"Brave" has nothing to do with it - Mothering Forums

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#1 of 60 Old 02-01-2009, 12:02 AM - Thread Starter
 
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Originally posted in my personal blog, but Isarma suggested I share it here, too:

When hearing the news that I had my last baby at home and am planning to have this one at home as well, the first response from most people is, "You're so brave."

This has to be one of the most irritating things that people say to homebirthers. The implication is that birth is dangerous and that we are willing to take on a tremendous risk to do it anywhere but a hospital. It negates the research and planning that we've done to come to this decision. It makes the choice about balls, not brains. After all, homebirth is "dangerous." Hospital birth is "safe." Therefor, it must be bravado alone that would lead a woman to choosing such an option. Right?

In 2003, over 20% of women had their labors induced, with a rate closer to 40% in many hospitals, while that rate should not exceed 10% (and has remained at 10% in most industrialized nations). Inductions are approximately 5 times more likely among planned hospital births than planned homebirths. An 1999 American Journal of Obstetrics and Gynecology "Green Journal" review of 7000 inductions found that 3 out of 4 of the inductions were not medically necessary. Inductions are performed unnecessarily for estimated size of the baby (too large or too small), going past the estimated due date, amniotic fluid levels that are low but not critically low (correctable in nearly all cases by rehydration of the mother), rupture of membranes without immediate start of labor, the mother being dilated/effaced but not in active labor, or scheduling reasons on the part of the mother or care provider. Approximately 40-50% of inductions fail (depending on the induction method used and the mother's Bishop score), and most failed inductions end in cesarean section. Inductions increase labor pain and length, and create, among other problems, an increased risk of fetal distress, uterine rupture, and cesarean section.

But homebirth is "dangerous." Hospital birth is "safe."

Over 30% of women in the US have cesarean sections, while overwhelming research has led the World Health Organization to set an ideal standard rate of cesarean sections at 10-12%, with 15% being the rate where more harm is being done instead of good. Cesareans are performed at a similar rate across all risk groups, low to high. The cesarean rate for planned births at home or in an independent birthing center is approximately 4%. Cesarean sections increase the likelihood of maternal death by as much as 4 times, and have other immediate and long-term heath risks for mothers that include, but are not limited to, infection, bowel or bladder perforation, hysterectomy, future infertility, and increased risk of uterine rupture for future pregnancies. Risks for the baby include respiratory distress, fetal injury, prematurity (if result of schedule section or failed induction), and breastfeeding difficulties. Four of the greatest causes for the increase in cesarean section are overuse of interventions during labor, concern for malpractice/liability on the part of care providers, failed labor inductions, and "failure to progress" (labor not progressing fast enough or regularly enough for care providers).

But homebirth is "dangerous" and hospital birth is "safe."

The ACOG and AMA have both come out against homebirthing, calling it a dangerous trend and referring to it as a "fashionable, trendy, [...] the latest cause célèbre," and they paint a horrible picture of complications arising in low-risk pregnancies with no warning that cannot be handled anywhere but the hospital. Despite that, the most thorough study ever done on homebirth safety, Kenneth C Johnson and Betty-Anne Daviss's Outcomes of planned home births with certified professional midwives: large prospective study in North America, BMJ 2005;330:1416 (18 June), found that the outcomes of planned homebirths for low risk mothers were the same as the outcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth group. The Lewis Mehl Study of home and hospital births, which matched couples in each group for age, parity, education, race, and pregnancy/birth risk factors, found the hospital group had 9 times the rate of episiotomies and tearing, 3 times the cesarean rate, 6 times the fetal distress, 2 times the use of oxytocin for induction/augmentation, 9 times the use of analgesia/anesthesia, 5 times the rate of maternal blood pressure increase, 3 times the rate of maternal hemorrhage, 4 times the rate of infection, 20 times the rate of forceps use, and 30 times the rate of birth injuries (including skull fractures and nerve damage). Breastfeeding success rates are higher and postpartum depression rates are lower for planned homebirths.

But homebirth is "dangerous" and hospital birth is "safe."

The United States spends more per pregnancy/birth than any other country, the vast majority of women in the US give birth in hospitals, and yet the US's maternal death rate is the worst among 28 industrialized nations and the neonatal mortality rate is the second worst. The Netherlands, where 36% of babies are born at home, has lower maternal and neonatal mortality rates than the US. Denmark, where all women have access to the option for a safe and legal home birth, has one of the lowest maternal and neonatal mortality rates.

