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

[Momof3littles]

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:

Many midwives practicing in hospitals are still stuck w/ having to practice under hospital policies, which are often not founded on good scientific evidence.

 

That's where it gets frustrating when you mention HBing to someone and they can't "get" why a CNM in a hospital isn't an acceptable option to you. Because the policies that those CNMs are often forced to follow is exactly what I want to avoid, kwim? And the evidence behind those policies is often nonexistant or very poor, to say the least.

 

I had a very "med"wifey midwife w/ my oldest's birth (in a hospital) and that's part of the reason I opted for a FSBC with my 2nd and a HB with my 3rd child.

[Cricket]

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 someone 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.

 

:iagree: I have had two (induced) hospital births and two homebirths. My dh almost delivered my first born....and we were in the hospital. The nurses never once checked on me after starting the pitocin. They didn't check until I had my husband track a nurse down to tell her I was pushing. Then they were yelling at me to stop pushing until the doctor arrived. Um, sorry, my body just pushes. I can't stop it! My dh actually delivered my oldest dd. That was a homebirth but my labor was less than an hour. The cord was around her neck twice but he simply unwrapped it. My last birth was a homebirth. My midwife was there for that one thankfully. My dd wasn't breathing when she was born and I hemorrhaged afterwards. My midwife immediately gave me pitocin and had dh call 911. By the time the ambulance arrived she had the bleeding stopped.

 

One of the questions I asked midwives I interviewed was under what circumstances they would transfer to a hospital and under what conditions they would not assist with a homebirth. The midwife I used was a surgical nurse and had several homebirths herself, one of which ended in the death of her baby. Her placenta shuts down before she goes into labor so she always has to have a hospital birth now. I felt comfortable that she would not stand in the way of transferring me to a hospital if necessary. That was a big thing in me trusting her.

[melissel]

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.

 

WHAT A GREAT POST!!!! That was beautifully said. I was a hair's breadth away from an unnecessary c-section with my first after almost 24 hours on Pitocin (and a overnight insertion of Cervidil that caused decelerations that had a nurse sprinting into my room in the middle of the night to remove it) nearly failed to bring on labor. The induction was prompted by an absolutely miserable experience with fetal monitoring in the doctor's office that resolved itself once I was being monitored in the hospital, but I was told we'd just go ahead with the induction anyway, since "I was already there."

 

I'm certain that, had a ended up with a c-section, it would have been noted in my records that it was a result of poor EFM results and emergent issues with the baby's heart rate while I was in labor :glare: No matter how those results and issues came about, of course!

 

Sorry, this is a hot button for me--it's filed under "Things I will forever wish I'd done differently." :( My second birth was with a wonderful midwife in a wonderful hospital with wonderful nurses, but if I ever have another, it will be at home--or at The Farm in Tennessee, if I could manage it!

Edited July 3, 2011 by melissel

[Lisa in Jax]

Read Henci Goer's books for clearly written, research-based information on birth (hospital, home, etc.). Two of her books that immediately come to mind are "Obstetric Myths vs Research Realities" and "Thinking Woman's Guide to a Better Birth." Both books provide information gathered from reliable research -- not anecdotes, statistics -- with citations given, so you can read the original research if you so choose.

 

Lisa

 

 

 

 

 

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.

[butterflymommy]

I had a bad homebirth experience. Not tragic, as baby and I are alive and healthy in the present day. But I was emotionally traumatized by the experience for many reasons. My MW did not provide me with good aftercare and I developed a serious infection (she would not prescribe antibiotics because "they aren't natural"). Like a previous poster, I had difficulty finding anyone in the "medical world" to treat me. It wasn't that they outright said "no," they just were very discouraging, and when you are weak and sick, it's hard to advocate for oneself. It was a bad experience all around, and I did not homebirth again.

[Little Nyssa]

Well, this is not a bad outcome, just a mistake:

When I worked as a nurse-midwife at a hospital, we received a transfer patient from a home-birth midwife. The lady had been pushing 4 hours with no baby yet, and so the home-birth midwife brought her in. When I checked, mom was only 3 or 4 cms dilated. [=not nearly ready to push!!]

She went on to have a fine labor & birth & baby was fine, but that was a big mistake for the home-birth midwife to make.

[melissel]

Well, this is not a bad outcome, just a mistake:

When I worked as a nurse-midwife at a hospital, we received a transfer patient from a home-birth midwife. The lady had been pushing 4 hours with no baby yet, and so the home-birth midwife brought her in. When I checked, mom was only 3 or 4 cms dilated. [=not nearly ready to push!!]

She went on to have a fine labor & birth & baby was fine, but that was a big mistake for the home-birth midwife to make.

 

:svengo: That poor mama's cervix! She must have been utterly exhausted from all that useless pushing. Yes, a very big mistake, and I can only imagine how disheartening it must have been for her to have almost her whole labor ahead of her still :(

[Soror]

I completely disagree with the premise that bad stories of hb are not put out there. Any time a bad outcome of hb happens the midwife is lambasted as a complete incompetent failure. However, whenever a bad outcome happens at the hospital- it is always good thing she was at the hospital.

 

A mw should give you a list of clients. I would say though that horror stories of various women around the world is not helpful to you in making a decision. You can talk to them, find out their experience, any training, education etc. I used 2 different lay midwives and both still yet had different training. The only really relevant information is that particular mw's outcomes though. To be honest though I think if this is how you feel about hb then I don't think it would be the best choice for you. If it is not something you really feel comfortable with then I wouldn't do it.

Edited July 4, 2011 by soror
edited due to unhelpful info

[Melissa in NC]

I understand why the OP asked the question here. I moved to a new area last fall and met a mom who is home birthing. When I asked a few questions about the whole process, I was greeted with the attitude that only stupid people have their babies in the hospital. It kind of creeps me out that you are NOT permitted to question how the process works.

 

The question I asked was: what happens if the MW has two deliveries at once. The mom did not know the answer and she did ask the MW. The answer was the MW only takes one delivery date per month.

 

BTW: my baby making days are over by a decade. I was just curious about how it all worked.

[Impish]

I honestly haven't heard of a 'bad' outcome here.

 

Midwives *only* deal with low risk pregnancies. They transfer at the first sign of trouble, and they have hospital priviledges. I'll be delivering at the hospital, water birth, attended by a midwife.

 

They are required to have two ppl in attendance at the birth. Usually, that's a 2nd midwife, although if #2 isn't getting there in time, a nurse at the hospital can and will stand in. They also have back up midwives in case they're attending another birth, or sick or away. The government limits them to something like 24 births a year, so average about 2 births a month.

 

I had a csection with my first, from being badly mismanaged. They knew he was face up instead of down, had me roll from side to side to turn him...but didn't bother to check his positioning before having me push for 3 hrs. He was turned so his nose was against my hip, and ended up terribly wedged, couldn't be turned by the time they did check.

 

Personally, I'm sick and tired of being treated like I'm a clueless idiot. With Princess, I had non-productive contractions for almost 48 hrs before they induced me. I begged 3 different shifts of nurses to check me for a UTI. They ignored me. I kept telling the staff during the induction that if I got an epidural, they broke my water, baby would be delivering in 2 hrs or less. I couldn't possibly know my own body! :glare:

 

Turned out I had a MASSIVE bladder infection, which landed me back in the hospial via ambulance after it spread to my kidney less than 2 days after Princess was born. And, gee, what do you know...after inducing me for over EIGHT hours to get me to 3 cm (I came in at 2.5!) they finally did get my epidural and water broke...and she was born a little over 2 hrs later. :glare:

 

I'd opt for a home birth if a) My hot water tank was decent. I can barely fill my reg tub without it running out b) I wouldn't have to worry about my other kiddos in the midst of labour and c) I didn't have RSD to contend with. I honestly don't know how RSD is going to react, and my kids freak when Mommy is hurting...labour and RSD combined would likely have them really upset, so I want to be sure that I am away from them and able to focus on what I need to do.

