I have to ask - Page 2

[the_lissa]

I can't imagine how people get the courage to have a hospital birth.

I have home births exactly because I want to give my baby the best shot at having a healthy birth.

My first was an attempted home birth- hospital transfer. My second was a home birth. My first was a good experience as far as hospitals go, but I will never go to a hospital again unless it was an emergency.

And even if one wants to have a hospital birth, it does not mean that you have to an iv, fetal monitoring, starve yourself, lay on your back, restrict movement, etc.

[MommytoTwo]

You have to do your own research and you will come to the right answer for you.

[Joyce in the mts.]

Gosh I reread my post and it's totally overkill...sorry.

I am admittedly passionate about birth and homebirth/midwifery in particular...but I do honor whatever a woman feels she seriously needs to do, no matter what that is or how I feel about it personally.

I just think women think that they have a full range of options across the board, but that's just not so for some of us in some states. We have some key issues to deal with.

Bottom line: I still say that where and how and with whom we birth are all decisions that fall under our reproductive rights to access the care we want and need throughout our potential childbearing years and beyond. Homebirth with a midwife is a viable and safe option along an entire continuum of perinatal care.

J.

[the_lissa]

I thought your post was great Joyce.

[sedalbj]

Originally Posted by alegna

I think birth centers are usually nothing more than a mind game. But, if that's what you need- go for it. A birth center has nothing over a homebirth midwife (unless you live quite a distance from a hospital otherwise or have a situation at home that makes birthing there a bad idea)

-Angela

BC's do serve a purpose, but it is true that they have nothing more to offer than a homebirth except for physical location. Our compromise for DD was a BC (he wanted hospital, I wanted home), and not until after a natural, safe, healthy birth did DH realize that we drove there for no reason, when we could have just stayed home and had the MW come to us. They bring the exact same equipment to your home that is in the BC. It is that 'institutional' feeling that some people (my DH for example) find comforting.

When someone says they are delivering in a hospital (actually I usually hear the DR is delivering their baby in the hospital, they are giving the DR credit he/she doesn't deserve) I feel sad for them and their family. They don't know what they are missing! But part of having a natural birth is feeling comfortable w/ your surroundings, and if someone truely feels more comfortable in a hospital (after learning the real truth about birth and the psycological and physical facts about it) then they should deliver there. With someone to play interference, of course!

[the_lissa]

I agree that everyone should birth where and how they feel most comfortable after they know all the facts.

It saddens me that in there is so much misinformation about pregnancy and birth in our culture.

[KittyKat]

Birth is as safe as life gets.

There are NO guarantees. Period. Most people don't really *comprehend* these words. Some do, but usually only people who have "been there."

It is possible to dot every medical i and cross every technological t, and end up with a dead baby.

It is possible to have the most blissful natural pregnancy, choose a natural-minded homebirth midwife who gives you all kinds of warm fuzzies, pick out your birth pool, read all the "right" books, and end up with a dead baby.

Wherever you choose to give birth, there is some risk involved. You have to weigh *for you* what the risks are, and which ones weigh on your mind most.
Do the risks involved with technological intervetion, iatrogenic complication, and hospital-borne superbugs concern you? Do you have a medical condition that makes it necessary for you to be cared for by a surgeon? Do you feel that you will be emotionally more able to allow your body to labor and open up in a hospital or at home?

I have been on the "other side" of this discussion. It's not just theoretical for me. Would I still choose homebirth? Abso-frickin-lutely. Is there a chance my situation could have had a different outcome? How the heck should I know? If it rained instead of being sunny, how would the day be different? I DO know that similar situations HAVE happened in hospitals, same outcome. Other times everything works out fine.

[Storm Bride]

I'm planning my next one (if and when) to be a homebirth. It's not a matter of courage at all. The idea of going back into the hospital and being subjected to another unnecessary surgery, and all the crap from the nurses, and the smugness from my doctor literally gives me nightmares. In fact, my hospital "births" have left me with the only nightmares I've ever had in my life. It would take a lot more courage for me to walk back in there than to stay home.

When I think back to my wonderful 20+ hours of labour before I went to the hospital with ds1, those are the only positive memories I have of the arrival of any of my kids. Everything that happened in the hospital was brutal. Home is...home.

[georgia]

KittyKat

I guess I am just wondering if anyone out there has a source that changed your way of thinking or an experience or anything.

