S/O: If you could have a "homebirth in the hospital," would you? - Page 5 - Mothering Forums
View Poll Results: If you could have a "homebirth in the hospital," would you?
Yes 74 23.05%
No 201 62.62%
It depends 40 12.46%
The infamous other! 6 1.87%
Voters: 321. You may not vote on this poll

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#121 of 148 Old 12-08-2008, 05:53 PM
 
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I voted It Depends ...

My first choice would be at home; however,

I personally want more choices for moms everywhere. I live in a state where options are limited because cpm are not recognized and I live in an area where VBAC is rare. My second baby needed to be born in the hospital. We traveled to a hospital an hour away to be at a more "family/patient" friendly hospital. There were 5 hospitals closer and 2-3 of them have top level neonatal units but they are heavy on the interventions and rules and you have to fight for everything out of the "norm" at all of them. The birth of my 2nd baby was still a beautiful event even though it was a c/s. The ob and staff were surprised at many of our requests/exclusions, but did not fight us on anything and accommodated all of our requests. I want that for other women.

I am pregnant again and am planning a HBAC with the same cpm. I am praying that no prohibiting complications arise - I do not want to have to fight for a VBAC with an OB. Though this mama bear will fight, pregnancy and birth should be a joyful time and not a battlefield.
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#122 of 148 Old 12-08-2008, 11:48 PM
 
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If it:

Was in the town where I live (I have VERY fast labors)
Had a big Jacuzzi tub
I had the option to go home right away

Then I would definitely consider it!

Lynisha ~Car Seat Tech-Scrapbookin'-Cake Decorating-semi-crunchy wife & SAHM to 2 + one on the way in Nov~

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#123 of 148 Old 12-09-2008, 12:08 PM
 
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As someone getting ready to have her first and with just so much uncertainty and lack of knowledge on my part at this point that would be a fantastic option. Sure, it's not a "real" homebirth. But if I could have the guaranteed low intervention, low pressure, private birth I want... and it could be at a hospital just to ease my fears with my first... well, I wouldn't still be trying to decide between a homebirth and hospital birth.
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#124 of 148 Old 12-09-2008, 02:03 PM
 
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No. "Homebirth in the hospital" is an oxymoron.. A true home birth wouldn't include Pitocin drips and electronic fetal monitors "standing by," and I wouldn't be subjected to intractably rigid, anti-evidence "policies" and "requirements."

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#125 of 148 Old 12-09-2008, 02:10 PM
 
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Originally Posted by beckyand3littlemonsters View Post
I voted no as my dad would say You can spray paint a turd gold but at the end of the day it's still a turd.


Marsden Wagner stated: "A hospital which claims to have a 'birth center' is like a bakery which claims to sell 'home-baked bread." Same idea.http://www.acegraphics.com.au/articles/wagner03.html

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#126 of 148 Old 12-09-2008, 02:15 PM
 
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No. "Homebirth in the hospital" is an oxymoron.. A true home birth wouldn't include Pitocin drips and electronic fetal monitors "standing by," and I wouldn't be subjected to intractably rigid, anti-evidence "policies" and "requirements."
I thought the idea of the question was that these things would NOT be an issue. There somewhere, sure, but not pressured into them, no rigid policies, etc. That was the point of the question, I thought.
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#127 of 148 Old 12-09-2008, 02:56 PM
 
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I really have to disagree that thinks like c/s and anasthesia makes (normal, low risk) birth safer. A lot of studies show, that for low risk birth, access to the things you mention is actually making birth less safe. All medical procedures have risks.
The idea, as I understand it, is not that one would put curtains in a hospital room and call it a "homebirth in the hospital" because, lo and behold, we have curtains. Rather, the idea is a revolution in the OB approach to birth, and a massive shift from litigation-centered maternity care to mother/baby-centered maternity care (sometimes called the midwifery model of care). OBs will tell you their care is baby-centered, but all too often, it's a strong combination of (a) fear of litigation; (b) avoidance of inconvenience when possible; and (c) strong priority on the baby.

I also did not say that anesthesia makes low-risk birth safer. I said I want access to anesthesia during labor without having to transport during late active labor or transition, especially since a non-emergency transport for me takes a minimum of an hour and a quarter, or as long as three hours in traffic.

