used to feel homebirth was best... but not anymore - Page 3

[aileen]

Originally Posted by applejuice

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

i wondered about this too.

[holothuroidea]

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?

I agree, and I never ask for studies about this stuff for my own information. People really believe whatever they hear when it follows "Studies show..." and I think that is very dangerous. Studies can be set up to show anything you want them too, to get the general public to believe it. I don't trust it.

My point is, who cares anyway? Who cares about someone else's definition of "saftey" and how that relates to what number of people die where? It all seems so irrelevant to me. My question is, why do we even bother with this stuff?

Me and my husband are both chemists, we spend a lot of time thinking about science. We've come to the conclusion that obstetrics is the LEAST scientific of any of the medicinal sciences, which tend not to be all that scientific anyway. You cannot apply science to the human condition, just ask Einstein.

[kittywitty]

I almost forgot. Pretty recently there was an article in Mothering about homebirth in Holland, right? I would highly suggest reading that article. It was very good and that will give a good perspective on the safety of homebirth for all those who doubt it.

http://www.mothering.com/articles/pr...n-holland.html
http://www.mothering.com/articles/pr...homebirth.html
http://www.midwiferytoday.com/articl...irthissues.asp
http://www.gentlebirth.org/format/my...t.html#Studies

I would also suggest the books Pushed, Born In the USA, and The Thinking Woman's Guide to a Better Birth.

[elfinbaby]

I'm glad you felt "safe" enough to tell your story on MDC. Often times we need to talk about our birth experience and I'm glad you were able to here.

Although what happened to you is rare, it does happen and can have tragic consequences. But I would ask you to see it from a different perspective. Homebirth is still a wonderfully safe option for most women and here's why - you listened to your INSTINCTS early on in labor and honored them. I think that is absolutely amazing!! How great was it that your body alerted you that something wasn't "right" and that you listened w/no questions (or so it seems in your post - leaving in 15 min. of the pain). Being in tune, trusting ourselves is part of hbing and I think your story is one of triumph b/c you did it! I am not at all trying to downplay the medical interventions that were required and what kind of toll they took on your body and birth experience. We are all hoping to avoid complications.

Oddly enough, I found your story to be a comfort. It proves to me that, even during labor, even experiencing pain, even with the many influences from drs./mw./societal birthing fears, your inner voice got through and said "Go." You did. You did an amazing thing.

I'm glad your recovery went well. Best wishes.

April - happy homebirther

[kittywitty]

Originally Posted by holothuroidea

I agree, and I never ask for studies about this stuff for my own information. People really believe whatever they hear when it follows "Studies show..." and I think that is very dangerous. Studies can be set up to show anything you want them too, to get the general public to believe it. I don't trust it.

My point is, who cares anyway? Who cares about someone else's definition of "saftey" and how that relates to what number of people die where? It all seems so irrelevant to me. My question is, why do we even bother with this stuff?

Me and my husband are both chemists. Obstetrics is the LEAST scientific of any of the medicinal sciences, which tend not to be all that scientific anyway. You cannot apply science to the human condition, just ask Einstein.

I agree. Is there anyway you can use the Quote function to say who you are quoting, though? I often forget what I say so I feel senile if I respond to something that wasn't me.

[frontierpsych]

I am very sorry for your experience.

I am one of those 6 in 1,000 (in America) whose baby was born still. Of course, there are times when I think of all the woulda, coulda, shouldas. But in reality, it happened so quickly (shoulder dystocia w/ cord compression) tha I know there was nothing I could do. I thought about condemning homebirth for it, but I know it wasn't the fact that she was born at home. When I was looking for online support I came across a mother who lost her baby the same way in a hospital.
I am very glad that you had enough warning signs of your condition to take appropriate action. Some of us aren't so lucky.
But I still do not believe that hospital birth should be default, of even you "ideal place". Bad things can happen anywhere. It's a scary thing to think about, but it is life. We need not blame our situations for these outcomes. Just realize that some things just *are*.

