used to feel homebirth was best... but not anymore - Page 2

[Contented73]

Additionally, who's to say that everyone has a good outcome with accreta - even if they ARE in the hospital? In your case, they were doing everything they could, yet it wasn't working so it still seems that it is only through the grace of god/luck/whatever you want to call it, that got you through it alive. Wouldn't you say?"
---
no, and i'm not saying that - please read my post carefully. i'm saying you would have a better chance in a hospital in the case of sudden serious problems. i'm not saying being in a hospital guarantees your survival.

I *did* read your post carefully. Looking back on my post, I realize I wasn't totally clear, but I was asking "wouldn't you say" to the part about them doing everything they could with you.

Yes, you did say that in case of a few, extremely rare, extremely serious, emergencies, you are better off in a hospital, but that ultimately there is no guarantee. I think pretty much everyone here would agree with that. I also think that many of us here would say, "because of a few rare and extremely serious situations, which are actually caused by being in the hospital, you are much better off at home."

I am truly sorry for your experience, and I'm glad there are posters like aileen who can really say something kind and beautiful. However, to me your story does not mean hospitals are safer for giving birth; it just doesn't. It's all about the risk that any individual woman is willing to take. Obviously, as you were getting at in your post, the ideal would be to have a birth place where no risk is introduced, yet extreme emergency care is readily available. Personally, I just don't think this is possible - something close to it, maybe, and I do fantasize about this very thing sometimes! But in the meantime, I'll take the risk and continue to have my kids out of hospital.

[pannacotta]

ok very last reply b4 bed.. (:

i had afe (mild afe) - acute hypotension (b/p 50/30 i think, acute hypoxia (face was turning blue, felt couldn't breathe, suffocating), some coagulopathy which might have been DIC from hemorrhage (i don't remember exactly what the coagulopathy was.. apart form the obvious 'why won't she stop bleeding..') but was corrected pretty quickly by an amazing anesthesiologist.

i suspect the pain was related to accreta but have no evidence. i've done a bit of research into this (web, asking obgyns etc) and the conclusions seem to be two 1/ accreta is rare and not many studies on it- at least no studies saying extreme pain in early labor suggestive of accreta and 2/the experts i talked to suggested that 'unusual pain in early labor often suggests underlying probs'

but again no evidence.. i'd love to dive into some hospital database and see if there's a connection. !

[pannacotta]

i love your 'i love this thread i think i'm going to live here..' tag line.. made me laugh..

i find all the responses interesting too but the whole topic is scary too.. i kind of posted originally as a kind of 'public service' message - (kind of read this as another opinion while you decide what birth you want) i'm just an average mom and not important except as an flesh n blood example of that scary 1%

now i'm really off to bed..

ok i'm trying to do smiley's the other way round as suggested.. (:

[pannacotta]

ok let me ask something i've been thinking about..

if such a place - totally homebirth like place - existed *within* a hospital (same floor as regular L&D), staffed by midwives, with tubs, showers, soft lighting, family members allowed, birth balls, massage, music, no compulsory limits on stages of labor, no 'routine ivs' no ban on food and drink etc ..whatever you would have at homebirth you have it here..just not in the 4 walls of your home

would you birth there?

getting back to my earlier question do most of you choose h/b because
a/ you want to avoid the bad things associated with hospitals

or b/ you're drawn to birthing in your home, in your nest, like you might be drawn to chocolate and cheese as a pregnancy craving.

[aileen]

pannacotta - your baby is lucky to have you.
not just because you made it through such a harrowing birth, but because you are thorough and passionate and open minded and brave.
and i think it's important that you posted your story. for you and for mamas who read it. i think you very well may save a life (imagine if there is a accreta/pain connection and now we are all more aware of it..)
i hope you sleep well after talking about it; i hope it doesn't make your mind race too much.

and holothuroidea, i love a stickler.
how's this? homebirth is not statistically unsafe, but it is so much more not statistically unsafe to me.

