Considering Homebirth? Think Hard.... - Page 2

[girlfromthefuture]

I just need to say a few more things.

First and foremost - I apologize if you felt offended by any of my comments (on either of your threads). I honestly was being respectful, and just engaging you in a conversation based on your post.

Our daughter, Eme, was VBAC'ed at home, at 42 weeks, safely and beautifully. And she was unexpectdly stillborn at birth. The medical examiner, hospital docs, paramedics, and our three skilled midwives all have concluded the outcome would have been the same - no matter where she was born.

NEVER once did we consider suing - ANYONE. Death, as difficult as it is to accept, is a natural part of life. As are birth defects, mistakes, malpractice, etc. Insurance money doesn't change any situation.

I am still a supporter of homebirth, and am currently planning another one. Home was the safest place for me. I spent my pregnancy switching practices - nurse midwives don't function under their own guidelines (in most states)- they have doctors dictating what they can and can't do, so while it can make a hospital birth more satisfying for some women, it also can be like having a birth supported by an OB/GYN. I did alot of research and soul-searching. I wasn't settled on a homebirth until about 31 weeks.

My first child was born via an emergency c-section (caused by the interventions made, which I take full responsibility for agreeing to). The drug used to induce me is not FDA approved for labor. And it's been shown to create a number of problems, most seriously fetal and maternal deaths. The hospital I birthed at no longer uses this drug. Should I sue them for malpractice? They even cut my son's head, while performing the surgery - should I sue them? I don't think so. I put myself into the situation. I wasn't as informed as I should have been. I have to take responsibility for what happened.

Liability insurance is at an all-time high. In CT rates are from 350,000 upwards/year. So you think this creates a situation where docs/CNM's are assisting with births out of fear for the outcome? You bet it does. There is much data and strong information for why America's C-section rate is 26.1%, and the news is alarming.

I am so grateful for having had the choice where to birth my daughter. I was not allowed to VBAC at some hospitals and birthing centers - due to liability. What about the liablility for me having another major surgery unnecessarily? It just doesn't make sense.

I think many women just go to the first OB they find. They may not like some things about the situation, but are willing to settle - and do what they're told, because they want a good outcome, and think they don't know best. And in our culture we're programmed to think someone with letters trailing their name knows more than we do about a natural process. Everything during the course of most pregnancies with a traditional medical practice does it's best to undermine our natural mothering/parenting instincts.

I know that we're grieving and healing in the way we are because our daughter was born at home, surrounded by so much love. My concern about your original post, is that by not broadening our perspectives and allowing people to make their own decisions, we take CHOICE away, and become a police state. Homebirth is illegal in many states, and threatened in others. In most states it's alegal, which is still dangerous to women because there is no recognition or guidelines for practitioners whatsoever.

There is so much more I could write. I think we can agree to want to birth our children differently. Many could try and persuade you to birth at home with scare tactics, and that's what your original post felt like to me. A scare tactic. No good decision can be made from a place of fear.

I posted on another support board looking for support - the negativity I received was overwhelming. I would love to see this discussion remain supportive - without you reading comments with a critical eye. I think most of us here just want to be heard with an open heart and mind.

[Rainbow]

My question:

Originally Posted by Rainbow

Are you just on a crusade against homebirth or here as an actual member of MDC?

was sincere. There are anti-homebirth trolls who are not good members of the community. It as, imo, a fair question.

There is risk in everything. Is there more risk in flying or in car driving? Well, car driving actually. However many will continue to make the choice to drive instead of fly for various reasons- money, environment, comfort, anything. You see, you can't live in fear of that small "what if" you have to use your reasoning ability and make the best decision with the info you have to work with.

My husband has worked the stats with a bias towards hospital births and yet he routinely comes up with stats in favor of homebirth. Still he has not been able to find comfort in the idea.

the stats are limited, but so far they favor homebirth if you are no high risk for some reason or another. Even if they didn't- there are many other factors to consider. Sometimes the choice isn't based purely on risk and stats.

I can assure you though that I've never met a woman who went against the grain and gave up the idea of a medical based birth without researching and uderstanding.

It seems to me that your problem might be more in how your wife has been treated by natural birth advocates. I get that and I don't condone "you'll do better next time" comments. The most important thing is a healthy baby- but birth really does play a much larger role. psycologically it can impact so much! Many women whose birth proceeds unlike she planned suffer depression and have bonding issues. There can sometimes be a great struggle internally- and such rude comments only increase that struggle.

I think advice to really educate yourself is a good one, but the idea that with education would come the dedication to hospital birth is a bit biased imo. That may be what *you* concluded- but many will conclude otherwise, and it doesn't mean they aren't equally informed.