[DevaMajka]

My story is similar to yours on a few counts. I had a totally normal pg (my obgyn said it was textbook), pitocin very very early (before 2cm), early epidural at 2cm or so (because ds's heartrate went WAY down). I was in labor for 8 hours, I think, and he was born vaginally. (I did not know that pitocin can cause baby's heart rate to lower- thanks for that info).
After he was born, he was perfectly fine, but I started hemhorraging. They ended up giving me 5 pints of blood, and gave me an option as to the 6th and I decided no. They never told me why I hemhorraged, and I'm not sure they know. They reached in to feel for placenta, didn't find any, took me to the OR, and ended up stuffing my uterus with gauze to stop the bleeding.
They had me sign a consent form for a hysterectomy, in case the bleeding didn't stop when they took the gauze out. Thankfully, it worked.
I was in the hospital for 6 days.
(lucky for us too, bf'ing worked out well. Dp did all the work for the first few days.)

I'm fairly certain that THEY caused my hemhorraging. But I'll never know for sure. If they didn't cause it, and I'd been at home, I very easily could have died. That's why I never want to get pg again. And if I do, I'll have the baby in a hospital.

My SIL is pg, and it sounds like they have the right idea here in BC (not sure if its the same in all of Canada or not). You can choose a midwife or a doctor, and both have rights to the hospital.

Thanks for sharing your story. It's hard to have a difficult birth like that. It takes a lot of processing, at least it does for me. You never really know the "what ifs" yk?

[Ladybyrd]

Originally Posted by pannacotta

This is exactly what I was thinking as I read the story. This is a story that supports homebirth. OP, you felt something was wrong and you transferred. In fact, your body gave you good clues that something was wrong. How does this make homebirth any less safe?

because some things happen *without warning*.

But you had warning - that pain was not normal. It was a warning that you needed medical help.

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.

Well, sure...but then what? I could live at the hospital for my entire pregnancy just in case something went suddenly, seriously wrong, too, but most would think that to be a little over the top.

BUT.. in the case of an emergency you want the hospital there.

Of course - and that's what the hospital is for - for emergency situations. Just like your emergency situation. That's why any midwife worth a grain of salt will have a mom transfer at the first sign of serious trouble. And that's why it's very important to screen one's midwives carefully.

My 3rd pregancy ended at 32 weeks with a complete placental abruption. I was warned by an excrutiating contaction that didn't subside. We went to the hospital and when they didn't find a heartbeat on ultrasound, put me under general anaesthesia for an emergency c-section. I lost so much blood that I was told that if I had shown up even 10 minutes later, we both would have died. It had been a perfectly normal pregnancy up to that point, and there was absolutely no reason for my placenta to abrupt. Things happen.

BUT, I will not say that because of that, ALL my births should be in the hospital, because I understand that it was an anomaly.

My 4th baby was born at home. My midwife knew my history, and was prepared to transfer if we needed to. A known high risk pregnancy should not be done at home - I will say that forever. But, being in a hospital "just in case" is a step backwards, especially in this day and age where we can have reliable, quick transport available to us in case of an emergency.

[Juvysen]

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.

Having had this experience and THEN choosing homebirth after, yes, I would still have a homebirth. Honestly, I had a great birth experience w/a hospital midwife who was a big supporter of natural birth (she's actually close friends w/one of my homebirth midwives). Labor is labor... mine were about the same, honestly. Even in the hospital, I was allowed to eat and drink, etc, Walk, use the tub, use the birth ball. The big difference was being HOME afer vs. being in a cheap imitation of home after. There's no way I would want to give that up unless there was an emergency that necessitated a ride to the hospital (most likely in an ambulance). This is where your story supports homebirth, really... you listened to your body, knew something was VERY wrong and made the best decision for yourself and your child. I'm betting your midwife won't make the mistake of trying to talk someone out of listening to her body again. You've actually made homebirth that much safer by helping your midwife remember that the body knows when something's so wrong.

[the_lissa]

Originally Posted by Ladybyrd

A known high risk pregnancy should not be done at home - I will say that forever. But, being in a hospital "just in case" is a step backwards, especially in this day and age where we can have reliable, quick transport available to us in case of an emergency.

Exactly, and there are risks to hospital births too.

