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

[Floopy21]

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

Hear hear Lulu. A good midwife is all you need for a straightforward labour and birth - leaving the doctors and anaesthetists to deal with the interventions - whether they are needed for medical reasons or because the mother wants them.

MrsExton, I live in an area with a very high immigrant population - we have large numbers of African/Caribbean women (who as a group have a c-section rate of over 30%), plus a significant number of women with fgm. We also have a lot of poverty here, like in any other inner city area.

Our local hospital has a c-section rate of 24%, which is 7% lower than a neighboring hospital in more affluent areas.

Personally I think the care in many hospitals makes c-sections necessary. In other words, they might have been avoidable, but the events of the labour make them necessary.

I don't think many doctors are scalpel happy in this country. Do think though that many women end up needing c-sections because of seriously inadequate care in labour.

I am to say the least, having had both my children at home.

I am partial to sandals though - the high heeled, strappy variety

A somewhat shallow article.

My first child was born in hospital and got MRSA and an amumndance of others skin troubles, it triggered severe exzema that didnt settle until he was 4 years old. Maybe he would have had the exzema anyway but not the nasty infections. My sister in law also had a baby who picked up an infection in hospital (and nearly died).

I recently had number three at home, with only one midwife, it was much better and they bring oxygen and the like.

I think birthing units are the best bet for 'normal' pregnancies, so there are lots of experts on hand for emergencies.

I hope Eeky has a moment to come back and answer some very cogent points by others in response to her post!!! I would be extremely interested to read her counter-response...

Its been said by several people on this thread that statistically home births are safer. I have doubts about statistics, they are easy to manipulate.
Most homebirths are low risk pregnancies so of course the statistics will be favourable. Its akin to saying that private schools turn out kids with better grades, they only take in the smart kids in the first place so the odds are stacked in favour of the desired outcome.

None of the children I know who are birth injured were homebirthed. I know many.

I dont think this proves hosptial births are dangerous but it doesnt seem to prove homebirths are more risky does it?

Anyhoo - watch out. That silly bint of a journo will be writing a peice in a couple of weeks:

^Why do modern women insist on medical professionals dancing attendance on them just because they are having a baby? How I long for the days when women would give birth surrounded by wise grandmothers and aunts. Panting on their mother's handcrafted bedspread, hands gripping the lovingly polished brass bedstead.

In my grandmother's day there was no fuss made. It was down to the robust womenfolk to birth babbies. How spoilt women are today with their doctors and epidurals and hospital rooms. Back then women would be back at the mangle mere hours after delivery.

If only modern Misses (as alas the majority have not bothered to actually marry the 'father') would realise pregnancy is NOT AN ILLNESS^

That last bit was supposed to be in italics. Just in case anyone thought I was being serious and not hilariously satirical .

Jemart - I belive that the comparison between the safety of hospital and home births is made using low-risk pregnancies in both cases, so the stats are not skewed in favour of home birth by bad high risk outcomes in hospitals.

This is from the homebirth.org website... I was looking for something a little more concrete but I've had a little too much wine and it's too late at night to look properly, so I'm ashamedly going to assume that these facts are correctly quoted:

"Where a healthy mother has a normal pregnancy, the benefits of home birth for infant health have been shown empirically. Mortality rates for planned home birth in low-risk cases have been shown many times to be the same as, or better than, those for hospital birth. However, the condition of the baby at birth is also important. The National Birthday Trust 1994 report on home births was one of the most comprehensive studies in this country, and its results echoed those of many others. Comparing low-risk women planning home births with low-risk women planning hospital births, the home birth group had half as many caesareans and forceps or ventouse deliveries (and this includes those transferred to hospital because of complications). Babies planned for home birth were less likely to be in poor condition at birth (5.2% APGAR score below 7, compared to 9.3% in the matched hospital group). Compared to babies whose births were planned in hospital, planned home birth babies were approximately half as likely to have resuscitation at birth, and less than half as likely to suffer from bruising during the birth.

It's been said before but everyone needs to make their own mind up based on careful research. FWIW most homebirthers I know have been very thorough about this.

