feedback for "My Illegal Home Birth"

1. I really enjoyed reading this Madeline. I love how practical and utterly unsentimental you are about it all!

   posted by : straightupmom on 6/23/2008 at 12:06 PM Flag For Abuse

2. With all the medical advantages of a modern hospital available to this author, it's the height of irresponsibility to choose to have a birth in a home. What if something had happened...how would the author EVER forgive herself? There are many, many OBs, you need to take the time to find the right one...that is no excuse for putting mother and baby in jeopardy.

   posted by : mrb on 6/23/2008 at 1:06 PM Flag For Abuse

3. I agree with straightupmom. I try not to judge others' choices, but it seems like the author was playing with fire. Glad that the result was positive.

   posted by : jane1987 on 6/23/2008 at 1:15 PM Flag For Abuse

4. Thanks for sharing your experience :)
   The only reason I didn't have a home birth with my second baby was that all of the midwives I personally know are a little too "woowoo" for me.... I was having a baby not a spiritual experience kwim?
   I realize that they are not all like that but... I had found an OB that I liked so I stayed with him.
   My only real concern in your case would be that because home birth is illegal in your state... how good is the attention at emergency if you do end up going ther?, In an emergency... I would be afraid of harsh and uncaring treatment at the hospital at a particularly vulnerable time...
   I do not believe that 99% of the births need to be in hospital...and that the "medical advantages" are only advantages if there is something wrong... most of the time they are actually "medical dis-advantages"

   posted by : rikkicarey on 6/23/2008 at 1:32 PM Flag For Abuse

5. While I am happy you had a wonderful outcome -- I couldn't in good conscience birth at 43 weeks at home. And place my placenta in the trash to subject the garbage people to -- that's not cool.
   
   There are birthing centers, and there are nurse midwives who indeed will assist you in the birth you want -- placing yourself and your child in danger is irresponsible.

   posted by : birthingmamma on 6/23/2008 at 1:34 PM Flag For Abuse

6. I just want to say how SORRY I am about the negative feedback you are getting. People on here are so horrible and judemental. It makes me so sad. It sounds like you had a beautiful, healthy, happy, natural birth. That is the way it is supossed to be. Congratulations for trusting yourself and your body and for making the right decision.
   
   I'm expecting my second homebirth experience any day now and wouldn't have it any other way. I love my home. I trust my body. I am sensible enough to go to the hospital if it is required. My midwife is wonderful (as it sounds yours was). My husband is amazing and supportive. I hate hospitals. I despise the way that medical staff often treat forward-thinking people. I see no need for all of the "monitoring" and controlling the hospitals require. I have done a lot of research and consider myself educated. I know what I want and I am going to make that happen. My 2nd homebirth will be beautiful, just as the first one was.
   
   There are so many people on this babble that speak without having any knowledge of the topic on which they are offering their opinion. Shameful.

   posted by : DezireeRos on 6/23/2008 at 2:05 PM Flag For Abuse

7. Hey, why don't we all stop judging the author, and instead just thank her, like we say we are? It's pretty hypocritical to say "i don't judge" and then follow with "but this was irresponsible." How do you know? Were you at her birth? Did you examine her prior to? Do you know her history?
   
   If you don't have anything nice to say...
   
   And Madeleine, CONGRATS on your birth! :)

   posted by : windycitykat on 6/23/2008 at 2:07 PM Flag For Abuse

8. Did you people even read the article? She COULDN'T give birth at a birthing center. Midwives are barred from practice in Missouri. If the AMA gets its way, home birth will be illegal in every state.
   
   I'm a smart girl, I can read all the literature and make an informed decision on what is best for me and my baby. Home birth is the safer option for women with low-risk pregnancies.
   
   Both mine were delivered at hospitals and the first experience was wonderful. The second time around, the anesthesiologist botched my epidural, the OB wouldn't put down his coffee long enough to read my birth plan and he absolutely refused to let me get into any other position than flat on my back, because it would disturb the monitoring device that the hospital required.
   
   Thankfully, my baby came quickly, or I could have been forced into a c-section and then denied health insurance because of it. Should we have another, any other way would be preferable and although I don't want a home birth, I would like a birthing center birth with a midwife.
   
   Give women the right to use their brains and trust their own judgement.

   posted by : Mom2Two on 6/23/2008 at 2:14 PM Flag For Abuse

9. People post their stories on this site to INVITE comments, both negative and positive. That's part of the process, there is nothing "shameful" about it, DezireeRos. Frankly, the comments here that are critical are respectful and competent.
   
   The fact is this person decided to put herself and her unborn child at risk by choosing to forgoe a birth in a medical center and go it alone at home with someone who does not have a medical degree. I know humans did this for centuries before medical science, but we also used to drill holes in peoples' skulls to "heal" them. Should we go back to that too, 'cause it gives a warm, earthy feeling?
   
   I don't think she's a bad person or a mom who does not care about her children, but it is irresponsible and very risky.

   posted by : mrb on 6/23/2008 at 2:20 PM Flag For Abuse

10. you should read about some of the things medical doctors with "medical degrees" have done ....yikes! midwives often have the equivalent of a medical degree if not an actual medical degree. in other countries, such as the netherlands, about 30% of women give birth at home and their rates of maternal and fetal health are better than ours. it's really not a witchy situation-- i want to respect your opinion but you're not really giving us much to work with...

    posted by : straightupmom on 6/23/2008 at 2:50 PM Flag For Abuse

11. ps that last comment was directed to mrb not the author of the piece...

    posted by : straightupmom on 6/23/2008 at 2:52 PM Flag For Abuse

12. Until after the 1950's 95% of all births were in home. People are so medically paranoid.
    
    I had my daughter "legallly" at home back in Aug of 06 she was born at 42 weeks...my third will be at home also this Dec.
    
    People who are anti homebirth are just highly misinformed or not informed at all. It's a shame because homebirth is so much easier and relaxing.

    posted by : carliec on 6/23/2008 at 3:02 PM Flag For Abuse

13. I think the author seemed well informed before making her decision. I actually have a technical question: with my 2nd baby, I had group B Strep, and the doctors recommended I have antibiotics in my system during delivery to prevent passing on the strep bacteria to the baby. I think this is quite common. What would a midwife recommend in this case? Would the group b strep even be identified in an exam? Thanks!

    posted by : strepbmom on 6/23/2008 at 3:10 PM Flag For Abuse

14. straightupmom - I am entitled to my opinion and have presented it here without being nasty. I'm sorry it didn't give you much to work with, but that's okay, I don't mind.
    
    To your points: saying some people with medical degrees are lousy providers of medical care doesn't support choosing to avoid hospitals during birth. Some lawyers are crooked, some mechanics, some bankers, some teachers...but we don't avoid all of them now do we? And we don't just lump them all into one broad category either. At least rational people don't.
    
    Midwives have the equivalent of a medical degree? That's quite a statement! According to what licensing agency? Come on. I'd like to see one pass the boards.
    
    By citing the Dutch statistic surely you're not implying that any increased maternal or fetal health is a direct result of more women giving birth at home with midwives are you? They have an entirely different (and superior) healthcare system from cradle to grave; where a woman gives birth could not possibly have such an effect. In fact, it's likely irrelvant.
    
    When you choose to not make use of solid, trusted and proven medical science and go it alone you are taking a risk that would be muted by being physically in a hospital. There is just no disputing this fact.
    
    Whether or not that is immoral or wrong I am not to decide. It would be for me and my wife.

    posted by : mrb on 6/23/2008 at 3:16 PM Flag For Abuse

15. I can't BELIEVE that midwife-assisted homebirths are illegal in Missouri. How barbaric! Statistics matter more than prejudice, and the fact is that homebirth is actually safer and much less likely to result in c-sections. Just because someone is wearing a white coat and there are lots of shiny machines beeping away in the background doesn't make that a safer choice for a normal pregnancy. Birth is treated abominably in this country (take it from someone who had an absolutely unneccesary c-section for her second after birthing the first naturally. A c-section is SO MUCH more horrible to recover from, also, by the way).

    posted by : Maverick on 6/23/2008 at 3:21 PM Flag For Abuse

16. So did the midwife administer antibiotics to prevent the baby from contracting an infection during the delivery? Very common these days. Oh but the birth plan is much more important than the health of the baby. The mothers feeling must come first. She can always have another baby. In the case of lots of bleeding, good luck making to the hospital. You and the baby are dead before you arrive. Stuck in the birth canal too long or cord compression causes brain damage. Ask my best friend, her healthy son has life long disabilities due to a lazy doctor who did not want to bother with a c-section. Or ask my neighbor who is raising her grandson after his healthy mother bled to death during his delivery at a mjor metropolitan hospital. You got lucky. In this day and age we consult medical staff to try to save lives. Childbirth and postpartum infection used to be the number one cause of death of women and their new babies. Looks like it is back in vogue.

    posted by : Sybil on 6/23/2008 at 3:49 PM Flag For Abuse

17. Comparing homebirth to drilling holes in the head? Give me a break! To say homebirth is about trading safety for a "warm, earthy feeling" is prejudiced and insulting - and in particular, clearly uninformed. Seriously, if you want to be able to discuss the issues involved, then do some research. You may still come out believing hospital birth is better (to each her own, I say), but you'd probably have more respect for the choices of other families.
    
    Hmm, and it looks like Sybil has provided some evidence about how *hospitals* are not safe for giving birth. :) Birth is risky, period.
    
    P.S. to GBS mom, there is something you can get - pronounced like "hippa cleanse" I'm not sure of the spelling, that is like a douche during labor to remove the GBS. Also helps in not getting all the problems related to overuse of antibiotics.

    posted by : CG on 6/23/2008 at 4:08 PM Flag For Abuse

18. Congratulations on your baby girl! Thank you for sharing your experience. It sounds like it worked out just the way you wanted.

    posted by : knittingzeal on 6/23/2008 at 4:17 PM Flag For Abuse

19. I, too, am sorry that you're getting so much negative feedback. While I had both of my kids drug-free in the hospital with a very supportive OB, I would LOVE to have a homebirth - especially a water birth. My husband, though, is an engineer and refuses to even entertain the possibility. Oh well, I did it my way, but in a location where he could feel comfortable and confident. It was a fair compromise, and good practice for all the compromises we have to come to as parents, together.
    
