After some talk at work last night, I decided I'd post on this subject. I've thought about it before, but, since it's a hot topic in some circles, I've avoided it.
But, I'm a brave girl...and I figure, "what the heck!" Why not? Maybe I'll learn something in the process too!
A warning to those who read me regularly, I'm not expecting this post to be light and fluffy and witty. I'll try my best to make it light, but I do feel strongly about some things (and this is one)!
A note to those just "accidentally" stopping by or those whose opinion will differ from mine, please be kind with your words! Please don't crucify me...please? I'd love to have this be a "dialogue" and not a nasty session...besides that, I'm kinda sensitive, and I'd probably cry if you said mean things!
Okay, so here goes:
Home births. As a nurse in a fairly large hospital, I see a lot of stuff. A lot of stuff, some of which I wish I didn't have to see and some of which brings me to tears of joy and happiness (which is more often the case).
As you know, I am a kind of "crunchy, granola" type of labor and delivery nurse...kind of. I have my own babies au natural, I love helping people through their own au natural experience (or non au natural experience--I love it all!!)...but, I also realize, that while many people have wonderful, romantic ideas about childbirth, it is a serious thing.
I've mentioned it before, but an "experienced" (read: older) nurse once taught her Labor class pupils, "Our end goal is a healthy mom and a healthy baby...not a fabulous labor experience". Some people are lucky enough to get all of the above. Some people, unfortunately, draw the short stick and wind up with unexpected plans to keep mother and/or baby healthy. That is the nature of my business.
While, I would never want to rob a woman of a wonderful birth experience, it sometimes needs to be...and that is why we have obstetricians and hospitals and operating rooms and fetal monitors.
I'm guessing the home birth advocates (and I could be wrong) are against hospital births for a reason. And I'm interested to hear what it is...truly.
In my opinion, I think home births are risky, dangerous, and, well...selfish. I know that sounds harsh, but that's how I feel. What about a home birth is safe for babies (and I'm not asking rhetorical questions, I do want to know what you think...I think it makes me a better nurse to see all sides)? In my mind, a home birth is a romantic ideal of a delivery...a delivery in which things can go horribly, atrociously wrong.
No woman is "risk-free" from a c-section, even the low risk, perfect pregnancy, the woman who's had vaginal births before...you could get a prolapsed cord, a placental abruption, a shoulder dystocia...things you would want to be in a hospital for...trust me.
I have to wonder, if you elect to have a home birth, and your baby has a severe shoulder dystocia...can you live with that decision as you are being whisked to the hospital in an ambulance with your dead baby's head between your legs? Could you handle hearing the thump...thump...thump...on your midwife's doppler of your baby's hearttones in the 60's...and falling, and know that when you get to a hospital your baby will likely have died?
Okay, I know that's harsh, and I'm sorry, but these are things that have happened. It sucks. I know it's a risk I would never take, and I'd like to tell you a few fabulous things about hospitals.
First of all, we, as nurses, are YOUR advocate. It's part of our job. We are here to assist you with the healthy, successful delivery of your baby...and to the best of our ability, we want this to be everything you've dreamed of. If I've said it once, I've said it a thousand times (okay, well...I think I have only said it once...) if you have a nurse that you do not feel is advocating for you or that you just don't mesh with, ask to speak to the charge nurse and tell her (kindly) how you feel and request another nurse. Often times, when a patient is upset with her care, she will end up getting the nicest, most compassionate nurse (as a little "service recovery", if you will!) if she requests a different nurse.
Would that be hard? Yes, but honestly, if you aren't lovin' your nurse, she's probably not lovin' you and you'll all be happy for a change.
Second, laboring in a hospital assures you that an operating room is near-by...in the unfortunate experience that you would need one. And it's a nice safety net to have...you know, just in case.
Third, we are not out to derail your birth plan. But, we do have standards that we need to adhere to. Write out your birth plan, be familiar with it, and then review it with your midwife/doctor and nurse, so everyone's on the same page. Birth plans are a wonderful way to communicate your wishes, desires, needs to the hospital staff.
And last, if you really can't stand hospitals...will you just consider delivery there? If you feel strongly about not being in a hospital, many docs will discharge mom and baby within a few hours of delivery if everything is okay. Just discuss it with your MD/midwife prior to delivery (waaaayyyy prior, like mid-way through your pregnancy...and have a lot of conversation about it.).
