Anyone want to share a Midwife/Homebirth bad outcome story?

[BethG]

The statistics are out there/published for in-hospital births, but this isn't

the case for homebirths by midwives. I'm not interested in midwife-assisted hospital births either (as these stats are out there as well).

 

I've heard many good midwife/homebirth outcome stories, so I'm not looking for those on this thread as I know there are MANY of these great outcome stories.

 

Anyone want to share a negative experience of their own homebirth or share a negative outcome of the homebirth of someone you know? Please share without giving names, locations, etc. --- to protect identities of all involved.

 

From my informal looking into this subject, it seems that the negative outcomes for homebirths and among midwives are treated more hush-hush, but in order to make an informed decision both sides, the good and the bad, is relevant and necessary. I figured this forum was a good place to seek such input.

 

Considering all angles,

Beth

[SailorMom]

I still can't imagine how horrible this poor couple felt.... Everyone was very supportive of them....

 

Had a completely healthy, normal pregnancy. During the homebirth, everything seemed to be going wonderfully. baby was delivered about 6 hours of labor. The cord had wrapped around his neck, and he died sometime during labor.

 

I am not against home birth at all, so this is not coming from me, but the mom said she really wishes she had been somewhere with a fetal monitor, as the baby could have been saved by c-section when distress was noted.

 

ETA - I wanted to add that my SiL has had 6 homebirths - all of which went wonderfully, and that of all the other births I know of - the above is the only instance of something like that happening. Also - bad things happen in hospital deliveries as well....

Edited July 3, 2011 by SailorMom

[Sharon H in IL]

A friend of mine (highly educated, well-informed, supportive family) had a homebirth (after two hospital births for her previous children) that went just fine. Baby was healthy. Mom had bleeding that didn't stop. She was taken to the hospital, where they refused to treat her, not by saying "We refuse to treat you" but by delaying treatment until she told them where to find her son.

 

Because obviously, having a home birth meant her newborn was in danger and this woman was trying to kill him or was neglecting him (he was home with Daddy and doula and friends of the family). Where is the baby?!!! Tell us! We're going to send the police /DCFS to save him. No medicine for you until you tell us! So her choice was to have her newborn taken away by the police/DCFS or bleed to death.

 

She lay bleeding on a gurney in the hallway and nearly died from preventable blood loss. The hospital denies any wrongdoing. She is looking into a lawsuit.

[Aelwydd]

The statistics are out there/published for in-hospital births, but this isn't

the case for homebirths by midwives. I'm not interested in midwife-assisted hospital births either (as these stats are out there as well).

 

I've heard many good midwife/homebirth outcome stories, so I'm not looking for those on this thread as I know there are MANY of these great outcome stories.

 

Anyone want to share a negative experience of their own homebirth or share a negative outcome of the homebirth of someone you know? Please share without giving names, locations, etc. --- to protect identities of all involved.

 

From my informal looking into this subject, it seems that the negative outcomes for homebirths and among midwives are treated more hush-hush, but in order to make an informed decision both sides, the good and the bad, is relevant and necessary. I figured this forum was a good place to seek such input.

 

Considering all angles,

Beth

 

If it's anecdotes you want, they are out there. Years ago, I participated on a birth-related discussion board, and women shared all kinds of birth stories, including the occasional poor outcome for a home birth.

 

I would advise you, however, not to base any final decision on such types of information, whether it's good or bad. If you are seeking the risks of mortality or morbidity associated with home birth, you need to research studies. There have been several done, with large enough populations, to constitute a body of evidence, from which to draw conclusions.

[Plucky]

The statistics are out there/published for in-hospital births, but this isn't

the case for homebirths by midwives. I'm not interested in midwife-assisted hospital births either (as these stats are out there as well).

 

I've heard many good midwife/homebirth outcome stories, so I'm not looking for those on this thread as I know there are MANY of these great outcome stories.

 

Anyone want to share a negative experience of their own homebirth or share a negative outcome of the homebirth of someone you know? Please share without giving names, locations, etc. --- to protect identities of all involved.

 

From my informal looking into this subject, it seems that the negative outcomes for homebirths and among midwives are treated more hush-hush, but in order to make an informed decision both sides, the good and the bad, is relevant and necessary. I figured this forum was a good place to seek such input.

 

Considering all angles,

Beth

 

I do not agree at all. I am one that had horrible hospital births and wonderful homebirths. I don't believe homebirth problems are kept hush hush. If anything I bet more hospital births are misdiagnosed. My sil had her last child admitted to ICU from a planned c-section (baby's lungs weren't mature enough). Of course, no doctor was to blame.

Edited July 3, 2011 by True Blue

[kalanamak]

So her choice was to have her newborn taken away by the police/DCFS or bleed to death.

 

 

So, she told them and the baby was taken away by DCFS?

[Peela]

I dont see how you could make an informed decision from asking for negative anecdotal cases here. Of course they are out there, but you won't be able to make an statistical comparison at all, so how would it contribute to an "informed" decision?

[abbeyej]

I'm not sure what possible good this question could do. Of course there are bad outcomes. There are bad outcomes in every situation. Finding a few anecdotes will not make you more informed.

 

And yes, the negative stories are out there. I had a fabulous unassisted home birth. I have friends who've had good and bad experiences at home, in hospitals, in birth centers... I don't think there's any great effort to "hush up" these stories.

[Pink Fairy]

Back in the 90's, a work friend of my dh's lost a baby during a waterbirth at home. I don't remember all the details, but somehow the baby drowned.

 

Even now thinking about it makes me cry. Such a tragedy! :crying:

[UnsinkableKristen]

I'm not sure what possible good this question could do. Of course there are bad outcomes. There are bad outcomes in every situation. Finding a few anecdotes will not make you more informed.

