Birthing ? - how comfortable would you be with your daughter

[StaceyinLA]

I AM excited and will be 100% supportive.

 

I have NOT, and wouldn't, try to sway her. She ASKS for my opinion. I have encouraged the home birth if she can find a good midwife (she is currently seeing hospital midwives).

 

I do want her to have the experience that I had, and know all the pros.

 

She WANTS me to be there to do labor support for her, but I would NEVER demand it if she didn't.

 

I was merely asking if anyone had input on why I might have the nervousness for HER when I never had it for myself? Why the fears? I also wondered how others would feel in this situation.

 

Just wanted to clarify...

Edited May 10, 2011 by StaceyinLA

[Hedgehog]

I AM excited and will be 100% supportive.

 

I have NOT, and wouldn't, try to sway her. She ASKS for my opinion. I have encouraged the home birth if she can find a good midwife (she is currently seeing hospital midwives).

 

I do want her to have the experience that I had, and know all the pros.

 

She WANTS me to be there to do labor support for her, but I would NEVER demand it if she didn't.

 

I was merely asking if anyone had input on why I might have the nervousness for HER when I never had it for myself? Why the fears? I also wondered how others would feel in this situation.

 

Just wanted to clarify...

 

Maybe because when you are watching someone labor, you are fully aware of what is happening but it's not happening to you, and you can't make any choices for them.. there is no control, you are just an observer.. that's what my dh says anyway, how it was for him watching me in labor.

[J-rap]

...

Edited September 9, 2023 by J-rap

[Princess Peach]

I would highly recommend that you meet her mw if at all possible. Meeting my mw put my mom at ease when I had my homebirth.

[elizabeth]

That made me :lol:

 

Yeah, because the hospital in my city where a clients partner contracted a staph infection just from being at the hospital with her was SOOOOOOOOOOOO freaking clean. Hospitals are NOT sterile. Homes are not sterile but it is filled with germs that a woman and the baby have been exposed to.

 

Please do research before you spout off about home birth, midwifery training, maternal morbidity rates, etc. in the U.S.

 

I have . Please reread my post. I said it is the best system in terms of training, equipment etc. I know plenty about staph, MRSA etc this is what I do for a living...prove that x failed to meet the community standard of care and caused y to occur. Actually a study released by amercian academy of pediatrics just led to the conclusion that while home birth is at an even level in terms of maternal outcome it is not at all equal in terms of outcome for a baby who is premature, breech and other factors. The romanticization of the home birth movement needs to be honestly analyzed. But that is my opinion and I certainly do not expect or care if others share it. I did not expect that especially on this board . From recent discussions about malpractice leading to fetal death reality just does not count with those who are so wed to the idea of home birth no matter what factors are in play leading to tragic injuries or death ,and does show a lack of reality based analysis of a negative outcome. I have no doubt that many here are excellent well trained practitioners my concern is with those who would ignore evidence based risk management leading to infections and death.

[happypamama]

I AM excited and will be 100% supportive.

 

I have NOT, and wouldn't, try to sway her. She ASKS for my opinion. I have encouraged the home birth if she can find a good midwife (she is currently seeing hospital midwives).

 

I do want her to have the experience that I had, and know all the pros.

 

She WANTS me to be there to do labor support for her, but I would NEVER demand it if she didn't.

 

I was merely asking if anyone had input on why I might have the nervousness for HER when I never had it for myself? Why the fears? I also wondered how others would feel in this situation.

 

Just wanted to clarify...

 

Probably because it's your baby! I don't feel particularly nervous when I get behind the wheel of my car either, but I'm sure I will when my children do! Our protective mama instincts are strong, and it's hard when we can't do anything to make sure it's all okay. :) I think I'll be nervous when my children are having babies, regardless of where they're birthing.

[coffeegal]

I was merely asking if anyone had input on why I might have the nervousness for HER when I never had it for myself? Why the fears? I also wondered how others would feel in this situation.

 

Just wanted to clarify...

 

:grouphug: My little sister is having her 1st baby next month, and I'm a bit nervous. I'll likely be a basket case when my dds are having babies, no matter where they choose to have the baby. Birth seemed a lot safer with my first at 24 BEFORE I heard all the horror stories of what can happen during birth in or out of the hospital. :001_smile:

 

As far as why you're more nervous now, it's your dd on the line now... not you. You were prepared for the risk to yourself, but none of us like to think of risking our dc. :grouphug:

[ocelotmom]

I have . Please reread my post. I said it is the best system in terms of training, equipment etc. I know plenty about staph, MRSA etc this is what I do for a living...prove that x failed to meet the community standard of care and caused y to occur. Actually a study released by amercian academy of pediatrics just led to the conclusion that while home birth is at an even level in terms of maternal outcome it is not at all equal in terms of outcome for a baby who is premature, breech and other factors. The romanticization of the home birth movement needs to be honestly analyzed. But that is my opinion and I certainly do not expect or care if others share it. I did not expect that especially on this board . From recent discussions about malpractice leading to fetal death reality just does not count with those who are so wed to the idea of home birth no matter what factors are in play leading to tragic injuries or death ,and does show a lack of reality based analysis of a negative outcome. I have no doubt that many here are excellent well trained practitioners my concern is with those who would ignore evidence based risk management leading to infections and death.

The idea that everyone who chooses homebirth would choose to give birth at home under any and all possible circumstances (or that their midwives would attend them under those circumstances) is insulting to the intelligence of the midwives and those who choose homebirth.

 

If I'm having preterm labor, guess what... I'm not staying home! I'm going to the local hospital where they're prepared to provide more support at birth! If it's before 34 weeks or so, they'll be transferring me to the closest big city, where there's a NICU and they can provide better support.

 

By definition, you're seeing the cases where poor judgement was used, either by the parents, the care provider, or both. Just because these cases exist doesn't mean that it's the norm.

[elizabeth]

The idea that everyone who chooses homebirth would choose to give birth at home under any and all possible circumstances (or that their midwives would attend them under those circumstances) is insulting to the intelligence of the midwives and those who choose homebirth.

 

If I'm having preterm labor, guess what... I'm not staying home! I'm going to the local hospital where they're prepared to provide more support at birth! If it's before 34 weeks or so, they'll be transferring me to the closest big city, where there's a NICU and they can provide better support.

 

By definition, you're seeing the cases where poor judgement was used, either by the parents, the care provider, or both. Just because these cases exist doesn't mean that it's the norm.

True indeed and well stated.

[phathui5]

I would be far more comfortable with my daughter having a home birth than a hospital birth, as I feel that for a normal pregnancy, hospital birth is far riskier.

[mommymilkies]

The idea that everyone who chooses homebirth would choose to give birth at home under any and all possible circumstances (or that their midwives would attend them under those circumstances) is insulting to the intelligence of the midwives and those who choose homebirth.

 

If I'm having preterm labor, guess what... I'm not staying home! I'm going to the local hospital where they're prepared to provide more support at birth! If it's before 34 weeks or so, they'll be transferring me to the closest big city, where there's a NICU and they can provide better support.

 

By definition, you're seeing the cases where poor judgement was used, either by the parents, the care provider, or both. Just because these cases exist doesn't mean that it's the norm.

:iagree::thumbup:

 

I also find it insulting that people would assume I would sit around and bleed to death instead of getting medical care. Homebirth is a personal choice. I don't think it's right to make people have one or make people have a hospital birth, either way. I am a former EMT and medical professional and trust me, hospitals are far from perfect. Even the local ones here have had several cases of fetal death from their negligence. Care should be available for emergencies, but I don't know any women who have chosen homebirth who aren't prepared and flexible in their approach. One of the reasons you see all of these bad cases of homebirth is because of the witchhunt against midwives and homebirth in this country. It's rather ridiculous. It certainly wasn't in the papers across the country when my OB almost killed me, sending me into shock and seizures from ripping out my placenta when she was sick of waiting the whole 3 minutes for it to come out since my ds was born. Oh yeah, and he has permanent neurological and digestive problems from their actions surrounding his birth. There are SO many more cases like mine, or even worse. But they don't all make the paper. The fear mongering around homebirth is absurd.

