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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

why are homebirth rate so low

536 replies

McHappyPants2012 · 05/02/2012 21:41

www.walesonline.co.uk/showbiz-and-lifestyle/health-and-beauty-in-wales/2011/02/05/wales-delivers-on-home-birth-rates-91466-28109298/

after watching 'call the midwife' it seems to me homebirth was quite common in the 1950.

when did hospital birth become a common

OP posts:
shagmundfreud · 08/02/2012 18:55

"It is ignorant in itself to declare that women who do not want to give birth at home are only doing so because they are ignorant and misinformed."

Yes it is. But nobody is saying this here so I'm not sure why you've made this comment. We all know that there are many reasons other than safety why women want a hospital birth. Pain relief for a start!

"But it is not fair to say that women who want a hospital birth even if they are low risk are ignorant and misinformed."

Of course not!

But they are 'misinformed' if they believe there is proof that hospital births are safer.

"If hospitals are so bad for low risk women, then they are free to have homebirths, and to tell their midwives that under no circumstances should they be taken to hospital."

Why would they tell their midwives not to take them to hospital? Hospital is exactly the place you need to go if your labour becomes difficult. That's what obstetricians are for!

Anyway kelly2000 your comments reflect two things: that you haven't read the thread, and that you don't REALLY understand very much about this issue. The misapprehension that the statistics showing homebirth is safe are unreliable because they exclude from the homebirth results those women who tranfer in during labour with difficulties has been addressed on several different occasions on this thread. And actually if you had read the research itself or a reasonable account of it (such as this: nhschoices ) you'd know this. So you are arguing from a position of ignorance of the facts. Not helpful when you're trying to have an informed discussion on any topic!

"Also lets not forget that intervention has been used for thousands of years"

And has often caused more harm than good. If you go back through midwifery texts from the middle-ages in Europe there are dozens and dozens of references to the damage done by doctors meddling with women's labours.

In any case - nobody who supports homebirth is categorically against intervention. Sometimes it's needed, and we're all very grateful that modern medicine exists to rescue women and babies from labours which would have killed them in the past.

Which is why it's extremely annoying that so many voices raised against homebirth on this thread have flagged it up as an issue when actually - it's not an issue. Have you ever heard of 'a straw man argument'? "A straw man is a component of an argument and is an informal fallacy based on misrepresentation of an opponent's position.To "attack a straw man" is to create the illusion of having refuted a proposition by replacing it with a superficially similar yet unequivalent proposition (the "straw man"), and refuting it, without ever having actually refuted the original position."

That's what's been going on on this thread - this stupid insistence that supporters of homebirth are making a case unassisted birth, and denying the very real advances in obstetrics in the past 100 years. I think you are doing this because you simply have nothing sensible or informed to offer as a proper challenges against the arguments put forward by homebirth supporters, whose views, unlike yours, are supported by the evidence.

"One more dissenter unleashes yet another 2 pages of howling down"

I think you'll find it's more 'reasoned argument' than 'howling down'.

Whatmeworry · 08/02/2012 18:58

I had a hb for my ds2 and I had 4 midwives. I regret I did it because I ended up bluelighted to hospital because I was bleeding heavily. I would have given birth to hospital I wouldn't have wasted resources like an ambulance!

To repeat, the question was "why are homebirth rate so low"

And to repeat, the answer is because home births offer no discernable advantages and major disadvantages if things go wrong.

Selectively choosing some research over others and howling abuse for pages upon page at people who disagree (based on the overall research) that homebirths are the best thing evah does not an argument make.

molly3478 · 08/02/2012 19:03

I wouldnt have a homebirth for many reasons. Firstly I dont think its fair that people at home get lots of midwives to themselves whereas often in hospital you are left to your own devices as they are so shortstaffed. I dont want to make it any worse than it is, will be worse nowadays with nhs cuts. When I had DD1 they were so busy that I only saw a midwife as the head was coming as they couldnt spare any more staff, and the midwife this time says its often like that.

Additionally dont want the midwives in my house, setting up a water pool is too much hassle and would use up too much water when you can go hospital and do the same there. I dont really see the difference either of doing it at home or at the hospital

belgo · 08/02/2012 19:04

shaketheshame - please don't feel guilty about wasting resources.

On average, a homebirth will cost less then a hospital birth - this is why in Belgium, my insurance company reimbursed me a significant amount of money because the cost of my home birth was less then the cost of the average hospital birth.

Osmiornica · 08/02/2012 19:16

This reply has been deleted

Message withdrawn at poster's request.

