home birth

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.

wrote in message
ps.com...
Hi,

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.

Homebirth and
midwifery were resurected and fought for and protected for about the
last 25 years and we seem to be losing ground again.

Actually, a lot of hospitals have midwives assist in the deliveries.
However, I am glad homebirth rates are decreasing. The babies have more
trained professionals available in a hospital than at home.

That said, inselected low-risk cases, home delivery appears as safe as
in-hospital delivery, if emergent transport to a hospital is available.

Personally, I think the best care is delivered by midwives in birthing
suites in hospitals, where there is good OB coverage and good emergency
neonatal care, when needed.

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.

Big hospital conglomates? THe biggest hospital conglomate controls what
percent of the hospitals or hospital beds in US?

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

I considered home birth with all 3 of my children.
I decided on the holspital for all of them.
I truly believe a woman knows how to give birth naturally. And the home
would be the best place for her to do this without interference.
BUT....I also didnt want anything to go wrong. And could not have lived with
myself IF my child died because I wanted a home birth.

My first child was a 4 hour labor and everything was fine until the end when
she had the cord around her neck 3 times and was born not breathing. 4 min
to get her breathing and 3 days in neonatel. I also had very bad tares to my
anus and needed extensive stitching. Btw I had no pain relief.
I made the right decission. Im glad I was at the hospital
Even though a midwife could have handled the delivery Im sure...we would
have had to go to hospital anyway.

As for my second he was 1 1/2hour labor and all perfectly fine. We only had
the midwife at the hospital, and it could have been a home birth. But again,
I didnt want to take the risk.I was home the next day. no pain relief

The third child 40 min labour and was perfectly fine. I was home 4 hours
later discharging myself.
So even though I think home births are a great idea, I think the hospital
system is good where it lets you give birth as you please. I was in control
with my last 2 births. I was only in the hospital(just in case)
My husband was fully involved with all 3 births, and took control when I
couldnt. If I was to fall pregnant again. I would do as my last have the
baby at the hospital (just in case) and then go home a few hours later. no
pain relief.
So to me the point is....as long as the hospitals are supportive of mothers,
allow a natural childbirth, (if the mother wishes), and is only on hand to
provide medical assistance then Im happy to have the child there.

All the best
Fiona

wrote in message
ps.com...
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.

Is "Jeff" Jeffrey P. Utz, MD?

If so, he may have learned "the pathological vision"...

Marsden Wagner, MD^^^ once said in an amicus brief:

"If a nurse or physician desires
to practice midwifery, then it is necessary for each to [undergo one
year or
more of training] to literally 'unlearn' the pathological vision to get
the
proper perspective of normality."

^^^Marsden Wagner, MD served for 15 years as the director of women's
and
children's health for the World Health Organization. The quote above
appeared in Wagner's amicus brief in the Peckman midwifery case and was

published in NAPSAC News Spring 1991 by the InterNational Association
of
Parents and Professionals for Safe Alternatives in Childbirth, Rt. 1,
Box
646, Marble Hill, MO 63764 USA.

Todd

Dr. Gastaldo
Hillsboro, Oregon
USA






ON MISC.KIDS...

Jeff wrote:
wrote in message
ps.com...
Hi,

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.

Homebirth and
midwifery were resurected and fought for and protected for about the
last 25 years and we seem to be losing ground again.

Actually, a lot of hospitals have midwives assist in the deliveries.
However, I am glad homebirth rates are decreasing. The babies have more
trained professionals available in a hospital than at home.

That said, inselected low-risk cases, home delivery appears as safe as
in-hospital delivery, if emergent transport to a hospital is available.

Personally, I think the best care is delivered by midwives in birthing
suites in hospitals, where there is good OB coverage and good emergency
neonatal care, when needed.

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.

Big hospital conglomates? THe biggest hospital conglomate controls what
percent of the hospitals or hospital beds in US?

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

Jeff wrote:
wrote in message
ps.com...
Hi,

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
few studies that show otherwise are horribly methodologically
flawed (and there are many methodologically sound studies
that show at least equivalent safety for home birth). In addition,
countries where home birth is commonplace have historically
had *better* birth outcomes than the US, where it is rare.