Please remember, we are not out to get you. Not in any way, shape or form. We are here to help you and support you. Research your options, if you want a "natural childbirth", seek out your options. Typically, in my experience, midwives are much more open to the "natural" way of things...and if need be, they always have an OB to back them. Look at the hospitals in your area, find a midwife or a doctor that you love, discuss your wishes, your desires, your goals.
Be on the same page with your provider. And please, please reconsider that home birth. Please?
Respectfully yours,
But, I'm a brave girl...and I figure, "what the heck!" Why not? Maybe I'll learn something in the process too!
A warning to those who read me regularly, I'm not expecting this post to be light and fluffy and witty. I'll try my best to make it light, but I do feel strongly about some things (and this is one)!
A note to those just "accidentally" stopping by or those whose opinion will differ from mine, please be kind with your words! Please don't crucify me...please? I'd love to have this be a "dialogue" and not a nasty session...besides that, I'm kinda sensitive, and I'd probably cry if you said mean things!
Okay, so here goes:
Home births. As a nurse in a fairly large hospital, I see a lot of stuff. A lot of stuff, some of which I wish I didn't have to see and some of which brings me to tears of joy and happiness (which is more often the case).
As you know, I am a kind of "crunchy, granola" type of labor and delivery nurse...kind of. I have my own babies au natural, I love helping people through their own au natural experience (or non au natural experience--I love it all!!)...but, I also realize, that while many people have wonderful, romantic ideas about childbirth, it is a serious thing.
I've mentioned it before, but an "experienced" (read: older) nurse once taught her Labor class pupils, "Our end goal is a healthy mom and a healthy baby...not a fabulous labor experience". Some people are lucky enough to get all of the above. Some people, unfortunately, draw the short stick and wind up with unexpected plans to keep mother and/or baby healthy. That is the nature of my business.
While, I would never want to rob a woman of a wonderful birth experience, it sometimes needs to be...and that is why we have obstetricians and hospitals and operating rooms and fetal monitors.
I'm guessing the home birth advocates (and I could be wrong) are against hospital births for a reason. And I'm interested to hear what it is...truly.
In my opinion, I think home births are risky, dangerous, and, well...selfish. I know that sounds harsh, but that's how I feel. What about a home birth is safe for babies (and I'm not asking rhetorical questions, I do want to know what you think...I think it makes me a better nurse to see all sides)? In my mind, a home birth is a romantic ideal of a delivery...a delivery in which things can go horribly, atrociously wrong.
No woman is "risk-free" from a c-section, even the low risk, perfect pregnancy, the woman who's had vaginal births before...you could get a prolapsed cord, a placental abruption, a shoulder dystocia...things you would want to be in a hospital for...trust me.
I have to wonder, if you elect to have a home birth, and your baby has a severe shoulder dystocia...can you live with that decision as you are being whisked to the hospital in an ambulance with your dead baby's head between your legs? Could you handle hearing the thump...thump...thump...on your midwife's doppler of your baby's hearttones in the 60's...and falling, and know that when you get to a hospital your baby will likely have died?
Okay, I know that's harsh, and I'm sorry, but these are things that have happened. It sucks. I know it's a risk I would never take, and I'd like to tell you a few fabulous things about hospitals.
First of all, we, as nurses, are YOUR advocate. It's part of our job. We are here to assist you with the healthy, successful delivery of your baby...and to the best of our ability, we want this to be everything you've dreamed of. If I've said it once, I've said it a thousand times (okay, well...I think I have only said it once...) if you have a nurse that you do not feel is advocating for you or that you just don't mesh with, ask to speak to the charge nurse and tell her (kindly) how you feel and request another nurse. Often times, when a patient is upset with her care, she will end up getting the nicest, most compassionate nurse (as a little "service recovery", if you will!) if she requests a different nurse.
Would that be hard? Yes, but honestly, if you aren't lovin' your nurse, she's probably not lovin' you and you'll all be happy for a change.
Second, laboring in a hospital assures you that an operating room is near-by...in the unfortunate experience that you would need one. And it's a nice safety net to have...you know, just in case.
Third, we are not out to derail your birth plan. But, we do have standards that we need to adhere to. Write out your birth plan, be familiar with it, and then review it with your midwife/doctor and nurse, so everyone's on the same page. Birth plans are a wonderful way to communicate your wishes, desires, needs to the hospital staff.
