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

[Floopy21]

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

I get your point Faintly. I too would never forgive myself if anything went badly wrong with a home birth.

A major factor in me choosing to have one was the fact that we live 4 mins away from the hospital. It was an informed choice which is what I'm advocating for ALL women!

I just hate that so many women, once under the hospitals system, end up having so many drugs/interventions that they may not have needed and sometimes aren't even given the chance to consent to.

People live in awe of medical professionals and don't question what is going on. This can result in women suffering extreme trauma and also the feeling that they totally lost any control of their birth experience.

I think you're right gizmo- people will always interpret the same set of data in different ways.

And also there are many women who opt for hospital birth for pain relief rather than medical need. Out of my first NCT group, although 8 of us had the option of delivering at home or in the local midwife unit, but in fact only 2 of us opted for this - the other 6 chose the hospital because they weren't confident to go without an epidural. So it's not even always a case of wieghing up the risks - there may be other factors apart from the medical issues which make so many women choose hospital.

I also think that women, no matter how natural childbirth is etc etc etc ,are not medical professionals and that sometimes they should trust the advice they're given. Again, it comes back to a point that has been made before that the problem is not necessarily the hospital or medical involvement in theory, but in practice where quality of care can vary.

I have a friend who resisted an Emergency c section for hours and who, while she had a natural birth in the end, practically destroyed her insides in the process. She thought she knew better than the doctors. She didn't.

And no, childbirth may not be an "illness" in that it's not something you can from a germ or a virus, but yes, it's a medical condition nonetheless.

I'm not anti HB but I do have an issue with choosing HB over hospitals because of a false perception that medical care is not necessary or wanted. If you make that choice as part of the informed decision making process discussed here, fine but you shouldn't be doing it in order to avoid doctors.

A large PPH could kill the mother even in hospital. Hospital provides no guarantees if something catastrophic occurs unannounced during labour- which thankfully is extremely rare.

There will always be people who take things to extremes unfortunately, when choosing a homebirth I was always of the opinion that if the midwife advised me to go to hospital that I would of course go. My midwife told me that during her long career she had only ever once felt uncomfortable with the situation, the woman had a large amount of meconium (sp?) in her waters and the baby was showing signs of distress but she refused to go to hospital. It took almost an hour to coax her into the ambulance as she was so adamant that she wanted a homebirth and that the midwives weren't being supportive of her choice. They did eventually get to hospital and the midwife was convinced that the baby was going to be damaged or dead but happily the baby was born healthy. When the midwives went to see her the next day rather than thanking them the woman proceeded to yell at them that they had sabotaged her birth and that they were irresponsible! So you can imagine that midwives are really quite wary of anyone who seems 'militant' in their choices or not considering that things can go wrong.

BD - I support women having the opportunity for informed choice about home births, but agree with you about the dangers of a false perception that medical care is not needed. In my experience this is is not the case at all for women choosing home births,who are only too willing to abandon thier plans and accept intervention if a professional explains the situation. I do however think there is a growing increase in this attititude with so-called "freebirthers" who choose to give birth without skilled attendants (often having received no antenatal care). Ifind this a worrying trend and think these women are complacent and ill advised, and are putting themselves and particularly thier child at risk.

Free birthing is a COMPLETELY different topic altogether. I would never even consider it, that is a very dangerous road to go down. I want someone experienced to pick up problems, treat me and take me to hospital if the need arises.

Oh the 'freebirthing' thing is another thread completely. I felt so uncomfortable watching that programme on Channel 5 last year, it was shown while I was pregnant and so many people thought that when I was planning my homebirth that that was what I was going to do - you've got to be kidding! One of my main reasons for a HB was to ensure that I had more medical attendants than during my first hospital birth - people are trained to help women deliver babies for a reason!

x-posts bigbang

I think it would be great if more midwives were taught to stand up to women and REFUSE to give them drugs unless absolutely necessary...
With my first birth (in hospital) I had a very 'no-nonsense' approach kind of midwife who basically told me just to get on with it - I was perfectly capable and there was no need for any kind of intervention... I HATED her at the time I had it written on my birth plan that I wanted no drugs but when it comes down to being in that situation for the first time a lot of us feel a bit differently!
Anyway, thanks to my bully of a midwife DC1 was born naturally, and I've gone on to have two more natural births (it helps a lot when you've done it once before and know that you can get through it).
However, the midwives at DC2's birth (at home) were practically waiving the syringes of pethidine in front of my face and were adamant about breaking my waters!! If I'd had those midwives in hospital for my first birth I may have ended up with c-sections for all three DCs!

God Bellebelle that story is terrible

I would never think that I had to have my home birth. The way I approached it was that having my baby at home was the plan but if circumstances led my midwife to advise transferring I would do it without question.

That woman was selfish and reckless imo.

I can assure you that doing an emergency section is a whole lot more effort than allowing a woman to labour "as nature intended" Why would a doctor do an operation that is going to take 45 mins at least of their time, increase duration of inpatient stay and take up room on the post op wards? Out of badness?
I really take issue with the notion that doctors are doing unnecessary ops for their own satisfaction and ignoring the wishes of the patient. Apart from anything else how do you think they come to know a patients labour isn't progressing normally? The midwife asks for advice, we don't just roam the corridors looking for people to chop up

duchesse has made a point i keep making, that is often overlooked. women and babies are compromised or die in childbirth in hospitals

also agree that the c.section rate of 25 - 30 % that has been creeping up and up and up in the UK is frightening... i do not think that almost 1 / 4 of women need a life saving c.s

the number of c.s performed for failure to progress ( hate that term!!) has a knock on effect as women choose electives second time as they are so terrified of what could go wrong a second time and do not have faith in their caregivers or their own bodies

routinely, women are given sweeps at 41 weeks and then booked for induction 3 -5 days later. wanting to go to or even, gasp!!, past 42 weeks, is just unfathomable.