Actually, a lot of hospitals have midwives assist in the deliveries.
However, I am glad homebirth rates are decreasing.

Actually, as far as I can tell, they're not decreasing.

Personally, I think the best care is delivered by midwives in birthing
suites in hospitals, where there is good OB coverage and good emergency
neonatal care, when needed.

It is still not equivalent care to a home birth.
While there are many very good midwives working in hospitals
(and OBs, for that matter), there are still issues with
the hospital model that introduce risks.
I think women should have access to whatever
birth location they feel most comfortable with, given that
there is no credible evidence that one is taking an undue
risk choosing a home birth with an appropriately trained
attendant, a normal low-risk pregnancy, and adequate
backup.

Best wishes,
Ericka

Grahame wrote:
I considered home birth with all 3 of my children.
I decided on the holspital for all of them.
I truly believe a woman knows how to give birth naturally. And the home
would be the best place for her to do this without interference.
BUT....I also didnt want anything to go wrong. And could not have lived with
myself IF my child died because I wanted a home birth.

What if your child died because you chose to be
in a hospital (iatrogenic infection, cascading unnecessary
interventions, problems related to discontinuity of care
or other mistakes that are more likely in hospital)?
I feel very strongly that women should go where
they feel most comfortable, so I certainly do not challenge
your decision to birth in hospital. If that's where you
wanted to be, then that's where you should be. I am only
poking at your "what if" question. So many people raise
that issue with home birth, but it is almost never raised
in the other direction, even though deaths due to those
causes are *far* more common (due to the fact that there
are so many more hospital births--the risks of bad outcomes
due to being in the hospital is about the same as the risk
of bad outcomes due to being at home and not being able to
transport in time to deal with an issue).
None of us get to choose a perfectly safe birth.
We only get to choose which set of risks we are more
comfortable with. It is not surprising to me that more
people are comfortable choosing the set of risks associated
with hospital birth, but I do wish that more people were
aware of those risks (so that they could attempt to mitigate
them).

Best wishes,
Ericka

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.

Fiona
"Ericka Kammerer" wrote in message
. ..
Grahame wrote:
I considered home birth with all 3 of my children.
I decided on the holspital for all of them.
I truly believe a woman knows how to give birth naturally. And the home
would be the best place for her to do this without interference.
BUT....I also didnt want anything to go wrong. And could not have lived
with myself IF my child died because I wanted a home birth.

What if your child died because you chose to be
in a hospital (iatrogenic infection, cascading unnecessary
interventions, problems related to discontinuity of care
or other mistakes that are more likely in hospital)?
I feel very strongly that women should go where
they feel most comfortable, so I certainly do not challenge
your decision to birth in hospital. If that's where you
wanted to be, then that's where you should be. I am only
poking at your "what if" question. So many people raise
that issue with home birth, but it is almost never raised
in the other direction, even though deaths due to those
causes are *far* more common (due to the fact that there
are so many more hospital births--the risks of bad outcomes
due to being in the hospital is about the same as the risk
of bad outcomes due to being at home and not being able to
transport in time to deal with an issue).
None of us get to choose a perfectly safe birth.
We only get to choose which set of risks we are more
comfortable with. It is not surprising to me that more
people are comfortable choosing the set of risks associated
with hospital birth, but I do wish that more people were
aware of those risks (so that they could attempt to mitigate
them).

Best wishes,
Ericka

DEAD BABIES AND "MEDICAL MISTAKES" (also: "BABY ER")

Babies are actually being VACUUMED to death - made to bleed to death
into their scalps - thousands per year (please check my math someone?)
- with MD-obstetricians senselessly KEEPING birth canals closed the
"extra" up to 30% as they literally vacuum/rip/separate baby scalps
from baby skulls...

See Dr. Hull made SOME changes I recommended, but he still
'forgets' those hematomas ABOVE the periosteum...
http://groups.google.com/group/sci.m...f53c2204fce76e

The birth-canal-closing crime is happening routinely at a hospital near
you - and in some home births.

