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

[Floopy21]

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

'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'

You see, I just don't believe this statement.

Even if it could somehow be proved that homebirths were a teensy slight bit riskier ( which statistics do not back up) but even if it were true,and home births were still legal in the interests of a woman having the right to choose, then I don't believe that Midwife-led units would be allowed to exist. Or, if they were, they would come with a health warning, rather like a packet of fags, saying 'Yes, you can choose to give birth here, but there is a MUCH HIGHER CHANCE THAT YOU OR YOUR BABY (OR BOTH) WILL DIE.'

And the fact is, they don't. My local unit has never in all the years it's been existence ever lost a baby or mother. Which is not true of my nearest hospital.

So I just do not beloieve that statement.

A high tech hospital is the right place for women to give birth if they are high risk. It was the right place for my Csection which was medically necessary. It was the right place for my VBAC (although it was a damn awful experience). But the midwife led unit was the right choice for my first child. I also think hospital is the right place if that is where the MOTHER chooses to be because it's what she wants. And actually, when you ask people about it, very often the mother chooses it simply because she wants the option of an epidural which is a specialised medical procedure requiring an anaesthetist. So there is no medical need for the woman to be in hospital,it's more about wanting pain relief. Which is absolutely fine if you choose that route - out of a large group of us at NCT who were allowed to deliver in the unit, only two of us did, as the rest wanted to go to hospital and have epidurals. Nothing wrong with that - but don't subsequently dress it up as making out you made the choice because it was 'safer' - it isn't.

the only foetal and maternal deaths i have heard of in the last 2.5 years of being involved at the local trust are from hospital births.

not to say home birth is risk free

but no-one has been arguing that

what a lot of people have issue with, which i am interested to know if you agree with, is the assertion that women making a choice - which the government is supporting - to give birth at home are spoilt and complacent and giving birth without medical support.

'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'

i would like some evidence for that , as everything i have read re home birth has indicated the opposite. for normal, low risk pregnancies.

Eeky

Can you provide some evidence for your statement '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'

Given that the evidence shows that the risk levels are the same for low risk women in home or hospital then if there are women and babies dying because they decided to give birth at home there are others dying because they decided to go into hospital.

eeky - I would just like a straightforward answer to the question:

Why was I allowed to deliver my baby in a midwife-led unit when, according to you, there is a 'much higher chance that I or my baby or both of us would die??'

None of the midwives or doctors I saw during antenatal care warned me of this risk. Quite the contrary. There were about 8 of us I believe in the same antenatal group who were told that we were eligible to deliver in the local midwife unit. Only two of us chose that option, but the other 6 chose hospital not for any medical reason, or for any safety reason, but because they were not confident of getting through labour without an epidural.

I find it quite extraordinary if I were really at this much higher risk you speak of, that no one in the medical profession actually warned me

My hospital birth was much more traumatic and enduring compared to my home birth. I think the epidural I opted for was the reason why my hospital birth was so bad, it slowed my labour and I spent 12hrs on a bed on my back, tied down by monitors and drips, which caused my baby to move from LOA to OP thus resulting in the hardest 2.5hrs of pushing her out and a third degree tear. The delivery room was ok but I found the 6 hours I spent on the maternity ward, which was very large and full to capacity, very stressful.

My first preganancy was deemed low-risk so when my second DD was due I opted for a homebirth. I would like to point out that I am not a hippy I am an aspirational career woman who has enough common sense to know her body and her limits and decided after weighing up all the 'what ifs' with her DH that a homebirth was the safest and best option. My main deciding factor was I felt sure I could manage the entire labour without any pain relief and I knew that with a homebirth I would be guaranteed two midwives to attend to me the whole time ? something that is not always guaranteed with a hospital birth.

The community midwives were great, they supported my decision from day one, they felt sure that I had enough confidence to manage without the need for epidural and they sat me down and talked me through a risk assessment. They covered all the situations that could arise that would mean a homebirth wouldn't be possible at all or would call for a transfer from home to hospital. The important factor was my previous delivery and antenatal history which meant the chances for complications before or during labour were extremely low. Taking that into consideration I decided that there was no reason I shouldn't deliver in my own surroundings, with the support of the midwives. I am not sure how professionally correct this is but the midwife who did my risk assessment said that they tend to be much more cautious with homebirths and will transfer to hospital at the slightest whiff of foetal distress or the mother struggling with labour, whereas they might let the mother struggle on a bit longer or monitor the baby for longer in a hospital situation because, in theory, they know they have an obstetrician down the corridor.