What did it for me was my completely horrific labor/birth experience in the hospital with my first ds and his iatrogenic $25,000+ three day NICU stay. When I finally began to even contemplate considering becoming pregnant again, I knew in my heart, there would be no way I would plan to birth in an institution with a surgeon attending or anyone else who had been trained in the medical model rather than a holistic model of care. Pregnancy and birth are not illnesses to be 'treated.'

After learning about the cultural practices surrounding birth in books like Birth as an American Rite of Passage and Obstetrical Myths and Research Realities and The Thinking Woman's Guide to a Better Birth...and meeting lots of homebirthing mamas and reading the Mehl study....I've never looked back. Except in certain circumstances, hospital birth is, IMO, by far riskier and scarier. From the 1977 Mehl study:

* In the hospital, 3.7 times as many babies required resuscitation.
* Infection rates of newborns were 4 times higher in the hospital.
* There was 2.5 times as many cases of meconium aspiration pneumonia in the hospital group.
* There were 6 cases of neonatal lungwater syndrome in the hospital and none at home.
* There were 30 birth injuries (mostly due to forceps) in the hospital group, and none at home.
* The incidence of respiratory distress among newborns was 17 times greater in the hospital than in the home.
* While neonatal and perinatal death rates were statistically the same for both groups, Apgar scores (a measure of physical well being of the newborn) were significantly worse in the hospital.

Mind you, these stats were back in 1977 when the C/S rate and routine technological intervention and disregard for evidence-based practices were no where close to what they are today. Here is a link to a 2005 safety study.

Gentlebirth Safety Link

Bottom line for me, a woman should have the options to birth wherever it is that *she* feels most comfortable, safe, confident, loved and secure. Not every woman has the same goals or life philosophy, and no one else can determine what constitutes "safe."

I inherently trust myself now and my judgement to make these decisions for myself, and I believe women everywhere should be empowered and encouraged to do the same without fear, coercion or condescension.

[mamato271828]

Originally Posted by alegna

I think birth centers are usually nothing more than a mind game. But, if that's what you need- go for it. A birth center has nothing over a homebirth midwife (unless you live quite a distance from a hospital otherwise or have a situation at home that makes birthing there a bad idea)

-Angela

I gave birth at a "birth center" with my second after having my first at home (in an apartment ). I don't think all birth centers can be lumped together. They really occupy the entire spectrum. Some are very much like hospitals, others are more like a home - just some else's home. My birth center was very small, quiet and homey and run by a homebirth midwife. And it was closer to a hospital than my home.

I didn't need to give birth at the birth center but my ds was at home (with my mom) and quite ill so my dh and I thought it would be in everyone's best interest to leave (we had been planning a homebirth). My stalled labor picked up very quickly and dd was born an hour after we made our decision. My point is that a women needs to birth where she is most comfortable as many others have said. I really do think home is the best place for most women but not everyone. Sometimes a birth center really can be the happy medium.

[MelKnee]

My 1st ds died because I chose OB care and because he was born in the hospital (and because of my own ignorance). My 2nd ds and my dd were born safe and healthy at home with a midwife.

Sometimes doctors and hospitals cause problems.

[lifescholar]

I definitely think that having a midwife is better than having an OB, in general.

Obviously, natural labour and birth are the best for the baby.

For me, a birthing centre, near a hospital, would be ideal. But, if my home was as close to the hospital as a birthing centre, then my home would be the obvious choice!

For me, the deciding factor is distance to the hospital. Like the OP, I would never forgive myself if my baby died because we needed to get to the hospital, and didn't get there in time. But, I don't feel the need to go to the hospital unless necessary.

It takes time to prep for even an emergency c-section. So, if I'm close enough that I can get from wherever I am labouring to the hospital by the time the room is ready, I figure that's the best I can do.

If my only option is going to the hospital, then that's fine. I wouldn't go until I was far along in labour, however. Just no need to be there early on!

My son's birth was induced, so I was in the hospital from the get-go. Interestingly, my DOULA was the one pressuring me!! My dr. suggested induction, but I felt TOTALLY comfortable saying no, if I hadn't wanted it! It was my DOULA whom I had trouble saying no to, since she wanted me not to have the induction. I also felt awkward telling her I wanted an epidural, but would have been FINE with telling my OB not to break my water!!

I think that the majority of women who go to the hospital are NOT well educated on birth, which is why there are more interventions, hence more risks.

However, if someone IS educated about the birth process, and does NOT have interventions, then I don't see how hospital birth is more risky than a home birth. Nobody is going to tie you down in the hospital, and MAKE you have IV's, oxytocin, epidural, etc. Doing something "AMA" isn't a sin....doctors aren't Gods!

