to the Doctor" media campaign completely ignored APNs.

However, the following studies and articles show that the care provided by APNs merits at least as much respect as that of their physician counterparts.

..."


A slightly different topic covering some of the same turf issues. Yes, this piece is an advocacy bit, but it offers a great deal of research to back up its statements.

[Radio_Lady]

127. I definitely do NOT plan to have my next child at home!

1. It might stain the Ralph Lauren southwestern-style sheets.

2. I'm 66 and can't claim I have any more fertile eggs.

3. Hooray!

[KalicoKitty]

129. I am sure glad my daughter was in a hospital!!!

She was in hard labor for a long time, and then tests show the baby was stressed. :scared:

The doctor performed an emergency caesarean and, thank God for that. The cord was wrapped around my little grandson’s neck twice and there was no way he could’ve gotten into the birth canal.

[fleabert]

136. as has been stated time and time again in this thread.

your anecdotal example, however important to you personally, does not impact the veracity of this study.

I cannot say whether or not your daughter had any interventions in the hospital that may have actually led to the fetal distress that led to her C-section, but it is a possibility, research has shown this to be true for many babies. That may not have happened to your daughter, but we really don't know, and never can. A homebirth may have resulted in a simpler, less surgical birth. you really cannot judge after the fact since so many variables would have been different.

A cord around the neck is not actually as much of a crisis as most laymen think, it happens a lot, and the simple fix is to slip a finger under the cord once the head is out and untangle it. If not possible, clamps can be placed before the shoulders are born and the cord cut immediately.

if you want anectdotal evidence about the cord situation: I know a woman whose son was born with a triple knot. The cord was actually KNOTTED three times between the placenta and the baby. No biggie, he's fine. And, I have attended 8 births, three of them were vaginal births where the cord was wrapped, no biggie again. They were fine, and no one freaked out, dr or otherwise. SOMETIMES it's a big deal and impacts breathing, and a good practioner (midwife, dr. nurse, etc...) would discover this thru checking on the baby during and after a contraction. Either FHM (which gives false distress readings sometimes) or a fetoscope can aide the practioner in discovering how baby is handling labor.

Midwives don't just sit and watch while a woman labors, nor do they leave the job up to machines, they participate and care for their patients. if a problem is discovered, they will refer and transfer.

[deadparrot]

135. Fine with me.

I don't really care where some other woman chooses to give birth. It's none of my buisiness.

I can tell you, though, I'll be going to the hospital. Just hook me up to the drugs.

[LeftyMom]

139. no shit.

Hey, I had a baby in one of those supposedely modern hospitals in one of the spiffy birthing rooms. You couldn't pay me to do it again. The whole time I was there it was "are you ready for your epidural yet?" "no" "I'll be back in half an hour, you'll be dying for it by then" and "I'm going to give you some pitocin to augment your labor" "No you're not." The spiffy birthing rooms don't mean jack when the mindset of the doctors is still stuck in the operating room mentality.

Home births have fewer stupid and dangerous interventions. That's all I need to know to stay home next time. Being able to keep people who think thier stethescope doubles as an asshole liscence away from me is a really cool bonus.

BTW, this was at UC Davis in Sacramento. I would advise against going there to give birth unless there's a high probablitity of dying before you can get up the road to Sutter. It was THAT bad, and I had a relatively easy, if slow, labor and birth.

[MountainLaurel]

146. That sounds dead on

With the experience of a good friend with a hospital "nonintervention friendly" birthing room. She was told that there would be birthing balls and bars available, she'd be able to get up and move, there was a tub available, she'd be able to birth in any position and breastfeed immediately after the birth to get the instinct going, etc. In other words, she'd be able to do all the things that speed and ease the birth process and start up mama-baby bonding.

Then she and hubby went on a tour and found that it was bullshit: the birthing room was the size of a walk in closet, she'd be strapped down to a monitor and given an IV once she arrived, there was one ball for a group of 20 suites, most likely she'd be giving birth on her back, and the baby would be taken away immediately after the birth to a nursery and wouldn't be brought back until the doctor saw him, which could be hours later.