 

Having had 4 hospital births, I'm thrilled to death to finally have a midwife. :D

[babs]

mentally impaired if I had not been in a hospital. He was my second child (first was hospital delivery natural). My water broke 6 weeks early after a weekend spent feeling like I had a bladder infection (was really labor but I didn't know it.) After getting to the hospital and spending the day in labor my doc said his opinion was that I needed a c-sec. After taking some time to pray we decided to honor his medical judgment. I had a sweet little nurse who came into my room while I was praying. She said to me, "I used to be a cardiac nurse and those patients went into surgery and did not get to come out with a baby." Then I realized: This birth is NOT about me or how I want the baby to come into this world. It is about making sure he gets here healthy! To make a long story short, he had to be removed by forceps in that c-sec. He looked horrible - he had a line around his head marking where he was stuck in my pelvis. He is FINE today. I later met a woman who had a similar delivery and the baby was not taken c-section. The boy has severe cerebral palsy. I credit my doctor and hospital for saving my son. If I had been at home I doubt that the outcome would have been as favorable.

 

The WHOLE point in having a baby is to HAVE A BABY not a birth experience that makes mom feel wonderful. It is really all about having a healthy baby. Really. So, if you do the research and find that more babies are born healthy at home, then that sounds like the best option. But I sure would want to have a hospital and doc with SOUND medical judgment on hand for when that midwife is in over her head.

[calandalsmom]

mentally impaired if I had not been in a hospital. He was my second child (first was hospital delivery natural). My water broke 6 weeks early after a weekend spent feeling like I had a bladder infection (was really labor but I didn't know it.) After getting to the hospital and spending the day in labor my doc said his opinion was that I needed a c-sec. After taking some time to pray we decided to honor his medical judgment. I had a sweet little nurse who came into my room while I was praying. She said to me, "I used to be a cardiac nurse and those patients went into surgery and did not get to come out with a baby." Then I realized: This birth is NOT about me or how I want the baby to come into this world. It is about making sure he gets here healthy! To make a long story short, he had to be removed by forceps in that c-sec. He looked horrible - he had a line around his head marking where he was stuck in my pelvis. He is FINE today. I later met a woman who had a similar delivery and the baby was not taken c-section. The boy has severe cerebral palsy. I credit my doctor and hospital for saving my son. If I had been at home I doubt that the outcome would have been as favorable.

 

The WHOLE point in having a baby is to HAVE A BABY not a birth experience that makes mom feel wonderful. It is really all about having a healthy baby. Really. So, if you do the research and find that more babies are born healthy at home, then that sounds like the best option. But I sure would want to have a hospital and doc with SOUND medical judgment on hand for when that midwife is in over her head.

 

 

What a fabulous example of all sorts of logical fallacy this is! Red herrings galore!

[Impish]

mentally impaired if I had not been in a hospital. He was my second child (first was hospital delivery natural). My water broke 6 weeks early after a weekend spent feeling like I had a bladder infection (was really labor but I didn't know it.) After getting to the hospital and spending the day in labor my doc said his opinion was that I needed a c-sec. After taking some time to pray we decided to honor his medical judgment. I had a sweet little nurse who came into my room while I was praying. She said to me, "I used to be a cardiac nurse and those patients went into surgery and did not get to come out with a baby." Then I realized: This birth is NOT about me or how I want the baby to come into this world. It is about making sure he gets here healthy! To make a long story short, he had to be removed by forceps in that c-sec. He looked horrible - he had a line around his head marking where he was stuck in my pelvis. He is FINE today. I later met a woman who had a similar delivery and the baby was not taken c-section. The boy has severe cerebral palsy. I credit my doctor and hospital for saving my son. If I had been at home I doubt that the outcome would have been as favorable.

 

The WHOLE point in having a baby is to HAVE A BABY not a birth experience that makes mom feel wonderful. It is really all about having a healthy baby. Really. So, if you do the research and find that more babies are born healthy at home, then that sounds like the best option. But I sure would want to have a hospital and doc with SOUND medical judgment on hand for when that midwife is in over her head.

Yes, a healthy baby is the goal.

 

So is a healthy mother.

 

I am MORE than a baby containment unit. I deserve to be listened to and respected, and to have *my* health a consideration as well. Not to be dismissed and treated as though I'm too stupid to know my own body, esp when its baby #4.

 

And as for sound medical judgement, many, MANY of the interventions that are done as SOP are unneeded, and lead to more csections. How is that sound? Routine use of pitocin to 'speed things up' is insane, but it happens in every hospital. Heaven forbid that nature be allowed to take its course! Staff has a schedule, you know! :glare:

[Stacie Leigh]

All home births/midwives are not created equal. I delivered at a birthing center with my last 2 and I cannot imagine them not using a fetal monitor throughout the process and honestly, I am assuming that when one is not used, it's because of the mother's choice not because of a midwife's preference.

 

Illegal home births are not at all the same thing as carefully planned deliveries with the help of a midwife that is certified and has a medical degree.

 

I had a FULL placental abruption during the delivery of my 4th. My midwife was incredibly calm, capable, helpful and firm. There's no doubt in my mind the outcome would have been worse at my local hospital where they would have forced me to go through C-section prep and deliver in the OR, in which time DD would have been compromised and I would have been half dead.

 

My midwife understood that DD was my 4th and of small size and she helped me to push her out immediately and without delay all while having the nurse prep us to be moved to the hospital for an emergency C if necessary. However, I got to push in the meantime and she carefully coached me that it was important to get the baby out NOW so we weren't going to pace ourselves like usual. Fetal monitors were used throughout the entire time and the nurse and midwife are trained in lifesaving measures for both of us.

 

Lifesaving drugs and devices were also on hand the entire time.

 

It's kind of like asking if anyone has had a bad outcome for any kind of medical treatment and then including a ton of stories from unlicensed doctors and procedures people attempted on themselves. Hardly a realistic view.

Edited July 4, 2011 by Stacie Leigh

[Stacie Leigh]

I wanted to add that I do know of one bad outcome from a homebirth and my experience is not at all that homebirth tragedies are kept hush hush. On the contrary, when a baby dies in the hospital, it does not make the news at all. It's just considered a private tragedy and I've been told by OB nurses that they love their jobs because of the day to day joy associated but when it's bad it's horrible because every OB nurse has had to attend a tragic birth if they've been there more than a year or two.

 

The poor outcome in a home birth that I know of was a young woman who was a friend of mine through high school and after. She became involved with a religious circle that strongly condemned medical intervention in favor of miracles and such. We grew a bit apart but I stayed in occasional casual contact. Her unlicensed, untrained MIL and SIL delivered her baby at home. She bled out and died. The baby is fine.

 

It was HUGE local news and made it to the nationwide circuit as well and both the MIL and SIL served jail time and their trials were covered by the media. A circus.

 

It was found that she had a very unusually shaped uterus and that blood was pooling inside so that those attending could not distinguish the true amount of blood loss so a very tricky situation. I believe it was classified as criminal because they were not honest about how bad her vitals were at the end and tried to falsify some records about who was in attendance and what exactly occurred.