[rabbitmum]

Sorry, long post

Here's another lovey post from me! I'm really sorry you had such a traumatic birth experience, and I think you were very brave to write about it - it must have been tough! I had a bad first birth experience because of severe hemorrhages too, so I can sympathise.

I think you're right that your "third alternative" should exist everywhere! I am so sad every time I read about American MDC mothers who are in a horrible pinch because of not wanting the interventions of the hospital, but really not feeling 100 % sure about a homebirth.

My second birth was a wonderful unplanned and unassisted homebirth, so I completely agree that a normal homebirth is about the most wonderful experience anyone can possibly have. But not everybody feels comfortable planning a homebirth, so there should be a good alternative available.

Originally Posted by pannacotta

well i'm an idealist and i also know that birth is a business.. it costs more to have more nurses looking after a women 1:1 rather than one nurse at the nurses' station monitoring contractions of 15 women via electronic fetal monitoring. sure - and that's probably why my ideal solution isn't happening in many places.

It is happening in a lot of places! It is the norm in Norway, and England too, as far as I know - and probably many European countries.

My third birth was a hospital birth in Norway's biggest hospital. I had a midwife assigned, as do everybody here, the doctor only turns up if something unusual happens, like hemorrhage, or to deliver the head of a breech baby. There's no electronc monitoring of the baby unless necessary, so I had none of that. I had a big room with a big birthing tub, a sofa, plants, a baby bed (which was very strange to look at), etc. I had no vaginal "fiddling" during the birth, I didn't want any unnecessary checking of dilation, which means I didn't have any at all. At the end I checked a bit myself, out of curiosity, but the midwife didn't seem like she thought it was necessary to do very much at all, except try to help me find positions that were comfortable. It was an extremely painful birth compared to my first two, and I asked for pain relief relatively soon, which I could have, since we were in a hospital. I also hemorrhaged badly and suddenly - the placenta was stuck - but help was immediately available without having to drive anywhere.

In my opinion this is close to the best of both worlds - as few interventions as possible, but help in immediate proximity for those who need or feel that they need it.

But giving birth in a hospital is absolutely free here, so it's maybe not business?

Originally Posted by pannacotta

if such a place - totally homebirth like place - existed *within* a hospital (same floor as regular L&D), staffed by midwives, with tubs, showers, soft lighting, family members allowed, birth balls, massage, music, no compulsory limits on stages of labor, no 'routine ivs' no ban on food and drink etc ..whatever you would have at homebirth you have it here..just not in the 4 walls of your home

would you birth there?

Yes, that is available in Norwegian hospitals, and that's what I chose.

[Alcyone]

Originally Posted by pannacotta

or b/ you're drawn to birthing in your home, in your nest, like you might be drawn to chocolate and cheese as a pregnancy craving.

That would be me. The situation in Denmark doesn't sound much different from Norway. I'm sure I'd be fine in a hospital, and if, for example, my mother or husband started to throw a last-minute hissy fit about staying at home, I'd probably rather go to the hospital than argue about it. I just feel relaxed and comfortable in my home in a way that I won't be anywhere else. I can probably get comfortable somewhere else, but I already am comfortable here, kwim?

[turtlewomyn]

I am truly sorry that you had such a traumatic birth experience.

I agree with you that we definitely need some hospital reform, to make birth more normal in the hospital (midwives for all low risk births, with OB's around to take the high risk births and emergencies, like many European countries do).

I still think that homebirth with well qualified DEM's should be an option for women who are well informed and still make that choice.

I am glad that you and your baby are OK now.