I believe, based on the evidence (which we could disagree about all day), that surgical births do save babies, including for low-risk mothers. Low-risk mothers can have sudden emergent situations or unexpected problems during labor. The numbers are low - no one would argue that. But given the choice, I would much rather be at a hospital where that c-section was minutes away and people already knew where I was and what was going on, than facing an emergency transport situation to an unfamiliar hospital where my midwives don't have privileges and I'll get an OB I've never seen who may be hostile towards the homebirth choice, the sudden appearance of an emergency, etc. Not to mention that it's very likely that decision time to baby out time, in a true emergency, would be faster in the hospital. No fault of my midwives or anything else, just a matter of making the 911 call, the long drive to the nearest hospital (about 20 minutes), anesthesia for me, getting me in the OR, etc.

Other women may be in a different situation and may feel they don't share the same risks, I get that. Or evaluate those risks differently. And heck, I chose homebirth over hospital birth to avoid the highly medicalized manner of birth. All I'm saying is, having my own bed, shower, and birth tub is not why I stayed home, nor would it be reason enough to prioritize that over the accessibility of medical assistance when needed in the hospital. What outweighed the availability of emergency care, for me, was the SOP of hospitals and feeling that that kind of hostile/pushy atmosphere was not conducive towards a healthy birth and that we were likely to be unnecessarily tampered with (intervention). If that were not an issue, for sure I'd hospital birth. I've always said that, for me, homebirth vs. hospital birth is about risk analysis. Change the nature of hospital birth and that alters my risk analysis.

If you're referring specifically to the BMJ study, of course we could talk about statistics a lot, but you might know that there's been some discussion of the data, the authors have talked about some perhaps questionable (or at least, questioned) choices they made with regards to the data set, and the full data that MANA has has not been published and will not be shared with anyone except those who agree to use it to promote midwifery and homebirth. I understand where they're coming from because there are a lot of homebirth enemies out there, but at the same time, if the data was really a slam dunk, I think they wouldn't be so reluctant to share.

Medical procedures do carry their own set of risks, absolutely. However, I know perfectly well that if I have a cord prolapse or complete placental abruption at home there's a good chance I'll lose my baby. My baby is more likely to live, in those rare and unusual circumstances, if we're at the hospital. If I could avoid CFM, restriction of movement, pitocin, epidural (unless I decided I wanted it), unnecessary VEs, etc. AND be in the hospital, I would totally do that. No question. That's what homebirth in the hospital means to me - respect for the patient, lack of strict or rigid policies that can easily derail an otherwise natural birth, continuity of care (i.e. a midwife who stays with me), and the ability to bring along some things from home to make myself more comfortable. Bringing it back to the issue of medical procedures having risks - (1) homebirth in the hospital to me would mean a truly low-intervention birth, like my homebirth; and (2) while I want to avoid those interventions whenever possible, and did so by showing up pushing with #1 and having a homebirth with #2, I would say that when medical intervention is needed, the risk of the intervention is almost always far less than the possible consequence of death, which is what I see as homebirth's biggest drawback (increased risk of baby's death). I know the BMJ study says the risk of the baby dying is the same, but I've spent some serious time looking at that study, and I do have concerns. Logically, it makes sense that some babies die at homebirth that would not die in the hospital. Possibly the reverse is also true, but it almost certainly would more often go the other way (homebirth).

This is in no way a reproach of anyone planning a homebirth or a condemnation of homebirth. I fully support homebirth! But I do think it carries some risks that differ from the risks encountered during a hospital birth. When a woman chooses her place of birth, hopefully she carefully considers all her options and makes an informed decision that she's comfortable with. I have no regrets about my homebirth.
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#128 of 148 Old 12-09-2008, 03:57 PM - Thread Starter
 
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I thought the idea of the question was that these things would NOT be an issue. There somewhere, sure, but not pressured into them, no rigid policies, etc. That was the point of the question, I thought.
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Originally Posted by Romana9+2 View Post
The idea, as I understand it, is not that one would put curtains in a hospital room and call it a "homebirth in the hospital" because, lo and behold, we have curtains. Rather, the idea is a revolution in the OB approach to birth, and a massive shift from litigation-centered maternity care to mother/baby-centered maternity care (sometimes called the midwifery model of care). OBs will tell you their care is baby-centered, but all too often, it's a strong combination of (a) fear of litigation; (b) avoidance of inconvenience when possible; and (c) strong priority on the baby.
Yes and yes.
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#129 of 148 Old 12-09-2008, 06:10 PM
 
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If you could have all the great things about homebirth at your disposal in the hospital, would you birth there? Total privacy, no machinery, no strangers, no interventions pushed on you, continuous one-on-one care, a pool, a big comfy bed, allowed to do what you want, etc. etc.? Dream up the most awesome hospital birth you can think of and tell me if you would choose that over home. I will give my own answer in a bit!
Bluntly? No way in hell. Home is where I'll always choose to be, hands down.

