Talk

Advanced search

Would you like to be a member of our research panel? Join here - there's (nearly) always a great incentive offered for your views.

obstetrician who had a homebirth

(36 Posts)
ClarityMa Sun 28-Aug-11 14:38:35

Has any one read that new book The Heart in the Womb written by Dr Amali the obstetrician that had a homebirth? Its really inspirational. I didn't know what to expect but it is a real women-power book.

MeconiumHappens Sun 28-Aug-11 19:21:58

Wow, havent read it but there arent many obs that would go for a homebirth. I think it must be realy difficult for them only ever seeing the difficult side of birth then having faith in their bodies, good for her. Will look out for the book, thanks.

ClarityMa Thu 01-Sep-11 11:35:50

Think you're right..... obstetricians probably have a post traumatic stress complex which clouds their judgement about normality. The book's only available online see www.theheartinthewomb.com

nannyl Thu 01-Sep-11 13:57:34

that book looks fab.

Im planning a home birth and am currently 38+4 weeks sitting here looking at all my homebirth stuff!
Interestingly the other person from my NCT group planning a homebirth is a midwife!

straighttalker Thu 01-Sep-11 14:42:19

"I think it must be realy difficult for them only ever seeing the difficult side of birth then having faith in their bodies"
"obstetricians probably have a post traumatic stress complex which clouds their judgement about normality"

I think you're probably right about past experience dictating future actions.

I know that, personally, as an anaesthetist, the hours I've spent squeezing blood bags by hand into a post partum haemorrhage has certainly reduced my faith in my body coping with five litre blood losses (i.e. total capacity) all on its own.
And those homebirths that are rushed into hospital for analgesia, foetal distress, etc that then become 'hospital statistics' for PPH, foetal hypoxic brain injury surely have probably clouded my judgement on normality.

It's strange to me that one of the questions I'm asked about patients in intensive care is - what would you do, doctor, or what would you recommend for your own husband/sister/mother if you were choosing, doctor - yet when it comes to obstetrics, people assume that our past experiences are irrelevant just because the vast majority of births go just fine. Childbirth is very safe - at home or at hospital, if you're healthy - but still probably the most dangerous event in most women's lives.

I think it would be lovely - in theory - to have my baby at home. I understand the reasons that women opt for home births. However any professional in the know - obstetrician, anaesthetist, midwife, paediatrician - who exchanges a potentially uncomfortable traumatic 24-48 hours in the hospital for a homebirth is criminally misguided, and someone I'd like to meet to ask why on earth she would do that. It could never be worth the alternative. From a doctor's point of view, a successful homebirth is someone who has risked everything and simply been lucky.

The only doctor I know who had a homebirth was a general medic - all well, mother and baby fine, thank goodness, although had to transfer in for retained placenta - chose to do so because her experiences with midwives in hospital during her brief stint as a paeds SHO led her to believe that independent one-to-one care would be best.

marthamay Thu 01-Sep-11 14:48:55

straighttalker
And those homebirths that are rushed into hospital for analgesia, foetal distress, etc that then become 'hospital statistics' for PPH, foetal hypoxic brain injury surely have probably clouded my judgement on normality.

Is that really true that these become hospital statistics? Are they 'planned' home births you are talking about or accidental (I don't think that gets covered in the statistics either) How do you find that information out? I'm asking because I'm considering a homebirth and trying to do as much research on it as possible and your post is very interesting from that perspective.

hester Thu 01-Sep-11 14:49:43

I know another obstetrician - quite a prominent one - who had a home birth.

Stormwater Thu 01-Sep-11 14:50:00

'criminally misguided'? shock

hester Thu 01-Sep-11 14:51:56

And yet, straighttalker, loads of midwives do have home births, and they presumably also see a wide range of births.

I think 'seeing what can go wrong' is part of it, but not the whole story.

mrsravelstein Thu 01-Sep-11 14:54:36

i would be pretty concerned about having someone with such an extreme view of childbirth as straighttalker attending at any of my births

PinkFondantFancy Thu 01-Sep-11 14:59:46

'From a doctor's point of view, a successful homebirth is someone who has risked everything and simply been lucky.' - do people really think this?

I am currently 36 weeks pregnant with my first baby and am seriously considering a homebirth. My husband and I are both very risk averse but feel that as I am considered 'low risk' the potential benefits of a homebirth outweigh the risks, which as far as I can tell are almost exactly the same risks that the baby and I would face in hospital in any case.

