Homebirth Debating - Page 3

[Joezmom]

Originally Posted by AniellasMommy

I can't see how....maternal and infant mortality occur at births (hospital or home) perinatal includes ALL deaths up until that point, even ones which aren't affected by the place one chooses to birth.

Yes, perinatal mortality can include stillbirths, death during labor and immediately following labor, and up to 7 days after birth according to Wikipedia. Infant mortality measures death up to 1 year, which includes death from dehydration , diarrhea, pneumonia, congenital malformation, SIDS, infanticide, abuse, abandonment and neglect. As awful as many of the causes of a higher infant mortality rate may be for the U.S., (it still seems to me) it is NOT the appropriate measure to compare the relative safety of home birth VS hospital birth. The unfortunate death of a baby who dies of pneumonia at 9 months or abuse at 6 months is unlikely to have any relation to her place of birth. The death of a baby during labor or immediately following
may very well be linked to her place of birth.

I'm not suggesting that home is better than hospital or vice versa, only that the statistics recited in an "arguement" make a difference, especially when comparing to another country, which may have a vastly different healthcare system, educational requirements for providers, and a less diverse population.

[ursusarctos]

Originally Posted by RachaelsMommy

Part of the problem is that everybody knows somebody who had some kind of complication during labor. They just don't realize that these complications are caused by the medical staff trying to control labor. So they think giving birth is dangerous and the doctor "saved" them.

Yes!

[Full Heart]

Originally Posted by Joezmom

Yes, perinatal mortality can include stillbirths, death during labor and immediately following labor, and up to 7 days after birth according to Wikipedia. Infant mortality measures death up to 1 year, which includes death from dehydration , diarrhea, pneumonia, congenital malformation, SIDS, infanticide, abuse, abandonment and neglect. As awful as many of the causes of a higher infant mortality rate may be for the U.S., (it still seems to me) it is NOT the appropriate measure to compare the relative safety of home birth VS hospital birth. The unfortunate death of a baby who dies of pneumonia at 9 months or abuse at 6 months is unlikely to have any relation to her place of birth. The death of a baby during labor or immediately following
may very well be linked to her place of birth.

I'm not suggesting that home is better than hospital or vice versa, only that the statistics recited in an "arguement" make a difference, especially when comparing to another country, which may have a vastly different healthcare system, educational requirements for providers, and a less diverse population.

Perinatal death rate includes all births from 22 weeks on. Thats not reliable in any fashion for comparing birth locations. Neonatal mortality (deaths in the first 4 weeks of life) is still better in Netherlands than in the US. Actually according to Unicef lots of countries have better neonatal mortality rates than the US.

Its that vastly different healthcare system that we are pointing to. Yes, they have a better outcome because they have better care - IE mws instead of drs. acceptance of homebirth. Those educational requirements that teach drs in the US that homebirth is unsafe is what is contributing to our higher neonatal mortality rate.

[ursusarctos]

Finland, where I live, has one of the lowest infant mortality rates in the world (lower than Holland's). Almost all births are handled by nurse-midwives, but at the same time it is almost unheard of to give birth outside of the hospital (less than 1%) and women who even give birth by accident at home regularly get in the news. Also, there is an extremely high rate of epidural use and a rather high rate of episiotomy. So intervention-free homebirths have not really been a contributor to the low death rate for babies and mothers. I would attribute it more to the comprehensive, cheap prenatal care and a well-nourished, mostly healthy general population. Also, they have phased out nurseries in most birth centers/hospitals nowadays so babies are usually never removed from the bedside of the mother (where they are still laying in a little plastic box, however and breastfeeding at least for a few months is the norm. It's like a compromise between evidence-based midwifery care and the paranoid, unscientific mainstream American OB care. Finns are very sensible, but at the same time tend to go overboard on preventing any conceivable risk and don't tend to question the establishment very much.
Unfortunately, Finland is moving towards a more American style of care all the time. There is currently one birthing center in the whole country, and it is located within a women's hospital (others were closed in the past decade due to "lack of funding"). Recently a minister in the parliament was calling for all births to be located within large hospitals with a full staff of specialists on hand, "just in case". It would be interesting to see what would happen to the mortality rates (would they go up?) if this happened. I bet that at least the C-section rate would shoot up from the current 15%.

[Emmeline II]

Originally Posted by AniellasMommy

But, how do you stay calm when they say really insulting things like "you must be crazy" and "you are going to kill your baby"? I have a hard time not taking that really personally.

"And you know this because of all the studies you have read on the safety of planned home birth vs planned hospital birth of uncomplicated pregnancies? Because the statistics favor the safety of planned home birth."

[rockportmidwife]

Originally Posted by ursusarctos

They just sort of give you this glazed look and say something like "but what if the baby wasn't breathing?" :

I have a friend that got so tired of comments like this that she told someone, " You know, you are right. My midwife would just stand there and let the baby die." She did end up telling the truth, but she gets very sarcastic when she is frustrated.

[barefootpoetry]

Originally Posted by ursusarctos

So intervention-free homebirths have not really been a contributor to the low death rate for babies and mothers. I would attribute it more to the comprehensive, cheap prenatal care and a well-nourished, mostly healthy general population.