And last, if you really can't stand hospitals...will you just consider delivery there? If you feel strongly about not being in a hospital, many docs will discharge mom and baby within a few hours of delivery if everything is okay. Just discuss it with your MD/midwife prior to delivery (waaaayyyy prior, like mid-way through your pregnancy...and have a lot of conversation about it.).
Please remember, we are not out to get you. Not in any way, shape or form. We are here to help you and support you. Research your options, if you want a "natural childbirth", seek out your options. Typically, in my experience, midwives are much more open to the "natural" way of things...and if need be, they always have an OB to back them. Look at the hospitals in your area, find a midwife or a doctor that you love, discuss your wishes, your desires, your goals.
Be on the same page with your provider. And please, please reconsider that home birth. Please?
Respectfully yours,
First time commenter. Thank you so much for posting this. I agree 100%. I ended up with an unplanned c-section due to labor complications. My baby and I would have been in a heap of trouble had we not been in the hospital and attached to monitors. I'm glad to see someone standing up for this side. Not just calling those of us who prefer a hosptial birth to be "sheep" following the herd.
ReplyDeleteI can understand both sides of the fence to a certain degree, and I must say that this was probably the best post on this topic from a pro-hospital birth advocate. I like that it wasn't insulting, just perfectly informative.
ReplyDeleteIt gave me much food for thought, even though I'm long past those days. I've had both, homebirth and hospital birth, and even though in my heart I love the *idea* of a homebirth, my mind also has one argument that you didn't mention... my husband has no sweet clue how to take care of me AFTER the birth, so I'd get a lot more help, rest, and care in the hospital in the days post-birth. I'd have no one asking me to do the dishes the very next day, you know? PERFECT ;)
Love ya!
P.S. It's "au naturel", rather than "au natural". The last syllable sounds like the letter L. :o) I'm French, what can I say?? ;)
ReplyDeleteMy first time posting as well. Found you through MckMama and slowly getting addicted to your blog as well. Love your humor!
ReplyDeleteI just had my second child at the end of April. I considered a home birth for about 3 seconds and then dropped the idea after I came to the conclusion that I totally would in no circumstances put my unborn baby at risk for my own "comfort"
This may be TMI but I too had a (pretty) natural birth. A little newbain (sp?) at 5 cm but that was it. And this is the honest to GOD truth. The newbain curbed the pain for about 1/2 hr and thats being generous. And from the time I had the newbain (at 5 cm) and the time my beautiful baby boy was OUT it was 1 hr. The only thing that quite frankly made me mad is I knew I had to push like overwhelming urge (i'm sure you know about that) and the nurse told me to WAIT because she wanted to check me to see if I was fully 10cm. Um I was a bad girl. I started pushing anyway. Ooops! Then she did manage to check me. Apparently I was only 9 1/2cm. I had him literally a minute and half later at 1 1/2 pushes. Dr wasn't there. Nurses and a mid wife were half way through my hospital room door. Had him on the bed. No legs in the stirups NOTHIN. The midwife was like "reach down and grab your baby" um I was like "hell no lady you do it" I was totally in way to much pain to even think about pulling him out myself. I thought she was nuts! haha. Mind you I had him in a small community hospital. Probably much different than a big hospital. So anyway, sorry for telling you my whole birth story. Short of it is..Home Births are NOT a good idea in my book. Way to risky.
Have a question though too. My son had the cord around his neck 3 times and was grey colored when he came out and wasn't really crying. They laid him on my chest and just let him go like that for a little bit (grey not the cord around his neck)I was like "aren't you gonna suction his nose and throat out" the nurse was like oh yes but didnt seem in a big rush. I didn't understand that. Can you explain?? Also as soon as they suctioned his nose and mouth he started crying and turned nice and red. Just seemed weird to me. Thanks.
ReplyDeleteGreat post Mama M! Totally agree with you. My little trouble maker was in a breech position. I knew this ahead of time but had I not I too would have been in a heck of a lot of trouble if I had been at home.
ReplyDeleteThanks for this post. I'm a causal follower of your blog....& after this thought out post, i will be reading more.