 

That is NOT the same thing as delivering with a midwife. Our local licensed midwifes openly recognize that they tend to low risk births and that they spend the entire pregnancy screening for anything that would disqualify a woman from delivering outside of a hospital environment.

 

They also have a working relationship with a local hospital in which they have privileges. This allows them to transfer and treat without delay and they actually openly give their clients the option of hospital or birth center delivery and will attend in either location. They have much lower infant mortality, complication and cesarean rates than the national hospital average.

[ktgrok]

No, there are not studies on uncertified, lay midwives. personally, I wouldn't use a midwife that wasn't certified. I would use on that wasn't legally acknowledged by the state, but not one that wasn't nationally certified. The stats are on all certified midwives.

 

As for the woman that mentioned her baby being 6 weeks early...well duh, you can't do homebirth for a preemie!

[TeacherZee]

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.

 

:iagree: It is a great book no matter what.

 

This is a story of a woman who had a home birth go bad, but she is still not anti-home birth.

 

Here most babies are born in hospitals with MW in attendance. OBs are only called in difficulties/emergencies/planned c-sections. We rarely hear stories of moms being induced because someone had a golf round to get to.

[AvasMom]

What a fabulous example of all sorts of logical fallacy this is! Red herrings galore!

 

:iagree: I feel like I want to print this out and tuck it into our copy of The Art of Argument as kind of a review. "How many fallacies can you find? The winner gets ice cream!"

[Momof3littles]

I was greeted with the attitude that only stupid people have their babies in the hospital. It kind of creeps me out that you are NOT permitted to question how the process works.

 

The question I asked was: what happens if the MW has two deliveries at once. The mom did not know the answer and she did ask the MW. The answer was the MW only takes one delivery date per month.

 

BTW: my baby making days are over by a decade. I was just curious about how it all worked.

 

Perhaps this is more of an issue with your friend? My midwife encouraged questions and open dialogue. She wanted to know our concerns and worries and questions before we put a deposit down on her services. She and two other local area midwives hosted screenings of The Business of Being Born and invited questions, etc. from those who were considering a HB. They would bring their standard birth bag and equipment, etc. so people could get a feel for what they provided.

 

My CNM homebirth midwife worked with an assistant. The assistant had a bachelor's degree in nursing and was actually finishing up her CNM degree. If I was in the earlier stages of labor, and my midwife was attending another birth, my midwife would have had the assistant come check on me, do vitals, get a feel for how things were going.

 

If my midwife was at another birth when I called and was concerned things were progressing quickly, she would have called one of the two backup midwives. They were midwives in the area with their own clientele, but they all provided some backup for one another in a pinch.

 

Most midwives are careful to not take on too many clients so they don't run a high risk of having women in labor simultaneously. Even if two cleints are simultaneously in labor, they are generally able to triage their needs using the assistant, etc. It is pretty uncommon for both women to urgently need to give birth right at the same time. If the need did arise, the backups would step in if necessary, but that was quite uncommon.

 

eta: fwiw, I've been made to feel uncomfortable in the past when asking my original OB (prior to switching into midwifery care) questions about the process, and what I'd be "allowed' to decline, etc. I also felt that way to a degree w/ the more "med wifey" CNM who delivered my oldest child. I think there are plenty of OBs who have a "don't question my authority or policies" type of attitude, which doesn't exactly foster patient communication. Or the patient is told to find another practice if they aren't going to conform to the OB's policies and practice guidelines (even if those guidelines are not well-founded from a research standpoint).

Edited July 4, 2011 by Momof3littles

[laundrycrisis]

I came back to add some things.

 

I was with midwives - CNMs - for both births. I am thankful I was under midwifery care vs OB care. With the first, the CNM and doula supported me pushing for almost 4 hours. An OB was called in then, but said I was so close and still making a great effort and DS1 was finally born with no c-section, suction, etc. I know most OBs would not support 4 hours of pushing. With the second birth I am glad I was under a CNM because I feel her response to the emergency (you push him out NOW lady !!!) was much better than what might have happened with an OB. I am not sure a crash C-section would have been fast enough.

 

I am glad I was in the hospital for DS2 and thankful for the monitor. We could not have known his cord was so tangled. I'm glad I didn't need a crash C-section but if I had needed one I would have been thankful for it. I'm glad he wasn't born in the van or in bed at home by accident. I don't think he would have been birthed quickly enough for DH and I to have had a chance to revive him.

 

I have many friends who home birthed. All but one turned out fine. What happened to him (dystocia) is often just as tragic in a hospital. I am not against home birth. I am simply glad I was in the hospital for DS2's unique birth. It was the best place for us to be. Homebirth is not a choice I would make but I support it as a choice for others.

 

In IL the law makes homebirth difficult. CPM is not recognized so homebirth under a CPM is illegal here. When a transfer has to take place, there is no hand-off. In an emergency the midwife has to disappear and not be mentioned. Homebirth is legal with an MD or DO giving written consent to a CNM. There are very few CNMs who practice homebirth here and so their availability is very limited.

 

I am in favor of legalizing and accepting the CPM license here. IMO it would make homebirth here safer because the CPMs would be working within the law, not as rogues outside of it. When a CPM provides poor services here or makes a dangerous mistake, nothing happens because the whole thing is undercover anyway. Legal CPMs would be more accountable. I also think legal CPMs would be less hesitant to transfer when necessary, and would be allowed to openly transfer their patient to the medical team, as CNMs can do.

 

I do believe the current state of rogue CPM births here, as well as completely unassisted births, is dangerous.

[dirty ethel rackham]

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.

 

The must only provide treatment if delivery is imminent. If someone is in early labor or not in labor, they don't have to take them on. Many hospitals will try to transport women who don't have insurance. Also, part of the problem is the way that women planning a homebirth are treated at hospitals if they do transport. That is what should be criminal.

[dirty ethel rackham]

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).

 

 

 

Au Contrare, my friend. There are well-done studies that show home birth with a qualified attendant to be as safe, if not safer than hospital births in risk-matched populations. Here is one from the British Medical Journal.

 

I also disagree with the notion that bad outcomes in homebirths are hushed up. As others said, it is more likely that the bad hospital outcomes are rationalized away, whereas a bad outcome in a homebirth setting is scrutinized more closely and blame is often improperly applied.

[forty-two]

I had a bad homebirth experience. Not tragic, as baby and I are alive and healthy in the present day. But I was emotionally traumatized by the experience for many reasons. My MW did not provide me with good aftercare and I developed a serious infection (she would not prescribe antibiotics because "they aren't natural"). Like a previous poster, I had difficulty finding anyone in the "medical world" to treat me. It wasn't that they outright said "no," they just were very discouraging, and when you are weak and sick, it's hard to advocate for oneself. It was a bad experience all around, and I did not homebirth again.

The bolded is similar to what happened to me, although at the time it was just a minor thing, and I was overall happy with my hb. I'm still satisfied with the birth itself, but I don't know what I think about my mw anymore, as the "minor thing" turned out to be pretty major :(. I'm Rh-, and dh is Rh+, and so the standard of care is to get a Rhogam shot at 28wks and after delivery (the latter only if the baby is indeed Rh+) to prevent sensitization, which I did with #1 (CNM, in hospital). But with #2, my mw (CPM) said she didn't do the 28wk shot, but I could get the after delivery shot if I wanted, which I did. I thought she'd do it herself, but when I asked after delivery, she said that I'd have to go to the ER to do it, and she didn't think it was necessary anyway. I wanted it, but having to just show up at the ER intimidated me and I let myself be talked out of it (plus payment was an issue - was on Medicaid at the time). Big mistake :(, as I found out with #3 - I ended up sensitized, and so this pg, plus any others, is now high risk. Tons of monitoring, and I had to be induced at 37wks, and baby J ended up in the ICU and needed a transfusion, all b/c of the Rh sensitization - and it gets worse with each subsequent pg. We're probably stopping now - can't imagine going through that again :( - and we had a *good* result, all things considered! - but I never imagined stopping at 3 :(.

