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the five reasons I'm against homebirth

Last week I posted all my pregnancy opinions in one giant post, which was fun, but tough for people to pick apart because who wants to debate that many tips at once? Not me, I refused. But I promised some follow-up entries on my attitudes and figured I'd start with the worst one: the fact that I'm basically against homebirth.

We've debated this in my livejournal before but my most ardent homebirth enthusiast reader unfriended me, and it's been a couple years, and my perspectives have shifted... more against it I'm afraid. So what the heck, let's do this again.

I will say I have one debate rule in my world though: no two-person back and forths. It's not worth it. If you post a comment, and someone replies, don't reply right back to them. Give it 24 hours to see if someone backs you up. That way you're not wasting time and energy on one person, when there are so many million more on the internet.

Okay? Here goes. The five reasons why I don't trust homebirth.

1) I trust professionals. This is probably because I'm an engineer - I want to make very safe airplanes, because I fly in airplanes, and my family flies in airplanes. So I assume doctors want birth to be safe because they give birth, and their family members give birth. When I hear people accuse doctors of caring more about making it to their golf games than doing what's best for their patients, I'm stunned, because I picture someone saying that about me and my airplanes. When you dedicate your life to something, attend years of school, live it every day, you're not doing it just for the comfy wardrobe. When we criticize medicine we act like it's some faceless entity - but it's humans.

2) I had two good experiences giving birth at my hospital. I realize not everyone's experiences are good, but in all things, the dissatisfied are bound to be the most vocal. And the very popular documentary "The Business of Being Born" paints a picture of NO ONE being happy in hospitals - that's what I didn't like about it, it was very black and white. Either you have a homebirth, or you end up with a Cesarian section. I had a natural hospital birth, surrounded by very supportive nurses. Luckily I saw the documentaries after my birth, otherwise I might have thought that would be impossible.

3) I don't think Cesarian sections are that bad. The homebirth movement says "Our c-section rate is way too high!" Is it? What's "too high"? I looked around at some other countries cesarian rates compared to their perinatal mortality rates and found mixed results... countries like India, South Africa, and the UK all had lower c-section rates than the US, but higher mortality rates. On the other hand Italy, Korea, and Switzerland all had higher c-section rates but lower mortality rates. The World Health Organization dropped its recommendation years ago that implied there was some ideal rate. All my friends who've had c-sections are fine with the births they had.

I am much faster to blame the lack of access to health insurance in the US for any death rate issues we're facing as a country. Until we make basic prenatal care a human right in this country we need to check our privilege when debating whether seeing a doctor is a "choice" a woman should make.

4) I do not "trust birth". I read a wonderful book called Brought to Bed full of fascinating stories about the lives of women 100, 200, 300 years ago - who lived under a shadow we cannot even imagine today. The statistics were mind-numbing. Left to have babies over and over at home with the help of just the village midwife, about 1 in 30 women eventually died in childbirth. 1 in 10 babies didn't survive. I do not believe people who say that nature made us perfect, or doesn't let babies grow too big, or kept us alive for centuries. Nature cares about a batting average, not you as an individual. The human race survives just fine with 9/10 babies surviving birth... but if I'm going to go through pregnancy I want a better than A- odds of holding my healthy baby. I like all sorts of other "unnatural" things - eyeglasses, filtered water, poly-cotton blends. Modern medicine fits right in.

5) Now the real controversy - I said in my tips that I thought Dr. Amy of SkepticalOB.com deserved a read, and I stick by that claim. She's anti-homebirth. Somebody's gotta be. She's not a crazy fringe activist in the woods - the American Congress of Obstetricians and Gynecologists has invited her to speak at their conferences. She reported last month that the Midwives Alliance of North America's own statistics showed the homebirth death rate was over four times as high as the one for hospital births when you compare apples-to-apples: they got to throw genetic abnormalities and high risk births out of their statistics so we should too. When she was accused of "bad math" she posted a video showing her work. And if that's not enough, she runs another blog called "Hurt by Homebirth" full of tragic stories of babies hurt or killed by obviously preventable issues... why in 2013 would any baby die of group b strep?! It's such a routine test! Do doctors and hospitals make mistakes? Sure. But a lot LESS, and they have a LOT more training to avoid them, and they circle around and look at their errors and have systems to get rid of bad doctors. What happens when a homebirth goes wrong? If you believe someone is qualified to be a midwife because they've been to lots of births, they don't have to tell you about mistakes they've made. If you believe birth is inherently safe and nothing to fear, there's no reason to even ask.

