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#71
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home birth
Ericka Kammerer wrote: enigma wrote: Ericka Kammerer wrote in : Grahame wrote: Thats true, Im sure if my child died, I would blame myself anyway, beyond reason. But to me thats more of an unlikely situation, than complications of childbirth. However, *statistically*, that's not true. If you start from the baseline of normal, healthy women having normal, healthy pregnancies, then the vast majority of complications can either dealt with at home just fine or give enough time to transport to deal with appropriately. out of curiousity, how much time *is* 'time to deal with appropriately'? The general recommendation is that it's best to be able to transport within 30 minutes. on a related note, is it really that uncommon here in the US to go into a hospital birth with a birth plan spelling out exactly which interventions you will not allow, or things you want done? i don't remember everything on mine, except no drugs, no cutting the cord until all the blood drained, & that i wanted Tom to help with the delivery. it had a whole page worth of stuff though. the OB nurse looked it over, said i could have everything except Tom helping & it was fine. in the end though, the doctor overrode the nurse & let Tom help. they did install a hep lock after 17 hours of labor because i was dehydrating & they are supposed to give an antibiotic 16 hours after the water breaks... but the fluids & antibiotic were delivered by robot & didn't show up until after the birth anyway (apparently the poor robot got stuck on an elevator). the point being that delivering in a hospital doesn't mean you have to give up control. Many hospitals in the US are exerting more control. Many people find that their birth plans are not allowed or are disregarded when the time comes. Many people don't have enough flexibility in hospital or provider choice (because of limited availability or insurance limitations) so it's not always possible to ditch a provider if you don't like the limitations. By far, the overwhelming reason most women who choose home birth choose it is to maintain more control. Best wishes, Ericka Fortunately, not *every* US hospital is that control-happy. Even though I *knew* that home births could be safe, my subconscious wasn't ready. Plus, even though I was considered low-risk, the closest hospital was 30 minutes away in good traffic, 45 minutes or more in rush hour. I was very lucky that the closest hospital was very progressive - I was allowed to walk around and move, no continuous monitoring, no pressure for meds, heplock instead of IV, food and drink allowed, etc. Plus, while my goal was to go med-free, I wasn't sure how I'd feel at the actual time, so wanted to leave my options a little more open. That is part of the decision for hospital vs home birth that hasn't been discussed - the easy availability of meds. I think that is a large part of the decision for women - they won't even consider a home birth if they have already decided they want an epidural. I will say, my OB wasn't necessarily supportive of the idea of a birth plan, I think because he had seen too many detailed ones that talked about a lot of stuff that didn't apply. Instead, we discussed everything ahead of time. I realize I was unusual - my OB had his own practice, not a group. And for dd, I had some narrow timing where I could've ended up with Joe Random Backup OB - my OB had a death in the family and had to fly out of town right after dd was born. So in that way, my OB experience had more continuity than a group midwife practice would have had, tho I did have the risk of a stranger attending my birth. Oh, and my birth plan was pretty loose. Basically, 4 goals - 1) healthy baby, 2) best start for bf, 3) easiest recovery for me, and 4) less pain for me (I forget how that last one was worded exactly). The implications were for a med-free vaginal birth w/out episiotomy, if you are trying to read between the lines, fwiw. Irene |
#73
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home birth
Cathy Weeks wrote: So, let me get this straight. 1. You don't think hospitals are by default safe. 2. But home births are by nature SO unsafe, that you have to be ****ing nuts to do it. 3. But taking ANY chance that your baby might die is unacceptable, depsite the fact that hospitals have their own set of risks where your baby might die, simply BECAUSE you are in the hospital. Never said that. 4. You've come to these decisions without doing one shred of research, nor will you consider ANY research that shows that for low-risk pregnancies, home birth is as safe as the hospital. Never said that either. You assume a lot of things. 5. You don't want to give birth and prefer to adopt. 6. You tried to get pregnant for years, and suffered many indignities in the process, despite preferring not to have to squeeze him out. After having adopted I felt no desire for a biological child. 7. You think that women who do not wish to go through said indiginties are whiners because they'd rather NOT have strangers shove speculums, fingers, etc into their vaginas. It's a mere inconvenience for the reward. 