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I Know You’re Judging Me For Having A Home Birth

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mom-newborn-baby-home-birthWhen my husband and I made the decision to have a planned home birth, I knew we would be met with some opinions and concerns, both from our loved ones and from any random stranger within an earshot of us talking about it. So after doing a ton of homework and arming myself with every fact and statistic I could find on the subject, I felt ready to take on the haters. I did a ton of research on midwives and bookmarked several websites on my phone that I would always have at the ready in case I needed some backup explaining why someone would choose this method of delivery. The problem is, many people just don’t know much about home births, nor do they want to. They’re happy picturing you burning sage while a woman in Birkenstocks chants over you and your naked family floating together in a giant inflatable tub in your living room (which, by the way, is totally cool if that’s your thing). One major thing I’ve realized is that most people who were upset with or concerned about our decision didn’t even know what a midwife was. Trying to argue the virtues of a home birth with them is like trying to talk politics with your parents – you just can’t.

The moment you tell someone you’re having a home birth you can feel the judgement and disapproval seeping out of their eyeballs. There is a litany of responses you’ll get.  There’s the usual uninformed response of “Isn’t that really dangerous?” and the guilt-laden “Wouldn’t you just feel awful if something went wrong?” But my favorite has got to be the TV-viewer response of, “Well I watch Call the Midwife and midwives are NOT doctors!”  How do I even respond to these? I obviously wouldn’t be doing anything that would put me or my baby at risk. All of these comments are actually thinly veiled ways of saying something that is very troubling: If things do go wrong, it’s the mother’s fault for choosing to have a home birth. Do we blame the mother who had a C-Section (planned or unplanned) when she has a complication like hemorrhaging or infection, both of which could end in death? Also, let’s please not compare my planned home birth in 2014 to a BBC series about nuns helping women in post-World War II London.

There are also the horror stories people want to tell you about their friend’s cousin’s sister’s friend that had a bad home birth experience. How do you argue with someone telling you a personal story about someone they know who had a bad experience? You don’t want to try and one-up them with a horror story that you heard about someone birthing in a hospital. What good is that going to do for anyone?

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337 Comments

  1. rockmonster

    October 10, 2014 at 11:10 am

    You made a well-informed decision and prepared for complications and that’s all that matters.

  2. Rosa

    October 10, 2014 at 11:11 am

    I support home birth, for those who are good candidates. I know people who have had great experiences with it. But let’s not pretend that pretty much every women is judged by someone simply for the way she chooses to give birth. Some women judge c-sections births and others judge home births. We shouldn’t, but we do. More power to you and your beautiful birth. I’m glad you were able to make the choice and I’m certainly not judging you for it.

  3. Valerie

    October 10, 2014 at 11:16 am

    Hey, you do you. It is not something I would ever consider but that’s due to my own anxiety and comfort level. I hold positively no judgement for other parents that do this- I assume they thought just as hard about the way they want to give birth as I did- they just came to a different conclusion. 🙂 Best of luck on your birth!

  4. Katherine Handcock

    October 10, 2014 at 11:27 am

    I would have been happy with a home birth — I was low risk with both pregnancies, and I’m much more comfortable and relaxed at home than at any office/hospital/etc. My husband, on the other hand, probably would have had a breakdown from nerves! Between that and the hospital being a half an hour away when I had my kids, it wasn’t the right choice for us.

    I think home births can be done safely when they’re done with care, which sounds exactly like what you’re doing.

    • PAJane

      October 10, 2014 at 11:35 am

      Yeah, I’m all for home births and birthing centers and whatever floats your boat. I’ve also always lived within 10 minutes of a hospital. Not having that Plan B available would probably make it seem like less of an awesome idea.

    • Katherine Handcock

      October 10, 2014 at 11:45 am

      Yeah, Sean was nervous in theory, but if we had been living ten minutes from a hospital when I was pregnant, it might have been okay. But we were thirty minutes away, and the ambulances patrol a really large area, so it probably would have been 45 minutes at least before I could have gotten to a hospital in an emergency. That was a big ol’ nope for him!

      As it turns out, I’m apparently one of those women who was born to give birth, so both of my labours were really fast. We probably would have been okay. But that’s as much luck of the draw as anything.

  5. Maria Guido

    October 10, 2014 at 11:27 am

    I think it’s great that you have a plan for your birth that you are happy with – good for you!

  6. Lt, Ft

    October 10, 2014 at 11:28 am

    More power to you, whatever your choice. My sis had homebirtha and it was all kinds of awesome. I was just the spectator and I still remember every detail. We had a great time laughing and watching bad tv and eating Popsicles. We even called my nephew by name when he seemed to be a little reluctant coming out.

  7. Megan

    October 10, 2014 at 11:33 am

    I don’t think you’re insane at all, I think home birth is awesome. I had twins, so with the increased risk of complications, I was more comfortable in a hospital, but I’m not so secretly hoping one of my friends opts for a home birth so I can beg her to be there, it seems like a really interesting experience.

  8. Spongeworthy

    October 10, 2014 at 11:41 am

    I’m not, actually. I really don’t give a crap about how women choose to give birth. If you’re ok and happy, and the baby is ok and happy, then it’s a success, however it came about.

    • Lt, Ft

      October 10, 2014 at 11:49 am

      Basically, this.

    • Hibbie

      October 10, 2014 at 12:06 pm

      For real. This should be the standard response, although there are some people who really need to get over what’s going on inside women’s uteri.

    • KatDuck

      October 10, 2014 at 1:16 pm

      I really only get side-eye-y with those who think EVERYONE should do what they did and insist that ALL childbirth is low- to no-risk and, yes, I’ve met a few of those.

      It sounds like the author did a good risk-assessment and got the clear from those with enough experience to make good guesses. I’d suspect there was a plan-B if things started going bad so, hey, whatever works for all involved.

    • Spongeworthy

      October 10, 2014 at 1:47 pm

      Yes, I definitely get a little eye-rolly when people spout off about how birth is natural, “our bodies were made to do this! Trust your body to know what to do!” But it seems like this author researched her options, has a plan, and is going for it. I wish her well. But beyond that, I really don’t care, you know? I’m not trying to be callous, but I’m just not going to have a lot of opinions about a stranger’s childbirth.

    • Lt, Ft

      October 10, 2014 at 2:13 pm

      I’m on the crunchier side of things and I don’t like that all or nothing attitude either. Birth is natural whoopty-do.

      My standard response is I don’t care and it’s not that I don’t care about the person as a human, it’s just I don’t care. Unless you’re hurting someone or an animal, do you.

    • Spongeworthy

      October 10, 2014 at 2:37 pm

      Yes X 1000

    • Her Vajesty

      October 10, 2014 at 2:38 pm

      Yes. I really wish we could move on from thinking “what’s your birth plan?” is a fun opener.

    • Lt, Ft

      October 10, 2014 at 2:46 pm

      How about “what’s your fun opener?” as a way to ask about a woman’s birth plan.

      Caffeine is making me giddy!

    • Her Vajesty

      October 10, 2014 at 2:48 pm

      I want some, but the kitchen is so far away…

    • Lt, Ft

      October 10, 2014 at 2:53 pm

      Stare longingly in the direction of the kitchen until a) someone see’s your sad face and feels sorry enough to get you coffee or b) you stare so hard that the kitchen appears closer and you finally get up to get it.

      I’m trying to train my dog to bring me bottled coffee. I’m completely serious. He can bring the remote and my phone so why can’t he learn to bring something actually useful?

    • LiteBrite(UterineDudebro)

      October 10, 2014 at 4:17 pm

      My son brought my coffee to me the other day. But he has a birthday on the way, so I think it was a one-off.

    • Lt, Ft

      October 10, 2014 at 4:23 pm

      Oh he’s planting seeds, I used to do that as a kid. He’s a bright one!

    • LiteBrite(UterineDudebro)

      October 10, 2014 at 4:28 pm

      Trust me; he’s got my number.

    • C.J.

      October 10, 2014 at 7:24 pm

      My darn dog would drink the coffee before it got to me. If I leave my Tim Horton’s on the table I will come back to an empty cup with the lid next to it. Not a drop left or spilled.

    • Spongeworthy

      October 10, 2014 at 3:02 pm

      I second this motion.

    • Jayamama

      October 10, 2014 at 3:47 pm

      I had two successful home births, and when I tell people around here, that’s generally the response. They seem to either shrug and say, “hm, that’s cool,” or they tell me that it’s pretty awesome and that they could never do the same. I generally don’t share that with too many people, though, because I don’t want them thinking that I believe my births were better than theirs. If everyone’s happy and healthy, the rest doesn’t matter in the end.

  9. notafan

    October 10, 2014 at 11:44 am

    The hospital five minutes from your house is a misnomer. Between getting there, getting checked in, etc, five minutes can turn into 30 minutes. Add in an ambulance and that can take 45 or so. I just cannot support homebirth because of the 3-4 times chance of infant death, because midwives are so unregulated in the US and that most midwives do not carry malpractice insurance so if they screw up, there is nothing you can do. Until home birth gets safer in the US, midwives are required to have more than a high school diploma and a bit of training, I think it is playing Russian Roulette with the life if your child and your own life.

    As my mother and I nearly died during my birth when she had a “normal no-risk” pregnancy and never had any health issues when her blood pressure suddenly spiked when contractions started, I will stick with the hospital that can see me in five SECONDS if something goes wrong.

    • Lt, Ft

      October 10, 2014 at 11:48 am

      To each their own, eh? Where did you get the stats that homebirth increases the chance of infant death by 3 or 4?

    • notafan

      October 10, 2014 at 12:04 pm

      From MANA themselves. They tried to spin the numbers but they released the raw data and it showed clearly that homebirth increases the chance of infant death.

    • Lt, Ft

      October 10, 2014 at 12:13 pm

      Thanks, I’ll have to check into that.

    • Lt, Ft

      October 10, 2014 at 12:19 pm

      Do you have a link for the raw data? I’m reading a study done by Journal of Midwifery & Women’s Health and it doesn’t support what you’re saying at all. It says of the 16,924, 95% had successful vaginal births. It appears the others were transfers but I haven’t read the entire PDF.

    • pontificatrix

      October 10, 2014 at 3:15 pm

      You’re right about the MANA data, but that is methodologically the poorest study out there and the midwife participants were by a vast majority, lay midwives or CPMs, not CNMs. If you look at studies that actually use well-trained midwives, rates of infant death are generally very comparable to rates of infant death in hospital.

      I don’t doubt that neonatal death rates are higher for women who give birth with poorly trained lay midwives, as were many of the midwives in the MANA study. However numerous studies done in countries where homebirth care is provided by well trained midwives with
      appropriate hospital backup, shows very comparable outcomes to those in hospital, provided the women involved are low-risk to begin with (or, in one paper, that they have given birth at least once before).

      De Jonge et al 2009, http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2009.02175.x/full

      Janssen et al 2009, http://www.cmaj.ca/content/181/6-7/377.short

      Brocklehurst et al 2011, http://wrap.warwick.ac.uk/46562/

      Even a study in the US whose main point was that homebirth is less safe than hospital birth, found that
      CNM-assisted homebirth had comparable neonatal outcomes to hospital birth – i.e. all of the increase in neonatal
      death attributable to homebirth is attributable to the quality of the care provider, and none to the location.

      Cheng et al., http://www.sciencedirect.com/science/article/pii/S0002937813006303

      (The finding on CNMs was buried in the results section and not mentioned in either the intro or the abstract,
      so you have to read the full paper to find it. But it’s there.)
      This makes it totally unsurprising that the MANA study, in which the majority of the participants were lay
      midwives or CPMs rather than CNMs, found higher rates of neonatal mortality in home than hospital birth.
      I’d still give birth at home with a CNM.

    • Poogles

      October 13, 2014 at 7:09 pm

      “and the midwife participants were by a vast majority, lay midwives or CPMs, not CNMs.”

      Well, considering that the vast majority of midwives attending homebirths in the US are CPM’s (or have no credential at all), it absolutely makes sense to use MANA’s data to talk about HB in the US.

      “However numerous studies done in countries where homebirth care is provided by well trained midwives with appropriate hospital backup, shows very comparable outcomes to those in hospital, provided the women involved are low-risk to begin with (or, in one paper, that they have given birth at least once before).”

      Sort of. The Birthplace study done in the UK did show similar mortality rates when the woman had successfully given birth vaginally previously and met the very, very strict criteria for risking-out that the study used; unfortunately, those very, very strict criteria don’t actually reflect reality and the homebirths that end up taking place in the UK. Risking out of HB in the US generally looks nothing like those criteria (everything is a “variation of normal” for most CPMs).

      In the Netherlands, HB did appear to be comparable to hospital for low risk women until they realized that the homebirths had worse mortality rates than high-risk hospital births and that the Netherlands has one the highest perinatal death rates in Europe.
      http://www.bmj.com/content/341/bmj.c5639.full
      http://www.ncbi.nlm.nih.gov/pubmed/19192585

      So, there may be a way to make homebirth at least reasonably safe (something like was done in the Birthplace study), but US homebirth looks absolutely nothing like that, with ill-trained midwives, high-risk women (twins, breech, VBAC etc.) attempting homebirth, no official transfer system set in place and vast parts of the country that do not have nearby hospitals (forget “5 minutes away” – we’re talking 30-60 minutes or more). Referencing those studies to discuss HB as it currently happens in the US is pointless – they are simply not comparable.

    • pontificatrix

      October 17, 2014 at 3:17 pm

      If you look at the Cheng et al. paper, which broke down US homebirths by birth attendant, you will see that the CNM-attended homebirths in the US (albeit they were a small portion of the total) had comparable outcomes to the hospital-based births.
      This to me is an argument that we should improve midwife training and oversight in the US, not that homebirth is inherently bad. It’s true that homebirth as currently practiced for the most part in the US is riskier than hospital birth, but this is not *inherently true of homebirth generally*, as the cited studies demonstrate.

    • Poogles

      October 17, 2014 at 4:52 pm

      “homebirth as currently practiced for the most part in the US is riskier than hospital birth, but this is not *inherently true of homebirth generally*, as the cited studies demonstrate.”

      I disagree. I believe the studies show that homebirth will always be at least slightly riskier than hospital birth (in an ideal homebirth system), but it can definitely be made “safe enough” that it can be responsible choice for women to make. We are no where near that in the US.

    • pontificatrix

      October 17, 2014 at 6:51 pm

      You’re certainly entitled to your opinion, but as mentioned the Cheng analysis suggests that if you can locate a CNM to do your U.S. homebirth (no mean feat, I agree) then you’re just as well off as you would be in the hospital from the perspective of neonatal mortality.

    • Poogles

      October 17, 2014 at 7:54 pm

      I’m sorry, but you can NEVER be “just as well off as you would be in the hospital” unless you have immediate access to an OR, blood bank, and experts in neonatal intubation, for just a few examples. I honestly don’t think we can even draw the conclusion that you will be “safe enough” with a CNM at home based on the small sample of CNM’s included in one study (in fact, I’m trying to figure out how they even defined “CNM” in that study, considering the line “Of note, certified professional midwives were categorized as CNMs in the 2003 Revision of Birth Certificate.”).

      Also, anecdotally there have been preventable homebirth deaths at the hands of CNM’s – so obviously no guarantee.

    • pontificatrix

      October 18, 2014 at 9:50 pm

      You are ignoring the fact of iatrogenic injury. Yes, there will always be bad outcomes that occur in homebirths that do not occur in hospital births. Similarly, there will always be bad outcomes in hospital births (nosocomial infections, postsurgical bleeding, etc.) that would not have occurred in homebirths. The outcomes of the studies I cited suggest that, among a low-risk population, those two will largely cancel out. Of course it is impossible to know in advance which group one may fall into.

    • Poogles

      October 21, 2014 at 3:26 pm

      “You are ignoring the fact of iatrogenic injury […]there will always be bad outcomes in hospital births (nosocomial infections, postsurgical bleeding, etc.) that would not have occurred in homebirths.”