[TurboClaudia]

Originally Posted by annakiss

The day I start making decisions based on liability concerns and not on my family's best interest is the day I have stopped being human. Living itself is a risk. That doesnt mean I choose not to have children simply because it may turn out bad for us. Don't come on this board and tell women the risks. All you have to do is read the the other boards to know we are very well aware of them.

what she said.

and i did think hard about birthing at home versus birthing at the hospital. i read and read and educated myself and still thought and felt that a birth at home was the best way for us to bring our baby into the world. i labored for 36 hours, and might have ended up with a birth via cesarean if i had been in a hospital. i know we made the right choice.

and our insurance has so far paid for approximately 60% of the midwives' fees and we are still waiting for the rest to be processed.

thanks for your thoughts, but i think we will have to agree to disagree on some fundamentals of what we consider when we make choices about our health.

warmly,
claudia

[AmyB]

Originally Posted by guvly

Any birth that results in a healthy and happy mother and child is a successful birth in our shared opinion.Guvly

The best argument FOR homebirth is contained in this sentance that you wrote yourself.

I just read "Ina May's Guide to Childbirth". She says that 95% of births with a well trained midwife result in no injury to mother or child. At the hospital over 50% of mother/child pairs end up injured. That means that at least 45/100 women who birth in a hospital end up injured with NO benefit.

If hospitals could equal the safety record of midwives then your argument might hold some weight, but just because the injuries aren't usuall fatal doesn't make them trivial. Obviously, homebirth with transport for emergencies is the best of all possible options.

I'm curious why you believe insurance wouldn't cover hospital costs in case a mother was transported? My insurance would certainly cover emergency room treatment. Or are you thinking that I would be able sue the doctor for malpractice and get big bucks if something went wrong?

Also, my homebirth MW charges $1,600 for a complete deluxe birth package. When I gave birth at the hospital the bills came to more than $20,000 (and nothing even went disasterously wrong, except that both baby and I were injured by hospital procedures). Since then I have realized that overtreatment (probably to cover their butts from the possibilty that I'll sue if something goes wrong) is a large reason for out-of-control health care costs in the U.S.

Your model of birth is neither safer nor cheaper and it is an example of one major reason why health care is such a crisis in the U.S. right now.

OK, I've thought about it and my conclusion is that your arguments just don't make much sense.

--AmyB

[pamamidwife]

Guvly, with all due respect, you came to the wrong place to post this.

You've made an erroneous assumption that the women here are not informed. That you need to come in and "save" them from making a mistake.

I'm sorry that your wife did not receive the support she deserved after her births. In my eyes, cesarean births need more physical and emotional recovery and support - and your wife deserved such support and warmth.

However, because of some interactions with people who are pro-homebirth and not supportive of your wife does not mean that you have the right to assume or make judgements based on the same ignorance that was bestowed upon you.

The women DO think hard. They research, they are informed and they are the minority of women in America that take responsibility for their births.

You know, and your partner knows, how it hurts to be judged and made assumptions about. Think before you do it to others.

I find it interesting that the first posts that you begin here at MDC after registering are some like these. I urge you to stick around and get to know these women before making such broad and uninformed assumptions. You may learn something in the process - I know I have.

I won't get into countering your "facts", because, frankly, they are wrong. You've once again made broad assumptions without doing any research and your "facts" are a result of your feelings towards the pro-homebirth people. If you are interested in actually having a conversation about the safety of homebirth, the incidence of Cerebral Palsy in children before the actual birth, or the insurance portion of homebirth coverage, I'm sure you'd get more of a willing audience.

Care providers can be sued no matter if they carry malpractice insurance or not. There are civil lawsuits that can be brought forth to cover medical expenses. However, many homebirth clients have full informed disclosure about birth, proceudres, interventions and testing than hospital birth couples. They typically take more responsibility for their births and are full decision-makers in the process, which leaves them feeling more empowered. I believe there is no guarantee of not being sued, but a healthy birth with fewer interventions and drugs results in fewer serious health concerns for a normal mother and child.

[Telepathy]

Originally Posted by guvly

Blue-

Well- I'll give it one more go since Blue's response was so nice.

If you read my posts, you'll see that safety isn't particularly my issue- my concern is negligence liability, which happens everywhere, whether in homebirth or in hospitals.

I also said that if in our state we could have had an insured homebirth, we might have considered homebirth. Given that we had an advocate midwife in the hospital, we didn't need to. I still stand by my original assessment- regardless of the comparative risk between home and hospital birth, even if home birth IS safer, it's not prudent to have a home birth without negligence insurance.

