Homebirth Risks? - Page 2

[Crunchy Frog]

Originally Posted by magentamomma

http://www.sciencebasedmedicine.org/...homebirth.html

These are just 2 that i found

Just understand that she has an agenda, and is well known to play around with numbers in order to reach her preferred conclusion regardless of what the actual evidence says.

[S.Elise]

Originally Posted by Eresh

I may catch some flack for this but I do think there are some situations where a mom or baby might die at a homebirth where they might have been saved at a hospital.

I think this is totally true. I may get some flack for this comment, but for me, if there was a hospital practicing evidence-based medicine and putting my wishes and best interest first over institutional, liability and profit concerns around here in the USA, I would go there instead of staying at home. That's why I did a "hospital" birth when living in London, England...I found a facility in a hospital that had none of the disadvantages we typically think of of hospital births, but also had emergency equipment (and pain meds if I wanted them) down the hall. That's the best of both worlds for me (I totally understand some people will always feel more comfy at home or just want to be there, and I support them with all my heart, I'm just not necessarily one of them). We should have both of these options readily available here in the US.

On the midwife training point, I think the main thing is that in countries like the UK and Netherlands (and every other developed country, I think, except maybe Canada), midwives are the primary caretakers of pregnant and birthing women, and they are fully part of the healthcare system, so their training is more standardized than it is in some US states. Here in NY, I understand we only have one kind of legal midwives, who are nurse-midwives, and I think their training is probably comparable to Euro midwives. Lay midwives that operate in other states I understand have a different background/training that I think differs more radically from European midwives. Which is not to say they are bad, but just different. But most of the anti-homebirth people seems to focus in on lay midwives, on the assumption they are the only people doing homebirths and thus homebirths are always attended by people who they feel are "less qualified" because they have this differing training. That argument seems to make no sense at all in my state --- all the HB midwives here I think could theoretically practice in a hospital if they wanted to.

[prancie]

I think the evidence is there to support the relative safety of home birth as compared to hospital birth. But people can tell me statistics all they want and it doesn't change the core issue for me. It is my right to choose to birth in my home even if it happened to be riskier. I am not about to let some government tell me where I can birth and with whom. I think that in a lot of ways western culture has thrown away basic concepts of personal freedom and chosen instead to fight battles on the field of science and statistics and to follow, like dogs, the advice of supposed experts of one's world view. Science and statistics have a place in decision making, but they should have only an extremely limited place in law-making.

[fruitfulmomma]

As for those 'negative links', all I can say is, Oh--HER. I thought, from your original post, that you must have stumbled into her bull hockey about hb.

That was my first thought... The only person I've ever heard quote those statistics is she who must not be named.

Frankly taken at its face value, I am not really sure I care if it is true or not. Sure if we are talking about about the difference being between 1 in 100 babies dying at home vs. 1 in 1000 dying at the hospital it would be problematic. But we are talking about 1 in 1000 vs. 3 in a 1000. Not a huge statistical difference imo. I highly suspect she purposely uses the phrase "three times" in order to hide the fact that she is not talking about a statistically significant difference.

but I do think there are some situations where a mom or baby might die at a homebirth where they might have been saved at a hospital.

I don't think anyone here would dispute you on this. There are clearly some women who need to birth at the hospital and who need the help of a skilled surgeon.

[Eresh]

Originally Posted by fruitfulmomma

I don't think anyone here would dispute you on this. There are clearly some women who need to birth at the hospital and who need the help of a skilled surgeon.

I meant to qualify that even among low-risk women that are candidates for home birth. While most complications can be seen coming and care can be transferred, there are real emergency, minutes count, cases where transferring is just not fast enough. The thing is, these cases are a very, very small subset of all births (at home or otherwise). The hospital scenario of the mom getting an infection from an epidural and dying or having all four limbs amputated to save her life is just as unlikely. In my mind it makes more sense to make my decision based on the likely scenarios of hospital interventions which, while not catastrophic, are still bad.

One of the things she-who-must-not-be-named maintains is that the Certified Professional Midwife (CPM) certification does not ensure adequate training. She cites as proof that some CPMs must take additional training in order to gain certification in Canada to practice there as midwives. As with most other things she says, there is a core of truth but it is largely misleading. The CPM certification does not require any classroom training. Instead you may attend a certain number of births with a preceptor and must pass the NARM evaluation. There is nothing in the CPM certification that requires a midwife to have the training to practice in a hospital environment because, guess what, CPMs never practice in hospitals. So a midwife with a CPM who wanted to certify in Canada would either have to have a nursing background already or take additional training since Canadian midwives also practice in hospitals.

As a side note, the CPM certification is unique from midwife certifications in Europe and Canada in that it allows direct entry midwives to certify without classroom training -- essentially through the apprenticeship model.

[*MamaJen*]

I've heard her referred to as "the Bill O'Reilly of the homebirthing world."