[JesseMomme]

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. In the US the closest thing (besides home itself) to what you describe would be birth centers, free standing or in-hospital. The criteria is often strict - you have to be what they consider low-risk, you have to be between 37-40 weeks, the baby can't be "too big" (and we know how accurate sonos are), you can't be a VBAC, and on and on.

When I first was pregnant with my second, I thought, perhaps a change of scenery would improve my birth experience. I aimed for the hospital's BC (same one I had my first birth in). They ruled me out at 34/35 weeks because of what they did to my son. My over managed labor sent ds into distress, when he was born they clamped his cord right away and so naturally he aspirated some old mec. During deep suctioning they punctured his lung. He developed pulmonary hypotension and was a gravely ill baby for the first week of his life. He's snuggled up with me now, I feel so blessed and lucky to have him here.

By the time I was about 35 weeks along, I had done a lot more research and realized that what happened to us wasn't some random occurrence, it wasn't "just one of those things we can't control", it wasn't fate. It was quite sadly typical. I was being denied what I thought I wanted (BC birth, after that I tried to "quit" hospital's care, and well that's a really long story) because the typical medical model of 'care' is dangerous. Talk about not fair.

So, after all that, I had no desire to look into any kind of BC ever again. I did more soul searching, and more research into homebirth and UC, and felt that UC was truly right for me (which I suspected was right for me evenwhile pregnant with ds2 but you don't just make that kind of paradigm shift in a short time). My second hospital birth, uneventful by medical standards at least, was what sealed the deal. I was not going deal with the pressure to be induced again with horror stories and threats of CPS and them being in a panic that I was a "disaster waiting to happen" at 39 weeks because of "pre-eclampsia" they suddenly discovered. I was not going to spend my whole labor fighting for what I had wanted even though I had a clear signed birth plan and copies that the nurses didn't even bother to look at, asking for an hour to get off the machines and into a tub, having my Dh throw himself between cord and Dr holding the clamp because she "forgot" about delayed cord clamping (he succeeded), getting 'standard' post partum pitocin without my prior knowledge..I could go on.

I'm not going to chance going through all of that based on the slight likely hood that something beyond anyone's control and no one's fault could happen.

My experiences have obviously helped to shape my opinion, likewise have yours. You're no longer comfortable with home birth, and I'm not trying to convince you otherwise, though I disagree with your conclusion that because there's a slight risk of something going wrong in a low risk preg, period, it's better to suggest the blanket solution of "hospital is the place to be".

Again, I do wish women had more options available. The sad truth is informed women are still rare, think hospital birth is the norm and were brought up to believe that birth is a scary event to be saved from. I sense changes happening and more women being informed, but the climate is more volatile I think. Just look at the climbing c-section rate in the USA.

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.

Honestly, both for me. Bad things associated with hospitals happened to me, and when the pressure was on me during my second pregnancy, I meditated one night to try to relieve the extreme mental and in turn physical stress I was under, and it became clearer and clearer that I wanted to be alone. Thinking about being alone in labor brought me an inner peace that I had never felt before.

Originally Posted by DoomaYula

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.

I had a mild PPH with my last birth. research and listening to my intuition and my body's signals (I also suspect that taking alfalfa prenatally played a part) is what kept it mild. I knew what to do, I didn't pass out, and I got through it. It was sort of "funny", I went into total take charge objective mode when I realized I was feeling dizzy.

Just a side note, because I disagree with you, the OP, doesn't mean I am attacking you. I think it's brave of you to share your story here, and hey, I'm glad you did.

Ok my kids are hungry, have to stop rambling!

[pannacotta]

yes. basically any scarring in the uterus can (in some women) logically cause problems later on. i believe studies on accreta do show a link among the risk factors. if i were an ob i'd look very carefully at the placenta-uterus interface in any woman who's had anything done to her uterus. mri can pick up some cases, ultrasound not as well but any case picked up beforehand makes for a better outcome, or at least more prepared docs.. blood ready, extra help on hand etc. sometimes the placenta is just left in the uterus to naturally be reabsorbed if it just won't come out and you don't want to yank it out and cause bleeding, there's been some success with that technique. 'course it won't work if you're already bleeding but not everyone does.

re the stats and all the papers cited.

