to think home births are selfish?

[woozlet]

I just watched a 'desperate midwives' that I had recorded and there was a home birth on it which went wrong. It worked out ok in the end and the baby was ok. But I was really scared watching it, it just seemed like an unnecessary risk to take.

I think it's worth pointing out that the USA has the highest rates of maternal death in the developed world - and 99% of babies there are born in obstetric units with massive amounts of routine intervention from ERM from 38 weeks to CS rates sometimes as high as 50%.

All deliveries have their risks - you can ask my mother's friend whose baby was delivered dead in hospital because they mismanaged the birth just last year. Or my MW sister in law whose colleague has just been struck off for the negligent way she dealt with a labour - ending up in the baby's death. That was on a high tech CLU with SCBU.

Homebirth has its risks, just like any birth. But to put blind faith into hospitals that they will make everything safe is simply not true, or at least not in my experience.

I once did a prisoner escort with a woman that was pregnant to our local CLU. The MWs told us to keep the noise down because there was a lady who had had complications and was high risk in the room opposite us. In the early hours of the morning she started ringing her bell. After about 5 minutes when no MW appeared I went to get one - they were all sitting watching the TV and eating toast in their rest room.

That's why I'm distrustful of hospitals and I do not subscribe to this idea that just because you're in a hospital you are necessarily "safe"

OP, I share your opinion of home births, which is why I would never shoose one. But, I appreciate that others have their opwn opinions. And I believe everyone should have the right to make her own (infomed) decision. So to make a sweeping statement that all home births are selfish is of course in invitation to be slaughtered MN style.

I would never have a baby any other way than a planned Caesarean. I believe it is the safest and healthiest way for both mother and baby. But, again, this is mny choice and every woman should have the right to make her own choice irrespective of mine.

Fab post Fibilou. Referring to your last 3 paragraphs, it says exactly why I became so terrorized about ever labouring again in a hospital.

I was once that high risk woman with lots of complications who was ignored for hours. It was hours (in my mind easily 5 hours) before they realized they could have 'lost' me or my baby and then they launched into a mad scary rush to save me from the precipice.

In that time I could have easily had the eclamptic fit which I eventually had and no one would have known till it was too late. I was a woman passing in and out of consciousness who had already that I was going to have to give birth alone - on a labour ward in a hospital full of all the staff and equipment that was suppose to help me.

Nope, you can have your hospitals. A long time ago the questions I had about hospitals never occurred to me because I intrinsically trusted that my safety was going to be paramount to the medical staff who came into contact with me.

I notice the OP had her birth(s) in an MLU. I wonder if she has seen that MLUs are imitating the home environment. Thereby it is a nod by Trusts that home is the best place for births.

Is it for me a logical thing to wonder all Maternity units shouldn't be more like MLUs than having lots of MLUs all over. Surely all women would like to labour in a less hospital like environment.

"I would never have a baby any other way than a planned Caesarean. I believe it is the safest and healthiest way for both mother and baby"

Have you had a baby yet AtheneNoctua ?

The inplication being that if I had I couldn't hold such a belief?

Silly girl. Of course I have.

Why call me silly just because I think you hold a very peculiar view on birth that C sections are safer than vaginal birth when medical opinion is that they should only be used when there is a genuine medical need ?

Don't call me a silly girl unless you want to be called patronising

Hollyoaks - maybe I can explain it this way:

If you lived equidistant between two hospitals, one which had 24 hour consultant cover (as some do) and one which didn't (as some don't), would you choose to go to the one with 24 hour consultant cover, even if the evidence showed that going to this hospital was considerably more likely to end in you having a c-section, failing to breastfeed, getting PND, getting a postnatal infection, and having a baby with low apgar scores, and that there were no benefits to you or your baby in terms of the likelyhood of maternal and infant death rates?

Why would you do that?

Remember that once you've had an emergency c-section your risk of infertility, hysterectomy and stillbirth in subsequent pregnancies also goes up. It's not just about yours and your baby's safety in this birth, but your health and well-being for your reproductive life in the future (on which your baby's well-being also rests).

Foxytocin - I heard that piece. Wasn't that doula lovely?

I have to say though, having seen the way NHS midwives have to work these days - the emphasis on protocol, note-taking and monitoring, I think it's almost impossible for them to provide the same sort of unequivocal, instantly responsive emotional support that a doula does.

'In that time I could have easily had the eclamptic fit which I eventually had and no one would have known till it was too late'

I had mine (fit) at home after being called a tie waster by the C-Led unit (after being referred several timeby the local antinatal clinic so ahrdly just turning up)

I hd another fit in the MLU whilst they waited for an ambulance (DH ahd been requested to take me there),they rushed me to the hospital blues and twos and when i got there they told me off again , refused my MW's begged request for a c-section (she had acocmpanied me after her shift ended).they said they'd send me home but it was 3am. An earlier registrar had verbally dx'd my spiking BP some weeks earlier as 'an anxious mother'.