But homebirth is "dangerous," hospital birth is "safe," and Brutus is an honorable man.

I didn't choose a homebirth because I am brave. Bravery has little to do with it. If anything, I believe women who choose to give birth in US hospitals are the brave ones, because knowing what I know about our technocratic obstetrical system, I can't imagine voluntarily choosing an obstetrician and a hospital for anything but absolute medical necessity. My decision to homebirth wasn't made in a void, but based upon years of research. I wonder how much research the average woman puts into her hospital birth? Considering how many times I've heard someone say "I'm glad I was in the hospital because..." and then given as her reason a non-emergent situation (such as fetal size or nuchal cords), I'd say not that much.

Call me stubborn, because I wasn't willing to accept out of hand the culturally held belief that hospitals are safer. Call me an idealist, because I believe that birth can be a positive, safe, and empowering experience for child and mother. Call me a nonconformist, because I choose to birth at home in defiance of a powerful technocratic system. Call me outspoken, because I can't keep my mouth shut when I hear about yet another iatrogenic birth calamity. Call me a "birth nazi," because I believe it's the right and responsibility of every woman to educate herself about birth and take ownership of her birth experience.

But brave? Don't call me brave. "Brave" has nothing to do with it.
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#2 of 60 Old 02-01-2009, 12:23 AM
 
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#3 of 60 Old 02-01-2009, 01:09 AM
 
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Excellent post!

In my experience, though, when people say I'm brave to birth at home, they've meant "OMG, no epidural! How ever did you survive?!"

I also second the annoyance at people who think that certain things are so dire that they or baby "would have died" had they been at home, since chances are pretty good that's not the case. My baby had his cord wrapped around both shoulders and his neck, and the force of him coming out in one fell swoop with all the entanglement caused a mild hemorrhage by partially detaching the placenta (so goes the theory, anyway). Well, nuchal cord and PP hemorrhage were NOT dire emergencies for us, not even close. He was pink and scored a 9 and 10 Apgar, and my MW dosed me with cytotec and methergine which stopped the hemorrhage ASAP. No problems for either of us.

But you know what sucks? Whenever I tell his birth story, I feel like I have to leave out these parts since I know it would just scare people and make them worry about the next homebirth (as it has when I've included those bits). It's also funny because my labor progressed very quickly and I was pushing before the MW got here -- every. single. time. I tell that to anyone, they say "weren't you scared?!" Well, no. I or DH would have caught the baby if she hadn't made it in time. That's not bravery, that's just acceptance of the fact that birth is natural and it happens!

Anyway, I think that's a big part of the problem - people have forgotten that birth is a natural process that generally doesn't need intervention. They think people other than the mom always have to do things to make the baby come out. Sometimes, sure, but not every time, and a midwife or even the parents can do most of them.

Sorry, didn't mean to hijack your post with my mini rant. Just wanted to add my 2 cents.

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#4 of 60 Old 02-01-2009, 01:19 AM
 
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Love it. Wonderfully written, mama.

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#5 of 60 Old 02-01-2009, 02:33 AM
 
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Awesome!! I HATE that "Oh, you're so BRAVE!" comment. Really irks me : .

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#6 of 60 Old 02-01-2009, 02:40 AM - Thread Starter
 
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Originally Posted by rachel616 View Post
Excellent post!

In my experience, though, when people say I'm brave to birth at home, they've meant "OMG, no epidural! How ever did you survive?!"

I also second the annoyance at people who think that certain things are so dire that they or baby "would have died" had they been at home, since chances are pretty good that's not the case. My baby had his cord wrapped around both shoulders and his neck, and the force of him coming out in one fell swoop with all the entanglement caused a mild hemorrhage by partially detaching the placenta (so goes the theory, anyway). Well, nuchal cord and PP hemorrhage were NOT dire emergencies for us, not even close. He was pink and scored a 9 and 10 Apgar, and my MW dosed me with cytotec and methergine which stopped the hemorrhage ASAP. No problems for either of us.

But you know what sucks? Whenever I tell his birth story, I feel like I have to leave out these parts since I know it would just scare people and make them worry about the next homebirth (as it has when I've included those bits). It's also funny because my labor progressed very quickly and I was pushing before the MW got here -- every. single. time. I tell that to anyone, they say "weren't you scared?!" Well, no. I or DH would have caught the baby if she hadn't made it in time. That's not bravery, that's just acceptance of the fact that birth is natural and it happens!