[LittleIzumi]

I have . Please reread my post. I said it is the best system in terms of training, equipment etc. I know plenty about staph, MRSA etc this is what I do for a living...prove that x failed to meet the community standard of care and caused y to occur. Actually a study released by amercian academy of pediatrics just led to the conclusion that while home birth is at an even level in terms of maternal outcome it is not at all equal in terms of outcome for a baby who is premature, breech and other factors. The romanticization of the home birth movement needs to be honestly analyzed. But that is my opinion and I certainly do not expect or care if others share it. I did not expect that especially on this board . From recent discussions about malpractice leading to fetal death reality just does not count with those who are so wed to the idea of home birth no matter what factors are in play leading to tragic injuries or death ,and does show a lack of reality based analysis of a negative outcome. I have no doubt that many here are excellent well trained practitioners my concern is with those who would ignore evidence based risk management leading to infections and death.

 

No midwife worth her salt would tell you to stay home if she felt the birth there would be unsafe. I have preterm labor issues. It starts earlier each pregnancy. With my second, I used hospital-based CNMs who threw the standard blood pressure meds at it (which did nothing), put me on full bedrest (statistically unsupported), threatened hospital bedrest (which would mean dh and I both could not work as we had no daycare for our two children), and it stressed me out horribly for two months, then said at 35 weeks I should stop all of the bedrest/drugs immediately and if she came, she was fine. Dd was born at 36 weeks 4 days, tiny and was in the NICU for a while.

With my third baby, I used a homebirth midwife (CPM). She did tons of research on the newest studies of the causes of preterm labor (I have the entire studies here to peruse, which I did in full at the time). She came up with a treatment plan based on that, involving therapeutic levels of anti-inflammatories and reducing stress as much as physically possible. I also have several other remedies here for stopping uterine cramping from her that helped a lot. (She also prayed about it, which is not "scientific" but I appreciated it.) She told me that we were doing everything we could to prevent a preterm birth--and that if I did indeed begin full-blown labor before 35 weeks, I was to get myself over the hospital immediately because THAT is where you need to be if you're having a preterm baby!! Don't stress about it but if it happens, don't be stupid about it either. Homebirth is for low-risk birth, not for serious known complications. (FTR, that baby was born at home at 39 weeks 6 days. He was posterior but flew out in 2 pushes, 9lbs even, and the best nurser she has ever seen. Healthy as a horse, to use the cliche.) I was at least 5cm before labor began, but I did not have any serious pre-term labor, just very slow, gradual dilation through the second half of pregnancy, thanks to careful, sensible, evidence-based management (including a heavy emphasis on prenatal health & nutrition, which my other practitioners didn't even mention). From a homebirth midwife. :)

 

To the OP--any time we don't have control it's SCARY!!!!

Edited May 10, 2011 by LittleIzumi

[ocelotmom]

I have . Please reread my post. I said it is the best system in terms of training, equipment etc. I know plenty about staph, MRSA etc this is what I do for a living...prove that x failed to meet the community standard of care and caused y to occur. Actually a study released by amercian academy of pediatrics just led to the conclusion that while home birth is at an even level in terms of maternal outcome it is not at all equal in terms of outcome for a baby who is premature, breech and other factors. The romanticization of the home birth movement needs to be honestly analyzed. But that is my opinion and I certainly do not expect or care if others share it. I did not expect that especially on this board . From recent discussions about malpractice leading to fetal death reality just does not count with those who are so wed to the idea of home birth no matter what factors are in play leading to tragic injuries or death ,and does show a lack of reality based analysis of a negative outcome. I have no doubt that many here are excellent well trained practitioners my concern is with those who would ignore evidence based risk management leading to infections and death.

Not meaning to pick on you, but I'm getting into rant mode...

 

Part of the problem here is that most birth injuries to the mother or baby in a hospital setting are not going to go to litigation. We look at outcomes pretty much exclusively in terms of maternal/infant death or certain categories of injuries to the infant.

 

Unnecessary episiotomies that extend to 4th degree tears, injuries caused by "purple pushing" or enforced back-lying pushing positions, and unnecessary c-sections are all things that happen every day in US hospitals, are not evidenced-based, and can have long-term impact on a woman's physical and mental well-being. They can lead to ongoing pain, urinary and fecal incontinence problems, impaired breastfeeding, and impact future childbearing options. But, despite not being evidence-based and causing harm, they're considered risks of giving birth and acceptable actions on the part of the MD, and therefore not ligitable. So you're not seeing these cases.

 

There's a saying that "Nobody gets sued for doing a c-section", and that attitude influences OBs' approaches to labor management, but it doesn't make for a truly safe environment for mothers or babies.

 

I'm not against hospital birth, and would, in fact, prefer hospital birth over homebirth given the right hospital. I had an absolutely wonderful hospital birth with my second baby, at a hospital that does its best to respect women's choices and provide quality, evidence-based care. They have very good outcomes, both in terms of mother/infant morbidity and mortality and patient satisfaction.

 

Unfortunately, this is an extraordinary hospital, and not the norm. So, when we moved away from it, I chose homebirth, as I had no reason whatsoever to believe that I'd come out of the local hospital intact.

 

(But, if it did appear that extra support was needed... that hospital is 5 minutes away.)

[Barb_]

Actually a study released by amercian academy of pediatrics just led to the conclusion that while home birth is at an even level in terms of maternal outcome it is not at all equal in terms of outcome for a baby who is premature, breech and other factors.

 

Link, please.

[Embassy]

having a home birth?

 

I had a home birth, and 2 others in a birth center, all 3 VBACs. My dd is considering a home birth. On the one hand I'm excited, but otoh, my older, more paranoid self wants her to have every emergency option at hand.

 

I firmly believe that home birthing is safe, but this is my baby having a baby. Why am I so paranoid though?

 

They live about 5 minutes from the hospital where she would deliver.

 

Any input?

 

I would be very proud of her.

[Murphy101]

It would not occur to me that my opinion matters in what other women, even my daughters, might choose for their labors and deliveries.

 

I will likely share my thoughts if asked, but otherwise, unless I see/hear something just crazy scary, I PLAN ( ;) ) to keep my mouth shut and my fears to myself.

 

I imagine dh and I will both be nervous wrecks with impending grand babies.

 

I imagine we will do lots of lawn care and house cleaning during those times to get the stress out. I hope our children and their spouses appreciate it.:)

[Barb_]

 

There's a saying that "Nobody gets sued for doing a c-section", and that attitude influences OBs' approaches to labor management, but it doesn't make for a truly safe environment for mothers or babies.

 

 

I went looking for my first homebirth because the local hospital had a 59% Cesarean rate. My neighbor who worked as an OB nurse there told me to avoid, avoid, avoid. She said one of the OB loved to start immediate traction on placentas. One time she pulled so hard the placenta flew out of the mother and smacked her in the face. My husband worked there and said, "Please just go talk to one of the OB's." I did and was scolded like a child when I said I'd rather have intermittant monitoring and walk around. He sputtered at me. "I've been doing this for X years and you have the nerve to come in here and tell me how to do my job." Come to find out, you push uphill in stirrups at that hospital, which probably contributes to the c-section rate.

 

I also had words with another OB at a different hospital in a different state who defended his right to vacations and a solid night's sleep. He routinely scheduled in his deliveries at 38 weeks with cytotec. If they haven't progressed to where he wants them by dinnertime, it's a c-section. He was matter-of-fact about it all and showed no embarrassment or guilt. Just entitlement.