Please report the crime.

I'm cc'ing Oregon Atty Genl Hardy Myers via .

Eventually law enforcement will stop looking the other way, as in the
arrogant boast of Steve B. Harris, MD:
"Without enforcement, there is no law. Without law, there is no crime.
These are elementary principles. Get an adult to explain them to you."
http://groups.google.com/group/misc....866f3384801ae9


Further comment below #####


Kathy Berry 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.

Jeff (P. Utz, MD?) replied:


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

Ericka replied:


And introgenic infections and medical mistakes and
such can also be deadly.

#### Ericka is, in effect, indicating here that MD-obstetricians
intentionally closing birth canals up to 30% is a "medical mistake."

#### Babies are DYING - MDs are LYING - and online childbirth educator
Ericka is euphemizing - "medical mistakes and such"...

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.

#### Regarding the risk profile for hospital birth, let's not forget...

"Many hospitals market their luxurious birth suites...neglecting to
mention
that they have little to offer the one out of ten babies who ends up
needing
an NICU. Those children will have to waste precious minutes or hours
being
transported [to a tertiary care facility] by ambulance...bumping
through
traffic instead of receiving lifesaving care right where they were
born...[M]any small patients arrive...[in tertiary care facility
NICUs]...via ambulance from other hospitals...their parents pale and
terrified in the car behind them, unable to comprehend...why they made
the
mistake of starting out at the wrong hospital in the first place..."
[Humes E. Baby ER: The Heroic Doctors and Nurses Who Perform Medicine's

Tiniest Miracles. NY: Simon & Schuster. 2000:12-13]


See also: Baby ER (Also: Homebirth midwife at a hospital birth)
http://groups.google.com/group/misc....425ecc4857967b


The
few studies that show otherwise are horribly methodologically
flawed (and there are many methodologically sound studies
that show at least equivalent safety for home birth).

#### MD-obstetrician experts have been/still are LYING to cover-up the
massive birth-canal-closing crime of MD-obstetricians.

#### Birth position studies have also been horribly methodologically
flawed - a form of "scientific" lying.

In addition,
countries where home birth is commonplace have historically
had *better* birth outcomes than the US, where it is rare.


#### The Western MD-obstetrician birth-canal-closing birth crime is
spreading right along with use of the chair.

See Toilet Training for Thai Army Recruits in: sMEG during squatting?
(also: Asian Pacific Americans)
http://groups.google.com/group/misc....044441c7aca66e


Actually, a lot of hospitals have midwives assist in the deliveries.
However, I am glad homebirth rates are decreasing.

Actually, as far as I can tell, they're not decreasing.


Personally, I think the best care is delivered by midwives in birthing
suites in hospitals, where there is good OB coverage and good emergency
neonatal care, when needed.

It is still not equivalent care to a home birth.

#### Home is mom's turf. Hospital is MD turf.

#### When the homebirth midwife apes the MD in the home - she is
robbing mom (and her baby) right in her home.

While there are many very good midwives working in hospitals
(and OBs, for that matter), there are still issues with
the hospital model that introduce risks.

#### "Good" midwives and "good" OBs - and "good" online childbirth
educators for that matter - do not dismiss obvious, sometimes fatal,
birth crimes as "medical mistakes and such."

#### To be sure, they are all doing much good - but by
ignoring/dismissing the bad - the crime - they do society a grave
disservice.

I think women should have access to whatever
birth location they feel most comfortable with, given that
there is no credible evidence that one is taking an undue
risk choosing a home birth with an appropriately trained
attendant, a normal low-risk pregnancy, and adequate
backup.

Best wishes,
Ericka
http://groups.google.com/group/misc....afb7dcf84fa6e3

#### Ericka and I are in substantial agreement - except that Ericka
does not call obvious MD crime obvious MD crime.

#### How serious is the obvious MD crime?

#### Again, babies are actually being VACUUMED to death - made to bleed
to death into their scalps - thousands per year (please check my math
someone?) - with MD-obstetricians senselessly KEEPING birth canals
closed the "extra" up to 30% as they literally vacuum/rip/separate baby
scalps from baby skulls...

