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 on a par with not talking about religion or politics. Very personal.

I have had 2 hbs and 2 hospital births. All uncomplicated - one hospital birth due to being so overdue (and actually it was a quick no intevention birth).
Took porters so long to get me to labour ward and he was being born in lift so it was in fact probably more risky than being at home.

It is about sensible choice - there are risks and will always be unforeseen complications.

I think with the staffing levels so low in the hospitals i am not sure it is actually much safer anyway.

'There are risks to everything we do in life. It is for each person to decide, based on their own situation, which risks are more acceptable to them. '

Quite.

As I pointed out previously risks differ not from location tolocation but woman to woman- the MWsusopected and was right that ds4 would be a precipitous labour; there is no question that he was asafer biorn at hoime with a MW etc than in the car which would have been what happened, hospital wasn't an option.

So each sit. differs massively.

"babies can get distressed during home or hospital births and i don't think anyone is claiming homebirth as a utopia where nothing ever goes wrong"

I'd have agreed, Lulumama, but some posters on here have claimed that their babies would not have got distressed if they had been at home, and I am interested in that.

Woozlet, look at the evidence base, not at an isolated event on the television.

Tee hee - VERY selfish as you get to have a WHOLE mid wife and TWO bottles of entenox all to yourself, and during the second stage an extra mid wife will usually turn up around here

But, that's if you can actully get thru to the community team in the first place.

Not possible in most hospitals, although usually the entenox is on tap...

YABU as I'm sure you well know.

If a woman gives birth where she is relaxed and feels in control, she is less likely to need pain relieving drugs (which could pass to baby - ironic when most mums avoid drink etc in pregnancy) or synthetic hormones to kick start labour which can put the baby in distress as they produce contractions which could be too strong.

Childbirth is not a medical event to be controlled with drugs or managed by doctors. It's entirely natural and our bodies are well equipped to handle it. Yes, in some cases, hospital is the best place where there is a genuine danger. However in the vast majority of cases, birth goes well.

Alas women are brainwashed into the idea that they cannot give birth without aid, that it's inherently dangerous or their bodies are flawed. It's a sad attitude which results in opinions expressed in the OP.

OK

My hospital birth involved 2 midwives over the course of a day and night, a medical team to perform the ventouse delivery, a medical team to manually remove the placenta in the operating theatre, spinal block, 3 nights in hospital and 2 units of blood transfused

my home birth involved 2 midwives over the course of about 6 hours. One of them was literally there for the delivery and probably didn't stay more than an hour.

If there had been any kind of problem of course I would have gone straight to hospital.

I would say my home birth used far fewer of the NHS's precious resources...

Bellisima and Fernie3 - re maternal death rates in history, I am not an expert in this area but was quoting Tina Cassidy who references a number of sources to come up with her est of 1% throughout the 19th century. This does refer only to childbirth itself, not pregnancy and post-delivery deaths.

She writes:
"The diary of the Rev Ezra Stiles, president of Yale in the late 18thc, noted that between 1760 and 1764 there were ten maternial deaths in Newport, Rhode Island, a rate of half of 1 percent....

In the 19th century [...] maternal mortality was fairly constant at about 1 per cent. While that number seems egregiously high, tuberculosis killed more women of childbearing age than birth did...

By 1932 [...] excluding deaths from ectopic pregnancy and abortions, 4.5% of [New York] women who delivered in hospitals died after what should have been a normal delivery, compared to 1.6% of those who delivered at home with a midwife."

But her stats focus mainly on America and I appreciate it's a very complicated subject and open to different methods of counting/interpretation etc.

I just wanted to make the broad point that it's not really fair to compare late 19th c/ early 20th c statistics against modern ones, as these were a historic low in maternal deaths for a number of reasons. The "natural" maternal mortality rate of healthy women is a lot lower than the 1/3 mentioned further down the thread.

I was looking at eighteenth century, mainly pre-industrialised and pre-dirty-hospital births, not nineteenth. I did go on to say that in some places the maternal mortality rate actually rose in the nineteenth century following industrialisation and an increase in the number of births per woman (earlier age of marriage led to this, not any taking/declining of contraception!). I think you are also saying this (increase in mortality rates in 19th century on industrialisation/urbanisation and other factors). I'm not trying to argue anything for or against home births, I hope I've made that clear, and i think the source I quoted is reputable and more reliable than your 18th century source (ie the diary of one vicar). Certainly the parishes I have looked at show rates more akin to the one I quoted (which incidently is not huge as some would believe) but rather higher than one in a hundred and, at 25 in a 1000 for non-hospital (higher for assisted though those might have been more risky anyway) rather higher than anyone would want now!