And I guess that's my thing with homebirth: people outside The System are saying they have a better way to do things. I believe in systems. I believe in following procedures, going to college, going to grad school, peer reviewed research, academic papers. If you have a better idea than that I think you should have to answer a lot of questions about it.

As for mothers: if you want to have a homebirth, fine, that's your choice. I might be more supportive if you're low risk, and if you choose to follow the advice of a certified nurse midwife (CNM) because they have a lot more training than certified professional midwives (CPMs) which in some states have very very few requirements, they can basically just call themselves that. I will be much less supportive of your unassisted birth, VBAC home birth, multiples at homebirth, or anything else that the homebirth movement considers a "variation of normal". If you try this and it's successful, my reaction will be wiping the sweat off my forehead, not a "woohoo go women!" and a high five.

That's really what got me. I joined groups of "crunchy moms" in 2010 after I had my natural birth and was breastfeeding and I thought I might have some things in common with them. It turns out, I didn't, because they were too busy throwing conspiracy theories at doctors, watching documentaries that I thought were seriously flawed, and "trusting" birth. Doctors are so busy being doctors that they don't have time to jump on mommy forums and defend themselves, there's just this internet tide of DIY-ers who think they can get all the information they need from googling. You'll never convince me of that.


( 57 comments — Leave a comment )
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Feb. 13th, 2014 08:49 pm (UTC)
FTR: I have had three homebirths, and hope to do it again going forward.

Regarding the cesarean rates: It probably doesn't matter much to you, planning on two children, or to many other women, but for someone like me who hopes for a larger family, I really don't want to bump against the limits of how many times someone can cut into my uterus. Sure, I even have good VBAC prospects in the PNW, but it could create issues if we move elsewhere to someplace where VBAC prospects are bleak. This mattered more to me when I was having my first few, but having alreayd had three successful vaginal births I worry less about my cesarean limiting my family size (I could have three cesareans for the next three children and it would probably be alright.).

I do wish we had better standards for midwfiery that translated across the US. I feel that the licensed midwife designation in my state sets a fairly high bar. I understand why my midwives have not become CNMs. I'm not blinded by the limitations on their practice. I would have a harder time trusting the midwife I hire in a state with less stringent regulations.
Feb. 13th, 2014 09:01 pm (UTC)
I had a single caesarean. I think that positive home birth experiences are possible, and there is a good reason to make more positive home births possible; but there are legislative issues in a lot of states that make it a challenge.

Maryland had very few home birth midwives who had to have OBs sign up as their back up. The few home birth midwives were overbooking themselves and putting some moms in the position to have completely unassisted home births. And after one particularly bad incident, I think that all of the OBs pulled their support, and all of the home birth midwives lost their licenses.

But we want better home births because hospitals are horrible places breeding antibiotic resistant superbugs, and we want to keep infants far far away from that.
(no subject) - neuro42 - Feb. 13th, 2014 11:02 pm (UTC) - Expand
(no subject) - altamira16 - Feb. 13th, 2014 11:54 pm (UTC) - Expand
(no subject) - tabloidscully - Feb. 14th, 2014 12:46 am (UTC) - Expand
(no subject) - spacefem - Feb. 14th, 2014 02:48 am (UTC) - Expand
(no subject) - tabloidscully - Feb. 14th, 2014 03:04 am (UTC) - Expand
(no subject) - erinmdmd - Feb. 14th, 2014 12:43 am (UTC) - Expand
(no subject) - Lisa Murakami - Feb. 13th, 2014 09:33 pm (UTC) - Expand
Feb. 13th, 2014 08:57 pm (UTC)
Feb. 13th, 2014 09:18 pm (UTC)
There are some very good professional midwives out there. Yes, with everything you have to do a ton of research on who you go with. But that's true with hospitals too, I'm afraid. We specifically did not go with the hospital closest to us because of a number of red flags we saw that put it right into the camp of things that everyone worries about. We did go to a hospital where I had a wonderful experience with great nurses who were awesome (oh yeah and that guy who got her out when she was stuck, sans c-section)