8. You assume that midwives are untrained quacks, despite the fact that the average midwive has had 6 years of medical training, and more than 2 years more OB training than family practice physicians. How many family practice phycians routinely deliver babies? Certifiied Nurse Midwives have 4 years of college, and usually 2-4 more years of specialty OB training. They are trusted by the medical and pharmaceutical boards to write prescriptions that are honored at any pharmacy, yet you boil them down to quackery. They are not the preferred profession to deliver a baby, IMO. Got it? 9. You don't think taxes or insurance dollars should pay for midwifery care, despite their having A) lower rates of C-sections, B) lower rates of maternal mortality, C) similar rates of infant mortality, and being cheaper to the taxpayers and insurance companies 9. But you don't believe the above statement, despite having done no research one way or the other to see if it's true. Never said that. You assume way too often. What I said is "data" can be contrive to report whatever finding it is you want to prove. I see. I might also add, that if you DID find research that proves your side of things, I WOULD change my mind. What makes you think I am trying to change your mind? It's obvious you are trying to change mine. I have no intention, nor have I ever had any intention, of changing anyone's mind. But you also have to find the studies that are well constructed and without serious methodological flaws (you do know how to spot those, right?) Obviously better than you do. But, I doubt you are up to such research, because you aren't interested in anything that doesn't suit your pre-conceived notions. You are under the mistaken presumtion that I feel a need to prove a point, or back my opinions with research. I don't. I don't care enough about it, honestly - I have bigger fish to fry at the moment. There is nothing pre-conceived about my "notions." I came to the conclusions I did for a reason - I feel no need to "convince" you of anything. You can't seem to get it through your thick head that this is my opinion - one I have the right to hold and put forth on an open, unmoderated newsgroup. Why that chaps your ass so badly, I'll never know, but you sure as hell aren't going to change my mind any time soon and I don't have any desire to change yours - not did I ever have any desire to do so. So you might as well quit getting yourself so worked up and quit babbling. -L. |
#74
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home birth
cjra wrote: Oh how wrong you are! This is the bane of hospital infection control staff everywhe getting doctors to *wash* their hands!!! I can't find it at the moment, but in the spring there was a great research article in which doctors were asked to put their hands on a culture plate. And then see what grew. You'd be *shocked*. No, I wouldn't. Everyone's hands are covered by bacteria. That's a first-grade science experiment. The hospital ICs have been asking us for recommendations on how to *force* doctors to wash their hands for the sake of infection control, but it's hard to force anyone to do anything. Don't believe what you see on TV. I'm sure surgeons scrub more when they're going into surgery, but docs going into rooms? Nope. I have seen three doctors this year - one FP and two specialists - one a surgeon. All three washed their hands in front of me. I cannot believe a doctor who is going in to deliver a baby doesn't a) scrub and b) wear gloves. Maybe it does happen, but rarely, I suspect. Doctors going into rooms is a different story altogether, and moot in terms of what we were discussing - neonatal infection, which *is* most likely airborne. -L. |
#75
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home birth
Irene wrote:
Plus, while my goal was to go med-free, I wasn't sure how I'd feel at the actual time, so wanted to leave my options a little more open. That is part of the decision for hospital vs home birth that hasn't been discussed - the easy availability of meds. I think that is a large part of the decision for women - they won't even consider a home birth if they have already decided they want an epidural. Sure, although it's always possible to transfer and get an epidural if you change your mind. That's part of the "all or nothing" fallacy. I certainly went into my planned homebirths knowing that if I felt like I needed an epidural, I'd go get one. I will say, my OB wasn't necessarily supportive of the idea of a birth plan, I think because he had seen too many detailed ones that talked about a lot of stuff that didn't apply. Instead, we discussed everything ahead of time. I realize I was unusual - my OB had his own practice, not a group. And for dd, I had some narrow timing where I could've ended up with Joe Random Backup OB - my OB had a death in the family and had to fly out of town right after dd was born. So in that way, my OB experience had more continuity than a group midwife practice would have had, tho I did have the risk of a stranger attending my birth. Well, that's hardly unusual. A fairly substantial minority of women have their births attended by someone they've never met or have only briefly met. You had a slightly higher risk that someone in a group practice, but even choosing a group practice doesn't guarantee that you'll get a known care provider. Best wishes, Ericka |
#76
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home birth
Cathy Weeks wrote: -L. wrote: You don't care any more than I don't care about what you believe. "Data" is only as reliable as the people who fund it and publish it. Interesting. What else is there for us to make decisions about the relatively safety of anything? You have to weigh everything. Sometimes what is not said is as important as what is said. How can anyone reasonably make ANY informed choice about anything at all? You have to be smart, make your own decisions and not trust data blindly. And when a doctor hands you a form that says you have a 1-in-X chance of having this complication, why would you believe it, given what you believe about data? I don't. I don't blindly trust anything anyone publishes - everyone has an agenda. -L. |
