interesting website - GP talking about home births, experience of midwives and breastfeedng etc

[mogwai]

Stumbled across this and I think it's very interesting.

It's basically a blog written by an NHS GP.

If you scroll down his pages, there are some very interesting discussions about homebirths and breastfeeding. The arguments stirred up are worth reading, but be prepared to get addicted!

nhsblogdoc.blogspot.com

looks very interesting indeed and you are right about it being addictive, once you start reading you just keep going! have marked it on my favourites.

Thanks - have put it in my favourites,too.:)

I would like to put this in my favourites but I fear for my blood prssure if I have have to read too much of it.

(I think it's fantastic

Oh boy.

I have just wasted nearly the whole afternoon reading the responses to \link{http://nhsblogdoc.blogspot.com/2006/05/home-birth-tragedy.html\Dr Crippen's views on homebirth} and the related articles.

Very interesting, in a stressy kind of way (I'm currently considering the pros and cons of a homebirth) but I think it's worth reading purely for the totally different language used by the doctors and the homebirth advocates. A very fine example of two sets of agendas talking past each other and unable to give any sensible response to women who would appreciate some guidance as to how to chose between a rock and a hard place.

Fabulous blog. Thanks for the link.

gosh, he's got an unfortunate name for a doc!

ok, now read it so can be serious.
Very tragic case - he's right in this instance, Im sure this baby would have stood a better chance having had speedy access to hosp facilities. But this was only one case, sad of course though it was. How about other births which might actually be safer at home? For example, I'm sure the fact that a woman is likely to feel more comfortable and confident at home is likely to help her progress effectively and therefore be less likely to need intervention and therefore avoid the dangers to her and the baby inherent in this.

'Midwives are the comprehensive schools of obstetric care. A cheap and cheerful option for the common folk'

Grr, I hope Mears doesn't have to put up with this type of CRAP!

yeah, I was a bit at that comment

I'm sure his name isn't really Dr Crippen! He could never afford to lose his anonymity could he??!

Fascinating reading.

Misschief, you say this was only one case. I would have been another case if I'd had a homebirth - the doctors had 5 minutes to get my baby out and told me he would have died if I'd been at home. OK, I know this is rare statistically, but having been through that experience I would never encourage anyone to have a homebirth.

I'm all for choice

But birth is so unpredictable. As the website says, things can go very rapidly pear-shaped.

He makes a very pertinent point - that mothers seeking a homebirth are placing the risk on their baby, whereas in hospital the risk is on them (or words to that effect - it's a couple of weeks since I read it)

It's that last point that has kept me awake at 2am this morning, worrying .

As I say, it's a rock and a hard place: on the one hand, it seems that even the studies supportive of homebirth suggest there is an increase in mortality when homebirthing over hospital outcomes of something like 1 in a 1000 (with a statistical variation that could vary that to parity with hospital births or 3 in a 1000). On the other, there is heavy anecdotal and logical evidence that care in hospitals gives poorer outcomes on all sorts of other measures. I'm personally convinced I would get better care in all these respects from my local NHS midwifery service if I did homebirth.

I'm going to have to go through all the homebirth studies and double check the stats. Which I'm not really qualified to do, but it's the only way to decide whether the statistics actually hold any truth for someone in my position.

In other words, what do these studies actually say about the risks for a slightly elderly second birther, with a very normal pregnancy and no history of labour problems, living approx 10 minutes from the hospital?

Perhaps a mumsnetter with a better understanding than I of how to analyse studies of this nature might care to have a look at the problem?

can't help you on the analytical side but can help you from my own experience. 1st time, booked for home-birth, failed to progress so asked to go to hosp where baby's heart-rate suddendly dropped so had to have v rapid assisted delivery. would heart rate have dropped at home? I wonder, I was so unconfident in my midwives, so frazzled by the time they checked me into hospitla that i'ms sure some of my distress transmitted to my baby. Anyway, he did come safely out, so we were lucky, possibly luckier than we would have been had he been born at home.
2nd birth - at home, brillaint midiwife in whom I had every confidence but my blood pressure plummeted dangerously after and I had to be blue-lighted to hospital after, even tho the birth itself had been fine. I got there in 10 mins from home and I was fine.

That's very interesting Mischief, why were you unconfident in your midwife the first time around?

we were in London - started labouring on a sat night, not the best time re staffing so had agency staff. my mw thought I was too out of it to hear but when 2nd mw came she was saying things like "thank God you're here, not sure about doing one of these.." etc etc, my body then just decided to freeze in protest I think. Just didn't feel confident or supported to actually deliver at home.
my mw for my 2nd birth (Nhs but new are) knew all this and was brilliant really reassured me, talked me thro' what to do with breathing, stopping, relaxing in a way that never happened 1st time.

new area, sorry..

Hmmmm, yes, and it's not that easy to change midwives, mid-birth, at home, is it? One can hardly say: 'oi you, I don't like your attitude now naff off! '

Actually, not that easy to do that in hospital, I guess...

well, are you in London? If not and you've got a stable mw team locally it shouldn't be a problem even on a Sat night. I know for sure I wouldn't have wanted to have a 2nd homebirth where we had lived before but didn't really have the same doubts with the team local to me now. I'd met them, talked thro' my concerns (for eg. they don't use agency staff) and felt whoever i got from the team, it would be ok at home. HTH.

No, in Cambridge, not London.

However, two complicating factors re midwifes: first, my community midwife is all very well, but not really my cup of tea. Hard to put into words why, except every conversation with her seems to be about local policy and doing things by the book, rather than any engagement with the real pregnancy (mine) that is in front of her.

Secondly, I don't think I'd get her anyway: my experience last time was that I saw no midwife I recognised throughout my birth and postnatal care. In fact I saw 4 different midwifes at home in the week after DS was born, which probably contributed to his rapid decline from jaundice. But that's a whole different story...

hmmh, tricky one. But how different would this be then from a hosp birth?? You could be stuck with one who's not on yr wavelength there too..
What does yr dh think??

homebirthds are brilliant

gps just dont like the fact that women can cope without them

enid, that's not my experience. i work with a gp who's very pro-home-birth and bows to superior knowledge of community midwives

and to be fair my gp did 1st check on our ds as he'd been born at home and he was fully supportive of homebirth. can honestly say that everyone I spoke to locally in the NHS seemed to be supportive of home-birht, refreshing & surprising maybe!

So's mine. She said - with the concern of a woman who'd recently had her third baby - "you do know you only have Entonox available at home, don't you?" and when I said yes, I'd go with that, she was absolutely cool. So was the lovely GP who came and did my checkup after having DD2 and sat on the bed with us and cooed over the baby.

I've also interviewed a lovely consultant obstetrician who's very relaxed about home birth.