Suffice it to say that I know of families that have been financially wiped out and struggle to find appropriate health care for their children because their midwives weren't insured and a defect occurred that might have been avoidable. I wouldn't wish that on anyone.

It is all about probabilities. In my opinion, a LOW RISK pregnancy has a higher probability of having something "go wrong" at the hospital than at home. I would rather forgo the insurance if it means that there is a much better chance that I won't need it at all. It doesn't mean much to me to have negligence insurance available to me at the expense of having a higher chance of actually needing this negligence insurance.

I know where you are coming from. I am also a man and have been aducating myself about homebirths, etc. and I had the same concerns that you do. In the end, I feel that in our case, the unassisted homebirth that we are planning is the best way to have our baby be born.

[lavendermama]

It is my understanding that there is a board of doctors that work for the insurance companies and decide what will be covered and what will not. Most doctors are against homebirth and their decisions prove it. The problem is that their motives are led by money, not the health of the mother.
I have had a successful vaginal birth, c-section because of breech, a successful VBAC last summer. I am now pregnant again and will be having my baby at home. Why? Well, besides the fact that I have always wanted a homebirth, the hospitals in my area are no longer providing VBAC's. Why? Well, certainly not because the statistics have changed on the safety of VBAC's. No, it is politics. So, I am supposed to trust these politically driven doctors with my health? No thanks-I will be at home with a trusted midwife who puts MY concerns first.

You did indeed post this in the wrong community.

[jessitron]

Ony, great post! Thanks for contributing.

[lorijds]

Originally Posted by guvly

Consider also that insurance companies don't insure home birth for a reason. Insurance companies care about one thing- Money. If home births were cheaper, they'd insure them in a minute. But in the end, it's less expensive for insurance companies to have babies in the hospital because it's safer.

Hey there, I am a nurse at an independent birthing center. I'd like to address this aspect.

It is not true that if homebirth were safer, insurance companies would pay for it. There are lots of cheaper, less invasive means of care that insurance companies won't pay for. In-home care, for example, for most long term care patients would be alot cheaper; but it is difficult to regulate, and insurance companies like things that are safe and familiar.

Another personal case in point--we are a clinic, similar to a doctor's office. We draw our own labs, then send them to the hospital, much like most doctor's offices do. For something like a fasting blood sugar, we can do that with a finger stick and a glucometer, and read it right in the office. We bill something like $5 for this. But because we are not a state certified lab (and to be a state certified lab you have to process the labwork on site with certain equipment and have a microbiologist/lab director full time), some insurance companies will not pay for this on-site glucose check. Instead they pay $35 for me to draw a venous sample and send it to the hospital lab to be measured. Exact same results, but one costs $30 more. This is one of many, many examples that I see on a daily basis. Another example is some insurance companies not covering VBACs. It takes roughly 2000 repeat c-sections to prevent a death from a uterine rupture during a VBAC. C-sections cost 3000-10000 dollars more than a vaginal birth. They aren't saving money, and a routine repeat section is not safer. It is more easy to control, however, so it is covered.

As a medical professional who attends out of hospital births, I take issue with your unsubstantiated claims that hospital births are safer than home birth. You can check out our statistics at www dot topekabirthcenter dot com. I challenge you to find ANY hospital with such great statistics. I'll bet you dinner than you can't find anything close to that in a hospital, anywhere, *even if you control for high risk moms and only measure the outcomes of low risk moms*.

I *am* sorry that your wife has had people comment negatively about her birth experience. That is crummy and insensitive. A hospital birth can be a wonderful, empowering experience. With a c-section, most people assume that something did indeed "go wrong," and luckily there is this wonderful surgery that can indeed save the life and health of baby or mom when something is going wrong. This might have been the motivation for at least some well meaning but completely insensitive comments.

Blueviolet and many of the others have said most else that I would want to say, and probably more eloquently than I could have. So I will leave it at that. Thanks for popping in, though. I hope you and your wife can come to peace with her births.

Lori

[pamamidwife]

Originally Posted by guvly

Some posted a bit earlier asking if I was a legitimate poster. Of course, there's no way to prove that, so you'll have to take the comments for what they are worth.

I was hoping to have a legitimate conversation about the issue, but after reading some of the reply posts, I don't think I'm willing to wade through them for legitimate response. My posting was respectful and moderate, but a large portion of the replies, such as the following:

"I wonder if your wife ever educated herself about homebirth, maybe she didn't consider it out of fear from a lack of support from her partner? An educated person, educates themselves about all the options."

...reflect the same attitude towards opinions that are different from one's own that I mentioned in my original post. My wife is not an idiot, nor am I, and just because I disagree with homebirth (an opinion my wife shares) doesn't mean I'm a non supportive partner.