See Dr. Hull made SOME changes I recommended, but he still
'forgets' those hematomas ABOVE the periosteum...
http://groups.google.com/group/sci.m...f53c2204fce76e

### Obviously, not all baby deaths can be prevented - it's just that
it's criminal to close the birth canal the "extra" up to 30%...
KEEPING the birth canal closed the "extra" up to 30% as one pulls with
a vacuum just makes the MD crime worse.

### The fact that MD-obstetrician experts are LYING to cover-up will
make prosecution easy - once law enforcement takes action...

#### For the Four OB Lies (they are whoppers)...

See Dents in babies' skulls"
http://groups.google.com/group/
misc.kids.pregnancy/msg/08abfc7ff242150e


Alternate URL:
http://health.groups.yahoo.com/group...t/message/3897


LADIES: To allow your birth canal to OPEN the "extra" up to 30%, just
stay
off your sacrum as you push your baby out. Many women like side-lying
delivery. Kneeling against the raised head of the bed works. So does
standing. So does hands-and-knees. Virtually EVERY delivery position
allows the birth canal to open maximally - except dorsal and
semisitting -
the two most commonly used by obstetricians.


Thanks for reading.


Sincerely,


Todd


Dr. Gastaldo
Hillsboro, Oregon
USA



PS Further comment - for Ericka... Ericka, you have been covering for
childbirth educator Henci Goer who is failing to inform women that
MD-obstetricians routinely KEEP birth canals closed the "extra" up to
30% when babies get stuck.

See Good one Ericka! (Ericka's sordid Henci Goer joke - again)
http://groups.google.com/group/misc....2db7f19d5db306

Similarly, Larry McMahan has been online
pretending that it's not crime when MDs keep birth canals closed when
babies get stuck - with MD-obstetrician experts LYING (see above) to
cover-up. Remember? Larry says that the birth-canal-closing STANDARD
care of MD-obstetricians is mere "substandard care."

#### See again: Good one Ericka! (Ericka's sordid Henci Goer joke -
again)
http://groups.google.com/group/misc....2db7f19d5db306

Larry is WRONG. [Crime is occurring.]

Women shouldn't have to ask their MD-obstetricians (or midwives) for
the "extra" up to 30%.


Most women don't KNOW to ask.


Which is why everyone should be calling the "medical mistakes" what
they are - CRIMES.

Everyone should also be emailing LAW ENFORCEMENT.

REMEMBER: MDs are depending on law enforcement looking the other way.

As noted above, Steve B. Harris, MD arrogantly boasts:

"Without enforcement, there is no law. Without law, there is no crime.
These are elementary principles. Get an adult to explain them to you."
http://groups.google.com/group/misc....866f3384801ae9



What - really - is the difference between the MD making his arrogant
boast and Ericka Kammerer euphemizing the obvious crimes by calling
them "medical mistakes and such"?

I SAY AGAIN...

Babies are actually being VACUUMED to death - made to bleed to death
into their scalps - thousands per year (please check my math someone?)
- with MD-obstetricians senselessly KEEPING birth canals closed the
"extra" up to 30% as they literally vacuum/rip/separate baby scalps
from baby skulls...

See Dr. Hull made SOME changes I recommended, but he still
'forgets' those hematomas ABOVE the periosteum...
http://groups.google.com/group/sci.m...f53c2204fce76e

The birth-canal-closing crime is happening ROUTINELY at a hospital near
you - and in some home births.

Please report the crime.

I'm cc'ing Oregon Atty Genl Hardy Myers via .

Eventually law enforcement will stop looking the other way.

Thanks.

Sincerely,

Todd

Dr. Gastaldo
Hillsboro, Oregon
USA


This post will be archived for global access in the Google usenet
archive. Search http://groups.google.com for "Dead babies and 'medical
mistakes' (also: 'Baby ER')"

Pregnant? To allow your birth canal to open an "extra" up to 30%, see
LADIES at the very end of this post.