    My mom had me in the hospital, but my brother and sister at home. The medical model of childbirth is dangerous for mothers and babies. Everyone has this idea that nothing bad can happen in the hospital - but plenty of bad things happen in the hospital. In fact, sometimes babies are exposed to germs and diseases that they wouldn't be exposed to at home. Sometimes those babies get sick and die, but you don't hear people crying for a return to homebirth!
    
    Take a look at the infant and maternal mortality rates in the U.S. vs. other countries where homebirth is more accepted before you go judging a mom who chooses a homebirth. It can be done safely and successfully, and responsible parents choose this sort of experience every day. I applaud the author for not only taking charge of her own health, but also for writing such a lovely description of her experience. Good for you, Mom!

    posted by : aaustin on 6/23/2008 at 4:59 PM Flag For Abuse

20. I'm glad the at-home birth worked out for you. (I find it amazing that it is ILLEGAL in Missouri!) Just wanted to add that you *can* have a great birth experience with the RIGHT OB/GYN. I had to trade doctors a couple of times early in my pregnancy, and make kind of a stink about it in order to do it, but once I finally had the doctor I wanted (who had been highly recommended to me by my IVF doc), I wouldn't have traded her for gold. She was an angel, and extremely competent. Just want to say that the right doc is a great thing, but the wrong doc is, as you found, not so great. Just be pro-active and be willing to argue with your HMO or insurance co. to get the doc YOU want.

    posted by : Anon on 6/23/2008 at 5:41 PM Flag For Abuse

21. There is ample research to indicate that for the majority of births, that is to say normal-risk births, home birth not only poses no greater risk to mom or baby, but are often safer than hospital births. Those that think a home birth is irresponsible simply have not done their research. Since the empirical data indicates that home birth may indeed be the best option for many mothers, it is equally incorrect to say that homebirth does not make use of solid, trusted, and proven medical science. In fact, it is quite the opposite.
    
    I had an excellent midwife for my first pregnancy. I did have a hospital birth for my first child, but am planning a home birth for my second with the same midwife (legal in Washington state). I, much like the author, came to this decision after careful consideration and evaluation the current research. My midwife is also an ARNP. As such she is qualified to advise me on current medical practice and available empirical data for issues concerning pregnancy and childbirth. Having a midwife does not necessarily mean that traditional medicine is unavailable to the mother.

    posted by : Camille on 6/23/2008 at 5:57 PM Flag For Abuse

22. My birth philosophy is to have a healthy baby via minimizing risks. I labor in hospitals.
    
    "Alice" is a certified nutcase. Allowing pregnancy go postdates raises risks of stillbirth. Advising mother against flu shots raises risks of birth defects. "Alice" should not be taking women who are older or overweight because they are high risk. AAP advises against water birth because that, too, causes stillbirth. Homeopathic medicine is snake oil.
    
    Contrary to popular belief home birth, especially home birth with direct entry midwife (and that's what Madeline had, I'm sure) is unsafe. The incidents of neo-natal death increase at least 2-3 times over low-risk hospital births. An excellent analysis of newly released government data is here:
    http://homebirthdebate.blogspot.com/2008/05/new-national-statistics-homebirth.html

    posted by : An Island Mom on 6/23/2008 at 6:25 PM Flag For Abuse

23. I gave birth in the hospital and had a great OB along with a wonderful doula who is also an RN. My doula originally wanted to become a midwife, but changed her mind when she saw how wrong things can go during a home birth. That is not to say that things don't go wrong in the hospital too. But you have to admit that this article cites "hospital" as the answer to every possible serious complication. The thought of laboring for hours, and perhaps even birthing at home, but then winding up on an emergency ride to the hospital afterall is just too much for me. What if the baby were in distress and you had to call 911, wait for the ambulance to arrive, get assessed and loaded in, wind through traffic, rolled into the doors of the ER, and then FINALLY get the necessary treatments. That's a lot of time. My doula talked about how a midwife could be charged with manslaughter if the mother, child, or both were to die in this kind of situation, she this helped her decide to become a maternity RN instead. Perhaps there is something wrong with the laws here, but perhaps not?
    
    I second the person who found the disposal of the placenta in the trash really questionable. It's a public health issue, and it was a pretty selfish way to get around the birth parents' squeamishness around disposing of the placenta per their midwife's instructions -- responsibly.

    posted by : Doula mom on 6/23/2008 at 7:01 PM Flag For Abuse

24. What if your baby had died as a result of the homebirth? Could have you forgiven yourself, knowing that if you'd made a different choice your baby might be alive?
    
    That is not meant to be a nasty question. I know real people it's happened to and they have to live with that decision every day.
    
    So many women have become so concerned with interventions and forget that women and babies used to die all the time. It's only because western medicine has made childbirth so safe that we now have the luxury to turn our backs on it.

    posted by : What if on 6/23/2008 at 8:50 PM Flag For Abuse

25. We throw pads filled with menstrual blood in the trash, don't we?
    A placenta is no more of a "public health issue" than that. It's just really weird, so it seems like it's got to be wrong. But menstrual blood, used condoms (!! now there's your health issue), rotten meat and God knows what else all go in the trash and it seems perfectly normal.

    posted by : CG on 6/23/2008 at 8:56 PM Flag For Abuse

26. Congratulations on the birth of your daughter! Sounds like it was a beautiful experience.

    posted by : ashers mom on 6/23/2008 at 9:26 PM Flag For Abuse

27. After trying to get a natural birth in the hospital three times I finally began researching home birth. What I found convinced me that home birth is as safe as hospital birth for low-risk women.
    
    I have had four homebirths, three were water births. The difference in the quality of the care I received really stands out. My midwives (different ones for different births) were great about telling me all the information I needed and letting me make my informed choice. How freeing after a doctor who only told me the information that would get me to do what he wanted (and I was assured by many that he was the best and most natural doc around) and who even bullied me when I dared to question whether I needed constant monitoring.
    
    When I went post-dates with doctor care I was told how it would be handled. When I went post-dates with midwifery care I was told what they usually do and my options were explained and asked what I wished to do. This difference was evident for just about every aspect of my care.
    And my midwives actually cared about me, talked to me AND wanted me to talk to them and ask questions. That was refreshing, no more needing to tackle the dr on the way out the door to ask a question!
    
    I had 4 wonderful homebirths with 4 healthy babies. I am so happy I discovered this option and thankful for my midwives. While it's not illegal here, drs try to make life miserable for homebirth midwives, so I really appreciate their willingness to give so many of us homebirthers the safe births we desire.

    posted by : homebirthissafe on 6/23/2008 at 9:33 PM Flag For Abuse

28. Thank you Madeline for your personal experience on birthing your second daughter. You and your husband obviously thought long and hard about your choice and I'm happy to hear that all went well. Kudos to sticking to your instincts and not second guessing yourself.
    
    I'm sad to see how judgemental some posts are both towards midwives and the author. Personally, I feel like the more experiences people (on both sides of the issue) read about, the more informed we all are. If you don't want the *risks* of an at home birth, then by all means don't do it. Thats a wonderful thing about this country: we have CHOICES.
    
    All birthing options work well in theory, but we all can appreciate that sometimes things go wrong. Shouldn't it be up to the mother to make an informed decision as to what the next steps should be? That is, assuming that the mother is given or knows about the options? And quite honestly, I am not likely to take advice from a non-medically trained man about how I should deliver my baby.
    
    CG is so right about the placenta in the trash. People throw away a lot of bloody stuff into the garbage (bandages, kleenex from a bloody nose, the liner from meat packages) and don't think twice. The author put thought into how to dispose of the placenta and was left with no other option thanks to the state (and a dog). Not everyone can afford a home with a backyard and not everyone has access to biohazzard disposal.

    posted by : KS on 6/23/2008 at 10:07 PM Flag For Abuse

29. one point about the "safety" of hospital births (well, okay, a few points) - i've had five at hospitals. I've been yelled at, sworn at, touched in places i didn't want to be touched WHILE i said no, been called a liar (if she wanted to see the poopy diaper i could have got it out of the bassinette's garbage container - instead she noted that i lied on my chart bcz she didn't believe me). I've had doctors pull on the umbilical cord after i told them that it made me hemorrhage on my last two births. I've had doctors who would not leave the room to let me use the bedpan with a little privacy (after refusing to let me go to the bathroom - this with my fourth son and with me promising i "didn't need to push, just pee")
    
    On top of this, hospitals are filled with sick people - one friend came home with c. difficile, one of her babies caught RSV at the hospital - she was tied down with leg and arm straps and a big ol' search light like an 1950's twilight birth, one gave birth to her stillborn baby, alone, crying for help, while listening to nurses mock her pleas in the hallway. My sister shared a room with a woman whose baby was stolen from the hospital (while we were visiting my sister - my dh testified at the court case)
    
    Basically, going to a hospital means giving up your right to any human dignity. My last two births were unassisted home waterbirths - both babies were beautiful, fat and healthy, and the births themselves were stress free and i felt that my children were given a safer entry into the world because it wasn't happening at a hospital...
    
    i'm not saying every birth is that bad - i've had one great birth at a Catholic hospital, and one great birth with a midwife in a hospital - but you are trusting a whole raft of strangers with the one thing in the world that is most precious to you.

    posted by : mamazee73 on 6/23/2008 at 10:23 PM Flag For Abuse

30. The fetal heart monitor saved my baby's life. For the women brave enough - and LUCKY enough - to be in a position where homebirth is possible and safe, more power to you and your magical vaginas. Me, I want the room next to the OR.

    posted by : birthbycesarean on 6/23/2008 at 11:16 PM Flag For Abuse

31. There are plenty of good studies to show that planned home birth for low-risk mothers is as safe as or safer than giving birth in the hospital. Check the British Medical Journal for one of the best studies. I believe it was 2005. Most of the women in the world give birth outside of the hospital. The countries with the best maternal and infant mortality rates utilize midwives more and often have a larger percentage of their babies born at home.
    
    Somehow, the human race survived prior to the advent of maternity wards.
    