BadDayAtTheOrifice · 08/02/2012 19:18
Flisspaps · 08/02/2012 19:42

Osmiornica Obviously not everyone thinks that, the SoM who visited me today said she attended a home birth, was there from 8.30am to 5.30pm ish and hadn't been offered so much as a glass of water.

Fortunately, we'd offered her second cup of coffee by the time she mentioned that Wink

molly3478 It's appalling that in some hospitals they do not have enough midwives for 1:1 care through labour. Truly it is. But home births are almost always attended by community midwives (who do the postnatal visits, the antenatal appointments and are 'on call' to attend to women in the community anyway) and so aren't taken out of the hospital. By having a homebirth, women aren't denying women in a hospital access to a midwife - hospital funding is what denies women 1:1 midwife support.

Not wanting someone in your house and having the faff of putting the pool up or filling it is a personal thing, and is as valid as someone wanting a homebirth not wanting to go to an unfamiliar environment or not wanting to chance the pool at the MLU not being available.

shagmundfreud · 08/02/2012 20:25

"Selectively choosing some research over others and howling abuse for pages upon page at people who disagree (based on the overall research) that homebirths are the best thing evah does not an argument make."

Hmmm, whose opinion is more valid, yours, or the Royal College of Midwives and the Royal College of Obstetricians and Gynecologists?

Because they've released a joint statement saying the home birth as 'considerable advantages' for mothers and babies.

And every single woman being cared for within the NHS is currently given information about place of birth setting out home birth as a 'safe' option for healthy mothers and their babies.

Perhaps you'd like to write to the RCOG, the RCM and the health secretary and point out that they've based their current recommendations about the safety of home birth on dodgy research. Grin

"and howling abuse for pages upon page at people who disagree"

Haven't done that as yet. Actually I've been very restrained, given how completely fuckwitted your stance is on this subject.

shagmundfreud · 08/02/2012 20:31

molly - if it's clear that one to one support in labour is necessary for optimal care (it is - clearly set out in current NICE guidelines on intrapartum care), then on earth would anyone feel that they have some sort of duty to forgo it? Duty to who? The only duty you have is to yourself and your baby, to get through labour in the safest and least traumatic way possible.

TBH I'm saddened that you're so accepting of substandard and possibly dangerous care for you and your baby. You must really worry about your water bill. Shock

molly3478 · 08/02/2012 20:39

shagmundfreud - I did most of the labour with just DHs help I dont think I really needed a midwife tbh. There was one there at the end but we didnt need to call for one as its something I could do on my own really. I will say they were very busy though and I think it is hard for them at the hospitals but of course not their fault.

molly3478 · 08/02/2012 20:40

Also its not traumatic imo not having a midwife I did it in the waterpool with dimmed light etc and it was pretty natural tbh.

Flisspaps · 08/02/2012 20:51

Your comments aren't making much sense to me insomuch as you wouldn't consider a homebirth because you wouldn't want to take a midwife away from someone else (which isn't the case) but you felt that you didn't really need a midwife anyway and not having one there (in your opinion) isn't traumatic Confused

But just because it wasn't traumatic for you and you didn't feel you needed a midwife (which I am pleased about) doesn't mean that it's the same for everyone - either physically, emotionally or both.

Having a midwife present (usually from when you are in established labour) - wherever you choose to give birth - is important as they know what to look out for wrt issues that may present themselves and how to manage those issues.

molly3478 · 08/02/2012 21:00

I just see it as I was low risk I did it at hospital and had midwives on hand if I rang the bell but was pretty much left to my own devices which meant medical staff had time to deal with the complicated cases on ward that night (of which there were a few). I just personallly wouldnt of felt comfortable having midwives at home with me when people were struggling due to cut resources within teh hospital. If everyone/majority suddenly decided they wanted home birthd were would the midwives come from?

Whatmeworry · 08/02/2012 21:14

Haven't done that as yet. Actually I've been very restrained, given how completely fuckwitted your stance is on this subject.

I shall add fuckwitted to the list your insults so far - a man, who has a lizard brain, doesn't care about a baby's safety, and am shaming myself.

Not bad, I can't wait for the next bit of, um, "restraint"

....and all for explaining to you that selectively quoting research that agrees with you and insulting people who disagree with you is not a persuasive method of winning an argument.

BadDayAtTheOrifice · 08/02/2012 21:19
Flisspaps · 08/02/2012 21:19

Molly - on the flip side if everyone decided to give birth in our already underfunded, understaffed hospitals where would the extra midwives come from? The community midwives would still be needed in the community for all of the other things they do, so you'd still either need more hospital MWs, or the ratio if women to midwives would be even greater, leaving more women to birth without appropriate care.

