to think this woman's misguided to say the least?!

[Floopy21]

www.timesonline.co.uk/tol/comment/columnists/melanie_reid/article6101189.ece

YANBU. Of course the woman is entitled to her opinion, and women are entitled to give birth where they feel most comfortable. What I find completely unreasonable is the tone of this article. It's rude, it's condecending and strongly suggests that any intelligent women would give birth in a hospital. I've got 2 DDs; DD1 was born in hospital where my care was shocking and if anything had gone wrong I have no confidence that they would been able to help me, because I was completely neglected. It was so traumatic that I had DD2 at home, where I had two wonderful MWs at my side every second, and it was a wonderful experience.

But I wouldn't presume to tell other women that they should have a homebirth simply because it was the better choice for me. And I cetainly wouldn't cast asperions on their intelligence because they chose a different route to me.

She's very misguided about the realities of homebirth.

And I also resent the implication that lentil weavers can't be intelligent! I'm as lentil-weavery as they come, though I wear Crocs instead of sandals . But I have two degrees and like to think I'm fairly intelligent.

I felt a wierd pressure to have a all natural, water or home birth and profound spiritual exexperience whilst giving birth. The reality was I was transfered to hospital from my birthing centre for an emergency c section. I felt so disappointed and felt like I wasn't as good as a mate who had had a natural homebirth.
In retrospect I can see that this is ludicrous. If it wasn't for the hospital and professionalism of the hospital then dd could have died. I did feel quite annoyed at the interventionalist approach of some of the midwives earlier in labour but I am now very happy with my deeply unfashionable c-section and would recommend one to every one. It was quick, efficient and prevented a lot of birth trauma. DD came out as chilled out as they come and had no bruising as is common with forceps.
If your labour is uncomplicated I can imagine a homebirth to be amazing.
I own at leat 10 pairs of sandals!

Sometimes mabe I think that the interventionalist approach may have led to a c section- who knows.

YANBU- the tone of the article is judgemental and we should be able to give birth where we like.
I do feel like women treat birth as a competetive sport though and often feel quite smug that they did without drugs etc. I hate the fact that I felt bad about the c-section. I didn't have drugs for the two days that was in labour though and had them only for the c-section. I feel pleased about that!I can see the point taht mabe a competetive approach to birthing may lead to unsafe practices.
My doula said that women give each other a hard time about their labour and she's right!

Interestingly, she had written another piece on how awful hospitals are. They woman can't make her mind up!!

To be fair, that article was about a&e, a whole different ball game.

Regarding the various posts (and the article) saying that women who manage to give birth without drugs can be 'quite smug' about it - I really don't think that's the case. I managed to give birth to my three with only gas and air and whilst I'm quite PROUD of myself for getting through it (probably the hardest thing I've done in my life), I wouldn't judge anyone else's decisions.
I think sometimes people who haven't had the births they want label those who have been fortunate enough to give birth naturally as 'smug' simply because they feel unhappy about their own experience.
I managed hours of pain without drugs for the sake of my baby - why shouldn't I be proud of myself for that??
Ultimately, my opinion is that any woman who has had a baby in whatever way has done something pretty amazing... I don't want to compare my experience to that of others and say I'm better, but I do want to be allowed to be proud of myself for what I've done!

I had a home birth with DD2. I chose this option because I believed I would actually get better medical care than in hospital.

The only hospital option around here is a large maternity unit, that is extremely over-crowded. I heard plenty of stories about women giving birth in corridors/lifts etc. from people who work there. The birth of DD1 (in the hospital) was very straightforward, and was a pleasant experience. Because I'd had an easy first birth, and because the hospital was stretched, I honestly believe I got better care at home than I would have done at the hospital.

WHat is more, if anything had gone wrong, I think it would have been noticed sooner, as rather than being left in a corridor to do my own thing, I had two midwives in constant attendence. Also, I live v. close to th hospital.

The author of this article is clearly writing cr*p.

PS DD2 was born in four hours after an extremely straightforward labor.

YANBU

I think the article is very biased. Yes there are some risks with giving birth at home - that problems can arise which require hospitalisation, and a 30 minute delay in getting the monther and baby there could be fatal. Hospitals have many positives, including immediatley available surgical assistance, and a wider choice of pain relief. She spells these out quite well.