When the time came I delivered my DD2 safely at home. The two midwives were there to assist but all they needed to do was monitor me and the baby as I managed to deliver pretty much on my own and the whole labour was over and done with in four hours.

loopylula - I'm glad that you managed to experienced the joys of a low tech birth following your difficult first experience.

I know so many people who have had a similar experience to you - ie: difficult first birth in hospital with epidural followed by various problems/interventions, and then as a reaction to that, they plan for a more low tech birth next time around. It's sad that it seems to almost be the case that women 'get' their better birth experience as a result of having had a bloody awful time the first time around. How much more positive to be able to experience that sense of empowerment the first time though.

I still maintain that had I been in a hospital for my first baby, I would put money on the doctors and midwives pressuring me to have an epidural or other interventions. In fact the midwife in the unit actually said to me after the birth, 'You know in hospital you probably wouldn't have been allowed to labour in second stage for so long - you'd have been pushed towards epidural and then forceps or ventouse'. Clearly none of these would have been medically necessary, as the fact that my dd was born naturally and absolutely fine proved.

Anyway, I'm still hoping eeky will come back on to answer my question, because I'm genuinely concerned as to why I wasn't warned about the very much higher risk of death I was exposing myself and my baby to when I booked into the midwife unit

I'm a GP, and I worked in obstetrics for a while. I would no more have a home birth than I would have my appendix removed at home. I have seen countless "uncomplicated" labours turn into situations that would have resulted in death of baby and/or mother if they'd been at home.

I also think it's unfair on stretched medical services to start off at home, then expect an ambulance to be on your doorstep if it goes wrong, and a team of scrubbed-up obstetricians to be ready and waiting at the hospital, the moment you're carried through the door, having had no opportunity to see what problems were developing.

Rebecca- I think it's a widely accepted fact that most medics tend to prefer medicalised births with every drug going!!

But no one is actually answering the question which I and several other posters have repeatedly asked. If home births and midwife-led unit births are so risky ('much higher risk of death of baby and/or mother' to quote eeky) then:

Show us the evidence to support this claim.

And Why was I allowed to deliver my first baby in a midwife-led unit without a 'health warning' about the huge risk I was taking?

Sorry, I just don't believe what you are saying.

These days I am more of a high heels and lipstick kinda gal. However, given the choice, I know my home is clean. If I want to spend ages sitting on the loo its fine, if I want to breast feed or change my knickers without showing the woman next doors relatives or move around in labour instead of being strapped to flippin machine in the same position for so long I get pins and needles then my home is the best place.

But thats just me.

I totally understand that some women feel safer in a hospital, sharing facilities and closer to the operating theatre should the need occur, and that too is great. I wouldnt knock that choice.

Which is why I find this article so damn rude.

How dare she insult me and assume anything about me. The stuck up cow. Its like me saying that everyone that wants a hospital birth doesnt care if their child catched MRSA. Its utterly ridiculous.

Report on a few facts love, in fact why dont you interview a few homebirthers before you write your manky article. Its called journalism.

catches...obviously

I know which side I am on. Primarily, I would be really worried about something going wrong very quickly and an ambulance not being able to get to me and my baby on time. As a secondary issue I would also be a bit worried about the potential mess it would make. Much as it is a nice thought of giving birth in the comfort of my home it is not one that me and my husband are fond of.

Ali - what do you mean what side you are on? This is a thread regards an article where the journalist says that women opting for homebirths are selfish - do you agree with that statement? If you just don't fancy a homebirth that's absolutely fine, plenty of people don't and many people on this thread have talked about the importance of choice.

It's all down to personal preference. Horses for courses and all that - some people prefer the idea of a homebirth and some a hospital birth, and no idea is 'wrong'.