[Soror]

My last 2 were hb's with lay midwives. I have done OB back-up with both though, largely due to the Rh issue. I knew we wanted a large family. My understanding with mw's, in our area at least, is you are expected to research each issue and make your own decision. I don't expect others to have the same values or weigh the cost/benefits the same. Some people do choose not to have the shot and are fine with that decision no matter the outcome. I'm sure not one of them though. Mw's here cannot obtain the Rh shot and knowing what I did I knew I wouldn't risk it. It was scary going in to got my shot, not knowing if I was going to get lambasted but thankfully my OB didn't give me hassle and last time I just got the nurses and was in and out in just a few moments. My mom had the same issue when she had me, they didn't give her the shot(she was in the hospital) thankfully though no sensitization occurred, I imagine I would be devastated in the same situation.

[Melissa in NC]

Perhaps this is more of an issue with your friend? My midwife encouraged questions and open dialogue. She wanted to know our concerns and worries and questions before we put a deposit down on her services. She and two other local area midwives hosted screenings of The Business of Being Born and invited questions, etc. from those who were considering a HB. They would bring their standard birth bag and equipment, etc. so people could get a feel for what they provided.

 

 

I did go online to read more about homebirth. I was turned off the subject by the term "birth rape". It was so inflamatory. It reinforced the idea that only stupid people have babies in the hospital.

 

My view is also tainted by the mw in VA who took on a high risk birth, and the babies head was trapped for 20 minutes. She was not licensed.

 

Just like homeschooling, home birthing is not for everybody. I would like to see a check list that people can refer to with questions to ask yourself and your mw to decide if you want to go down that path. Not all mw are educated the same or have the same system of back ups. My friend did not say that her mw had any back up or assistance.

 

My point of all of this is I can understand why the OP is asking the question. There is much confusion and "true believers in the cause" that are murking up the waters. Questions are good. Choices are good. If the OP goes with a mw, she now has a better understanding of her choice.

[Soror]

I think it certainly happens, especially in certain circles, that women choose hb just because they think it natural and good and assumes that means everything will be perfect. I had a friend had a hb with the same view point and she did not really research or know much about the birth process or even interviewing the mw to find out about these various things involved. Most of the time things do go well but I think it is your responsibility to do those things, I believe the same things when picking an OB as well. There are good and bad out there of every field.

 

I used a lay mw last time and choose her over the LPM I interviewed. She had more experience, more knowledge, greater bedside manner and I did not feel that it was safe to use the LPM. However, I am sure that many thought that licensure somehow means that everything is great, the same happens with OBs though, people often assume because they are a Dr. that they will be competent, which isn't necessarily the case. I do think HB is the best option for those that are low risk. I researched my options and thoroughly interviewed the mw's to find experience, education and their practices. I picked the one that was the best and was not dissapointed. I do also have OB back-up though. I used him for a hospital birth with ds, he is great as well, imo(and many others) the best for our area. There are never any guarantees in life though regardless of how good any mw or OB is there are those problems, although for the good ones they are rare.

[Momof3littles]

I did go online to read more about homebirth. I was turned off the subject by the term "birth rape". It was so inflamatory. It reinforced the idea that only stupid people have babies in the hospital.

 

My view is also tainted by the mw in VA who took on a high risk birth, and the babies head was trapped for 20 minutes. She was not licensed.

 

Just like homeschooling, home birthing is not for everybody. I would like to see a check list that people can refer to with questions to ask yourself and your mw to decide if you want to go down that path. Not all mw are educated the same or have the same system of back ups. My friend did not say that her mw had any back up or assistance.

 

My point of all of this is I can understand why the OP is asking the question. There is much confusion and "true believers in the cause" that are murking up the waters. Questions are good. Choices are good. If the OP goes with a mw, she now has a better understanding of her choice.

 

There are practitioners in every profession who are inept or unqualified, or who make terrible decisions.

 

I can't fathom hiring a MW without knowing what her backup plans are. No, not all mw have the same system. In my mind, it is something most people would discuss w/ their MW before contracting their services. I have seen checklists, etc. available online that include discussion points. I consider that type of thing par for the course before committing to any practice. Similarly, I would have a list of questions if I were considering seeing an OB for care.

 

I don't particularly care for the term birth rape, but I think it arose out of an intense need for some women to vocalize how traumatic their birth experiences were. Many times I have heard people say "all that matters is that you had a healthy baby" to a woman who is filled w/ overwhelming emotions following the birth of her child. Some women end up with legitimate PTSD and so forth, and I think the "birth rape" language arose out of a need for some of those women to feel heard. It isn't a term I would use, but I think the women using it feel a need to express just how truly traumatic their experiences were. Many of those women are patted on the head and told to just be happy they have a healthy baby to show for their experience. It wasn't or isn't considered socially acceptable for them to express feelings of being traumatized or violated. While a healthy baby is important, many women have had their traumatic experiences dismissed by family, friends, and medical professionals, and I think the strong language comes from a place of wanting to be heard. However, I understand why it can be upsetting to hear the term birth rape, and as I said, it isn't a phrase I would use. I do not consider it isolated homebirthers, as I've heard (or read) the term used by women who have never had a homebirth.

 

One other thought on licensure. This piggy backs off of the comment about the unlicensed midwife in your post, and off the comments about Rhogam and transfers. When that BMJ study came out, there were comments in the journals and online from folks at ACOG saying we can't apply homebirth safety studies from other countries to the US. The rationale that was offered was that many of the European countries that have had excellent outcomes w/ homebirth midwives have a system in place where the midwives are "integrated into the medical system" which is not always the case in the US. I found that rationale striking, as our system has done everything possible to make sure that midwives are not integrated into the system. For example, requiring CNMs to have OB backup in order to be able to practice as HB midwives. It sounds great on paper, until you realize that backup is nearly impossible to obtain. As a result, the licensed, trained, and degreed CNM has a difficult time actually managing to attend HBs legally. In the state I homebirthed in, my midwife was a CNM with backup. There was no recognition of a CPM being legal, but there were several big pushes to allow it. Therefore, the CPMs are not "legal" practitioners and are not licensed...because there is no option for them to be licensed. And of course, they still practice, and women still choose them for their HBs. In many places, while legal, a CNM isn't even a viable option due to the backup requirements. (eta: I don't think a CNM is inherently more desirable than a CPM). Not integrating homebirth midwives into the system is the cause of many tragic outcomes, IMO. We criticize them for not being part of the system, but the system does everything in its power to keep them out.

 

(eta: there are studies showing homebirth is a safe option for low risk women in the US. I just mentioned the BMJ thing because I recall after that favorable study came out, I was dumbfounded that ACOG, etc. didn't want to see it applied to the US since US midwives are generally not as well-integrated into the "system".