ReplyDeleteI consider home birth, wanted/desired that gloriously painfull & REAL waterbirth (that you see on tv on the discovery channel) my family's concern for baby & ruled that out pretty quckly. & that's okay, b.c at the end of the day, My son had not descended beyond -2, i was dialated to 9-10, (as it turns out, my tailbone-for lack of the proper name- is inverted & with every contraction my son's head was being squeezed...& his heart rate was dropping...so i ended up wth an emergency c section. I love that my midwife stayed after her hours on friday to be with me & I love that they wouldn't out right rule out VBAC (if the circumstances are right)
well thanks for sharing, i look back on my L&D and realize i would have been in big time trouble if i had gone with a home birth.
(sorry i didn't proofread my above post) sloppy!
ReplyDeleteMama M, that was a very enlightening post! I am forever grateful I had my daughter in a hospital. Not only did I have meconium in my fluid, but my daughter was born with ABO incompatibility. The day we were discharged from NICU (8 days after delivery), a baby born at home the same day as my daughter was admitted with a bilirubin level over 30-- that could have been us if we hadn't been in the hospital with such a competent staff!
ReplyDeleteI am probably not going to change your mind, and don't really have time to try, but I will throw in my couple of thoughts.
ReplyDeleteOne big reason for me to avoid the hospital for giving birth (unless I really need it) is iatrogenic infections (MRSA, is the biggies obviously) and right now the flu. The odds of needing a TRUE, emergency, no-warning, minutes to spare emergency birth are SMALL, and right now especially, a smaller risk than the dangers of the nasty bugs at the hospitals.
I have a lot more reasons for choosing and supporting home birth, but the reality is that study after study has shown it to be safe. That is all that really matters. I understand the fear that you and the your commenters have, because it does seem counterintuitive that it would be worth the risk to stay at home to give birth, but in reality there are lots of confounding factors and when it comes to NORMAL birth there are more important issues than the rarely needed 'safety net' that the hospital provides. Honestly, most people will not understand until they have actually attended births at home. If you really want to understand I'd suggest you find a local home birth midwife and see if she will let you come and provide labor support, so you can see for yourself.
(FYI, my first birth was c-section for prolapsed cord and my second was at home. It was not a decision made lightly, it was based on 3 years research)
Anonymous #1 back again...
ReplyDeleteTo further elaborate on my situation and why I am so supportive of hosptial births and taking advantage of medical technology... I had a very easy and textbook pregnancy. I am young and healthy and baby was perfect. I'm sure plenty of midwives would have okayed a home birth for me. I was in unproductive, uncomfortable, but otherwise textbook labor for several hours. Again - nothing would have sent up red flags. However, the most comfortable position for *me* turned out to be very detrimental for my baby. His heart rate rapidly decreased if I layed in my comfortable position. If I had not been on a monitor, I may have laid like that for hours for my frustratingly SLOW labor, putting him at extreme risk for decreased blood flow, brain damage, or worse. He ended up being totally stuck, not descending, no dilation, in distress, etc - hence the c-section.
I do not homebirth unassisted. I have a trusted licensed midwife who is skilled in normal birth and the typical "problems" that arise like shoulder dystocia, which CAN be handled successfully outside of a hospital setting (agreeably, not ideal, but safely doable - google the Gaskin Maneuver). She is skilled at spotting a problem before it becomes life threatening and transferring for hospitalized help when necessary and has no qualms or pride about calling 911 or loading in the car and heading into a hospital. THAT is the key to a safe out of hospital birth - lack of pride for help when necessary.
ReplyDeleteThere are sooooooooooooooooo few doctors/nurse midwives and accordingly hospitals who TRULY will allow a woman to "do her thing" without intervening on their timeline. I don't want to be tied to a monitor for continuous monitoring when intermittent is just as safe until the final stages of labor. I don't want to have a heplock in my arm "just in case" when I can drink water. I want to eat if I am hungry because I am doing a LOT of work! I don't want anyone expecting me to dilate 1cm an hour because that is what "most" people do. I don't want pitocin administered as a matter of course post delivery when I can breastfeed and accomplish the same effect with a natural hormone vs synthetic one. A large majority of hospitals and its workers are not willing to allow these things. Why would I intentionally be "that person" who has to argue and battle to birth?
If I could find an OB and a hospital who would let me have an unfettered birth, and my insurance didn't cover homebirth, I would consider it. But my insurance covers homebirth with a licensed midwife in my state. And I don't have a billion years when pregnant to interview a zillion doctors to find the ONE who will not worry about getting home to his wife or golf game or whatnot and hand me off to a less understanding doctor.
