Originally Posted by Jane93
I understand that emergency "crash" c-sections can be performed in as little as 8 minutes.
There frequently IS a difference in being OOH in terms of timing, and people choosing homebirth should choose it with that understanding rather than trying to claim "its the same timing".
I absolutely agree with this, but always come back to the fact that, for me, assuming I am as "low-risk" as almost every woman in my family has been, there would be greater risks in the hospital to start with. Not necessarily huge risks, but greater ones. And I'm just talking about physical risks.
I think sometimes when a homebirthing woman says "the mortality risk is equal (the morbidity risk is lower) at home*" people respond as if the woman said "as long as nothing goes wrong" or "as long as nothing goes significantly wrong." So people respond "well, yes, but it's best to be in the hospital 'just in case.'"
And it's like... Nooooo...
You aren't listening.
And I mean that. I'm not even talking about discussing and breaking down various studies and whatnot. I'm not talking about "I disagree that it's as safe or safer, because of blah." That's fine. We can argue that. I'm saying it's illogical and kind of condescending/paternalistic at its heart to respond that "yes, as long as everything goes fine, it's just as safe, but not if it doesn't."
Pretty sure it's just an effect of avoiding cognitive dissonance, etc. but I'm just saying. If a person asserts that A is as good as B, overall, in general, statistically speaking, period, she should not be presumed to "mean" that A = B in every instance (and thus need "correcting" by the listener). Those are two different kinds of assertions.
I don't know... just musing on this, because it comes up a lot. And I mean even when I say it very explicitly, with disclaimers, "outcomes over populations are equivalent blah blah statistics..." I get, "well, USUALLY you're right, but blah blah in some cases blah and you have to consider ALL possible outcomes, not just the more common ones yadda." It's like... Did you hear me? I understand those serious cases in which even a low-risk woman would be or have been better off at the hospital, but what I'm saying is that A) there are just as many cases where the opposite is true and B) the overall incidence of either is very low. Which is another aspect of this... If you are talking about a cord prolapse with no warning, no AROM, etc., okay, let's talk about that-- you're better off at the hospital. But if your mental inventory of Things That Can Go Wrong includes things like C/S for FTP, CPD, episiotomies to for "sticky" shoulders, Pitocin given because of slow or "slow" progress... Not to mention things of varying urgency that happen overwhelmingly to higher-risk women, or things that very directly happen because of hospital intervention-- say, a life-threatening allergic reaction to an epidural medication that absolutely happens suddenly and needs a swift response... Those are all things that could "go wrong"-- and if you think the hospital is best for all of those things, then you're REALLY treating the speaker like she's naive as h3ll. Because to you, she's saying "Homebirth is exactly as safe as hospital birth, always" and you're thinking "Sure, it's as safe as hospital birth unless you have a complication-- which is 50% of the time." (Or at least 25%. When the true incidence of Things That Go Very Wrong, Very Suddenly in Low-Risk Women and Are Not Caused by Routine Hospital Intervention is far, FAR lower.)
I know I'm not being super-articulate here, but it's a really glaring disconnect that has little to do with actually arguing the safety of homebirth, and it fascinates me.
It would be like saying... "Studies have shown that driving a Honda Accord is just as safe, on average/statistically, as driving a Toyota. So if you're concerned with safety, either is an equivalently good choice."
And someone responds, "Well, yeah, they're both equal... as long as you don't get a defective Accord with bad brakes! Better to get a Camry."
How would that be a logical response, KWIM?
*With all the usual caveats, particularly having a low-risk PG and a skilled care provider, being <15-30 min from a hospital, etc.