I'm not trying to start a fight - I'd really appreciate people's opinions on this, especially the reasons why a homebirth would be considered to be 'criminally misguided'. Giving birth is the most important and potentially dangerous thing that I'll do in my life, and I really don't want to mess it up by making poor decisions.

ciwi Thu 01-Sep-11 15:00:13

If straighttalker kept me and my baby safe I really wouldn't care. I personally can't understand why anyone would risk a homebirth, it's just not worth it for mother or baby but then that is just my opinion and I think that people who do give birth at home are very brave.

straighttalker Thu 01-Sep-11 15:20:49

marthamay, it varies between hospital trusts and areas as to how this data is collated. The only people who will know are the hospital statisticians (maybe the midwives) for the area in which you are giving birth. In my current place of work, a birth which takes place in hospital (no matter the location of the majority of the labour) is classified a hospital birth.

I wouldn't be concerned, mrsravelstein. I'm a very safe and experienced anaesthetist. I don't see how my personal view (emphasise personal) that hospital is a safer place to give birth would colour my anaesthetic management of your birth in the unlikely event I would encounter you - which would, after all be taking place in hospital.

Criminally misguided is perhaps a bad choice of words on my point. You could never be prosecuted for taking a homebirth option - which a lot of women do, after all. It's just - when the consequences are what they are - I struggle to understand why people make the choice.

I don't have the answers and most people have pretty strong views on this subject anyway which I'm unlikely to affect but I just object to the point of view that most doctors - obs, anaes, etc - automatically reject homebirth because we're so medicalised we think everything needs to happen close to a doctor, and it will be disastrous otherwise.
I've seen very happy homebirths transferred in for repair of tears/removal of placenta, and these were ladies who had a very relaxed happy experience at home. I actually envy them. But I've also met the ambulance at the A&E ambulance bay and made the run to theatre with the ones that didn't go so well and they're a little more prominent in my mind.

Like I said, experience does inform future actions - I understand why a lot of mothers choose homebirth but I really really struggle to understand why any doctors do. The vast majority wouldn't - but anecdotally, as shown in this thread, there will be a few who do.

Not me. At least not on purpose :-)

mrsravelstein Thu 01-Sep-11 17:22:25

i apologise, i didn't mean it to sound aggressive, and i realise that as an anaesthetist it wouldn't necessarily impact. but if, for example, an obstetrician shared your view that a homebirth is 'criminally misguided' then i would expect that in general they would have a very interventionist attitude to my delivery, and for that reason i wouldn't want them anywhere near me.

and in fact one of the main reasons i chose a homebirth for attempted vbac 2nd time round, was because i wanted 1 to 1 monitoring by a midwife rather than being attached to electronic monitors etc which i believed would hamper my chances of a normal delivery. as it happens, i would have much preferred to be in hospital trying for a natural birth, but that simply wasn't an option the NHS was prepared to offer me.

HyenaInPetticoats Thu 01-Sep-11 17:31:33

Straighttalker, I had two serious pphs, both a couple of hours after delivery, one in hospital, where I was scolded by a cleaner for getting blood on the floor and told to pull myself together by a midwife when I tried to stand up and collapsed, and went home finding it hard to breathe to be blue-lighted back in for a transfusion when I passed out at home, and one after a lovely homebirth, when my midwife saw me turn pale, took my bp and called an ambulance immediately. I lost less blood with the second, 45 mins from the nearest A and E. I was safer as well as happier at home.

4madboys Thu 01-Sep-11 17:32:04

actually i dont think thats true, the bit about the figures then being included in the hospital birth statistics, from reading other threads on here i am sure it still goes down as home birth statistics.

am sure someone like spud will be along with the correct facts.

but from what i have read that is not right.

magicmelons Thu 01-Sep-11 17:53:49

Lots of Midwives have homebirths. Having worked in A&E for many years i'm of the opinion that that you have to not think the worst or you would literally do nothing in life and you can't deal in worst case scenarios all of the time but can take calculated risks and the statistics for homebirth are pretty good. I know lots of Doctors who have had homebirths or their wives have.

I also know an orthopaedic consultant who won't let his daughter on/near a trampoline it depends what parts of your job you take on board.
Calling it criminally misguided is scaremongering and not based on the statistics but on your personal experience which of course given your job you see the worst of.

msbuggywinkle Thu 01-Sep-11 18:39:08

Thing is though, there are things that could go wrong in hospital that wouldn't happen at a home birth and things that could go wrong at home birth that wouldn't in hospital.

For example, my DD1 was born with an agpar of 0. In hospital. Because the midwives were not available and left us un-monitored alone for 4 hours. We tried to get hold of them, they didn't respond.

