"Your choice to have a homebirth second time around was a very expression of how non-vulnerable and autonomous you were."
Well no. Had I not been lucky enough to have a colleague who is an independent midwife who stepped in and supported me, I would have had to go into hospital. My luck was knowing the right person and getting her support.
Anyway - I'm telling you what I felt and I don't particularly appreciate being challenged on this subject by a complete stranger who knows nothing about me. I WAS SCARED. I WAS SCARED when I opted to have my third baby at home, following the shoulder dystocia I experienced with my second. As a homebirth support contact for the NCT I've talked to lots of mothers over the years who are contemplating a homebirth. I can tell you categorically that these women don't as a group appear to have a cast iron belief that birth is always easy or uncomplicated. They often have very complex reasons for choosing to give birth out of hospital - sometimes positive (they believe they will get better care at home), sometimes negative (they've had traumatic experiences in hospital and are too frightened to go back).
And I think in settling on 'mothers attitude' as some sort of solid explanation of why mothers giving birth at home have better outcomes - well, it smacks of desperation.
"Had you been in hospital, you would most likely have refused what you perceived to be over-intervention.
I'm sorry - you don't seem to have any understanding of the psychology of birth. Read some of the stories on this thread. How many women DO refuse intervention in labour in real life? It's very unusual - women are in no position in advanced labour to think rationally. They are vulnerable and often very frightened if things aren't going to plan. They develop a relationship of trust and dependency with the health professionals who are caring for them that makes it extremely unlikely that they will reject their recommendations in labour, particularly as they are aware that these recommendations are usually made in good faith.
I certainly didn't reject any recommendations that were made to me in any of my three labours, and I was PROFOUNDLY grateful to put myself fully in the hands of a midwife I was close to and who I trusted in my second and third birth.
"Second births are generally easier than first births, so your more succcessful outcome of your second birth may not have been a function of the fact that your second child was not born on NHS trust property".
Yes - this is prossibly true. But I'll never know for sure. What I do know is that I was happier DURING my labour and AFTERWARDS because of the different type of care I had at home, compared to hospital.
"The difference between a low risk and a high risk delivery is that no major risk factors have been identified. This does not mean that there is not risk present and you might not know you are high risk until you have a dead mother or baby. "
Yes - I agree. We may not know if the mother is particularly vulnerable to developing a blood clot, which will be more of a risk if she ends up having major surgery. Doesn't stop us telling her that hospital is a safe option for her, despite knowing that by simply walking through the hospital doors in labour she is doubling the likelyhood that she's going to need surgery to deliver her baby.
In any case - the proof of the pudding....
On the evidence we have right now it appears that the outcomes for low risk women giving birth in hospital are poorer than for low risk women giving birth at home. They are more likely to experience birth injuries and no more likely to emerge with a well baby.
"If the RCOG is using this study as part of their evidence, Im not impressed.
The second study accepts in its abstract that it may be biased too."
It's part of the evidence.
In any case where is the solid good quality evidence for the safety of hospital birth. You clearly believe there is good evidence that hospital is safer for low risk women.
So link me to it!
"the statistics appear to show giving birth was riskier then".
Yes - but it was also riskier in hospital.
"women who give birth in hospital have POORER health following delivery and higher rates of operative birth'
The Dutch study, first on the RCOG list above, shows no statistical evidence of increased caesarian sections or instrumental delivery"
But all the studies conducted in the UK do.
Any - I am with you on the quality of the evidence. There isn't cast iron proof for the belief that either hospital or home are equally safe or that hospital is safer.
I just don't - as you do - accept that hospital must always be the 'default mode' in the absence of evidence, which in any case, will never be forthcoming, because of the impossibility of randomising or controlling for all factors that may influence birth outcomes.
"Anyway, women can refuse ANY intervention. Wherever they are."
I repeat - this point is laughable. Women overwhelmingly DON'T refuse interventions in labour, no matter how confident or assertive they are when they're not in labour.
"This is why I cringe when I hear people singing the praises of homebirths."
Why - because you KNOW that your friend would have died if she'd given birth at home?
Despite the fact that - out of 10's of 1000's of births at home over the past two decades, no other mothers have died?
If you clearly believe that homebirth is dangerous you really need to ask why the Royal College of Midwives supports it.
Either they are being cavalier with the lives of mothers and babies, or they are acting in ignorance of the facts.
Which one is it?