SmackDown: Should Women Have Home Births?

Tom, if you think a labour room is a sterile field, you are nuts!

Midwives carry THE EXACT SAME BASIC BIRTH TOOLS as the hospital, all nicely sterile, wrapped in the exact same green cloth as the packages at the hospital. However, since home births focus on only using interventions when they are medically indicated and are designed to prevent iatrogenic problems, using those tools is pretty darned rare.

C-section rates are so high because the vast majority of birthing women are given medical interventions as standard (pitocen, IV fluids, ABX, epidurals, continuous EFM, AROM...) that, combined with non-medically induced inductions (baby not ready to come out), impatience with the normal pace of labour, inefficient birth positions and a systematic unfamiliarity with physiologically normal birth means that 1 in every 3 women get wheeled into operating theatres for surgical deliveries.

ERGO: remove the use of pitocin, the use of continuous EFM, the IV fluids, AROM, epidurals and add in more flexible labour timetables, encouragement of labour movement, flexibility of birth position and you suddenly have safer, healthier births for moms and babies and less surgery.

No brainer. Healthy pregnancies have better outcomes when examining all factors - mortality AND morbidity - and when attended by a trained and licensed midwife of MD.

When you let surgeons oversee the birth processes of all birthing women, you will end up with more surgeries.

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How about it is no one's damn business where a woman decides to give birth? dear god, between this and breastfeeding, it's amazing maternity wards, PTA meetings and Mommy & Me classes aren't battlefields, complete with mustard gas and bloodshed.

How about women make the best choices for them when it comes to parenting and everyone else butts the hell out?

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Wow, I thought both articles were lamely written. Both seemed so terribly flawed. The guy was too sarcastic and the woman, a bit dramatic. A nurse who doesn't know how to deliver? Didn't happen at my hospital. The nurse made it very clear that she could do the job if the doctor didn't arrive on time.

Here's one thing to consider as well. What about the baby being too big for you to deliver? That can sometimes be difficult to know until its too late. That was the case with my first one. After the doctor intervened, he said that no amount of pushing would have ever gotten him out. Try getting through that at home. Also why pass up the glorious painkillers? Its easier to "enjoy the moment" when you're not suffocated by the pain. Just my thoughts, enjoy the home birth experience if that's what you want. Me? I want to be drugged ;)

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ALL the existing scientific evidence, as well as US national statistics and state statistics such as those from Colorado show that PLANNED homebirth with a homebirth midwife TRIPLES the rate of neonatal death.

Homebirth midwives (CPMs) are nothing like certified nurse midwives or the midwives in other first world countries. In fact, homebirth midwives have less education and less training than ANY midwives in the first world. ALL other midwives have university degrees and many have master's degrees. The CPM is nothing more than a post high school certificate. American homebirth midwives (CPMs) do not have enough education to be licensed in The Netherlands, the UK, Canada, Australia or any other industrialized nation.

For a glimpse of the harm they cause, read Wren's story on Hurt by Homebirth. Today is the first anniversary of his homebirth and death.

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Home births are dangerous! I don't care about anyone's birth plan! You never ever ever know what can go wrong (as I learned first hand) and it is best to be in the hospital when it does!

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I think it is a very individual choice, and depends on the circumstances. I don't think a homebirth is inherently dangerous and wrong, and I also don't think a hospital birth is unnatural etc. I had my first, and thus far only, child at a hospital, and it was a very enjoyable (as far as labor goes haha) experience. I wanted to attempt it without drugs, and I did. I was allowed to stroll around the halls with my husband and mom accompanying me, stopping to rub my back when contractions came, and just made it back to the room every half hour or so in order to monitor progress. I could use the birthing ball, or lay on the bed, whatever I wanted and I did all of these at different points. Overall, I wouldn't trade it at all!
Purely anecdotal evidence, but it seems to me that most of the epidurals, inductions, and c-sections came from that mother's choice. And that's not my place to decide. If you don't agree with your doctor's views (ie s/he wants to induce, etc.) then shop around for a doctor or midwife more compatible with your ideas. There are a great variety of medical professionals out there, and just like most everything else, there isn't a one-size-fits-all here!

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Amy, please tell me where you found those statistics. I have not found any studies that say that planned homebirth = tripled neonatal deaths.