#77
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home birth
Irene wrote:
Fortunately, not *every* US hospital is that control-happy. Even though I *knew* that home births could be safe, my subconscious wasn't ready. Plus, even though I was considered low-risk, the closest hospital was 30 minutes away in good traffic, 45 minutes or more in rush hour. I was very lucky that the closest hospital was very progressive - I was allowed to walk around and move, no continuous monitoring, no pressure for meds, heplock instead of IV, food and drink allowed, etc. That's excellent. My own experiences with hospital birth haven't been all that bad, actually. I've only had one kid, and she was born at home (and healthy). But I'm much older than either of my brothers, and was present for their births. Oldest brother was born in a hospital 40 minutes from my parent's home, because my mother didn't trust the local (VERY small town) hospital, so we went to the university hospital instead. Baby was born 13 minutes after we got to the hospital, delivered by the nurse, before the OB could get there. Labor was only about 90 minutes from start to finish. The nurse did perineal support and massage, and Mom had no episiotomy. There was no need for walking around or an IV because everything happened so quickly. This was back in 1983, before having siblings present was commonplace, and because it was in the middle of the night, she let me stay (I was 14). She was also put MUCH more at ease with the idea of me staying, since i'd been to the childbirth classes with my parents. My second brother was born at the local hospital, because Mom was worried about birthing in the car, after the previous short labor. Ironically, she had an 8 hour labor. She was attended by two doctors actually, who acted like a couple of midwives. They hung out with us, did perineal massage and support, chatted, etc. The birth was slightly higher risk, due to her having early signs of preecclampsia, and the only "intervention" was they did attach a scalp monitor for awhile. So all in all, my mother had really good hospital births. My mother-in-law had my husband at a US Army hospital in Germany, during the Vietnam war, and her experience was TERRIBLE. Like if she tried to get out of bed to walk around, they would literally push her back onto the bed. Stuff like that. Then, when my stepson was born, they decided to do an episiotomy without consulting either his mom, or my husband. Doc just said "I'm cutting now!" and did it with no anesthesia whatsoever. She screamed and lifted her hips off the bed in response, and my husband said blood squirted everywhere. This was all due to mild shoulder distocia. They did it because a) the doctor was an intern doing his OB rotation and was inexperienced, and b) he didn't think to change her position and c) had her in the classic lithotomy position and should have had her change position and do the... can't remember the manuver that helps open things up. What was most upsetting was that the baby was NOT in distress, and there was time for them to have at least discussed the options with them. When my daughter was born, we of course had a backup plan should something go wrong. We had two hospitals relatively nearby - Princeton Medical Center was 25 minutes away, but is very very mother-unfriendly with a 40% c-section rate, a 60% epidural rate and a 75% episiotomy rate. The other hospital was Mercer Medical Center in Trenton and was slightly further away - 30 minutes instead of 25. The advantage to Mercer was that it was midwife-friendly (my midwives had delivery rights there) so even if I transferred, my midwives could continue leading my care, unless we decided an OB was called for. The OBs that my midwives trusted (and who backed up the midwives) were also based there. And they had a level 3 nursery, which was more advanced than in Princeton. So we decided that the extra 5 minutes was worth it. As for your being uncomfortable with homebirth - I completely understand it, especially given your distance. For us, 30 minutes was the MAX it would take to get there. Homebirth really isn't for everyone. My stepson's mom, when she had her second kid, decided against homebirth herself, despite my recent home birth, and despite the fact that her mother had assisted in several homebirths (with a trained midwive leading things, of course!). Teresa just laughed and said "I don't want to clean up the mess" (my midwives took care of most of that). I suspect that her husband wasn't comfortable with the idea either. But what she did do, was choose a midwife practice that did in-hospital births. She did go to Princeton Medical Center, and I warned her of their stats, and she laughed and said "I know so much more now - I've picked the right caregiver." Then she told me who her midwife was and I had to laugh- Ursula was well-known in the area for being willing to butt heads with the hospital staff, so that her patients can walk around, have a hep-lock instead of an IV, use the birthing pool (only for labor though - the hospital wouldn't budge on water births - which Mercer Medical did allow), and to get the nurses to quit suggesting a "little short of something to take the edge off" every 5 minutes. She also let her patients eat during labor, if they