I agree wholeheartedly that homebirths are often too far the other way (and I know someone whose baby died because they didn't fucking have a backup plan). But they don't have to be, and if you're careful about them with a hospital backup and good midwife who really does have medical training, go for it.

I agree you have to be much more diligent and careful in selecting a midwife. But midwives often do deliver in hospitals as well (at least around here) so I feel like as long as you check out that they have real qualifications then I think your (first) argument falls apart. So does your fourth - a village midwife before modern medicine is different than someone who has has training today. Yes, make sure your person is really a professional and has the training to be a professional. Check and see what your state standards are. But like erinmdmd said... just being a midwife does not mean they're not professional. Don't lump them together.

Also your #2 doesn't necessarily equate to other people having good experience. Data, not anecdotes. Again, this is why I chose the hospital (with birthing center) that I did, rather than the one very close to me.

I mean, I'm with you I'm totally not ever interested in home birth for myself. But there's a reason that hospitals are starting to take note of making the birthing experience NOT SUCK as much, because there are good things about being in an environment that helps you do the natural thing.

You can have a good, safe, home birth as long as: you choose a really qualified (medically) midwife; you have a good backup plan in case things go awry. This means doing more research, I think, than otherwise

Many people also have really good hospital experiences -- but again you have to research and be able to go to a place that will be like that. Health insurance has a big influence on where you can go, and that's a shame.

Feb. 13th, 2014 11:42 pm (UTC)
1. I trust professionals as well. However, midwives do most of the prenatal and birthing care in many countries, and these would be the exact same people you'd get attending your homebirth in the U.K. In the U.S. I admit it's rather more iffy since not many nurse midwives do homebirth. So your complaint makes sense in the U.S., but in the U.K. it's comparing apples to apples. You only get an O.B. in the U.K. if you're high risk.

And, while I agree that professional is good, it's not cost effective. The reliance on OBs in the U.S. healthcare is a major aspect as to why healthcare is so expensive there. In other countries, the healthcare system works well with midwives and nurse practitioners doing much of the routine work with no major decrease in quality in terms of outcomes.

2. I liked my hospital as well. But I was at one of the top 10 women and children's hospitals in the U.S. at the time. It was, in a word, posh. Now that I live in the U.K. it's not so great. The local hospital is, in a word, ghetto.

3. Have you tried *having* a C-section? I won't go into detail, but they suck. Besides which, C-sections are especially problematic for multiple births. Have you tried controlling for parity? If you're planning on having an only child, then go ahead, have a C-section. Once you get to two pregnancies things start getting dangerous. http://www.ncbi.nlm.nih.gov/pubmed/16582111
In most first world countries, women are usually having 1 or 2 children, so this doesn't present a problem. But if you look at the results of multiple C-sections you'll see a large number of complications: http://www.obgmanagement.com/home/article/repeat-cesarean-again-and-again-and-again/79e78ef6b2c736556e2343c317b0a9a2.html I initially wanted to have a lot of kids but my past C-section now puts me at having no more than 3 for health reasons, particularly if I have to have repeat C-sections instead of VBAC (which my healthcare providers have been pushing on me).

4. I'll agree with you there.

5. I don't think it's really fair to compare homebirth to hospital birth in a country where it's largely illegal and unregulated (the U.S.). It's like anti-choice activists saying that abortion ruins your future fertility. Yeah, that was the case when people were pushing knitting needles up their cervixes... not so now that abortion is safe and legal. If you look at the homebirth complication rates in the UK you'll find they're the same complications level with a drastically lower C-section rate (except for first time mums for some reason).