I didn't end up with a homebirth although I had planned one but I found the evidence-based approach that it made me take was hugely helpful in the very medicalised but still very positive induction of my dd.

The full NICE guidelines on birth are here and include full details of all the research that was assessed in drawing up the guidelines. This is meant for professional rather than public consumption so it is a bit heavy going but the recommendations are here:

"Recommendations on planning place of birth

Women should be offered the choice of planning birth at home, in a midwife-led unit or in an
obstetric unit. Women should be informed:
? That giving birth is generally very safe for both the woman and her baby.
? That the available information on planning place of birth is not of good quality, but suggests that among women who plan to give birth at home or in a midwife-led unit there is a higher likelihood of a normal birth, with less intervention. We do not have enough information about the possible risks to either the woman or her baby relating to planned place of birth.
? That the obstetric unit provides direct access to obstetricians, anaesthetists, neonatologists and other specialist care including epidural analgesia.
? Of locally available services, the likelihood of being transferred into the obstetric unit and the time this may take.
? That if something does go unexpectedly seriously wrong during labour at home or in a
midwife-led unit, the outcome for the woman and baby could be worse than if they were
in the obstetric unit with access to specialised care.
? That if she has a pre-existing medical condition or has had a previous complicated birth that makes her at higher risk of developing complications during her next birth, she
should be advised to give birth in an obstetric unit"

I think hospital births are now seen as the norm together with high c-section rates because hospitals and doctors are so scared of being sued for medical negligence if anything goes wrong.

I'm not trying to sound smug but just saying it as it felt at the time. During my homebirth I felt there was implicit trust between my midwife and myself. I think giving birth makes you very vunerable as you are taken out of your comfort zone completely and usually in such pain you can't think straight.
I felt it was really important to have a midwife who was going with my timetable rather than a hospitals. And as I was in my home I felt i could do my own thing within reason and I did feel empowered so when I really did'nt want a student there I said so.

Hi I've just joined MN Am 27 wks with my first and have been planning a water home birth for several weeks now. Despite the poor "journalism" in the original article, I for one am pleased it's stirred so much comment. I've read this whole debate and found it informative and very helpful. Thanks all!

Glad something good has come out of that dreadful article then! Good luck mamanicky!

Hi mamanicky

Glad you found it informative!

I had a home birth with my first baby (well all in water apart from the actual delivery as I was most comfortable kneeling and in the pool this meant sliding all over the place!). I ended up giving birth to my wee girl leaning over our sofa!

I would be happy to answer any questions you may have - just get in touch

Why do women have to keep criticising each others' parenting choices from birth onwards? Aren't we all in this motherhood thing together regardless of our differences of opinion? I really wanted a home birth for my dd no 1 (even though both my parents are doctors and my mother had all 5 of her children in an environment comfortable and familiar to her- a hospital). Couldn't happen in the end as my low risk turned to higher risk for the baby at 38 weeks. I got over it and made the informed decision based on the medical advice I was personally given at the time to have dd in hospital. Dd no 2 is due at the end of Aug and again a home birth is planned as long as I stay low risk this time. The consultant doesn't feel he needs to see me and the midwives are happy that my decision is informed. Why on earth would any fellow mother feel they need to pass judgement on my choices? I'm a grown up who knows what childbirth can mean and would never endanger my baby or myself. I could make plenty of comments on planned private CS- but frankly if those particular women are making informed decisions too, why would I? Come on ladies..!

Thanks Bunny I'm planning to meet up with a couple of ladies from local NCT who've hb'd recently. I'm living on Guernsey now and all things medical/maternal seem to be a little different over here! Want some local experiences. Will def get in touch if needed as plans progress. Got GTT on Monday and probable house sale Weds, so rather distracted this week! Cheers.

Was this article a piss-take? It's certainly got us riled up.

Jemart: the statistics are favourable for homebirths because women who opt for homebirths are in the main low-risk. If you were a high-risk birth your health authority wouldn't support your choice to give birth at home. So it's not a case of skewing the research, just that when a pregnancy is simple and straightforward it's very likely that the birth can take place without medical intervention at home and for those who's birth looks set to be more complicated or for those who are just more anxious, hospital or midwife-led centres are a more appealing option.