[PassionateWriter]

Originally Posted by pannacotta

i love your 'i love this thread i think i'm going to live here..' tag line.. made me laugh..

i find all the responses interesting too but the whole topic is scary too.. i kind of posted originally as a kind of 'public service' message - (kind of read this as another opinion while you decide what birth you want) i'm just an average mom and not important except as an flesh n blood example of that scary 1%

now i'm really off to bed..

ok i'm trying to do smiley's the other way round as suggested.. (:

1%??? i dont think thats accurate. can someone w/ stats readily available chime in on this.

i dont think anyone here has some euphoric belief that nothing will happen if they have a homebirth. i would hope that MOST, if not ALL, moms to be read read read about the dangers of not having trained surgeons on site..but the stats are weighed AGAINST hospital births. The mortality rates of hospital births are HIGHER than homebirths (and probably even worse than we know b/c many homebirths arent reported as such, but "accidents").

i for one want to know my chances of risk in a homebirth. I wanted to have a trained MW present, etc. etc. I am pretty confident that is something is wrong (which you figured out rather quickly) that we will be transferring.

but to simply suggest that women go to hospitals and fight w/ OBs and nurses while in labor to avoid unnecessary routine procedures is simply not realistic. Most women in labor can NOT fight well for themselves and many doulas and husbands will back down and not fight enough for them...resulting in stalled labor.... etc. etc. etc.

[Lisa85]

Call me dumb, but I don't understand your reasoning at all. Moms and babies die while birthing at home. Moms and babies die while birthing in a hospital. Statistically though, homebirth is safer if you are low risk. So while for you personally a hospital is a better choice due to your history, statistically speaking the rest of us are better off at home. You did the right thing, you knew something wasn't right and you went to the hospital. You had the warning signs and you listened. The rest of us (hopefully) will do the same thing. If we get a warning sign, we'll go to the hospital. If not, we stay home where statistically speaking our chances of a successful birth are better.

Because you didn't have an ideal birth at home, and required a hospital birth, doesn't mean the rest of us should. We know the risks. We've read the stories. We know what can happen. We also know all of that for the other side, and for healthy low risk women, it sways to homebirth.

[nashvillemidwife]

Originally Posted by pannacotta

in the case of sudden rare emergencies, home birth is riskier than hospital birth, i don't think that's up for discussion. i'm not disputing that hospital interventions *cause* many complications, but that's another topic

Yes. So statistically, what are the odds of developing a complication caused by hospital interventions versus an unforeseen life-threatening emergency at home. Seriously, do you have that statistic? I don't, but I have the statistics from all the other studies of outcomes of planned home births and they do not agree with you. You are certainly entitled to your opinion, and I'm sorry that such a tragedy occurred to you. I don't think many homebirthing families are ignorant that sometimes bad things do happen at home that could be prevented in the hospital. But, as you yourself pointed out, there are risks to either decision.

[nashvillemidwife]

For me, it comes down to refusing to live in fear. Women die in childbirth all the time, whether it is at home or in the hospital. As you mentioned, mortality rate from placenta accreta and amniotic fluid embolism are high, even with hospital care (which is where almost all of them take place). If I thought that way, I would never leave my house. Do you know what the chances are that you will be injured or killed in a serious car accident? When I think about it, driving terrifies me. But I've got places to go, and if I dwell on the possibility of every bad thing that could happen to me I would be immobilized by fear. At some point you've just got to accept that everything in life has risk and go on with your life. Some people find it more acceptable to take the risks of birth in a hospital. Some people find it more acceptable to take those risks at home. We are each entitled to our opinions. It was very brave of you to share your opinion, but the actions you are urging other women to take it based only on your opinion.

[Septagram]

I, too, am sorry for what happened to you. Thank goodness everything turned out fine.

Nashvillemidwife hit the nail on the head for me, though. I refuse to live in fear. I ended up passing out after my homebirth from blood loss. My skilled and experienced midwife stopped the blood and everything was fine. That's why I hired her, after all. I felt most comfortable hiring someone to come to me when I was ready. She arrived when I was in transition because that's when I wanted her here. Had I felt more comfortable in a hospital I would have birthed there again, but my experience there was torturous and terrible. I was willing to take my chances if that meant that I could birth on my terms and not on someone else's turf. Even with a birthing center environment availible to me, I wanted to be on MY TURF.