Edited July 5, 2011 by Momof3littles

[Pretty in Pink]

Just like homeschooling, home birthing is not for everybody. I would like to see a check list that people can refer to with questions to ask yourself and your mw to decide if you want to go down that path. Not all mw are educated the same or have the same system of back ups. My friend did not say that her mw had any back up or assistance.

 

I just saw a checklist of questions online the other day that was probably 30+ questions long. I cannot imagine using a MW who told me that Rhogam wasn't necessary, or to stick a garlic clove in my birth canal if I tested positive for GBS, or that all she was there to do was catch the baby and that if I wanted any more information about routine prenatal testing it was up to me alone to research those tests and figure out how to obtain them on my own time. That is ridiculous.

[Oak Knoll Mom]

My water broke 6 weeks early after a weekend spent feeling like I had a bladder infection (was really labor but I didn't know it.)

If I had been at home I doubt that the outcome would have been as favorable.

 

Except you wouldn't be at home in your situation. No midwife would deliver a six-week premature baby at home.

[Soror]

Around here mw's are not able to obtain certain things, like Rh, unless I guess they are LNM, which don't exist on my side of the state and are pretty sparse even then. Some couples choose to do GBS, GTT, US and other such screenings/tests, some do not. With both of my mw's I was told what they could do and what they couldn't do and then it was up to me if that was acceptable or if I wanted to obtain things elsewhere. I had an OB and did GBS through him for baby #2 and Rhogram with both. I could have went the ER route for the rhogram but preferred to do it through him to miss the possibility of a hassle. Last time my mw had a lab to send GBS testing to, so that is what I did. I think the GTT is not necessary, unless it is indicated by warning signs or risk factors so didn't do it. My ob didn't have an issue with that and neither did the mw. If you are in a state like me with such restrictions on mw it is entirely different, the dr's and hospitals work to make sure they do not have access to such things, in which case a client has to determine if that is acceptable to them and their situation. It was a collaborative thing though, she would discuss what she was comfortable with in regards to care- in which case we might want to seek outside help or transfer. I had to decline or accept. Those standards vary from mw to mw.

[MelanieM]

I would not have a baby anywhere but in the hospital, first let me say. Other people can do what they want to. But I would just caution anyone who is considering it to think about all the women who died in childbirth before the advent of modern medicine. And the thought of the birth of my first dd always scares me: the OB did an exam when I was about 33 weeks and said the baby was head down and everything was great. Turns out she was footling breech and there was no turning her around. If I'd been at home in that situation, thinking she was head down when she was not, it could have been bad. I had a c-section.

A homebirth does not mean birthing without the advantages of modern medicine. I have had two homebirths attended by very well trained, experienced midwives. They had modern medical equipment with them at the births, just in case it was needed. They also had a plan for transfer in case it was deemed necessary, at which point we would have had access to hospital emergency services. That's hardly the same as a birth prior to modern medical intervention. (Though I could argue that modern medical intervention often causes more harm than good in any case.)

 

Also, it sounds like your OB was lacking in experience if s/he was saying baby was head down when she was footling breech. This is actually the exact scenario I was discussing with my chiropractor last night; she had a breech baby and a doctor that said everything was fine, and because of the doctor's inability to correctly determine positioning she was unable to seek support for turning baby head down. Her delivery resulted in a c-section, and she is now planning to contact my midwife to plan ahead for her next birth (which she hopes will be a homebirth) so she can avoid a similar scenario a second time. So, rather than thinking how lucky she was not to have been planning a homebirth, she wonders how much better it could have been had she had a more skilled practitioner providing care that could have helped her avoid surgery. Just to point out that there are always different perspectives in such circumcstances.

[Veritaserum]

I've had four great home births and know at least a hundred women locally who have had home births. Some midwives are safe. Others are not. I'm going to differ somewhat from the other home birth supporters by saying that bad home birth stories ARE taboo within the homebirthing community. Some people just don't want to deal with the fact that midwives who "trust birth" to the extreme are just as unsafe as OBs who meddle endlessly in the process.

 

My SIL planned a home birth with her first baby, who was born about 16 months after my youngest. SIL had been at my youngest dd's birth and liked how, well, natural and calm it all was. My mw is more medically-minded than other midwives. She has a higher transfer rate (usually for pain relief, but she also transports for situations that may or may or may not be safe at home). She will intervene in the process if indicated or requested, even though other home birth midwives would still sit back and watch. She's not perfect and has stepped in when it probably wasn't needed, but I feel more comfortable with her approach, especially since she answers all my questions with data and respects me when I say no. My mw is licensed by our state.

 

My SIL hired a "trust birth" midwife, who is also licensed. Neither of us knew how extreme the midwife's beliefs were until the birth. I've attended births of friends with this midwife and didn't see anything alarming. SIL developed symptoms of pre-eclampsia toward the end of her second trimester. Her mw treated it with diet and bedrest. At 34 weeks, SIL went into labor. BIL called me. I asked him if he had talked to their mw and he said she was on her way. SIL was 3cm when the mw checked that morning. Baby sounded good, but SIL was clearly in labor. I expected her mw to transport at that time. She didn't.

 

SIL's midwife told BIL and SIL that their baby, who was 6 weeks early, would be fine if born at home. Her reasons for believing such were: labor would get him ready to breathe, he felt big, and she felt like everything would be ok. :glare: BIL called me again later and I spoke with the mw on the phone. She said those things to me. I was alarmed and told BIL that 34-weekers can be fine, but that his baby would likely need assistance--possibly more assistance than their mw could provide. I told him to ask more questions and we hung up.

 

At this point, based on the recommendation of the mw they hired to keep the birth safe, BIL and SIL decided to stay home. No, the mw didn't go into detail about the benefits/risks of staying home vs. the benefits/risks of going to the hospital. She just said that everything would be fine at home. Because it was illegal for her, as a licensed mw, to attend a 34-week home birth, she verbally transferred care to her unlicensed student midwife. The licensed midwife stayed to supervise.

 

SIL began bleeding heavier than her normal period, but the licensed mw blew that off as normal. At 9cm, SIL felt like something was wrong. Baby's heartrate started to drop. BIL and SIL went out to the car because they wanted to transport. The midwives were supposed to join them shortly. One of them would drive and the other would monitor. Apparently they stayed inside to clean up their stuff first because it took 15 min. before they came to the car. During that time, SIL experienced an excruciating pain, which turned out to be a complete abruption.

 

By the time the midwives finally came to the car, the monitoring mw couldn't find a heartbeat. They did call ahead to the hospital and a NICU team was waiting. Still no heartbeat. SIL pushed out my nephew within a couple of minutes after arrival. He was completely limp with no heartbeat. The NICU team worked on him for five minutes and got him back. He has brain damage that seems to be affecting language. He is otherwise a reasonably healthy toddler today.

 

I got to the hospital about half an hour after he was born. It was all I could do to not scream at the mw. What was she thinking?! If she had transferred in early labor due to prematurity, my SIL and nephew would have had access to medical care that was needed in their case. SIL knows a c-section when he crashed, 20+ minutes before he was born, might have prevented some or all of the brain damage. "Trusting birth" when it's very clearly not normal and therefore not trustworthy is insane.

 

When I started talking about this birth in our local homebirth community I got mixed reactions. Many people were horrified and will discourage people from using this mw. Other people have come to the mw's defense. They accused me of making it all up! They thought up excuses for the mw, arguing that my SIL pushed to stay home even though the mw recommended transfer (that's the spin the mw has pushed). The birth should have been reported to the licensing board, but it wasn't. The mw community should have stepped in to do peer review, but it hasn't. I'm still angry about it. I trust the community less as a result. If we can't police our own and things don't get reported properly, mothers and babies will pay the price.