      I wasn’t ignoring it, the rate of iatrogenic injury is quite small in L&D, especially comparing it to the rate of preventable injury and death from HB. Generally speaking, the bad outcomes of those injuries are no where near as severe as the bad outcomes for injuries that happened in a OOH birth (e.g. nosocomial infection in a setting where it can usually be easily identified and treated v. infection from HB, possibly not identified until emergency, have to transfer for treatment and in the case of the newborn being the one infected the time lost in identifying and transferring may be the difference between life and death http://onlinelibrary.wiley.com/doi/10.1002/jmv.23517/abstract & http://hurtbyhomebirth.blogspot.com/2011/03/wrens-story-on-1st-anniversary-of-his.html; postsurgical bleeding in a setting where it can be easily identified and resolved v. PPH at home where the attendent may not correctly estimate blood loss (especially if a waterbirth) or may no longer be present when the PPH begins, needs emergency transfer with possible transfusions needed, possible death if treatment is too far away http://www.dailymail.co.uk/health/article-2198725/Claire-Teague-death-Wife-bleeds-death-midwife-Rosie-Kacary-persuaded-homebirth.html http://news.bbc.co.uk/2/hi/uk_news/england/suffolk/7399358.stm)

    • pontificatrix

      October 21, 2014 at 4:42 pm

      You’re citing anecdotes, not data. (Some of them totally irrelevant btw – when did I ever say I thought it was a good idea to birth your baby into a tub of dirty water?) For every anecdote about a failed homebirth I can raise you one about a iatrogenic injury that would raise the hair on the back of your neck. (I’m an MD – though not an Ob – and yes, when I was on my Ob rotation in med school there was a maternal death that was directly related to medical intervention. My friends all have similar stories, at least the honest ones do.) It’s difficult to do research on iatrogenic injury but since it’s obvious as you note that there are some cases in which hospital-based births should clearly have a better outcome, the results of the homebirth studies suggest that there should be an equal number of cases in which the opposite is true.

      I’m not sure why you find this unbelievable at all by the way. Sure you can ‘identify and treat’ a nosocomial infection but if it’s resistant MRSA of the type that hangs around hospitals you might not have much luck in treating it, you’d have been far better off avoiding it in the first place. Not to mention the abx are going to come with their own set of problems (C. dif anyone?). Yes PPH may be more easily and quickly treated in the hospital, by the same token hemorrhage is a common complication of surgery; if you avoid the surgery (and I believe it’s well established that US c/s rates are above the optimal) you avoid the hemorrhage. In general almost every medical intervention comes at some cost so it’s always a question of whether the cost of the intervention is worth the benefit of treating the condition. When the condition is low-risk to begin with that calculus looks very different than when the condition is high-risk.

    • Poogles

      October 21, 2014 at 10:08 pm

      “For every anecdote about a failed homebirth I can raise you one about a
      iatrogenic injury that would raise the hair on the back of your neck.”

      Really? First, “failed homebirth” – what does that even mean? transfer? injury? death? all of the above? Secondly, the linked anecdotes were for illustrative purposes, real-life examples of the things I was talking about, not meant to be evidence. Third, as I’m sure you know, we would have to compare the rates (not absolute numbers) of each to actually get anything useful.

      “there are some cases in which hospital-based births should clearly have a
      better outcome, the results of the homebirth studies suggest that there
      should be an equal number of cases in which the opposite is true.”

      I disagree. First, looking across all of the studies on homebirth shows that it has an increased rate of perinatal death. The only possible exception is the Birth Place study, but again that study used risk-out criteria far, far more strict than what is actually in use in the UK. The maternity care in UK hospitals has also been under heavy criticism, with many stories of babies and mothers being injured or dying, so being almost as safe as the hospital may not mean what people think it means. Same goes for the studies done in the Netherlands – yes they may show the risk is about the same in hospital as out, but when you realize they have one of the worst perinatal mortality rates in Europe it becomes clear that it’s not that homebirth is so safe there, it’s that maternity care there needs drastic improvement overall.

      “if you avoid the surgery […] you avoid the hemorrhage.”

      So, I am assuming you’re saying here that if you avoid the surgery you avoid surgery related hemorrhage, since obviously postpartum hemorrhage is common in vaginal births as well as CS and “avoiding” the CS does not mean you won’t hemorrhage. Assuming that is what you meant, it seems like a silly thing to say; well, of course if you avoid surgery you won’t have surgery-related bleeding. Just like a hospital-acquired infection – sure you avoid the MRSA in the hospital, but that doesn’t mean you won’t get MRSA in your community.

      “(and I believe it’s well established that US c/s rates are above the optimal)”

      There is no optimal CS rate. The WHO pulled a number out of the air they thought sounded good (15%) but was not based on any data or evidence – and they later admitted as much: “Although the WHO has recommended since 1985 that the rate not exceed
      10-15 per cent, there is no empirical evidence for an optimum percentage
      or range of percentages… the optimum rate is unknown … Ultimately, what matters most is that all women who need caesarean sections actually receive them” (http://whqlibdoc.who.int/publications/2009/9789241547734_eng.pdf?ua=1)

    • pontificatrix

      October 21, 2014 at 10:31 pm

      1.The point about certain maternity care systems potentially needing improvement is fair, but again, it’s a separate issue from the homebirth question. If you want to know whether *place of birth* makes a difference to safety, you compare similar women in and out of hospital, with everything else kept steady as far as possible. If your rates of poor outcomes are higher than you wish, but equivalent in and out of hospital, that may mean your maternity care system needs improvement, but it nevertheless suggests that making sure everyone delivers in hospital won’t change anything.

      2. Yes, you understood my point about CS and hemorrhage correctly, and you’re free to label it ‘silly’ but it is the direct and correct reply to your pulling out random anecdotes to ‘illustrate’ the lack of safety of homebirth. As there are dangers specific to homebirth, there are dangers specific to hospital birth. I’m just pointing out that there are also anecdotes on the the other side, the only way to settle the question is by comparison with large studies, and as I mentioned most of those that have used equivalent low-risk populations and reasonably well-trained attendants have found relatively equivalent risks.

      3. Yes there is no clear optimum rate for c/s because it depends on the population served. That said, rates of 40% as are found in many community hospitals in the US are well above where they should be, and cause a great deal of excess M&M particularly in subsequent births. C/s rates in homebirths are more often in the <5% range so even if there were a marginally elevated increased risk in neonatal mortality that is an outcome that is measured in the per thousands, so it might well be worth that small increased risk to avoid the high likelihood of an unnecessary c/s in hospital, especially for a woman hoping to have more children in the future.

    • Poogles

      October 22, 2014 at 5:03 pm

      “rates of 40% as are found in many community hospitals in the US are well above where they should be, and cause a great deal of excess M&M particularly in subsequent births. ”

      How do you know they are “well above” where they should be? Without better technology to predict which babies and mothers will make it through labor and birth relatively unscathed, OB’s tend to err on the side of living, healthy patients at the end; some of those babies/moms may have made it through ok without surgery, but you can’t always be certain so why risk it when it may mean death or a lifetime of disability? I certainly wouldn’t want an OB to risk my or my child’s health just to lower their CS rate.

      As far as a “great deal” of excess mortality and morbidity, I think you are overstating that a bit, though you are correct that subsequent births are where you see it the most. For the first CS a woman undergoes (assuming it’s not done emergently, which adds risk), the risks to mom and baby are pretty equivalent (though different) to those for a vaginal birth and the risks only go up slightly for the 2nd and 3rd (from things like placenta previa and accreta). I don’t find that the evidence suggests there is a “great deal of excess M&M”.

      “C/s rates in homebirths are more often in the possibly unnecessary CS. A single preventable neonatal death is one too many and anyone who is willing to risk that to avoid a relatively safe surgery and the possible risks to a future hypothetical pregnancy/child is not someone I would want to associate with and an OB with that view shouldn’t be practicing.

      I also feel you overstate the likelihood of getting a CS, especially an “unnecessary” one. The chance of having a primary CS in the hospital is only around 21% (for a primipara the risk is 30.8%, for a multip it is only 11.5%) and this includes CS that are done for breech, transverse, twins and other indications that are too risky to attempt vaginally. The chance of a low risk woman with her first pregnancy going into the hospital with no prior indications for CS is only ~25%; that number includes “elective” cs (which “included maternal request, multiparity, women desiring a tubal ligation, advanced maternal age, diabetes mellitus, human papilloma virus, postterm or postdates, pregnancy remote from term, group B streptococcus, polyhydramnios, fetal death,”) with the other major indications being for failure to progress and nonreassuring FHR. http://journals.lww.com/greenjournal/Fulltext/2013/07000/Primary_Cesarean_Delivery_in_the_United_States.6.aspx

      As far as which CS are necessary – what do you consider “unnecessary” and how do you tell beforehand?

    • pontificatrix

      October 24, 2014 at 2:25 pm

      Here is the ACOG statement on why the US c/s rate is too high, what the negative effects of this are, and what should be done to prevent it.
      Note particularly the table with the much higher *maternal* mortality for c/s deliveries:

      http://www.acog.org/Resources-And-Publications/Obstetric-Care-Consensus-Series/Safe-Prevention-of-the-Primary-Cesarean-Delivery

    • Poogles

      October 24, 2014 at 4:11 pm

      “with respect to your pooh-poohing the issue of surgical hemorrhage”

      To be clear, I did not “pooh-pooh” the issue of surgical hemorrhage itself, I thought that the way you brought it up was disingenuous. In response to my pointing out that things like PPH pose a much higher risk of death/injury when they occur away from needed treatment (the hospital), you bring up that in hospital you have a chance of having a CS which has a chance of surgical hemorrhage: “Yes PPH may be more easily and quickly treated in the hospital, by the same token hemorrhage is a common complication of surgery; if you avoid the surgery […] you avoid the hemorrhage.” Which really has nothing to do with the fact that being away from the hospital when you have a hemorrhage is much more risky that having a hemorrhage (of any origin) in the hospital.

    • pontificatrix

      October 24, 2014 at 4:18 pm

      It has to do with it because it is a potential explanation for why the m&m rates for homebirth (*under appropriate safety conditions*) approximate the m&m rates for hospital birth.

      There is a set of risks (as you note) that accrue to home over hospital birth. There is another set of risks (which you dismiss) that accrue to hospital over home birth. Under appropriate conditions of risk assessment and attendant training, those risks appear largely to cancel out.

    • Poogles

      October 24, 2014 at 5:27 pm

      “it is a potential explanation for why the m&m rates for homebirth (*under appropriate safety conditions*) approximate the m&m rates for hospital birth.”

      Another potential explanation, as I mentioned before, is that the M&M rates in the hospital are higher than they should be (such as in the Birthplace Study and the Netherlands studies), so when you compare them to the HB M&M the HB numbers don’t look so bad.

      “There is another set of risks (which you dismiss) that accrue to hospital over home birth.”

      It’s not that I dismiss them, I just don’t see the availability of more treatment options as a risk in and of itself. The only reason a hospital “risk” such as surgical bleeding is not a risk at home is because you cannot get the surgery at home even if you need it. For every hospital “risk” I can think of off the top of my head there is similar risk at homebirth (e.g. MRSA/infection can be caught at home or hospital) or a much greater risk created by avoiding the hospital’s treatments and the risks that go with them (needing an emergent CS while at home). Please do share if you can think of a hospital “risk” that doesn’t fall into one of those two categories.

    • pontificatrix

      October 25, 2014 at 2:47 pm

      The availability of more treatment options is not a risk in itself, but this is not the only difference between home and hospital. Resistant infections are not equally likely to occur at home or hospital – they are much more commonly acquired in the hospital (such that treatment algorithms differ, e.g., for community-acquired vs hospital-acquired pneumonias, etc.). Complications of surgery accrue only to hospital births. Risk of amniotic fluid embolism is greatly increased by surgical and other interventions. Etc.

      You refuse to believe the risks from these dangers could possibly be as high as the risks from giving birth at home. But the data from the De Jonge, Janssen, and Brockleton studies suggest that (for low-risk and well-attended laboring women) you are not correct in this assessment.

    • Poogles

      October 24, 2014 at 5:13 pm

      “Note particularly the table with the much higher *maternal* mortality for c/s deliveries:”

      It only makes sense that the mortality is going to be mcuh higher when you’re comparing all CS (maternal request, “elective”, emergent, crash) to vaginal birth – the sickest/highest risk women are most likely to end up with an emergent or crash CS which are riskier than scheduled CS (“elective” and maternal request) in addition to the increased risks stemming from whatever complication led to the CS in the first place (infection, cardiomyopathy of pregnancy, abruption, pre-existing health conditions, etc.) .

      On the other hand, in this study they compare the risks of “elective” CS (which includes any scheduled CS, such as ones that are medically indicated but not emergent) with the risks of vaginal birth and find only a small increase in maternal mortality (C-section is 8/100,000 and vaginal delivery is 6/100,000, for a difference of only 2/100,000): http://www.ncbi.nlm.nih.gov/pubmed/23635679

    • pontificatrix

      October 24, 2014 at 5:21 pm

      So you disagree with ACOG that CS-related m&m is too high then? What’s your basis for disagreeing with the assessment of the professional association of obstetricians in the US on this matter?

      (Additionally, if you are a low-risk woman planning a vaginal birth, by definition if you end up with a CS it is unlikely to meet the criteria for an elective procedure. As you may recall we were talking about this in the context of risk assessments of home vs hospital, and the degree to which the reduced risk of CS or other intervention, or of other potential risks associated with hospital birth, might be weighed against potential risks associated with homebirth. It therefore doesn’t make sense to use stats associated with elective CS for risk assessment in this context.)

    • Poogles

      October 24, 2014 at 9:26 pm

      “So you disagree with ACOG that the CS rate and its related m&m are too high then? ”

      I disagree that ACOG makes such a claim. The closest they get is “the rapid increase in cesarean birth rates from 1996 to 2011 without
      clear evidence of concomitant decreases in maternal or neonatal
      morbidity or mortality raises significant concern that cesarean delivery
      is overused.” This is not the same as them saying “that the CS rate and its related m&m are too high” – they are merely saying that there has been a increase between the years noted and there is a lack of clear evidence that the increase was matched by a decrease in M&M, which raises the concern that CS is overused. A subtle but important difference.

    • pontificatrix

      October 25, 2014 at 2:48 pm

      So they published an entire statement on how and why to reduce the c/s rate but they don’t definitively think CS is overused, they merely have a ‘concern’ that it is overused? Think about that for a second.

    • Poogles

      October 27, 2014 at 7:05 pm

      I have. This statement isn’t really any different from the guidelines that have been in place for decades regarding when to move to a CS (with the exception of allowing a longer amount of time before diagnosing arrest of labor). They do not think the CS is definitively overused, they want to see if ways exist, with our current technology and with appropriate adherence to these guidelines, to safely reduce the CS – maybe we can, maybe we can’t. So, we might be able to avoid some of the surgeries, but we should only do so if it can be done safely for the individual being treated: “The information […] should not be construed as dictating an exclusive course of treatment or procedure.” I certainly think the overall CS rate can be lowered, without an increase in M&M – once we have better technology to peer into the womb and tell how the baby is really doing, not having to rely on only a heartbeat to decide when the baby can no longer handle labor.

    • Poogles

      October 24, 2014 at 9:40 pm

      “As you may recall we were talking about this in the context of risk
      assessments of home vs hospital, and the degree to which the reduced
      risk of CS or other intervention, or of other potential risks associated
      with hospital birth, might be weighed against potential risks
      associated with homebirth. It therefore doesn’t make sense to use stats
      associated with elective CS for risk assessment in this context.”

      It doesn’t make sense to use stats of emergent/crash CS because those aren’t the types of CS that homebirthers are typically trying to avoid by being out of hospital – indeed, those are the type of CS they usually believe will be immediately available when they need one and transfer to the hospital. The types of CS they want to avoid usually fall into the “elective” category, which again, is any CS scheduled in advance (even if “scheduled in advance” only means 30 minutes before); so, they avoid the hospital because they want to avoid a CS for things like failure to progress when the FHR is still fine (elective) or having broken waters for too long with no signs or soft signs of infection (elective).

    • pontificatrix

      October 25, 2014 at 2:52 pm

      Elective caesarean is planned prior to the onset of labor.
      http://en.wikipedia.org/wiki/Caesarean_section

    • pontificatrix

      October 24, 2014 at 2:47 pm

      ..

    • Poogles

      October 22, 2014 at 5:27 pm

      “comparison with large studies, and as I mentioned most of those that have used equivalent low-risk populations and reasonably well-trained attendants have found relatively equivalent risks.”

      Which studies, besides the Birth Place study and the paper from the Netherlands, compared equivalent low-risk populations both with reasonably well-trained attendents (which, by definition, excludes CPM/LM/DEMs etc. and pretty much all HB in the US) in both hospital and home?