I read a ton of books, dozens of studies and articles, and looked at what could really happen to me during and after my labor. I was 100% comfortable with my choice. I had a very normal pregnancy, labor, and birth. Homebirth was the right choice for me. Had something been wrong I would have transfered, but since nothing was outside the scope of what the Midwife could take care of, we didn't have to.

[holothuroidea]

Please, ladies, site your sources that show that home birth is safer, reduces mortality, please.

I have never seen any sources that say this with any kind of certainty.

Statistics, in the case of home birth, really cannot prove anything. This happens for various reasons. "Safety" is a relative and poorly defined term. It is virtually impossible to collect an accurate population sample of home birthing women in the United States, and it is even more impossible to find an adequate hospital control group to compare them too. The data that exists now (In the BMJ study, for example) can be (and has been) manipulated to show that either way is safer.

This is something that we should accept, that good statistics do not exist, instead of pretending like they show us what we want them to show us.

Just a friendly reminder.

Home birth will never be about "the statistics show us it's safer," anyway. Even if the statistics made a very good case against home birth, most of us would still do it. Why do we even bother to spout these mistruths at people? Reassurance? From what? What monster living under our beds has forced us to recede to believing this nonsense?

[CherryBomb]

Thank you for sharing your story mama. I'm glad you and your baby pulled through such a terrifying experience.

[applejuice]

Originally Posted by holothuroidea

Please, ladies, site your sources that show that home birth is safer, reduces mortality, please. I have never seen any sources that say this with any kind of certainty.

The Lewis Mehl study is the most comprehensive, scientific to date and has been cited here 1000s of times.

To the OP:

Veteran of four homebirth; no flames here. You did your research.

I am sorry your homebirth did not workout. You did the right thing when you transferred with the awful pain. Your body told you something was wrong and you did the appropriate thing. I doubt if you had planned on a hospital birth from the git-go things would have been different, except now, you know what happened and are better informed. I am sure that having educated yourself that you truly know your surgery was necessary, which is not always the case with most women who have had a surgical birth.

As for placenta accreta, many surgeries are done on nulliparas now without informing women of the full risks of the surgeries.

1. If you ever had your fallopian tubes blown out for infertility, that can introduce bacteria into your uterus and tubes and cause the very thing it is looking for - scar tissue.

2. Cervical biopsies can be extensive and introduce bacteria into the uterus, causing scar tissue and set the stage for placenta accreta and previa.

3. If you ever had an IUD, these act by irritating the uterine lining, causing a low grade infection and can cause, not necessarily, but can cause scar tissue.

4. A previous D&C can cause scar tissue also to form in the uterus. So even if you have not had a caesarean section there are other opportunities to cause scar tissue in the uterus and set up a condition for placenta accreta even before a woman is a mother.

If you want a reference or source for this information, read the consent forms for them.

So a previous caesarean section or myomectomy are not necessarily the only way to get scar tissue growing in the uterus or to have a minor infection.

Did you have a hysterectomy?

[DoomaYula]

I'm glad you survived that horrible situation. It sounds very scary

However, I agree with many pp who say that it was your intuition that was of utmost value to you. I believe that your case is actually pro-homebirth, as you planned it, researched it, and then when you realized something was wrong, you went to the hospital and received appropriate medical care. Had you been ignorant to the signs/symptoms of medical emergencies, you might have died at home.

I think it's the women who choose homebirth who do the research; women who blindly give birth in hospitals without even giving it a thought are often ignorant of the reality of giving birth.

I think you are prescribing that every woman give birth in a medical facility because of your experience, which is dangerous. Just because you had a very rare complication, does not negate the statistics which state that homebirth is AS safe as hospital for low-risk women. (cite: JMB study)

I had a pph with my homebirth. It sucks, but it's a risk and I knew it was a risk when I chose to homebirth. I transferred after the baby was born for appropriate medical care. But I didn't go until I knew I needed more than what could be done at home. And even having had a pph, I will give birth at home again (if we have more kids), fully knowing the risks.