Anyway, I think that's a big part of the problem - people have forgotten that birth is a natural process that generally doesn't need intervention. They think people other than the mom always have to do things to make the baby come out. Sometimes, sure, but not every time, and a midwife or even the parents can do most of them.

Sorry, didn't mean to hijack your post with my mini rant. Just wanted to add my 2 cents.


I don't mind at all if you hijack! I posted here for the sake of discourse, not to lecture at already like-minded people!

I have, in the past, found myself censoring my birth story for some people. It's something I'm working on, though. People need to talk about homebirth if it's every going to be normalized.
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#7 of 60 Old 02-01-2009, 03:09 AM
 
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Very well written!

If I get the "brave" line, I'll just say, "No, I'm really scared. Scared of having my vagina or uterus cut open, scared of my baby's skull being fractured, and scared of MRSA."

Erin~ Mommy to 3 curly-headed children and expecting #4 in December. ***4***8***12**16***20***24***28***32***36***40**
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#8 of 60 Old 02-01-2009, 03:35 AM
 
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Nice! My standard response to the "brave" comment is that I think people who go to the hospital are brave! Nothing scares me more than unnecessary abdominal surgery!

Mama to DS (6/07) h20homebirth.gif, DD (6/09) h20homebirth.gif, and DD (07/12) homebirth.jpg..

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#9 of 60 Old 02-01-2009, 03:39 AM
 
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Man, I wish I'd written that!

Would you mind if I linked to it on a couple birth lists I'm on?

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#10 of 60 Old 02-01-2009, 03:43 AM
 
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Just what I needed to read. I saw this on new posts and had to stop in. I JUST got done having this conversation with a SIL. It's so irritating (we UC so it has a whole new level of "bravery")! I finally told her that it wasn't a courage thing. It was I'm not about to repeat our hospital birth. It's bravery to go back that route (in my case). If you don't mind I'm going to send her your blog post. I think it would be useful for her to read!

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#11 of 60 Old 02-01-2009, 04:07 AM
 
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Huzzah!!! I am not brave....in fact, I am way too chicken to ever give birth in a hospital again!
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#12 of 60 Old 02-01-2009, 04:33 AM
 
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I copied this onto my blog, but gave the link of your blog. I hope that's ok.

Erin~ Mommy to 3 curly-headed children and expecting #4 in December. ***4***8***12**16***20***24***28***32***36***40**
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#13 of 60 Old 02-01-2009, 05:14 AM
 
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Beautifully written! I hate the brave comment too! I am not brave, just too scared to go to the hospital. My DD 18 months was delivered at a free standing birth center Now this one, that I am currently 38 weeks pregnant with is gonna be born at home, and into daddy's hands!
The risks of me birthing in a hospital far outweighs any risks with a HB!
You know it never even really crossed my mind for me to ever go to a OB, or birth in a hospital...
I hate the OMG you are crazy comment, not crazy well educated thank you very much! Even DP has a stance on birth center/ Hbs...Hospitals are for sick people..hehe.
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#14 of 60 Old 02-01-2009, 12:11 PM
 
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I copied this onto my blog, but gave the link of your blog. I hope that's ok.
I'm hoping to do the same thing, it says it all with the stats! I've been hearing that a lot too since my daughters beautiful, spiritual, amazing, and above all SAFE home birth. Normally I don't have the time to respond with more than, I disagree, I think its the women who go to the hospital to be the brave ones. And politely smile.

Do you mind if we repost and give you the glory?

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#15 of 60 Old 02-01-2009, 01:02 PM
 
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That was a great post!!

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#16 of 60 Old 02-01-2009, 01:29 PM
 
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Very well written!

If I get the "brave" line, I'll just say, "No, I'm really scared. Scared of having my vagina or uterus cut open, scared of my baby's skull being fractured, and scared of MRSA."
That's a good one! I will have to remember that!
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#17 of 60 Old 02-01-2009, 01:33 PM
 
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#18 of 60 Old 02-01-2009, 01:36 PM - Thread Starter
 
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Anyone who wants to repost is welcome to do so!
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#19 of 60 Old 02-01-2009, 04:03 PM
 
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AMEN! From another "brave" mama

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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#20 of 60 Old 02-01-2009, 07:04 PM
 
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Very well written!