    Sometimes bad things happen. Simply spending millions of dollars, and giving birth in a hospital doesn't prevent bad things from happening. The United States spends more money on health care than any other country in the world, but our maternal and infant mortality statistics are near the bottom of the list of industrialized nations. In fact, the number of women in the US who die as a result of pregnancy or childbirth is rising. So clearly, hospitals and money alone are not the answer.
    
    Instead of crying wolf over the five percent of women in this country who have their babies at home, perhaps our energy would be better spent lowering the c-section rate, improving infant and maternal mortality rates, discovering the reason for and rectifiying racial disparities in these rates, and giving women both the right to choose where to birth and dignity and respect during the process.
    
    Rock on Madeline!

    posted by : stcelia on 6/23/2008 at 11:19 PM Flag For Abuse

32. I wish to God I had stayed home, and next time I will. I went in for a VBAc and my CN midwife was out of town and that left my husband and I to fight off an on-call who didn't know me. She made me stay on my back, refused to let me move to work through my contractions. Insisted I be given an IV that I didn't need until they finally got it in after sticking me for a whole hour. They scared me, made me terribly uncomfortable and made my labor stall, then told me the heart rate was dropping and kept strongly suggesting I got another c/s. I didn't need one until I got there and not letting me move most like caused the drop in heart rate... duh, laying on your back is the WORST position to labor in. I gave in and had another c/s that I didn't want or need and it was all because the doctor made it so I needed one.
    
    Next time I have a baby I will do it at home. I'll be VBA2C and I will not go to the hospital (which is 3 minutes away) unless there is an emergency. I know my facts and I wam ready. I'll have my current midwife ready to go in case of an emergency so I don't have to deal with snotty hospital staff, but I'm planning a homebirth!!
    
    Having a birth at home isn't irresponsible. Currently in the US, most women are being subjected to sub-par care, but are blind to that fact because we've been told that the hospital is safer. What about epidurals possibly causing long-term effects or not working? Do doctors tell you that? What about making you lay on your backs to push? Doesn't it make more sense to be up and moving to help the baby down? What about being numb so you can't feel when to push, thus needing an episiotomy? What about inducing with Pitocin which cause stress on the baby? What about all of the evidence that shows that women being given gentle support during labor without being managed, being able to move and eat and drink during labor, in most cases provides a better outcome for moms and babies? It's out there, folks, but we aren't being told that.
    
    Bad things happen everywhere, even in hospitals with all-mighty doctors (hell, they cause the problem most of the time). THe point is/should be that good care should be done ANYWHERE! We should demand it. ANd we're not currently getting good maternity care in the US. Period.

    posted by : unnecesarean2 on 6/24/2008 at 1:45 AM Flag For Abuse

33. First: thank you for sharing the story and congratulations on your beautiful baby.
    
    Mom2Two is right, though--anyone who writes on babble invites and expects opinions to be shared. Personally, I think it's shocking and terrible that home births are illegal; however that unfortunate reality alone would cause me to opt for a hospital birth in that state. It seems to me that there would be too little oversight/regulation of midwives and too great an opportunity for malpractice. I'm not saying that home births are not a safe option generally (though I have not done any research and was happy with my hospital birth experience). But what recourse would you have if, God forbid, something went wrong? It seems like the midwife (who could go to jail) may have a vested interest in keeping you at home and away from the hospital.
    
    I don't know, the bottom line to me is indeed that you can't "control" birth, and in the end the most important outcome is a healthy baby and mom. If it were me, I think that I would have felt that the risks in this situation outweighed any benefit.

    posted by : kellyanne on 6/24/2008 at 10:42 AM Flag For Abuse

34. Home birth may not be a wholly dangerous choice, but it is more dangerous than having birth in a hospital. There is simply no disputing this with a shred of intelligence.
    
    Let's look at the claims about hospitals peppered through the pro-home birth posts:
    
    People get sick in hospitals. That's true; some people do get sick in hospitals. Hundreds of millions of American patients enter and leave hospitals without getting sick each and every year. In fact, most of them actually leave healthier than when they entered. You don’t count the 98% of people who DON’T get sick in a hospital? That makes it very convenient to overlook the 98% of babies born in hospitals who go home with mommie happy and healthy. Learn what statistics mean if you’re going to cite them.
    
    Doctors are rude. So are people of every single other profession, including your Exalted Midwives. Do we stop interacting with an entire profession because some are rude or nasty? Good lord.
    
    The infant mortality rates are better in some countries where home birth is more prevalent. I await the data showing that this correlation effect is in fact a causation effect. Otherwise, hush, you have nothing but coincidence which is utterly worthless. Again, learn statistics.
    
    Midwives are medically trained. A CNM? A DEM? It's no surprise that I had to look both of these up even though I have worked in the medical field for over ten years. They're not doctors. They have not spent eight years (or more for high risk OBs) in school/training. No comparison whatsoever.
    
    Mothers have been giving birth without medical intervention for centuries. That's true. Let's go back to those halcyon days when, what, 50% of the babies and/or mothers survived. Those really were good times. And mamazee73...you chose to give birth UNASSISTED...twice? I truly think you take the prize for Bad Parent, surely more than Pot Mom and Daddy's Drawer (Pot) Daddy. Outrageous.
    
    I couldn't do it "my" way in the hospital. Perhaps this is just my totally wacko personal opinion, but birth SHOULD be about the safety of the mother and baby, shouldn't it? Not about making sure your personal relationship with the person who delivers it gives you all the warm fuzzy feelings you need. That's selfish. It's about doing everything you can as parents to minimize every single risk that you can. So you have to pee in a bedpan while there are others in the room. So what, get over it.
    
    Put your babies first. They won’t remember it whether you have scented oils, candles, incense and some midwife chanting or beeping fetal heart monitors and nurses and doctors dressed in scrubs. But they’ll sure be reminded of their parents’ choice to forgo generations of medical advancement if something goes wrong in the bathroom. I simply can’t believe anyone would take such an unnecessary and irresponsible risk with their and their child’s life.

    posted by : mrb on 6/24/2008 at 12:10 PM Flag For Abuse

35. mrb - simply for the fact that you are so extremely argumentative and i'm intrigued by your attitude and the way your mind works, (but disgusted by the hateful tone you use) can you debate the issue brought up about the dangers a mother and baby are subject to by submitting to things like epidurals, episiotomies, fetal monitoring etc. that a lot of educated mothers chose to forego for the SAFETY of their babies and the outcome of the birth? i just want to hear what you think. please keep it cival. you can refute statments without being mean. "scented oils, candles, incense and some midwife chanting..." not at all what i experienced with my home birth and awfully steriotypical for you to say... if my highly qualified midwife read that i wonder if she would be offended...?
    
    mdmamma- thank you for the informative information! it was nice to hear your perspective!

    posted by : ruthr on 6/24/2008 at 12:29 PM Flag For Abuse

36. ruthr--I apologize for the scented oil comment which was stereotypical and rude, but honestly, the rest of my posts have not been hateful in any way and they have relied on facts. I'm sorry you take my differing (and heavily mainstream I might add) opinion as hateful, but that's got nothing to do with me or how my mind works. Frankly, if your midwife is offended by my comment I would understand, but if she is offended by a discussion of whether or not there are more risks giving birth at home than in a 1st world hospital then she is, I'm sorry, a fool, and trusting a person like that with the birth of a child is outrageous.
    
    I did debate the issue of risks attendant with hospital in the very post to which you refer. But I'll try to illuminate the overriding theme again.
    
    It seems to me that you and others here are comfortable with saying sometimes moms and babies get hurt, sick, die during a hospital birth, therefore hospital births are unsafe and giving birth in a hospital should be avoided.
    
    That is no different than saying kids sometimes fall off jungle gyms (or big wheels, or bikes, or tire swings, or...) and break bones, therefore they are unsafe and should all be removed from playgrounds.
    
    My point, again, is that you are IGNORING the fact that millions of mothers give birth around the world in hospitals every month with NO ill effects and risks muted effectively. Instead you rely on the outliers to support your point and that does not hold water in the slightest.
    
    Not in the birth at home debate and not with jungle gyms either. I could cite a hundred examples of this mentality if you wish. But you might call me mean again! I'm sorry, I'm not trying to be, but I am sure not sorry for exposing the myth of safety giving birth at home versus in a healthcare setting.

    posted by : mrb on 6/24/2008 at 1:42 PM Flag For Abuse

37. Ugh, this argument is so familiar. It's too bad. There are reasons why home birth can be NOT SAFE. And there are reasons why hospital birth can be NOT SAFE. Or on a more positive note: both places are safe depending on the situation.
    
    If hospitals made changes to their policies and there were more birth centers available to women who want to have a reasonable shot at having a normal birth, these flaming debates wouldn't be so necessary.
    
    It seems really important that we all stop attacking one another because the fact is when home birthers make hospital birthers feel like shit, they just get defensive and hurt. And when home birthers are made to feel like freaks they lash out, too. It's really horrible b/c we all want to be informed and taken care of. And hospitals NEED TO BE BETTER. There is a genuine crisis in maternity care in America and if everyone is so hell bent on winning this argument (which is un-winable b/c "safest" depends on SO MANY variables), we'll never get anywhere. Likewise, if home birthers think that by opting out, the problem has been solved they're wrong,too. So MOM AND DAD PLEASE STOP FIGHTING.
    
    A lot of the debate points can be explained by the simple words "it depends."
    
    lt would be beneficial to everyone if women had more of a choice *in the hospital* about how to give birth. Doctors aren't evil, they just have to pay so damn much for insurance they can't afford to support every laboring woman from start to finish. And without that kind of support how the hell are you supposed to go without drugs. The technical birth has taken over where doctors and midwives used to be. And that isn't great for women-- it just isn't!
    
    So everyone, please, whatever side you're on can you try to crack open your mind for a second? WE NEED TO CHANGE THE SYSTEM.

    posted by : straightupmom on 6/24/2008 at 3:09 PM Flag For Abuse

38. agreed with straightupmom that we need to change the system, but let's not forget here that for women living in 1st and 2nd world countries giving birth in a hospital is the NORM. it's home birth that is the exception to the rule. "hospital birthers" have nothing to defend, the onus is on home birthers to defend their choices by convincing the "rest" of us that for some reason it's safer away from a team of doctors and medical, life-saving devices.

    posted by : comeon on 6/24/2008 at 3:28 PM Flag For Abuse

39. Where I live in Canada all costs related to midwife assisted home births are fully covered by the government - I can't believe it's actually illegal anywhere in the United States...THAT seems like something out of the dark ages to me...

    posted by : Don Mills Diva on 6/24/2008 at 3:59 PM Flag For Abuse

40. I switched from a practice of OBs & Midwives to a practice of one OB & 2 midwives 6 weeks before my second daughter was due. I talked to doulas and childbirth educators to get the real scoop on which midwife to see. I had a wonderful un-medicated birth in a hospital about an hour and a half after I got there. I wish more women knew how nice it can be to birth with midwives whether you choose to do it at home or in a hospital.
    