The medical model's lack of control on the part of the woman giving birth was a serious issue for her: She's a trauma victim, and bright lights, not being in control of her body, and people she's not comfortable with coming in to touch her are all triggers. The joke was that she'd be the one in the fetal position if she had to give birth there. So, she and her hubby decided to go for a home birth with a midwife through a local birth center. From the first appointment, she knew this was the right decision: She'd never had a prenatal visit that lasted longer than 10 minutes, yet her first visit with the midwife was 90 minutes and covered everything from her PTSD issues to nutrition to family issues that might cause undue stress.

It all went relatively well, except for some bleeding problems afterward (apparently her placenta was huge and knotty instead of nice smooth disc) but nothing requiring intervention. The midwife was there each day to check on her, and the plan was that if she was still bleeding after two days, she'd go to the hospital. For her, it was definitely the right decision.

[athenap]

156. Infernal Fetal Monitoring

With my first, in one of the "mom-baby-friendly" birthing hospitals, I had to have internal fetal monitoring. Even my midwives began to pay more attention to the machine than me. And wouldn't you know it, I was asked to push faster than I wanted, which resulted in 2nd degree tearing, because the monitor said the baby was starting to show signs of distress. Turns out that the monitor picked up *my* heartbeat (only about half as fast) instead of the baby's. I sat on icepacks for three weeks over what amounted to the technology not doing its job.

So anyone who thinks the more technology is the better 100% of the time is misled. If you're birthing with a surgeon--someone trained for, and expecting the worst, it's only natural that that person is going to find what they're looking for, in order to justify their own existence.

And in my hospital, the anesthesiologist expected to be worshipped. When I didn't fall all over myself and told him I was only getting an epi because of swelling, he became a real asshole. Last thing I wanted coming near me with a giant needle.

[gollygee]

158. We finally told our labor/delivery nurse to just leave us alone

we had a midwife and our hospital was supposedly natural-birth friendly, but the nurses hadn't gotten that memo. And I'd studied Bradley natural birth and this woman liked Lamaze natural birth and kept telling me I was "doing it wrong." Uh, in the middle of labor is NOT the time to switch from one natural birthing method to another.

But I avoided the stupid fetal monitor (the machine that goes *ping*) for all but 10 minutes when I showed up. I avoided any pain medicine or anything like that. I avoided an episiotomy. I avoided all those things. I had a labor that was only a 3 hours long, had a baby who was almost 10 pounds and had a minimal tear that didn't require any stitches.

Natural birth works. Hospitals create more problems than they solve, and most of the emergencies where they save the mom and/or the baby were caused by their intraventions in teh first place. Women are not made to give birth lying on their backs. Women are not made to give birth when they can't feel what's going on. As long as the pregnancy is low risk, women do the best job giving birth when they're left the hell alone.

[SHRED]

150. We had a daughter at home in '83

Great experience with 3 midwives and a transport plan plus supporting Doctor. 4 months of classes.

We didn't choose a hospital birth because the mother and child were not sick. Among other reasons. Hospitals are infectious places where sick people go. They are a much higher risk place for infection of an otherwise healthy pregnancy/birth. Your home has your natural antibodies built in. The hospital does not.

[fleabert]

157. another great reason many families choose home birth, thanks for sharing!

we need more positive stories about birth shared, ususally all that is shared is horror. I have attended 8 births and there was more positive to report than negative in all of them. I wish more women had positive experiences to share, rather than negative.

congrats!