Ya know, you're probably right. Americans in general are in poor health, eat junk, and get really crappy prenatal care AS WELL as practically nonexistent postpartum care. This might be a factor in our high infant mortality.

Originally Posted by rockportmidwife

I have a friend that got so tired of comments like this that she told someone, " You know, you are right. My midwife would just stand there and let the baby die." She did end up telling the truth, but she gets very sarcastic when she is frustrated.

That's a good one!

[cileag]

I'm a pretty big fan of bring up the World Health Organization, which states that
"So where then should a woman give birth? It is safe to say that a woman should give birth in a place she feels is safe, and at the most peripheral level at which appropriate care is feasible and safe (FIGO 1992). For a low-risk pregnant woman this can be at home, at a small maternity clinic or birth centre in town or perhaps at the maternity unit of a larger hospital.
However, it must be a place where all the attention and care are focused on her needs and safety, as close to home and her own culture as possible. If birth does take place at home or in a small peripheral birth centre, contingency plans for access to a properly-staffed referral centre should form part of the antenatal preparations. "

From Care in Normal Birth: http://www.who.int/making_pregnancy_.../en/index.html

But that's kind of long--so I usually just smile and say, "I'm planning on doing what I think is best for me and my family, and we believe it's no more risky than hospital birth."

[ursusarctos]

Originally Posted by rockportmidwife

I have a friend that got so tired of comments like this that she told someone, " You know, you are right. My midwife would just stand there and let the baby die." She did end up telling the truth, but she gets very sarcastic when she is frustrated.

:

Originally Posted by cileag

I'm a pretty big fan of bring up the World Health Organization, which states that
"So where then should a woman give birth? It is safe to say that a woman should give birth in a place she feels is safe, and at the most peripheral level at which appropriate care is feasible and safe (FIGO 1992). For a low-risk pregnant woman this can be at home, at a small maternity clinic or birth centre in town or perhaps at the maternity unit of a larger hospital.
However, it must be a place where all the attention and care are focused on her needs and safety, as close to home and her own culture as possible. If birth does take place at home or in a small peripheral birth centre, contingency plans for access to a properly-staffed referral centre should form part of the antenatal preparations. "

From Care in Normal Birth: http://www.who.int/making_pregnancy_.../en/index.html

But that's kind of long--so I usually just smile and say, "I'm planning on doing what I think is best for me and my family, and we believe it's no more risky than hospital birth."

Exactly. This is partly why I don't try to convince everyone that homebirth is the safest option for everyone - not only is it impossible, it's probably not true because everyone is a specific individual with their own psychological and physical needs. If only the hospital-birth nazis would understand this too

[Kim919]

Tell them you'll discuss it after they have had a baby both at home and at a hospital.

[Comtessa]

My sister-in-law said to me from her hospital bed yesterday, clutching her newborn, "I know you think a home birth is a good idea, but you haven't even thought of all the things that can go wrong in labor! I never would have dreamed all those horrible things would have happened to me! If I hadn't been in the hospital, I would have DIED!"

She was, of course, only a few hours recovered from a 36-hour labor, an incredibly severe tear, and a lot of obstetrical drugs, so I bit my tongue and smiled at her, telling her I was proud of how well she did.

Then I went home and screamed.

Now my family wants to know how I could possibly consider a home birth, considering how dangerous my sister-in-law's birth ended up being. She was a high-risk pregnancy and a high-risk induced labor who really needed to be in the hospital for her birth. I'm a low-risk pregnancy and fully intend on keeping it that way. Why anyone would dare to compare the two experiences is beyond me - especially when the conclusion is, "you just must not know what you're doing."

Excuse me while I go throw something!!!!!

[ursusarctos]

Originally Posted by Comtessa

My sister-in-law said to me from her hospital bed yesterday, clutching her newborn, "I know you think a home birth is a good idea, but you haven't even thought of all the things that can go wrong in labor! I never would have dreamed all those horrible things would have happened to me! If I hadn't been in the hospital, I would have DIED!"

She was, of course, only a few hours recovered from a 36-hour labor, an incredibly severe tear, and a lot of obstetrical drugs, so I bit my tongue and smiled at her, telling her I was proud of how well she did.

Then I went home and screamed.

Now my family wants to know how I could possibly consider a home birth, considering how dangerous my sister-in-law's birth ended up being. She was a high-risk pregnancy and a high-risk induced labor who really needed to be in the hospital for her birth. I'm a low-risk pregnancy and fully intend on keeping it that way. Why anyone would dare to compare the two experiences is beyond me - especially when the conclusion is, "you just must not know what you're doing."

Excuse me while I go throw something!!!!!

Oh dear, I so know what you mean! I recently had a similar frustrating experience with a friend who had a very low risk pregnancy/labor but thanks to the "midwife" (at the hospital, and I use "midwife" loosely here) ended up with an epidural, pitocin, and episiotomy, and then proceeded to tell me that "it really wasn't all that bad in the hospital" (referring back to my telling her in detail why I want a homebirth) and keeps asking me "are you really sure you want to give birth at home?" as if she just can't believe how "brave" I must be to take such a "risk". Sigh...