    Homebirth is legal in Virginia now, but it is hard to find a midwife (either CNM or LM) who has a back-up doctor in my area.
    
    Thanks for sharing.
    
    Amy
    Mom to 3
    www.sofiabean.com

    posted by : Amy at Sofia Bean on 6/24/2008 at 4:10 PM Flag For Abuse

41. I think it's easy to assume that being close to an OR in a hospital sounds safer, simply because it's what we are used to.
    
    As I posted before, I am a student in a typical allopathic medical school in my clinical years. As long as I continued to be a low-risk pregnancy (as screened and monitored by my trained midwife), giving birth at home allowed my to adhere most closely to the recommendations of the Cochrane Database, totally state-of-the-art.
    
    As other posters have mentioned, there are risks inherent to birth. There are particular risks which can best be addressed by being in a hospital, but there are added risks which occur as a result of being in a hospital - the balance will tip depending on the individual patient and her health history, and the local hospital environment.
    
    When I started my obstetrics clinical rotation, the OB's giving the introductory lecture made it explicitly clear that many hospital practices do not increase patient safety. Fetal heart monitors, specifically, have done nothing to decrease morbidity/mortality, clearly increase the rate of cesarean delivery with all its attendant comorbidities, and are followed to appease the insurance companies. While in the mornings they showed us powerpoints discussing how moving around during labor and use of positions such as delivering on all fours helps to avoid the need for drugs (which carry their own risks and side effects) or cesarean delivery, in the afternoons and overnights we would see birth after birth with the mother flat on her back, constrained by the iv and monitor lines.
    
    When I moved along to pediatrics and we had the breastfeeding module, the professors taught us that in our modern hospitals, nursing was initiated immediately with skin-to-skin contact after the birth, to take advantage of the freebie let-down caused by the labor hormones. The medical students corrected the professors. Only three of us had ever seen a baby put skin-to-skin. Many of us had seen nurses delaying that first contact to get their birth paperwork finished up and the bed linens changed so they could leave the room and move onto their next patient. The professors were chagrined.
    
    It's not that the hospital staff were rude or willfully contradicting the latest research in safest birthing practices and best support of the mother-baby dyad. They were covering multiple rooms, overworked. A few times as I stood between a woman's legs, gowned and masked, elbow to elbow with the obstetrician, waiting for the final push to catch a new baby. "Do you know the mother's name?" the Dr would asked me. How is that in her best interest? I want my birth attendant to know my name, my allergies, my physical capacity, my flexibility and strength, and what language works for me when encouraging me to labor effectively.
    
    Birthing at home, I had the constant attention that has been statistically proven to reduce the length of active labor, thus reducing my risk of pelvic floor damage. I was able to move freely and even turn during the second stage of labor to allow my daughter to slip out more easily. I was able to initiate nursing immediately. And all that without being exposed to the bacterial flora of the hospital environment. All of these are issues I researched in the medical databases.
    
    My midwife carried the same emergency drugs that are stocked in a hospital delivery room. If I had needed to go to an OR for a cesarean - I happen to know that hospitals push to get their OR prep time down to 30 minutes for a Code White - which they could certainly do while I'm en route, need be.
    
    My point is that while the "norm" (hospital birth) often seems safer because it's familiar, it isn't all that cut and dried. It really depends on the personal history of the woman, and the home and hospital environments available to her.

    posted by : mdmama on 6/24/2008 at 5:42 PM Flag For Abuse

42. mrb - 1 in 7 American babies are delivered by either a CNM or a DEM. I dunno what part of the medical field you are working in, perhaps dentistry?

    posted by : yeah on 6/24/2008 at 5:44 PM Flag For Abuse

43. way to go mdmama! thank you for taking the time to chime in.

    posted by : straightupmom on 6/24/2008 at 6:35 PM Flag For Abuse

44. I am with the skeptics. Here the statistic that people forget: human births are extremely dangerous compared with the birthing process for most any other mammal. The reason for this is that during the last several million years our brains have gotten much larger, causing us to need to have our babies earlier in a more vulnerable state.
    
    Because we have such massive brained babies compared to other mammals, childbirth is one of the most dangerous things we do as humans. Have you looked up the statistics of how often mothers and babies died in childbirth prior to modern medicine? Do you remember how common the phrase "died in childbirth" was in old novels and historic accounts? Do you know how common it used to be for babies to die in childbirth? My mother's brother died in childbirth, and at that time (in the 40s) it was far more common than it is today.
    
    What we are dealing with here, is what is called the "naturalistic fallacy," the misconception that all things natural are better than all things unnatural. This turns out not to be true. Naturally grown mushrooms will kill you if you eat them. Infanticide and rape are naturally occurring events among non-human animals. And children and mother's naturally die at an unacceptably high rate during natural childbirth.

    posted by : skepticalpopa on 6/24/2008 at 7:01 PM Flag For Abuse

45. s'popa, this is exactly why it's important to distinguish between birthing unexpectedly on the side of the road, or on the African savannah, or in a high school bathroom, and birthing at home with proper preparation under the care and direction of a trained midwife. We had chux pads and sterile gloves and a doppler heartbeat and a Rhogam shot at my homebirth.
    
    Too many studies lump all non-hospital births together to compare them to all hospital births. The key to safe homebirth as practiced across Europe is being under the care of a trained professional.

    posted by : mdmama on 6/24/2008 at 7:47 PM Flag For Abuse

46. I just want to thank mdmama for helping all who read the posts to be more informed/educated. I really really appreciate all of the facts and the time you've taken to share the details that matter!

    posted by : ruthr on 6/24/2008 at 11:08 PM Flag For Abuse

47. To me the problem with this topic, on both sides, is the tendency to make gross generalizations discounting either home birth or hospital birth based on individual negative experiences. I most respect the arguments that focus on the benefits of either home or hospital birth without seeking to show how superior their own choice is to the other, and how wicked the alternative is.
    
    I am more fearful of the absence of immediate medical support if needed than I am of the threat of perhaps nonessential medical intervention. It is very true that bad things can happen in hospitals, but that is also true of births that occur in the home. I think women should have both options and the freedom to choose what seems right for them, though I do feel that either way, the presence of a trained person to assist with the birth is the wise, responsible choice. When it comes to unassisted home births, I'll admit you've lost me :)
    
    I'm glad the author had such a positive experience with the choice she made.

    posted by : violetbeauregarde on 6/25/2008 at 12:44 AM Flag For Abuse

48. Congratulations on your home birth. I am glad it all worked out well.
    
    Due to the flawed AMA policy on VBA2C, I am tentatively planning a home birth for when I have my 3rd child in a few years. As long as I have a healthy, normal pregnancy that is.
    
    The misinformation and flawed medical opinions have really tainted the birth experience here in the United States. It's a shame -- home births ARE indeed a safe alternative IF you are having a normal, healthy, low-risk pregnancy.
    
    Here's to hoping that my next one is just that . . .

    posted by : 2C to HB on 6/25/2008 at 2:35 PM Flag For Abuse

49. Thanks for writing this Madelaine! It was nice to hear it from start to finish. As of yesterday, Midwives are legal here in Missouri. Finally.
    Just wish you were back here, it was park day today...
    Celina

    posted by : Celina on 6/25/2008 at 2:49 PM Flag For Abuse

50. some doctors can get in the way because they aren't trained to deal with normal births. OBs are surgeons whether you like it or not, so in the end, they'll be more incline to be hands on with a birth that may not need them. My birth didn't need them and the c/s resulted from them interferring. It does happen.
    
    But yes, women should be able to have quality care anywhere, whether it's in a hospital or at home. But assuming the hospital is safer isn't wise. In most normal, healthy pregnancies, there isn't much to do except watch and support a labor. That's it. But add the IVs, the monitors, the drugs (that may not be needed), not letting a woman move to make herself comfortable and move the baby down, not having continuous, kind care, constantly being probed and told you have to hurry up, then the labor is more likely to take a turn for the worse. It's proven.
    
    So, while I'm angry and hurt by my very recent hospital experience, I know that the goal isn't for all of us to become home birthers. It's to fix this broken system, so that OBs handle emergent cases and midwives handle normal cases. Where the hospital (if you choose it) is a calm place where you don't have to worry about being steamrolled into things you don't want, or need. And where home birthers aren't seen as crazy, and are treated well if something does go wrong (which happens in the hospital as well). Where the c/s rate isn't over 30% and climbing because it's easier (let's be honest here) to schedule it and be done with it even though it most times isn't needed (tisk, tisk, doctors for doing this and allowing it).
    
    Simply put, women and families need to take control of the care they're receiving and PAYING for. Demand better and if you can't get what you want/NEED in a hospital, then choose a home birth... but keep fighting to get quality care for all.

    posted by : unnecesarean2 on 6/25/2008 at 3:28 PM Flag For Abuse

51. Don't discount how many mothers request a c/s when you look at the 30% rate. C-Sections are very very popular here in New York city. I had a threatened placenta previa and a breech baby and thought I was on my way to the operating room, but the placenta sorted itself out as my stomach grew and the baby turned. I found out that I was in the clear for a vaginal delivery early in my third trimester and the sonogram technician said that placenta previa was a highly requested diagnosis here -- by women who are hoping for a c/s. There are lots of people are "too posh to push".
    
    My OB, and those of my friends, are not quick to perform an episiotomy or a c/s, and absolutely will not allow an elective c/s. My OB's practice does not do episiotomies, they allowed me to have a doula, and to call the shots from my hospital bed. I was asked whether or not I wanted an epidural, if I wanted to have the sac broken, etc. Full disclosure: I had an epidural and I still thank god for it, even though my labor and delivery were quick! Had I wanted to labor and birth naturally, I would have been allowed to be up and moving until the baby came. Many mothers labor up and down the hallways in the NYC hospital I used. They are free to shower, pace, sit on a yoga ball, and birth in whatever position they want -- assuming mother and baby are doing well.
    