Hospitals DO have a place and DO save many many babies and mommies. I do not think homebirth is for everyone and certainly not those who want help/medication for birth. But for the majority of births they are not necessary for low-risk women under the care of skilled midwives. Considering the rate of infant/mother morbidity & mortality in our country compared to other *industrialized* countries like England and Sweden where there are more out-of-hospital births and better outcomes, its sort of a no brainer for those that *trust* birth, their bodies, choices and personal research.
I didn't realize that having a home birth is even an option, I really thought it was a thing of the past. There are so many risks with child birth I would feel safer delivering at a hospital.
ReplyDeleteBravo! Well-written, you gutsy gal!
ReplyDeleteThis post was a wonderful refresher course seeing as I am about to be in the whole L&D thing. I did not like my nurses for either birth (I prefer quiet and to be left alone as much as possible. I don't want to here about how room134 is going to bear me)and will totally take your advice for speaking up.
For me home birth is just not an option if I even wanted to do it. I am a high risk patient. My son was born 3 months premature and with my daughter I had high blood pressure the entire time I was pregnant. Going to the Dr for a checkup every week was so not my idea of fun. But I had a great Dr and a great delivery with Stacey. It helped that my husband was comfortable with our doctor too. I mean he should be he practically lived at his house (his kids and my husband were all in High School together) during high school. I know why people would want to have a home birth and if you have a licensed midwife who has done tons and tons of them go for it. I just know for me its not a choice I can consider.
ReplyDeleteI just got so worked up I jumped on my husband's shoulders and started cheering "Go Mama! Go Mama!"
ReplyDeleteALL of my babies benefited from being born in the hospital! And I loved every minute of being there! I don't like to pretend to know what is best for anyone else, but screw the birthplan, just give me a healthy baby!
I think there is something to be said for the fact that the U.S has the highest percentage (over 30%) for c-sections. To my knowledge, that number represents scheduled and unscheduled c-sections but it is stinking high. A hospital is where sick patients go to get better so why would a pregnant woman go there for such a natural occurrence unless she is high risk?
ReplyDeleteI had the best situation and delivered at a birth center. My midwives did all of the appropriate testing and my son's bili levels (something that is VERY common) were getting high a few days after he was born so we went to the hospital. While I liked most of the various nurses and staff (there were so many that came in and out of our room!) I am so glad that I did not deliver there. At the birth of my son, there was one midwife, one nurse, one doula, my sister and husband and I knew them all personally.
I think there is a lot of fear in the medical field surrounding birth and I'm just gonna say it as cliche as it sounds "women have been giving birth for a long time". I hear about so many "emergency c-sections". Doctors and OB's are trained for SURGERY. Sure they deliver the baby in the very end for natural births but I hear stories all the time about how the DR didn't make it and the nurses delivered the baby. I am thankful for hospitals in case of a TRUE emergency but that's where it should stay, for emergencies. Our society needs to bring back midwives and let them do the job they're trained to do...deliver babies and I don't believe it NEEDS to be in a hospital.
Kudos for putting this out there. I'm with you on this subject. Home birth would never even have been an option for me due to prior issues (my OB would have laughed at me if I had even asked about it!), but even if it had been, I still would have chosen hospital births for both of my kids. WIth my son, I had a great labor (though induced). It was fast and easy. With my daughter, which was also induced, we had major issues. Her heartrate kept slowing after they broke my water(we think she was laying on the cord)and eventually her cord prolapsed. Thank God for c-sections! So after one great labor, I ended up in a very stressful emergency situation the next time. Turns out in addition to the cord issue, she had her hand on her head and was kind of stuck anyway and not decending properly (which is probably a good thing since she would have compressed her cord). Even with the c-section, they had to use a vacuum to get her out. So, to make a long story short. I am all for having babies in the hospital. In the end it isn't about having a beautiful experience, it's about making sure that both mom and baby get to go home together.
ReplyDeleteFirst of all, you are doing women a disservice by asking them to reconsider their homebirth plans.
ReplyDeleteI have 2 children, one born in the hospital and one born at home. I think all women need to do research and make the decision that is best for them and their family. If you want to have your baby in a hospital, fine! But please respect MY right to give birth as I choose.
Homebirth with a skilled midwife is just as safe (or safer according to some studies) as a hospital birth. When babies die as a result of a homebirth, it makes the news. Babies die in the hospital too, it's just not sensationalized.