[tamagotchi]

Originally Posted by lifescholar

if someone IS educated about the birth process, and does NOT have interventions, then I don't see how hospital birth is more risky than a home birth. Nobody is going to tie you down in the hospital, and MAKE you have IV's, oxytocin, epidural, etc.

I believe that in my case, hospital birth would have been more risky than homebirth was. Hospitals have rules and if the birth is not going according to their standards, eventually they do intervene. I pushed for almost 5 hours, most of that time with no progress, but my baby was fine the whole time and I eventually pushed him out. I believe that I wouldn't have been allowed to push that long in the hospital. A friend of mine had a similar birth in a hospital, and after 2 hours of pushing, they told her that 2 hours was as long as she was allowed to push, so she was getting a c-section.

[the_lissa]

There are also hospital acquired infections, and that some people's (like me) bodies would tense up and not be able to labour naturally.

[Storm Bride]

Originally Posted by lifescholar

However, if someone IS educated about the birth process, and does NOT have interventions, then I don't see how hospital birth is more risky than a home birth. Nobody is going to tie you down in the hospital, and MAKE you have IV's, oxytocin, epidural, etc. Doing something "AMA" isn't a sin....doctors aren't Gods!

What about women who say no to an episiotomy and are cut, anyway (no consent - not even a warning)? What about the famous court-ordered c-sections? (I don't think this is happening, anymore.)

With my first section, nobody tied me down - but they did kick my ex out on false pretenses, then ambush me with "you need a c-section"...then proceed to ignore my "no", while six people prepped me for surgery. Sure - in theory I could have, and should have, done whatever it took, including getting up and walking away...but that's not quite as straightforward as it might sound. My ex couldn't deal with the medical staff, as he walked back into the room to find a near-hysterical wife, a scene of bustling medpros and was basically told "your wife has to have surgery now or your baby will die".

[alegna]

Originally Posted by lifescholar

However, if someone IS educated about the birth process, and does NOT have interventions, then I don't see how hospital birth is more risky than a home birth. Nobody is going to tie you down in the hospital, and MAKE you have IV's, oxytocin, epidural, etc. Doing something "AMA" isn't a sin....doctors aren't Gods!

It is riskier. There is a lot of pressure to follow hospital "rules" which are often presented as law. As mentioned, women are cut without consent every day. It happens. Add to that the increased chance of injury or death due to dr. or nurse error. Tack on the cess-pool of germs that live there.

Hospital birth IS riskier for most births.

-Angela

[storychick]

Once I read all the research (Thinking Woman's Guide to a Better Birth is a good start for that) I realized that statistically there was a much worse chance that the doctors would *cause* a problem than that something would happen at home (and that most of those kinds of things are just as likely to happen at the hospital and wouldnt have any better remedy there than what a competent midwife could handle, either). In the end I was much more afraid of the hospital and their policies than anything random that was very much unlikely.

That said, you need to birth where you feel safe, and if that's the hospital then go there. Its better that you recognize what you need (and maybe get a doula to help you out) than to push yourself to homebirth in fear.

[ColoradoMama]

Great question. Thanks for having the courage to ask it here, because I imagine it could have felt a little intimidating with all these homebirth supporters and being afraid you'd get flamed!!!

I have had two hospital births and two homebirths. I had the two hospital births solely because of my husband's fear. I cannot tell you how much guilt I have for not following my instincts with the first two. I truly feel like I put them in danger by having them in a hospital. Now, don't get me wrong. I think every woman needs to give birth where she feels most comfortable and for some women that is a hospital - BUT - I was not one of those women. Plus, there are some women who cannot for various physical reasons need to birth in a hospital. For me though, it was safer for me to give birth at home. Interestingly, both my girls had meconium staining and both my boys needed oxygen after they were born. So, I have a unique perspective on hospital vs. homebirth. My first daughter was very traumatized (and quite frankly so was I ) by her birth and the was she was treated afterwards. The nurses worked on her the way they believed was right, but they were rough and they scared her and they traumatized her. My second daughter was treated gently and respectfully. She was never traumatized. Her birth and first minutes in the world were peaceful. Also, the nurses at the hospital DID NOT GET ALL HER MECONIUM AND SHE CHOKED ON IT LATER THAT EVENING AND WAS FREAKED OUT AGAIN. Nothing like that happened with the midwives at home. My first son's entrance into the world wasn't nearly to traumatic, but we dodged a bullet. He got stuck coming out. I am so thankful every time I look at him that I had an unmedicated birth so that I was able to move around the way I needed to to get him out. I am also thankful (and feel just darn lucky) that they midwife we had there wasn't incredibly medical minded because she did what she needed to to get him out without interventions.
We could have EASILY ended up with interventions or even a C-section. I have lots of guilt about it because of what could have happened simply because of the environment that we chose. I did not feel safe when I birthed in the hospital, but I felt very safe when I birthed at home. I did my research and I knew that the statistics were so much better for homebirths, and there's a good reason why. Hospitals create stress and interventions are common in hospitals. At home, women are allowed to trust their bodies, listen to their bodies, and do what needs to be done in a peaceful, gentle way.