DD2, technically a more difficult birth (posterior brow presentation, unknown until she was crowning) born at home with no problems and an agpar of 8 because there was continuous one to one care.

usingapseudonym Thu 01-Sep-11 18:45:09

I know several people who have worked in AnE won't let their children near trampolines! It's certainly made me wary of having one in the garden.

I'm thinking about a HBAC at the moment but still not 100% sure. 1 in 1000 have scar ruptures which really would be far safer in hospital (would be life threatening for mother and baby) BUT as said above - at home I would have proper 1-1 care, regular proper monitoring and more chance or a natural, healthy delivery. It's a minefield.

belgo Thu 01-Sep-11 18:46:28

My GP and several midwives I know had a homebirth. I think it does help to have some medical knowledge of what is happening.

Northernlurkerr Thu 01-Sep-11 18:51:10

I don't think Straighttalker should be attacked for holding the opinion she does. She is speaking from her personal experience of seeing severly compromised women.
Anybody who has a homebirth thinking it will be safe because PPH etc just won't happen to them really would be kidding themselves. Women choosing homebirth should be doing so understanding the risks and rewards of both options and choosing accordingly. Nobody should be choosing either option in the belief that one is 'safe' and the other not.

coffeeaddict Thu 01-Sep-11 19:06:13

Brief trampoline hijack - I was very anti, having spoken to doctor friends, but have just installed one sunk right down into the ground and surrounded by a zip-up net. Also it is a brand called Springfree which has all the springs underneath, so no-one can catch their foot. Just wanted to put it out there... smile

I also know a private obstetrician who had a home birth or rather his wife did.

umf Thu 01-Sep-11 19:13:11

I had an HB second time. It was much, much safer than the hospital where I had DS1. There were actual real live midwives, to start with.

pinkytheshrinky Thu 01-Sep-11 19:19:40

I have has three out of four babies born at home (the first was prem) and it was all well and good - another way of looking at it is that you have two midwives just solely there for you and your baby - much less chance of something going wrong.

I do think they make you aware of the risks when they book you but I can only say good things about it

spudulika Thu 01-Sep-11 19:51:39

"And those homebirths that are rushed into hospital for analgesia, foetal distress, etc that then become 'hospital statistics' for PPH, foetal hypoxic brain injury surely have probably clouded my judgement on normality."

straighttalker, can't comment about individual hospital statistics, but a couple of questions:

Do you feel that those women who book a homebirth are more likely to have a PPH than similar mothers birthing in hospital? And their babies are more likely to experience fetal distress? Because your post implies that you feel the inclusion of women transferring in from homebirths with these problems is inflating hospital figures.

Have you any evidence which you could share with us here which confirms that there are higher rates of serious complications for women birthing at home? And also poorer outcomes for babies?

Homebirths currently make up only about 2% of all births in the UK. Do you work in an area with a particularly high homebirth rate?

"In my current place of work, a birth which takes place in hospital (no matter the location of the majority of the labour) is classified a hospital birth."

My understanding is that current recommendations on place of birth are based on a number of studies none of which identified increased rates of mortality and morbidity associated with planned home birth. The largest of the studies was The National Birthday Trust study from 1994 which looked at the outcomes from 8000 births, based on place of booking, not place of birth. It found no evidence of poorer outcomes for either women or babies, and did find lower rates of fetal distress, instrumental delivery and emergency c/s.

Anyway, the findings of new and important research into outcomes associated with place of birth will be published this month I think and I'll be interested in what it says. I appreciate that there are methodological problems with all the current studies on homebirth because of the impossibility of randomising and that many are underpowered to identify rare poor outcomes. Never the less, there is clearly enough evidence for both the Royal College of Midwives and the RCOG to publish a recommendation that homebirth is 'safe' and 'has many benefits'.

You'd really have to ask yourself why two reputable bodies would make this recommendation if there was good evidence that home birth was clearly associated with poorer outcomes for either women or babies.

"However any professional in the know - obstetrician, anaesthetist, midwife, paediatrician - who exchanges a potentially uncomfortable traumatic 24-48 hours in the hospital for a homebirth is criminally misguided, and someone I'd like to meet to ask why on earth she would do that."

Quite a few midwives opt to have their babies at home. I assume for most, they've reviewed the evidence and made their decision as to what's best for themselves and their babies in light of it. The midwives I know are convinced that women birthing at home are less likely to need interventions in the birth, and no less likely to end up with a well baby.

Anyway, sorry I've yacked on a bit, but still would be interested in knowing about the homebirth rates in your area and whether you believe women having their babies at home are more at risk of a serious PPH.

Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now