Plus , Strep B is kind of a strawman. That's not homebirth related, that's prenatal care. I live in the UK and whether or not you get a homebirth you'd get tested for Strep B, and that's what professional midwives in the U.S. do as well.
Feb. 14th, 2014 12:47 am (UTC)
I would love to see a study comparing legal and regulated homebirths in the US to other scenarios. The few i've seen seem to largely lump any out of hospital birth into the equation- not all are created equal!
(no subject) - Lisa Murakami - Feb. 14th, 2014 04:28 am (UTC) - Expand
(no subject) - spacefem - Feb. 14th, 2014 02:46 am (UTC) - Expand
Feb. 13th, 2014 11:49 pm (UTC)
Probably because of my background in the sciences, I agree with your feelings and thoughts 100%, on all counts.

We train and educate professionals to do their job. There's a reason why they spend thousands of dollars, are trained, and qualified to do their job.

If we want to go back to the anti-hospital, anti-vax movements, it's no brainer where that will lead with infant and child mortality soon.
Feb. 14th, 2014 12:31 am (UTC)
You know my position as I was one of the idiots who got sucked into a fight here with someone pro-homebirth. I also got bullied out of my month community by the mod, who was having a home vbac that I didn't approve of.

I can't help it though... I'm going to judge anyone who takes that kind of risk with their birth. But these days, I'm not going to fight over it.
Feb. 14th, 2014 01:07 am (UTC)
Yeah, I pretty much disagree on all fronts, but since I'm involved in Birth Without Fear, a natural birth center and a host of other pro-natural birth accolades, I recognize I will be perceived as biased, even as this entry is already pretty one-sided.

Personally, I think the idea of judging how other women give birth is stupid and pointless. I've obviously outed myself as pretty granola, but my best friend had a completely elective C-section. She was happy with it. She asked my opinion, I gave it, she went a different way. And despite my day job of educating women on the very real and present dangers attached to unnecessary C-sections, have I ever called her a bad mom? When her stitches got infected and she caught staph as a result because the hospital conditions were riddled with bugs, did I use that as an opportunity to remind her that could have probably been avoided if she'd just delivered naturally? Did a moment pass after her birth where I thought, "Wow, that's a beautiful girl she's got there, but it's a real bummer she was reckless with her health because she didn't want to be in pain."

Nope*, because I recognize that how another woman chooses to labor and deliver seriously has ZERO impact on anyone else, except herself, the child (assuming she sees it as a child) and any other involved parent/partner/party. You want to judge a parent who chooses not to vaccinate their kid and leading to the death of an immunocompromised classmate as a result, fine; there is an arguably a reasonable amount of ground there, but this serves no purpose other than assuaging egos unless you're somehow working to change laws regarding birthing practices. Otherwise, I say shut up and quit engaging in unnecessary paternalism.

Which brings me to another point. In discussing this with my husband, recently, I asked him, "How can we sit here and trust women to know they don't want to be pregnant, then turn around and sanctimoniously undercut those who do stay pregnant by telling them they don't know what's best for them in the realm of giving birth?" We can't have it both ways, and women's autonomy matters more to me than splitting hairs with people who have a different idea of birth than I do.

*And before anyone jumps on me about, "Well, you just did"; yes, for the sake of this post, I utilized judgment I have seen lobbed at moms who have birthed on either side of the divide.

Edited at 2014-02-14 01:25 am (UTC)
Feb. 14th, 2014 03:00 am (UTC)
I guess that's where you and I differ... I don't think these discussions are bad. I think you can ask questions about a woman's decisions, and it's not the same as calling her a bad mom. I think women are individuals and we deserve the right to be open and honest with each other, even if it means we disagree.

What does "autonomy" mean, anyway? The freedom to do what you want and not get thrown in jail, or the freedom to do what you want and have nobody ever question you?

Almost every entry in my blog has a "persuasive" tone... why engineering is a great job, why guinea pigs are great pets, why I support feminism and gay rights and eliminating pennies and switching to the metric system. I've written recently on why atheists make good parents, why vague blog titles are an annoying trend, why you shouldn't spend a lot on your babies christmas presents.