[kittywitty]

Originally Posted by pannacotta

ok let me ask something i've been thinking about..

if such a place - totally homebirth like place - existed *within* a hospital (same floor as regular L&D), staffed by midwives, with tubs, showers, soft lighting, family members allowed, birth balls, massage, music, no compulsory limits on stages of labor, no 'routine ivs' no ban on food and drink etc ..whatever you would have at homebirth you have it here..just not in the 4 walls of your home

would you birth there?

getting back to my earlier question do most of you choose h/b because
a/ you want to avoid the bad things associated with hospitals

or b/ you're drawn to birthing in your home, in your nest, like you might be drawn to chocolate and cheese as a pregnancy craving.

No I wouldn't. In this country, they almost don't exist. Especially if you are a VBACer or you are like most of us who have doctors who find it more convenient to cut you. Just b/c you don't require an IV or can eat doesn't mean you won't be forced into lithotomy with your baby taken from you for 3 hours under the warming lights and given unnecessary shots and interventions while you have your placenta pulled out of you.

Of course h/b is better for the reasons hospitals are not good. That's the point, isn't it? It is a place you can be comfortable and safe. You needn't worry about random strangers coming in to observe your coochie while you are laboring. You don't have to beg people not to invade your body.

I think what you propose is honestly pretty offensive. It suggests that people who choose homebirth all do it out of fear and know nothing of the risks to ANY birth. There are *always* risks with everything. Heck, you can die from drinking too much water!! While you also are ignoring the studies on homebirth saying they aren't "recent" whatever that means. God knows when it comes to giving birth only the studies from the past couple years matter? Not the whole biological fact that it is a normal process and it's very rare for things to actually go wrong.

Why go to a hospital for a normal delivery where you face a higher chance of c-section, infections, and non-necessary interventions???

I suggest you read these reports and studies before you assume we all don't know anything about rare risks in homebirth. If it makes anyone feel better, I saw some from 2005 on there. :
http://www.gentlebirth.org/ronnie/homesafe.html


On that page from BMJ:

Neonatal Outcomes:

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.

And since all of the people pushing that hospital birth is the only acceptable way because they lurve to use scare tactics against women going through a normal, natural process, here are just a couple reasons hospital births are not the way to go for almost every woman:
http://www.emedicine.com/ped/topic1619.htm
http://www.gentlebirth.org/ronnie/mederrors.html
http://www.childbirthconnection.org/...e.asp?ck=10166

Originally Posted by holothuroidea

Please, ladies, site your sources that show that home birth is safer, reduces mortality, please.

I have never seen any sources that say this with any kind of certainty.

Statistics, in the case of home birth, really cannot prove anything. This happens for various reasons. "Safety" is a relative and poorly defined term. It is virtually impossible to collect an accurate population sample of home birthing women in the United States, and it is even more impossible to find an adequate hospital control group to compare them too. The data that exists now (In the BMJ study, for example) can be (and has been) manipulated to show that either way is safer.

This is something that we should accept, that good statistics do not exist, instead of pretending like they show us what we want them to show us.

Just a friendly reminder.

Home birth will never be about "the statistics show us it's safer," anyway. Even if the statistics made a very good case against home birth, most of us would still do it. Why do we even bother to spout these mistruths at people? Reassurance? From what? What monster living under our beds has forced us to recede to believing this nonsense?

My pleasure. And FWIW since my dh was a chemist in pharma and I have taken way too many stats classes for my own sanity, there are NO good 100% unbiased studies. EVER. Seriously. All data can be manipulated. So you are right about that. But that also unhinges the view that hospital birth is safer. The AMA definitely has something to lose with that. Just ask all us Illinoisians.

So if you are convinced that stats never matter because they aren't infallible...why ask for studies?