Oh, the sources she uses for her 1% are not the vicar - they're explained earlier in the book and in the refs but I can't be bothered to trawl through and find them.

I wasn't trying to contradict your stats at all Bellissima - I'm sure your 2-3 % is quite correct.

I just thought as you'd raised the whole issue as a discussion I'd explain where my quote came from in case you were interested.

As you say, interesting subject with a lot of misconceptions around it.

Overall, one baby in 1,400 died during birth or in the first week, whereas one baby in 800 born at home or intended to be born in the home died.

The risk was greatest for intended home births where complications arose and mothers had to be transferred to hospital. One in 150 of those babies died.

The research is published in the British Journal of Obstetrics and Gynaecology.

Professor Philip Steer, its editor in chief, said mothers should be informed of the increased risk of opting for a home birth.

He said: "If it if your first pregnancy, then one in four women will develop a problem during labour that was unforseeable.

"A successful home birth can be great but the tragedy is that it can go wrong."

This was in a times article, but it does say the results should be treated with caution!!!

YABU. Home births are as safe as hospital births for low-risk mums. What if something goes wrong? Well, that is why midwives train for four years instead of 20 minutes.

Must say I find the 1930s NY stats flippin frightening on both counts - particularly as they exclude ectopic pregnancies and (presumably back street) abortions - both of which had terrible death rates. Of course general deprivation probably had a large part to play. We are all a lot luckier now in developed countries.

I had a home birth, with my 3rd, well I had planned one but needed a blue light run.
I knew the risks and knew that I was close enough to help if needed.
My previous births had been so easy I had no reasons to suspect anything would be different.

woozlet - to when do your figs for infant mortality refer? I deliberately didn't quote anything for infant mortality for earlier periods because, as well as any 'birth' effects, infants were just incredibly vulnerable to eg outbreaks of scarlet fever, or indeed just about any other illness sweeping around. In particularly bad years the death rates could be awful but have precious little to do with where the poor child was born, so just aren't comparable.

the article was 2008 and it said it had been a 10 year study.

Oh sorry - then scarlet fever not a factor, obviously!

me23 - how am I being rude about midwives? All I said is that they don't have the same level of medical knowledge as a consultant. That's a fact! If they did, we wouldn't need obstetricians would we? Obstetric consultants have a medical degree and train for many years in obstetrics. Midwives don't. If you're not having any problems it's an advantage to have a midwife, but if you are having problems a consultant can be very handy!

I don't see this whole 'childbirth isn't a medical issue' thing. It really is, or can be. If you're having a straightforward no-problem birth then that's great. But not all 100% of births can be like that, they just can't. And if you happen to be one of the ones that aren't straightforward you will be bloody glad to have a consultant there to step in.

Hospitals may not be actively paid for a homebirth, but they save the bed and they take pressure away from beds, equipment, doctors' time etc. etc. All of which look good on their figures. It really IS a numbers game, and the reason they are pushing home births is financial.

YABvvvvvvvU.

InMy Before I really must do some work! - I had two hospital births, indeed sections, for reasons given - so I think you can safely say that I'm not biased towards home births(!) - but I don't think hospitals 'push' them. i think they are quite clear on possible risks and I think that those who arrange a HB (including a friend of mine who had two) have to be reasonably assertive.

YABU

Can't really add much to many of the arguments already made, except to perhaps sugest you read this book. analysis of the stats from the last century does not support the theory that a move to hospital births has made birth safer.

One thing thesecond - you picked up a strep b infection that didn't show at the 36 week test?? (Its bacterial surely) - that's a bit frightening.

Woozlet, is it possible that the study you are quoting didn't differentiate between planned and unplanned homebirths? This is certainly true for one of the studies I remember reading about perinatal mortality and complications in homebirths v hospital births.

This is significant because planned homebirths usually only happen in low risk pregnancies, and if the figures for women whose homebirth wasn't planned were removed from the study, then the figures for complications in homebirths were much closer to those for hospital deliveries.