I thought I could provide some information that people would find helpful, perhaps an alternative opinion. I've done that, and will let the flaming continue without further reply. But I will include a final caution to pending parents that if for whatever reason you don't have a birth like hardline homebirth advocates dictate, expect a large number of them to cast aspersions on your character as they have in this thread.

If you wanted to have a discussion about this, you would have worded your initial post differently. Instead, you came in with this "warning" like a father telling his child that he knows what is best for him/her.

I also think that part of the response comes from your obvious judgement of "hardline homebirth advocates". Instead of knowing who we are, and knowing how we operate and what we support, you make judgements.

Judgemental attitudes, as you know from personal experience, does not say "hey, I'm a friendly person - let's discuss!". C'mon.

[guvly]

My apologies- I didn't realize I had started 2 threads with my initial post. Sorry for that.

[weesej]

: : : : : : :

Ignorance is bliss- I'm glad this guy knows it all

[gottaknit]

1) My insurance pays the same (80%) whether I have a hospital birth or a homebirth. Guess they're just more enlightened out here in Oregon...

2) If labor gets "long and complicated", then you get in the car and drive to the hospital if you want. What's the big deal?

[georgia]

I have had two different, very large insurance companies cover both my homebirths. The cost-savings for my dh's company (self-insured) was enormous. I would gently recommend to any woman who is interested in a safe birth THINK HARD about giving birth in a hospital and do her homework about her birthing options.

Planned homebirth has been scientifically shown, for decades, to be as safe, if not safer than hospital birth, and several studies show that for multiparous women, the mother and baby are SAFER at home than in the hospital. No study has ever shown that planned homebirth with a trained attendant who took proper precautions increased the incidence of poor outcomes among low-risk women at home, compared with low-risk women in the hospital.

In Obstetric Gynecology 1998 Sep;92(3):461-470, Murphy PA, Fullerton J, the conclusion was reached that “Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary.”

The cost-savings of planned homebirth are considerable. According to Anderson RE. Anderson DA. Dept. of Economics, Centre College, Danville, KY 40422, USA, homebirth is cost-effective. As published in the Journal of Nurse-Midwifery. 44(1):30-5, 1999 Jan-Feb.:

“As health care costs increase every year, informed birthing decisions cannot be made without information on costs, success rates, and any necessary tradeoffs between the two. This article provides the relevant information for hospital, home, and birth center births. The average uncomplicated vaginal birth costs 68% less in a home than in a hospital, and births initiated in the home offer a lower combined rate of intrapartum and neonatal mortality and a lower incidence of cesarean delivery.”

According to the research, planned homebirths reduce the amount of expensive and potentially iatrogenic labor/delivery interventions such as inducement, augmentation, unnecessary IVs, continuous internal fetal monitoring, epidural anesthesia, narcotic analgesia, forceps delivery, vacuum extraction and most expensive of all, Cesarean section. According to the Public Citizen’s Health Research Group (Wolf & Gabay, 1994), unnecessary Cesarean sections cost society more than $1.3 billion dollars a year. The national C-section average is hovering just over a quarter of all births in the United States.

According to Social Science & Medicine, 37(10)1993 Nov. Sakala C., Health Policy Institute, Boston University, MA, midwifery care and out-of-hospital birth settings reduce unnecessary cesarean section births.

In studies using matched or adjusted cohorts, U.S. women beginning labor with midwives and/or in out-of-hospital settings have attained cesarean section rates that are considerably lower than similar women using prevailing forms of care--physicians in hospitals. This cesarean reduction involved no compromise in mortality and morbidity outcome measures.

[Victorian]

I think that you really need to do some more research and think hard about the FACTS and not your own experience. Here are some great places to start: the Scientification of Love by Dr. Odent, Obstetrical Myths vs. Research Realities by Goer and finally, The Impact of Birthing Practices on Breastfeeding. You see, I have studied nothing but birth and breastfeeding for 6 years.

Let me just point out a few facts for you...first of all, homebirthing women, on average, tend to be well educated, middle/upper class women. WELL EDUCATED.

The UN does not see a need for a c-section rate higher than 7-10%. Figuring that the current c-section rate is the US is about 25%, statisically, your wife's c-section might not have been necessary. Every birth in the hospital is full of interventions that cause c-sections. Considering that my midwives c-section rate was less than 5%, I feel that I must have been in very good hands. If we are not allowed to ever question a c-section, how can we make the needed changes to improve the system. I am sorry for both of your pain over the birth. Maybe the Birthing From Within birth processing class would help.