Stacy - mom to Lily 5-20-06 , Angel, stillborn @ 25 wks 12-17-07 , and Cami 4-21-09.
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#130 of 148 Old 12-09-2008, 11:26 PM
 
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To expand on my pp, in order for me to dream up the most awesome hospital birth ever, first I'd have to dream up aradically different practice of health care in America - not just OB/GYN, but across the board. And frankly, I am too cynical to get very far with that.

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#131 of 148 Old 12-09-2008, 11:31 PM
 
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I went with the infamous other. In some ways, I feel like a really kick ass groovy birth center is better than any other alternative, because let's face it, in a teeny tiny percentage of the time, proximity to a hospital would save a mother or baby. It's not big enough for me to worry and it certainly doesn't outweigh the other risks of going to what most hospitals are actually like, but it does give me pause.

I had a fantastic birth center birth with my first. If I'd stayed living where we were I probably would not have explored homebirth and gone back. However, now having had a homebirth, it was so completely different and just better in a million ways that could never be duplicated away from home, that I can't see ever wanting to do it any other way. BUT, I also have had 2 extremely uncomplicated deliveries. If I'd had any complications, maybe I'd be more interested in a hospital/birth center.

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#132 of 148 Old 12-16-2008, 03:27 PM
 
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What a great post!

I agree.

Also, my baby is important to me, but frankly I am just as important- if not more important, to me.

Quote:
Originally Posted by Romana9+2 View Post
The idea, as I understand it, is not that one would put curtains in a hospital room and call it a "homebirth in the hospital" because, lo and behold, we have curtains. Rather, the idea is a revolution in the OB approach to birth, and a massive shift from litigation-centered maternity care to mother/baby-centered maternity care (sometimes called the midwifery model of care). OBs will tell you their care is baby-centered, but all too often, it's a strong combination of (a) fear of litigation; (b) avoidance of inconvenience when possible; and (c) strong priority on the baby.

I also did not say that anesthesia makes low-risk birth safer. I said I want access to anesthesia during labor without having to transport during late active labor or transition, especially since a non-emergency transport for me takes a minimum of an hour and a quarter, or as long as three hours in traffic.

I believe, based on the evidence (which we could disagree about all day), that surgical births do save babies, including for low-risk mothers. Low-risk mothers can have sudden emergent situations or unexpected problems during labor. The numbers are low - no one would argue that. But given the choice, I would much rather be at a hospital where that c-section was minutes away and people already knew where I was and what was going on, than facing an emergency transport situation to an unfamiliar hospital where my midwives don't have privileges and I'll get an OB I've never seen who may be hostile towards the homebirth choice, the sudden appearance of an emergency, etc. Not to mention that it's very likely that decision time to baby out time, in a true emergency, would be faster in the hospital. No fault of my midwives or anything else, just a matter of making the 911 call, the long drive to the nearest hospital (about 20 minutes), anesthesia for me, getting me in the OR, etc.

Other women may be in a different situation and may feel they don't share the same risks, I get that. Or evaluate those risks differently. And heck, I chose homebirth over hospital birth to avoid the highly medicalized manner of birth. All I'm saying is, having my own bed, shower, and birth tub is not why I stayed home, nor would it be reason enough to prioritize that over the accessibility of medical assistance when needed in the hospital. What outweighed the availability of emergency care, for me, was the SOP of hospitals and feeling that that kind of hostile/pushy atmosphere was not conducive towards a healthy birth and that we were likely to be unnecessarily tampered with (intervention). If that were not an issue, for sure I'd hospital birth. I've always said that, for me, homebirth vs. hospital birth is about risk analysis. Change the nature of hospital birth and that alters my risk analysis.

If you're referring specifically to the BMJ study, of course we could talk about statistics a lot, but you might know that there's been some discussion of the data, the authors have talked about some perhaps questionable (or at least, questioned) choices they made with regards to the data set, and the full data that MANA has has not been published and will not be shared with anyone except those who agree to use it to promote midwifery and homebirth. I understand where they're coming from because there are a lot of homebirth enemies out there, but at the same time, if the data was really a slam dunk, I think they wouldn't be so reluctant to share.