If I get the "brave" line, I'll just say, "No, I'm really scared. Scared of having my vagina or uterus cut open, scared of my baby's skull being fractured, and scared of MRSA."


Well argued, ladies!

Mom to : Belle and Izzy
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#21 of 60 Old 02-01-2009, 11:05 PM
 
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Well said. I also love it when they tell me I should get a medal. Yes, I gave birth at home to get a medal. *oy*

Mommy to 6 year old dd and almost 2 year old ds, working to become happy every day and healthy along the way!
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#22 of 60 Old 02-01-2009, 11:37 PM
 
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I find myself not even mentioning DS was born at home in some company. Like the lady at daycare who was upset her OB let her tear instead of giving her an episiotomy. Eventually I did mention it and she gave the "oh, you're so brave" comment. I just said I thought women who did natural birth in the hospital were brave (to deal with all the crap hospitals want to foist on them). My MIL also gave me the "you're so brave" comment. I'm so horrible thinking up responses on my feet I just kind of smiled awkwardly and changed the subject.

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#23 of 60 Old 02-01-2009, 11:53 PM
 
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Yeah, that bravery comment from other women was one thing I never expected about having a home birth. I get it all the time.

It doesn't annoy me, it makes me sad. I wish more women understood that we ARE ALL BRAVE because we ALL GIVE BIRTH...and giving birth does require courage no matter where or how you do it.

I may be "brave" to some because I had my babe at home...but I think all those women are even more courageous for having their babies in hospitals. And I say that honestly every single time I hear that comment.
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#24 of 60 Old 02-01-2009, 11:55 PM
 
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i heart you.
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#25 of 60 Old 02-02-2009, 12:01 AM
 
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This is great. I want Mothering to publish it in their next magazine. You're awesome, mama.

ETA: can I repost this on my own blog? I'll link to your LJ, but it's really powerful and I want to share it.

knit.gifWife to Ageek.gif since 7-7-2006, Mother to Mnocirc.gif since 11-23-2007ribboncesarean.gif, and N slinggirl.gifborn on 4-9-2010vbac.gif
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#26 of 60 Old 02-02-2009, 12:06 AM - Thread Starter
 
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This is great. I want Mothering to publish it in their next magazine. You're awesome, mama.
That's so flattering, so thank you so much! Because I don't cite resources for my stats, I definitely wouldn't feel comfortable submitting it to Mothering or any other publication as-is. I do hope to have articles published with Mothering in the future, though.
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#27 of 60 Old 02-02-2009, 12:16 AM
 
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That's awesome. I also hate the brave comments. I've even been told I was brave for not finding out the gender of our baby! Someone once said to me "It's not like you get a medal for having your baby at home." Yes, that's exactly why I plan to give birth at home. I want a shiny medal. I went home and told dh, and he said that he would make sure to get me a medal so if anyone else says that, I can say "Yes I did!"

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#28 of 60 Old 02-02-2009, 01:33 AM - Thread Starter
 
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That's awesome. I also hate the brave comments. I've even been told I was brave for not finding out the gender of our baby! Someone once said to me "It's not like you get a medal for having your baby at home." Yes, that's exactly why I plan to give birth at home. I want a shiny medal. I went home and told dh, and he said that he would make sure to get me a medal so if anyone else says that, I can say "Yes I did!"

I usually respond to that with "an undrugged baby, an undisturbed birth, and being able to fall asleep in my own bed an hour later WAS a medal/trophy as far as I'm concerned."
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#29 of 60 Old 02-02-2009, 01:37 AM
 
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I haven't given birth, not even pregnant yet - but, great post. I totally agree.

Honestly, for me personally, I think it's brave to go into the hospital when nothing is wrong with you. I'm really freaked out by hospitals. They're places of emergency and dire sickness situations. So, to be healthy, and go in there for birth, seems very brave to me. I want a homebirth precisely because it feels so much safer than the hospital.

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#30 of 60 Old 02-02-2009, 02:18 AM
 
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Awesome post! I wanted to shout hurray! This is totally what I know and want to share with every person who says this to me... or expresses doubts about the safety of homebirth.

Seriously, what is it with the Drs trying to pull out the "trendy" card -- like we're birthing at home because stars do it? Um, I had my first DD at home before Ricki Lake talked about her homebirth... we're just happy that someone is finally talking about it in a way that's got the mainstream media's attention. And my hb midwife has had a steady practice for the last 25 years... some "fad", eh?

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