1/

yes i believe most countries in europe have i believe better birth outcomes in general (this may be too broad a statement) and this is probably due to socialize medicine more than anything else. by this i mean healthcare is free for all, so women get care throughout their pregnancies from midwives (with ob's if unusual probs), there are midwives at births. holland i believe has the best outcomes anywhere, with 30% or so of women birthing at home with midwives.

there's also a feeling that birth is a natural process, it's a rite of passage and so on. (which i support). the flip side is in many countries in europe you must request an epidural ahead of time, have a little interview on why you want it because many hospitals don't have 24/7 epidurals available.

i'm from europe actually and i'd found a great 'birthing home within hospital' place i had planned to go to to give birth in my country, had plane ticket and everything, but then for family sickness reasons i couldn't go back at that time.. so i chose the next best thing here.

we can't really compare one country with another in this sense, because the US for-profit system is so different and serves a population of women from rich to poor, some who've had no healthcare because they can't afford it, (and so more probs that might have been caught pre birth).

europe is trying to reign in healthcare costs too, and while i know in holland midwives still visit the woman at home after birth (whether she birthed at home or not) for a couple of weeks i believe (they clean, cook, look after mum and baby,help with breastfeeding etc), in england this service is being cut back dramatically and women in many areas dont' have access to it. (look on guardian.co.uk).

re the statistics. the only way you could design a study would be a prospective one, randomly assigning low risk women to birth at home or hospital and then compare the outcomes. and that's obviously can't be done.

also i'm very aware that hospitals cause many of the problems they then 'rescue' you from in birth, hence i think it pays to go in prepared and knowing what you will accept (because you've done a lot of research) and what you will not. and have a support person who can be a friend, doula or anyone who is willing to offer the best support.

if you don't accept routine interventions in hospitals then all they are saving you from is existing problems that manifest themselves within those 4 walls. you don't have to accept routine vaginal exams (which can track infection up and cause fever in the mother and danger to the baby), you don't have to lie in a certain position, or accept iv fluids and pitocin and you can certainly say no to cytotec induction which esp in women who've had c-sections can cause uterine ruptures..

i mean you can can say no and they must respect that, but because you will be in labor i think you need a person to advocate for you while you sit there wearing earplugs or music and don't get distracted from what you're there to do.

i was taking little steps around the bed- despite the epidural - as i felt my legs and felt stable. my husband was right behind me to catch me if i happened to suddenly faint (possible effect of epidural). yet a bossy nurse stormed in, saw this and lectured me on how i had to lie down. i saw i will not and after more hassle she left. she can't make me do anything.

re statistics again. studies can prove that home or hospital is safe 99% of the time (and to the poster who asked, i'm using 99% as a figurative number to say 'in the vast majority of cases' since every study will come up with a new number and i can't cite them all), BUT if you are in that 1% you risk more by being away from a hospital.

it's all about risk and what you accept of it. most of us drive - we accept the risk that even if we are perfect drivers, a crazy person can hit us and kill us.

but in the case of birth we can *lower* our risk by going somewhere where there's a safety net (until my utopian 'birthing homes run by midwives in hospitals' is established (: ) and in something so important as birth i think we should consider if the risk of voluntarily doing without a safety net is worth it.

the complications that hit you without warning are rare - look at the Farm outcomes - they have been in business for decades (i seriously thought of going there actually, have incredible respect for ina may) and they have never had a maternal death. they have been lucky and i hope they continue to be, they are very skilled and experienced but they can't predict everything sadly.

i believe the higher risk of death at home in the case of rare unpredictable complications has such horrible consequences for a family - motherless baby, sad partner, other siblings etc - that it's not worth it. you can manage what is done to you in a hospital. by law you can say no to anything if you're consicous, but you can't manage the outcomes in the case of a rare problem that may kill you anyway whether home or hospital, but less likely to kill you if intensive medical help is right there. it's no guarantee, but i believe it lowers the risk and this is such a great even in anyone's life.

so i'm not really comparing the 'intervention heavy' hospital birth with homebirth, that would show such a list of hospital-caused problems there's be no room to write them, but i'm saying consider managing your hospital birth exactly as you want, with no routine interventions, sitting in the position you want, etc etc. visit the hospital beforehand, figure out how it works, how to get around things, find an Ob you gel with and pump them for info (since you prob can't guarantee they'll be on call that day) find what they routinely do and what they might insist on more. be prepared, you can say no to things just as you can say no to the car repair guy who wants to tack on lots of extra jobs (:

happy saturday to all

it's no guarantee, i'm well aware of how fragile life is.