But Melanie Reid's opinion is clearly a product of the post-war medicalisation of the birth process, however 'revisionist' and provocative she thinks she is. I mean, fancy calling home birth a 'fashion' - how old does she think the NHS is - where pray tell does she think women gave birth before c.1948?

Of course, homebirth isn't for everyone and if a woman is more comfortable with the hospital option then good for her. We should each individual in her choice.
Giving birth is a momentous enough occasion without having to endure other women's catty sniping about the way in which they choose to do it.

Likewise the first few months with a baby is hard enough without another female critiquing the way you choose to feed them. Although as someone who is still breastfeeding their baby (not quite to secondary school age - yet) I have heard more horrible comments about women who breastfeed from those who don't than the other way around, which makes me think that behind all these nasty belitting comments is an inferiority complex?

If you choose to have a caesarean then bottlefeed - who cares? It's noone else's business but yours... just leave the sandal-wearing, breastfeeding, homebirthers alone.

Anyway, who doesn't wear sandals in the summer months?! This woman is NUTS!!

I agree with what Morloth said right at the start.

Does the journo write for Observer Woman? She appears to have switched off her brain before typing.

Message withdrawn

Maybe the choice of Davina McCall as ambassador for The Natural Childbirth Trust was not a good one . I'm sure she wasn't on her own with just one midwife which is why it was such a joyous experience for her. Had anything gone wrong she would have had specialists immediately to hand which is not a luxury the rest of us can afford.

Onestonetogo (hey, me too!), the fact is that many women find that the medical intervention can cause unnecessary complications. I am such a woman. So 'this anti-medicine trend' is not just a trend, and should not be dismissed in such an offhand manner.

The article is extraordinarily biased: just read Naomi Wolf's 'Misconceptions' and you'll get a very different view of the US approach to birth from the rose-tinted view portrayed in this shallow article.

It's an opinion piece, therefore nothing but froth. A waste of space, IMO. They should have devoted proper resources to discussing this contentious and important subject.

Onestonetogo - I would disagree that a homebirth is 'anti-medicine'. There are two trained midwives in attendance at a homebirth, the same pain-relief options minus an epidural and a large amount of medical equipment available to the midwives to use in a variety of circumstances. IMO having a homebirth is nothing to do with being 'anti-medicine' it is simply choosing a different environment to birth your baby.

I've had two homebirths. And I was totally spoilt for both of them. Two midwives and a student midwife with 40 years experience of midwifery between them, resus, IV and monitoring equipment all in my own home (paid for by private medical insurance which is the norm in Belgium).

I wouldn't fancy trying my luck on an NHS hospital, not from what I've seen.

Out of seven women I know who have had homebirths, two are midwives, and two are doctors(GPs).

I never announced to anyone I was planning a homebirth, for the very reason the article shows. Judgement and stereotyping.

Oh, God, I knew I would get thoroughly flamed, that's why I don't post about work-related matters very often! I accept all the other points of view posted, and am not trying to persuade anyone to deliver in a fashion which they dislike. All I tried to do is point out the facts which are irrefutable. I am fully aware that working in a high-risk environment makes me mor aware of complications and need for medical intervention. However, this does not cloud my judgement - I am fully aware that the majority of women have normal vaginal deliveries. (Although probably not as many as most think).
What I am trying to explain is that labour is still an unpredictable process in many cases, and you cannot safely predict whether a woman is high or low risk. Low-risk women can become high-risk very quickly, with no warning - and if you are in a midwife-led unit or at home, then there is a much higher chance that you or your baby (or both) will die, than if you were in hospital. Yes, this happens rarely, and yes, deaths can still happen in hospital, but I would not want to ever think that my baby's death could have been avoided if only I had chosen to labour elsewhere.

Oh, and to the poster who seems to think that all doctors are men interfering in women's labour - we have had women obstetricians for quite some years now, you know! We are, on the whole, quite human and we have babies ourselves! I'm probably the most pro-vaginal delivery doctor I know, and would have been gutted if I'd needed a section. I also LOVE it when I'm about to do a forceps/ventouse/section and labour progresses so quickly that I manage to deliver a baby normally!