 

 

I disagree.

 

If all she has ever heard are positive "everything was completely perfect" stories about homebirths, then hearing some less-perfect ones may balance out her perspective, allow her to weigh the perceived risks, and make a more informed choice. If you have never heard of anyone having a baby hurt or die during a homebirth, it's easy to forget that it can and does happen. The same with a hospital birth, if all you ever hear are horror stories, you can forget that some people have great hospital births. And vice versa to both counts.

 

It is always good to hear both sides of a story.

[SonshineLearner]

Lady here, in her house, had her baby die with a midwife attending. Different midwife, same town, had a baby die because the midwife didn't call a DR. Baby would have been totally able to be saved, had the DR been called. Dr was there within 3 minutes from calling, I think? Midwife was trying to save baby, had the airtube down the wrong spot... over and over the mistakes went on. She was "retired" after that and is now doing a different job in a center. Midwives are great, but now gods. They can work with nature, but if you want intervention, they need to be able to call if it's not looking good.

[DarlaS]

A friend of mine (highly educated, well-informed, supportive family) had a homebirth (after two hospital births for her previous children) that went just fine. Baby was healthy. Mom had bleeding that didn't stop. She was taken to the hospital, where they refused to treat her, not by saying "We refuse to treat you" but by delaying treatment until she told them where to find her son.

 

Because obviously, having a home birth meant her newborn was in danger and this woman was trying to kill him or was neglecting him (he was home with Daddy and doula and friends of the family). Where is the baby?!!! Tell us! We're going to send the police /DCFS to save him. No medicine for you until you tell us! So her choice was to have her newborn taken away by the police/DCFS or bleed to death.

 

She lay bleeding on a gurney in the hallway and nearly died from preventable blood loss. The hospital denies any wrongdoing. She is looking into a lawsuit.

 

I hope she sues their a$$es off. No doubt they have better lawyers...

[cjbeach]

I had a good experience but I think one of the reasons you don't hear about negative homebirth stories that much is that a good midwife would transfer the patient if there was an issue.

My MW had a doppler to monitor fetal heart tones during the birth to listen for decels. IF there was an issue with the baby she transferred patient to the hospital. I had conversation with her one time about some of her patients just not being able to handle the pain of a homebirth (for various reason, including baby position) and many times they ended up being transferred. She went with the patient to the hospital in a transfer case.

[UnsinkableKristen]

I think one of the reasons you don't hear about negative homebirth stories that much is that a good midwife would transfer the patient if there was an issue.

 

 

 

:iagree: That is a very good point.

[kamom]

I know a very large home birthing circle. Of all the women I know personally who home birth (about 100!) I know of one who's baby died. I also helped a lay midwife for awhile with no negative stories, but one lady had a failure to progress and went on to have a cecarean. I know a midwife personally who did over 1000 home births without a death. She would transfer to a hospital if she felt it was needed.

 

I've had three homebirths and love it. I hope I never have to have one in the hospital, though I would go if I knew I needed to. But home is what I'm comfortable with!

[DarlaS]

I do not agree at all. I am one that had horrible hospital births and wonderful homebirths. I don't believe homebirth problems are kept hush hush. If anything I bet more hospital births are misdiagnosed. My sil had her last child admitted to ICU from a planned c-section (baby's lungs weren't mature enough). Of course, no doctor was to blame.

 

Of course not. :tongue_smilie:

 

Hospital birth mishaps are absolutely kept hush-hush. They have the resources to make sure of it. I can assure you EVERY time a baby dies under a midwife's care, it makes the news.

 

Lots of elective inductions end badly. Yet people still choose to do them and doctors go along with it. What's wrong with a baby being born on or slightly after the due date?

 

Thankfully, the doctors are able to save the babies in those situations... that they themselves created.

[Rhonda in TX]

There was a midwife (with a birthing center) at our old church. She had a woman attempting a VBAC. The woman's uterus ruptured and the baby died. Very, very sad. This midwife will not longer do VBACs. I also know she won't do deliveries with moms that have placenta previa or breech births.

[GWOB]

You may want to read the book "Babycatcher" by Peggy Vincent. She talks about her experience as a home birth midwife, including a truly horrible experience.

[Koerarmoca]

I can say that I know of 2 homebirth deaths of friends online. 1 was avoidable baby died several hours later because their wasn't a good exam of her done that issues where missed. and The 2nd was unavoidable stillbirth that was no fault of the midwife and most likely happened a few days prior to the birth. Very very sad :( but to those 2 I know about 80 wonderful outcomes too.

 

I am not comfortable enough to share my own birth experiences publicly here but I do hate hospitals and I blame them for something that happened to me, but I risk out for home birth so I didn't have many options. I want to be a homebirther so badly though and if I ever find a willing certified mw I would be so happy.

[Quad Shot Academy]

I would say the largest problem with a home birth is the lack of ability to get medical treatment if needed because of the stigma attached. I had a wonderful home birth after 2 bad hospital births. With number 4, I was planning another home birth when, I fell and had a placental abruption. I went to the hospital twice, but they refused to treat me due to planning a home birth. They told me that I had made my decision to deliver at home and was stuck with that choice. I called most of the OBs in my area trying to get in and be delivered in a hospital, including the one that had delivered my previous baby. 3 weeks later, I finally started bleeding out. I called an ambulance and was treated like a criminal. I was yelled at the whole delivery. They were trying to get me to admit to taking drugs, saying my baby would die if I did not fess up. 25% of the placenta was dead when I delivered. My baby was taken and drug tested. I was mocked and scowled at for the 48 hours in the hospital. They refused to help me with even the most basic of requests like water. Worst of all, my son and I almost died, due to lack of care. I had my next baby in the hospital out of fear of a similar situation. :glare:

[Ravin]

Well, I had a homebirth that resulted in a transfer to hospital. It was a VBAC attempt. My midwife monitored the baby at intervals, and a bit more closely when the water broke--so when his heart rate dropped alarmingly, she had me back off pushing and got me on oxygen, then called an ambulance--i.e., she did the job she was truly there for, a big part of which was to recognize an emergency when it happened and act accordingly.