Wow, that turned out a lot longer than I had planned!

[Romana]

First,

where do so many people come up with the courage to homebirth???

Now the real question is, where do people come up with the courage to birth in the hospital?

Research published in the summer of 2005 showed that for low-risk pregnancies and healthy moms, mortality for homebirths and hospital births is the same, and morbitidy (i.e. injury(ies)) to mom and baby are HIGHER in the hospital. (this is from that study posted in the third reply to your post, I think)

So basically, if you're low-risk, you and/or your baby just as likely to die in the hospital, AND you and your baby are more likely to be injured in a hospital birth.

Also, if you believe that birth is more than just "mom and baby survived, so it's a good outcome" then homebirth may be something you want to consider. Women are often disrespected in the hospital and subjected to unnecessary interventions such as pitocin augmentation, AROM (doctor breaking the bag of water), and epidurals that ultimately may result in a worse birth experience and cause some of that "morbidity" we're talking about above - like unnecessary c/s, vaccuum, forceps, episiotomy, etc.

I'm sure I'm not saying anything the pps haven't said already, but the truth is that homebirth IS safe. Many women who are educated about birth realize that some risks may be higher in the hospital.

Also, if your really look into the kinds of birth complications that may occur in a low-risk pregnancy, very rarely would you find a better outcome at a hospital (and clearly, if this is true, then based on the numbers, just as many times you may end up with a worse outcome at the hospital for something that could have been handled better in a homebirth). Think about that emergency c/s, for one. Every woman has to be prepped, an anesthesiologist called, surgeons, nurses, and the OR prepped . . . even with an emergency c/s, it usually takes 20-30 min before mom is on the table. If you're doing a homebirth, your midwife or doctor will call the hospital as soon as the need for c/s is apparent and as long as you live within a reasonable distance of a hospital, by the time you arrive it simply means the surgeon, staff, and OR are ready for you and there probably will be very little difference, if any, in how many minutes elapse before the c/s begins regardless of whether you were at home or at the hospital when the need for c/s became apparent.

Also, midwives and homebirth doctor's don't just bring skill and expertise to the home. They also bring basic medical equipment - essentially everything but the OR. They can provide an IV, pitocin (for hemorrhage), oxygen for a baby in trouble, vaccuum or forceps if necessary, etc. They generally arrive with medical equipment standard to a labor and delivery room.

The only reason the decision to homebirth is "courageous" is because most people don't realize homebirth is just as safe or safer, and therefore anyone who makes that choice is going against the norm. But for women who have spent time to become educated about birth, the choice to homebirth is usually an obvious one.

There's an emotional element to it, too. If after doing the "facts and statistics" research as well as the "anectodal" research you still feel that you would be uncomfortable or afraid doing a homebirth, then don't do one! The most important thing is to have a healthcare provider who shares your philosophy and desires for your birth and will be supportive, and that you birth in an environment where YOU feel most comfortable. For many women, that turns out to be home.

HTH!

Julia
dd almost 10 mos

[hubris]

Originally Posted by jackieslilpie

where do so many people come up with the courage to homebirth???

If/when I have a third child, I plan to give birth at home. DH and I have made this decision because after two hospital births - one that wasn't so great and one that was probably close to the ideal hospital birth - we both strongly feel that normal healthy birth does not belong in a hospital. Reese's birth was a fabulous hospital birth by most people's standards...but it was still a hospital birth, it was still medicalized, and it should not have been. I don't want that experience again. I want to give birth the way I believe birth was intended to happen.

I have two friends who have had homebirths in my town, both with the same midwife. A third friend is having a hospital VBAC very soon with the same midwife. Knowing them has made homebirth seem much more real to me.

I still have what-if thoughts. Every now and then I see a birth story here in which a homebirth turned tragic. Those stories make me worry. But you know, there is far far far greater risk to my baby in the hospital than there is at home. I remind myself of that. I'm a healthy woman who has given birth to two healthy children and my next baby is overwhelmingly likely to be healthy.