 

I won't even get into the details of my first birth with my 4th degree lacerations. The OB (whom I'd never met before that day) stumbled in pulling on his mask and said, "push hard!" which I did, and she shot out past his hands and almost to the floor. That would never have happened at home with a midwife who was with me the whole way through and REALLY knew me. I'm convinced by the research and by personal experience that hospitals are no place for low-risk birth. Doctors are trained to want to DO SOMETHING and a normal birth entails a lot of waiting around quietly and watching. Doctors are trained to heal and fix. So they often try to fix things that aren't broken, and break them in the process.

Edited May 10, 2011 by Barb F. PA in AZ

[ocelotmom]

I imagine dh and I will both be nervous wrecks with impending grand babies.

Yep, I imagine I'll be the same, regardless of the birth method/location.

[elizabeth]

Link, please.

 

http://www.ajog.org/article/S0002-9378(10)00671-X/abstract Here it is . There have been many editorials criticizing the study as well. Google scholar should give you plenty pro and con on the Wax study/home birth. There is money involved in Obstetrics and that clouds the real issues all around.

[warriormom]

I believe that having a home birth is unwise. Both I and my sil had situations where we could have lost our babies (my 1st, her 2nd). We had a VB but both of our doctors did save the day (gave me antibiotics since I ran a maternal fever...my water broke and that is how I went into labor... my baby's heart rate went down during labor also).

 

I lost a baby to a non-life giving birth defect (my 2nd). That was beyond my control. If you have some control, I believe better be safe than sorry. My OBGYN (who came in during her vacation time and her days of not being on call in all 3 births- 1 baby was already deceased) is a good friend of mine. She has told me that unfortunately worst case scenarios happen more often than people really believe. I always thought nothing bad would never happen to me.....but it did. Birthing centers or hospitals can be great places to have a natural birth experience.

 

I am sorry if I come across a bit opinionated. Unfortunately I am apart of a club I would rather not be apart of (the mom of a dead baby club). I did not sign up for it. I would really rather not have any other members.

Edited May 11, 2011 by cabreban

[Oak Knoll Mom]

I believe that having a home birth is unwise. Both I and my sil had situations where we could have lost our babies (my 1st, her 2nd). We had a VB but both of our doctors did save the day.

 

Would you mind sharing what your situation was? I ask because when I was planning my home births, so many people told me about their/their friend's "emergency c-section." Over and over again they told me stories that were not true emergency situations OR were pregnancies that would not be eligible for home births.

 

My midwife explained it this way...you don't go from perfect pregnancy/labor/delivery to need a c-section right this instant in one fell swoop. The journey from everything is fine to needs intervention has lots of road signs along the way. Some of those road signs are mother's blood pressure, labor not progressing, baby's heart-rate not recovering well after a contraction, meconium, etc.

 

As an aside, one of my planned home-births ended up at the hospital because there was a lot of meconium in my water. The midwife I used had very strict protocols in place that required transport for that.

 

I'm always curious when people tell me about situations like yours and your SIL's. I'd love to hear more!

 

ETA--I see you edited and added more info. A mom with a fever would most likely be transported to the hospital for IV antibiotics or the midwife would give IV antibiotics at home. I know my midwife can give IV antibiotics at home in cases of Group B Strep.

Edited May 11, 2011 by Oak Knoll Mom

[Barb_]

http://www.ajog.org/article/S0002-9378(10)00671-X/abstract Here it is . There have been many editorials criticizing the study as well. Google scholar should give you plenty pro and con on the Wax study/home birth. There is money involved in Obstetrics and that clouds the real issues all around.

 

:iagree: You are so right there. Without looking into the criticisms of the study, the first thing that jumps out that me is that the perinatal mortality rate (which I've seen defined as the period from viability to 7 days post birth) is actually slightly lower for homebirth than for hospital birth. I know I'm losing brain cells as I age, but I don't see where this study has defined the cutoff point for the perinatal vs. neonatal stage. Furthermore, while looking up the terms to be sure I understood what I was reading, I found that each country has it's own way of labeling a death prior to birth, during birth or in the days following birth, up to a month later. Since this is a meta analysis, I would think the discrepancy would come into play when trying to tease out the statistics in the studies.

 

Also, as the study indicates: "The absolute risk was small, reflecting the low prevalence of home birth and rarity of the outcome, despite its significantly increased OR."

 

I chose to accept the negligible risk of infant loss to avoid being strapped down, spoken down to, scolded, threatened, yelled at, grabbed, groped, touched and cut against my will while feeling vulnerable and unable to defend myself.

 

Also, I found this line particularly telling:

 

"These results confirm and complement those of prior large cohort studies assessing outcomes by actual birth location, suggesting generalizability to and value in counseling low-risk women considering home birth particularly with highly trained, regulated midwives who are fully integrated into existing health care systems. Therefore, these data may be of limited applicability to women opting for home birth in the United States.36 "

 

Basically, we (the ACOG) will do everything in our power to ensure midwives are effectively run out of practice and then we (American Journal of Obstetrics & Gynecology) will tell you you shouldn't attempt to birth at home because there aren't any homebirth midwives fully integrated into the healthcare system.

 

Huh.

 

Barb

[Crimson Wife]

Assuming a low-risk pregnancy and attendance by an experienced CNM, I'd have no problem with either of my DD's opting for a home birth.

[Barb_]

I believe that having a home birth is unwise. Both I and my sil had situations where we could have lost our babies (my 1st, her 2nd). We had a VB but both of our doctors did save the day (gave me antibiotics since I ran a maternal fever...my water broke and that is how I went into labor... my baby's heart rate went down during labor also).

 

I lost a baby to a non-life giving birth defect (my 2nd). That was beyond my control. If you have some control, I believe better be safe than sorry. My OBGYN (who came in during her vacation time and her days of not being on call in all 3 births- 1 baby was already deceased) is a good friend of mine. She has told me that unfortunately worst case scenarios happen more often than people really believe. I always thought nothing bad would never happen to me.....but it did. Birthing centers or hospitals can be great places to have a natural birth experience.

 

I am sorry if I come across a bit opinionated. Unfortunately I am apart of a club I would rather not be apart of (the mom of a dead baby club). I did not sign up for it. I would really rather not have any other members.

 

:grouphug: I'm sorry for your loss. There is nothing more to say about that.

 

As far as your first situation, the fever you ran was likely a result of foreign bacteria you picked up in the hospital. Once the water breaks, midwives I know don't do internal checks at all so to avoid infection. If signs of infection were picked up, you would probably have been transported. If you had a CNM, she may have been ok to give you antibiotics herself. It's an urgent situation, but not an emergency. The heart rate decels are common in hospital labors. When you lie down during labor for the fetal monitor you press on the main artery leading to the baby. So the monitor use often causes the decrease in heart rate.

 

Barb

Edited May 11, 2011 by Barb F. PA in AZ

[hana]

It's interesting, in terms of "better safe than sorry," right--some of us see the hospital as safer, and some of us see home as safer.

 

I had to have a c-section (placenta previa that had been bleeding, and my son was transverse breech); there's no way I would have risked a home birth in that situation. But, under normal circumstances, I'm absolutely an advocate of homebirth for women who choose that option. My daughters (and sons) will always know both that I advocate for homebirth, but that I am entirely supportive of whatever well-educated birth choices they make.

[Oak Knoll Mom]

 

I had to have a c-section (placenta previa that had been bleeding, and my son was transverse breech); there's no way I would have risked a home birth in that situation.

 

:iagree: And I highly doubt you'd find a qualified, certified, and licensed midwife who would have delivered you at home.

[Ginevra]

I believe that having a home birth is unwise. Both I and my sil had situations where we could have lost our babies (my 1st, her 2nd). We had a VB but both of our doctors did save the day (gave me antibiotics since I ran a maternal fever...my water broke and that is how I went into labor... my baby's heart rate went down during labor also).

 

I lost a baby to a non-life giving birth defect (my 2nd). That was beyond my control. If you have some control, I believe better be safe than sorry. My OBGYN (who came in during her vacation time and her days of not being on call in all 3 births- 1 baby was already deceased) is a good friend of mine. She has told me that unfortunately worst case scenarios happen more often than people really believe. I always thought nothing bad would never happen to me.....but it did. Birthing centers or hospitals can be great places to have a natural birth experience.