[kiraboo]

159. I grew up the daughter of an obstetrician/gynecologist

who had trouble supporting the move to home birthing. His explanation was that, certainly, the vast majority of births go smoothly and without complications. But it only takes one emergency situation and the potential for a dead baby and/or a dead mother becomes very real. I wholeheartedly respect the woman who chooses to birth at home; for my part, I chose the hospital. And it was a good thing: my first child was a frank breech who moved into that extreme position late in pregnancy, much to everyone's surprise. A natural birth was not possible. And my last child, my third, arrived with the umbilical cord looped around his neck. His heart stopped and the situation was very frightening for a while. So I'm glad for the care I got. Having said that, I had my second child as a VBAC, and as a natural birth with no medication, delivered by a marvellous midwife who had been my prenatal caregiver as well. But I delivered in a hospital, and it worked for me. I guess we are all fortunate at this stage that we have a choice, and that in the event of an emergency there is usually critical care close at hand.

[HuckleB]

160. No offense, but that is the usual explanation.

Unfortunately it's based in anecdote rather than research, something that scares me when it comes to many practices continuing in many areas of medicine.

[kiraboo]

163. In my Dad's case, it was based on personal experience. No offense taken.

[JackDragna]

161. Question for those in the know...

For the docs, nurses or anyone who knows anything about childbirth..do you think serious complications that could occur shortly after childbirth would still make a traditional hospital a better choice?

[HuckleB]

167. The evidence of safety for home births says not necessarily.

Or, rather, it says, no, traditional hospitals are not generally a better choice, depending on the risks level of the pregnancy. (I'm a nurse practitioner, with a great deal of social and professional contact with midwives and OBs. Further, I've spent more than a few weekends in the Health Science library covering the research on this, for my own piece of mind in regard to my wife's pregnancy.)

[Ilsa]

176. Sometimes I ponder this possibility when it comes to childbirth:

the more interventions you have, the more you are likely to need. For example, continuous fetal monitoring might lead the team to jump the gun and perform and immediate C-section;
Anesthesia for the surgery may lead to fever or a dramatic change in blood pressure for the mother;
a fever in the mother may lead the pediatrician to give the neonate antibiotics prophylactically;
antibiotics may least to a yeast infection in baby and/or mother; Surgical birth may lead to mother on morphine for a day and unable to feed her baby, interrupting breastfeeding for the beginning; and on and on...

Of course, with any of these, the result doesn't have to be poor, but it may have that potential.

[KittyWampus]

162. Kicking For Important Topic

[Deja Q]

164. At one point there were no hospitals. Plop, plop, there it is.

That's not to say that hospitalization is unwarranted; theu just want to find ways to cut costs.

Always about money; never about helping one's fellow man. Or woman, in this case.

[shrike]

169. And a lot of women died, and a lot of babies died

I have nothing against home births. It is up to the family involved. But don't trivialize childbirth. Used to be that widowers were more common than widows. A man might go through two or more wives in his lifetime. Complications in childbirth was a major reson.

[HuckleB]

170. Indeed.

While some mothers can use the benefits of hospitalization, depending on their condition, the research is very interesting, as it notes that the move to hospitals did virtually nothing to decrease the dangers of pregnancy to the mother or to the child.

[bunny planet]

174. Some first time mothers do not even know they are high risk until they

are in childbirth. I had a very close call delivering my second baby at a maternity center with a midwife. My first delivery with a midwife at the same maternity center was uneventful (though hallucinogenically painful), but I was hemourraging with my second child and the midwife did not transfer me to the hospital until it was dangerously late. Had to have a week of blood transfusions and almost died. Midwives do not routinely do any sonograms that might indicate problems during the pregnancy that might only show up during delivery. The best option is a maternity center at a hospital, and a back-up physician in case of an emergency. Home births are more risky unless you have an ambulance on call in case you need to be transferred and are close enough to a hospital. If you have a back-up physician that can do one (at the outside two sonograms, too many may be harmful) during the pregnancy to point out potential risks or lack of risks beforehand then a home birth, of course, is an amazing experience. Maternity Centers do try to create as much of a home atmosphere as possible while you are there though, and if you and the baby are well you can be sent home within 12 to 24 hours.

[HuckleB]

175. ?

So research means nothing. What's best is what you say is best, just because?