      Again, the Birth Place study does not reflect the reality of homebirth in that or any other country and the Netherlands study showed relatively equivalent risks, but further study has only shown that to be due to the riskiness of midwife-led birth in the Netherlands regardless of place of birth (midwives with low-risk patients in and out of hospital had higher mortality rates than physicians caring for high risk women! http://www.bmj.com/content/341/bmj.c5639). Neither are really an endorsement for HB, especially not in the US where the situation is much, much worse.

    • pontificatrix

      October 24, 2014 at 2:33 pm

      I already agreed with you that homebirth as typically practiced in the US cannot in any way be characterized as ‘safe.’ My point is that with the ideal safeguards, risk assessments, and attendant training, homebirth has the potential to be as safe as hospital birth. I cited three studies that showed that. I’m not sure why you don’t like them. I agree that the Birthplace study reflects an ideal approach to homebirth rather than one that is currently widely used. This in no way contradicts my position on this issue. We *should* be trying to figure out what the appropriate conditions are under which homebirth is safe, and under what conditions it is not safe. This would be a better approach than blanket proscription of homebirth.

      I wrote an extensive discussion of the Evers study down below and don’t care to repeat it here, but the bottom line is that given the large number of factors that differed systematically between the groups in that study, there is very little information that can be extracted from it. There are too many possible explanations for the results and no way to differentiate between them. However one of the possible explanations (that homebirth is inherently less safe than hospital birth) is unlikely because of the De Jonge results. The other two potential explanations (that there is a problem with the method by which maternal risk is assessed, or there are inadequacies in midwife training in the Netherlands) cannot be discriminated on the basis of this study. However neither of them have any bearing on the question of whether, *with other factors held constant*, birth location makes a difference to birth outcome.

    • Poogles

      October 24, 2014 at 6:41 pm

      “My point is that with the ideal safeguards, risk assessments, and attendant training, homebirth has the potential to be as safe as hospital birth”

      On a population level, it may be argued that under the ideal conditions (which currently do not exist) HB may potentially be about as safe as hospital birth.

      “the question of whether, *with other factors held constant*, birth location makes a difference to birth outcome.”

      For each individual woman who decides to give birth away from the hospital, there is always the added risk that the birth location will make a very, very big difference to the outcome of the birth – life and death differences. That’s where I can’t agree that HB can ever really be comparable to hospital birth in terms of safety, because any one of the women who choose it may end up with a devastating outcome simply because of where they were located (away from emergency help). Unless HB comes to include portable ORs, blood banks, EFM and a whole team of care providers (for both the mother and the newborn), it’s not even a question in my mind.

    • pontificatrix

      October 25, 2014 at 2:42 pm

      Again, while you are right, you are only presenting half the story. There is *also* a risk that any individual woman who chooses a *hospital* birth may end up with a devastating outcome simply because of where they were located. I agree that the thought that these should be largely equivalent risks is counterintuitive, and I (like you and many others) also believed hospital birth must inevitably be safer, before I started reading the data. And the primary data in this field, as with many other tenets of medicine which were previously assumed to be true but have been upended by controlled studies, have shown this assumption to be false.

    • Poogles

      October 27, 2014 at 6:52 pm

      “I (like you and many others) also believed hospital birth must inevitably be safer, before I started reading the data.”

      Don’t assume I have a uninformed, knee-jerk reaction to hospital and homebirth safety. I used to be a strong advocate of homebirth and even freebirth/unassisted birth…before I started reading the data.

      “And the primary data in this field, as with many other tenets of medicine which were previously assumed to be true but have been upended by controlled studies, have shown this assumption to be false.”

      I, and many others in and out of the field (Obstetrics), don’t agree that the data has shown that assumption (that hospital birth is safer) to be false. At best, the data only seem to suggest that hypothetically high-quality home birth and high-quality hospital birth can become near each
      other in terms of safety within very well organized systems adhering to very strict safety guidelines that currently do not exist in the real world (with the possible exception, I just realized, of Canada – not entirely sure on that though). More realistically, it shows a 3-7x increase in neonatal death, not to mention increases in things like neonatal seizures and 5 minute Apgar scores of 0 (meaning no signs of life).

    • pontificatrix

      November 1, 2014 at 10:49 pm

      Actually you’re very well informed – having read the primary literature puts you way ahead of 99% of the people spouting off on this topic. My read on this literature differs from yours, although perhaps not by all that much in the end.

      It seems that overall we agree that under some set of very good (‘ideal/unreachable’ for you but ‘optimal/reachable’ for me) conditions, homebirth can approximate hospital birth in terms of risk to the neonate, and that under the more typical conditions that dominate in the US, homebirth is clearly much less safe than hospital birth.

      To me the data breaking out the CNMs in the Cheng study demonstrate pretty clearly that the conditions under which homebirth is safe *can* be fulfilled in the US as a practical matter, although in the vast majority of cases they are not. I’m actually still not clear why you differ on this point.

    • Poogles

      November 3, 2014 at 3:29 pm

      “To me the data breaking out the CNMs in the Cheng study demonstrate pretty clearly that the conditions under which homebirth is safe *can* be fulfilled in the US as a practical matter, although in the vast majority of cases they are not. I’m actually still not clear why you differ on this point.”

      As I’ve said previously, I don’t feel that that small piece of data buried in the Cheng study is strong enough to draw a conclusion from, especially since there is other, more robust, data showing that US CNM-attended homebirth is NOT as safe as hospital birth (OB or CNM attended), such as this study which included 13,529 CNM-attended homebirths:

      http://www.ncbi.nlm.nih.gov/pubmed/20182433

      “For the 5-year period there were 1 237 129 in-hospital certified nurse midwife attended births; 17 389 in-hospital ‘other’ midwife attended births; 13 529 home certified nurse midwife attended births; 42 375 home ‘other’ midwife attended births; and 25 319 birthing center certified nurse midwife attended births. The neonatal mortality rate per 1000 live births for each of these categories was, respectively, 0.5 (deaths=614), 0.4 (deaths=7), 1.0 (deaths=14), 1.8 (deaths=75), and 0.6 (deaths=16). ”

      So, a US CNM-attended hospital birth has a .5 mortality rate versus CNM-attended home birth which has a 1.0 rate – that is double the death rate, most likely attributable to place of birth since the HCPs were of the same type with the same training.

      “conditions under which homebirth is safe *can* be fulfilled in the US as a practical matter”

      I have very high doubts that the “optimal” conditions can even be achieved in the US due to our lack of universal health care, shortage of maternity providers and the vast stretches of the US that are not close enough to even a small community hospital, let alone one equipped to deal with receiving obsetric emergencies in progress, to name a few obstacles.

    • Poogles

      October 28, 2014 at 4:29 pm

    • pontificatrix

      November 1, 2014 at 10:53 pm

      This is a semantic quibble about the use of a particular word, and the author agrees with me about the general overuse of c/s in the US today.

    • Poogles

      November 3, 2014 at 1:28 pm

      It may come down to an argument over semantics, though I wouldn’t describe it as a quibble – the meaning and connotations of a specific word are important, sometimes very much so. Using the words “necessary” or “unnecessary” when describing a CS has specific connotations and implications that are not appropriate for discussing the procedure:

      “The problem with the term is that we don’t know what would have happened if we hadn’t done the cesarean, and as such we have no idea if the cesarean was necessary […] arguing that a cesarean was unnecessary because one believes that they were going to go on to have a healthy vaginal delivery without it is fallacious. It implies something that just isn’t true, and is ultimately unfair to all parties involved.”

      If no one can tell for sure whether the procedure was in fact necessary or not, then it is inappropriate and misleading to discuss the procedure in those terms. Even if one agrees that there is a “general overuse” of CS in the US does not mean that we can tell which ones were necessary, even in retrospect.

      And just to be clear, in a very general sense I can agree that there are almost certainly CS that take place that could’ve gone on to be relatively safe vaginal birth – this does not translate to thinking the rate is currently too high. With the imperfect information we have on the fetus and all the variables that play into complicated or uncomplicated vaginal delivery during labor, and with the expectation that every baby should come through relatively unscathed, I think the current CS rate is totally defensible. I do, however, look forward to advances in technology that will allow us to better determine which fetus is going to be fine even if their heartrate is a little concerning, which needs to come out NOW even though their heartrate is only a little concerning and which ones should never even be allowed to progress to labor because there is so little chance they will make it through unscathed.

    • pontificatrix

      October 18, 2014 at 9:51 pm

      Again, you’re ignoring iatrogenic injury. See my other comment.

    • Tourmalily

      October 10, 2014 at 11:56 am

      They don’t waste time checking you in if you’re crowning in the waiting room or if your baby is stuck and going into distress.

      You also aren’t under any obligation to wait for an ambulance.

    • ohladyjayne

      October 10, 2014 at 11:58 am

      Word. I transferred for a total non-emergency and they still didn’t make me wait in a waiting room or anything. My wife checked me in after I was already in a delivery room.

    • Tourmalily

      October 10, 2014 at 12:03 pm

      Ikr?

      I once drove my DH to the ER at 3 am for severe, sharp abdominal pains that turned out to be just be extreme gas but hey you never know. They whisked him away to a room immediately and I checked him in instead.

    • notafan

      October 10, 2014 at 12:11 pm

      You are assuming the hospital isn’t incredibly busy that night, that the only doctors who can help are already in surgery doing C-Sections, that the mother is actually able to get to the vehicle and is not in such severe distress that she cannot move, etc etc. If the mother needs transport to the hospital most liely she is unable to move under her own power and will need an ambulance. At 39 weeks I was perfectly healthy and could barely bet out of bed without a forklift assist. I could not imagine trying to move in the middle of active labor.

    • Tourmalily

      October 10, 2014 at 12:15 pm

      Yes, because laboring AT the hospital guarantees they won’t be overworked, understaffed, or simply have a sudden influx of laboring women.

      Also what you can or can’t imagine is kind of not relevant? Some women are more mobile than others throughout pregnancy and labor/delivery.

    • C.J.

      October 10, 2014 at 8:28 pm

      Yep, labouring in a hospital is not a guarantee! For my youngest the doctor was delivering a first time mom when my daughter was ready to come out. I had a nurse standing at the end of the bed holding my knees together. I had to hold her in for an hour until the doctor came in. She was born in the middle of the night so there was only one doctor on duty.

    • Tourmalily

      October 10, 2014 at 8:35 pm

      OMG I would punch that nurse out and use her as a landing pad for the baby.

    • C.J.

      October 10, 2014 at 8:42 pm

      In the nurse’s defence, she and the other nurses were worried about delivering the baby without the doctor because I had haemorrhaged with my first. I was worried about delivering without him there too. It was actually a good thing we kept her in until he got there. Things were a little dicey for a few minutes. He advised me not to have any more after her because the haemorrhaging was so much worse. It’s not easy to hold an almost ten pound baby in when she wants to come flying out though!

    • JAN

      October 10, 2014 at 3:22 pm

      You’re assuming your labors are like everyone else’s. I walked into L&D with my second, 30 sec between contractions, when they checked me I was an eight and by the time I walked *yes, walked* to the delivery room I was dilated to a ten. By the time I laid down the baby was crowning. I had my daughter in three pushes, 23 minutes after I got to the hospital. I was still wearing my toddler in a baby carrier on my back at 39+ weeks pregnant and could shave my legs and tie my shoes. I’m not trying to brag, but just point out the problem with assuming your situation or experience is the same as everyone else’s. I gave birth two out of three times with a CNM in a major metropolitan city in the US. Homebirth, CNM, midwives who worked in a hospital attached birthing center and at home. As a healthcare professional who works in critic care, there are circumstances where a Homebirth is as safe and sometimes more so than a hospital birth. Circumstances aren’t all equal all the time.

    • Poogles

      October 13, 2014 at 6:43 pm

      “As a healthcare professional who works in critic care, there are circumstances where a Homebirth is as safe and sometimes more so than a hospital birth. Circumstances aren’t all equal all the time.”

      I can not think of a single situation where you can know with certainty beforehand that home will be “as safe or safer” than hospital – even in the lowest of low risk pregnancies, sudden and serious complications can happen that need immediate treatment not available out of hospital (e.g. shoulder dystocia not easily resolved with position changes, severe PPH, neonate in need of immediate, extensive resusitation – not just an ambubag and a little O2 from a tank, umbilical prolapse and/or compression).

    • Allyson_et_al

      October 13, 2014 at 3:09 am

      And they wouldn’t already be in surgery if your birth suddenly went south in the hospital?

    • rrlo

      October 10, 2014 at 2:03 pm

      I waited too long when I was labouring with my second and it was literally half an hour from house to birth of baby.

      And my husband drove like a maniac – we totally could have gotten stuck in traffic and have a baby in the car. Or get into a car accident. And my baby could have been in distress too and suffer as a result of us waiting too long.

      So while I believe hospital birth is overall less risky than home birth – every situation is different.

      Also, I would like to add the reason I waited too long is because a) we WERE in the hospital just hours before getting induced and b) I phoned the hospital and because my pains weren’t that bad, they didn’t think I needed to come in.

      So it wasn’t really anyone’s “fault” – just what happens in real life.

    • Poogles

      October 13, 2014 at 6:29 pm

      “They don’t waste time checking you in if you’re crowning in the waiting room or if your baby is stuck and going into distress. You also aren’t under any obligation to wait for an ambulance.”

      Not quite correct – yes a baby who is crowning or partially delivered (e.g. breech transfer or shoulder dystocia transfer) will likely be delivered before anything else is done. Barring that, you do not automatically get whisked back to the delivery room or the OR. According to this Pediatric Emergency Medicine doctor (someone who works with emergency transfers and provides care for the babies afterward):
      “Large teaching hospital ED (common in a large metropolitan
      area): If you’ve called EMS, they may have called in to let us know what to expect and we have called a “Code White” (OB emergency) and the OBs are sprinting to the ED. But sometimes the radio connection is spotty and this message is not relayed. If you drive yourself or take a private vehicle, it is maybe 5 minutes to load the car, then 5 minutes to drive (so only 10 minutes), but we have no advance warning and the OB team will not be there waiting for your arrival.

      You arrive in the ER. If we are aware that you are coming, an entire team descends upon you in our resuscitation room, placing IVs, hooking up monitors, trying to get the story and your history. Someone will need to diagnose the problem. Likely someone uses the portable U/S machine to check your baby (unless he/she is crowned or head out, then we try to get the baby out and/or go to the OR). I’d estimate that this would take AT LEAST 10 minutes. If we have no warning (private vehicle), you will go to the triage area first (yes, even if you are bleeding and screaming in pain). Likely, you will be whisked back to the resuscitation bay, but it adds yet more time to the clock.

      Keep in mind that we do not know you or your history (past medical problems, allergies, medications, etc). The goal of the ED team is to
      save YOU. Your baby is secondary because if you die, the baby will likely die as well. Even the best team is going to take an additional 10 minutes after you arrive to have you prepped and in the OR for an emergency c/s (that’s with a rapid intubation and general anesthetic and an OR that is prepped and ready to go). So let’s say best case scenario from “decision” to “baby” is 45min and likely much longer.” [emphasis mine]
      http://www.skepticalob.com/2012/05/pediatric-er-doc-homebirth-5-minutes.html

    • CMJ

      October 10, 2014 at 11:59 am

      There are midwives who are also actual nurses.

    • notafan

      October 10, 2014 at 12:08 pm

      Yea but how many will do home births? To be a midwife in a hospital you HAVE to be a nurse. Not so in the home birth world.

      Again, I am not against home birth in general. I am against it as it is done today. It may be 2014 but a lot of the cases I have read it might as well have been 200 years ago from the insane lack of care given. midwives need to have actual nursing degrees, they need to be a heck of lot pickier on who does a home birth.

    • Tourmalily

      October 10, 2014 at 12:12 pm

      Obviously some of them do. Why all the concern-trolling for other women? Do you automatically assume they haven’t done their homework when it comes to choosing a midwife?

    • notafan

      October 10, 2014 at 12:30 pm

      So because I care about women and children being duped by the home birth industry, I am a concern troll? No, I am trying to make people do actual research before they become a statistic. Excuse me if I want to make sure both the mother and child make it through the birth and end up healthy on the other end. I guess I won’t bother anymore, since it seems like you don’t even want to bother to listen. Do yourself a favor and actually look for real homebirth stats and how many children have died or have severe brain damage from lack of oxygen and tell me how supportive you are. women are being grossly misinformed about supposed homebirth safety so their decisions are NOT made with full knowledge.