Medical procedures do carry their own set of risks, absolutely. However, I know perfectly well that if I have a cord prolapse or complete placental abruption at home there's a good chance I'll lose my baby. My baby is more likely to live, in those rare and unusual circumstances, if we're at the hospital. If I could avoid CFM, restriction of movement, pitocin, epidural (unless I decided I wanted it), unnecessary VEs, etc. AND be in the hospital, I would totally do that. No question. That's what homebirth in the hospital means to me - respect for the patient, lack of strict or rigid policies that can easily derail an otherwise natural birth, continuity of care (i.e. a midwife who stays with me), and the ability to bring along some things from home to make myself more comfortable. Bringing it back to the issue of medical procedures having risks - (1) homebirth in the hospital to me would mean a truly low-intervention birth, like my homebirth; and (2) while I want to avoid those interventions whenever possible, and did so by showing up pushing with #1 and having a homebirth with #2, I would say that when medical intervention is needed, the risk of the intervention is almost always far less than the possible consequence of death, which is what I see as homebirth's biggest drawback (increased risk of baby's death). I know the BMJ study says the risk of the baby dying is the same, but I've spent some serious time looking at that study, and I do have concerns. Logically, it makes sense that some babies die at homebirth that would not die in the hospital. Possibly the reverse is also true, but it almost certainly would more often go the other way (homebirth).

This is in no way a reproach of anyone planning a homebirth or a condemnation of homebirth. I fully support homebirth! But I do think it carries some risks that differ from the risks encountered during a hospital birth. When a woman chooses her place of birth, hopefully she carefully considers all her options and makes an informed decision that she's comfortable with. I have no regrets about my homebirth.
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#133 of 148 Old 12-16-2008, 09:50 PM
 
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Its not truly home... Really the thought of strangers outside "waiting" for my emergency would make me nervous.
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#134 of 148 Old 12-18-2008, 04:19 PM
 
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The MRSA germs don't know that that's the "homebirth" room and to stay out. Until hospitals get a handle on the problem AND local physician hand washing compliance reaches above 40%, I'm staying away from any hospital unless it's life-or-death.
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#135 of 148 Old 12-20-2008, 03:44 AM
 
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I voted "no" because one of my reasons for home birth is that the hospital is an expensive "hotel" that I don't need--and you didn't list cost as one of the factors.

I did have two good hospital births with my first two daughters. Then 3 home births.

But..ahem...you can't do it--get a home birth in a hospital. There is still the drive.
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#136 of 148 Old 12-20-2008, 03:47 AM
 
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The MRSA germs don't know that that's the "homebirth" room and to stay out. Until hospitals get a handle on the problem AND local physician hand washing compliance reaches above 40%, I'm staying away from any hospital unless it's life-or-death.
Unfortunately, this line of reasoning is one that draws ridicule from the medical establishment--because realistically, infection is not killing birthing women.

Of course the threat of infection (not necessarily MRSA, but GBS and others) does lead to quite a few cesareans.
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#137 of 148 Old 12-20-2008, 03:56 AM
 
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No. I'm an asocial recluse. Generally, I don't enjoy leaving home, lol.

It can't be "like home" ... it has to be home. I won't feel comfortable or relaxed otherwise.

Besides that, if I'm having a healthy pregnancy, then there is no reason for me to go to a hospital. When I think of hospitals, I think of emergencies or diseases that need to be treated in patient.

I never think of birthing there ... the connotation just isn't there for me.
Yup, that. My hospital birth wasn't really bad, but I realized too late just how much I hate people when in labor. And I spent hours wishing for my own pillows.
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#138 of 148 Old 12-20-2008, 04:20 AM
 
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Even if we suddenly invented teleporting transport machines so we wouldnt have to drive or walk to this "homebirth hospital", i STILL would rather birth at home than the hospital. As a classic introvert, for me, nothing beats being at home.

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#139 of 148 Old 12-20-2008, 04:38 AM
 
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would and did.

For us there were several considerations, the main ones being that 1--hospital was fully covered on insurance and we were utterly broke 2--the hospital and OB available to us were extraordinarly good (ie, it was very homebirthy!) and 3--DH was not comfortable with home, and there was no birth center option.

Birth center is my ideal, and my hope for next time. I don't know if DH will ever be wholly comfortable with home, and honestly i ike the idea of someone else handling prep and cleanup...

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#140 of 148 Old 12-20-2008, 05:21 AM
 
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Yes, but ask me again in seven months and my answer might be different.

Right now I'm coming from a perspective of never having had a homebirth. This will be my first homebirth and I'm nervous. I'm not due til June so I'm trying to get all of my obsessive panicking done now so that by the time Bun is born I can be calm and thrilled and happy to be having a homebirth.

I had four hospital births and did not hate them. There were certain aspects which I didn't love and certain aspects which I did. My hospital births were pretty close to birth center births with one major exception ~ the first one was heavy with interventions. The two hospitals where I gave birth were striving for a birth center model. One room {no seperate rooms for labor, delivery, recovery ~ just one room for everything, unless you had to go to the OR. If so, you were returned to that same starting room for the remainder of your stay}. As home like of an atmosphere as a hospital can get. The first one had a jacuzzi in every room. They weren't terrible, but they were still hospitals. The last one was the best ~ midwife, the birth-center-in-a-hospital setting, I was mostly in control ~ but there were still parts which I did not like. Which is why I'm choosing a homebirth this time.