 

I wouldn't call it a negative outcome, though. The hospital and on-call OB were cool when we got there. My midwife acted as doula for me and I had another trial of labor with oxygen and pain meds (after the emergency and general exhaustion my ability to manage my own pain went out the window and I asked for an epidural) and close monitoring, but DS wasn't budging and I wound up with a C-section.

 

Midwife and I went over things in the postpartum appointment and honestly neither of us could think of what we'd have done differently, which was definitely not the case with my first birth (hospital/induction/c-section).

[Wildiris]

Ina May Gaskin wrote many birthing stories in Spiritual Midwifery. Not all of the stories ended well, but these stories (if you can get past the dated language before my time) are some of the more truthful stories about home birth and midwifery that I've read.

 

A local lay midwife went to jail because of her lack of preparation when a home birth went wrong. I think if one chooses to birth at home the responsibility to know as much about birth and its complication rests with the parents as much as with the midwife. Accepting responsibility for one's choice is no small matter.

 

Of my three home births (baby #1 was an unplanned hospital baby) each baby lingered in those fragile moments after birth between life and death. For two of the babies labor had to stop for the midwife to slip the cord, double wrapped from the baby's head. One baby came into the world blue, another refused to come into her body and lay listless for too long. Everything turned out fine, but it was a huge leap of faith and knowing to choose home birth, but I felt confident that everything would be Okay.

[DarlaS]

I would say the largest problem with a home birth is the lack of ability to get medical treatment if needed because of the stigma attached. I had a wonderful home birth after 2 bad hospital births. With number 4, I was planning another home birth when, I fell and had a placental abruption. I went to the hospital twice, but they refused to treat me due to planning a home birth. They told me that I had made my decision to deliver at home and was stuck with that choice. I called most of the OBs in my area trying to get in and be delivered in a hospital, including the one that had delivered my previous baby. 3 weeks later, I finally started bleeding out. I called an ambulance and was treated like a criminal. I was yelled at the whole delivery. They were trying to get me to admit to taking drugs, saying my baby would die if I did not fess up. 25% of the placenta was dead when I delivered. My baby was taken and drug tested. I was mocked and scowled at for the 48 hours in the hospital. They refused to help me with even the most basic of requests like water. Worst of all, my son and I almost died, due to lack of care. I had my next baby in the hospital out of fear of a similar situation. :glare:

 

Wow. So, the biggest risk in a homebirth may very well be, ironically, the hospital.

 

Also, where was your family during all this? Were they not allowed to be with you? I can't imagine they would treat a woman like this in front of her husband...

Edited July 3, 2011 by darlasowders

[Impish]

I would say the largest problem with a home birth is the lack of ability to get medical treatment if needed because of the stigma attached. I had a wonderful home birth after 2 bad hospital births. With number 4, I was planning another home birth when, I fell and had a placental abruption. I went to the hospital twice, but they refused to treat me due to planning a home birth. They told me that I had made my decision to deliver at home and was stuck with that choice. I called most of the OBs in my area trying to get in and be delivered in a hospital, including the one that had delivered my previous baby. 3 weeks later, I finally started bleeding out. I called an ambulance and was treated like a criminal. I was yelled at the whole delivery. They were trying to get me to admit to taking drugs, saying my baby would die if I did not fess up. 25% of the placenta was dead when I delivered. My baby was taken and drug tested. I was mocked and scowled at for the 48 hours in the hospital. They refused to help me with even the most basic of requests like water. Worst of all, my son and I almost died, due to lack of care. I had my next baby in the hospital out of fear of a similar situation. :glare:

That is just so many levels of insane, I can't even begin to put words to it. :cursing:

[Hannah C.]

There is a blog, hurtbyhomebirth, which contains stories of horrible home births. Imo, they happened because of errors on the part of the midwives, which is the risk you take. The stories range from just sad to quite disturbing, but they do show the other side of home birth. The person who runs the blog is extremely biased against home birth and direct entry midwives.

 

I've never known anyone in real life who has had a negative outcome with a midwife/home birth, and I've known several with good outcomes.

[BethG]

The only midwife (laymidwife) I know of is 1.5 hour away from me. I don't know her personally and she certainly wouldn't hand out a client list for me to call. I know few ladies who opt for homebirths so I can't hear their testimonies that route.

 

As for consulting with the research, I would be very interested in finding valid research on the subject. So, if any of you know of any reputable studies on the subject (outcomes of laymidwife-at-home births), please pass on where to find these.

 

I cannot imagine TRUSTING such a study as the two witnesses to the event is a midwife whose interest is in covering her own behind and reputation and a client who may be completely ignorant of the normal labor and delivery experience and normal neonatal outcomes -- who also isn't exactly in observation mode during the pushing out of the baby.

 

So, I confess these studies wouldn't be easily trusted by me unless they were verified/reported by a 3rd party (as is the case in hospital births -- you have many more witnesses involved than the attending doc and the birth mom ---- people, test strips, monitor results, and are cross-checked and compared to data across the nation that control for similar environments/settings -- let's face it a birth in an Ohio hospital, for the most part, is quite similiar to a birth a Florida hospital, so the data is fairly consistant across the board).

 

Ideally, I'd have had a midwife assisted birth in a hospital but that's not an option here. That would be the best of both worlds IMO.