    This catch is, in my opinion, you really need to have a doula in the hospital to assist with all of this. Even though I wanted the epidural, I had a wonderful doula there with me who helped me through labor and delivery. She was there as a support for me and my husband, but most importantly as a patient advocate just in case things got out of hand. My doula is an RN and she works at the hospital where I delivered. I essentially had a private nurse so I had a really great experience. Had I been laboring on my own with only my OB and an assigned nurse, I would have been fine, but it would have been a less pleasant experience.
    
    One thing I could have done without was the hospital stay. Yuck! I was able to leave a little over 24 hours after the birth because my baby and I were doing great and I begged my doctor to discharge me. That said, the short hospital stay was well worth it for me. I never would have been comfortable having my baby at home. Aside from the worry and possible dangers -- what a mess!

    posted by : doulamom on 6/25/2008 at 6:55 PM Flag For Abuse

52. 2C to HB -- Keep in mind that many hospitals refuse to do VBACs because there is a real risk of severe hemoraging, and they can't take the insurance claim risk if a patient has severe complications or dies. Only the best hospitals perform VBACs (vaginal births after cecareans). I wouldn't risk it.

    posted by : vbac_caution on 6/25/2008 at 7:59 PM Flag For Abuse

53. Anyone who makes a sweeping conclusion that home birth is unsafe by the mere fact that the birth is at home rather than at a hospital has not done the research. Period.
    
    This is the largest study to date on the matter:
    http://www.bmj.com/cgi/reprint/330/7505/1416
    
    The conclusion was that, among other things, home births for low-risk pregnancies that are attended by certified midwives in Canada and the United States, despite using far fewer interventions, are just as safe for the mother and child as hospital births. At the same time, risk of infection for both mother and child is decreased for home births.
    
    It should be easy to see why a woman with a low-risk pregnancy would want to have a home birth - it's just as safe, and she doesn't get unnecessarily poked and prodded and cut up, which can affect recovery times and therefore, for example, the efficacy of breastfeeding and the mother's overall satisfaction with her experience.
    
    With midwives, there is also the continuity of care - the woman knows who will be attending her labour - as well as postpartum follow-up that includes home visits. And they do not tinker with what doesn't need to be tinkered with.
    
    Of course, home birth is not for everyone. Labour should occur where the woman feels the most comfortable and secure. But for many, this is at home and not at a hospitable, and this is a very reasonable, educated decision. A woman shouldn’t be attacked for it out of sheer ignorance.

    posted by : chasing8 on 6/26/2008 at 10:01 AM Flag For Abuse

54. Some good points presented here, but not enough to sway this individual. If you ladies wish to endure perhaps the most dangerous event your bodies (and your babies' bodies) will go thru as female homo sapiens at home away from proven life-saving and life-extending medical technology then my best to you. I think it's outrageous and I assure you my wife and I would never make such a decision we feel is irresponsible and highly risky. In our opinion it's not the birth that is so memorable...it's everything that comes after it. Taking any chance on not getting to form those memories isn't one we would take for any reason.

    posted by : mrb on 6/26/2008 at 11:22 AM Flag For Abuse

55. Good news!
    Midwifery is now legal in Missouri. This just changed this past Tuesday.
    
    Here is a link:
    
    http://www.stltoday.com/stltoday/news/stories.nsf/missouristatenews/story/B016D84627AB294D8625747300125007?OpenDocument

    posted by : AMC on 6/26/2008 at 12:42 PM Flag For Abuse

56. Homebirth is a reasonably safe choice under certain circumstances:
    
    * Women are screened to ensure that only low risk women birth at home.
    * Birth attendants are adequately trained to manage labor complications and identify those that require hospital transport.
    * Birth attendants are integrated into the health system and have relationships with with doctors and hospitals so that emergency transfers can take place smoothly and quickly.
    * Hospitals are close enough that if transport is needed, it can take place quickly.
    
    The problem is these conditions do not exist in the U.S. It's pointless to look at the BMJ study or homebirth in the Netherlands, because those countries have a completely different healthcare climate.
    
    In Europe, women receive free prenatal care and are risked out of homebirth if they have a condition that makes them high risk; the birth attendants must meet national education and licensing guidelines, are part of the integrated health system and have hospital admitting privileges as well as working relationships with doctors; and Western European countries are generally much smaller and more urbanized than many parts of the U.S., so hospital transports can take place very quickly.
    
    In the U.S., particularly in states where midwives are illegal, you have no way of knowing if your care provider is adequately trained, knows how to spot birth complications and will quickly transport you in an emergency. Plus with our suburbs and highways, it can take a long time to get to the hospital. This is a huge problem because even very low risk pregnancies can have life-threatening complications such as hemorrhage and shoulder dystocia.
    
    The homebirthing medical student who has posted above is not representative of most women. Because of her education and training, she is able to evaluate the competence of her birth attendant plus she herself is able to identify many potential complications of birth and assess whether a transport is needed.
    
    As long as the U.S. does not have the conditions to support a safe homebirth, I don't think it's a good option for even low risk women. European homebirth is a whole other story and shouldn't be used as a justification to attempt a homebirth in the U.S.

    posted by : Alisa on 6/26/2008 at 1:02 PM Flag For Abuse

57. Alisa, the BMJ study is of births solely in the United States and Canada.
    
    And mrb, no matter how outrageous and risky home birth might seem to you, I don't see the point of repeatedly stressing opinions which cannot be backed up other than how you "feel" about it. It's fearmongering that spreads misinformation. You can keep repeating how irresponsible women are to choose home birth, but the data is not in your corner.

    posted by : chasing8 on 6/26/2008 at 2:12 PM Flag For Abuse

58. And as far as "proven life-saving" technology goes, iatrogenesis is the third leading cause of death in the United States. Granted, the technology is great, and sometimes we need it. But in some cases, especially where everything is fine, using it unnecessarily causes more difficulty.

    posted by : chasing8 on 6/26/2008 at 2:15 PM Flag For Abuse

59. No data? Just opinion?
    
    The WHO reported increased risk of perinatal mortality in home birth (in Europe no less, the land of milk and honey for home birthing if you believe the comments here).
    
    The US government has begun to collect data on homebirthing. For the most recent data available the government determined that homebirthing with a DEM is the most dangerous type of planned delivery possible.
    
    A very recent study published in the UK showed more than TWICE the rate of preventable neonatal death in home deliveries (after removing twins and breech births).
    
    Many studies have also reported that C-sections and episiotomies, use of forcepts, etc...were reduced in homebirths. That's great. BUT MORE TWO TIMES AS MANY BABIES ENDED UP DEAD. Real safe.
    
    I'm sorry, I am really not trying to be an ass, but if you can minimize risk to your health and the health of the baby you've been carrying around for almost a year then why wouldn't you? It's not as safe. Period.
    
    Caveat emptor, mommies to be.

    posted by : mrb on 6/26/2008 at 3:38 PM Flag For Abuse

60. chasing8- Don't worry. Reasonable, rational thinkers will not read what mrb says and make up their minds. mrb is simply likes to rant and rave and argue points without providing evidence, proof, or facts. some people just love to debate but are not good at it.

    posted by : ruthr on 6/26/2008 at 9:56 PM Flag For Abuse

61. ruthr...go check it out for yourself on the internet, that's where I and everyone else gets references and information. You, ma'am, have contributed NOTHING to this discussion except to trash me. Provide some facts of your own lady, and then come back and talk your big game. I love how all of a sudden it's a "rant" instead of just a different opinion. Actually, it's not opinion at all, it's fact. Having a baby at home exposes the mother and baby to more risk than having it in a medical facility. Only a complete idiot would argue otherwise. If you are so concerned about this, check it out, smarty. Instead of trashing other peoples' opinions, do some research for yourself doofus and lay off others.

    posted by : mrb on 6/27/2008 at 11:40 AM Flag For Abuse

62. mrb- could you please provide links to these very recent studies? i would be interested in reading them. there are lots of women who give birth at home and there are huge differences among them. for example, my husband's people give birth at home for religious reasons. their midwives do not have formal medical training, and they do NOT go to the hospital no matter how "risky" the situation. but many people i have known who have given birth at home have done so under the care of midwives who will only allow homebirth if the pregnancy is low risk. similarly, many women give birth at hospitals- some of these births are very high risk. so a study would need to compare low risk homebirths with low risk hospital births. twins and breech births are both high risk situations.

    posted by : magda on 6/27/2008 at 12:12 PM Flag For Abuse

63. British Medical Journal showing a doubling of the rate of preventable neonatal death: http://www.bmj.com/cgi/reprint/330/7505/1416
    
    This article also highlights some positives about home birth, but the statistic that MATTERS is the mortality rate. Babies were twice as likely to die. How is that not enough to convince? Wow.
    