wanted. Her daughter was born with no pain medication, and without the need for an episiotomy (she flipped onto her hands and knees). Etc. One of the things that I realized while I was in labor, that being able to relax is KEY to making it through an birth without pain meds (if that's a goal for you). If you can't relax, then it HURTS more. Despite my having practiced my bradley relaxation exercises through pregnancy, well... I still found myself tensing up during contractions. It wasn't until I was in transition that I was starting to get the hang of relaxing fully. Now in retrospect, I think that if you are scared of your surroundings, then being able to relax would just fly right out the window, thus lengthing labor, and possibly even causing complications. So unless you are really confident of birthing at home or in a free-standing birth center and have a backup plan in place, then birthing out of the hospital is just not a good idea. Cathy Weeks |
#78
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home birth
Ericka Kammerer wrote: Irene wrote: Plus, while my goal was to go med-free, I wasn't sure how I'd feel at the actual time, so wanted to leave my options a little more open. That is part of the decision for hospital vs home birth that hasn't been discussed - the easy availability of meds. I think that is a large part of the decision for women - they won't even consider a home birth if they have already decided they want an epidural. Sure, although it's always possible to transfer and get an epidural if you change your mind. That's part of the "all or nothing" fallacy. I certainly went into my planned homebirths knowing that if I felt like I needed an epidural, I'd go get one. True, it's not all or nothing - but it certainly adds another layer of things you have to do in order to get the epidural. Which can be both a good and bad thing, of course - you have to really want that epidural in order to get it! I will say, my OB wasn't necessarily supportive of the idea of a birth plan, I think because he had seen too many detailed ones that talked about a lot of stuff that didn't apply. Instead, we discussed everything ahead of time. I realize I was unusual - my OB had his own practice, not a group. And for dd, I had some narrow timing where I could've ended up with Joe Random Backup OB - my OB had a death in the family and had to fly out of town right after dd was born. So in that way, my OB experience had more continuity than a group midwife practice would have had, tho I did have the risk of a stranger attending my birth. Well, that's hardly unusual. A fairly substantial minority of women have their births attended by someone they've never met or have only briefly met. You had a slightly higher risk that someone in a group practice, but even choosing a group practice doesn't guarantee that you'll get a known care provider. I know - I was mainly pointing out that since I think single OB practices are relatively rare, that my continuity of care with an OB was correspondingly rare. But since some people (I forget who) were implying that midwives gave better continuity of care, that perhaps at least some of that depends on whether it is a single or group practice. Irene |
#79
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home birth
-L. wrote: cjra wrote: Oh how wrong you are! This is the bane of hospital infection control staff everywhe getting doctors to *wash* their hands!!! I can't find it at the moment, but in the spring there was a great research article in which doctors were asked to put their hands on a culture plate. And then see what grew. You'd be *shocked*. No, I wouldn't. Everyone's hands are covered by bacteria. That's a first-grade science experiment. Except doctors are supposed to be washing their hands. Annonymous surveys have been done where docs have *admitted* to not following strict infection control guidelines such as regular hand washing. Infection control, and the difficulty with getting doctors to follow it, is a big issue for most hospitals. That's why there's an entire department dedicated to it in most places. The hospital ICs have been asking us for recommendations on how to *force* doctors to wash their hands for the sake of infection control, but it's hard to force anyone to do anything. Don't believe what you see on TV. I'm sure surgeons scrub more when they're going into surgery, but docs going into rooms? Nope. I have seen three doctors this year - one FP and two specialists - one a surgeon. All three washed their hands in front of me. I cannot believe a doctor who is going in to deliver a baby doesn't a) scrub and b) wear gloves. Maybe it does happen, but rarely, I suspect. Doctors going into rooms is a different story altogether, and moot in terms of what we were discussing - neonatal infection, which *is* most likely airborne. Ignorance is bliss eh? Your suspicions would be incorrect. This is an enormous problem in hospitals. I work with the infection control staffs of all our area hospitals and it's something we are combatting *daily*. The best place to acquire an infection is in a hospital. |
#80
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home birth
Anne Rogers wrote: I think you overestimate the politeness of doctors in keeping their mouths shut when they thing something is someones fault, many women who have transferred from homebirths have suffered bullying from doctors, when there has been absolutely no justification for it. Definitely overestimating the politeness of doctors. |
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