Birth in itself is NOT dangerous! It is a natural event that our bodies are made to do. I refuse to believe that a womans body can create and nourish a baby for 9 months, then just gets stupid and doesn't know how to get the baby out. A lot of "emergencies" you hear about in hospitals are caused by interventions such as giving pitocin, AROM, epidurals, etc.
A trained midwife can usually tell when something isn't right and will take action before it becomes an emergency. And if it was something so bad that they couldn't make it to the hospital on time, chances are they would die in the hospital too.
Somebody mentioned breech babies. Most midwives will deliver a breech baby without batting an eye. I have a friend who had a shoulder dystocia at home and her midwife handled it just fine. Another friend (who uses the same midwife as me) had a cord prolapse, and they transported to the hospital just fine.
A midwife I know has delivered over 500 babies. Her mortality rate is .2% and her c-section rate is 3%. Find me an OB that has a 3% c/s rate with healthy low risk women.
I'd also like to say that women who opt for homebirth aren't just doing it because it's a fad. They have out lots of research into it. The care I received from my midwife was far superior to the care I received from my OB. And my recovery after my homebirth was so much easier. I, and every homebirther I know would abandon my plans and go to the hospital the instant something changed and a hospital birth was the safest option. We would never sacrifice our babies' health just for a better birth experience, and I am appalled that you would suggest that we would "selfishly" do that.
Let me let you in on a little secret: Having a healthy baby, and a wonderful, empowering birth experience are not mutually exclusive. You CAN have both. Again you are doing a disservice to women everywhere by suggesting that it is selfish for a woman to want to have a peaceful, beautiful and empowering birth experience. Thanks for setting the women's rights movement back another 20 years.
Just curious, if I was a patient in your hospital, would you really respect my wishes if I said I didn't want an IV or hep lock, I didn't want continuous monitoring, I want to labor and deliver in water, I want to eat and drink as I please, I want the placenta to be delivered in it's own time, I don't want immediate cord clamping, I don't want the baby suctioned, I don't want the baby to leave my room for any reason, I want to keep my placenta, I don't want any pitocin whatsoever, etc.
Would you REALLY say, "Ok, I'm here to advocate for you."?
I am not trying to change anybody's mind here, because how YOU give birth is none of MY business. I am all about women's rights. While I would never have an elective c-section or induction, I would NEVER stand in the way of another woman's right to do so.
As women and as mothers, I think we need to be more respectful and less judgmental of the decisions other women make for their families.
I probably would have not felt the need to comment if it hadn't been for the previous commenter's post.
ReplyDeleteI agree with you, Mama M completely, as to the safety. No matter if you are healthy and have no complications during pregnancy, it is much better to have that safety net. I was high risk, so it was never a thought in my mind as to whether or not I would go to the hospital.
I just wanted to say that your comment about her doing women everywhere a disservice makes me sad. My husband is in the military and fights to protect our freedom of speech so that we can express ourselves freely on things like our own blogs. I applaud her for doing just that. Very good post, and thank you Mama M for speaking from your heart.
Have you done any research on homebirths? As I read this, I see a lot of your opinion and no evidence that you’ve done research. The studies show that planned homebirth is as safe as or safer than a low risk hospital birth. Things such as shoulder dystocia can be handled at home safely by an experienced midwife. Hell, I have a friend whose son was born in the hospital w/ shoulder dystocia. He has cerebral palsy due to the doctor’s lack of knowledge in trying to just yank the baby out. The hospital is a great place for emergencies & a good midwife knows how to spot possible emergencies & safely transport to the hospital. In reality, the majority of transfers are for exhaustion or failure to progress. Not the emergencies you seem to think will happen. Now, deaths will happen no matter where you give birth. PLENTY of deaths occur in hospital. That includes preventable deaths. The truth is, these interventions woman say they needed tend to do more harm than good. I will happily have my babies at home to avoid the cascade of interventions & raise my chances of a normal birth. If I’m selfish for actually reading the research available & not just listening to the money-machine you call the ACOG, then so be it. Begging women to reconsider homebirth is not respectful at all. Just because you have an opinion that is in no way based on fact doesn’t mean you should project that onto others. Honestly, it the arrogance in hospitals that I see here that makes me so happy I choose to avoid hospitals.