    I know there are positives and for low-risk women you are probably not going to run into problems. But why take the risk at all? I just can't understand it. And I think it's a big enough deal to speak up about. Some people don't like that. Tough I guess...that's why we have these comment boards.

    posted by : mrb on 6/27/2008 at 12:23 PM Flag For Abuse

64. mrb- i am glad that you are speaking up about something you feel strongly about. but i had read the study that you linked to, and i must be missing the part where it says that babies were twice as likely to die. under "conclusions" the study says, "Planned homebirth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States." so, that sounds to me like the study is saying that homebirth and hospital birth are equally safe in low risk situation. but again, i may be missing something.

    posted by : magda on 6/27/2008 at 2:21 PM Flag For Abuse

65. A recent study in the British Medical Journal, "Outcomes of planned home births with certified professional midwives: large prospective study in North America" (Johnson & Daviss, June 2005), concluded that outcomes were similar and "medical intervention rates (such as epidural, episiotomy, forceps, ventouse, and caesarean section) were substantially lower than for low risk US women having hospital births", however, this study showed that homebirth had an excess rate of preventable neonatal death. For example, amongst the home birth women, 3.7% ended up having a caesarean section compared to 19% for the US as a whole (for a similar risk profile) [2000 data]. The intrapartum and neonatal mortality was 1.7 deaths per 1000 low risk intended home births after planned breeches and twins (not considered low risk) were excluded, almost twice that of the hospital group of 0.9 per 1000.[9]

    posted by : mrb on 6/27/2008 at 2:32 PM Flag For Abuse

66. vbac_caution, a vbac has only slightly more risk than a regular birth. Hospitals ban vbac because the ACOG told them too after the vbac push in the 80s. More problems were arising because of the active management of vbacs and because of the use of cytotex, which wasn't even OK'ed by the FDA to use to induce labor, but was used anyway, hence causing ruptures in vbac cases and many women and babies died. There is research out there that acknowledges that vbacs are better left alone to progress as they will, that's why most OBs don't induce vbacs, but they still can cause issues by not allowing movement, forcing epidurals, etc. Read "Born in the USA" by Marsden Wagner. I will be pursuing a vba2c at home as well in a few years.

    posted by : uneceserean2 on 6/27/2008 at 4:08 PM Flag For Abuse

67. It strikes me that there are a number of minor operations that usually go smoothly and sometimes develop complications that people could do at home if they wanted to. You could cast broken arms at home, remove pre-cancerous derm pigmentation ... heck you could probably have cavities filled at home if you really wanted to.
    
    But why do this when there are facilities that are set up specifically for the purpose of tending to these needs, that are prepared to handle any complications in the meantime?
    
    Here's the real question for me: is this for the baby or the mom? Is this part of some kind of throwback fantasy of giving birth in a meadow or something? Why not take it a step further and give birth in a canoe on a lake or on a mountain top?
    
    Frankly this seems rather sentimental and new-agey to me. I don't mean to criticize other people's decisions -- it's certainly a fine thing to do if the midwife is properly trained and you are close enough to a hospital. But it seems to me treating the birth of a human as a personal emotional or spiritual journey is confusing who this process is for.

    posted by : Idontgetit on 6/30/2008 at 10:05 AM Flag For Abuse

68. Idontgetit...of course you're right, but you won't find too much agreement with the obvious here!

    posted by : mrb on 6/30/2008 at 10:49 AM Flag For Abuse

69. This is also for the baby. At home, the baby can have immediate skin-to-skin contact with mom and breastfeed right away. Exams that force mom and baby to be seperated in a hospital in most cases, can be done while mom holds the baby. The umblical cord can be allowed to finish pulsing before being cut so the baby receives all of its blood back from the placenta. In a hospital, parents may have to fight for that. Women have more control over what happens to their bodies at home (as long as the pregnancy and labor are normal) so it creates a safer environment for women to relax to allow their bodies to work to push the baby out. Stress caused by being in a place where one feels unsafe, uncomfortable or unsupported can stall labor (this happened to me). Some parents don't want their babies to have certains procedures done. Rather than fighting off hospital staff, birthing at home makes it easier to just enjoy the baby.

    posted by : unneceserean2 on 6/30/2008 at 11:50 AM Flag For Abuse

70. "But it seems to me treating the birth of a human as a personal emotional or spiritual journey is confusing who this process is for."
    
    Isn't bringing a baby into the world a spiritual experience though? It's a wonderful thing... can't we all agree on that? So if being in a comfortable, yet safe setting, makes the process easier for some moms, who cares? I think the real issue isn't whether or not women should have babies at home. Of course, it should be an option under the right circumstances. But what about what hospitals and doctors are currently doing to women and families? Unnecessary procedures that endanger the mom and baby. Quality care should be the norm and currently, unfortunately, it isn't. Women are constantly told what they can and can't do for reasons that aren't backed by science or medicine. Births that should be normal are hindered and quickly become emergencies. Birth doesn't have to be that way. It doesn't have to be a terrifying, medicalized experience. If doctors and hospitals would provide better care for moms and babies, maybe there wouldn't be so many women choosing to stay at home.

    posted by : unneceserean2 on 6/30/2008 at 11:57 AM Flag For Abuse

71. I don't know what hospital experience other mothers are having, but my wife and I had a great experiences (two so far) at our hospital -- the doctors and nurses were very focused on encouraging mother/baby bonding, they encourage breast feeding as soon as possible, they discouraged circumcision calling it "unnecessary."
    
    My sense is that in the last decade hospitals have responded to the criticism that they were being inadequately deferential to the mother/baby experience. At least our hospital is (NYC Cornell). Efforts to make hospitals more sensitive to the preferences of the mom -- without risking the lives of either mother or baby -- make a lot of sense.
    
    If mrb's statistics are correct, however, and infant mortality among low risk pregnancies is twice as high at home, that is about as much information as I would think most mother's would need.

    posted by : Idontgetit on 6/30/2008 at 12:25 PM Flag For Abuse

72. unneceserean2--I can agree that bringing a baby into the world is a wonderful thing, but that's where my agreement with your last post ceases. Considering the United States enjoys the status of a population with a strongly increasing birth rate (one of few on the planet) and increasing life-expectancy your statements in this post are borderline outrageous. Virtually every single statement you make is a wild generalization based on......? You obviously had a lousy hospital experience and are just plain against it. That's fine, you can give birth whereever you want, but stick to the facts if you want credibility. Your individual and personal life experiences matter strongly to you, as they should, but they don't matter in the bigger picture if you look at real data. I wish you would back up your wild claims with meaningful data.
    
    As to your previous post, our son was placed upon my wife's naked chest within a minute or so and stayed there happily for quite awhile as he learned to nurse. I got to cut the cord! We felt safe, with friendly nurses the whole way through. When it was time to actually deliver a team of physicians came in quickly and ontime and professionally and carefully delivered our son. That's what I wanted...professionals who ONLY do this day in and day out. Safety first. Nothing else in terms of the "experience" even comes close in importance to that. But there I go again...that's my personal opinion about birthing. Silly me.
    
    All the best to you, I'm glad your babies are doing well. Done with this conversation.

    posted by : mrb on 6/30/2008 at 12:49 PM Flag For Abuse

73. I love this discussion and thanks everyone for writing in.
    I think the range of interest in how and where and among whom we birth goes directly to a larger point of the debate and something I'd argue for: there should be more options open to families for safe birth not fewer. (And there is real and clear, irrefutable and studied evidence that home birth for low-risk women who are attended by a trained and skilled midwife/doctor is, indeed, safe, no matter how questionable it may seem on the surface to some).
    One caveat to anybody attempting to go the home birth route -- it strikes me as imperative that you have a fully supportive birth partner. If the partner isn't on board and feels scared of out-of-hospital birth, that would seem to me to sink the whole enterprise. Which is why, mrb and idontgetit, it's a wonderful thing you and your wives have great hospital birth experiences and doctors and hospital staffs whom you like and trust (congratulations, truly). Home birth really wouldn't be a wise choice in your case. And that's very, very OK.

    posted by : Madeline Holler on 6/30/2008 at 1:15 PM Flag For Abuse

74. Thanks Madeline...I enjoyed your story even though I disagree with your choice. My apologies if I sounded mean-spirited at any point. The goal is healthy mom and baby ultimately, everyone agrees on that. Thanks for sharing your tale.

    posted by : mrb on 6/30/2008 at 2:16 PM Flag For Abuse

75. Virtually every single statement you make is a wild generalization based on......?
    
    Facts. Just too tired to find them and list them.
    
    Watch Businees of Being Born.
    Read anything by Ina May Gaskin.
    Read Born in the USA by Marsden Wagner.
    Read Pushed by Jennifer Block.
    Talk to a trained midwife.
    
    I had a terrible experience. There are many women out there who have... take a venture to the ICAN website. Read the birth stories online. It's not pretty. And I realize that not all women are having unsatisfactory experiences, but many are. Just because you felt things were fine at your hospital doesn't mean the same care is being given everywhere.
    
    mrb--you may be done with the conversation, but there's a birth movement that's going to keep it going and hopefully create change for the better.

    posted by : unneceserean2 on 6/30/2008 at 4:04 PM Flag For Abuse

76. Sorry, no time to read the several books you mentioned. I just wanted verifiable facts to back up your comments about the dangers of giving birth in a medical facility in the United States.
    
    I'm sure the birth movement will indeed continue. Hopefully those involved will put babies' safety at the forefront of the "movement", as it clearly should be.

    posted by : mrb on 6/30/2008 at 4:50 PM Flag For Abuse

77. Sigh. Well, when you have the chance, the resources I mentioned have the information, especially Born in the USA... for anyone interested. :)

    posted by : unneceserean2 on 6/30/2008 at 11:20 PM Flag For Abuse

78. Congratulations on your baby girl! I gave birth to my daughter 2 weeks ago today, at home (also illegally, in a different state), in probably the same brand of three ring fishie pool. It was the most beautiful experience of my life, and I have absolutely no doubt that she and I were both healthier and safer outside of a hospital. If others want to birth in hospital, that's certainly their choice. The key is choice.

    posted by : WednesdayMom on 7/1/2008 at 1:33 PM Flag For Abuse

79. Wow, I'm reading a lot of reactions based more on fear and ignorance than facts. Home birth, in most cases, is perfectly safe- how do you think most of the world, throughout most of human history, gets born? That said, doctors and hospitals have their place, and should be involved in high-risk births. Whether they should be involved in routine births should be up to the woman. Do some home births go badly? Yes. Do some hospital births go badly? Yes. Can anyone predict exactly what will happen at a particular birth? Heck no, so why the uproar of judgment and second-guessing?

    posted by : mrsberts on 7/1/2008 at 3:13 PM Flag For Abuse

80. mrsberts - "Can anyone predict exactly what will happen at a particular birth? Heck no, so why the uproar of judgement and second-guessing?"
    
    exactly, you can't predict what will happen when you give birth to your child. therefore of two options: home vs. hospital, choose the one where you have no support system or medical professional back-up...do it at home. After all, like you say, no one can predict exactly what will happen at a particular birth?
    
    just unbelievable. taking such a chance...it's sick.

    posted by : comeon on 7/1/2008 at 3:35 PM Flag For Abuse

81. Wow, Americans are weird.
    
    Here doctors have nothing to do with childbirth; it's all done by midwives. Caesareans only happen in absolute emergencies and are of course performed by a surgeon - the only time a doctor gets involved. You do not need a doctor in order to give birth any more than you need a doctor to help you conceive the child in the first place.

    posted by : Ghostlove on 7/1/2008 at 4:15 PM Flag For Abuse

82. Ghostlove, what a brilliant idea! We should have a doctor on hand for every biological function, in case it goes wrong. We'll be relieved that we've doctors on hand to keep us from blowing our brains out along with our noses, busting a gut when we use the toilet, and who knows what could happen if we're allowed to conceive at home without professional assistance. Sure, some free-wheeling risk takers think that they can do those things without extensive monitoring and pharmaceutical management, but we don't hold with those crunchy earth-mother notions. It's time for doctors to make house calls again- every house, every day.
    [/sarcasm]

    posted by : mrsberts on 7/1/2008 at 9:37 PM Flag For Abuse

83. Thank you, Ghostlove! In many countries, with BETTER mother/infant mortality rates than ours, midwives ARE the standard of care. Midwifery care is the recommended way to go, as far as WHO is concerned--NOT OB care, unless the pregnancy is high-risk. The USA's birth safety stats are near the bottom of all developed countries.
    