    • Lt, Ft

      October 10, 2014 at 12:33 pm

      Duped? What would be the point of a midwife “duping” a pregnant woman?

    • atmtx

      October 10, 2014 at 12:34 pm

      To get business. If they don’t homebirth, she doesn’t make money. Obviously.

    • Lt, Ft

      October 10, 2014 at 12:37 pm

      Right… cause midwives make a ton of money. Okay then.

    • atmtx

      October 10, 2014 at 12:48 pm

      If women don’t homebirth, they make none. It’s in their best financial interest to encourage women to do homebirth.

    • Lt, Ft

      October 10, 2014 at 12:49 pm

      If women don’t deliver in hospitals, OB’s don’t make money. It’s in their best financial interest to encourage women to have a hospital birth.

    • atmtx

      October 10, 2014 at 12:50 pm

      OBGYNs have a second part of their practice, gynecology. That’s actually MUCH more lucrative and lower risk to them. They have plenty of clients. Also, someone has to be at the hospital when homebirthers transfer.

    • Tourmalily

      October 10, 2014 at 12:54 pm

      Could you troll a bit more quietly, I’m trying not to have a rage aneurysm today.

    • atmtx

      October 10, 2014 at 12:56 pm

      Disagree and has facts that are logical = troll. Got it.

    • Tourmalily

      October 10, 2014 at 1:01 pm

      Well if you ever feel like sharing any of those facts, let me know. All I read in those last few comments was a bunch of irrelevant attempts at “gotcha” logic that don’t even hold water.

    • atmtx

      October 10, 2014 at 1:03 pm

      Please explain. List what I say, and let me know what you think and how it doesn’t make sense. Don’t just say troll. That’s lazy arguing. I’ve stated that OBs do more than just deliver babies. That’s true. I stated that homebirth midwives only make money on homebirth. Also true.

    • Tourmalily

      October 10, 2014 at 1:30 pm

      No, that isn’t what you said. You said, exactly, “If women don’t homebirth, they make none. It’s in their best financial interest encourage women to homebirth.”

      Except, that isn’t a fact. There are midwives who work at birthing centers and who also do homebirths. There are midwives with admitting privileges at hospitals, but I know that doesn’t fit nicely with your anti midwife screed so you moved the goal posts and rephrased it as “homebirth midwives”.

      Nice try though, but either way the overall argument is not an effective one against choosing a homebirth if that’s what the woman wants.

    • Allyson_et_al

      October 13, 2014 at 2:38 am

      I used to see my midwife for mu annual pelvic exam until she moved away. It was a regular part of her practice.

    • Ennis Demeter

      October 13, 2014 at 4:56 pm

      We’re not talking about nurse midwives. We’re talking about the kind of midwives who attend homebirths. They are NOT medical professionals, and not fit to deliver mail, let alone babies.

    • TheQuirkyDiva

      October 10, 2014 at 5:47 pm

      Actually, that’s bullshit. My midwife provided the same level of well-woman care than an OB/GYN would. She had the ability to order labs, do pap smears, breast exams, and prescribe birth control. As well as deliver my perfectly healthy daughter at home. After *hours* of consultation, visits, and examinations. For $3,000. Which was covered by insurance. After I fired my OB/GYN for *refusing* to allow me to attempt an unmedicated birth in the hospital. Fuck off.

    • Lt, Ft

      October 10, 2014 at 12:59 pm

      Right?! I’m done with this one. Ignorance is one thing, it’s that self0righetous indignation that makes me all twitchy.

    • Jayamama

      October 10, 2014 at 4:05 pm

      *IF* homebirthers transfer. The vast majority are successfully birthed at home.

    • Ennis Demeter

      October 12, 2014 at 12:29 am

      Most of those women would have birthed successfully all on their own, no need to waste $5,000. They paid for nothing but a false sense of security.

    • Jayamama

      October 12, 2014 at 5:16 pm

      My midwife’s fee was for more than her presence during the birth. It was for my entire prenatal care (all the same things a doctor would do), and my postnatal care. It paid for me to use a birthing tub, for the oxygen my first daughter had, and for the equipment used to patch me up after the deliveries. It paid for the vitamins, teas, pads, sitz baths, etc, that they gave me to use. It paid for hour-long appointments where we could talk in-depth about how the pregnancy is going and any anxieties. It paid for coaching on labor and pain management techniques. And most importantly, it paid for the ability to call her up at any hour of the day during the pregnancy and weeks following to ask her questions and ease my worries about everything from spotting, fetal movement, and weird pains to breastfeeding and umbilical cords. Midwives are not false security. They become family members and a vital resource about all things babies.

    • Ennis Demeter

      October 13, 2014 at 4:58 pm

      If you home birthed a baby who needed oxygen at birth, then you should know better than anyone how dangerous it is. Stop pretending its safe.

    • Jayamama

      October 13, 2014 at 7:36 pm

      She didn’t *need* oxygen. She was attached to me the entire time through the umbilical cord, so she was getting oxygen just fine. They just gave her a little to help her breathing for about 30 seconds or so. In the hospital, it would have been turned into an emergency because they cut the cord immediately. She WAS perfectly safe the entire time. You really shouldn’t assume things without enough information.

    • Poogles

      October 13, 2014 at 7:49 pm

      “She was attached to me the entire time through the umbilical cord, so she was getting oxygen just fine.”

      Contrary to popular belief, the cord does not continue to provide sufficient oxygen after the baby is born – once the uterine cavity is empty, the uterus begins to shrink and the placenta peels away from the uterine wall – which is where the oxygen was coming from. There is very little, if any, oxygen being transferred in the immediate aftermath of the birth and it continues to fall drastically as the placenta detaches and is delivered.

    • Jayamama

      October 13, 2014 at 8:03 pm

      Oh, for gosh’s sake, people, let it go. If you’re going to site something that goes against “popular belief,” then you need to attach a source. Otherwise, it’s hearsay as far as I’m concerned. And it was literally less than a minute that they used a little oxygen, just to help her perk up a bit. My placenta wasn’t expelled until a full fifteen minutes later, so it had barely started to detach, anyway. Please. Just let it go. I seriously don’t understand why it even matters to other people whether my baby needed oxygen or not. It’s like the rest of my post was completely ignored for that one small detail.

    • Ennis Demeter

      October 12, 2014 at 12:25 am

      OBs are salaried employees who don’t make more or less money if any particular woman decides to birth at home.

    • Allyson_et_al

      October 13, 2014 at 2:42 am

      Private practice OBs can charge whatever they want for their services. You do know that medical care for childbirth doesn’t begin with the labor and end with the birth, right? There’s all that prenatal care at the doctor’s office, which is often not at the hospital. Most OBs, in the US at least, have private practices and hospital privileges.

    • Ennis Demeter

      October 13, 2014 at 4:59 pm

      But why are lay midwives exempt from profit seeking? Isn’t paying for safety and access to effective pain management money well spent?

    • Tourmalily

      October 10, 2014 at 12:52 pm

      Isn’t this logic not really especially relevant?

      I mean unless every hospital and birth center is a not-for-profit and every OB/GYN is in the business out of the goodness of their hearts, and not to make $$.

      Let’s apply slightly MORE logic to the situation. A midwife is employed to assist in a birth. Her business would suffer if her clients were losing babies left and right, don’t you think?

    • atmtx

      October 10, 2014 at 12:55 pm

      You’d think. Google Brenda Scarpino (she’s lost at least 9 babies). Still in business.

    • Tourmalily

      October 10, 2014 at 1:08 pm

      May I ask, out of how many live births, and over how many years? It matters. Without all the information I would say on the surface that yes, that is unacceptable. But unless she is EVERY MIDWIFE, your argument once again isn’t so strong.

      I’m sure I can find hordes of doctors in every field who did terrible things and were in business far too long. That doesn’t mean that every medical profession is out to get you. Similarly, you can’t reasonably put this woman out there as representing the entire profession of midwifery. That’s just ridiculous and if that’s what you’re asking me to do I’m done engaging you

    • atmtx

      October 10, 2014 at 1:11 pm

      Definitely not. I’m putting it out an an example of someone who shouldn’t be practicing, and still is, because midwives are protecting her. Rather than attacking her as the horrible bad apple that she is, she’s protected and still practicing. If they truly cared for the safety of women and babies, she’d never get a client again. I don’t have the numbers on how long/out of how many, but I can guarantee that losing a full-term, healthy baby is completely unacceptable for ANY provider, even OBs.

    • Tourmalily

      October 10, 2014 at 2:05 pm

      “I can guarantee that losing a full-term, healthy baby is completely unacceptable for ANY provider, even OBs.”

      Stillbirths do still happen. I doubt that every OB who has ever had a baby die was forced to relinquish their license.

      That said, I’d be interested to know if there are actual guidelines, legal or medical, on what if any losses are acceptable for a licensed midwife or OB. Because I can guarantee your that it still happens, whether you find it acceptable or not. No one is infallible.

    • Ennis Demeter

      October 12, 2014 at 12:26 am

      Healthy, full term babies almost NEVER die in US hospitals, They die all the time in home births.

    • M.

      October 12, 2014 at 7:59 am

      Where are you getting this information? Because I couldn’t even round up a number for healthy full term babies who die in hospitals alone (only “infant mortality,” which is really nebulous and obviously would include babies with a variety of issues that would probably not be ok’d for home birth and includes babies who die all the way up until their 1st birthday).

    • Allyson_et_al

      October 13, 2014 at 2:36 am

      You seem very invested in this. Do you have any real, non-anecdotal data to back up the statement, “They die all the time in home births”?

    • M.

      October 12, 2014 at 7:45 am

      And you go ahead and Google Dr. Allan Zarkin, who carved his freaking initials into a woman’s stomach after her c-section, or either Azzam Ahmed or Charles Momah, who were both convicted of raping/assaulting patients (and I could go on). Not all OBGYN’s are good OBGYN’s either.

    • Lt, Ft

      October 10, 2014 at 1:00 pm

      Dead babies are surely a way to stay IN business, amirite? Plus with the 20 clients she’s juggling, who has time to even count which ones are alive or which ones are in the dishwasher.

    • Anj Fabian

      October 13, 2014 at 10:46 am

      No. I’ve heard of mothers losing babies at a homebirth and then not only choosing to HB again, but to use the same MW. That’s faith for you.

      More often, women who suffer a loss at a HB, dump the idea of HBing, cut all ties to the MW and not only birth at a hospital with an OB but may also opt for a maternal request cesarean.

      That’s evidence for you.

    • Ennis Demeter

      October 12, 2014 at 12:23 am

      High school educated people with no ability to do emergency surgery or highly educated and trained ObGyn with access to equipment to perform lifesaving procedures? Hmm, so hard to decide until I do some “research”.

    • notafan

      October 10, 2014 at 12:37 pm

      Because home birth is a business. You think midwives do this for free? And as a lot of insurance companies will not oay for home birth, that is cash to the midwife, who does not pay a cent in malpractice insurance. Home births run about $3000-$10000 a women, do a few a month and you are rolling in dough. With no pesky student loans to pay off because all you have is a high school diploma and 20 hours of online training.

    • Lt, Ft

      October 10, 2014 at 12:41 pm

      $10k for a homebirth? High school diploma and 20 hours of online training? Clearly you are trolling and don’t have any knowledge about homebirth. I live in crunchy ass expensive California and homebirths are about 6k. The midwife takes on 8-9 mothers per year. That’s an average of 54k annual salary. Rolling in the dough indeed.

    • notafan

      October 10, 2014 at 12:50 pm

      There are multiple classifications of midwives. Lay midwives, which JUST required a high school diploma, only requires 20 hours of online training. I too am in southern California, near where all the idiot antivaxxers live. I have a co-worker planning a homebirth whose midwife is charging $10k and currently has 20 othr patients, which I found out when she was complaining that her midwife never answered the phone. 20x$10k = $200,000. Looks pretty cushy to me.

    • Lt, Ft

      October 10, 2014 at 12:54 pm

      I don’t believe you but if that’s true about your coworker then she chose a bad midwife. How the hell can one midwife have 20 patients? My sister was turned down by her first choice because the midwife already had a client due within 3 weeks of my sister.

    • Lt, Ft

      October 10, 2014 at 12:55 pm

      Lay midwives are required to have a high school diploma, yes, but that doesn’t mean they ONLY have that education. They apprentice for years under a more experienced midwife and a lot of them began as doulas so they have many years of attending births.

    • Ennis Demeter

      October 12, 2014 at 12:20 am

      You know what professionals study for years and attend many births during their training? ObGyns.

    • Jayamama

      October 10, 2014 at 4:03 pm

      Even if that’s true, they also have to pay any assistants or back-up midwives. Actually, especially if they have 20+ clients. While they’re at a birth, which can take up to a day or two, who takes care of their other clients? All good midwives work in pairs or groups to make sure that all the women are taken care of, and all their equipment costs money. So it’s not like they’re keeping all the dough and going home to roll around in their wads of cash at the end of the day.

    • Lt, Ft

      October 10, 2014 at 4:22 pm

      That’s why I have a hard time believing a midwife would take on 20 clients at one time. As I said before my sis’s midwife wouldn’t take her own because another client would overlap by three weeks. Not only does the midwife attend the birth for up to 48 hours but she then come back 24 hours after the birth, 72 hours after, then one week after, then three weeks after. She has to sleep sometime.

    • Jayamama

      October 10, 2014 at 4:39 pm

      Exactly. But let’s do some real math here. Suppose a pair of midwives charged $5000 for their services, which is more than I’ve ever seen in real life, but maybe it’s more expensive elsewhere. And suppose that because there’s two of them, they can take on two clients due per month, which is a total of 24 per year. That’s $120,000 annual gross income, split between them. But they also have to pay rent for an office building or gas to drive to clients’ homes, assistant’s fees (since there should always be two attendants present at a birth and one midwife must be available for other emergencies), and equipment like birthing tubs, oxygen, supplements, etc. I would think that most midwives don’t take an annual income of more than $40,000 or so, and they have one of the most demanding jobs I can think of.

    • Lt, Ft

      October 10, 2014 at 4:44 pm

      You are absolutely correct, great example!
      I’ll bet with that 40k a year they can afford things like a refrigerator and a smart phone. Thanks, Obama!

    • Allyson_et_al

      October 13, 2014 at 2:33 am

      Not to mention malpractice insurance in a field with crazy high rates.

    • Anj Fabian

      October 13, 2014 at 10:42 am

      Let’s not forget their malpractice premiums!

      oh that’s right…they don’t carry medmal insurance.
      If anything happens to under their care, oops too bad, so sad.

    • Allyson_et_al

      October 13, 2014 at 2:32 am

      My midwife was in the (hospital) room with me for almost the entirety of my 13-hour labor with my daughter and my 16-hour labor with my son. My mom had just died a few weeks before my daughter was born, so having a supportive female presence that whole time was so appreciated.

    • Ennis Demeter

      October 12, 2014 at 12:18 am

      ObGyns work in shifts with actual OB nurses and nurse midwives. They run drills about how to treat obstetric emergencies and they have equipment and experience and training above anything a lay midwife will ever have.

    • Jayamama

      October 12, 2014 at 2:19 pm

      Except how a normal, unmedicated birth with no interventions is supposed to go. And how to treat pain with acupressure, meditation, water, etc.

      Of course, some will know these things, but for most, the solution is at best to drug the woman, and at worst to cut her open.

    • Ennis Demeter

      October 13, 2014 at 4:50 pm

      Those are alternative medicine, and OBGyns practice actual medicine, which is what women and babies deserve.

    • Anna

      October 14, 2014 at 1:36 am

      You are just plain WRONG and are parroting bad information you know NOTHING about other than reading it on like the internet somewhere.

      I have seen PLENTY of unmediated natural births and I’m a fucking resident. What you call “physiological” birth is just fucking BIRTH and trying to pretend doctors don’t know about it or see it is plain stupid and shows how ignorant you are

    • Jayamama

      October 14, 2014 at 2:06 am

      Okay… calm down. Firstly, I never used the word physiological, so I don’t know why you brought that up. Secondly, I didn’t say that doctors know nothing about birth. Of course they do. But it’s becoming harder to find drs that are used to dealing with unmedicated births, and nearly impossible to find any that are comfortable with alternate forms of pain medication. That’s all I meant.