 

I am sorry if I come across a bit opinionated. Unfortunately I am apart of a club I would rather not be apart of (the mom of a dead baby club). I did not sign up for it. I would really rather not have any other members.

:iagree: I feel the same way and for the same reason.

 

 

Would you mind sharing what your situation was? I ask because when I was planning my home births, so many people told me about their/their friend's "emergency c-section." Over and over again they told me stories that were not true emergency situations OR were pregnancies that would not be eligible for home births.

 

My midwife explained it this way...you don't go from perfect pregnancy/labor/delivery to need a c-section right this instant in one fell swoop. The journey from everything is fine to needs intervention has lots of road signs along the way. Some of those road signs are mother's blood pressure, labor not progressing, baby's heart-rate not recovering well after a contraction, meconium, etc.

 

As an aside, one of my planned home-births ended up at the hospital because there was a lot of meconium in my water. The midwife I used had very strict protocols in place that required transport for that.

 

I'm always curious when people tell me about situations like yours and your SIL's. I'd love to hear more!

 

ETA--I see you edited and added more info. A mom with a fever would most likely be transported to the hospital for IV antibiotics or the midwife would give IV antibiotics at home. I know my midwife can give IV antibiotics at home in cases of Group B Strep.

 

I'm sorry to butt in, but the bolded is not necessarily correct. It honestly is what truly irks me about the homebirth/birthcenter argument. Low-risk does NOT mean no-risk; too often I think it is conveyed that way. My pregnancy/birth turned from low-risk to intrauterine death very quickly. It is true that I had a negative sign (bleeding), but midwives don't rush moms to the hospital the second a negative sign shows up. My baby died five minutes from the hospital. :(

 

Numerous things can go wrong during the actual labor of someone who was low-risk. It is true that babies also die in the hospital and I can't be sure what would have happened if I had been in the hospital when I was in labor with my dd. However, I do wish that I was one of the people who could say, "Yeah, they gave me an emergency c-section and it probably wasn't even necessary!" People whose life or baby's life was saved by an emergency c-section don't necessarily realize how close a brush with death they actually had.

[warriormom]

 

I'm always curious when people tell me about situations like yours and your SIL's. I'd love to hear more!

 

ETA--I see you edited and added more info. A mom with a fever would most likely be transported to the hospital for IV antibiotics or the midwife would give IV antibiotics at home. I know my midwife can give IV antibiotics at home in cases of Group B Strep.

 

Well, I went into labor after my water broke at 2 am. I was not group B strep positive. After about 16 hours of labor, I started running a high fever. I was progressing, but I started running a fever. I was placed on antibiotics and oxygen due to the baby's heart beat decelerating. Of course, I was really scared and feeling terrible due to the fever. I could not imagine being at home in that situation (no matter how wonderful the midwife). They did an ultrasound to find out if the baby was sunny side up. He was. I got into position to hope he would turn. When it came time to push, I had to push every 2nd contraction because the baby's heart rate was decelerating...not recovering well after the contraction. My doctor notified me that she did not like how the baby was recovering from the contractions...that I needed to trust her if she needed to take me in for an emergency c-section. She would try to avoid it, but she did not want to gamble with his life. Right before he was about to crown, his heart decelerated dramatically. She told me that she needed to use a vacuum assisted delivery if it continued. It did. Under the circumstances, that was the right choice. He was sunny-side up. He was in distress until after he was delivered. She helped me AVOID a c-section. When the placenta was delivered, it was infected. I only had a 2nd degree tear which under the circumstances is very impressive. When Captain America was born, he had a weak cry but he was healthy and safe thanks to my competent doctors and nurses who saved the day!:001_smile: No I have no health issues. I was 28 when I delivered him. I had a perfect pregnancy with no alarms at all.

 

SIL had a very traumatic childbirth at 30 years old. She progressed fairly quickly. Her baby went into distress. They called in her doctor. DS heart was decelerating when she was pushing. He was born at 4 lbs and some change with a VB(although her midwife thought he would be 9lbs like his brother). Although she had ultrasounds every once in a while through out the pregnancy they did not know that there was an umbilical cord issue with an inadequate placenta. It was a complete surprise to everyone (she was 30). If he had been born even an hour later the doctor did not think he would not survive. He went straight to NICU....and he was on oxygen. He was in the hospital for 1.5 weeks. He was is brachycardia (sp?) and found to have VSD (not known until after delivery). Again, she would have put her baby in great risk if she had had a home birth.

 

Maybe the midwife's protocol at some point is to transfer people when they have a situation like ours. All this to say, an at-home birth is not necessarily the best choice. Give me any statistic you want...but common sense and experience tells me otherwise. I am thankful my sil and I made the decision to have a hospital delivery. I love my birth experience despite the drama because my son and I came home. That is what is important. The "wedding" was not perfect but the "marriage" has been awesome.

 

This is of course a personal decision. Based on my own experience and knowing what it feels like to lose a baby, I do not think that being able to say "I gave birth to you at home with no intervention" is worth it. In my opinion, go to a birth center or a hospital with a birth plan if you want minimal intervention. I think that is fair. I will NEVER give birth to a child at home on purpose. I would discourage my daughter and any close friend from having a home birth. Unfortunately the worst case scenario happens to someone. I would rather have a bad memory with a good outcome than a dreadfully sad, preventable regret.

 

Sorry if this offends you. Just my opinion. Now I will climb off of my soap box.:tongue_smilie:

[Veritaserum]

Well, I went into labor after my water broke at 2 am. I was not group B strep positive. After about 16 hours of labor, I started running a high fever. I was progressing, but I started running a fever. I was placed on antibiotics and oxygen due to the baby's heart beat decelerating. Of course, I was really scared and feeling terrible due to the fever. I could not imagine being at home in that situation (no matter how wonderful the midwife). They did an ultrasound to find out if the baby was sunny side up. He was. I got into position to hope he would turn. When it came time to push, I had to push every 2nd contraction because the baby's heart rate was decelerating...not recovering well after the contraction. My doctor notified me that she did not like how the baby was recovering from the contractions...that I needed to trust her if she needed to take me in for an emergency c-section. She would try to avoid it, but she did not want to gamble with his life. Right before he was about to crown, his heart decelerated dramatically. She told me that she needed to use a vacuum assisted delivery if it continued. It did. Under the circumstances, that was the right choice. He was sunny-side up. He was in distress until after he was delivered. She helped me AVOID a c-section. When the placenta was delivered, it was infected. I only had a 2nd degree tear which under the circumstances is very impressive. When Captain America was born, he had a weak cry but he was healthy and safe thanks to my competent doctors and nurses who saved the day!:001_smile: No I have no health issues. I was 28 when I delivered him. I had a perfect pregnancy with no alarms at all.

 

SIL had a very traumatic childbirth at 30 years old. She progressed fairly quickly. Her baby went into distress. They called in her doctor. DS heart was decelerating when she was pushing. He was born at 4 lbs and some change with a VB(although her midwife thought he would be 9lbs like his brother). Although she had ultrasounds every once in a while through out the pregnancy they did not know that there was an umbilical cord issue with an inadequate placenta. It was a complete surprise to everyone (she was 30). If he had been born even an hour later the doctor did not think he would not survive. He went straight to NICU....and he was on oxygen. He was in the hospital for 1.5 weeks. He was is brachycardia (sp?) and found to have VSD (not known until after delivery). Again, she would have put her baby in great risk if she had had a home birth.

 

Maybe the midwife's protocol at some point is to transfer people when they have a situation like ours. All this to say, an at-home birth is not necessarily the best choice. Give me any statistic you want...but common sense and experience tells me otherwise. I am thankful my sil and I made the decision to have a hospital delivery. I love my birth experience despite the drama because my son and I came home. That is what is important. The "wedding" was not perfect but the "marriage" has been awesome.