[Quad Shot Academy]

Wow. So, the biggest risk in a homebirth may very well be, ironically, the hospital.

 

Also, where was your family during all this? Were they not allowed to be with you? I can't imagine they would treat a woman like this in front of her husband...

 

It took hubby a couple hours to find someone to care for our other kids. The nurse's behavior actually escalated when he got there. She was trying to convince him to "tell on me" to save our child's life. The baby had a heart acceleration and she started screaming at him, accusing him of giving me cocaine right then! :001_huh:

[stripe]

I have seen something about a midwife who was stripped of her credentials due to some problems. You could look at those.

 

I asked a midwife I considered using and she told me a story of a death of a child with a severe disability that was not known until birth bc no ultrasound, leading her to think ultrasounds were perhaps more important for out of hospital births.

 

I know about other deaths after birth but these are in other countries. My mother in law gave me the impression many are due to severe bleeding. Btw there was a really good show on PBS on Wide Angle about midwives in Mozambique bc they have learned to perform c sections. It was really fascinating.

Edited July 3, 2011 by stripe

[Aelwydd]

As for consulting with the research, I would be very interested in finding valid research on the subject. So, if any of you know of any reputable studies on the subject (outcomes of laymidwife-at-home births), please pass on where to find these.[/Quote] Sure, I'd be happy to look for some.

 

I cannot imagine TRUSTING such a study as the two witnesses to the event is a midwife whose interest is in covering her own behind and reputation and a client who may be completely ignorant of the normal labor and delivery experience and normal neonatal outcomes -- who also isn't exactly in observation mode during the pushing out of the baby.[/Quote]

 

I don't think you are familiar with the design of most studies then, and the instruments they use to measure data. The large scale studies I've referred to were most certainly not predicated on the subjective data provided by a few people.

 

Studies the compare hospital birth to home birth use the same data for comparison, such as mortality rates and morbidity rates, how many home births ended in a transfer, and so forth. These data are not something someone can just pull out of the air and call it "evidence."

 

When a poor outcome occurs in a hospital, or at home, it gets notated by city or county health officials, because midwives must report injuries and deaths the same as anyone else. Otherwise, they're at huge risk of criminal charges--and really, what parent is going to hide their baby's poor outcome by refraining to call 911 or go to the hospital?

 

 

So, I confess these studies wouldn't be easily trusted by me unless they were verified/reported by a 3rd party (as is the case in hospital births -- you have many more witnesses involved than the attending doc and the birth mom ---- people, test strips, monitor results, and are cross-checked and compared to data across the nation that control for similar environments/settings -- let's face it a birth in an Ohio hospital, for the most part, is quite similiar to a birth a Florida hospital, so the data is fairly consistant across the board).[/Quote]

 

Before a study is published, it must undergo something called peer review, which means that the design of the study, the methods used to collect data, the bias of the researcher, and so forth, must all be carefully investigated and pass muster with the group's standards. Only then, may the study be published, and even so, may be challenged on any of the above bases by other researchers and health statiticians.

 

I just don't understand valuing the independent, totally biased, subjective type evidence from individuals (whose judgment is going to be questionable, due to the fact that they were in pain, scared, didn't understand all the medical terminology or complications, and so forth), over the information gleaned through a third party, that is rigorously tested before being submitted to the public.

 

Ideally, I'd have had a midwife assisted birth in a hospital but that's not an option here. That would be the best of both worlds IMO.

 

I think a midwife-assisted birth in a hospital is a good option, too. They don't offer it in your area at all?

 

Things I'd consider before home birthing:

 

 

 

1. Your health (should be low risk) and your birth history

 

2. The education and training of midwives in your area (I'd personally only use a Certified Nurse Midwife, a Certified Professional Midwife, or a Licensed Direct-Entry Midwife; I'm not on board with most lay midwives).

 

3. Your proximity to the closest hospital with a NICU (20 minutes or less is ideal)

 

4. The relationships your midwife has with the hospital and the obstetric community in your area; I would require that she has at least an informal arrangement with a doctor, in case you need to transfer, so you're not just an "unknown" to the medical community. Your midwife's back-up OB gives you more credibility and reduces the chances of the "punishment" that hospital staffers have been known to mete out against home birthers for "endangering" their baby.

 

5. The option of birth centers--are there any in your area?

 

6. Last, but not least, is your comfort zone. If you are not comfortable with home birthing, and with assuming responsibility for your birth outcome, I would seriously reconsider home birth as an option.

 

[ktgrok]

MANA has the statistics you are looking for. I'm not sure why you think they are not there?

[nd293]

I would advise you, however, not to base any final decision on such types of information, whether it's good or bad. If you are seeking the risks of mortality or morbidity associated with home birth, you need to research studies. There have been several done, with large enough populations, to constitute a body of evidence, from which to draw conclusions.

 

:iagree:Anecdotal evidence is not the same as evidence from a statistical survey. Here are summaries of a whole lot of studies on homebirth. You should of course try to find the original source documents for at least some of those studies to verify the summaries.

[ktgrok]

The only midwife (laymidwife) I know of is 1.5 hour away from me. I don't know her personally and she certainly wouldn't hand out a client list for me to call. I know few ladies who opt for homebirths so I can't hear their testimonies that route.

 

As for consulting with the research, I would be very interested in finding valid research on the subject. So, if any of you know of any reputable studies on the subject (outcomes of laymidwife-at-home births), please pass on where to find these.

 

I cannot imagine TRUSTING such a study as the two witnesses to the event is a midwife whose interest is in covering her own behind and reputation and a client who may be completely ignorant of the normal labor and delivery experience and normal neonatal outcomes -- who also isn't exactly in observation mode during the pushing out of the baby.

