home birth

wrote:
Hi,

It seems to me that women are having fewer home births now. I am
saddened by this and wonder why this is happening. Homebirth and
midwifery were resurected and fought for and protected for about the
last 25 years and we seem to be losing ground again. Of course, I
don't have studies or anything to base this on.......just observations
over the last five years especially. My thought: The big hospital
conglomerates are masterful at marketing fear about our bodies and
concealing their own inadequacies.

Any way I would love to be part of a discussion of this topic.

I give birth in a hospital because with all three of my kids, I had
post partum hemorraghing. I would have had to been rushed to the
hospital all 3 times, so why not start out there?

Stasya

wrote:

Hi,

It seems to me that women are having fewer home births now. I am
saddened by this and wonder why this is happening.

I'm not sure it is happening - my impression (purely that) would have
been the opposite. However, I couldn't find any stats on it.

Clisby

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. It's just a fraction of a percent
of the time where you encounter complications that require
immediate access to high tech care in order to avoid a bad
outcome for mother or baby.
Similarly, in a fraction of a percent of the time,
there are bad outcomes that can be traced to problems
encountered in the hospital that wouldn't have been
encountered at home.
So, the bottom line is that those two sources of
risk *ARE* about the same magnitude. Assuming you'd have
been a candidate for home birth anyway, you're not improving
your odds of a good outcome by going to the hospital over
choosing an appropriate home birth setting. You are,
however, choosing *different* risks. Some people are
more comfortable with one set of risks, and some people
are more comfortable with another. That's fine, and
to be expected. It's just the misconception that choosing
one birth location over another *in general* is somehow
"more safe" that I have a beef with. (Note that there
are also situational differences--all home birth choices
and all hospital choices aren't the same, so for some women
in some situations home births would be more risky and
for other women in other situations hospital birth would
be more risky. I'm just talking in broad generalities
here.)
And, of course, statistics don't mean a thing
if you're actually dealing with the bad outcome. I'm
sure we'd all struggle with blaming ourselves no matter
where the bad outcome happened, and no matter what was
logically the case. That's part of why I think it's so
important that women choose what they feel is most
appropriate for them. At least if a bad thing happens,
they aren't *also* dealing with the guilt of choosing
against what they felt to be in their best interests.

Best wishes,
Ericka

In article ,
Ericka Kammerer wrote:

It seems to me that women are having fewer home births now. I am
saddened by this and wonder why this is happening.

If there is a problem with during birth, the time it takes to get to the
hospital could be deadly.

And introgenic infections and medical mistakes and
such can also be deadly. Statistically, for normal, healthy
women with low risk pregnancies (the sort who are eligible
for home births), the risk profile of home births is as good
as or better than the risk profile for hospital birth.

The difficulty with this discussion is that neither you nor the OP have
indicated which part of the world you are talking about. Is it the whole
world? The English-speaking world? Or something else?

The risks to mothers in hospitals vary according to local practice. I am not
sure it is even meaningful to talk about a "hospital model" of birth across
countries, for example.

And as you suggest (I've just snipped for brevity) the problem with working
from statistics is that the tiny risk of Something Awful happening at a home
birth, because it *is* a home birth, still means that Something Awful *will*
happen to someone. Ditto the risk of hospital-acquired infection and
iatrogenic problems in a hospital, of course -- but a mother won't blame
herself for those things.

Of course, I have a particular attitude because I was "low-risk" right up
until the moment I had eclampsia. Even fifty years ago, I probably would have
left the hospital in a box :-/

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"Parenthood is like the modern stone washing process for denim jeans. You may
start out crisp, neat and tough, but you end up pale, limp and wrinkled."
Kerry Cue

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'?
i live in a semi-rural area, but there are 3 hospitals within
a 35 minute drive by car. however, in the case of an
emergency, there's the time it takes to call 911, talk to the
dispatcher, get the emergency crew dispatched (i *think* the
ambulance drivers are at the station during the day, but not
at night, but the crews would be at thier regular jobs & have
to get here too), have the entire EMT crew get to the house,
stabilize & transport... adding a minimum of 20 minutes or so
onto the trip... (i'm guessing on the time because that's how
long it took for the fire dept to get here when i had a
chimney fire. i live less than 2 miles from the station)

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.
lee
--
Question with boldness even the existence of god; because if
there be
one, he must more approve the homage of reason than that of
blindfolded
fear. - Thomas Jefferson

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'?
i live in a semi-rural area, but there are 3 hospitals within
a 35 minute drive by car. however, in the case of an
emergency, there's the time it takes to call 911, talk to the
dispatcher, get the emergency crew dispatched (i *think* the
ambulance drivers are at the station during the day, but not
at night, but the crews would be at thier regular jobs & have
to get here too), have the entire EMT crew get to the house,
stabilize & transport... adding a minimum of 20 minutes or so
onto the trip... (i'm guessing on the time because that's how
long it took for the fire dept to get here when i had a
chimney fire. i live less than 2 miles from the station)
[snip]

Chookie's point that country matters is very relevant here.

In the UK, you would have called out a medically qualified midwife
relatively early in labour, certainly by the time you would have
gone into hospital for a hospital birth. She would have spotted the
signs that require you to be rushed to hospital, and would have
contacted the emergancy services on your behalf.