ReplyDeleteI have no intention of changing your opinion, but urge you to do some research. Here’s a few good starting points.
http://www.bmj.com/cgi/content/full/330/7505/1416
http://mana.org/hbref.html
Know that as of 2000 The Farm, in 30 of providing home birth services to 2,028 women, has had 95.1% completed home births. 3.6% non emergency transports, and 1.3% emergency transports.
http://www.naturalbirthandbabycare.com/farm-statistics.html
Oh and FWIW, Cochran Reviews have shown no difference in the outcome of births when using continuous EFM vs not.
I never said she doesn't have a right to express her own opinion.
ReplyDeleteBut I do think trying to talk women out of making an educated choice is doing us a disservice. Whether that be an educated choice to deliver in a hospital or a birth center or at home.
If you had read my whole post, you would see that I am for women's rights. Even if a woman chooses something that I wouldn't personally choose.
And to Mama M, you sound like a wonderful nurse, and your hospital must be awesome if just being on the same page with your OB is all it takes to get an un-hindered natural birth. BUT from my research and my own hospital experience, that is the exception, not the rule. Also, many women I know go to a practice, and aren't even guaranteed that "their" OB will be there for the birth.
For some women, a homebirth with a midwife is their ONLY alternative to a scheduled c-section. And many women don't have the option of shopping around for hospitals. And as I said previously, homebirth IS every bit as safe as a hospital birth. Studies have proven that.
I'm not trying to change anybody's mind, just hoping to open some. We all want what is best for our families, and I don't think there's a one size fits all plan for everybody.
It is every mother's right and responsibility to make an educated and informed decision about where, and with whom, she will labor and deliver. It's a very personal choice, and one that should not be taken lightly. You are asking women to reconsider there decision to have a home birth - I would ask all women to carefully consider and reconsider ALL their decisions and options.
ReplyDeleteI'm honestly quite offended by the picture you paint of home birth. Just like hospital births, the home birth experience is as broad and varied as the women who choose it. While there are woman who choose to labor unassisted, many are in the care of a competent, experienced, well trained midwifes, who are constantly monitoring mother and baby, and are equipped to handle any number of emergencies. The truth is that very few emergencies are without warning signs, and usually allow for plenty of time to transfer to a hospital, if necessary. Of course there are unfortunate circumstances where a true emergency occurs, and it would have been better to be in a hospital. However, as Heidi mentioned, study after study has shown that maternal and neonatal mortality rates for low risk pregnancies are almost identical in the hospital or at home with a licensed midwife.
What is not identical is the rate of unnecessary intervention. This is the information that is often ignored or downplayed by the medical community. I have worked in a hospital for years, and have also attended a number of home births as a doula and midwifery apprentice, so in addition to cold hard facts provided by scientific studies, I have personally experienced both sides of this issue. Why is the cesarean rate in the US more than twice what the WHO recommends for developed nations? A cesarean is a major surgery, and is not without risk to mother and infant. Of course they are sometimes necessary, and I'm grateful for the technology and providers who are there in these situations. But many times they are definitely NOT necessary, and are performed for a number of reasons other than the well being of mother and infant. Even more disturbing, in my opinion, is the rate of secondary infections acquired at the hospital, not just with labor and delivery, but with ALL hospital stays. This is a truly terrifying phenomenon that needs to be addressed head on.
Disclaimers like "as nurses, we are YOUR advocate", "Please remember, we are not out to get you", and your plea to " Please don't crucify me...please? I'd love to have this be a "dialogue" and not a nasty session" are total BS. If you are a L&D nurse, you should be the first one to admit that not all nurses are "YOUR" advocates. Just like showing up in the ER, you may end up with someone wonderful, who truly is your advocate, who is educated, and supportive, and all the things you would want someone taking care of you to be... OR, you may end up with someone at the end a long week, who's burned out, grumpy, disillusioned with their job, could care less about you, and just wants to go home. One of the things I love about home birth is the ability to decide who will be present. I think your post clearly indicates a position, to which you are most definitely entitled, but don't claim you're not "out to get" woman who choose home birth. Saying "In my opinion, I think home births are risky, dangerous, and, well...selfish" and asking women to reconsider their decision, without providing an unbiased, realistic, view of all the options, is clearly "crucifying" women who make a decision you don't agree with.
I love your post! I agree with you but am not a nurse so who would listen to me. I hate hate hate hospitals( its just creeps me out) but there is no where else I would rather be to have my baby. I had 2 text book pregnancies(sp?) and am young and healthy but first there is no epidural at home and I am a fan and second all those things that can go wrong were and are always dancing around in my head.