 

So, I confess these studies wouldn't be easily trusted by me unless they were verified/reported by a 3rd party (as is the case in hospital births -- you have many more witnesses involved than the attending doc and the birth mom ---- people, test strips, monitor results, and are cross-checked and compared to data across the nation that control for similar environments/settings -- let's face it a birth in an Ohio hospital, for the most part, is quite similiar to a birth a Florida hospital, so the data is fairly consistant across the board).

 

Ideally, I'd have had a midwife assisted birth in a hospital but that's not an option here. That would be the best of both worlds IMO.

 

The studies are not subjective. They don't ask "did things go according to plan." The look at actual numbers/events. And for the record, hospitals DO doctor the numbers and results. I can't tell you how many women I know that have gotten their medical records and found out right lies in them. One woman has pictures of her baby being born, and the baby is alert, pink, and crying. Her medical record says the baby had an APGAR score of 1 and was near death, which is why they "HAD" to do the c-section. A total lie just to justify the surgery.

 

But either way, there are many studies. MANA keeps the results. As to "lay midwife" I'm not sure what you mean by that. Do you mean a certified professional midwife (CPM) ?

[AppleGreen]

6. Last, but not least, is your comfort zone. If you are not comfortable with home birthing, and with assuming responsibility for your birth outcome, I would seriously reconsider home birth as an option.

[/indent]

 

:iagree: This is the biggest issue to me when choosing a home birth. That means choosing a reputable care giver, assessing your risks, proximity to medical support if needed and really giving thought to various outcomes. We had a c/s, two home births and a planned home birth that transferred (as soon as I said I thought I wanted to be at the hospital, my MW was on it. We were in the car and on our way w/in 7 mins) to the hospital and ended w/ a completely natural hospital birth. Part of our preparation for each of those home births was a serious heart to heart between dh and I regarding birth outcomes.

[celticmom]

Wow. So, the biggest risk in a homebirth may very well be, ironically, the hospital.

 

 

 

:iagree::iagree: I am more afraid of a hospital birth than a homebirth. I refuse to even say the name of the institution that my daughter was born in. I refer to it as "that place" when I refrain from using profanity.

[Farrar]

I had a planned lay midwife assisted homebirth that resulted in a hospital transfer, so in that sense it was a negative outcome for my hopes for my birth. However, it was me who didn't want to go and the midwives who insisted. In the end, I was able to give birth vaginally to two healthy babes, but if they had not been there advocating for me (in the role of doulas) then that would not have been able to happen. They argued and advocated loudly in ways I couldn't while in labor.

[Food4Thought]

One of my friends had a homebirth that did not go according to plan. When there started to be issues with labor, the midwife did not seek out hospital help. When my friend finally did make it to the hospital, she needed 6 units of blood and had to have her entire undersides stitched back together. Thankfully, the baby lived. My friend had two miscarriages afterwards, due to an "incompetent" cervix (massively deformed by scar tissue). Thankfully, she had a healthy baby again about a year ago, but I remember a large group of us just sat and cried when she told us about her first experience. The worst part is that the midwife kept saying everything was fine, and it absolutely wasn't.

 

On the other hand, I also have several friends who have had successful home births, water births, and unassisted VBACs in their own driveways (that one was unexpected, to say the least). I've only ever heard that one truly horrible story, and I think it was that particular midwife.

[BethG]

The studies are not subjective. They don't ask "did things go according to plan." The look at actual numbers/events. And for the record, hospitals DO doctor the numbers and results. I can't tell you how many women I know that have gotten their medical records and found out right lies in them. One woman has pictures of her baby being born, and the baby is alert, pink, and crying. Her medical record says the baby had an APGAR score of 1 and was near death, which is why they "HAD" to do the c-section. A total lie just to justify the surgery.

 

But either way, there are many studies. MANA keeps the results. As to "lay midwife" I'm not sure what you mean by that. Do you mean a certified professional midwife (CPM) ?

 

By lay midwife, I mean a person who just opts to apprentice themselves alongside a midwife (whether that midwife-teacher is certified herself or not). I mean a person who has had no official medical training or certification whatsoever. I realize that what I'm calling "lay-midwifery" is not even legal in many states, but it certainly goes on routinely.

I'm sure there are definitions of CNM, etc., and I doubt I have the correct/official terminology.

[eloquacious]

I had a good experience but I think one of the reasons you don't hear about negative homebirth stories that much is that a good midwife would transfer the patient if there was an issue.

My MW had a doppler to monitor fetal heart tones during the birth to listen for decels. IF there was an issue with the baby she transferred patient to the hospital. I had conversation with her one time about some of her patients just not being able to handle the pain of a homebirth (for various reason, including baby position) and many times they ended up being transferred. She went with the patient to the hospital in a transfer case.

 

 

Yes, this.

 

My first was an attempted homebirth. My water had broken but labor was not progressing adequately after nearly 36 hours. Even with that, she felt uncomfortable going so long. Technically we should have gone to the hospital after 24 hours but that was in the evening and she wanted to see if labor would pick up overnight, as it frequently does.

 

It didn't, so we transferred to a hospital, where I was given Pitocin to speed up labor. Immediately, my baby's heart rate plummeted, and they had him out within five minutes of alarm bells going off, about half an hour after the Pit drip had started.

 

I'll never know whether it was the Pitocin that caused his heart rate to crash or whether he was just weakened (he was 5.5 lbs at full term, I had had awful celiac disease issues during pregnancy) and God was protecting him and me by sending us to the hospital. Regardless, I consider our story a successful homebirth, despite the emergency hospital C-section. Successful because part of the strength of a good midwife is acknowledging her weaknesses and knowing when to call upon the strengths of the OBs/hospital.

[BethG]

Sure, I'd be happy to look for some.