Then suddenly I want to talk about birth, and I'm being too judgmental about women's choices? why is this the place I'm supposed to keep my opinion to myself?
(no subject) - tabloidscully - Feb. 14th, 2014 04:37 am (UTC) - Expand
Feb. 14th, 2014 01:10 am (UTC)
Trusting birth is a concept related to helping women go into childbirth without fear. It's like saying "think positive" - which much like trust birth doesn't equal, "nothing bad could possibly happen." If what you mean is that you would feel more comfortable in a hospital in the event of a complication, more power to you. You have that choice. Not everyone shares your opinion and they should be free to make that choice too.

Dr. Amy is, first of all not actually a doctor. On top of it she is incredibly, aggressively mean to women on no other grounds than she disagrees with their personal healthcare decisions. There is room for debate around the accuracy of her information but I don't see how anyone can comfortably promote a woman who uses a woman's loss to promote her cause without her permission. I would feel similarly about a woman doing that with the countless hospital-based deaths. It's just unethical to me at best. The science blog who used to publish dr. Amy stopped doing so due to questions around the validity of her information so there's that to consider too when you recommend her as a source. There has to be a better one if you want the "not homebirth" angle.</p>

There is not a single person that I have ever met that would say c sections are bad. You must be confused there. Unpleasant? Sometimes. Over prescribed? Sure! Even ACOG recently changed their recommendations because the US ranks 50th in maternal and fetal deaths and there is far reaching consensus that our c section rate is part of the issue.

Is Ina May Gaskin not a professional in your view? Even she loves the existence of c sections. Who wouldn't?

I also had a great hospital birth and chose intentionally to have my second at home because I was low risk and it was deemed safer because I have precipitous labors. As things worked out my son flipped frank breech in transition. Had I chosen a hospital birth there would have been no chance of a section. His entire body save his head was birthed in minutes. So a hospital birth would have meant taking my chances with a care provider that had never delivered a vaginal breech before (assuming I made it to the hospital before things got ugly). For me, being home with a trained professional midwife skilled in managing vaginal breech complications (including head entrapment) literally saved my son.

Your whole post reads a little like nonsense you read from the pro life community. I get that it makes you personally uncomfortable but no one is forcing you into that choice like women often feel coerced into hospital-based birth practices. A debate over whether it is statistically actually safe or not is obviously pointless, but I guess I am mostly baffled why you would begrudge a woman's right to make the decision for herself which care provider she thinks is best for her and her child. The tone of your post suggest this is your intention. Particularly where you say "it would be ok" if you are low risk. Risk assessment is subjective and the scientific data used to support hospital based protocols is far from definitive and changing annually.

Women need to do what sits right with them. They live or die with that choice.

Feb. 14th, 2014 01:25 am (UTC)
Your comment is awesome. Thank you for articulating the anti-choice rhetoric side of it, which also makes me very uncomfortable. I don't understand how someone who believes in pro-choice ideology can not see the inconsistency in such an approach here, but you articulated it much more clearly than I did.

Also, Ina May Gaskin, Ibu Robin Lim, Jeannine Parvati Baker, Rosanne Gephart, Peggy Vincent--these women will never command the kind of respect that is so easily given to a woman that apparently isn't even an actual doctor any longer and has incredibly biased posts like, "Homebirth midwives don't give a damn about safety."
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Feb. 14th, 2014 01:33 am (UTC)
OK I'm not currently a mother but would like to be and indeed hope to be despite I'd be quite a high risk pregnancy.
I've read heaps and I've thought tuns. I've never really understood the thing about home births. So so many things can go wrong, and at least you've got all the experts at the hospital so I definitely agree with you there.