 

This is of course a personal decision. Based on my own experience and knowing what it feels like to lose a baby, I do not think that being able to say "I gave birth to you at home with no intervention" is worth it. In my opinion, go to a birth center or a hospital with a birth plan if you want minimal intervention. I think that is fair. I will NEVER give birth to a child at home on purpose. I would discourage my daughter and any close friend from having a home birth. Unfortunately the worst case scenario happens to someone. I would rather have a bad memory with a good outcome than a dreadfully sad, preventable regret.

 

Sorry if this offends you. Just my opinion. Now I will climb off of my soap box.:tongue_smilie:

 

You are right to wonder if a midwife's protocols would have resulted in your transfer to hospital. My mw would have transported you due to fever with ruptured membranes. There are mws who stay home with stuff they should NOT (my SIL used a mw like that and it nearly cost the life of my SIL and my nephew). After my SIL's experience with a "trust birth" kind of mw, I have been a lot more cautious about recommending home birth. The mw matters a lot.

 

However, until hospitals and ACOG adopt WHO guidelines as standard of care, hospitals cannot claim a monopoly on safe birth. Your comment about going in with a birth plan is laughable. The nearest hospital to me (where I gave birth to my first) is wholly uninterested in and derisive of birth plans (as are most OBs in the area). No mws have rights at this hospital. The epidural rate is over 95%. Over 80% of women are induced. A birth at this hospital, for a low risk mom/baby, is not safer than a home birth with a competent mw because a woman at this hospital will be forced to consent to procedures that have not been proven to increase safety. If she refuses, she will be bullied, be told that she must want a dead baby, or ignored. I have experienced this treatment personally, have witnessed it happening to others, and have heard about it from still more. :(

 

There is a hospital over an hour away that actually practices humane and evidence-based care. Dh and I are planning on adding baby #6 next year and I am considering using this hospital. Of course no birth is risk-free and I join you and others in being frustrated with those who like to say that it is. However, I refuse to go to the other extreme of treating every birth as an emergency and claiming that medical interference increases safety without risks of its own. The risks of interventions should only be incurred when there is a clear medical indication for their use. A normal pregnancy and birth by itself does not indicate medical interference.

[warriormom]

[As far as your first situation, the fever you ran was likely a result of foreign bacteria you picked up in the hospital. Once the water breaks, midwives I know don't do internal checks at all so to avoid infection. If signs of infection were picked up, you would probably have been transported. If you had a CNM, she may have been ok to give you antibiotics herself. It's an urgent situation, but not an emergency. The heart rate decels are common in hospital labors. When you lie down during labor for the fetal monitor you press on the main artery leading to the baby. So the monitor use often causes the decrease in heart rate.

Barb

You may be right. Due to the fact that I had an infected placenta, it may have been that I had stronger bacteria present in my tract or an immune response due to my genetic makeup..Regardless, I was in a place where a doctor could handle any type of emergency with no transfers needed .....and had medicine, surgeon and a pediatrician/NICU team readily available if I had a need in a moments notice. BTW, The decels were due to my baby being sunny side up during birth coupled probably with being attached to an infected placenta...and I had an internal heart monitor with DD. No decels. Luckily I had a perfect delivery with DD.

[warriormom]

Your comment about going in with a birth plan is laughable. The nearest hospital to me (where I gave birth to my first) is wholly uninterested in and derisive of birth plans (as are most OBs in the area). :(

 

I do understand that a lot of hospitals are not "labor plan" friendly. If you have a good, reputable birth center nearby, wouldn't that be a better option?

[happypamama]

I do understand that a lot of hospitals are not "labor plan" friendly. If you have a good, reputable birth center nearby, wouldn't that be a better option?

 

It depends on the birth center. Some are just a fancy name for the birthing wing of a hospital, and they may not be labor plan friendly, may still be very interventionist, etc. A freestanding birth center, otoh, might or might not be right next to a hospital, and it's going to vary depending on the midwives who staff it. I had my first baby at one of those, and it was a lot like having a homebirth in someone else's house. Oxygen was available if needed (but tucked out of sight), and the MWs could do certain drugs (not epidurals, but certain injectibles if needed); the ambulance was on speed dial, and the hospital was down the street. My second baby was a planned homebirth, and there was no difference between what those MWs had on hand/could do vs. the MWs from the birth center for #1; the MW who attended DS1's birth did have oxygen, and a hospital was just a few minutes away.

 

I am so sorry for those of you who have lost babies -- it sounds like the worst kind of pain, and nobody should ever have to go through that. :( My SIL had full prenatal care with an OB, the standard tests and ultrasounds, etc., and one of her babies still died in utero at 36 weeks, due to a knot in the cord that was never detected at all. Such a completely unfair and terrible loss. It did affect us all very heavily with subsequent pregnancies, though in completely different ways, and she and I made the choices that were right for each of us.

[Veritaserum]

I do understand that a lot of hospitals are not "labor plan" friendly. If you have a good, reputable birth center nearby, wouldn't that be a better option?

 

The only birth centers here are staffed by home birth midwives. They have the same emergency equipment that my mw brings to a home birth (oxygen, anti-hemorrhage meds, etc.). The only difference between home and a birth center is the drive in the car.

 

The ideal solutions would be:

1. Support of midwives from ACOG and other professional medical associations so that when/if a woman risks out of midwifery care she can be transferred safely without fear of maltreatment.

 

2. Discontinuation of practices that increase risk without increasing safety. No routine episiotomies, denial of food and drink, standard IVs/saline lock, continuous fetal monitoring, artificial time limits on labor, overuse of pitocin/c-section/assisted delivery, and on-the-back pushing.

 

3. Adoption of evidence-based care. Encouraging movement, hydration through drinking water and juice, nourishment by eating food, intermittent monitoring, letting labor unfold on its own timetable if mom/baby are fine, using less risky means of stimulating labor or facilitating a birth, and encouraging women to use anatomically helpful birthing positions to reduce effort and minimize perineal trauma.

 

If hospitals everywhere adopted points two and three, many women would choose hospital birth instead of home birth because the hospital's policies would be in line with an approach that treats birth as normal unless it isn't. I actively seek medical intervention when indicated. I am opposed to it being forced on me when there are no problems to be solved.

[kolamum]

Because you are feeling like the protective Mamma..

 

That said, no matter how I felt about it if my daughter was married and living on her own her choices are her own so I'd smile and be as supportive as I could and hide in the other room to cry and worry when she wasn't looking. ;)

[Ginevra]

The only birth centers here are staffed by home birth midwives. They have the same emergency equipment that my mw brings to a home birth (oxygen, anti-hemorrhage meds, etc.). The only difference between home and a birth center is the drive in the car.

 

The ideal solutions would be:

1. Support of midwives from ACOG and other professional medical associations so that when/if a woman risks out of midwifery care she can be transferred safely without fear of maltreatment.

 

2. Discontinuation of practices that increase risk without increasing safety. No routine episiotomies, denial of food and drink, standard IVs/saline lock, continuous fetal monitoring, artificial time limits on labor, overuse of pitocin/c-section/assisted delivery, and on-the-back pushing.

 

3. Adoption of evidence-based care. Encouraging movement, hydration through drinking water and juice, nourishment by eating food, intermittent monitoring, letting labor unfold on its own timetable if mom/baby are fine, using less risky means of stimulating labor or facilitating a birth, and encouraging women to use anatomically helpful birthing positions to reduce effort and minimize perineal trauma.

 

If hospitals everywhere adopted points two and three, many women would choose hospital birth instead of home birth because the hospital's policies would be in line with an approach that treats birth as normal unless it isn't. I actively seek medical intervention when indicated. I am opposed to it being forced on me when there are no problems to be solved.