The next day nobody spoke tome though a porter wassent totakemeforascan;next day I camefrom the shower (wondering why I was there as they'd said I could go home previous day) to amessage that abby had lost weight in utero,needed emergency induction; had 5lb 5oz38 weeker next day after a labour where my bloods were lost so epidural for BP couldn't be administered,and csection couldn't be given as paedwoulodn't come out to MW despite (I found out later) babied heart showing signs of distress.

Said baby is ten next month but does have SN and I willneverknow if that is related tomy PG and delivery.

I thought they had improved at that unit,but I found out last week that afriend who has a condition rendering her almost entirely infertilebut had managed to conceive against massive odds lost her baby as a result of being given the wrong meds; I know of another woman who waslaughed at when she said she was in labour and baredfrom the unit,she had already had a premmie and her baby died that night twohours after birth.

now,that is a no brainer for a HB IMVHO!

(Should emphasise I now live nowhere near said unit, we've moved about several times,so people living near my profile location should not worry!)

So you think "peculiar" is less patronising than "silly"?

My opinion is not peculiar. It is held by many in and out of the medical world -- as is evident by the caesarean statistics in the modern word where casareans are commonly available. You mentions "medical opinion". I think you meant "financial opinin" since the realy issue is what they cost and not that they harm the baby or the mother.

We can argue this til the cows come home. All I meant to achieve by comming here was to say that home-birthers are just as entitled to their preferences as I am to mine. And to start a thread calling them all selfish was really not a very productive thing to do.

the doulas were lovely, sabire. they seemed almost innocent of the controversy like this one and in the way they described supporting mothers through birth (of course I know that this was my preception judging by the ease they seem to be carrying on their vocation.)

I think I will always remember a paragraph from the book Birthing from Within I think it is called where it quotes an obstetrician I believe saying that all women should have a doula with her while giving birth. A very wise position to hold for a person trained in the traditional medical model of birthing, imo.

Foxytocin, I heard about half of the programme. I do worry they will try to get doulas in to effectively replace mw for a lot of postnatal care if we don't watch it.

Fibilou, as I understand it, a lot of the US deaths are attributed to lack of ante-natal care, because of the problems with health insurance in the US, and many women not being insured. Hospitals are not permitted to turn away women in labour, however, and are required to treat them for free if necessary, but by then some women can be in a pretty poor state.

By the way, when in hospital with SPD earlier this year I was absolutely shocked at the appalling level of care of some of the other women collectively left to sob away quietly on the ward as they suffered in early labour. I think a more or less unattended hospital birth has to be the worst of all worlds. It all looked very inhumane to me.

Athena - there will never be complete agreement on this issue among medical professionals as individuals.

But there is a broad consensus that rates of serious injury and death are higher among low risk mothers having elective caesareans, than among a similar group having vaginal births (even when taking into account the 15% of this group which will have emcs, which has worse outcomes than planned elective sections).

I understand why some people choose elective c-sections, but I do think it's important for people to know that organisations like the RCOG don't support the view that operative birth is inheritently safer, or more satisfying for wome.

"since the realy issue is what they cost and not that they harm the baby or the mother".

Athena - most midwives are aghast at the thought of the majority of women starting their lives caring for their new babies immediately following major abdominal surgery. It's really got bog all to do with cost. It's got everything to do with not exposing women unnecessarily to the dangers of surgery at the most challenging time of their lives.

I agree Boffinista. I think we are definitely going down the road to hell in a hand basket if the NHS ever starts to treat doulas as a replacement to midwives. The representative from the RCM (?) also expressed a view that chimes in with what you say. I think she said something along the lines that currently midwives cannot give the all encompassing care which they are supposed to give a woman due to the shortage of midwives and that with doulas being trained in some of the non medical skills which are part of being a midwife can lead down the path of midwives being more obstetric nurses rather than midwives.

I couldn't help thinking at that point that there is precisely where I see the midwives in my area at. They are so used to being in a major CLU to support child birth that they hadn't the skills to support a HB anymore. They seemed terrified at my request for a home birth. As if I was asking them to do something outside their normal remit. they were finding what were my not unreasonable request very uncomfortable and expressed that by lying ot me and by 'finding' a danger in my pregnancy where none existed.

Maybe it was the protocols of the CLU that needs updating and training. But that was no reason to deny anyone a home birth.

"Athena - there will never be complete agreement on this issue among medical professionals as individuals. "

Precisely my point. And that is why everyone should be given the necessary information to make her choice.

One way is not better than other for everyone.

Oh, and the statement somewhere down this thread that a caesarean effects your fertility for subsequent pregnancies is not true.

The caesarean statistics are swewed because when a women attempts vanginal delivery and then ends up in a caesarean the whole thing goes into the caesarean statistic where actually it is the vaginal delivery that was the problem and the caesarean the solution.