My sister desperately wanted a home birth but it wasn't going to happen. She was induced at 42 weeks. I was kind of relieved as my family were quite worried about the decision.
Feb. 14th, 2014 03:23 am (UTC)
I'm not interested in homebirth simply because I want to be close to modern medicine should anything go wrong, not a 25 minute drive away. HOWEVER, I am deeply uncomfortable with the idea of a standard hospital birth. Because I've been in hospitals. And sometimes you get a great nurse and a caring doctor and you feel loved and supported and listened to and it's awesome. And sometimes you get a curt, rude nurse and a "holier than thou" doctor and you have no idea what's going on and no one will stop to explain it. And since you can't research every possible birth complication in advance, you need a team you trust to (a) give you information (b) help you make a decision (when it's one there is time for you to make) (c) respect your decision and (d) make good split second decisions. And I don't trust hospitals to be consistent in providing that.

So I want a midwife. I want someone who can get to know me ahead of time. Someone who has done this before and can coach. Someone who will take the time to explain and will advocate for me if I'm getting bullied. I want someone to hold my hand.

Unfortunately, in Alabama, midwives are illegal. There are no birthing centers, that I'm aware of. The hospitals are moving to having "labor and delivery" rooms with private baths. (Not sure how that experience compares to birthing centers?) So I either have to lie ("this is my FRIEND") or roll the die on what kind of staff I'll get...not really crazy about either option. I'd love to have a midwife and a doctor who can work together, have a professional relationship, etc.
Feb. 14th, 2014 03:31 am (UTC)
I'm trying to find a link about midwives being illegal in Alabama. It's proving difficult. Here's what I can verify for sure:
-midwives doing home births is illegal
-midwives cannot be certified in Alabama
-there are very few midwives who can/will do hospital births

So, they are not *totally* illegal, but for all practical purposes they are.
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Feb. 14th, 2014 03:32 am (UTC)
I agree with the sentiment that women shouldn't go into birth afraid and that trying natural is a good first line strategy. However, I think it's really important to acknowledge that a huge reason we no longer fear birth is the availability of medical interventions. I think in a lot of ways the success of science has been its own worst enemy. We've gotten rid of a whole hell of a lot of scary ways to die and so there's this false impression of safety in our society. That safety is brought to you by antibiotics, fertilizers, surgery, antiseptics, etc.

Also, where does the "hospitals are dangerous places for newborns" thing come form? can anyone site any actual examples of a newborn catching a superbug in a hospital? this seems like paranoia to me...

(in case anyone cares, i tried natural childbirth for more than 24 hours, in the end i had an emergency c-section because my baby wasn't descending and her heart rate was dropping like a rock. as it turned out had her cord wrapped around her neck. so make your own judgements... i do mourn the fact that I was unable to birth my baby but what other option or choice did i have exactly?)
Feb. 16th, 2014 06:30 pm (UTC)
See, I think a c-section counts as "birth". Was it tense? Did it change your body forever? Was there a recovery involved? Did you go from "pregnant" one moment to "a mother" the next? All those things to me mean birth, no matter how it happened.
Feb. 14th, 2014 06:26 am (UTC)
Sanity on the interwebs!

I think I've found a new eljay buddy :D
Feb. 14th, 2014 04:43 pm (UTC)
that's good, it'll make up for anyone who unfriends me over this since I didn't exactly emerge unscathed last time I brought the topic up!
Feb. 14th, 2014 08:20 am (UTC)
Despite having (almost) had a home-birth myself, I agree with almost all of your points. I think #1 is one of the most important, and that is where my experience differed. I absolutely 100% agree with the professionals -- and that's why as I prepared to give birth in the Netherlands, we prepared to do so at home. Non high-risk pregnancies are handled by midwives who are all certified by the Royal College of Midwives -- as rigorous and regular (they have to renew regularly) as any medical doctor certification -- and one of the things they are trained to recognize and plan for is contingencies that would warrant transferring to a hospital. That's why I trusted them 100% when the plan was to give birth at home, and 100% when about two hours after they arrived while I was in labor they said "If things don't shape up in half an hour or so, we're heading to the hospital" and we did. It's because never once was I not under the care and guidance of highly-trained, highly-regulated professionals whom I trusted.
Feb. 14th, 2014 11:02 am (UTC)
I get confused about the options available in the US, because UK options are different (for instance it is common here to have a hospital birth attended mainly by midwives). I find the way that some USian rhetoric assumes your choices are essentially "schedule a caesarian" or "give birth in your garden without anyone to help you" really deeply weird.