 

Personally, I've noticed that most women don't want the type of birth you describe. IOW, some women do not mind at all having Pitocin rather than labor for 28 hours. I've spoken to two women recently who were totally satisfied to schedule a c-sec with their 2nd baby because they had had one with their first and didn't see the point in laboring for 20 hours only to have a section. So, for example, saying the hospital's epidural rate is 95% means nothing; the far majority of women want an epidural. It is entirely possible to have a baby at the hospital and not be given an epidural, it's just totally rare.

 

And - I know I'm hypersensitive about this because of my experience - but continuous fetal monitoring might have saved my daughter's life. :angelsad2: You can't know that the baby's in distress if you are listening every so often. My midwives listened for my dd's heartrate twice; when I arrived and discovered I was bleeding and then 15 or so minutes later, when there was NO HEARTBEAT. With my subsequent baby, I was on CFM for 24 hours (there's a long story there, but I'll spare you) and it was unimaginably comforting. But it was only unimaginably comforting because I'd already suffered a tragedy. It's a terrible thing that one of my children died before I could see the wisdom in CFM. :( That is my ultimate point: those who have benefited from interventions and took home a living baby may thumb their nose at the interventions that saved their life or their baby's life without realizing what they could have gone through instead because nobody thinks their baby will die.

 

Personally, if my dd or dils want to have a home birth, I will tell them every gory detail and impress upon them that babies and mothers can and do die in labor, even when everything pointed to a healthy, normal birth for the past 39 weeks. I will beg them to reconsider. An "unnecessary" caesarean is not the worst thing that can happen!

[Veritaserum]

I see no reason why American hospitals can't adopt evidence-based care as the default and offer epidurals/whatever for the women who want them. Unfortunately for women who are very concerned about safety (as measured by statistics and data), most American hospitals do not offer a safe environment for normal births. Hospital birth comes with risks of its own. It is up to each woman to decide which set of risks she is willing to take: the risks of naturally-occurring complications or the risks of doctor-caused complications?

 

If I knew that the hospital would support my choice to only receive evidence-based care, the hospital would be safer. They wouldn't do things that increase risk with little/no benefit and they would be prepared to handle any naturally-occurring emergencies that might arise. That would be awesome! That would be safe.

 

The 95% epidural hospital that I mentioned is openly hostile to women wanting to avoid risk-increasing, routine interventions. If you don't want the kind of birth that they offer, they don't want to deal with you. So I don't go there for a normal birth.

[Mrs Mungo]

I see no reason why American hospitals can't adopt evidence-based care as the default and offer epidurals/whatever for the women who want them. Unfortunately for women who are very concerned about safety (as measured by statistics and data), most American hospitals do not offer a safe environment for normal births. Hospital birth comes with risks of its own. It is up to each woman to decide which set of risks she is willing to take: the risks of naturally-occurring complications or the risks of doctor-caused complications?

 

:iagree:

 

That said, I will probably be freaked out when my dd has a baby, no matter what she decides.

[Ginevra]

I see no reason why American hospitals can't adopt evidence-based care as the default and offer epidurals/whatever for the women who want them. Unfortunately for women who are very concerned about safety (as measured by statistics and data), most American hospitals do not offer a safe environment for normal births. Hospital birth comes with risks of its own. It is up to each woman to decide which set of risks she is willing to take: the risks of naturally-occurring complications or the risks of doctor-caused complications?

 

If I knew that the hospital would support my choice to only receive evidence-based care, the hospital would be safer. They wouldn't do things that increase risk with little/no benefit and they would be prepared to handle any naturally-occurring emergencies that might arise. That would be awesome! That would be safe.

 

The 95% epidural hospital that I mentioned is openly hostile to women wanting to avoid risk-increasing, routine interventions. If you don't want the kind of birth that they offer, they don't want to deal with you. So I don't go there for a normal birth.

 

Obviously, hospitals are different all over the country, but I'm saying that the hospitals I went to gave epidurals if you wanted them and not if you didn't. What I'm saying is the 95% epidural rate doesn't speak to what the doctors require, it generally speaks to what the women request. Anecdotally, I haven't heard of a hospital birth that started out normal and ended up with the mother and/or baby dead or damaged due to interventions, but I have heard of hospital births where the baby and/or mother would have died if they had not been in the hospital. I'm not saying it never happens the way you're saying, just that I have not personally heard of it.

 

I have never heard of a women going in to the hospital, intending to give birth vaginally and without drugs, but the doctor instead insisted that, though there were no known complications, they would personally just prefer to do a c-section because they had a 5:00 tee time. I've never heard of a mother or baby dying of CFM or IV fluid intake. It is possible these things have happened in a hospital somewhere, but I've never heard of it.

 

Sometimes I also think the crunchy moms assume they will have limits on their freedoms in the local hospital without even knowing for sure what the case is. My last baby was born at a hospital where they were very cooperative with my requests. Such things exist, but I think some people have been scared off of hospital births by misinformation and so they think they're going to be chained to a bed and have the baby pried out against their will. :001_rolleyes: I remember one women in my acquaintance who was so proud of her previous three homebirths that when she had an emergency c-sec with her fourth, all she could do was bi*ch and whine about how miserable it was to have a c-sec when she planned another homebirth. HER BABY LIVED! I wanted to slap her. SO WHAT if you need a surgical birth if your baby gets here alive and well! :rant:

 

But, obviously, I'm touchy about this subject. :tongue_smilie:

[coffeegal]

I've never heard of a mother or baby dying of CFM or IV fluid intake. It is possible these things have happened in a hospital somewhere, but I've never heard of it. :

 

It was close in one case I know of. CFM flat on her back alone for several hours. Nurses came running in saying baby was in distress and they needed to do a C-sec ASAP. Due to complications in the c-sec, baby nearly died and did lose a kidney.

 

Most of my friends have had wonderful births using a midwife in the hospital or birth center. I birth at home though. I adore my midwife, and most of my births are 1, maybe 2 hours from "hmmm, I'm not feeling well. I'd better call the midwife." to "It's a ...!" That coupled with dh arguing with me a few times about the baby coming, :glare: baby and I are safer with a planned birth at home than an unplanned birth at home, on the road, or in the hospital parking lot.

 

Birthing is not without risk, where ever you choose to birth. That's my opinion as to why the OP is worried. She knows the risks.

[kchara]

NM... misread the post...

[dirty ethel rackham]

Obviously, hospitals are different all over the country, but I'm saying that the hospitals I went to gave epidurals if you wanted them and not if you didn't.

 

Lucky you. Okay, none of the hospitals I know of tied a woman down and forced her to have an epidural. But they did create an environment where it was very difficult to do the non-pharmacalogical and proven-safe comfort techniques to make labor more manageable. At our local hospital, women who want a natural birth are ridiculed "Oh Honey, we do epidural births here." They forbid doulas. They don't allow a woman out of bed because the "monitor might slip and your baby will die" kind of scare mongering. They yell at her if she changes positions too many times because the nurse has to get up and adjust the monitor. In fact, about 75% of the births at our local hospital, the woman receives pitocin or cytotec, despite the scientific evidence that deplores this practice. Other hospitals in this area are similar. There are some better ones, but those have CNMs who have some autonomy. But, if you are not having a midwife-attended birth at these hospitals - beware. I taught childbirth classes for 12 years, attending births in many of them, so I am very familiar with what goes in our area hospitals. When those women who came in with the intention of having a natural birth "cave" in to the subtle and not-so-subtle pressure, the nurses gloat.

 

What I'm saying is the 95% epidural rate doesn't speak to what the doctors require, it generally speaks to what the women request.

 

But, much of that desire for epidurals is fear-based and a result of our cultural attitudes about birth, by the psychological warfare starts long before birth, and even long before pregnancy. Our culture depicts labor as an unbearably painful phenomenon. Anesthesiologists, fully recognizing that epidurals are their bread and butter, compare childbirth without an epidural to amputation without anesthesia -a ridiculous analogy. A small to medium sized hospital cannot afford to keep an anesthesiologist dedicated to L&D (which shortens the decision-to-cut time for c-sections) if they do not have a thriving epidural practice. Our culture contributes by telling and retelling birth horror stories - it is a competitive sport in this country. In many European countries that do not have high rates of medicated births, the cultural belief is that birth is manageable. They do not have that fear mentality. I saw that in my students who were raised in those countries. They were quite baffled by this attitude.