There is some real vaginal birth propoganda out there. Women are not given all the facts. But, as I have said twoce before on this thread, I do think that women who wish to have a home birth should have the right to do so.

Athene: Have you ever heard the term 'placental accreta'?

"midwives cannot give the all encompassing care which they are supposed to give a woman due to the shortage of midwives"

I don't accept that it is always about staffing levels. It's also about the insistence on adherence to protocol, the high levels of medical management of even normal births and concerns about medical negligence claims that keeps midwives from providing the sort of emotional support women sometimes need.

"The caesarean statistics are swewed because when a women attempts vanginal delivery and then ends up in a caesarean the whole thing goes into the caesarean statistic where actually it is the vaginal delivery that was the problem and the caesarean the solution".

Which particular study are you referring to? Good quality research into birth outcomes wouldn't do this - as it makes a nonsense of the results. It's like research into homebirth which assesses the outcomes of birth by taking into account only those babies born at home, and not those babies whose mothers had planned to birth at home, but who ended up transferring.

I think the phrase is analysis according to 'intention to treat', rather than actual treatment.

Anyway - I'm explaining it very badly Athena, but the point I'm making is that the RCOG isn't that stupid to ignore such a glaring anomoly in its analysis of the outcomes of cs vs v births......

i think this is the bit where the right conclusion is that women's choices/beliefs should be respected even if it is in direct contradiction to our own beliefs.

I think we should assume that Athene would have also done her own research and that she wouldn't have done anything to endanger her DCs? I have met both of them by the way, and they are scrumptious (waves at Athene).

I had a vaginal and an emergency CS. Despite all the complications of the second one, i must say that my first was a more traumatic experience.

Athena - far larger numbers of women who have a c-section go on to have no more children, compared to women who have vaginal births, even when maternal age is adjusted for. Research hasn't definitely identified whether physiological, social or psychological issues are at the root of this, but there is a link between c-sections and smaller family size.

For me it makes complete sense that women who have higher rates of postnatal infection, scar adhesions, abcesses, hysterectomy, blood loss, placenta praevia and placenta accreta/percreta after cs (compared to vaginal birth) would result in higher rates of infertility, never mind the fact that women who opt for elective c/s may also be those who have to work hardest to achieve a pregnancy in the first place.

Foxytocin - one of my friends and her baby nearly died from placenta percreta in a pregnancy following 2 c-sections. Both she and her baby survived, but she lost her uterus, was in hospital for months and months, and needed reconstructive surgery on her bowel.

Its not something I can have as I am a group B Strep carrier and personally I would prefer the mess somewhere other than at my house, also I live in a terraced house and would be embarrassed with the neighbours. Also I like the fact that there is help right there...... however that is my choice and everyone is entitled to their choice!! I also have a dd at home and she would hate to see me in pain!

YABU - Its personal choice!!

sparklycheerymummy - sorry, but you've hit on one of my pet hate phrases and I can't let it lie... Being a GBS carrier doesn't mean you can't have a HB any more than it means you have to have IV ABs during labour. As mentally competent adults we have the legal right to make our own decisions, whether those are in line with medical advice and/or hospital policy or not - which is a lot of what this thread boils down to really

All that said, I'm all for informed choice as long as women are given information and facts rather than biased and innacurate advice - in which I seem to totally agree with you

My friend's daughter recently had a disaterous homebirth.
It was her first baby and she had a birthing pool in the living room.

After the head had delivered in the pool the midwives realised they had a case of shoulder dystocia.
They had to pull Mum out of the pool on to the floor as she was unable to stand up on her own.(The Mum is very heavy so this took some time to do).
Midwives could not get the baby out and the baby went into distress.
By the time the ambulance crew arrived, the baby had been literally dragged out somehow with brute force. She was a blueish grey colour, and was not breathing independantly. At this point the baby was to all intents and purposes dead.
The baby was resuscitated in hospital and she had to be chilled to a low temp to prevent furthur brain damage.
She was on a ventilator for 2 weeks and they didn't know if she was going to make it.
She has survived thankfully, but the doctors don't know the extent of the brain damage yet, caused by lack of oxygen.
Whether or not this would have happened if the birth had taken place in hospital I don't know but those precious minutes lost while waiting for the ambulance to come and driving to the hospital may have made a difference.
If you are in hospital a crash team, paeds and obstetricians can be there within seconds.

I have been informed by mu MW that is less risk to my unborn child if I am in hospital as I carry a heavy growth of strep B. When faced with the statistics and thought of babies dying due to the risks..... I am not willing to take the chance!!!!! I am perfectly mentally competant thanks!!!! I am having the IV anti bs in labour as my baby is too important to risk and my poor dd contracted it and we had an awfully stressful time getting her right. Informed choice also includes difficult personal cirumstances and history!!