      Clearly you are passionate about this, and frankly, I don’t want to start a debate that will get us nowhere and make us both mad. It’d be very hard for a medical resident and someone who’s had two home births to see eye to eye. So how about we just say that we respect each other as people, if not each other’s opinion, and leave it at that?

    • Lt, Ft

      October 10, 2014 at 1:58 pm

      My sister is here reading over my shoulder and she told me (yes told, not asked, as is her nature) to add the midwives fee was 6k but there was a sliding scale and most of her clients didn’t pay that. Even if they did pay the full fee it’s not all at one time. My sis paid $500 for deposit then spread the rest out over 6 months. She also paid in breads and cakes because she’s a kickass baker.

      My addition is even if a midwife were making this mythical 200k per year, so what? People should get paid to do a job. I hate that righteous poor people attitude that a lot people have.

    • Ennis Demeter

      October 12, 2014 at 12:14 am

      What were the credentials of that “midwife”? Did she have any medical training? Did she even go to college?

    • Jayamama

      October 10, 2014 at 3:58 pm

      My midwife here in NM charged $3700. That was actually more than her usual rate because she had to travel. My midwife in OK charged about the same amount, though I can’t remember the exact number. I follow the latter on Facebook, and I have such a respect for what midwives do. The never-ending chaos, unpredictable hours, sleepless nights, always being on call and not getting a break… I couldn’t do it. They work for every penny, and in my opinion, they don’t get paid nearly what they’re worth.

    • Lt, Ft

      October 10, 2014 at 4:26 pm

      Seriously, this. My sister’s midwife spent so much time with us that she felt like a cousin. Not just the birth but the 90 minute appointments before that plus the invaluable advice and wisdom and comfort she provided.

    • Ennis Demeter

      October 12, 2014 at 12:16 am

      I’d rather have 10 minutes with an Obgyn than waste my time with a high school graduate who won’t be able to save my baby if something goes wrong, no matter how nice she is.

    • Allyson_et_al

      October 13, 2014 at 2:28 am

      You do understand that CNMs have a nursing degree (usually 3 years for an RN or 4 years for a BSN) , and then more education on top of that to get their midwifery certification, right? It’s not just a Certificate of Lady Parts from Willow Rainbow’s School of Childbirth and Macrame. I bet the woman who wrote this article is literate enough to read her midwife’s credentials. Thanks for the concern trolling, though.

    • Ennis Demeter

      October 13, 2014 at 4:52 pm

      And do you understand that in the US, CNM’s are almost never the ones attending homebirths?

    • Allyson_et_al

      October 13, 2014 at 5:03 pm

      Do you have stats to back that up?

    • Emily

      October 14, 2014 at 1:39 am

      Omg, 90 min appointments wi a random chick who knows nothing about helping babies or women.

      Dude if you want to pay for a FRIEND, get a fucking escort.

    • lilin

      October 13, 2014 at 2:57 pm

      20 hours of online training is more than some midwives receive.

      Although there are midwives who are trained professionals, there are two states with voluntary licensure – Oregon an Utah. These states do not require any license whatsoever to practice midwifery. I could go to either one and say I’m a midwife. Thirteen states have no laws whatsoever. I could, again, say I was a midwife, but the law is gray about whether I could be arrested or not for practicing.

    • M.

      October 11, 2014 at 7:37 am

      What even are you talking about? I’m about to have my 2nd birth center birth with midwives who also do home births and my insurance covered it (I paid about $700 out of pocket, which was spread out through the appointments and paid up by week 36, which was the same as my 1st birth 3 years ago) and would have covered home birth too. In my state midwives are required to carry malpractice insurance. They are also required to go through 3 years of school to be licensed and cannot practice without state licensing. My particular midwives consult with an OBGYN who is linked to their practice and will only do home and birth center births that have the lowest risk (if you have higher risk they will assist in your hospital birth). They are allowed to administer oxygen, IV fluids, and other things (as well as do PAPs and breast exams), which they bring along to home births.

      You’re making a lot of weird assumptions about all midwives everywhere, and while I agree that some states are severely lacking when it comes to licensing and regulating midwifery care, women are perfectly capable of doing this research and deciding whether a particular midwife will be able to offer them the level of care they are comfortable with. And being in a hospital does not insure that you and your baby will be fine, there are other risks to hospital births (like picking up infections and superbugs like MRSA) that you wouldn’t have doing a home birth.

    • Ennis Demeter

      October 12, 2014 at 12:12 am

      Home birth so-called midwives with no real medical training whatsoever get paid thousands of dollars to catch babies they are not equipped to save if something goes wrong.

    • Tourmalily

      October 10, 2014 at 12:35 pm

      Lol, okay.

      1) you’re not the ultimate arbiter of what is and isn’t safe for every woman

      2) pretty sure no one is asking for or looking for your particular type of “concern” – the type that assumes other women aren’t doing research and aren’t being responsible with their births

      3) lol “home birth industry” because hospitals and insurance companies haven’t made an industry of birth at all.

    • Lt, Ft

      October 10, 2014 at 12:43 pm

      Yeah that homebirth industry is like the mafia!

      Less than 5% of women choose homebirths in the U.S. so there’s not a lot of cash to be had in the first place.

    • Tourmalily

      October 10, 2014 at 12:49 pm

      But, but, women EVERYWHERE are being duped into shelling out $10,000 to a 20-something dropout who took a online course in birthing!!

      Except, no.

    • Lt, Ft

      October 10, 2014 at 12:52 pm

      Cause that’s exactly who I’d use as my midwife and that’s absolutely all the midwives who make up the homebirth industry *eye roll*.

      If I had known that other one was a a troll I wouldn’t have responded in the first place now I can’t stop. Help me, Tourmalily, help me.

    • Tourmalily

      October 10, 2014 at 12:55 pm

      Hang on to me! We’ll make it out of here!

    • Lt, Ft

      October 10, 2014 at 12:56 pm

      I wish I could post gifs! I’m holding on just don’t let go until we make it over this mountain of ignorance!

    • rockmonster

      October 10, 2014 at 2:47 pm

      Using a social media account cuts down on the length of time needed to make a “ real” account. And you can always post gifs by copying the image URL into the comment box.

    • Lt, Ft

      October 10, 2014 at 3:01 pm

      I don’t do social media because I am on a NSA, TSA, PPO, PTA watchlist.

      I didn’t know that about the gifs, thank you. Y’all better watch out now!

    • TheQuirkyDiva

      October 10, 2014 at 5:49 pm

      They’re sitting in smoky rooms twirling their mustaches and going MUAHAHAHAHA DEAD BABIES!!!

    • Rosa

      October 10, 2014 at 12:57 pm

      I’ve had a lot of friends have successful home births and most of them have expressed that it’s hard to do your homework since midwives (that aren’t nurse midwives) can be fairly unregulated depending on the state. Home births are far safer in other countries that have a well regulated system for monitoring and training certified midwives. Home birth and hospital birth can be made safer.

    • Tourmalily

      October 10, 2014 at 1:55 pm

      I definitely agree that there’s massive variation in the regulation (or lack thereof) on midwifery throughout the US and I for one would like to see a more uniform set of regulations across the country. I would also do away with any laws that make it difficult for a woman to obtain adequate care and support for a homebirth.

      In short, I am in favor of expanding the options for expecting mothers and ensuring the greatest quality of care is available whether she chooses to birth at home or in a birthing center or hospital.

    • guest

      October 10, 2014 at 1:00 pm

      Since when having an opinion concern-trolling?

    • Her Vajesty

      October 10, 2014 at 2:37 pm

      All of the CNMs in my city will perform home births, and they’re also extremely picky about who can have one…actually they’re picky about who they’ll provide for even at the hospital. I don’t think it’s the free-for-all you’re imagining.

    • Rosa

      October 10, 2014 at 1:06 pm

      Many states have laws that make it difficult if not impossible to a nurse midwife to legally attend a homebith. It’s ridiculous if you ask me because the presence of a well trained nurse midwife would make home birth a safer option for more women.

    • Ennis Demeter

      October 12, 2014 at 12:09 am

      Nurse midwives don’t do home births in the US

    • Allyson_et_al

      October 13, 2014 at 3:08 am

      That is absolutely untrue.

    • Poogles

      October 14, 2014 at 6:44 pm

      You’re right…it is technically untrue. The truth is that very, very few CNMs who attend homebirths in the US. The vast majority are attended by some form of lay midwife – CPM, LM, DEM etc.

    • Jen TheTit Whisperer

      October 10, 2014 at 1:00 pm

      You absolutely have that right to do a hospital birth. That’s the choice I would make. But well informed, not informed, misinformed etc. it’s not up to us to attempt to dictate to someone else how their birth should go. Don’t do it if it’s not your thing.

    • alexesq33

      October 10, 2014 at 1:17 pm

      meh – I was admitted to the hospital with emergency back pain and it took them 3 days (and me gaining 60 lbs of water weight in those three days) to diagnose preeclampsia and FINALLY do an emergency C-section. the whole time just giving me painkillers which could have had a very bad effect on my babies (fortunately we’re all ok). So hospitals are not always the “best” or “quickest” – even if you ARE in there.

    • LisaL

      October 12, 2014 at 9:38 pm

      But you were in the right place to make sure you were going to get diagnosed. You and your baby were OK b/c they did finally figure out what was wrong and had the professionals there to help you. Don’t undermine what they did for you just b/c it took 3 days. You and your baby are here b/c of them and the help you received.

    • alexesq33

      October 13, 2014 at 6:43 am

      Oh gosh I guess I need to tell the whole story. No they never diagnosed me with preeclampsia until I went to a specialist after the birth. They didn’t LISTEN to me that I had gained that much weight – despite having my MEDICAL CHART right there. My doctors words were “it’s normal to have some swelling with pregnancy”. They didn’t believe me when I said that my blood pressure is naturally very low – so for me, 130 over 90 was VERY high. They diagnosed kidney stones despite not seeing any on the ultrasounds they performed. Because I didn’t fit into their diagnostic “box”.
      Ultimately, they got the babies out and we survived.
      However, I was responding to the above poster who said she wanted to be in a hospital so that “something could be done in 10 seconds if anything went wrong”.

    • Em may

      October 14, 2014 at 1:29 am

      Guess you should have just chilled at home and died then, that’s WAYYYYYY better than waiting 3 days

    • alexesq33

      October 14, 2014 at 9:12 am

      Finally a voice of reason!! Totally agree with you!

    • Poogles

      October 14, 2014 at 6:42 pm

      “it took them 3 days (and me gaining 60 lbs of water weight in those three days) to diagnose preeclampsia and FINALLY do an emergency C-section.”

      “No they never diagnosed me with preeclampsia until I went to a specialist after the birth.”

      So either they diagnosed it and called an emergency CS as a result or they didn’t diagnose it and called an emergency CS because…??

    • Ursi

      October 10, 2014 at 1:33 pm

      Brace yourself for some caustic because I can’t be quiet about this.

      Higher chance of infant death? So what.

      I’m serious. Do you have any idea how many choices parents make that may or may not result in the death of a very fragile new life? Pregnancy is one big risk assessment and nobody plays it safe 100% of the time. You might never leave the house with that child and the child could still die of SIDS.

      I’d never in a million years want to give birth outside a hospital. That’s not a risk I’m willing to take. But if other women feel that this is what’s best for them then what right do we have to give them a hard time about it?

      This is not the equivalent of refusing to take a sick child to the hospital or praying in lieu of antibiotics or something. Birth is a natural process. I think it’s a safer process in the hospital but it’s not my pregnancy. Let’s not act like our way is the only way.

    • Lt, Ft

      October 10, 2014 at 1:38 pm

      Standing up clapping for you. Very well said.

    • rrlo

      October 10, 2014 at 2:34 pm

      You said all that I want to say on this topic but never can. You are my word hero.

    • Lt, Ft

      October 10, 2014 at 2:44 pm

      The hero we deserve.

    • Ennis Demeter

      October 12, 2014 at 12:09 am

      Nobody wants to force women to give birth in a hospital. That doesn’t mean it is not a foolish, dangerous decision. Birth is a natural process that is actually quite painful and not a little dangerous. It’s not about what you “think” is safer.

    • lilin

      October 13, 2014 at 2:47 pm

      “Higher chance of infant death? So what.”

      This is a truly stupid argument. And you’re deliberately making a truly stupid argument. Acting like a 300 percent increase of death, on what is already the day a child is most likely to die, shows exactly how little you know about risk assessment. Of course a woman should be given the freedom to choose where and how she gives birth. You can emphasize that point without pretending that an option with a massive increase in mortality rates is just like choosing a brand of formula.

      Also, yes, you could never leave the house and your kid could die of SIDS. That’s why there was a massive campaign to get parents to put the kids to sleep on their backs, and it cut the SIDS death rate in half, saving over 2000 babies every year. And that is how you actually look at risk.

    • Rachel Sea

      October 10, 2014 at 1:49 pm

      Scientific studies show, over and over, that home birth with a licensed midwife is as safe or safer than a hospital birth for a normal pregnancy.

      When a homebirth has to transfer to a hospital, calling ahead means the staff there is prepped and ready to whisk you off to an OR with as much haste as if you had been in the hospital already. As someone who has spent a LOT of time in hospitals with relatives, and for myself, I can tell you that response times are often even better when you roll in off an ambulance, because the hospital has had your drive time to get their shit together, whereas if you are already in the hospital, you may have to wait for a nurse to get off their ass and take you seriously.

    • jo

      October 11, 2014 at 4:03 pm

      Yes, they will get immediate attention in the ER, but sometimes they are too late and is heartbreaking. In the hospital when there is an infant or situation that we that we have a bad feeling about we’re at least able to monitor it closely.
      Also, it depends on where you live. Not all ems services have a dedicated call system so you have to cross your fingers that they don’t have to page it out 5 times before someone decides to show. And if your local hospital have only 2 ambulances they go both conceivably be out on calls. Not saying that home birth is bad, but these are things to consider.

    • Ennis Demeter

      October 12, 2014 at 12:31 am

      Really? What “scientific studies” are those? And what licenses do these midwives have?

    • surrounded byidiots

      October 13, 2014 at 10:58 pm

      No it isn’t! MANA’s own stats said it is 450% more likely for a baby to die in a homebirth. In Oregan it is 9800% more likely for a baby to die in a homebirth! Dear lord, the University of Google is not a place to get your information. Stats can be spun when writing articles or blogs. Look at the actual raw data before you spew propaganda about homebirths.

      The data, BTW, that MANA refused to release for YEARS because they knew how awful it was.

    • Elevatorshoe

      October 10, 2014 at 3:04 pm

      Every type of birth becomes a statistic, just as all death becomes a statistic. We’re a statistic-lovin’ nation

  10. ohladyjayne

    October 10, 2014 at 11:54 am

    Thanks for this. I had a planned home birth turned hospital birth (which of course people point to as a reason for why home births shouldn’t happen). I didn’t transfer because home birth is inherently dangerous, I transferred because after 2 hours of pushing, my giant-headed-baby needed forceps, and my midwives stayed with me the whole time because they have privileges at the hospital.

    I’m lucky to live somewhere with regulated midwifery – home birth is pretty common where I live and I didn’t actually encounter any negative feedback about my decision to plan a home birth. Even my sister – who is a very logical, type A personality, totally the opposite of crunchy-granola, she’s a math and statistics person – had a home birth with a midwife.

  11. Kate Spencer

    October 10, 2014 at 12:08 pm

    I liked this post over at Jezebel yesterday, where the author talked about how much she loved her scheduled C section: http://jezebel.com/an-unnatural-birth-in-praise-of-the-caesarean-section-1644334373

    It reminds me of this post about home birth too – in the way that people jump to so many conclusions and feel like it’s totally acceptable to openly comment on how you give birth/labor/parent, etc. Like, why do people think it’s ok to shout at me from their cars on a cool day that my kids’ should be wearing sweaters? I wonder what it is about motherhood in general that people feel like they can do that. I don’t experience it in any other part of my life.

    • Ashley Austrew

      October 10, 2014 at 12:46 pm

      Or the people who comment on my tattoos or ask where my son’s socks are (he kicked them off in the car, thank you very much), or tell you how big/small you look when you’re pregnant, or tell you to cover up when feeding, or shame you for using a bottle. I totally agree: the second you become a mom it’s like you become everyone else’s property. It’s obnoxious.

    • Rachel Sea

      October 10, 2014 at 1:43 pm

      People still want the part of village life where they’re entitled to an opinion about other people’s decisions, but not the bit where they have to stick around for the consequences of expressing them like a douchenozzle.