ReplyDeleteIt was interesting to read through the comments. Hey everyone has their opinions!
And one last note, who cleans up after a home birth? I mean its pretty gross!
Ok one more last note, I promise! I absolutely loved my nurse who was with me delivering my son. If I ever have another baby I will hunt her down!!
Baby "J's" mom had a text book pregnancy. She had all the right prenatal care and had three ultrasounds that showed a healthy baby boy. She did her research and found a Nurse Midwife with 20 years of home birth experience. There was NO reason for her not to try a home birth. Her labor and delivery were also textbook and beautiful. 15 minutes after birth, Baby "J" began to turn blue. The nurse midwife immediately realized that something was wrong and called 911. They lived 15 minutes from the hospital. Baby "J" had an undiagnosed heart defect. Despite the "perfect" circumstances and the nurse midwife doing EVERYTHING right, Baby "J" suffered a severe brain injury due to lack of oxygen from his undiagnosed heart defect. Medical help was only 15 minutes away but not close enough. Baby "J" never made a recovery.
ReplyDeleteThat may be the worst home birth case I have encountered in my 9.5 years as a pediatric nurse but unfortunately I have seen WAY too many like it.
Sure, for every 1 home birth gone bad, there are 100s that go right, but I don't want my baby to be the one that goes wrong. Do you?
Jamie H., your comment is one of the most ridiculous fear tactics I've encountered in a discussion on this subject. No CNM would be at a home birth without something so basic as oxygen. Any CNM would also be trained in neonatal resuscitation, and would not just sit around and wait for the paramedics to arrive while a baby was in distress. If your story is true (which I seriously doubt), the nurse midwife did not "do EVERYTHING right", and should have been criminally prosecuted for showing up to a birth without oxygen.
ReplyDelete"Sure, for every 1 home birth gone bad, there are 100s that go right, but I don't want my baby to be the one that goes wrong. Do you?" Are you serious? What about all the babies and mothers who die in hospitals every year from mistakes made by hospital staff, and from hospital acquired infections?
Steph-
ReplyDeleteThe CNM DID have oxygen and WAS trained in neonatal resuscitation! Unfortunately this baby had Transposition of The Great Vessels. When his Ductus Arteriosus closed off, the baby lost circulation to the body. The baby suffered a neurological insult because Prostaglandins were not readily available to keep the DA open. An easily missed, yet VERY serious heart defect!
That argument is moot b/c more babies die in hospitals than at home. Your baby has a higher chance of dying in a hospital than at home! C'mon people!
ReplyDeleteTIFFANY~
ReplyDeleteSo Jamie H. what would the hospital have done differently to this baby that was transfered? I know that not all heart defects can be diagnosed via ultrasound... Many women who birth at home do get ultrasounds and check for all things abnormal. The truth is ALL women need to do their research, not just put complete trust in their OB's. This country's C-section rate is outrageous. Women who do homebirths are extremely educated who know about their normal BP, urine dips and what to look for, proper diet and SO much more. How many hospital patients know what all the tests mean and their BP's, signs of toxemia, proper diet??? Women should have the right ALWAYS to choose where and how to give birth. It is after all there bodies, their babies and THEIR CHOICES!!!
I can understand both sides. Personally, I like the "just in case" safety-net of beingin a hospital with my midwife. However, my labors are so fast that I am always prepared (probably not enough, though) for an emergency home birth - but then head to the hospital. Thank God I have a fire station just a few blocks away straight down the street!
ReplyDeleteMany of my friends have had home births and one lost her baby during labor. What I still don't understand is why she went to the doctors' office (with the doctor who was present in her home at the time) when they lost the heartbeat instead of calling 911 and getting to the nearest hospital.
I totally agree that the goal is to have a healthy mom and healthy baby, not to be able to know and say later where the birth took place.
mychildsview.blogspot.com
chickhatching.blogspot.com
I'm in the process of starting a website that collects stories of natural births. If you'd be willing to share your stories, I'd love to have them! Email me:
ReplyDeletenaturalbirthstories@gmail.com
I was just reading this blog for the first time and I just have to say... a VBAC delivery at home?!?! I don't care who you are or what your midwife says, that is just NOT responsible!!!!!!! I am an RN too, I used to do some L&D but I don't now. VBACs can be dangerous and should NEVER be done at home... NEVER. I just had to say that!
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