 

 

Anecdotally, I haven't heard of a hospital birth that started out normal and ended up with the mother and/or baby dead or damaged due to interventions, but I have heard of hospital births where the baby and/or mother would have died if they had not been in the hospital. I'm not saying it never happens the way you're saying, just that I have not personally heard of it.

 

And, if they listen to their lawyers, you're not going to hear about it. It will be spun as "look at all we did to "save the baby" and the baby died anyway." Doctors don't get sued for the interventions they do, they get sued for the ones they don't do. There is little incentive for them to not do interventions. Many times, those babies who were "saved by being in the hospital" actually needed saving due to the hospital practices that prevented labor from developing normally. Not all, mind you, but a larger number than you'd suspect. Of course, no doc is going to tell you that the c-section was because they did x,y and z to you.

 

The well-regarded studies that compare like populations show that home birth is as safe or safer than hospital birth. All these interventions are not improving baby outcome on a statistical level, but they do have an impact on maternal morbidity. The studies that say otherwise are comparing apples to oranges and have been largely criticized in the scientific literature.

 

I have never heard of a women going in to the hospital, intending to give birth vaginally and without drugs, but the doctor instead insisted that, though there were no known complications, they would personally just prefer to do a c-section because they had a 5:00 tee time.

 

Okay, most docs are not going to be that overt. But, I have heard of women who were "pitted to distress" by a doc who showed up in a tuxedo, obviously annoyed that his special plans were disrupted. (I am sorry, but don't go into OB if you cannot deal with the fact that your life revolves around nature's timetable when you are on call.) Pit-to-distress is when they keep turning up the pitocin until the baby shows signs of distress. They do turn it down to see if it resolves itself, but those end up as c-sections quite often. I hear OB nurses commenting all the time about doc so-and-so who does this all the time.

 

I've never heard of a mother or baby dying of CFM or IV fluid intake. It is possible these things have happened in a hospital somewhere, but I've never heard of it.

 

They may not die or have serious complications from these interventions in and of themselves, but from the cascade of interventions that result. In the last 25 years, we have had study after study that shows CFM is NOT superior to intermittent auscultation (listening) in preventing bad outcomes. It does, however, increase the likelihood of c-section and all those risks. CFM and IVs restrict movement. I described above a common scenario where continuous monitoring discourages women from moving around - not only to find comfortable positions to help manage the labor, but also to encourage good positions of the baby and good labor progress. In some women, the IVs are very problematic, from either heightened sensitivity to that constant irritation to infections that took a long time to heal. All of these can lead to epidurals, pitocin and each of those has risk factors - in and of themselves and in the c-sections that often follow.

 

Don't get me wrong, I am not opposed to hospital births when risk factors are present, nor am I denying that there is inherent risk in childbirth. It is just that hospitals that truly embrace evidence-based care are not the norm.

 

For me coming around to choosing a home birth was based upon lots of research as well as my experience with the unsafe practices at our local "highly regarded" hospital. I am still dealing with the permanent dysfunction that is a result of unnecessary intervention with my first birth at that hospital 17 years ago. I would love to have sued for it if only to get that doctor out of the business as well as change practices at this hospital, but the difficulty in finding an expert witness willing to break the "doctor code of silence" to testify on my behalf as well as the emotional toll of such a lawsuit discouraged me. I say "thank God" that my son did not have any permanent damage as a result of what happened. My second birth was better, but only because I showed up pushing and had a nurse (a temp, not a normal staffer) who projected me much of what they wanted to do to me. They still did things that were unnecessary and unsafe. With my homebirth, I researched and found a competent midwife, a back up doctor (she had one, but his hospital was too far away) and created two back-up plans - one for an emergency transport to the crappy-but-closer hospital and one for a non-emergency transport to a friendlier hospital a little further away.

[Ginevra]

Lucky you. Okay, none of the hospitals I know of tied a woman down and forced her to have an epidural. But they did create an environment where it was very difficult to do the non-pharmacalogical and proven-safe comfort techniques to make labor more manageable. At our local hospital, women who want a natural birth are ridiculed "Oh Honey, we do epidural births here." They forbid doulas. They don't allow a woman out of bed because the "monitor might slip and your baby will die" kind of scare mongering. They yell at her if she changes positions too many times because the nurse has to get up and adjust the monitor. In fact, about 75% of the births at our local hospital, the woman receives pitocin or cytotec, despite the scientific evidence that deplores this practice. Other hospitals in this area are similar. There are some better ones, but those have CNMs who have some autonomy. But, if you are not having a midwife-attended birth at these hospitals - beware. I taught childbirth classes for 12 years, attending births in many of them, so I am very familiar with what goes in our area hospitals. When those women who came in with the intention of having a natural birth "cave" in to the subtle and not-so-subtle pressure, the nurses gloat.

 

 

 

But, much of that desire for epidurals is fear-based and a result of our cultural attitudes about birth, by the psychological warfare starts long before birth, and even long before pregnancy. Our culture depicts labor as an unbearably painful phenomenon. Anesthesiologists, fully recognizing that epidurals are their bread and butter, compare childbirth without an epidural to amputation without anesthesia -a ridiculous analogy.<snip>

 

I agree that our culture promotes this. I'm just saying it's not the fault of the hospitals or the doctors. Also, I don't see why someone can't just follow their convictions if they're in a hospital, no matter how much the nurses roll their eyes. With my fourth baby, I was offered an epidural numerous times and "one last time" when I was getting near the point where it could no longer be chosen. I don't consider this to be undue pressure.

 

 

And, if they listen to their lawyers, you're not going to hear about it. It will be spun as "look at all we did to "save the baby" and the baby died anyway." Doctors don't get sued for the interventions they do, they get sued for the ones they don't do. There is little incentive for them to not do interventions. Many times, those babies who were "saved by being in the hospital" actually needed saving due to the hospital practices that prevented labor from developing normally. Not all, mind you, but a larger number than you'd suspect. Of course, no doc is going to tell you that the c-section was because they did x,y and z to you.

 

With all due respect to you and others who choose homebirth, I disagree with this view. It paints doctors with a broad brush as if doctors care about nothing but malpractice suits. I would at least frame it this way, "Doctors are not fearful that baby or mother may die from the interventions they do, they know that baby or mother may die from not doing interventions that could save them." Doctors see babies die. They see mothers die. They are totally aware that things can go wrong and they are beholden to *DO* all they can to avert disaster. It makes sense that given a set of negative circumstances, they may choose to do a caesarean, which they've done a hundred times with no bad result, vs. "hoping" that the bleeding will not increase, "hoping" that the baby will make it through the birth, etc.

 

The well-regarded studies that compare like populations show that home birth is as safe or safer than hospital birth. All these interventions are not improving baby outcome on a statistical level, but they do have an impact on maternal morbidity. The studies that say otherwise are comparing apples to oranges and have been largely criticized in the scientific literature.

 

 

 

Okay, most docs are not going to be that overt. But, I have heard of women who were "pitted to distress" by a doc who showed up in a tuxedo, obviously annoyed that his special plans were disrupted. (I am sorry, but don't go into OB if you cannot deal with the fact that your life revolves around nature's timetable when you are on call.) Pit-to-distress is when they keep turning up the pitocin until the baby shows signs of distress. They do turn it down to see if it resolves itself, but those end up as c-sections quite often. I hear OB nurses commenting all the time about doc so-and-so who does this all the time.