I think the main argument in favour of homebirth is that hospitals are, well, kinda yucky. Even if your medical team is A++++++ amazing hospitals stink and the food is bad and the beds are uncomfortable (I've never had a baby, but I have stayed in hospital). You are much more likely to be *comfortable* at home with *your* bed and *your* food and *your* favourite comfy chair... for an uncomplicated birth you are probably going to be a lot happier at home.

Of course for a birth that goes wrong you're going to be a lot happier if you can have the appropriate medical intervention immediately.

There's a question of transfer times - do you live 5mins drive from hospital? or do you live 100 miles from the nearest anything?

I wouldn't be worried about a doctor in a hurry to run off and play golf; I would be worried about a doctor who thought that they knew better than me to the extent that they completely ignored the need to *get consent* to perform medical procedures (doctors know a lot about what procedures are likely to have what outcomes; but they don't know jack shit about how I rank possible outcomes in terms as good/bad/etc).

I don't see why there should be One True Option For Everyone - people have very different preferences, and they should be able to access health care that suits those preferences to the greatest extent possible. You wanted a hospital birth - so you booked one, and had it; other people want a home birth - they presumably have different preferences and priorities.

I agree it is useful to look at the numbers, but it is not useful to assume that the numbers are the end of the question.
Feb. 14th, 2014 12:14 pm (UTC)
Well and this is why you do research on your doctor and the practice in general. Ditto on the hospital. The hospital I gave birth at had great food as it happens (shout out to the goat cheese salad), and it was nice to have someone just bring it to you when you wanted it and clean up the massive quantities of blood for you (not just as part of labor but as part of the aftermath). It was also nice to have a pediatrician check on the baby and be around for questions. Giving birth in a hospital isn't just about labor, it's about the recovery too.

And you don't just get a generic doctor. You get someone from your practice, hopefully someone you've had the opportunity to meet. Different practices have different philosophies, so pick one you're comfortable with, that's small, where you've met all the doctors and then you won't have to worry about your preferences being overridden. Also, they can't do anything to you without your consent. If you're in labor and they need to do a c-section, you have to sign a "consent to treat" and if you're unconscious then your designated medical decision maker has to sign it so I'm not sure where this "without consent" thing is coming from.

And once again, can someone point me to something that says hospitals are bad for babies because of super bugs? This just gets thrown around like it's fact. Maternity wards are kept separate for a reason - this reason in fact. Nurses on maternity wards don't also care for people there for infectious diseases, the ventilation systems are kept separate, etc. Are there any documented cases at all of babies getting sick this way?
(no subject) - naath - Feb. 14th, 2014 12:24 pm (UTC) - Expand
(no subject) - metcodon1 - Feb. 14th, 2014 03:11 pm (UTC) - Expand
Feb. 14th, 2014 07:35 pm (UTC)
Homebirth does not always dramatically slow access to needed interventions.

I live five minutes from my local hospital. It is a Level I hospital: no NICU, no anesthisiologist in the building at night, etc. It is a 90-minute drive to a Level II. In the event of a transfer from home, my CNM would have called ahead to the hospital and they would have begun prepping what was needed (if they had it) or arranging transfer to a bigger facility. I would have arrived before the anesthesiologist/helicopter. </p>

Yes, I accepted an increased risk in the event that baby or I needed, say, resuscitation because, though my CNM and her assisting CNM (which is, by the way, the role I think most appropriate for a CPM) are trained in and practice neo-natal resuscitation, we clearly did not have access to a full code team.

But home birth did simultaneously decrease other risks. A couple specifics: my local hospital has a 33% cesarian rate; 85% epidural rate (related to things like no birth pools, which have been very helpful in both my births); and mandatory (corded) EFM. We have only two OB/GYN practices in town, and in neither one can a woman choose who will attend her birth: she gets whoever's on call.

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