 

Dh and I want to have one more baby. I'm torn about whether I want to do another homebirth, even though mine were fine. I'm leaning toward using a CNM at the one hospital in my state that is mostly in line with WHO recommendations for birth (leave it alone unless there's a problem). That hospital is an hour away and it is the only one I will consider for a normal birth. The others have policies that increase risk without improving outcomes, which is why I chose home birth in the first place.

[melissel]

I've had four great home births and know at least a hundred women locally who have had home births. Some midwives are safe. Others are not. I'm going to differ somewhat from the other home birth supporters by saying that bad home birth stories ARE taboo within the homebirthing community. Some people just don't want to deal with the fact that midwives who "trust birth" to the extreme are just as unsafe as OBs who meddle endlessly in the process.

 

My SIL planned a home birth with her first baby, who was born about 16 months after my youngest. SIL had been at my youngest dd's birth and liked how, well, natural and calm it all was. My mw is more medically-minded than other midwives. She has a higher transfer rate (usually for pain relief, but she also transports for situations that may or may or may not be safe at home). She will intervene in the process if indicated or requested, even though other home birth midwives would still sit back and watch. She's not perfect and has stepped in when it probably wasn't needed, but I feel more comfortable with her approach, especially since she answers all my questions with data and respects me when I say no. My mw is licensed by our state.

 

My SIL hired a "trust birth" midwife, who is also licensed. Neither of us knew how extreme the midwife's beliefs were until the birth. I've attended births of friends with this midwife and didn't see anything alarming. SIL developed symptoms of pre-eclampsia toward the end of her second trimester. Her mw treated it with diet and bedrest. At 34 weeks, SIL went into labor. BIL called me. I asked him if he had talked to their mw and he said she was on her way. SIL was 3cm when the mw checked that morning. Baby sounded good, but SIL was clearly in labor. I expected her mw to transport at that time. She didn't.

 

SIL's midwife told BIL and SIL that their baby, who was 6 weeks early, would be fine if born at home. Her reasons for believing such were: labor would get him ready to breathe, he felt big, and she felt like everything would be ok. :glare: BIL called me again later and I spoke with the mw on the phone. She said those things to me. I was alarmed and told BIL that 34-weekers can be fine, but that his baby would likely need assistance--possibly more assistance than their mw could provide. I told him to ask more questions and we hung up.

 

At this point, based on the recommendation of the mw they hired to keep the birth safe, BIL and SIL decided to stay home. No, the mw didn't go into detail about the benefits/risks of staying home vs. the benefits/risks of going to the hospital. She just said that everything would be fine at home. Because it was illegal for her, as a licensed mw, to attend a 34-week home birth, she verbally transferred care to her unlicensed student midwife. The licensed midwife stayed to supervise.

 

SIL began bleeding heavier than her normal period, but the licensed mw blew that off as normal. At 9cm, SIL felt like something was wrong. Baby's heartrate started to drop. BIL and SIL went out to the car because they wanted to transport. The midwives were supposed to join them shortly. One of them would drive and the other would monitor. Apparently they stayed inside to clean up their stuff first because it took 15 min. before they came to the car. During that time, SIL experienced an excruciating pain, which turned out to be a complete abruption.

 

By the time the midwives finally came to the car, the monitoring mw couldn't find a heartbeat. They did call ahead to the hospital and a NICU team was waiting. Still no heartbeat. SIL pushed out my nephew within a couple of minutes after arrival. He was completely limp with no heartbeat. The NICU team worked on him for five minutes and got him back. He has brain damage that seems to be affecting language. He is otherwise a reasonably healthy toddler today.

 

I got to the hospital about half an hour after he was born. It was all I could do to not scream at the mw. What was she thinking?! If she had transferred in early labor due to prematurity, my SIL and nephew would have had access to medical care that was needed in their case. SIL knows a c-section when he crashed, 20+ minutes before he was born, might have prevented some or all of the brain damage. "Trusting birth" when it's very clearly not normal and therefore not trustworthy is insane.

 

When I started talking about this birth in our local homebirth community I got mixed reactions. Many people were horrified and will discourage people from using this mw. Other people have come to the mw's defense. They accused me of making it all up! They thought up excuses for the mw, arguing that my SIL pushed to stay home even though the mw recommended transfer (that's the spin the mw has pushed). The birth should have been reported to the licensing board, but it wasn't. The mw community should have stepped in to do peer review, but it hasn't. I'm still angry about it. I trust the community less as a result. If we can't police our own and things don't get reported properly, mothers and babies will pay the price.

 

Dh and I want to have one more baby. I'm torn about whether I want to do another homebirth, even though mine were fine. I'm leaning toward using a CNM at the one hospital in my state that is mostly in line with WHO recommendations for birth (leave it alone unless there's a problem). That hospital is an hour away and it is the only one I will consider for a normal birth. The others have policies that increase risk without improving outcomes, which is why I chose home birth in the first place.

 

That is a heartbreaking and horrifying story :grouphug: I'm so glad the outcome wasn't much worse that it actually turned out to be.

[MelanieM]

When I started talking about this birth in our local homebirth community I got mixed reactions. Many people were horrified and will discourage people from using this mw. Other people have come to the mw's defense. They accused me of making it all up! They thought up excuses for the mw, arguing that my SIL pushed to stay home even though the mw recommended transfer (that's the spin the mw has pushed). The birth should have been reported to the licensing board, but it wasn't. The mw community should have stepped in to do peer review, but it hasn't. I'm still angry about it. I trust the community less as a result. If we can't police our own and things don't get reported properly, mothers and babies will pay the price.

What a horrible story! I'm so glad your nephew survived, and hope he continues to thrive with limited effects from his birth situation.

 

As for the quoted portion of your post above... I think this goes to show that there's equal opportunity denial, regardless of what arena you're working with. I have heard many women offer up reasons why their doctors did XYZ (potentially unnecessary procedure) to them, and I have no doubt it happens with midwives and homebirth situations as well. I think a lot of this comes from the fact that no one wants to believe that they could be treated in such a way, or that the people they trust with their care could be such morons. If you can blame it on something out of anyone's control, it becomes easier (for many people) to swallow.

 

There are brilliant and incompetent people in every field. I really do think birthing women would be better off overall if they were more empowered to trust themselves and take responsibility for their own care, and not to defer to others simply because they carry around a title that labels them an expert. That's not to say we shouldn't ever look outside to trained professionals for advice and support, or that taking more responsibility ourselves would remove all potential issues from occuring. But it would certainly help with all the nonsense that comes from people asserting that there's only one way to do something, or that it's inherently dangerous not to listen to a particular person/governing body when making individual choices.

 

Fwiw, I am supportive of whatever birth arrangement a woman decides is right for her. I have had one hospital birth with an amazing OB and nurses in attendance, and two homebirths with different midwives that were also fabulous.

[laundrycrisis]

I'm going to differ somewhat from the other home birth supporters by saying that bad home birth stories ARE taboo within the homebirthing community. Some people just don't want to deal with the fact that midwives who "trust birth" to the extreme are just as unsafe as OBs who meddle endlessly in the process.

 

 

I have seen a bad outcome hushed up. The midwife was an experienced and established CPM. That credential is not recognized here so these homebirths are not legal. She was "never there". The community closed ranks around her. The birth story is known but the identity of the midwife is pretty much a secret. When the credential is not legal anyway, there is no peer review, etc. Any exposure of the situation might hurt the political efforts to get CPM homebirth legalized here.