So ask me again after I actually have a homebirth and my answer might be completely different.
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#141 of 148 Old 12-20-2008, 12:30 PM
 
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Only if I had some reason why being in the hospital would be advisable, but the real issues that would make homebirth at home inadvisable, are usually serious enough to make birth inadvisable in favor of section. But I am sure there are a few things that could make it safer to birth vaginally in a hospital that aren't cause for section. If I were going to vaginally birth a breech other than frank breech, I would want to do it in that "perfect" hospital scenario. So yes, if I were attempting footling breech, and I could do it vaginally without any interventions or hassles, and just have someone with oxygen and emergent supplies if needed, I would opt for that instead of automatic section.

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#142 of 148 Old 12-27-2008, 12:43 AM
 
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As many have said, it is called homebirth for a reason- it's at home. I don't care how many accomodations a hospital has I still have to travel their (in labor no less) and it still isn't that comfy place I call home. It isn't familiar. It doesn't have my germs. It doesn't have my kitchen and my stuff. I still have to pack things and go there. And let's face it, even with all the accomodations you aren't going to find a hospital who offers an atmosphere where you don't have to deal with people you don't know- there will always be people you don't know at a hospital- not my idea of peace in a very vulnerable state.
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#143 of 148 Old 12-29-2008, 01:41 PM
 
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I had posted an article in the health and healing area a little while ago. MRSA is not JUST a hospital thing. People get it every day. It happens outside the hospital. I have had these several times and not gotten it from a hospital. One of them actually PUT me in the hospital where it was treated. Had I not went to the hospital to get it treated, I could of risked my life and the life of my unborn son. While pregnant with my first homebirth baby I developed this multiple times and kept getting it before I got pregnant with my angel and even while pregnant with her. MRSA is picked up everywhere, not just in a hospital, where it can actually be treated!!!!

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#144 of 148 Old 12-29-2008, 10:15 PM
 
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I had posted an article in the health and healing area a little while ago. MRSA is not JUST a hospital thing. People get it every day. It happens outside the hospital. I have had these several times and not gotten it from a hospital. One of them actually PUT me in the hospital where it was treated. Had I not went to the hospital to get it treated, I could of risked my life and the life of my unborn son. While pregnant with my first homebirth baby I developed this multiple times and kept getting it before I got pregnant with my angel and even while pregnant with her. MRSA is picked up everywhere, not just in a hospital, where it can actually be treated!!!!
Studies have shown over and over that the cases of *hospital acquired* MSRA are skyrocketing.

Is that the only place you can get it? Of course not. Locker rooms are also notorious- wouldn't catch me birthing in one of those either

-Angela
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#145 of 148 Old 12-30-2008, 01:57 PM
 
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Absolutely not. If a hospital becomes necessary at any point during my pregnancy or birth, THEN I'll go but there is no way I'd travel, expose myself and baby to germs/protocols/rules, and simply not be in my own space if there wasn't a very compelling medical reason. Just doesn't make any sense to me. Baby and I are safest at home.

Mama to four remarkable kiddos, all born at home.
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#146 of 148 Old 01-01-2009, 01:37 PM
 
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I wasn't going to post because I know so many here are so against hospital births, but I voted yes. DH doesn't feel comfortable with a homebirth and if he's not comfortable, I wouldn't be. I know a hospital birth could never truly be a homebirth, but my doctor and hospital are trying to do their best for us. We have really great birthing suites and I will get to labor in tub, or not, no monitoring, no medical intervention unless necessary, birth in whatever position I want. And really the best thing? My DH will get to 100% deliver the baby (yes, the doctor will be there, but I don't care).
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#147 of 148 Old 01-01-2009, 02:19 PM
 
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I would vote for a Birth Center in a separate building from the hospital, but now that I've learned more about birth centers, I don't think they're all that they tout themselves to be (most of them don't even allow VBACs, how totally lame!).

Anyway, I'm planning an HBAC, seeing out of hospital mws, and at this point, I have absolutely no reason to think that a hospital/birth center birth would be any better than home.
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#148 of 148 Old 01-02-2009, 05:33 PM
 
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I voted no - home is the best place for me and my family. Ds1 woke up from nap came downstairs to meet his baby brother.

April thankful mommy to my boys Big Red 3/06 Little Z 9/08 and happily awaiting the arrival of 10/10 :
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