I have had both a birth in the hospital with a CNM and a homebirth with one of those uneducated, dirty, backwater midwives. I can assure you that the care that I got in the hospital does not even come close to the care I received from the homebirth midwife. Plus, in addition to care I got love, support and all I could eat during labor. My hospital birth did not go the way I wanted either, and instead of blaming others, I did some searching into my heart and know that the blame is for me and the CNM to bare together.

As to your basic point, my midwives did not have any insurance. If something had happened, I would not have sued them anyway. I completely trusted them to do right by me, and if something went wrong, I would know that it was meant to be. Birthing in a hospital, I would have a higher chance of damage being caused. My midwives carried "heroic" medicine such as pitocin for hemmorage, they have oxygen with them, they know what to do in emergency situations and if necessary, they can transport to the nearest hospital. I refuse to live my life in a bubble on the off chance (in this case teeny-tiny chance) that something might happen.

I will leave you and your offensive post here and go co-sleep with my homebirthed, intact, non-vaccinated, breastfeeding one year old (just to give you more ideas on things to post negatively about).

Victorian

[3 little birds]

Ironically, in my area only 5 OB's currently have malpractice insurance, and the ones that do are insured by the state. The OB's claim that the insurance is too expensive and they refer all "high-risk" to the state docs.

I handed responsibility for the birth of my twins over to my OB's. That is my fault. I had an unnecessary c-section and the OB's LIED on my records to protect themselves. I didn't find out about the lying until I read my records 2 years later, preparing for my home VBAC with a licensed midwife. I tried to get a VBAC at a hospital, but the interventions, plus the "rule" that I could not go past 38 wks, led me to homebirth.

I chose a homebirth because, after mountains of research, I believe it to be safer than hospital birth. I also realized that I needed to take responsibility for the birth, instead of handing responsibility over to a caregiver and then suing when things don't go my way (unless there was intentional harm done). I think also, that many people believe that homebirthers stay at home, even when something goes wrong. This is inaccurate. When things aren't going as they should, transport is available and utilized. Hospitals are great for true emergencies and I wouldn't hesitate to go to one if necessary.

My insurance did pay for my homebirth. We have another one planned for next year.

It is unfortunate that insensitive comments were made to your wife. I am sorry that she suffered for it.

[Greaseball]

Suffice it to say that I know of families that have been financially wiped out and struggle to find appropriate health care for their children because their midwives weren't insured and a defect occurred that might have been avoidable. I wouldn't wish that on anyone.

Are you talking only about malpractice insurance? What about the mother's health insurance? My insurance paid for my homebirth. If we had to transfer to the hospital, they would have paid for that as well. They also would have paid for any NICU stays or other care given to the baby.

Anyone who is concerned about birth defects or infant death usually knows that these things occur mostly in hospitals. Hospital stays are one of the leading causes of death.

I just love how men come and tell us how to give birth! : Maybe they would like to post in the breastfeeding forum and tell us how to do that too. Perhaps we women can all band together and tell men how to spit and lift heavy objects and hunt mastadons.

[FSUBecca]

You are sorely mistaken if you think most choose homebirth on a whim. Though you may think it is dangerous and financially irresponsible, what research or education has led you to believe that? I have a Master of Public Health in Maternal and Child Health and my husband is an Obstetrician of all things, and WE choose homebirth!
No responsible homebirth midwife, or homebirth doctor, would allow a mother to give birth outside of the hospital without them being aware of the risks, responsibilities, and benefits. Furthermore, many many insurance companies cover homebirth (including my BCBS insurance company), and many states mandate that homebirth be covered in their states. If my baby was born with a health problem, they would cover that as well! You can sue a midwife just as easily as you can sue a doctor. I think your concern is that the midwifes pockets just aren't deep enough?

Homebirth is safe, but no birth - in any setting- is without risks. When one takes on the responsibilty of becoming a parent, one must realize that their is no guarantee of a perfect baby -- or even a live baby! Sometimes bad things happen, and it is possible - even in these litigious times- that no one was to blame. When I make decisions for my family's healthcare, I weigh which options and providers will give the safest and most competent care. Not which option brings me greatest opportunity for future legal recourse

[MamaAllNatural]

:trollicon

My mother had all of her children at home. My Aunt had all of her children at home. I had my children at home. So did my sister, friends, midwives and millions of other women too. Welcome to the HOMEBIRTH FORUM!

BTW, where are the mods?

[Mummoth]

Hey, how come we don't have any cute little flip-off smilies like in my DH's 4X4 forums? I mean, we aren't opposed to hand gestures as a whole... :

C'mon! I wanna to flip someone off!! Work with me, here!