[Veritaserum]

I have seen a bad outcome hushed up. The midwife was an experienced and established CPM. That credential is not recognized here so these homebirths are not legal. She was "never there". The community closed ranks around her. The birth story is known but the identity of the midwife is pretty much a secret. When the credential is not legal anyway, there is no peer review, etc. Any exposure of the situation might hurt the political efforts to get CPM homebirth legalized here.

 

Aside from the fact that this midwife nearly killed my nephew due to negligence, I am p!ssed as h@!! about what these kinds of true homebirth horror stories do to the political movement. I worked for five years to get home birth midwifery legalized in my state. I attended more legislative meetings than I can remember, many of them requiring me to leave my home at 6 am. I testified at several of them, assuring legislators that midwives would practice within the scope of normal birth. I passed out literature documenting home birth safety. I was a poster child for the movement, being interviewed on television and for newspaper articles.

 

The negligence that stems from cavalier attitudes about what kinds of births should be attended at home infuriates me because it endangers mothers and babies AND it feeds mainstream society's fears about the dangers of home birth. I feel betrayed and used to work so hard to legalize home birth midwifery only to have midwives repay the favor by attending births they know are too risky to be attempted at home. I worry that the few unsafe midwives will ruin it for the rest of us and the law will again restrict the birthing choices of women. It makes me sick.

[fairfarmhand]

Yes, a healthy baby is the goal.

 

So is a healthy mother.

 

I am MORE than a baby containment unit. I deserve to be listened to and respected, and to have *my* health a consideration as well. Not to be dismissed and treated as though I'm too stupid to know my own body, esp when its baby #4.

 

And as for sound medical judgement, many, MANY of the interventions that are done as SOP are unneeded, and lead to more csections. How is that sound? Routine use of pitocin to 'speed things up' is insane, but it happens in every hospital. Heaven forbid that nature be allowed to take its course! Staff has a schedule, you know! :glare:

 

I guess I am fortunate in that I;ve never been treated like an idiot, nor have I had my judgement questioned in a hospital situation. Perhaps I give off some kind of vibe....I do know that it is the responsibility of the patient to be well educated and informed about their options and possible outcomes. I think that in our time, women can be somewhat ignorant of their options because they feel they can depend on their practitioners to make good decisions for them. However that is not always the case. I would advise you to thoroughly interview all candidates for your care and make sure they will respect your wishes, inform you of all your options and be willing to understand what their own limitations are.

[I.Dup.]

Yes, a healthy baby is the goal.

 

So is a healthy mother.

 

I am MORE than a baby containment unit. I deserve to be listened to and respected, and to have *my* health a consideration as well. Not to be dismissed and treated as though I'm too stupid to know my own body, esp when its baby #4.

 

And as for sound medical judgement, many, MANY of the interventions that are done as SOP are unneeded, and lead to more csections. How is that sound? Routine use of pitocin to 'speed things up' is insane, but it happens in every hospital. Heaven forbid that nature be allowed to take its course! Staff has a schedule, you know! :glare:

 

ITA. I have had 4 hospital births and I am planning for my 2nd homebirth.

 

I am not against hospital births and in some ways I am tempted to go back (mainly for the cushy recovery time I get afterward where I have a room to myself with baby, no other children to take care of, etc)

 

But I strongly believe there are WAY too many interventions done during labor. The constant EFM drives me up. the. wall. It's ludacrious. They really have to see what the baby's heart rate is doing every, single second?! There are naturally going to be decels but when they're watching it every single second they freak out over every little thing and rush mom off for a C/S at the slightest sign of "distress."

 

I also hate the 500 questions that need to be asked of me, usually when I come in I'm in hard transition, throwing up, and don't want to be asked 500 questions. I also hate that I have to get an IV needle in during this time.

 

So for those reasons (mainly the constant EFM and heightened risk of a C/S) I choose the risks of home birth. That is if I make it to 37 weeks, if this baby comes early like most of my others have, I will happily give birth in the hospital.

[Momof3littles]

There are certainly different perspectives, I understand that. When they determined the baby was footling breech (because I ended up with preeclampsia and had to have an ultrasound) I asked about turning her and the doctor said that was a risky procedure. And I live at least 20 minutes from a hospital, so what would they do if an emergency c-section was needed in that case? I just think about worst-case scenarios, and if someone was in my case and didn't know the baby was footling breech or something and tried to deliver and was so far from a hospital, if the cord got wrapped around the baby's neck or something. Again, a home birth is not something I ever considered, so I don't have an objective opinion about the situation, but I am glad I had a c-section with my baby, I think it was the best thing for us both and I know, although the rates are higher than they should be, that they are necessary sometimes. I know mw don't do high-risk pregnancies, but I just worry about something looking totally normal and then requiring an emergency c-section with someone so far from a hospital.

 

There are rural hospitals all over America that don't employ 24 hour anesthesia services and have to transfer any mother needing an emergency C. This is one of the things the NIH panel on VBAC mentioned in their report. Some hospitals have taken a no VBAC approach for this reason, so they can do scheduled Cs for these patients while the anesthesiologist is available.

 

I raise that point because an undetected breech could require a transfer between hospitals, just as a homebirth might require a transfer into a hospital.

 

Many hospitals in this country do not offer 24 hour emergency C sections/surgical theatre on site, even though they have maternity wards.

 

http://host.madison.com/wsj/news/local/health_med_fit/article_81d27312-f400-11df-bfce-001cc4c03286.html

 

http://consensus.nih.gov/2010/vbacstatement.htm (scroll a little more than halfway down)

 

From the above:

 

-Two recent surveys of hospital administrators found that 30 percent of hospitals stopped providing trial of labor services because they could not provide immediate surgical and anesthesia services.

 

 

- experts in tracking anesthesia staff resources have found that there are too few anesthesia providers to ensure “immediate†anesthesia availability for all hospitals providing childbirth services. Moreover, they predict that these shortages will worsen in the future.

[Pretty in Pink]

There are rural hospitals all over America that don't employ 24 hour anesthesia services and have to transfer any mother needing an emergency C. This is one of the things the NIH panel on VBAC mentioned in their report. Some hospitals have taken a no VBAC approach for this reason, so they can do scheduled Cs for these patients while the anesthesiologist is available.

 

My local hospital won't allow VBAC for this very reason, and I wouldn't even classify it as a rural hospital.

[Mommy22alyns]

I guess I am fortunate in that I;ve never been treated like an idiot, nor have I had my judgement questioned in a hospital situation. Perhaps I give off some kind of vibe....I do know that it is the responsibility of the patient to be well educated and informed about their options and possible outcomes. I think that in our time, women can be somewhat ignorant of their options because they feel they can depend on their practitioners to make good decisions for them. However that is not always the case. I would advise you to thoroughly interview all candidates for your care and make sure they will respect your wishes, inform you of all your options and be willing to understand what their own limitations are.

 

 

Same for me. It is possible to have a hospital birth without being manhandled, ignored, and abused. It is possible to have a GOOD hospital birth. And sometimes the hospital is absolutely, positively, 100% necessary.

[theYoungerMrsWarde]

My mother has had all 12 of her births at "home" (the last one was actually in a hotel room.) Long story short: I didn't grow up with my parents after I was 4, so I was never present at any of her births.