:eyes:

You're confusing low risk with no risk. Further, you're refusing to note that complications arising at birth are dealt with in home births just as safely, if not more safely, than they are for hospital births.

[bunny planet]

177. Just giving my opinion based on my experience. I think it's safer to be

at least near a hospital, have transfer to a facility planned for in an emergency, and a back-up physician familiar with you during your pregnancy. I've had three natural childbirths and I totally believe in a midwife assisted birth even after my very difficult experience. I just think that home births can be, and the operative word is CAN, be more risky. And I'm not confusing low risk with no risk, I'm just saying that sometimes you do not know you are high risk until you are in the middle of childbirth. Very simple really.

[HuckleB]

180. Again, that doesn't mean you're high risk.

It means that low risk still has risks, and things can happen. That's the simple definition. I'm following the evidence of the matter (of which, the study that began this thread is but one small piece) and the evidence shows that a back-up physician is seldom necessary, doesn't need to be familiar with the mother, and may actually lead to non-necessary interventions if the physician is too involved. Experience is great and worthy, as one small piece of evidence, but it remains anecdotal and flawed, and far too many flawed medicial procedures remained and remain status quo based on "experience" rather than actual evidence of benefit.

[bunny planet]

181. Have you ever had a baby with a midwife or been to a maternity center?

The back-up physician is required by the maternity center or they will not agree to deliver you there. You see him or her once during the pregnancy and then again only if the midwife feels the complications that arise are too serious for her to handle. It very rarely leads to intervention. Avoiding doctors and unnecessary intervention is why women go to maternity centers in the first place.

I'm not basing anything I'm saying on just my own experiences, I have a close friend who is a midwife. She has worked for independent midwifery groups that do home deliveries and she has worked for maternity centers that are separate facilities and ones that are affiliated with hospitals and in the same buildings as the hospitals. She much prefers the latter, being right there at the hospital in case a transfer is needed is the safest and less stressful situation for the midwife and the patient in her opinion.

It doesn't mean that low risk still has risks, it means that high risk is not always a known factor. I had two babies with midwifes and both times was considered low risk, they wouldn't have let me deliver with them unless I was deemed to be so. My third child was delivered naturally, no intervention at all, by an obstetrician in a hospital because the midwifes had determined in the middle of my disastrous second delivery that I was high risk. So I had high risk obstetricians overseeing my third pregnancy and delivery. They knew my philosophy and left me alone to deliver naturally but were there if I needed them. It's all relative. If you are saying that statistics tell you more than interviews with actual delivering mothers, I'd rather listen to the mother's experiences any day in the week in making my decision for what kind of birth I'd prefer.

[HuckleB]

182. Have you read this thread?

If so, you'd know my background, and you'd know that I am extremely familiar with a number of midwives and gynecologists, among other health care providers. You would also know that I am a health care provider myself. You'd also know that I and my wife have spent a great deal of time researching this matter at a health science library. Anecdotes are great, but they don't dismiss what the research shows. And, again, low risk does not mean no risk. Say what you want, but you do not seem to understand the definition of low risk, so please don't spin that one around again. Thanks.

If you'd read this thread, you would be able to note many sources regarding this issue that show why your statements don't follow the research. You have the right to make those statements, and I have the right to point out that your opinion ignores the evidence at hand.

[CTyankee]

183. My daughter had HELLP Syndrome

a particularly vicious form of pre-eclampsia. I truly feel that if she had been monitored by a good midwife she would have been in better hands. No, she wouldn't have had a home birth but the midwife would have caught it before it became as serious as it did. My daughter had an emergency C section and was in the ICU for 2 days but she is fine and the baby is fine. Her doctor in my opinion was criminal in his neglect. NO ONE caught this before it became a real emergency.

She is now high risk for this happening again and will be looking for another practice for her 2nd pregnancy and delivery.

[SarahB]

184. There's been many studies done.

Read Obstetrical Myths Vs. Research Realities by Henci Goer. For most women, homebirths are safer.