    Also, YAY!! for Missouri's Supreme Court for legalizing their midwives. I don't live in Missouri anymore, but had my little girl in a hospital in Jefferson City last year, instead of at home as planned, because I got into a car accident a month before she was due--on my way home from lobbying Missouri's legislature to change the law!
    
    I had a halfway decent hospital birth experience, but only managed a natural childbirth because I am a very stubborn person...and I was pretty sure they weren't going to actually force me to do anything with my husband right there. Since I had planned on a homebirth, and had had all my prenatal care with an illegal midwife (the only kind in MO then), I couldn't produce prenatal records or even tell the hospital my midwife's NAME, and, at 35 weeks hadn't yet had a Group B strep test, of course, so I let them give me the antibiotics during labor. Guess what? My baby ended up with a hospital-caught infection. Seems that, for every time that nurse goes to check your cervix, the risk of a hospital-caught infection increases by about 25%.
    
    We will have our 2nd baby in October, at home, barring any MORE unforseen circumstances. My current midwife, using the latest findings, recommends that women who use probiotics during pregnancy are less likely to test positive for GBS.
    
    To the person who thought not getting a flu shot during pregnancy was irresponsible--I would say that GETTING a flu shot during pregnancy is what is irresponsible! Thimerosal (which is a type of mercury, a neurotoxin which CAN cross to the developing fetus) has NOT been removed from flu shots.
    
    By the way, the homebirthdebate site is run by a person without a medical license & WITH an axe to grind. Read the actual FACTS and ignore "Dr." Amy & her twisting of them.

    posted by : heatherj on 7/1/2008 at 10:52 PM Flag For Abuse

84. "In Europe, women receive free prenatal care and are risked out of homebirth if they have a condition that makes them high risk; the birth attendants must meet national education and licensing guidelines, are part of the integrated health system and have hospital admitting privileges as well as working relationships with doctors; and Western European countries are generally much smaller and more urbanized than many parts of the U.S., so hospital transports can take place very quickly.
    
    In the U.S., particularly in states where midwives are illegal, you have no way of knowing if your care provider is adequately trained, knows how to spot birth complications and will quickly transport you in an emergency. Plus with our suburbs and highways, it can take a long time to get to the hospital. This is a huge problem because even very low risk pregnancies can have life-threatening complications such as hemorrhage and shoulder dystocia."
    
    These are reasons to expand and support homebirth here--NOT ban it. In an "illegal" state, it is still quite easy to check out your midwife's credentials and experience. Most are forthcoming about it, and the Certified Professional Midwife credential given by the private NARM is internationally recognized & is used as the standard by many states, including, as of last week, MO.
    
    Ever live in a very rural area? I have. Did during my last pregnancy, in fact. No hospital closer than 30 miles & that one not a place I would go to get a cut stitched, let alone give birth! Midwives are trained and equipped to deal with most emergencies, believe it or not. They are trained to deal with such things an shoulder dystocia or an unexpected breech birth. In fact, they are frequently BETTER equipped to do this than an OB, who is only trained to cope with such issues through major abdominal surgery. A woman who has quick labors is all too likely to not make it to the hospital if she's way out in the country--unless she can find a way to spend her last few weeks of pregnancy away from home to be near the hospital.
    
    Check history. Contrary to common propaganda, hospital births are not now & have never been safer than homebirths. The reductions in neonatal and maternal mortality have FAR more to do with better sanitation, proper use of soap and water, etc. than with any "magic" of doctors and hospitals, although they are, as usual, fine with taking credit that doesn't belong to them. What caused women to die of "childbed fever"? That was a catchall term for infections caught by a woman after a doctor (or midwife) stuck his unwashed, ungloved hands inside her--maybe right after using the bathroom.

    posted by : heatherj on 7/1/2008 at 11:18 PM Flag For Abuse

85. heatherj - hogwash. provide some facts to back up your wild claims.

    posted by : comeon on 7/2/2008 at 10:43 AM Flag For Abuse

86. Which claim is wild? That sanitation and hand washing have caused much greater elimination of disease of many sorts than any miracle of modern medicine? That's no "wild claim", it's just common sense--and medical history. Look it up yourself--I expect even Wikipedia will help you out. Unfortunately, medical personnel have a horrible tendency to forget this...which is why we have such things as MRSA epidemics in our hospitals STILL.
    
    Even now, iatrogenic (this means hospital caused) disease and medical error are LEADING causes of death in the USA. As someone else pointed out.
    
    Or is it the "wild claim" that a woman or baby might catch an infection because their caregiver stuck unwashed hands inside the lady? Remember, the notions of germs and handwashing didn't really catch on until AFTER 1900. At this time, a woman was much safer birthing at home than in the hospital, as the risk of infection was actually smaller at home. At least the doctor or midwife might have washed since the last patient. In hospitals of the time, doctors thought nothing of going from, say, the cholera ward to the labor ward without even LOOKING at soap and water on the way.
    
    The rest is mainly personal experience, but here's a few references, anyway:
    Cervical checks & infection (especially after the water breaks. In my case, the seat belt broke my water in the car accident):
    http://books.google.com/books?id=9vAIkXXaEREC&pg=PA16&lpg=PA16&dq=labor+cervical+checks+infection&source=web&ots=HxhvjpL3Tk&sig=2jnlZVR3ENt1NbKuOGtFV42xrq4&hl=en&sa=X&oi=book_result&resnum=8&ct=result
    http://books.google.com/books?id=7e5-npisacsC&pg=PA71&lpg=PA71&dq=labor+cervical+checks+infection&source=web&ots=rfzR2DXaYd&sig=2GrhOit7apkEMptVz7u7RjOS3lA&hl=en&sa=X&oi=book_result&resnum=3&ct=result#PPA71,M1
    
    Here is the organization that licenses Certified Professional Midwives--the standard used in many states, if you want to check their expectations for midwife training:
    http://www.narm.org/
    
    And a couple of bits of medical history:
    http://en.wikipedia.org/wiki/History_of_medicine (scroll down to "modern medicine")
    http://www.collegeofmidwives.org/safety_issues01/rosenbl1.htm
    
    As to flu shots still containing thimerosal, look it up for yourself, or even ask your doctor. It's readily available information. As to thimerosal being a hazard, well, they took it out of contact lens solutions back in the late '80's (I don't have a link--this is memory, as I wear contacts, & all the solutions were suddenly advertising being thimerosal-free at the time). I'm supposed to allow a substance that it is not safe to put in my eye be injected into my bloodstream (or my child's)? NOT!

    posted by : heatherj on 7/3/2008 at 12:45 AM Flag For Abuse

87. Much of what you cite is true to my knowledge, but does not change the fact that proceeding with the riskiest human behavior (birth) at home instead of in a healthcare facility is utter folly. Do so at your own risk. Shameful.

    posted by : comeon on 7/7/2008 at 10:55 AM Flag For Abuse

88. Heatherj, if God Herself came down and said "Home birth is safe as houses, so don't sweat it unless I tell you otherwise", comeon would still insist that it's too risky to contemplate. Perhaps comeon permanently resides in a hospital- either way, it's pointless to continue to present facts or reason.

    posted by : mrsberts on 7/10/2008 at 12:16 AM Flag For Abuse

89. As a nurse with reasearch training (and incidentally a homebirth mother), I feel the need to point out that the quote mrb provided above (I have coppied it below), does not actually appear to come from the BMJ article uder discussion Johnson & Daviss, June 2005. I have the article in front of me and have re-read it carefully. A few obvious clues: the article does not contain the word twice or the word excess (as in excess rate, which would have been used precisely as it is an epidemiologic and statistical statement). Also the statement of "1.7 deaths per 1000 low risk intended home births after planned breeches and twins (not considered low risk) were excluded, almost twice that of the hospital group of 0.9 per 1000.[9]" makes no sense as the study did not have a hospital group, but rather compared its results to a range of results from other studies of low risk hospital and out of hospital birth. As is typical, the studes used varying methodologies and also varried in whether they reported intrapartum or neonatal mortality. The rates reported for intrapartum mortality only ranged from 0.6-3.5/1000 for midwife attended out of hospital births and 1.0-1.9/1000 for hospital births attended by physiciansv The hospital range widens a bit if you include studies that measure neonatal rater than intrapartum mortality (0.5-3.4/1000). In this context Johnson & Daviss' rate of 1.7 is indeed comprable. Statistical comparisons between these rates can only be made in a competent meta analysis. It really sounds like mrb was quoting from the lit review in annother paper or article that may have been combining studies.
    