    • Rebecca

      October 11, 2014 at 5:08 am

      I absolutely LOSE MY SH** when people ask where my kids socks are (I’m looking at you grandma). How the f*** should I know? They’re not my damn socks. If it’s cold or snowing I tell them to go back upstairs and get some socks on, but they’re 7 years old, and at 50 degrees and up, who cares. Also, I would really appreciate it if people stopped assuming that my son is wearing a pink My Little Pony t-shirt because I’m so ahead of the gender curve. I was too lazy to do laundry, and that was clean(ish). So MLP FTW.

    • MomInCombatBoots

      October 12, 2014 at 12:02 pm

      hello fellow tattooed mama! I’m not covered in tats, but I have a big tiger “tramp stamp” (yup, being a young 22 yr old Mil chic I decided to get in touch with my inner ho! lol), a lioness and her cub on my left shoulder blade, and the three key words in the serenity prayer going around my forearm/wrist, my muscles when I wear tank tops are very visible, and apparently my yankee accent just makes that a trifecta when I open my mouth. But, I don’t notice these things personally. The “looks” are typically pointed out by my husband or people around me. It’s funny because if people talk to me they’ll see that, even though yes I come off very brash and sometimes a little fuck you, i’m genuinely a nice respectable person (unless you can’t drive or you’re an asshole to my kid for no reason). I also bottlefed (honestly no one ever made comments to my face on that one), and when my daughter and I would go places before she could talk, I would still spend our entire trip through the store talking to her (probably in that annoying baby voice, so sue me). The only time “no socks/ improper clothes” come across my radar is when its 3 degrees outside and your kid’s in summer clothes. but, the same goes for chics wearing booty shorts in the same weather. seriously man, I’m freezing in my uniform, warm socks and boots, jacket, and hat, you HAVE to be freezing too!

    • Spongeworthy

      October 10, 2014 at 1:51 pm

      I really liked that piece. I’ve had a few of the “oh, I’m so sorry!” reactions to my c-section, and while they don’t bother me, it is weird that that is the response of some random person I barely know. Why are you sorry I had a c-section? I wouldn’t tell a stranger I was sorry if I found out they had an unmedicated birth.

    • aheb

      October 10, 2014 at 2:58 pm

      I had two unmedicated births because they were both quick. I have had people tell me they are sorry I didn’t have time to get drugs. Why would you wish longer labors on someone?

    • Spongeworthy

      October 10, 2014 at 3:02 pm

      Oh, I believe it. People say the most thoughtless stuff. It’s just such a weird thing to say. “Sorry your birth didn’t go the way I, a random person, believe is the best way to go.”

    • blh

      October 11, 2014 at 10:24 am

      I very much doubt they wish you had a longer labor, they’re probably just saying they wish you didn’t suffer.

    • aheb

      October 11, 2014 at 10:57 am

      I’m sure that’s what they meant, but if you think it through logically, I would’ve had to be in pain LONGER in order to have time for the epidural to happen.

    • Guest

      October 13, 2014 at 10:50 pm

      That drugs give you longer labors is bullshit. Thank you for perpetuating biased information.

    • aheb

      October 13, 2014 at 11:00 pm

      I didn’t say drugs cause longer labors. I said my labors would have had to be longer for me to have gotten drugs. Mathematically speaking, I would have had to labor longer while waiting for the anesthesiologist, instead of just popping the kid out.

    • LiteBrite(UterineDudebro)

      October 10, 2014 at 4:27 pm

      When my MIL found out I was having a C-Section her reaction was “Oh…that’s too bad.”

      Really? I thought having a healthy grandchild would be a **good** thing. In her defense, she was clueless that the miracles of modern medicine had made it so that having a C-Section was no longer the long, arduous recovery it used to be, but I still was a little insulted. Then again, I’m insulted by a lot of things my MIL says.

    • MomInCombatBoots

      October 12, 2014 at 12:09 pm

      lol my favorite way to respond to chics who “pity” me for that because *gasp* it leaves a scar (seriously, I already have a 6 inch scar on my abdomen, plus two small ones from an appendectomy, I figured third times a charm) is: “well, since I’m not going into a career in Porn, I didn’t see the problem with them slicing me open again”

    • Litterboxjen

      October 10, 2014 at 8:41 pm

      I had an unplanned c-section for my first (and was happy for it), and a planned c-section that became an unplanned VBAC with my now week-old son. I had someone congratulate me on my successful VBAC. Um, thanks?

    • MinaMinaPumpkinEater

      October 10, 2014 at 9:44 pm

      I didn’t have an epidural because there was no anaesthetist available and I had midwives and friends congratulating me on having a natural birth. I didn’t even WANT a natural birth (I mean, I genuinely didn’t have a plan one way or the other – if I was coping with the pain, great. If I wasn’t, drugs) but the fact that everyone thought I was some sort of superhero really showed me what they would have thought had I gone ahead and had the pain relief I wanted. When I was being prepped for the epidural (before they worked out there was nobody to give it to me) one of the midwives said to me, ‘One in three women have pain relief when they give birth. Don’t feel like you’ve failed.’ WTF? Why would I think that??

    • Litterboxjen

      October 11, 2014 at 12:00 pm

      Oh god, yes. I was begging for pain relief the entire time I was labouring with my son, and he was just coming too fast. They told me if I could manage to sit up, they’d get the epidural in (and they were still trying to prep me for a c-section birth, bless their hearts), and I sat up and immediately said I couldn’t stay that way, I needed to lie down (I was 9 cm and they were saying that it wouldn’t take full effect, but it would help). The whole time I was thinking I could handle things if I only had pain relief, but that just wasn’t in the cards with my monster. 😛

      Believe me, I don’t feel like a failure in any way for trying to get all the drugs. Drugs are good when you’re in pain, and make you less annoyed at all the people who keep asking you stupid questions like what your birth date is. 🙂

    • MinaMinaPumpkinEater

      October 12, 2014 at 6:50 am

      Oh my god, I was SO ANNOYED with basically every person who came near me. The midwives kept talking to me like it was super important to me that I had a natural birth, and I couldn’t seem to get across to them that I didn’t give a crap, and that I just wanted to take every drug in the universe and ram it in my face. They kept saying, ‘Before you have the epi, why don’t you let us give you another internal examination, and then we can tell you how close you are. If you’re nearly at 10cm, you might decide just to go for it without the drugs.’ Um, hmm, so you’re basically suggesting I should shunt a human being out of my vagina with no pain relief? No thanks!

    • MomInCombatBoots

      October 12, 2014 at 12:13 pm

      lol people amaze me! I still remember, during a childbirth class, they were going through the slides for various dilation points and what to expect. The nurse got to 10cm and I raised my hand and said “um, it didn’t mention getting drugs in any of these slides. so when can we get those?”. The other chics in my class looked at me like I was nutso! the nurse chimed in “ladies, I’ve been doing this a long time, and MOST women do end up begging for drugs at some point”. Thank you nurse lady! 🙂 I ended up with a c section, and they ran out of sticks to bite down on, so they did give me a nice numbing drug for that one 😉

    • Litterboxjen

      October 13, 2014 at 11:55 am

      God, I thought the lady in my childbirth class who was only interested in the non-drug pain relief options was nutso. 😉

    • Litterboxjen

      October 13, 2014 at 11:55 am

      Oh my god, if I could’ve set up the epidural at home before anything started, I would’ve done it in a heartbeat. That was partly why I wanted a c-section this time, and not to be induced (which was how my first went down). I didn’t want to be labouring at home, in pain, for however many hours it took to get to the magic “okay, now come to the hospital” number. Fortunately? my son had his own timeframe in mind and came crazy fast.

      And part of me thinks if we hadn’t taken the time to have showers at home (because I thought it would take forever to go from water breaking to active labour), then I would’ve shown up in time to have my epidural. But 20/20 and all that. 😛

    • Allyson_et_al

      October 13, 2014 at 2:12 am

      My lamaze teacher, when I told her that I pushed for 4 hours (yes, 4 HOURS) to have my daughter, told me that was probably because I had an epidural. I didn’t expect a medal, but you’d think a damn childbirth educator would at least know better than to shame a first-time mother while she’s still in the damn hospital bed and can’t even leave in a huff. It’s been almost 14 years, and I still want to punch that woman in the throat.

    • Ms.Anne'sNotoriousLadygarden

      October 13, 2014 at 6:48 pm

      Failed? Fuck that. I knew that I would get an epidural before I even was sure I wanted kids. Ever since I was a teenager and some fundamentalists explained that women’s pain in childbirth was part of god’s plan for marriage. And I LOVED my epidural.

    • Allyson_et_al

      October 13, 2014 at 2:06 am

      Congratulations on your new baby!! How’s that? 🙂

    • Litterboxjen

      October 13, 2014 at 11:51 am

      It’s been good, and tough at the same time. I keep having to remind myself he’s not his sister, and that we went through a lot of these newborn hoops last time. The roughest part is that he’s a snuggler, so he won’t sleep in the bassinet — and so we’ve had him in the bed with us every night. I don’t mind much, since he’s pretty quiet for the most part, but I don’t love it for the safety aspect. That said, I’m much more chill this time around (HUGE understatement there), so I’m trying to roll with the punches and just do what works (such as giving him some formula at night if necessary so everyone, including our toddler, can get some rest).

      Part of me just wants to fast-forward a few weeks until things like nights/days are sorted out, and so on, though. 🙂

    • MomInCombatBoots

      October 12, 2014 at 12:07 pm

      I like the whole “our bodies are MADE to give birth” anti-c section, anti medical intervention women *NOT*. Here’s the thing, I don’t care how one gives birth. But people need to remember, women and babies DIED back in the day before the advancements of modern medicine, and sometimes even today, it still happens. So, the end goal for me was having a healthy baby (and I wanted to survive it too< how selfish of me). If you can have a successful home birth, go for it! If you want to give birth in magical healing waters surrounded by dolphins and rainbows, cool! just as long as it's safe for baby and mama

    • LiteBrite(UterineDudebro)

      October 10, 2014 at 4:25 pm

      I liked it too because that’s exactly how my birth went: kid was breech, we scheduled a date and time to come into the hospital, I made chili the night before, we got up the next day and watched a movie, I went into the hospital, and a few days later we went home with our newborn. Done and done.

      But my way isn’t necessarily better; it just kind of worked out that way for me.

    • guest

      October 10, 2014 at 11:05 pm

      Your way absolutely sounds better than my way!!

  12. Rosa

    October 10, 2014 at 12:09 pm

    Can everyone agree that no one about to have a baby needs to hear any horror stories about birth no matter how that women plans to give birth?

    • Deanmon

      October 10, 2014 at 8:58 pm

      Yes, yes. A million times yes.
      I’ve given birth twice already. Not really any surprises left. However, I don’t care to hear about your 4th degree tear. No thank you..

    • Stacy48918

      October 13, 2014 at 5:39 pm

      Ok, how about true stories then? There are plenty of true homebirth stories out there that I’m doubting the author of this piece read – partly because she didn’t want to and partly because the homebirth crowd didn’t want her to. You can find a few at the blog Hurt by Homebirth.

    • Rosa

      October 13, 2014 at 6:22 pm

      I’ve read hurt by home birth stories too, and The stories are awful. I was just saying that as someone whose 23 weeks pregnant I don’t need to hear about all of the things that can go wrong when you give birth. I’m planning on a hospital birth (possible c-section as I am expecting twins) and people keep telling me c-section horror stories. Hearing these stories doesn’t change my mind about what I want to do, all they do is make me anxious.

    • pontificatrix

      October 17, 2014 at 6:48 pm

      Sure, but bad outcomes from the hospital aren’t publicized nearly so well. Why is that? Do you not think anyone has ever been hurt by hospital birth? As a physician I can tell you I have seen plenty of iatrogenic morbidity and, yes, mortality. According to most of the available studies, as long as you have a well-trained birth attendant, birth location is pretty much a wash.

  13. Airbones

    October 10, 2014 at 12:14 pm

    Nope, I’m not. Good try though.

  14. Harriet Meadow

    October 10, 2014 at 12:15 pm

    I don’t judge you for choosing a homebirth, as long as you’re not one of those people who thinks that “have a homebirth” is a solution for every thing that can go wrong in a hospital (because nothing can go wrong at home, amirite?).

    • Lt, Ft

      October 10, 2014 at 12:21 pm

      Anyone who says “I don’t judge as long as…” is being pretty judgmental. Just sayin’.

    • Harriet Meadow

      October 10, 2014 at 3:15 pm

      I am not being judgmental toward the author of this piece and people like her, but toward people who generalize about other people’s situations. Let me clarify: I recently read an article about “ten things that might happen during your labor” that focused on hospital births. In the comments, several people were suggesting that the way to have a complication-free, convenient, nuisance-free birth is to do it at home. Which, of course, is not necessarily true. There are potential drawbacks to having homebirths, too. Now, if you acknowledge that and choose to have one anyway, more power to you – I think it’s a perfectly valid option (not that my opinion matters)! Which means that I absolutely would never judge someone like the author of this piece for her choice of a homebirth. But if you go around telling everyone to “have a homebirth because everything will be perfect” without considering their actual situation, then yes, I judge you (and, I believe, rightfully so).

    • Lt, Ft

      October 10, 2014 at 3:21 pm

      I agree with you and said pretty much the same thing somewhere on this page. The all-or-nothing attitude on either side is unproductive and misleading.

    • Lt, Ft

      October 10, 2014 at 3:22 pm

      I don’t agree about still judging though. I actually don’t care about what people do with their bodies or families or whatever. I may make different choices but it doesn’t matter. No one is knocking down my door asking how I feel about their life decisions.

    • Harriet Meadow

      October 10, 2014 at 5:41 pm

      I don’t care what people do with their bodies, either (and I’m sorry if that somehow came across in my post). I do care when they think they know what’s right for me and *my* body, which is really all I’m talking about (and, unfortunately, I do get a lot of that attitude, coming from hippie-ville). And yes, I realize I’m being judgy about people being judgy, but I accept my judginess on that account lol.

  15. coffeeandshoes

    October 10, 2014 at 12:18 pm

    My cousin is a midwife up in Maine, and I have the utmost respect for what she does. She is a consummate professional and is very good at her job; she also teaches at the midwifery school where she trained.

    With that said, it is not a choice I would personally make, as I am a total nervous Nellie and am a big ‘what if?’ kind of thinker. I would be too nervous, so I know it’s not the choice for me if/when the time comes. But the beauty of it is that she knows where I stand and doesn’t judge me for my choice, nor do I judge her clients for theirs.

  16. guest

    October 10, 2014 at 12:46 pm

    Honestly I really don’t care how babies exit other people’s vaginas.

    • Her Vajesty

      October 10, 2014 at 2:45 pm

      Fresh outta fucks

    • Lt, Ft

      October 10, 2014 at 3:00 pm

      Um, isn’t that how the baby got in there in the first place?

  17. Ashley Austrew

    October 10, 2014 at 12:50 pm

    I don’t judge. People are afraid of what they don’t understand, so unfortunately you’re dealing with a lot of ignorance. I couldn’t have a home birth just because I have anxiety/hypochondria and will basically never be able to trust my body no matter what (and also: madly in love with Epidurals), but shit. If that’s how you want it, you go, Glen Coco.

  18. Guest

    October 10, 2014 at 12:51 pm

    I’m judging you and I do think you were foolish, but even more I am judging the midwives and doulas who make money by misrepresenting the safety of this procedure.

  19. Lisa Walker

    October 10, 2014 at 12:51 pm

    No. I don’t judge those who had a home birth. I don’t judge those who have midwives. All the power to you. However, in my birthing class, I was super hella judged for being the only person in the class who wasn’t using a midwife. I had to explain away why it was better for me to be in the hospital as I have kidney disease and I was so mad that I had to defend my choice when I didn’t say one word about ever other woman’s choice that I stopped going to birthing class.

    • AP

      October 10, 2014 at 4:38 pm

      I don’t understand the point of birthing class. What are they going to teach you in a class that you can’t learn in a book or on a reputable medical website? Heck, the hospital/medical association/whatever could even put together a video on their website.

    • Brandy

      October 10, 2014 at 6:27 pm

      I didn’t attend a birthing class. I asked my doctor if it was really necessary. He asked if I read. I answered of course, and he said that a few good books would be sufficient to give me all the information I needed for less money and less time. I have no regrets!

    • C.J.