[the_lissa]

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. I had a hospital transfer with my first, and the car ride was complete hell, and my hospital is pretty much what you described there.

I birth at home because it is comfortable, normal, no stress, and many, many other reasons which I cannot begin to list at the moment, and it has nothing to do with crappy hospitals.

[pannacotta]

thanks to everyone for replying btw. i knew there's be a range of views when i wrote and i don't feel attacked - it's not about me after all, but about what we're talking about. so keep 'em coming..

peace

[Juvysen]

what about the cases where interventions (especially cesareans) are forced on women via doctors getting courts involved? VBAC has fewer possible problems than a repeat cesarean, but many hospitals don't allow for vbac, and yes, they can force surgery on you if you show up in labor, even if everything's going perfectly. Also, doctors can be very coercive (pull the "bad mommy" card) if the see a possibility of anything going wrong or EVEN if you've been laboring most of the day and they're ready to go home. They call it "failure to progress", but what it usually is (no not every time...) is coersion to do things their way.

[roadfamily6now]

Quote:
The way I see it, you listened to your gut, and that's a very valuable thing. You felt something was very wrong, insisted that there was something not right, and went to the hospital. I haven't met any women who would do otherwise. Your point is moot, IMO.

This is exactly what I was thinking as I read the story. This is a story that supports homebirth. OP, you felt something was wrong and you transferred. In fact, your body gave you good clues that something was wrong. How does this make homebirth any less safe?

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?

And of course the flip side of this is, how many extremely rare but life-threatening situations occur as a result of being in the hospital? I think you could point out a number of things which happen purely as a result of having been in the hospital, that happen 1 in 60,000. Like acquiring an infection that significantly debilitates or kills the mom or baby. No one (well, except us maybe ) tries to say that a hospital is a dangerous place to have a baby because of those extremely rare things.

Edited to add: hopefully you don't see this as attacking you! It must have been an awful and scary situation for you, and I'm really happy for you that you trusted your intuition and had a midwife you respected you!

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Last edited by Contented73 : Yesterday at 10:49 PM.

This is exactly what I was thinking.

[pannacotta]

yes those happen - i'm actually looking into this now, how often it happens, in what circumstances and so on and for sure there are some bad sadistic docs out there like in any job. and there are also women who make mistakes too should take that c section to save the life of the baby and they do not. it works both ways. docs are not always right, and women are not always right.

it's hard, because it takes energy to go up against an expert (in any job) when our focus is elsewhere. and experts are not perfect, just as women's intuition is not perfect.

i think it should never come to a court ordered c section. it's terrible and suggests there's been a breakdown of communication and trust so bad that you have to reach for the law in such an intimate moment.

i know many hospitals aren't allowing vbacs (hey i'm due with #2 in a few months..and guess what.. they want a scheduled section, but i've made it clear that's not going to happen. i'll labor at home, then in hospital and do everything i can to have a normal birth.) and i'm sorry if you're in an area where there really area none that allow this. i do have a vbac choice (albeit under pressure) but if i didn't i think i'd go somewhere i did, it's that important to me.

the vbac-c section problem is another topic however (: i'd be surprised if there were a whole area of a state (i.e. you have no choice) where ALL hospitals immediately get a court order for a c section the minute a woman shows up in labor wanting a vbac, though i imagine if their 'policy' is to ban them women in the area know this and stay at home as much as possible or pick the friendliest of the anti-vbac hospitals..

it's sad that it's come to this. i agree with you. and i agree that c sections carry their own physical risks, not to mention mental effects that can strike some women who hadn't been planning on one. (of course some people also don't care, they just want the baby. i'm not one of them.)