 

 

 

They may not die or have serious complications from these interventions in and of themselves, but from the cascade of interventions that result. In the last 25 years, we have had study after study that shows CFM is NOT superior to intermittent auscultation (listening) in preventing bad outcomes. It does, however, increase the likelihood of c-section and all those risks. CFM and IVs restrict movement. I described above a common scenario where continuous monitoring discourages women from moving around - not only to find comfortable positions to help manage the labor, but also to encourage good positions of the baby and good labor progress. In some women, the IVs are very problematic, from either heightened sensitivity to that constant irritation to infections that took a long time to heal. All of these can lead to epidurals, pitocin and each of those has risk factors - in and of themselves and in the c-sections that often follow.

 

My point with the CFM is that it's easy for someone who did not have a baby die in labor to say that it is "unnecessary" to monitor continuously. If I had been on CFM when my baby died in labor, she may have been saved by the more-complete picture given by CFM. So, to me, if CFM increases c-sections SO WHAT if, in the end the baby lives! Why is it bad to have a complete picture of how the baby's heartrate is functioning, rather than a snippet? The snippet did not tell the story of what was happening in my case. True - I did avoid a c-section! My baby died contained in my smooth, unbroken uterus.

 

You could also say that sonograms lead to the use of pitocin, epidurals and c-sections. With my fourth, I had a sonogram at 3 weeks pre-date. I was sent directly to the hospital to have the baby as soon as possible. Because I was not in labor, I had pitocin. Fortunately, I didn't have an epidural or a c-section, but the point is this: The sonogram didn't cause the medical intervention, but may have prevented my son's death. It revealed what couldn't be ascertained otherwise. I am very thankful for those interventions. I would also be if I had needed a c-section.

 

 

For me coming around to choosing a home birth was based upon lots of research as well as my experience with the unsafe practices at our local "highly regarded" hospital. I am still dealing with the permanent dysfunction that is a result of unnecessary intervention with my first birth at that hospital 17 years ago.

 

I get it; our experiences color our beliefs. It is why I believe as I do and why you believe as you do. But none of us can know for certain what would have happened otherwise. That is why the term "unnecessary intervention" bugs me. Doctors cannot predict the future. They have to make their best assessment of what will keep you and your baby the safest. Why should they not think *doing* something is preferable to doing nothing?

 

For my own part, I regret that I shut my ears to the couple of people who discouraged my plans to have a birthcenter birth with midwives. Why did I shut my ears? I shut them because all the crunchy homebirth supporters were so emphatic that doctors are just dying to cut women open to avoid lawsuits. I wish I had listened to the L&D nurse I know who said things can go very wrong, even with no prior risk factors. I wish I had listened to the man that told my dh his wife had a placental abruption in labor and they both nearly died (was that prophetic? Was it a warning from God that I failed to listen to, as this is what happened to me?)

 

No woman considering a homebirth wants to hear that things can go terribly wrong, but I think we all need to know that THEY CAN! They can though you've had two perfectly healthy babies before; they can with no known risk factors. The question I wish I had considered was this: If the baby died in a homebirth, are you so committed to a non-hospital birth that you believe you can accept it? Or will you be tormented with the question of What if I had been at the hospital? Would she have lived?

[Tracy]

:grouphug:

 

I would totally support her, because I think it can be absolutely wonderful. But I would be paranoid about it (hopefully in private), because if I had not been in the hospital when I had my dd, she would have died. But because of the emergency C-section, she was just fine.

 

OTOH, I have a friend that has done it 5 times. The first 4 were totally smooth. The last had some minor complications due to the baby's size, but ultimately all was well.

[ocelotmom]

I agree that our culture promotes this. I'm just saying it's not the fault of the hospitals or the doctors. Also, I don't see why someone can't just follow their convictions if they're in a hospital, no matter how much the nurses roll their eyes. With my fourth baby, I was offered an epidural numerous times and "one last time" when I was getting near the point where it could no longer be chosen. I don't consider this to be undue pressure.

1. A woman in labor is emotionally and physically vulnerable. She should not have to fight for her perfectly reasonable requests, and some may not be capable of fighting off undue pressure.

 

A birth where you spend the whole time fighting the establishment about every single perfectly reasonable, evidence-based little thing is not quite the joyous memory it could be.

 

2. There's some things you can't reasonably fight off. I fought off the epidural with my first birth, but was given an episiotomy against my wishes, for what I suspect may have been spiteful reasons.

 

No woman considering a homebirth wants to hear that things can go terribly wrong, but I think we all need to know that THEY CAN! They can though you've had two perfectly healthy babies before; they can with no known risk factors. The question I wish I had considered was this: If the baby died in a homebirth, are you so committed to a non-hospital birth that you believe you can accept it? Or will you be tormented with the question of What if I had been at the hospital? Would she have lived?

Again, I wish people would stop insulting the intelligence of homebirthing mothers. We're not all airhead hippies going blithely along thinking that doing everything in the perfect crunchy way will guarantee a perfect outcome.

 

OF COURSE we realize babies can die, and that in some circumstances homebirth may contribute. That there's the rare thing that can happen with little or no warning that could be remedied in a hospital, but not in a home setting.

 

OF COURSE we worry about whether we're making the wrong choice.

 

OF COURSE if my baby died I'd be tormented by those questions - even if being in the hospital would be unlikely to have changed the outcome.

 

I feel that every choice is a trade-off. It isn't a matter of "Go to the hospital and the baby will be guaranteed to be safe" or "If you have a homebirth, everything will be perfect." Going to the hospital may get me a dead baby for reasons that would never have happened at home. And vice versa. And there's a lot of factors other than death to consider, too.

 

I did research from reputable sources when deciding to homebirth. This research showed that for low-risk births attended by a trained midwife, outcomes at home and in the hospital were similar, and the risk of significant injury to myself was much lower at home.

 

Do you drive with your child in the car for any reason other than absolutely necessary? Did you know that motor vehicles are the second leading cause of death for children 0-19 (perinatal conditions being the first)? Securing the child in a seat appropriate for their age will help, but isn't foolproof. Sometimes children are killed even in the safest car seats available.

 

But I bet you take your kids on totally unnecessary car trips on a regular basis without a second thought. And let them ride bikes, swim (drowning is the second leading cause of unintentional injury), go over to friends' houses, have Christmas trees (BIG fire hazard - you hear about houses burning down due to Christmas tree fires every holiday), etc. Most parents, even today, understand that quality of life matters. Homebirthers think that this applies to birth, as well.

[Barb_]

Just as with home education vs. brick and mortar, someone's choice to birth at home doesn't negate your decision to use the hospital system. No one here is saying we made a better decision than you, just that knowing what we know, and being a product of our own unique experiences, we've made the best decision for ourselves and and our babies. We are not flaky, crunchy, or stupid, nor are we romanticizing the birth process at the expense of our children. No one is trying to convince you to homebirth, so show a little respect, take a step back and remember that birthing is a highly emotional undertaking for all of us and your own experiences are just that...your own experiences. That's why we have to look at the evidence and outcomes over the past 20 years and say, "Wow, as far as survival goes, each choice is roughly similar!" Sadly, babies still die in both places. You may add, "But I feel more comfortable in the hospital where my small risk of losing a baby is reduced farther still," while I feel more like, "I would rather birth at home where I feel safest and the risk of non-life threatening injury to myself or my baby is minimized." It's all about choosing your comfort zone. According to the research, both choices are entirely valid.

 

Barb

 

ETA: Here are the actual numbers, crunched from the study Elizabeth linked:

 

Hospital death rate 0.09%

Homebirth death rate 0.2%

 

Looked at another way,

 

9880 in 10,000 born at home were born alive

9991 in 10,000 born in the hospital were born alive

 

The drive home from the hospital was more dangerous at any rate.

Edited May 12, 2011 by Barb F. PA in AZ

[Ginevra]

Thanks to the recent posters who have made very good points in support of non-hospital birth. I need to step off this thread now because it's surpassed my ability at rational discussion. My point has been made well enough, I'm sure.