 

She has had bad bleeding after a lot of her deliveries. Accoding to my father (who is clinically crazy) after one of her deliveries she "died" and he laid hands on her and she came back to life (NOT joking. He still stands by that story.) The last time I actually was in the hotel (we were all there for my Papa's funeral. They didn't let anyone in to help until after the baby was born.) She sat up, showed off the baby and nursed him, and after people left she went gray and collapsed and took a while to wake up.

 

But as far as I know, none of the babies were born with problems themselves.

[Pretty in Pink]

Same for me. It is possible to have a hospital birth without being manhandled, ignored, and abused. It is possible to have a GOOD hospital birth. And sometimes the hospital is absolutely, positively, 100% necessary.

 

While I do agree, a lot of this is solely dependent upon the provider you have delivering your child as well as hospital policy. The truth is that often times no amount of preparation or research on the patient's part will change the fact that the hospital demands IVs for all patients, demands EFM, demands progress of 1 cm per hour, etc.

 

Another thing to consider is that many patients are stuck with the provider that their insurance will cover, and that provider is not always a good fit. I'm dealing with that right now. Though homebirth is honestly not my preference we did considere it this time simply because we are so uncomfortable with our current provider and hospital.

 

I recently asked the midwife at my current practice about hospital policies regarding things like IVs, EFM, delivery positions, etc. She said there's not wiggle room. I asked her about the facilities -- do they have birthing stools, tubs, squatting bars, will I be allowed in the shower during labor, etc. Again, nope. No amount of research on my part is going to change these things. I am in the position of selecting between two birthing options, neither of which I'm comfortable with.

 

The truth is I will probably end up taking off the EFM (I'll do 15 min per hour unless there is a problem), I'll end up refusing to lay on my back to deliver, I'll be shouted at to lay down and to push by hospital staff (why do they do that???), my baby will end up with goop smeared in her eyes even though both dh and I are free of gonorrhea.

[Ginevra]

I had a CNM-attended birth planned for a freestanding birth center that went badly. My daughter died in labor due to placental abruption.

 

I do not place blame on the MWs; I don't feel that they were negligent. My daughter died in utero shortly after they had gotten a heartbeat by doppler, plus I had only been at the birth center for a few minutes. I do not feel that she would necessarily have been saved had I been planning a hospital birth.

 

However, I am no longer a supporter of out-of-hospital birth. In my opinion, the most common misconception in the midwife-supported birth community is that low risk = no risk. I did not even realize it was possible to have something go so horribly wrong when the pregnancy was fine, the mother was healthy and previous births had been without incident.

[Veritaserum]

While I do agree, a lot of this is solely dependent upon the provider you have delivering your child as well as hospital policy. The truth is that often times no amount of preparation or research on the patient's part will change the fact that the hospital demands IVs for all patients, demands EFM, demands progress of 1 cm per hour, etc.

 

Another thing to consider is that many patients are stuck with the provider that their insurance will cover, and that provider is not always a good fit. I'm dealing with that right now. Though homebirth is honestly not my preference we did considere it this time simply because we are so uncomfortable with our current provider and hospital.

 

I recently asked the midwife at my current practice about hospital policies regarding things like IVs, EFM, delivery positions, etc. She said there's not wiggle room. I asked her about the facilities -- do they have birthing stools, tubs, squatting bars, will I be allowed in the shower during labor, etc. Again, nope. No amount of research on my part is going to change these things. I am in the position of selecting between two birthing options, neither of which I'm comfortable with.

 

The truth is I will probably end up taking off the EFM (I'll do 15 min per hour unless there is a problem), I'll end up refusing to lay on my back to deliver, I'll be shouted at to lay down and to push by hospital staff (why do they do that???), my baby will end up with goop smeared in her eyes even though both dh and I are free of gonorrhea.

 

:iagree: with the bolded. I taught natural childbirth classes for eight years to hundreds of women. The ones who worked hard to find a respectful care provider and/or were confident enough to say no to unnecessary procedures had positive experiences inside of hospitals. The ones who went along with whatever was recommended to them, even if they didn't want what was offered, had not-so-great experiences. The ones whose stated wishes were ridiculed or denied were traumatized. Some were even verbally or emotionally abused by providers.

 

Of course it's possible to have a good hospital birth. But it takes a heckuva lot more effort if what you want varies at all from what the hospital typically offers. In many places it is impossible to get evidence-based care inside a hospital. That is why many women choose to give birth at home or in birth centers. They are more comfortable with the risks inherent to birth than they are with the risks of common and widely implemented obstetric practices.

 

It sure would be nice if hospitals adopted policies that actually improve the safety of birth instead of adding iatrogenic risks to the inherent natural risks of birth....

[C_l_e_0..Q_c]

Since you're asking for 'bad' stories, there's one that is making the news locally

 

http://www.montrealgazette.com/health/Birthing+centre+subject+three+investigations/5014845/story.html

 

First, the baby got born with complications.

Second, the midwives called 911 for transfer

Third, 911 dispatched the firefighters (also first responders in almost every case), which is not protocol.

Fourth, the firefighters were denied access to the baby, and did not take it well

Fifth, one firefighter threatened to break the door down to get to the baby

Sixth, the baby died still awaiting transfer

7th, the neonatal unit finally showed up.

 

A big big mess between all the first aid units not talking to each other properly.

 

Follow-up:

http://www.montrealgazette.com/health/Quebec+midwives+defend+their+actions/5027736/story.html

[OH_Homeschooler]

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.

 

Did she tell the hospital where the baby was ASAP? Was she trying to keep it a secret? You make it sound like the mother was being neglected because she had a homebirth. How would the hospital know that was the case unless she told them?

 

Don't forget that unfortunately, there are such things as dumpster babies. It seems unthinkable to a message board full of caring parents but there are in fact people who give birth then ditch their babies, leaving them to die.

 

So the mother was in a dire situation, but for all the hospital knew the baby was too. I don't understand why the mother would withhold the basic information that she had a homebirth, and that the baby was being cared for by the father. That doesn't make sense to me at all, especially if this smart woman felt like she didn't do anything wrong by exercising her right to give birth at home.

[Melissa in NC]

I keep hearing about 1/3 of all births end in c sections. In my case, my dd had her cord prolapsed and the doctor calmly and quickly responded to force a vaginal birth. She could as easily done an emergency c section. Not all doctors are c section happy. Just a different experience here.

[lvbnhome]

Was labor being induced?

Were the membranes being ruptured artificially?

 

I keep hearing about 1/3 of all births end in c sections. In my case, my dd had her cord prolapsed and the doctor calmly and quickly responded to force a vaginal birth. She could as easily done an emergency c section. Not all doctors are c section happy. Just a different experience here.

[Veritaserum]

Did she tell the hospital where the baby was ASAP? Was she trying to keep it a secret? You make it sound like the mother was being neglected because she had a homebirth. How would the hospital know that was the case unless she told them?

 

Don't forget that unfortunately, there are such things as dumpster babies. It seems unthinkable to a message board full of caring parents but there are in fact people who give birth then ditch their babies, leaving them to die.

 

So the mother was in a dire situation, but for all the hospital knew the baby was too. I don't understand why the mother would withhold the basic information that she had a homebirth, and that the baby was being cared for by the father. That doesn't make sense to me at all, especially if this smart woman felt like she didn't do anything wrong by exercising her right to give birth at home.

 

Home-born babies of moms who transfer postpartum can be subjected to mandatory separation and invasive testing. It's common practice to transfer mom solo and then have dad arrive later with the baby so that the baby doesn't get admitted unnecessarily. Home birth is legal in my state, but hospital workers are not always kind or reasonable when they receive a transfer.