      October 10, 2014 at 8:53 pm

      All the birthing class did was make my husband annoy me. He kept trying to get me to practice breathing. I finally told him I already knew how to breathe, I had been doing it for 26 years.

  20. aCongaLine

    October 10, 2014 at 12:55 pm

    I’m not judging. Not my monkeys, not my circus. Rock it. Would it be my choice? Nope. Am I the Queen of Choices? Nope. If everyone’s okay, it’s a win. Congrats!

    • Lt, Ft

      October 10, 2014 at 1:06 pm

      I like the monkeys line. It beats my standard dry response of I don’t care.

    • aCongaLine

      October 10, 2014 at 1:14 pm

      🙂

    • whiteroses

      October 10, 2014 at 8:28 pm

      This. A home birth is not something that I would ever, ever do given the choice, but it’s not up to me to decide that.

    • MomInCombatBoots

      October 12, 2014 at 12:17 pm

      I am with you on that. For me, I’d be afraid that IF something goes wrong, even if there have been no problems up til that point, there is no medical team with advanced medical equipment there to intervene. So, FOR ME, I liked being in a hospital with professionals and equipment available in the event that her life (or mine) were in danger

    • LoveInfinitely

      October 14, 2014 at 10:29 am

      “Not my monkeys, not my circus” is my new favourite expression. And I don’t even have kids! lol Thanks!

  21. Jen TheTit Whisperer

    October 10, 2014 at 12:57 pm

    I absolutely think you are crazy. Crazy brave. I want the drugs. All the drugs. Seriously though. You’ve done your research, talked it over with your man, made a well informed decision. That’s all you can do. Bad stuff can happen anytime or anywhere. Good stuff too. Wishing you the best of luck with your new nugget!

    • LeggEggTorpedoTits

      October 10, 2014 at 2:24 pm

      100% This’ness.

  22. UnpopularOpinion

    October 10, 2014 at 1:12 pm

    Obviously to each their own. But I judge. Choosing a home birth is not choosing the safety of your baby. It’s prioritizing your “experience.” And I can’t respect that.

    • pontificatrix

      October 10, 2014 at 3:18 pm

      Nope. Safety is comparable provided mother is low-risk and birth attendant is well-trained. Read the stats.

      De Jonge et al 2009, http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2009.02175.x/full

      Janssen et al 2009, http://www.cmaj.ca/content/181/6-7/377.short

      Brocklehurst et al 2011, http://wrap.warwick.ac.uk/46562/

    • lilin

      October 13, 2014 at 3:26 pm

      Oh, the De Jonge is a fun one! It says that mortality in a planned home birth with a midwife is the same as mortality in a planned hospital birth with a midwife. In the Netherlands.

      Two problems:

      1. Infant mortality in low-risk pregnancies under the care of midwives in the Netherlands is actually higher than infant mortality in high risk pregnancies under the care of doctors. (http://www.ncbi.nlm.nih.gov/pubmed/21045050) In other words, if you got a Dutch midwife, you kid is more likely to die, whether they’re in a hospital or not.

      2. (And this one applies to the two other studies – done in Canada and in Britain.) There is not one state in the US that has standards as high as the Netherlands or any other industrialized nation. If American midwives practiced in Europe the way they do in the US, they’d be locked up as criminals. But they keep citing studies of more well-trained people.

    • pontificatrix

      October 17, 2014 at 3:27 pm

      So the Evers study compares two groups that differ on so many variables it is impossible to make any conclusion. You have one group that is high risk, attended by physicians, and gives birth in hospital. The second group is low risk, attended by midwives, and gives birth out of hospital. Not only that, there was no adjustment for confounding factors, of which one would expect there to be very many given the total non-comparability of the two study groups.

      There are going to be a vast number of variations between those groups such that there could be a large number of different explanations for the outcome, which the poor study design gives no way of selecting between. For example, potential explanations could be
      – Homebirth is more dangerous than hospital birth (but this is contradicted by many other, better-designed studies with more equal comparison groups)
      – Midwife training in the Netherlands is inadequate
      – The system of determining which women are low risk vs high risk is flawed
      Etc.

      The explanation that homebirth is inherently more dangerous than hospital birth is one possible but not the most likely explanation; but given the horrible study design, really the only conclusion one can draw is that there is no information here.

    • lilin

      October 17, 2014 at 8:00 pm

      If you believe there’s no data, then you should probably apologize for saying this, “Safety is comparable provided mother is low-risk and birth attendant is well-trained.”

      I mean, especially since you say training in the Netherlands could be inadequate – considering training standards for US midwives are universally lower and, in some cases, nonexistent.

    • pontificatrix

      October 18, 2014 at 9:57 pm

      You are conflating two issues: midwife training and homebirth safety. The De Jonge study addresses homebirth safety only. It appropriately compares two groups that differ only in birth location. Both groups were under midwife care. This study showed that location did not make a particular difference to outcome. It is possible that the midwife care may have been worse than physician care however; that study was not designed to address that issue. But it could well be that midwives in the Netherlands are not sufficiently well trained, and that this could be part of the reason for the high neonatal mortality. This would have no bearing on the question of birth location however.

      I agree with you that midwife training standards in the US are woeful. This is a separate issue from the question of whether birth location itself makes a difference to outcome (with provider skill kept constant). The data by and large suggest that it does not.

    • lilin

      October 18, 2014 at 11:41 pm

      I guess whether I’m “conflating two issues” depends on what I think the issues are.

      For me there’s one issue, a commenter coming in and saying that homebirth is just as safe as hospital birth and citing several studies while:

      1. Quietly not citing studies that show it’s not as safe as hospital birth. You didn’t even say “some studies show”. You just said it like it was an established fact, which it isn’t, not matter how much you disagree with any of the studies that show it isn’t.

      2. Talking about “well-trained” providers, and citing a study of them, while not mentioning that those well-trained providers had higher rates of death, no matter what the setting, than actual doctors. In other words, not mentioning that well-trained providers aren’t quite as well-trained as they say.

      3. Not mentioning that even a marginally “well-trained” provider is nowhere to be found in many countries.

      In other words, my issue, which isn’t conflated with anything else, is that you made a short statement asserting a proven fact which is not actually a proven fact, and you did it without mentioning the many complications that arise in reality, even if the fact were proven.

    • pontificatrix

      October 21, 2014 at 4:31 pm

      1. Yes, I did not cite the Evers study because it is a badly designed study that yields no information. I cited well designed studies. All studies are not equally valid, and I’m not obliged to post a link to every POS article out there just because it exists.
      2. I believe I discussed the issues with provider training quite extensively in my other comments up above, and also cited the Cheng study which parses out providers at different levels of training. Read it, it’s enlightening.
      3. I also mentioned the issue with finding well-trained homebirth midwives in the US repeatedly, not sure why you suggest I ‘didn’t mention it.’

    • pontificatrix

      October 18, 2014 at 9:59 pm

      Also, I did not say ‘there are no data’ in general. I said the Evers study is not at all informative due to the poor study design.

  23. Kristen

    October 10, 2014 at 1:14 pm

    A home birth is SO not for me, but I don’t care much either way if its for you. I don’t think you’re particularly brave or badass or crazy, or at least no more brave or badass or crazy than any other mama. As long as you and your baby are good, I’m glad for you.

  24. alexesq33

    October 10, 2014 at 1:14 pm

    For my emergency C-section those present were: the surgeon, the anesthesiologist, and a midwife who was all up in there (According to my husband) sewing me up and holding organs, etc. so yea, I’m guessing there was SOME sort of medical training before they let her do that…

  25. There is one

    October 10, 2014 at 1:39 pm

    Sorry but I had a horrible birth and both myself and my son nearly didn’t make it. There was no indication anything would have gone wrong. I was in perfect health, young {30}, no preexisting conditions, full term and baby in perfect health until delivery. Anyone would have said I was a great candidate for a home birth. There is just no way to know how things will go. I was extremely fortunate to have a large medical team and hospital facilities around me. After that experience I have a tough time believing any home birth is worst the risk.

  26. Lt, Ft

    October 10, 2014 at 1:49 pm

    Since when does anyones experience trump another person’s decision? All these horror stories don’t mean a thing to the person making an informed choice. I was in a horrible near fatal car accident so no one should be allowed to drive at night. I know someone who got stung by a bee and died of anaphylactic shock so no one should go outside anymore. My FOAF bought a brand new 60″ tv and dropped it on the porch before she could get in the house. How dare manufacturers even make TVs that large?

    Come on, people! It sucks that you had a horrible experience and I hope you recover from that. Does your one experience mean the choice is bad for everyone else on the planet? Probably not.

    • KatDuck

      October 10, 2014 at 7:28 pm

      The one person I “know” (well, a friend of a friend, so it’s second-degree) who died in childbirth was doing a hospital birth at a place with a great reputation and, as she was in the medical field herself, she got the best. The day before she gave birth it was all totally normal and then, suddenly, it wasn’t. The baby was fine but the mother died despite all the very best modern medicine could do.

      Sometimes thing happen.

      I mean, I’ll still do my research and possibly do it more thoroughly than otherwise, but at some point … and that’s not going to keep me from hospitals.

    • Poogles

      October 14, 2014 at 6:26 pm

      “Since when does anyones experience trump another person’s decision? All these horror stories don’t mean a thing to the person making an informed choice.”

      Frequently, women who are planning HBs are warned not to read any “negative” birth stories, just positive ones. Not only that, but neonatal deaths at the hands of lay midwives (CPM/LM/DEM) tend to get swept under the rug and not discussed by anyone in the HB community (the mother/family is usually shunned as well, unless they continue to tow the party line and refrain from bringing up their loss). See the Hurt By Homebirth blog or look into the #notburiedtwice campaign.
      So, really, how “informed” is a choice when you never see how things can go wrong? When you’re told to “trust birth” and that the less healthcare you receive from your provider the safer your birth will be? I don’t think anyone is trying to “trump” her decision, just point out the things that frequently get left out of one’s “research” when it comes to HB.

  27. rrlo

    October 10, 2014 at 1:50 pm

    I believe that home births are riskier than hospital births BUT like everything else, each individual decision is based on factors beyond absolute risk.

    Ultimately, home births are legal and you are an adult – what you do is none of my business.

    What irks me (and that’s not what you are doing) are long winded rants on Facebook about how midwives are amazing and OBs suck. Which is absolutely ridiculous.

  28. Angela

    October 10, 2014 at 1:56 pm

    Honestly, I used to judge home birthers. It had a lot to do with the fact that when I worked as an ER nurse we saw all of the home birth train wrecks. I know that we never saw any of the good outcomes so my perception was a bit skewed, but it’s still hard to see any tragedy that you know could have been prevented. Over the years though I’ve come to see that much of the problem lies not so much with home births, but my state’s particular laws governing them. Here we make it illegal for Certified Nurse Midwives (CNMs) to attend home births, so the only option for home birth attendants are lay midwives or doulas. Often a lay midwife will undergo some sort of training/apprenticeship and I’m sure that some are better trained that others, but there is no regulation or accountability. Also, lay midwives (unlike CNMs) are not licensed prescribers so it is illegal for them to provide things like oxygen, suction, IV fluids, or medications if there is an emergency situation. In places where CNMs are allowed to attend home births they tend to bring emergency kits with those types of supplies. They may not use them often, but in a real emergency it can make all the difference.

    I feel that it’s such a shame that we don’t give women that option. No matter how much a woman wants a natural home birth I think most women would still prefer that their baby is resuscitated with oxygen if born unable to breathe or want IV fluids administered in the case of a massive hemorrhage. I think many would prefer to have a provider that’s officially licensed and regulated. But unfortunately in my state women have to choose either a hospital or birthing center if they want emergency medical supplies on hand.

    • oceanlily

      October 10, 2014 at 3:01 pm

      That is why I would never do a home birth, it is because a lot of the midwives are not regulated. I keep hearing about cases where the midwife would leave before the paramedics get there and/or outright have the parents lie about her ever being there at all. I would be afraid of finding a midwife with glowing reviews and her turning out to ditch me when things went south. If that happened in a hospital I could sue the doctor but one can’t do that usually with home midwives as they don’t carry malpractice insurance. I wish home birth could be safer but until it is I will stick with hospitals.

    • Allyson_et_al

      October 13, 2014 at 2:19 am

      I had both my births attended by a CNM (the second ended up being a c-section, so the OB did the actual delivery part); they are definitely regulated and very well-educated. Lay midwives, on other hand, could have a Certificate of Lady Parts from Willow Rainbow’s School of Childbirth and Macrame for all I know.

    • Jayamama

      October 10, 2014 at 3:51 pm

      I live out in the middle of nowhere in the desert, so finding a CNM to attend my home births wasn’t possible. I found a pair of CPMs to attend my births, but I made sure that they were more than qualified to do so. They did bring oxygen and other supplies, though. My first daughter had a rough start, so they gave her some oxygen to help her, and I bled a bit much in my second delivery, so they gave me something to help just in case. I live in NM, so maybe it varies by state.

    • Angela

      October 10, 2014 at 6:40 pm

      It does vary a lot by state. CPMs are also not legally authorized to practice in my state. There still are some who will still attend births, but they are not permitted legal access to oxygen, meds or medical supplies and assume a lot of risk because in the eyes of the law they are practicing medicine without a license. This results in the cases where they’ll call the paramedics and then abandon the mom so that they aren’t prosecuted. It also means that it’s difficult for midwives to get the training they need. Most of them do take some sort of course (some more reputable than others) and complete some kind of apprenticeship with another midwife. That’s certainly a great start, but since most home births are relatively low-risk pregnancies it can be difficult to get sufficient preparation to handle high risk situations if your training is exclusively with home births. IMO the best training programs also include a hospital rotation where they can focus on high risk births and emergencies. Thankfully it’s rare that such skills are required for a home birth, but extremely essential when it does occur. Unfortunately my state does not permit midwives to receive such training.

    • Jayamama

      October 10, 2014 at 6:55 pm

      That’s really sad.

      It seems like, in this case, midwifery and abortion ironically have something in common: fewer laws against them could mean that fewer people die from botched procedures.

    • Angela

      October 10, 2014 at 11:20 pm

      So true! Although I’d actually like to see more laws to regulate home births, but better ones. For example, I’d like to see all midwives subject to stringent licensing criteria and regulated by the state. I feel that they should be required to bring oxygen and certain emergency supplies, and I thing that health insurance plans should be required to cover home births. But yeah, the laws in my state were written more to limit access to home births rather than make them safer and it is much like laws to restrict abortion access in that it just makes them much more dangerous.

    • Lilly

      October 10, 2014 at 9:22 pm

      this I totally agree with — I live in Ontario which has fully licensed/trained midwifes who are authorized to do home births and most have hospital previledges (these are paid for by the government health insurance) so there is a complete set of standards for who can do a home birth, what needs to be brought by the midwives, what criteria necessitate a transfer to a hospital etc. I have no problem with how homebirths are done here, but in places without these types of controls scares me to no end.

  29. helbryce

    October 10, 2014 at 2:04 pm

    ‘Call the Midwife’ is not really about nuns ‘helping’ people. (but yeah there are nuns in it). Until the mid 50’s and even beyond that was how babies generally came into the world- at home with midwifes attending. The births would have been planned and the midwives were trained. Midwives are regulated over here, and are actually considered a separate profession to nursing (a midwife is not a nurse and cannot practice as one and vice versa). Of course the training has developed since the 40s – all midwives now are degree educated. Even in hospital births you will be attended to by midwives only seeing a doctor if it is high risk or complications arise.

    • Looby

      October 10, 2014 at 2:47 pm

      I really missed proper midwifery here. The US system is SO medicalised.
      Lx

    • helbryce

      October 10, 2014 at 3:30 pm

      I was surprised that the US doesn’t really have midwives. I’m currently 26 weeks pregnant and have seen a doctor about my pregnancy once, and that was because I have an existing condition and it was just a ‘check up’ thing. If (fingers crossed) my pregnancy carries on this smoothly I won’t see another doc. Although I joke about midwives I think I far prefer seeing them rather than a doctor every check up!

    • Looby

      October 10, 2014 at 4:03 pm

      I think it depends a lot on which state you’re in. I have relatives who are MW back home in England and they seem bloody brilliant

      I was being really closely observed by my Doctor because I basically ticked all the wrong boxes. Very overweight, over 35, horrible HG and other chronic conditions that needed to be managed

    • lilin

      October 13, 2014 at 3:28 pm

      The US has relatively few trained midwives. There are a few states where you can legally just call yourself a midwife with no training, and start delivering babies.