However there are also risks with giving birth at hospital. MRSA, higher risk of episiotomy (sp?), forceps delivery, unnecessary drug intervention e.g. speeding up labour with a drip rather than trying patience and changing position..... all of these can cause damage and at worst fatalities too. The stress of giving birth in an unfamiliar environment where you feel out of control slows labour too. None of these are addressed.

Oh, and also, if your hospital midwife only checks on you every hour, surely this is higher risk than a home birth with constant midwife attention and a 30 minute time to get you into hospital if necessary? I hear it's common for people to be left unattended in busy labour wards - this never happens with planned home births where you have a dedicated midwife, not two or three covering however many labouring women turn up on the day.

IMHO the risks of home birth are really low if you are within quick reach of a hospital should a rare complication arise. Meanwhile, the antenatal care is much better as you have a consistent midwife.

Having said this, I'm planning to give birth in a midwife lead center (very close to my home) because this is my first and I don't quite know what to expect, therefore am opting for slightly more backup.....

Agree with other posters that the article reads like only one choice is "sensible" and "intelligent". the way the article is written is far from either of these - whatever happened to considering the evidence?!

I don't give a fuck where anyone else chooses to give birth. As long as it's not on my nice new sofa

Next time i'm giving birth in a 5 star hotel where I can get room service to bring me a constant supply of bacon sandwitches. Anyone who doesnt think that this is the best way to give birth is sick and doesnt care about the safety of their children.

Actually, I think the article is a refreshing change in the views usually presented in the press.

I am an obstetrician, currently working in a very busy unit with a fairly high caesarean and assisted delivery rate. Let's get a few things clear:

The vast majority of hospital midwives and doctors are very happy when women have an uncomplicated normal delivery.

We do not, on the whole, unnecesssarily intervene in otherwise normal labours. Apart from anything else, we are busy enough and wouldn't have a reason to make extra work for ourselves! Taking someone into theatre is a hell of a lot more labour-intensive for us than a normal delivery.

If we DO intervene, it is because we are using our many years of experience to judge the risks and benefits of such intervention, versus letting nature take it's course. Let's be absolutely clear on this, if there are problems such as failure to progress or fetal distress, or maternal concerns during labour, WE ARE TRYING TO STOP BABY/MUM/BOTH FROM DYING! That's our job!

Many women think this is melodramatic, but believe you me, death of women in labour still happens each year, and death or permanent disability of babies happens all too frequently - this is nature's way unfortunately. I can remember every bad outcome I have been involved in on a labour ward, most unavoidable despite excellent treatment but some avoidable due to attempted home or midwifery unit deliveries which have suddenly gone wrong. I can remember every baby I delivered dead in such circumstances and they still haunt me.

There is no such thing as a low-risk labour, except in retrospect. If you choose to deliver at home then most of the time it willl be fine, but if you have a prolonged fetal bradycardia, a shoulder dystocia or a flat baby that needs intubating, or if you bleed 2 litres in 5 minutes, then there is a strong chance you or baby will die. There is no way round that. No matter how good you midwife (or 2) or how close you are to the hospital, it won't help.

Clearly these complications don't happen to all women, but they are NOT that rare.

Just a point of interest, most of the pregnant women we see from developing countries or who are asylum seekers are extremely grateful to have free, up-to-date medical care available for all when they have their babies. They usually think that anyone considering a home birth is mad to reject this care and increase the risk of complications.

good post eeky - you'd have written the article in a far better way than the woman in The Times managed it!!

Well said, eeky (you know you're going to get flamed, right?)

Eeky, but study after study shows that homebirths are statistically no riskier than hospital births.

Hardly surprising that asylum seekers are rather glad to have free medical care.

eeky, do you agree though with the premise that homebirthers are stupid, spoilt and self indulgent which was the tone of the article, and one that has raised a lot of hackles?

i thikn that is what a lot of people have taken issue with

Eeky - but don't you see only the more 'emergency' side of things, which might have clouded your views somewhat?

I would also have to make the point that in most cases, MWs would get a woman to hospital way before such emergency interventions became necessary. It takes time to set up a theatre for an EMCS, and to get blood found and set up for a transfusion. The woman/baby would be in the ambulance and at the hospital often before these things were ready for them.

Women don't labour in surgical theatres or with bags of blood hanging above them ready for transfusion. So surely when you consider time taken to get these emergency measures into place it makes little difference whether you're blue-lighted in or are already in the hospital?

eeky.... what about midwife-led units, where there is no operating theatre, no doctor , no anaesthetists or epidurals.....??