 

 

 

I don't think you are familiar with the design of most studies then, and the instruments they use to measure data. The large scale studies I've referred to were most certainly not predicated on the subjective data provided by a few people.

 

Studies the compare hospital birth to home birth use the same data for comparison, such as mortality rates and morbidity rates, how many home births ended in a transfer, and so forth. These data are not something someone can just pull out of the air and call it "evidence."

 

When a poor outcome occurs in a hospital, or at home, it gets notated by city or county health officials, because midwives must report injuries and deaths the same as anyone else. Otherwise, they're at huge risk of criminal charges--and really, what parent is going to hide their baby's poor outcome by refraining to call 911 or go to the hospital?

 

 

 

Before a study is published, it must undergo something called peer review, which means that the design of the study, the methods used to collect data, the bias of the researcher, and so forth, must all be carefully investigated and pass muster with the group's standards. Only then, may the study be published, and even so, may be challenged on any of the above bases by other researchers and health statiticians.

 

I just don't understand valuing the independent, totally biased, subjective type evidence from individuals (whose judgment is going to be questionable, due to the fact that they were in pain, scared, didn't understand all the medical terminology or complications, and so forth), over the information gleaned through a third party, that is rigorously tested before being submitted to the public.

 

 

 

I think a midwife-assisted birth in a hospital is a good option, too. They don't offer it in your area at all?

 

Things I'd consider before home birthing:

 

 

1. Your health (should be low risk) and your birth history

 

2. The education and training of midwives in your area (I'd personally only use a Certified Nurse Midwife, a Certified Professional Midwife, or a Licensed Direct-Entry Midwife; I'm not on board with most lay midwives).

 

3. Your proximity to the closest hospital with a NICU (20 minutes or less is ideal)

 

4. The relationships your midwife has with the hospital and the obstetric community in your area; I would require that she has at least an informal arrangement with a doctor, in case you need to transfer, so you're not just an "unknown" to the medical community. Your midwife's back-up OB gives you more credibility and reduces the chances of the "punishment" that hospital staffers have been known to mete out against home birthers for "endangering" their baby.

 

5. The option of birth centers--are there any in your area?

 

6. Last, but not least, is your comfort zone. If you are not comfortable with home birthing, and with assuming responsibility for your birth outcome, I would seriously reconsider home birth as an option.

 

 

I assumed that there weren't valid studies on the goings-on of lay midwife births (see my personal definition of lay midwife in preceding post), and I'd be interested in any if there are some out there on lay midwifery births. I'd also be interested in the research on CNM (certified) midwifery outcomes as well. I assume that the CNMs delivery outcomes IN A HOSPITAL SETTING likely are BETTER than MDs in the hospital setting, but I doubt the outcomes for CNMs are better than MDs in home settings.

 

I'd love to see this research if you could pass it along.

 

I wasn't aware of these sites wherein ladies discuss their experiences, thus my thread here.

[Camarell]

The biggest problem with these kinds of anecdotal stories is you don't really know what happened. Most of them here are second and third hand accounts so how you can anyone say the death/injury was a result of the homebirth and not some other circumstance?

[joannqn]

I had planned four out of hospital births and ended up with three hospital births.

 

My first birth started with rupture of membranes. My midwife refused to do a cervical exam because doing so put me on a 24 hour clock. I finally asked her to check. I got to 9 cm but then my cervix swelled. We couldn't get the swelling down and I was tired from 70 hours of very slow labor, so we transferred. They forgot me in the ER for nearly an hour. Meanwhile, my husband had parked the car and was waiting for me up there. He overheard the nurses talking about that woman (me) who came in for an epidural because she couldn't handle the pain. Pain wasn't even an issue. He was pretty mad. I had an epidural to stop labor and allow my cervix to rest. Then they restarted labor with pitocin. Knowing it would be a while, we sent my husband back home to deal with the animals we forgot about. While he was gone, they put the pitocin up too high, and my DD's heart rate dropped. They wanted to do a c-section but my midwife talked them into stopping the pitocin to see if her heart rate recovered, and then turning the pitocin back on more slowly. My husband was pretty mad that they nearly caused me into an unnecessary c-section while he was gone. Fortunately, my midwife's suggestion worked and I had a vaginal birth. Then the nursery nurse wanted to put DD on a bottle immediately despite my expressed desire to breastfeed. She declared DD's blood sugar would be high, but again my midwife stepped in and told her to check her blood sugar before assuming. It turned out to be fine, no bottle needed. So, the nurse brought DD over to me (finally) and manhandled my breast trying to force DD to nurse right then and there because she had to eat within minutes of being born. DD was too doped up on the very heavy morphine epidural they gave me (I couldn't feel my legs at all) to nurse. My midwife whispered in my ear that DD didn't need to nurse right away, she was fine, and not let them treat me that way in recovery. Then in recovery, I wanted to go home but they told me that even if I was discharged, I'd have to leave my baby in the hospital even though nothing was wrong with her. She was a tad bit cold because the nurses never bothered to suggest I should put clothes on her. They also never told me where to find diapers so I hadn't checked for wet/poopy diapers. I was so tired and doped up that I couldn't really think for myself and it was my first child.

[Camarell]

I would say the largest problem with a home birth is the lack of ability to get medical treatment if needed because of the stigma attached. I had a wonderful home birth after 2 bad hospital births. With number 4, I was planning another home birth when, I fell and had a placental abruption. I went to the hospital twice, but they refused to treat me due to planning a home birth. They told me that I had made my decision to deliver at home and was stuck with that choice. I called most of the OBs in my area trying to get in and be delivered in a hospital, including the one that had delivered my previous baby. 3 weeks later, I finally started bleeding out. I called an ambulance and was treated like a criminal. I was yelled at the whole delivery. They were trying to get me to admit to taking drugs, saying my baby would die if I did not fess up. 25% of the placenta was dead when I delivered. My baby was taken and drug tested. I was mocked and scowled at for the 48 hours in the hospital. They refused to help me with even the most basic of requests like water. Worst of all, my son and I almost died, due to lack of care. I had my next baby in the hospital out of fear of a similar situation. :glare:

This is illegal in the US, it violates the Emergency Treatment and Labor Act. No person is to be denied emergency treatment from any public hospital. I would have brought the whole place up on charges.