BABIES DYING/MDs LYING

....AND ERICKA'S SORDID JOKE...

Ericka Kammerer is whining about people not being informed (see below)
- even as she supports prominent childbirth educator Henci Goer in
failing to inform women that MD-obstetricians are keeping birth canals
closed the "extra" up to 30% when babies get stuck - as they pull with
vacuums.

Babies are actually being vacuumed to DEATH - made to bleed to death
into their scalps - thousands per year (please check my math someone?)
- with MD-obstetricians senselessly KEEPING birth canals closed the
"extra" up to 30% as they literally vacuum/rip/separate baby scalps
from baby skulls...

See Dr. Hull made SOME changes I recommended, but he still
'forgets' those hematomas ABOVE the periosteum...
http://groups.google.com/group/sci.m...f53c2204fce76e

This crime should be REPORTED not ignored...

Yes, Ericka puts out a lot of good information - but she is engaging in
a grave act of omission.

Women shouldn't have to ask for the "extra" up to 30%.

Most women don't know to ask.

Law enforcement needs to address this obvious crime.


Fiona/Grahame wrote:

I considered home birth with all 3 of my children.
I decided on the holspital for all of them.
I truly believe a woman knows how to give birth naturally. And the home
would be the best place for her to do this without interference.
BUT....I also didnt want anything to go wrong. And could not have lived with
myself IF my child died because I wanted a home birth.

Ericka Kammerer replied:


What if your child died because you chose to be
in a hospital (iatrogenic infection, cascading unnecessary
interventions, problems related to discontinuity of care
or other mistakes that are more likely in hospital)?

#### With MD-obstetricians closing birth canals up to 30% and KEEPING
birth canals closed the "extra" up to 30% when babies get stuck...

#### With MD-obstetricians failing to obtain informed consent - with
MD-obstetrician experts LYING to cover-up...

#### Women are - in effect - "choosing" MD-obstetrician CRIMES for
themselves and their babies.

I feel very strongly that women should go where
they feel most comfortable, so I certainly do not challenge
your decision to birth in hospital.

#### I, too, believe women should birth where they feel most
comfortable.

#### But powerful cultural authorities - MD-obstetricians have called
homebirth "child abuse" - a crime.

#### This abuse of cultural authority has helped women "choose"
hospital birth.

If that's where you
wanted to be, then that's where you should be. I am only
poking at your "what if" question.

#### Ericka is rather TIMIDLY poking. Babies are DYING and MDs are
LYING.

So many people raise
that issue with home birth, but it is almost never raised
in the other direction, even though deaths due to those
causes are *far* more common (due to the fact that there
are so many more hospital births--the risks of bad outcomes
due to being in the hospital is about the same as the risk
of bad outcomes due to being at home and not being able to
transport in time to deal with an issue).

#### The transport issue should indeed be raised "in the other
direction"...
"Many hospitals market their luxurious birth suites...neglecting to
mention
that they have little to offer the one out of ten babies who ends up
needing
an NICU. Those children will have to waste precious minutes or hours
being
transported [to a tertiary care facility] by ambulance...bumping
through
traffic instead of receiving lifesaving care right where they were
born...[M]any small patients arrive...[in tertiary care facility
NICUs]...via ambulance from other hospitals...their parents pale and
terrified in the car behind them, unable to comprehend...why they made
the
mistake of starting out at the wrong hospital in the first place..."
[Humes E. Baby ER: The Heroic Doctors and Nurses Who Perform Medicine's



Tiniest Miracles. NY: Simon & Schuster. 2000:12-13]


See also: Baby ER (Also: Homebirth midwife at a hospital birth)
http://groups.google.com/group/sci.m...fbc37fe969e6c0


None of us get to choose a perfectly safe birth.
We only get to choose which set of risks we are more
comfortable with.

#### But the set of risks for hospital births is reduced - even by
prominent childbirth educators like Henci Goer - with Ericka Kammerer's
support.