Studies and reports:

http://www.bmj.com/cgi/content/full/330/7505/1416?ehom
http://www.naturalchildbirth.org/nat...omebirth01.htm
http://www.mothering.com/articles/pr...nder-fire.html
http://www.homebirth.org.nz/articles...irthsafety.pdf
http://www.yin-yang.com/vbfree/docs/schlenzka.htm
http://www.ncbi.nlm.nih.gov/pubmed/9...?dopt=Abstract
http://www.gentlebirth.org/ronnie/isleMan.html
http://www.gentlebirth.org/archives/whoplace.html
http://www.globalmidwives.org/files/...rth-safety.pdf
http://www.bmj.com/archive/7068pr4.htm
http://www.bmj.com/archive/7068pr4.htm
http://www.bmj.com/archive/7068pr4.htm
http://www.bmj.com/archive/7068pr1.htm
http://www.bmj.com/archive/7068pr1.htm
http://www.changesurfer.com/Hlth/homebirth.html

From a World Health Organization (WHO) report - subsection on Place of Birth:

It has never been scientifically proven that the hospital is a safer place than home for a woman who has had an uncomplicated pregnancy to have her baby. Studies of planned home births in developed countries with women who have had uncomplicated pregnancies have shown sickness and death rates for mother and baby equal to or better than hospital birth statistics for women with uncomplicated pregnancies.

http://www.collegeofmidwives.org/leg...1/synopsis.htm
http://www.collegeofmidwives.org/leg...1/synopsis.htm

From http://www.gentlebirth.org/ronnie/homesafe.html

From a report on homebirth in England:

More recently, the 1992 House of Commons Select Committee on Maternity Services, now known as the Winterton report, went to the heart of the issue in the first of more than 100 recommendations and conclusions on pregnancy, labour and postnatal care.
On the basis of what we have heard, this Committee must draw the conclusion that the policy of encouraging all women to give birth in hospitals cannot be justified on grounds of safety.

Elsewhere the report went further. "There is no convincing or compelling evidence that hospitals give a better guarantee of the safety of the majority of mothers and babies. It is possible, but not proven, that the contrary may be the case."

BTW your chance of your infant dying during a c-section is three times as high for elective c-sections. So you are right:

Originally Posted by holothuroidea

Reassurance? From what? What monster living under our beds has forced us to recede to believing this nonsense?

What reassurance does elective c-sections give us? What reassurance does a hospital birth give us? That if we are one of the vast minority a hospital may help us yet very well may kill us with an unnecessary c-section or MRSA or even more likely, medical mistake? What has forced us to believe THAT nonsense? Do people really believe that even though women have given birth since time immemorial that we are somehow incapable of doing it without a full hospital backup any more? And of course women died during childbirth. They still do! Now most often b/c of anesthesia or c-section complications or infections. Surely if anyone used to know anything about germ theory and how it wasn't actually a good idea to stick a dirty hand up into a birthing woman then less would have died from childbirthing fever, right?


Nashvillemidwife

[ThreeBeans]

I'm sorry you had a bad experience.

That being said, you planned on a homebirth, listened to your body, and knew you needed medical intervention. That does not mean homebirth is unsafe. It means that for this particular pregnancy YOU needed a hospital birth.

You had a bad experience but statisics show that by far homebirth is safer. Don't denigrate women who intelligently choose homebirth because YOU needed to birth in a hospital.

[ThreeBeans]

Originally Posted by pannacotta

ok let me ask something i've been thinking about..

if such a place - totally homebirth like place - existed *within* a hospital (same floor as regular L&D), staffed by midwives, with tubs, showers, soft lighting, family members allowed, birth balls, massage, music, no compulsory limits on stages of labor, no 'routine ivs' no ban on food and drink etc ..whatever you would have at homebirth you have it here..just not in the 4 walls of your home

would you birth there?

.

No, not unless I needed to be there.