[Whitworth]

I assumed that there weren't valid studies on the goings-on of lay midwife births (see my personal definition of lay midwife in preceding post), and I'd be interested in any if there are some out there on lay midwifery births. I'd also be interested in the research on CNM (certified) midwifery outcomes as well. I assume that the CNMs delivery outcomes IN A HOSPITAL SETTING likely are BETTER than MDs in the hospital setting, but I doubt the outcomes for CNMs are better than MDs in home settings.

 

I'd love to see this research if you could pass it along.

 

I wasn't aware of these sites wherein ladies discuss their experiences, thus my thread here.

 

Our son was born in a birth center with CNMs. It was across the street from a hospital, and it was just as safe as anything in a hospital.

[laundrycrisis]

I do not want to share too many details. I know them, but it is not my story and is very personal. To simplify, a friend attempted an HBAC with a midwife. After a very long slow progressing labor, baby was stuck (shoulder dystocia). Midwife could not get him out. 911 was called and could not get him out. Baby was born en route to hospital, but he was very brain damaged and lived less than 24 hours. He was perfect in every way. His birth just went very wrong.

 

My own is not a homebirth bad outcome story but it could have been. Our DS2 was born in a hospital with a CNM after a 3-hour labor and mad rush to the hospital. As soon as I started pushing, he crashed. Midwife called for help immediately but told me what was happening and talked me through pushing him out between contractions. He was not breathing and was gray but had a heartbeat. He was quickly revived by the crash team and is fine. IMO his life was saved by the fetal monitor and very proactive midwife who told me exactly what to do instead of just waiting on the crash section team to make it down the hall. I do not think even an emergency C-section would have been fast enough to save him. I know that if his had been a homebirth situation without constant monitoring and a crash team to work on him he probably would not be here. His birth was easy in every way except that his cord was around his shoulder several times and compressed tightly with my first push. I am thankful every day that he was born when and where he was, and not at home or in the van on the way there.

Edited July 3, 2011 by laundrycrisis

[Momof3littles]

There are different risks to hospital birth vs. a homebirth. I can't imagine anyone who homebirths who isn't aware of this. Yes, you can lose a baby in a homebirth. You can also lose a baby in a hospital due to risks inherent with hospital policies. In rare instances, a c/s may have been a life-saving measure had the birth been in a hospital. If you are looking at the broader picture, there are women who give birth in a hospital via unnecessary c/s and have babies that experience respiratory distress or other negative outcomes (death, etc.) as a result of unnecessary surgery. There are rare cases where being in the hospital could have been life-saving, but there are also cases where the very act of being in a hospital and adhering to hospital policies caused poor outcomes.

 

There will be cases where perhaps electronic fetal monitoring might have clued in someone that there was a problem. But the overall research shows routine EFM does not improve outcomes. It does increase the c/s rate, which comes with its own set of risks. So yes, anecdotally there will be cases where EFM might have been beneficial, but on a population level, it also *creates* problems. Fwiw most homebirth midwives do intermittently monitor via fetoscope or doppler.

 

If a woman is rushed in for an unnecessary c/s, her physician isn't going to be exactly forthcoming about it ending up being unnecessary (false alarm due to EFM reading, failure to progress, etc.). There will be reasons offered up like "the cord was looped around the neck." That isn't to say that those types of events can't result in a problem, but something like 1/3 of babies have a cord looped around their neck. Most midwives unloop it as the baby is emerging. There are women all over the US who are convinced the cord being wrapped around their baby's neck means the baby certainly would have died w/o the c/s. Certainly there are times when it is a problem, but those are rare. With a 30-40% c/s rate in this country being deemed unacceptable (by the WHO, for example), clearly women are undergoing unnecessary c/s. However, if you speak to individual mothers, the vast majority have been told their baby would not have survived without the c/s. No physician is going to say..."well...your c/s was likely not necessary." Instead, reasons and justifications are offered up. Yes, there *are* legitimate reasons and necessary, life-saving c/s. However, a 30+% c/s rate means there *are* unnecessary c/s, and those come with risks.

 

What I don't see acknowledged often enough is that not only does c/s have risks to mom and baby's health (sometimes outweighed by true need, for sure!), but it also has an impact on the health of future babies carried by that mother. With VBAC hard to come by in many parts of the country, women are often forced into repeat Cs, with their own set of risks. There is a risk of rupture in a future pregnancy. So it isn't just the risk that the primary c/s confers, but the risk to that woman's future pregnancies, kwim?

 

Birth is messy and imperfect and has risks. There are a different set of risks to homebirth vs. a hospital birth. Both come with risk. If you look at the studies, homebirth is not "riskier" IMO. It is a different set of risks.

 

Some studies in the past have also tried to lump unplanned, unattended "homebirths" in with planned homebirths with a trained attendant. Clearly there are risks to not planning on a homebirth and giving birth at home without an attendant. Lumping them together is unfair. Similarly, lumping in homebirths taking place in an extremely rural area where one must drive an hour or two to a hospital vs. a homebirth occurring within a reasonable transfer of a hospital is somewhat misleading.

 

It has not been my experience at all that homebirths gone wrong are hush-hush.