BadDayAtTheOrifice · 08/02/2012 21:22
molly3478 · 08/02/2012 21:26

I dont think there is anything wrong with the minority choosing homebirths as they do now however I think it would be unworkable if everyone strted doing it in our current system.

Flisspaps · 08/02/2012 21:47

Molly - that is something we agree on. Then again more homebirths would free up hospital MWs to some extent so they could give more attention to the women who DO birth there.

The bottom line is, I don't see why we are all arguing on this thread (not aimed at you Molly!) Grin

Some women want a homebirth. Let's support their choice.

Some women want a hospital birth. Let's support their choice.

Some women want a MLU birth. Let's support their choice.

Some women want a CS. Let's support their choice.

Give every woman as many evidence based facts and statistics (not rumours or opinions) on each setting, and let her make the choice for herself. Don't assume any woman will make a particular choice as that is what 'everyone' does. Whatever her choice, why not support it? Her choice affects her and her family. Not you. Not your baby. Just because it's not what you would choose it doesn't mean it's the wrong choice. It's the wrong choice for you which is not the same thing.

We should be putting all of our energies into getting better maternity services for all of us, ensuring we all get the care we want and need and that midwives WANT to give us, by demanding more midwives in all settings, not fucking bickering over who us right and who is wrong. Because there is no right or wrong answer Angry

shagmundfreud · 08/02/2012 22:18

"I think it would be unworkable if everyone strted doing it in our current system".

It'll only ever be a minority choice.

But having more hb, and more birth centre births would reduce the c/s rate, which would reduce the stress on obstetric facilities, and free them up for the care of women with complex pregnancies.

"not fucking bickering over who us right and who is wrong. Because there is no right or wrong answer"

I think it's important to challenge inaccuracies, myths and prejudice. Nobody's arguing that one type of birth is 'right' or another is 'wrong'. But it's quite fair to argue that someone has their facts wrong!

Whatmeworry · 08/02/2012 22:29

I think it's important to challenge inaccuracies, myths and prejudice. Nobody's arguing that one type of birth is 'right' or another is 'wrong'. But it's quite fair to argue that someone has their facts wrong!

Shagmund, I think your advice on this thread....

www.mumsnet.com/Talk/am_i_being_unreasonable/1402389--to-consider-VBAC-homebirth

....is not just clearly ideologically led but is the most uncaring about safety that I've seen on this subject to date.

kelly2000 · 08/02/2012 22:29

shag,
Why are you being so offensive to people who do want homebirths? You wanted a homebirth, you think they are better which is fine ad your choice, but you seem determioned that everyone else not only has to agree with you, but admit they are stupid because they do not agree with you. And actually accusing people who want to give birth in hospital of not caring about their babies health is disgusting. I know someone who was low risk and got no intervention - their baby died and would have survived if they had got intervention. The next two births were still considered low risk, but this time they opted for ahospital c-section, and the babies were born safely and healthy. I suppose you think she was a bad mother by going to hospital, and shoud have accepted that natuire knows what it was doing and her child's death was just natural selection in action!!!!! You have no right to accuse women of not caring about their child's safety for not doing what you do.

And no I am not ignorant about how research papers are carried out. It is up to the paper's authors how they consider different births so long as they clarify this in their methods section. But then you think that the only people who are not stupid and ignorant are you and anyone who agrees with you. You attitude seems to be homebirths are much better than hospital, but if anything becomes slightly complicated lets dump the homebirth and scurry off to hospital and all their nice equipment and medicines.

kelly2000 · 08/02/2012 22:41

There has been plenty of criticism of this paper, but it shows that there are studies supporting each arguement, and all people can do is decide for themselves.

^We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth.

Study Design

We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated.

Results

Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates.

Conclusion

Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate"^

J Wax article from american journal of obs and gyn, 2010

www.ajog.org/article/S0002-9378(10)00671-X/abstract

shagmundfreud · 08/02/2012 22:43

Well - luckily Whatmeworry, the OP has the advice of her consultant and her midwife to balance out the personal opinions of posts she reads on mumsnet!

I should have said 'You careless, unfeeling, selfish FOOL! How COULD you put your baby's life at risk!' That would have been more helpful and much kinder. Not.... Hmm

kelly2000 · 08/02/2012 22:44

No shag, anyone who disagrees with you you claim is inaccurate and must be challenged. Andthere is no more risk between c-sections and vaginal deliveries which is why NICE is saying women should have a choice. Or are they wrong?

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