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this is what drives me nuts on this subject, when something goes terribly wrong and the baby and the mothers' life is possibly at RISK then we rush to the hospital, why not give your child the best benefit and a good beginning and go to a certified birthing center or the best local hospital. Being a Mom means putting your baby ahead of yourself. Yeah! for those of you who had a home delivery without complications. Consider yourself blessed as it's not always the case.

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Why on earth did you choose this guy for a debate on this topic? It just makes a mockery of the whole issue. While I have not chosen a homebirth, I do believe it is a viable option for a lot of women. There are also some reasonable concerns about homebirthing.

But this?

This is just a not-ready-for-primetime stand-up routine.

There is no fact, no information, no argument.

And the c-section bit is downright ignorant. Tell me, why is the c-section rate in the United States triple what is considered ideal? Why is our maternal death rate so outrageously high compared to other developed nations?

About 5% of births really necessitate a c-section. To be conservative, a rate of about 11-15% saves more lives than it takes. So, why on earth do we have a c-section rate of over 32%? Is that really necessary?

And this outrageous rate has real deadly implications for both women and for babies.

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I recently had a relative, in her 20s, with a completely normal pregnancy, have a serious problem with the baby at birth and the baby had to be airlifted from her regular hospital to a children's hospital in the nearest major city. She was in a hospital, and her baby nearly died--had she been at home, what are the chances she would have been able to get the emergency services her baby needed in time to save her life? Sorry, I know women have been having babies forever, but when you have expert options in medical care, do you really want to take the risk with your child? Sorry, the inconvenience and "embarrassment" of having medical providers looking up your skirt is a small price to pay for safety. If the one baby in a thousand that needs help (and sometimes it's the mother who is gravely ill!) is yours, the statistics don't really matter. When I had my kids more than 25 years ago, I had healthy babies and healthy pregnancies but problems in labor and delivery--thankfully I had trained people to save my children!

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Actually, studies around the globe (including the US) have shown that home-birth with a qualified home-birth attendent (be it Dr. or Midwife) for a normal low-risk pregnancy have better outcomes overall for both mother and baby. These studies have also shown that hospital interventions that escalate to c-sections and repeat c-sections are more harmful to the mothers to the points of permanent damage and possible death. C-sections deaths related are highly under reported because they cause infections that are not usually found until after a mother goes home from the hospital and returns. These are rarely noted as birth related deaths even though they are.
This is an extremely loaded topic and deeply personal. I have had horrible hospital birth experiences, where the Dr. acted like I was an idiot and was too stupid to make any decisions for myself. These types of people need to be removed from birth altogether, there is no place for a self-righteous Dr. playing God. I have dealt with the escalation of interventions and know how easily my birth(s) could have turned into unnecessary c-sections. I would recommend the book Pushed, Jennifer Block. She does a very good job of showing both sides of this issue and talks with Doctors, midwives, and nurses. She cites all her sources (studies, research) and gives what I believe to be a very clear assessment.

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For one, I really don't think a man is the best option to argue these points. Yes, fathers can be/and are active participants of the birthing experience, but ultimately it is the woman who has the most invested in the process. It's not only about the baby.

To each their own. It's none of my business or should it be the business of anyone else where/when/ and how a woman decides to give birth to her child.

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I get sick and tired of how the hospital OB SAVED all of these women's and babies lives. If they didn't have all of these stupid medical interventions, drugs and procedures to alter labor then maybe they wouldn't need to be SAVED! Don't go putting one sad story about a homebirth gone wrong! How rude! Did you read about the baby in Canada last year who died because of the hospitals procedures used during his birth? Would I use that against you if you chose a hospital birth...I hope not what a jerk I would be! And I have used a CNM for a homebirth, and frankly I would never ever do that again. For all of her medical training she has sadly lost sight of her female intuition.
And this mans commentary being put up against a homebirth article must have been for fun. Because we all know the illusion of hospital sterility is a breading ground for disease. You're giving birth and two floors up a man is hacking up phlegm as he fights MRSA! That sounds fun! I am so glad my hospital is right down the road so if I have an emergency, and I have, then I can go there. But I would never go there in-case of emergency! Absurd! This arguement is so old to me. I am planning my 5th homebirth. I just can't stand when disillusioned people give credit to their OB for saving their life without acknowledging that that same OB is also responsible for causing the life threatening emergency!

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you konw it,just not miss it

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