  30. ted3553

    October 10, 2014 at 2:09 pm

    I may have my opinion on a lot of things but I also know that unless asked, no one wants to hear them. I have nothing against a well planned homebirth if you’re low risk. Problems can occur at any time-even if you were in a hospital. If you’re at risk or a long way from a hospital, I would encourage you to make a better decision but ultimately-it’s not my choice-it’s yours.

  31. Rachel Sea

    October 10, 2014 at 2:12 pm

    All the science says that if your birth attendant is well trained and equipped, that homebirth is super, and at least as safe as hospital birth for a normal pregnancy. If I could get pregnant, I would absolutely choose a homebirth because I live in a state where CNMs are allowed to attend, and have a level 3 NICU minutes away.

    • Lt, Ft

      October 10, 2014 at 2:15 pm

      My maybe-surrogate is interested in a homebirth and approached me about it with some trepidation. I was surprised and happy because if I could pop a kid out of my uterus I’d probably have a homebirth. I’ve been to three and they were fantastic.

    • Lt, Ft

      October 10, 2014 at 2:15 pm

      Well I wasn’t the one laboring and pushing so it was fantastic for me!

    • Rachel Sea

      October 10, 2014 at 3:07 pm

      I’ve been to a few and I’m very much in favor, all were way less stressful and chaotic than the hospital births I’ve attended. One was for a baby who was going to be born still, and being in a safe comfortable space was really good for the family.

    • Lt, Ft

      October 10, 2014 at 3:11 pm

      That is sadly beautiful. I’m glad that family was able to get a little bit of peace in a heart-wrenching situation.

    • lilin

      October 13, 2014 at 11:18 pm

      No, no all the science doesn’t say that. Some studies (http://www.ajog.org/article/S0002-9378(10)00671-X/abstract) show the rate of planned home birth infant mortality is triple that of planned hospital birth infant mortality. Again, “all the science” does not, in any way, show that home birth is at least as safe as hospital birth.

  32. 0katykate0

    October 10, 2014 at 2:34 pm

    When I told my mother in law I was thinking about a home birth (my aunt had had eight… EIGHT!) she clutched her pearls and said “NOT WITH MY GRANDCHILD” ughh that women. Ended up with an epidural and had a successful birth at a hospital cause I liked my OB So much. No regrets though, other then not being able to spite my MIL.

    • Anne Gillingham

      October 12, 2014 at 5:03 am

      I would have decided on a home birth, right then and there. I would have gotten all of the high-tech prenatal care, and if all looked normal, then I would have made a birthing stool out of a toilet seat and home depot bucket, hired a minimally qualified midwife and gone to town! But that is me .. .. .

    • 0katykate0

      October 12, 2014 at 9:23 am

      Hahah Anne! I know right!! She doubts me in pretty much all aspects of my life, so I still get pleatly of oppertunitys to spite her.

  33. rockmonster

    October 10, 2014 at 2:42 pm

    *wakes up after two-hour nap* … Where’d y’all come from?

    • Lt, Ft

      October 10, 2014 at 2:44 pm

      Lol for real! The comments started off so slowly. I thought this was one of those articles that would get a lot of comments and clearly I was wrong.

  34. Whoops

    October 10, 2014 at 2:48 pm

    Better a planned homebirth than an unplanned home birth. That was… Messy. Oh so messy. (Everyone survived, happy and healthy, except my sheets, comforter and best towels)

    • carosaurusrex

      October 11, 2014 at 12:58 pm

      This is honestly a big reason that I don’t think I’d ever want a homebirth: the mess. I don’t want to clean that shit up and my dude might try, but let’s be real, he would probably vomit or faint before he could.

    • M.

      October 12, 2014 at 7:20 am

      The midwives clean everything up for you, it’s part of the package 😉

    • Ms.Anne'sNotoriousLadygarden

      October 13, 2014 at 6:53 pm

      The best thing about my hospital birth is that they did all the cleaning up and waited on me for two days. I loved it.

  35. Elevatorshoe

    October 10, 2014 at 3:02 pm

    The midwives of “Call the Midwives” are pretty awesome at what they do, and I would think that would increase confidence in the abilities of real midwives. Not saying one should base opinions on a show either way. I debated having a home birth, but decided that all of the pet hair that constantly floats around my house wouldn’t be a fun birthing experience. Plus, I can just picture my dog stealing the placenta and eating it

    • Lt, Ft

      October 10, 2014 at 3:06 pm

      Is that really a show??

    • rockmonster

      October 10, 2014 at 3:34 pm

      Yup. It’s on PBS sometimes in the States. It also shows on BBC One, ABC (Australia) and TVNZ. It is not broadcasting now, but will premiere it’s fourth season in May.

    • Lt, Ft

      October 10, 2014 at 3:35 pm

      Thanks, I’m in. Going to troll the interwebz for old episodes.

    • rockmonster

      October 10, 2014 at 3:36 pm

      It’s actually Call the Midwife (singular). That will help the search engine find stuff.

    • Lt, Ft

      October 10, 2014 at 3:37 pm

      Gracias, my fav Rockmonster.

    • Lt, Ft

      October 10, 2014 at 3:38 pm

      It’s on Amazon Prime and Netflix in case anyone else is interested.

    • wmdkitty

      October 12, 2014 at 11:20 pm

      I’m tokophobic, and I find CTM to be a delightfully horrifying period piece.

      I like that they’ve tackled disability issues, and abortion, and adoption, and all done compassionately and showing disabled people as… people.

    • TheQuirkyDiva

      October 10, 2014 at 7:05 pm

      It is! And I love it so hard. My husband laughs at me because I watch it like sports and yell out coaching advice and cheer out loud when the babies come.

    • Elevatorshoe

      October 10, 2014 at 9:32 pm

      Yeah, on PBS. It’s pretty good!

  36. Mummy uk

    October 10, 2014 at 3:52 pm

    Bit of a click bait title. Remember you have plenty of readers outside the US where home births are encouraged especially with a second pregnancy after an uncomplicated first delivery

  37. Sydneymom

    October 10, 2014 at 5:00 pm

    Good on the author for making a real researched choice for her and good on all the commenters for echoing my thoughts about how we choose to give birth is no-ones business. I too got sick of defending my planned c section – in Australia known as elective c- section. I apparently elected to have a c-section in preference to the very real chance of rupturing my uterus if I went into labour – apparently this means I was unwilling to ‘even try’ to have the baby naturally – upshot all the judgy mcjudgers can fuck off

  38. TheQuirkyDiva

    October 10, 2014 at 5:36 pm

    Good lord. Is this a thing? People talking about how they’re planning on having their babies before they have them? Or asking pregnant moms what their plans are? Nobody asked me and I only shared my plans with my parents, sister, and in-laws because the moms and my sister were on call to come help after the birth. If anyone *had* asked, my answer would have been, “Why are you asking?” Now…I have shared my home birth story after the fact when I’m with a group of mothers swapping birth stories (like you do), and I’ve had to do a little defending. But it’s been mild because after all, I had a good experience and a healthy baby.

    • CrazyFor Kate

      October 11, 2014 at 2:56 am

      Really? Virtually everyone I’ve known who’s had a baby in the past few years has gone on and on about what they plan to do and where they plan to do it utilizing which body parts. Maybe your family’s just classier.

    • TheQuirkyDiva

      October 11, 2014 at 9:38 am

      ROFL!! Not so much! I don’t know…I think the whole obsession with pregnancy and birth wasn’t such a thing eleven years ago? Or maybe I just didn’t run into the right people. 🙂

    • M.

      October 11, 2014 at 8:08 am

      I had a lot of people ask me what hospital I was delivering at (which I thought was kind of weird), and I had a birth center birth, so I didn’t have a choice but to answer that I wasn’t planning on a hospital birth. A lot of people have asked me where I delivered after my son was born, too. It’s not something I’ve ever asked anyone, but people do ask.

  39. shorty_RN

    October 10, 2014 at 6:18 pm

    No judging here. If you don’t judge my c-section, i wont judge your home birth.

  40. C.J.

    October 10, 2014 at 8:57 pm

    There will always be someone around that will judge how every one of us gives birth, or doesn’t give birth. People really need to mind their own business.

  41. Cindy Ailey

    October 10, 2014 at 10:26 pm

    Totally judging. I think it’s hopelessly naive and unnecessarily risky. Glad you are only 5 minutes from the hospital.

  42. Nara

    October 10, 2014 at 10:37 pm

    This might be an odd question but… how does everyone and their dog know that you’re having a home birth unless you’re shouting it from the rooftops? It’s not like most people go around saying, “So, are you planning to give birth in the triage room or the maternity ward?” or “I can’t wait to spend 23 hours in labour!”
    If you have backup arguments saved on your iPhone maybe you should consider that you might be a little too defensive about this, and whats behind that feeling.

  43. CrazyFor Kate

    October 11, 2014 at 2:47 am

    I wouldn’t judge you for having a home birth unless you were really obviously negligent or something, like if you were told you had serious complications and wouldn’t bother to get them looked at (but I’m guessing that would be pretty rare). And of course, if you were being a sanctimommy about said homebirth. But that’s more about being a sanctimommy than about the birth.

  44. Jezebeelzebub

    October 11, 2014 at 3:05 am

    actually, I think I’m judging you for thinking that I was judging you when I wasn’t judging you.

  45. ChickenKira

    October 11, 2014 at 5:20 am

    I’m not judging because I don’t really care.
    I know that sounds mean, but I really don’t care what other people do in regards to things like this, that would take way too much effort that I can put into things that actually do have an effect on me.

  46. thisshortenough

    October 11, 2014 at 9:53 am

    If there are people watching call the midwife and using it as a reason to dislike home births then they obviously aren’t watching it well enough. The women the show is based on worked night sad day to make sure that babies were born safely and even recommended stays in the maternity home or hospital if a labour was going to be difficult. They never claimed to be doctors but they do claim to be extremely knowledgeable in childbirth

  47. the_ether

    October 11, 2014 at 8:08 pm

    Can I just add, mothers feel guilty as fuck about everything anyway, and someone implying they are actually guilty/responsible for horrible things happening during/after birth is the exact opposite of helpful.

    • Ennis Demeter

      October 12, 2014 at 1:19 pm

      Yet they are guilty if they choose to give birth far from live saving equipment and experts.

    • the_ether

      October 13, 2014 at 5:55 am

      Well, shit, I guess I’m guilty of making my son sick because I happened to give birth at a hospital that doesn’t routinely test for the infection he got. Cheers, that’s helpful to know.

    • Ennis Demeter

      October 13, 2014 at 5:10 pm

      Trusting professionals is not the same as trusting woo peddlers.

    • the_ether

      October 14, 2014 at 7:47 pm

      My birth was attended by a midwife with the same level of education and training that a homebirth midwife would have had, if I’d chosen home birth. What you’re saying is, if a woman who chose a particular model of care had negative outcomes, she is to blame for them.

  48. Ennis Demeter

    October 11, 2014 at 11:49 pm

    if you are giving birth in the US, those ¨midwives¨that you trust so much are probably not really midwives, as in Nurse Midwives and actual medical professionals. They might not even have college educations.

  49. Ennis Demeter

    October 11, 2014 at 11:50 pm

    “Midwives” who attend homebirths in the US are not medical professionals. They don’t even have to have a college degree.

  50. Ennis Demeter

    October 12, 2014 at 12:05 am

    I am under no obligation to respect foolish risks parents take with their children’s lives, and people who deliberately birth far from the experts and the equipment that can save their babies if something goes wrong are so frustratingly foolish it hurts my head. Those “midwives” (almost certainly not nurse midwives) you trust so much don’t have the education or the expertise to save your baby if something goes wrong, and a laboring woman in a birth gone wrong is NEVER “5 minutes away” from the hospital. In any case, five minutes is too long anyway for a baby stuck in the birth canal and deprived of oxygen. I beg you to reconsider- do it for all the women in history who would have loved to have access to safe hospital births, but weren’t able to.

  51. Anne Gillingham

    October 12, 2014 at 3:58 am

    Darlin I could give a damn about when, where, how and why you whelp your pups. Do it in a hospital, plane, train, or on a bed with a stain as far as I am concerned. This probably bothers you tremendously. Nobody cares about how you live your life or how you raise your family, as long as you aren’t violating the rights, freedoms or privacy of others.

  52. wmdkitty

    October 12, 2014 at 4:01 pm

    I’m all for doing things the hippie-dippie way.

    At the same time… I’m thinking that the safety of both Mum and Baby ought to be top-priority, precisely because so much can go so, so very wrong in even the most perfect of pregnancies and births. (And when things go wrong, you want all necessary personnel there, like, NOW.)

    • kristin

      October 13, 2014 at 10:01 am

      A single mom can profit $6500 in 1 month on the compute only from working part time off a laptop

      http://careers.com

  53. dragonzflame

    October 12, 2014 at 5:43 pm

    I find this mistrust of midwives a bit odd. In NZ, births (under our public health system) are almost always done through midwives. You’d only go through a hospital-based obstetrician if there’s a medical reason. A lot of midwives will do home births, but where I live there are two birthing centres where you can have your baby, chill for a day or two (in a hotel-like room with a double bed so your partner can stay), get fed, and go home. They’re both within five minutes of our local hospital if anything does go wrong.

    I’m pretty sure you go to hospital if you need to be induced or something, but even then the birth is usually presided over by a midwife and you’ll often transfer to the birthing centre afterwards. Places that don’t have birthing centres just use the hospital, but again it’s normally midwives. It’s so interesting how different countries have different norms.

    • dragonzflame

      October 12, 2014 at 5:47 pm

      …should add, you need no less than a bachelor’s degree in midwifery to practice.

    • whiteroses

      October 12, 2014 at 5:54 pm

      My son was born in Australia, and I had two nurse midwives attending my sons birth. They were consummate professionals and helped me considerably through a difficult birth. So I get what you’re saying.

      I also understand the American mistrust of midwives- quite a few of them here are unregulated and unqualified, so nothing like what you and I are used to.

    • Stacy48918

      October 13, 2014 at 5:43 pm

      Yes but (lay) midwives in the US are nothing like midwives in any other industrialized nations like Canada, England, Australia, NZ and the Netherlands. The US has 2 classes of midwives: CNMs that are similar to the midwives you used…and the other type. Lay midwives. CPMs/LMs/DEMs. They have much less rigorous education, no hospital experience, no hospital privileges and a neonatal death rate 3-8 times that of hospital midwives.

      THAT is why we distrust homebirth midwives in the US and THAT is why the author is being judged.

  54. LisaL

    October 12, 2014 at 9:47 pm

    If you want to home birth, go for it, but I will judge the hell out of your decision, especially if you start to spew off the stupid woo-fanatic statistics and false information about how it’s safer, how interventions are EVIL, how 5 minutes away from the hospital means everything would be ok in an emergency and all of that other nonsense that comes from “research” of home birth. And the one that always gets brought up… how women have been giving birth at home for forever! And of course it’s ALWAYS conveniently forgotten that women and babies have been and still are dying to this day b/c of birth. Women who choose to home birth are NOT properly informed of just how dangerous it can be. No, they find the opinions and cherry picked research that suites their choice.

    But like I said, if you want to home birth, go for it. Just don’t kid yourself in to thinking that it’s the safer choice.

  55. AugustW

    October 13, 2014 at 8:48 am

    I don’t judge you at all, but yes I can confirm I’ve been judged for having an emergency c section.

  56. kristin

    October 13, 2014 at 10:00 am

    A single mom can profit $6160 in 1 month on the compute only from working part time off a laptop

    http://careers.com

  57. Stacy48918

    October 13, 2014 at 5:45 pm

    I’m not judging you for having a homebirth. I’ve had one myself. I’m judging you for spouting anti-intellectual nonsense about it’s safety.

    Did you know there was a failed birth attempt at Ina May’s Farm yesterday? The baby died.

    “Trust birth” my butt.

  58. Skeptical PhD

    October 13, 2014 at 10:22 pm

    Great decision. You may even get a Darwin Award out of this. http://www.darwinawards.com

  59. Quinn

    October 27, 2014 at 7:20 pm

    “Do we blame the mother who had a C-Section (planned or unplanned) when she has a complication like hemorrhaging or infection, both of which could end in death?”

    I’m sorry, but that’s not the same thing. C-sections are sometimes necessary, while home birth is never necessary. Also, yes, we frequently do, unfortunately.

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