What's really wrong is the way this woman is branding women who opt for a home birth as spoilt and complacent. She offers noevidence for her arguments, which is also what's lacking from this thread. I've read that the risks of complications are higher, but I haven't seen any evidence of it. I'd be interested to see some.

x posts Belle!

Oh and yes the mess! The terrible mess! I swear that was the first thing most people mentioned when I told them I was planning a homebirth as if the walls would be running with blood and that we'd need industrial cleaners afterwards. Honestly a few old towels which we just threw in the bin and that was it.

Still waiting in hope for some answers, eeky and rebecca.........

From what I've read there have been no studies which prove a planned homebirth to be riskier than a hospital birth, however there doesn't seem to be a massive amount of research conducted which leaves those studies out there open to criticism from those opposed to homebirths. There have been some great letters to the times in response to this article (search for editors letters on timesonline, sorry can't link on my phone) from NCT and medical professionals with some positive figures but the most interesting imo is from the head of obstetrics at Leeds who talks about the inertia in this country regards research into perinatal mortality and the fact that there just isn't enough research into the whole field of childbirth in the UK.

I had a homebirth for my first baby because I felt that I wanted to labour in a familiar & comfortable environment.

Like Morespamthanglam I liked the privacy & control of details e.g. munching on breakfast of choice halfway through, moving from room to room at will etc.

I read around the issue & felt that the level of risk to myself & babe was likely to be no greater than a hospital birth. As previous posters have commented the individual course of labour cannot be predicted & I would have transferred to hospital in a flash at any sign of trouble. (If that makes me spoilt, so be it)

(P.S. I do not fall neatly into the spiteful stereotyping
outlined in this poorly researched article either.)

Violet - I don't think that eeky has anything to back up what she says, seems like an opinion rather than fact IMO. I think she is saying that if anything did go horribly wrong then surely the baby and/or mother would be more likely to die but isn't basing this on anything other than a feeling. But I think we've already said that the likelihood of anything going wrong at home is less likely as you are monitored more carefully and also there are very few circumstances which a midwife couldn't actually deal with. I guess we're talking about a baby who needed to be put on a ventilator or a mother who haemorrages and can't get an infusion on time?

Reid is trying to be controversial, especially using insulting language like 'spoilt' and 'complacent'. Actually it is 'intelligent' 'logical' 'progressive' women who research the options themselves, don't necessarily believe the scare stories the consultants feed them (I was given utter bullshit by one), and then, if they decide that is what they prefer, give birth at home, with the option to transfer to hospital, with all the wonderful technology, if they need it.

I had a good homebirth (VBAC) after a horrible and traumatic hospital one, but I wouldn't try to convince another woman that my way was right for her. Each to their own.

In answer to the article directly - no it is not selfish or complacent to have a homebirth. I know potential mothers generally mean to do the best for their child and themselves.

However, from what I have read from the medical experts who have put their view on this thread (you will actually note there is one obstetrician who puts her view across quite strongly), and also from my own midwife and the literature I have read, the risk of complications is greater with a homebirth and this is just a fact - not a matter of opinion.

Personally, I would prefer to listen to the views of those that are qualified to give it.

I listened to those qualified e.g. my midwife, G.P. etc. & they were supportive of my choice. I feel it is a little simplistic to assume that all medical professionals share the views as expressed on this thread. Research shows homebirth to be as safe, if not safer, than hospital birth. So no, risk of complications being greater is not just a fact as far as I'm aware.

It is simplistic and imo ridiculous to assume all medical professionals feel the same about home births.

I had the full support of my community midwife team and guess what??? I did not see one single doctor, consultant or obstetrician from day 1 of my pregnancy until the day I gave birth on my sofa!!!

Because I did not need to. I was not ill.

I know my body better than anyone else and having enjoyed every day of pregnancy and having no problems and indeed being a healthy young woman I put my faith in my body's ability to do what it has been designed to do!

I stand by my (extremely well informed) decision and look forward to baby number 2 being born at home.

AliGrylls

"However, from what I have read from the medical experts who have put their view on this thread (you will actually note there is one obstetrician who puts her view across quite strongly), and also from my own midwife and the literature I have read, the risk of complications is greater with a homebirth and this is just a fact - not a matter of opinion."
Can you link to the literature that says the risk is higher in a homebirth?