See Good one Ericka! (Ericka's sordid Henci Goer joke - again)
http://groups.google.com/group/misc....2db7f19d5db306


It is not surprising to me that more
people are comfortable choosing the set of risks associated
with hospital birth,

#### But they aren't "choosing." MD crimes are being IMPOSED upon them
without their consent.

but I do wish that more people were
aware of those risks (so that they could attempt to mitigate
them).


#### This is MY point. Why are prominent childbirth educators failing
to tell women that if their babies get stuck, their birth canals will
be KEPT closed the "extra" up to 30%?

#### Why is Ericka Kammerer supporting Henci Goer in this childbirth
education fraud - even as she whines about wishing that more people
were aware of risks?

See again: Good one Ericka! (Ericka's sordid Henci Goer joke - again)
http://groups.google.com/group/misc....2db7f19d5db306


#### Why do I care?

#### As I recently noted in this thread...and already said above:

Babies are actually being VACUUMED to death - made to bleed to death
into their scalps - thousands per year (please check my math someone?)
- with MD-obstetricians senselessly KEEPING birth canals closed the
"extra" up to 30% as they literally vacuum/rip/separate baby scalps
from baby skulls...

See Dr. Hull made SOME changes I recommended, but he still
'forgets' those hematomas ABOVE the periosteum...
http://groups.google.com/group/sci.m...f53c2204fce76e

The birth-canal-closing crime is happening routinely at a hospital near
you - and in some home births.

Please report the crime.

I'm cc'ing Oregon Atty Genl Hardy Myers via .

Eventually law enforcement will stop looking the other way, as in the
arrogant boast of Steve B. Harris, MD:
"Without enforcement, there is no law. Without law, there is no crime.
These are elementary principles. Get an adult to explain them to you."
http://groups.google.com/group/misc....866f3384801ae9


Adults: Please report the crime - and start asking why prominent
childbirth educators like Henci Goer aren't mentioning it.

Ericka's "joke" is a sordid joke. (see Good one, Ericka!, URL above).

Thanks for reading.

Sincerely,

Todd

Dr. Gastaldo
Hillsboro, Oregon
USA


PS Obviously, not all baby deaths can be prevented - it's just that
it's criminal to close the birth canal the "extra" up to 30%...
KEEPING the birth canal closed the "extra" up to 30% as one pulls with
a vacuum just makes the MD crime worse.

The fact that MD-obstetrician experts are LYING to cover-up will make
prosecution easy - once law enforcement takes action...

For the Four OB Lies (they are whoppers)...

See Dents in babies' skulls"
http://groups.google.com/group/
misc.kids.pregnancy/msg/08abfc7ff242150e

Alternate URL:
http://health.groups.yahoo.com/group...t/message/3897

I am in favor of pardons in advance for MDs. As medical students, MDs
are TRAINED to commit obvious felonies.
LADIES: To allow your birth canal to OPEN the "extra" up to 30%, just
stay
off your sacrum as you push your baby out. Many women like side-lying
delivery. Kneeling against the raised head of the bed works. So does
standing. So does hands-and-knees. Virtually EVERY delivery position
allows the birth canal to open maximally - except dorsal and
semisitting -
the two most commonly used by obstetricians.

Personally, I think the best care is delivered by midwives in birthing
suites in hospitals, where there is good OB coverage and good emergency
neonatal care, when needed.

I'm not convinced, as soon as you have a group of midwives practicing
together, they start to lose their professional autonomy, because you don't
know who will be there on the day, it suddenly becomes less important that
you see the same person each antenatal visit and so on, I don't doubt that
you can get very good care from midwives in birthing centre, but I'm far
from convinced that for the low risk women it's going to amount to being
better. You start to find that midwives are doing VEs because it's policy to
do one on admission, not because doing that VE is going to tell them some
useful information which could potentially change the course of action and
so on.... suddenly women are on a conveyor belt and a midwife becomes little
more than an obstetric nurse.

I'm also not clear on whether you are talking about a midwife led unit with
fast access to obstetric and neonatal care, or a consultant led unit, with
the main care provided by midwives, the two are very different, to the
extent that in some places they exist within the same building and the
outcomes for low risk women starting in the former are better than starting
in the latter.