and the truth is a lot of those women will sit on the antenatal ward for 24 + hours, not in labour, waiting for the pessary to work, or waiting for a place in the labour ward.

it is not appropriate on so many levels

as for freebirthing, i am totally opposed to it and have refused to support freebirthers, i am especially frighened by those who shun all ante natal care aswell as giving birth without a MW around.

freebirthing and homebirthing are as comparable as apples and oranges

my local hospital is currently working on ways to reduce IOL and c.s and is starting a VBAC clinic and trying to recreate an MLU in the CLU as the MLU was closed down. the notion of choice is just that, a notion.

saw client recently who was put off a waterbirth by a MW who told her the baby could drown

how can women make an informed choice based on information like that!!

I so wish that the bastard obstetrician who stood at the foot of my bed a hour before I gave birth and said "if this woman hasn't given birth in 45 minutes she's going into theatre" could have read up on how he was meant to be managing a normal, if prolonged labour, with utterly normal signs (no dipping fetal heart rate, no meconium, no excessive blood loss on my part, etc...)... I gave birth to a 8 lb 12oz porker with a massive head circumference vaginally btw. Slow labour for a reason- moulding his 38cm bonce gently down to manageable proportions...

I think what most people are concerned about MrsExton is the so called 'cascade of intervention'.
Many people feel a sense of losing control when they go into hospital and putting themselves into the hands of the drs/ midwives. It also might feel safer to have pethidine/ an epidural if you feel like you are being 'looked after' by a medical team than if you are at home, and that can lead to further complications.

I don't think anyone really believes that midwives want women to have c-sections against their wishes as a matter of course...

I think it's more that most people's attitude changes somewhat when they go into hospital, they feel less in control...

so mrs exton - can you answer the point I asked eeky, though she hasn't come back onto the thread.

Why is there such disparity in Csection rates between various hospitals and between various consultants? If there were consensus among the professionals about what exactly constitutes a medical emergency (ie CS necessary to save life of mother or baby or avoid serious damage) then there wouldn't be such a degree of variation would there? We'd see pretty standard rates.

But the fact is, some doctors and hospitals are far more ready to go down the intervention route, and pressurise the mother.

Well said re the c-section rate Lulu.

I gave birth at 41+1 and was happy to go to 42 weeks without induction.

And just to add I in no way support freebirthing. It is a dangerous and foolish practice.

And MrsExton - I have in no way implied that doctors roam hospital corridors looking for people to chop up! Neither have I said that unnecessary interventions come about through doctor's "badness".

The fact is that section rates are soaring - are you telling me that every single one of those is essential??

MrsE please don't think that many people feel that way about doctors in labour. I don't, if one told me I needed xyz I would go with their opinion and be thankful for their input, I think most people would. The only reason I can think of that a doctor may perform unnecessary intervention is because they think and see the worst case rather than the best due to their previous experiences. But even then its debatable as to wether the intervention was unnecessary or not because we would never know the outcome of the situation if it was handled differently. And it is true that one intervention can lead to another in some cases, but again this isn't necessarily someone's fault, being cruel for the fun of it or anything.

I was just saying on the matter of choosing a home birth I would listen to my midwives over doctors because of their experiences of birth. I don't think doctors are evil.

That Times article is hysterical nonsense and I am suprised they paid for it and printed it. I got it free with my Ocado delivery but if I had bought the paper it would make me think twice about buying it again.

'I really take issue with the notion that doctors are doing unnecessary ops for their own satisfaction and ignoring the wishes of the patient'

And yet during NHS antenatal classes our midwife was quick to stress that a healthcare professional is at risk for being sued for up to 21(?) years after the birth of that child should they suffer from any health problems as a result of labour and birth.

There are great midwives and consultants out there, there are also those more concerned with protecting their own backs - human nature.

For what it's worth I tend not to take much notice of newspapers. I once read an article on menigitis in a broadsheet that had got 8 facts wrong - ones that wouldn't take much research to confirm their validity. Made me question the whole paper - if such mistakes could be printed as correct what about the rest of the articles?

Writer is entitled to her opinion but just shows her incompetence at researching her article and so loses all credibility.

Rates vary depending to patient populations and expectations, as well as clinical judgement which has to be done on an individual basis. For example at the maternity hospital I worked in a significant number of patients were obese or morbidly obese at the booking appointment. These women are high risk and may require more intervention. If you work in an area with lots of women who have been subjected to female circumcision they will also require more intervention. More affluent areas tend to have less chronic ill health, accordingly the intervention rates may be lower there. it really does depend on so many variables I don't think assumptions can be made on why rates vary.
Hindsight is a great thing, it is the easiest thing in the workd to look back and say "that was not necessary" but there is a reason why Obs and Gyn consultants have the highest medico-legal insurance, and that is because things can go wrong in a hearbeat and when they do the blame is squarely landed on the doctor

the cascade of intervention, the lack of MWs and the expectation of 1 cm progress per hour is a huge factor in augmentation of labour/ induction , failure to progress/ distress and then subsequent c.s i believe.

Lack of midwives definitely does affect things. Where I worked (and am returning to to have my baby) there is a 1 to 1 ratio of labouring women to midwives, and I must say I was amazed to hear that there are places where 1 midwife looks after 2 or 3 people. It must affect patient satisfaction and outcomes, and I feel very fortunate to be delivering there.

i bet it would save teh NHS a lot more in time and money, in having to manage complaints and litigation to actually employ more midwives in teh first place, to prevent foetal and maternal compromise and help women feel better supported.