--
Penny Gaines
UK mum to three

"enigma" wrote:

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.
lee

I think a lot of this depends on the location. My family was really
surprised that I was making a "birth plan" because they'd never heard of it
before. They delivered in hospitals in northern indiana.

I was originally planning on having a hospital birth because of my husband's
wishes, but we switched to a birth center after an incident with the doctor
where she told me that under no circumstances would I be allowed to eat or
drink during labor, I would not be allowed to move around once I got there,
I would immediately get an IV, I would be allowed to "try" other positions
but they didn't do "that Bradley nonsense". She also scoffed at my no-drug
plan and told me that 90% of women end up needing an epidural.

I called someone for a birth center recommendation and found out that the
hospital I was planning on going to was the worst in the area for birthing,
and they do enforce all of the above, regardless of the situation.

I am very happy with the way my birth center birth turned out and am
planning a homebirth this time. I'm also pretty close to a hospital if we do
need to be transported there.

--
Rebecca Jo
Mama to Alexander 6/6/05
EDD 6/27/2007

On Mon, 18 Dec 2006 09:32:19 -0500, "Rebecca Jo"
wrote:

I think a lot of this depends on the location. My family was really
surprised that I was making a "birth plan" because they'd never heard of it
before. They delivered in hospitals in northern indiana.

I had never heard of it, but I delivered my kids in the early 70s. I
don't think my dil had a birth plan in Illinois either.


--
Dorothy

There is no sound, no cry in all the world
that can be heard unless someone listens ..

The Outer Limits

out of curiousity, how much time *is* 'time to deal with
appropriately'?
i live in a semi-rural area, but there are 3 hospitals within
a 35 minute drive by car. however, in the case of an
emergency, there's the time it takes to call 911, talk to the
dispatcher, get the emergency crew dispatched (i *think* the
ambulance drivers are at the station during the day, but not
at night, but the crews would be at thier regular jobs & have
to get here too), have the entire EMT crew get to the house,
stabilize & transport... adding a minimum of 20 minutes or so
onto the trip... (i'm guessing on the time because that's how
long it took for the fire dept to get here when i had a
chimney fire. i live less than 2 miles from the station)

the gold standard for c-section is 30minutes from decision to cut, but there
isn't all that much evidence to support that, sometimes it needs to be a lot
lot faster, others the time delay doesn't really matter, the key thing is
though that most decisions don't happen with no warning, in a homebirth with
care from a midwife, they should have been with you for several hours and
pick up any signs and arrange transfer before it becomes a dire emergency,
some emergencies do happen fast, such as waters breaking and cord prolapse
occuring, but that is actually more likely to happen prelabour than during
labour, so that's an emergency that happens at home to women who've planned
hospital births.

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.

it seems to me that nowadays almost everyone makes a birth plan, but you
were lucky that it was only a case of the nurse saying Tom couldn't help and
that being overridden, some doctors/nurses will not allow delayed cord
cutting, or insist on medicine to deliver the placenta, or demand VEs every
4hrs and so on. I've had two hospital births that started as planned
homebirths, with transfers prior to labour, though I fully understand and
accept and am content with those births basically having to occur in
hospital, I definitely lost a lot of control a lot of things were just
assumed, no one ever asked my permission before examining me, or explained
why they were examining me, whereas at home, either these things would have
occured, or the exam wouldn't have happened, we'd have then found somewhere
comfortable and a good position. You can be in control in a hospital birth,
but it's likely that you'll be in control within a certain set of
parameters.
Anne

Chookie wrote:
In article ,
Ericka Kammerer wrote:

It seems to me that women are having fewer home births now. I am
saddened by this and wonder why this is happening.
If there is a problem with during birth, the time it takes to get to the
hospital could be deadly.
And introgenic infections and medical mistakes and
such can also be deadly. Statistically, for normal, healthy
women with low risk pregnancies (the sort who are eligible
for home births), the risk profile of home births is as good
as or better than the risk profile for hospital birth.

The difficulty with this discussion is that neither you nor the OP have
indicated which part of the world you are talking about. Is it the whole
world? The English-speaking world? Or something else?

Sorry. Talking about the US, as her description
didn't seem to fit anywhere else.

And as you suggest (I've just snipped for brevity) the problem with working
from statistics is that the tiny risk of Something Awful happening at a home
birth, because it *is* a home birth, still means that Something Awful *will*
happen to someone. Ditto the risk of hospital-acquired infection and
iatrogenic problems in a hospital, of course -- but a mother won't blame
herself for those things.

Of course, I have a particular attitude because I was "low-risk" right up
until the moment I had eclampsia. Even fifty years ago, I probably would have
left the hospital in a box :-/

There are certainly things that happen, though
I think people often underestimate the ability of midwives
to spot trouble and transfer as needed. Many seem to think
that home birth is a "come hell or high water" sort of thing,
which I suppose it is for a few die hards. Also, while
caregivers in hospital can afford to overlook some things
(and can afford to choose some potentially risky interventions)
precisely *because* they have a hospital at their backs,
home birth caregivers generally know their patients well,
have great continuity of care, and have great instincts
when things aren't going quite right for that particular
person--precisely so that they can transport in plenty of
time for the vast majority of complications.

Best wishes,
Ericka