 

I think there is obfuscation in hospital birth as well. Most women who are rushed in for an emergency C are given a "justification" of why it was necessary. If you look at the statistics, there is no justification for a 30+% c/s rate. Women never hear of the fact that perhaps it was a blip on the EFM and everyone got jumpy, or that the doc felt there was "failure to progress" and had she been given enough time, she would have been able to vaginally birth the baby. I absolutely believe there are life-saving C/s, but I don't believe c/s are without risks and I don't believe that there is a justification for 30+% of births being via c/s. I think hospitals participate in obfuscation. Who is told their c/s wasn't necessary? I'm not aware of too many women who have been informed that their c/s was not needed. If you look at the statistics, clearly there *are* unnecessary C/S (and WHO and other health organizations agree w/ this).

 

Typing with toddler underfoot.

 

eta: One other thing to think about. In 2006 there was a study looking at how evidence-based ACOG guidelines were. They looked at practice bulletins from 1998-2004 and presented their research at the 72nd Annual Meeting of Central Association for Obstetricians and Gynecologists. The conclusion? Only 29% of the American College of Obstetricians and Gynecologists recommendations are level A, based on good and consistent scientific evidence.

 

Level A defined by ACOG as: Based on good and consistent scientific evidence

 

It is available as a PDF file IIRC. American Journal of Obstetrics and Gynecology (2006) 194(6):1564-1572. I don't know if there has been a more recent look since that study. Abstract here: http://www.ajog.org/article/S0002-9378%2806%2900300-0/abstract and Jefferson has a good pdf file available online if you do a search for it.

Edited July 3, 2011 by Momof3littles

[misidawnrn]

I can tell you many stories of homebirths transferred to the hospital because I work in L&D. I think the reason why we don't have many "bad" outcomes in the hospital is because the doctors will just do a c/s when there might be a little issue with hearttones, maternal temp, etc. If a doc does a c/s then they are a hero for saving the baby. If a midwife has to transfer for a complication, then she is a bad midwife for failing to birth the baby. I see this attitude reflected everytime a woman is transferred and it makes me sad. A midwife should not be thought of as a failure when she has to transfer a mom/baby. Isn't that what transfer is for? I am pro midwife and pro homebirth and I am going back to school to get my CNM right after I finish my BSN in December of this year. I hate that women's choices are being taken away and replaced by medical intervention. I think intervention has it's place...when needed, not for every birth. I am not going to tell anyone's story because of HIPPPA laws but I could type for the rest of the day on the transfers, but I think that transfers aren't a bad thing. They are the example of when intervention is needed.

[cin]

There was a midwife (with a birthing center) at our old church. She had a woman attempting a VBAC. The woman's uterus ruptured and the baby died. Very, very sad. This midwife will not longer do VBACs. I also know she won't do deliveries with moms that have placenta previa or breech births.

 

This, to me is one reason MW have 'high success rates'. If they are smart, as this MW seems to be, they do routine, normal, little-to-no-complication births. Placenta previa and breech births can come with MAJOR complications in hospitals.

 

I think midwives and doulas are great, don't get me wrong. But I think they have a place, just like the Physician's Assistant or Nurse Practitioner. And I will gladly see them if our symptoms are somewhat routine. Sore throat, earache, deep slice that needs stitches, rash (and my PA called the Dr in to look at the rash, which honestly, made me MORE confident seeing her) etc.

[cin]

Wow. So, the biggest risk in a homebirth may very well be, ironically, the hospital.

 

Also, where was your family during all this? Were they not allowed to be with you? I can't imagine they would treat a woman like this in front of her husband...

 

They wouldn't with my husband. Trust me. He can be very very calm and polite, and yet still get his very aggressive point across. Oh, can he. I saw it once, ironically I was in the hospital having a D&C.

 

The nurses were determined to get the IV started. And it just wouldn't happen. He stepped close to me, on the same side that the nurses were on and looked them straight in the eye and said 'She's had enough, I believe'. The one nurse replied that they have to get the IV started before they could take me down to surgery, yadda yadda. He looked her straight in the eye and said 'she's had enough'. Maybe he has a 'psychotic' calmness; I didn't think he seemed threatening at the time, but both nurses high-tailed it out of there. (And I had bruises on the back of both hands and the inside of both elbows.) He apologized profusely to me for leaving the room when they came in.

 

Funny thing, the nurse anesthetist started the IV in less the 5 seconds, and I didn't feel a thing.

[silliness7]

Ideally, I'd have had a midwife assisted birth in a hospital but that's not an option here. That would be the best of both worlds IMO.

 

I had midwife assisted birth in a hospital for baby #6. (All other births were OB in hospital.) Unfortuantely my water broke on the morning of the 4th of July and after ONE hour of no contractions she put me on pitocin. After all, she had a reunion to get to. :glare:

 

My best births in terms of no complications and good pain management were #2 and #7. Both with OB in hospital. I take it back, the OB was not present for the birth of #7. He came fast!! But I was in a bed with medical attendants. #2 I had an epidural. None with #7.

 

I'm sorry I'm going off topic. Those weren't the anecdotes you wanted. I just wanted to point out that you do the best you can, make the best informed decision you can but there are so many stinking variables that it's impossible to plan the perfect birth. Minimize risk, minimize pain to the best of your ability and then you just take what you get whether at home, at hospitable, in an ambulance, or on the side of the road.

Edited July 3, 2011 by silliness7

[Momof3littles]

This, to me is one reason MW have 'high success rates'. If they are smart, as this MW seems to be, they do routine, normal, little-to-no-complication births. Placenta previa and breech births can come with MAJOR complications in hospitals.

 

 

 

Even if you compare low-risk women giving birth in a hospital to low-risk women giving birth at home, midwives still have good outcomes.