There is just no way these units would be allowed to function if they didn't have an exemplary safety record! When you think about it, their safety record has to be greater than that for home births. Even where a woman is allowed to exercise her right to a home birth, even if she doesn't fall into the low risk category, she is not going to necessarily be allowed to deliver in a midwife unit if the risk is considered too great.

Thousands of women give birth successfully in these units - they don't need doctors, epidurals, drips or obstetricians. My local unit is about 20 miles from the nearest hospital, so it isn't as though everything is 'on hand' yet the unit has never had a single tragedy, which is more than can be said for the hospital. And yes, I know that's partly because the high risk women will be at the hospital rather than in the unit, but it does rather refute your stance that every woman should be labouring right next door to an operating theatre, with ostetricians on hand and every available technology known to man.

I don't know eeky, I hear what you are saying and I respect your opinion because you obviously know what you are talking about. But I do think your opinion is very biased. I was talking to my uncle and cousin, both doctors about this and they both said that because as doctors, they vast majority of women they see are in trouble. It is very rare for them to witness a normal straight forward birth.

I think that because you see women in trouble every day it becomes the norm for you, whereas my midwives have told me that the problems and extremes you mention are actually quite rare. They deliver babies at home and hospital day in day out with no problems what so ever. I trust them implicitly to do the best for me and my baby, and they would not be supportive of my choice if they thought I was taking such a massive risk. They may not be as highly trained as obstetricians but they are very skilled practitioners and have years of experience with totally normal and natural births, as oppose to years of medicalised births. I think thats why I trust their opinions as much, if not more than doctors in this situation.

So Eeky are you saying that it's "refreshing" to call us well informed women who have chosen to have a home birth are "spoilt and complacent" as per the article??

And does it not occur to you that maybe working at the frontline of maternity care and seeing more of the emergency births as opposed to straightforward natural births may have somewhat clouded your views??

Saying that doctors only intervene to save lives is simply NOT true. I personally know 2 women who were deemed as failing to progress and were, in their own opinion, hurried along by means of intervention. One of these ended up having an emergency section.

There is a domino effect once doctors choose to follow the path of intervention. Of course it isn't the case EVERY time but to deny it's existence is foolish.

Hundreds of women end up having emergency sections which would have been avoided were they allowed to labour as nature intended.

Absolutely bunny. And is eeky really saying that the CS rate in some hospitals of over 30% is really truthfully medically necessary? Sorry, but I find that very hard to believe. Surely the extreme differential in rates between different obstetricians and different hospitals is proof in itself that there is no agreed consensus among the professionals on what constitutes a 'medical necessity' or an 'emergency'?

But Bunny, what reasons would a doctor have for doing that? Aren't they all busy enough already with births which are complicated from the outset?

God gizmo there are SO many reasons.

Off the top of my head....

They don't want women cluttering up delivery suites for hours and hours. Get the baby out as quickly as possible and get mum out onto the ward.

They see medical problems where there are none because as a doctor they are trained to LOOK for things that are wrong and to treat illness. Childbirth is NOT an illness.

Hospitals are male-centred places. Men do not understand or feel comfortable around birthing women. The male approach is to get it over with.

Again it all seems to be down to perceived risk rather than people looking at and trusting the statistics. One of my best friend's (met at NCT while eating lentils and wearing sandals obviously )is pregnant with her 3rd DC, she would dearly love a HB but her husband is a pediatrician and just can't bring himself to agree to it. He completely admits that he has a biased view because he sees all the things that can go wrong in a birth so just can't bring himself to go along with a HB even though the logical part of his mind tells him that the risk is no greater. I completely respect him for this, if you spend your days seeing the 'bad' side then it must be difficult to discount the 'what if' fear.

BunnyLebowski, I completely understand the 'cascade of intervention' concept and don't deny that it can happen. But in choosing to have a hospital birth I am balancing the risk of a cascade of intervention resulting in emCS against the risks of shoulder dystocia, large PPH etc that could result in death if occurring at home. Although the latter may have a lower chance of happening, if they do happen, the outlook can be devastating. And if it does happen to you, it doesn't matter that home births are as safe as hospital births on a population level.

Sorry, I'm struggling to express myself clearly here, I hope you get my point.

I hear you FM - you're very clear. And funnily enough I went through exactly the same process before deciding on a homebirth.

I'm not critising your decision here, it's just an interesting example of how two people, using the same set of data, probably, can come up with a different decision. I imagine that's because we probably have a different level of risk tolerence.