[prothyraia]

Originally Posted by pannacotta

if you don't accept routine interventions in hospitals then all they are saving you from is existing problems that manifest themselves within those 4 walls.

re statistics again. studies can prove that home or hospital is safe 99% of the time (and to the poster who asked, i'm using 99% as a figurative number to say 'in the vast majority of cases' since every study will come up with a new number and i can't cite them all), BUT if you are in that 1% you risk more by being away from a hospital.

but in the case of birth we can *lower* our risk by going somewhere where there's a safety net (until my utopian 'birthing homes run by midwives in hospitals' is established (: ) and in something so important as birth i think we should consider if the risk of voluntarily doing without a safety net is worth it.

My problem with your argument is that it assumes you can go to a hospital, decline interventions, and have a normal birth. That's not always how it works, even in a very supportive hospital environment.

I had a hospital birth with my son, attended by a midwife, in a place that had birthing balls and waterbirth tubs and squat bars. Frankly, it was nicer than my apartment at the time. No one ever tried to coerce or scare me into anything. I arrived at 'the perfect time'- 6cm, well into active labor. The second I walked in the door, my contractions went "pfft" and I didn't have another good one until six or seven hours later when we had my membranes ruptured and then started pitocin.

Women/mammals are biochemically evolved to birth in a familar environment. My body *will not* labor somewhere strange, around people I don't know. I was lucky, in that the interventions I had didn't lead to any serious complications. But for me, to attempt to give birth in a hosptial is likely to require "help", which then jumps me right into the intervention-laden-c-section-prone, more likely to have something awful happen to me or my baby, sort of catagory. And I can't be the only woman like this!

I don't think anyone can deny that sometimes, a low-risk woman births in a hospital and the fact that medical attention is there saves her or her baby's life. Thank goodness you were there! But I think it's far, far more likely for a low-risk woman birthing in a hospital to end up losing her life or her baby than if she was at home: even *if* she is educated about interventions. Because changing your environment is in and of itself the FIRST intervention, and in some cases it can be enough to start that cascade that ends up with failure to progress/fetal distress/c-section.

[pannacotta]

again, you can *manage* what is done to you in a hospital. you can say no to anything, you can literally have no one touch you from the minute you get in. you have to consent to anything - though it's not always made clear.. (:

you can't manage your chances of an emergency- a real one i mean, not something that gives you time to transfer.

[Ladybyrd]

Originally Posted by pannacotta

words about refusing routine procedures...

Yes, but a mother in labor shouldn't have to fight to be left alone. She shouldn't have to fight to NOT have her labor managed. A mother in labor does not need to be additionally stressed - this in itself can interfere with a normal birth. Heck, just being in a strange place (like, say, a hospital) is enough to stop some labors.

Saying, 'just wear earplugs and have someone advocate for you' isn't going to work. When I'm in labor, I don't want strange people in my room. I'm going to notice if my birth support team is arguing with someone; and not only that, others cannot refuse procedures FOR you - you have to refuse them yourself.

It's just not that easy.

but in the case of birth we can *lower* our risk by going somewhere where there's a safety net (until my utopian 'birthing homes run by midwives in hospitals' is established (: ) and in something so important as birth i think we should consider if the risk of voluntarily doing without a safety net is worth it.

I think this illustrates the point that you're missing, though. Being at the hospital does NOT lower our risk, unless the pregnancy is a high risk one. The studies show that the mortality rate of homebirth vs. hospital birth is about the same; however, the morbity rate is much lower in a homebirth. If the mortality rate is the same for either place, that means that being at a hospital isn't really much of a safety net. For low-risk pregnancies, of course. If the mortality rate is about the same, and the morbity rate is lower at home, you can damn well bet I'll be at home. The hospital is a safety net - For emergency situations and high risk pregnancies. Not for normal, low risk pregnancies.

i believe the higher risk of death at home in the case of rare unpredictable complications has such horrible consequences for a family - motherless baby, sad partner, other siblings etc - that it's not worth it.

That's just it, though, the risk of death at home is NOT higher.