    A recent study in the British Medical Journal, "Outcomes of planned home births with certified professional midwives: large prospective study in North America" (Johnson & Daviss, June 2005), concluded that outcomes were similar and "medical intervention rates (such as epidural, episiotomy, forceps, ventouse, and caesarean section) were substantially lower than for low risk US women having hospital births", however, this study showed that homebirth had an excess rate of preventable neonatal death. For example, amongst the home birth women, 3.7% ended up having a caesarean section compared to 19% for the US as a whole (for a similar risk profile) [2000 data]. The intrapartum and neonatal mortality was 1.7 deaths per 1000 low risk intended home births after planned breeches and twins (not considered low risk) were excluded, almost twice that of the hospital group of 0.9 per 1000.[9]

    posted by : al on 7/14/2008 at 9:54 PM Flag For Abuse

90. I loved this story! Thank you Madeline for making me NOT want to choose a hospital! I am due in 4 wks (if all goes well) and I love reading why other moms or moms to be choose to have a birth at home! and how brave you are, living in a state that is illegal to give birth at home!
    I would have chosen the same path...
    Congratulations on your birth and your birth experience! I'm sure it was rewarding!

    posted by : nenet509 on 7/17/2008 at 11:10 AM Flag For Abuse

91. I might have made the same ignorant and judgemental comments that so many others are making had I not watched "The Business of Being Born" last night. It really opened my eyes to the whole world of childbirth outside of a hospital. I was totally ignorant and personally thought it was for crazy, irresponsible people as well. I'm happy to say that I was completely mistaken. There are many great reasons to choose homebirth and I'm glad I've learned more about it. Please watch the documentary. And to the author, I'm so glad everything worked out well for you. You can bet that you would have been induced and there is a very good chance you would have had an episiotomy had you stayed with your OB. Good for you for sticking to your guns!

    posted by : oak on 7/18/2008 at 10:01 PM Flag For Abuse

92. Madeline, thank you for writing one of the best birth stories I have read in a long time.
    
    Congrats, Missouri, on the Supreme Court midwife ruling! 25 years was a long "gestation," eh?
    
    I left the medicalized model of care and went "off grid" with my first pregnancy. I did some snooping and discovered the hospital c-section rate was 50% and my OB's personal episiotomy rate 80%. So I'm thinking, what is this--half of women there can't give birth except surgically, and only 2 in 10 can trust their perineums to stretch enough? I knew there was something deeply wrong about those figures. My OB was elderly with shaking hands who alternated between boredom and irritation about my desire for no episiotomy or epidural. He informed me the first day I saw him that he probably would not be present for the birth, and likely a medical student would handle it. He made sure I understood I would likely be cared for by strangers who could care less if I did not want an episiotomy or an epidural. I felt like I was getting on a factory assembly line instead of being treated like a human being. And paying for the "privilege."
    
    I dropped him 4 months into my pregnancy. My husband and I read up on birth complications, and kept prenatal appointments with a midwife who was very knowledgeable and experienced and not too "out there". Our state, like most states and unlike Missouri, did not punish women for giving birth at home. We had a beautiful boy, after a 43-week pregnancy and an 11-hour labor. (We had an ultrasound and tests the day before he was born and made sure all was well. Most overdue pregnancies turn out just fine.) I had the freedom to move around, without medical employees at the ready with their needles and scalpels. Taking of heart tones or other needful things were done in a way that did not throw off the "birthing groove". Everything was so calm. I birthed the way it felt best, standing up. The pain wasn't a distressing, "something's wrong" kind of pain, but the normal pain of my laboring body at work, and me working through it and with it. I learned firsthand my body produces its own painkillers, such as endorphins. It wasn't unmanageable at all, but an empowering experience. I needed no episiotomy or epidural and had an almost 8-pound first baby with no tearing. I was hooked in a big way. I went on to have six more home births, all of them amazing experiences and totally normal.
    
    People tell me when they learn I had all our children at home, that they think I'm so brave. I tell them I think people who have their babies in the hospital are brave! The statistics I found on overly-medicalized normal births in US hospitals scared me into home birth. Over the years, I have found many studies which show that a woman having a normal birth is more likely to have a complication caused by the hospital, and then be "rescued" from the problem the hospital caused in the first place. The hospitals are under pressure to make unnecessary interventions to protect them from lawsuits. I do feel for my friends & relatives who are doctors and nurses. Unfortunately, the medical community so often has its hands tied by the insurance companies and lawyers. For the small percentage who need it, there is a place for high-tech, high-intervention care, as long as it is done in the patient's best interest, and not out of fear of litigation or insurance concerns. I do respect that some emergencies are better for the hospital to handle. We were always ready to transport, should I have had a prolapsed cord, hemorrhage, etc. For a normal pregnancy, I believe the 5% risk of having a complication at home to be the better risk *for me* than the larger risk of having problems caused by the hospital. Every woman must make her own choice.
    
    Born in the USA, by Marsden Wagner, former chief OB for the World Health Organization, is a recommended must-read for fact freaks like me considering the risks of home birth vs. hospital. Also recommended is Pushed, by Jennifer Block.

    posted by : Cat2008 on 8/13/2008 at 2:30 PM Flag For Abuse

93. Wow, I'm amazed at how freaked out some people are at the thought of a homebirth. First and foremost, congrats on your happy and healthy day!
    
    I'm due in February with my first. and for the record, the thought of homebirth gives me the willies. childbirth is scary, and the thought of having to find a taxi if anything goes wrong -- i live in new york city -- just doesn't work for me.
    
    but no one can deny that there is some bad, bad hospital care out there. over and over in these comments, what i'm hearing isn't that people particularly want a homebirth, per se: what they want is to have some input. to be able to be in a position other than flat on your back. to not have pitocin or other drugs just because you're laboring at a rate slower than the hospital's accountants would like. to not have episiotomies or c-cections just because some anxious, inexperienced, overworked resident gets a little scared. and having your baby taken away so that nurses can finish some paperwork 90 seconds after birth is just wrong.
    
    i feel incredibly thankful to have the options that I do. i'm having my baby in a birthing center that's within a hospital, so that if anything goes wrong i'm a short elevator ride away from increased medical care. and i'm being co-managed by a midwife and an OB, so that if i do become high-risk it's under control.
    
    all i can hope is that everyone else in the US eventually has the same kind of options. in the meantime, let's try to assume that we all have the same goals -- healthy, safe childbirth for both baby and mom.

    posted by : NY Pearl on 8/18/2008 at 3:32 PM Flag For Abuse

94. Reading your post made me realize how lucky I was to have the midwife and the birthing center that I had 5 minutes from my home. I had a very satisfying experience all throughout my pregnancy and I had an all natural water birth. I was planning on a fully medicated birth, because I was afraid of how it was going to hurt, but when the moment came, I was just one of those people who didn't hurt as much (it still hurt though, but not as bad as other people) and I didn't need the medication. I had no tears from the birth and I shudder to think how painful the recovery process would've been if they gave me an episiotomy just as a routine. Having all these options and support from the staff was very helpful. I wish more doctors/midwives and birthing centers are like this. I now moved to a different city and when I get pregnant again, I will look for a place that has the water birth option.

    posted by : KY on 11/14/2008 at 3:03 PM Flag For Abuse

95. sounds like it worked out perfect, just one question.... at that point after not seeing a "regular obgyn", not delivering in a hospital, and not being able to realy admit openly you did a of this "illegally" how do you get the child put into the system for medical care and schooling?

    posted by : Lindsey_RCM on 11/20/2008 at 10:56 PM Flag For Abuse

96. It's not that hard to get a kid into the system for medical care and schooling- you fill out the forms to certify that the birth took place within the time limits for your state, apply for a SSN, and health care depends upon insurance requirements- but I've never heard of insurance being denied to a kid that was born outside of a hospital- or else what would they do about all the kids whose non-hospital births are unplanned?

    posted by : mrsberts on 12/1/2008 at 5:46 PM Flag For Abuse

97. People are bizarrely insistent on the benefits of the health care system! I work within it, and believe me, it is seriously flawed. When I worked on a maternity unit we used to joke about how there were hardly ever any cesarians on the weekends because the doctors were out playing golf. Goes to show how emergent all those c sections are.
    Anyway, thanks for sharing this wonderful account of your experience. I don't have any children yet, but when I do I'm planning on having a home birth if possible.

    posted by : LC on 12/8/2008 at 12:53 AM Flag For Abuse

98. Bizarrely insistent is an understatement. I, too, work in the healthcare field - for a hospital no less - and delivered 4 children within the walls of a hospital. Never again, though, after my last delivery; my OB/GYN was the one suggesting home birth as a possibility - and I am high risk with a seizure disorder (not on medications), syringomyelia, and multiple sclerosis. Why? After noticing bleeding in my 7th month, DH rushed me to the hospital (the one I work for and the one my OB practices from), where I was thoroughly excoriated for not calling my OB first to see if that was "okay" for me to come to the unit (mind you, these are my COWORKERS, and I was bleeding PROFUSELY). After 2 hours of monitoring during which I was coughing horrendously (whooping cough, and the cause of my premature labor), denied cough syrup or even some ice chips, I was informed by Nurse Stupid that I would be going home since my contractions had stopped. Ummmm, no, they had not and were, in fact, becoming more intense. But I must be mistaken, retorts Nurse Stupid. Well, this is only my FOURTH delivery, so I guess I don't know my body at all, do I? There's no need to be sarcastic, honey, (calling patients honey and sweetie is clearly written in the "rules" as a no-no, but I guess rules don't matter much to The Stupid Family), Nurse Stupid turning and walking back to the nurses' station. About 3-1/2 minutes later, in a violent coughing attack, I proceeded to deliver my premature infant son onto the hospital bed - by myself. Of course, during all her platitudes and false smiles, Nurse Stupid never bothered to CHECK me; and, of course, since I was going home, nothing was ready to care for a premature infant coughed onto the bed.
    
    Needless to say, my doctor was equally as furious as I - at her stupidity, her carelessness, her CALLOUSNESS, and her complete incompetence. Think about that for a minute: If a COWORKER gets such shoddy care, what can REGULAR patients expect? From the point of walking through the doors on, it was nothing but stupidity piled on top of stupidity: No antifungal prescribed for skin yeast developed as a result of antibiotics given for sepsis (he was not septic, after all) that led to open ulcerations from head to toe (he isn't septic, so let's make him so???), social worker coming to "visit" us while we were in the nursery due to "severe concerns" over the fact that our son was born profoundly Deaf (as is my husband, it's HEREDITARY) and needing to ensure we were "capable" of caring for him, and eons of hell in the form of Nurse Stupid showing up to hug me and act like my best friend (too bad I'd already reported her to my boss, huh?).

    posted by : fanniefunny on 12/12/2008 at 5:02 AM Flag For Abuse

99. I don't understand why some people here are so condemning of disposal of a placenta in the garbage....what about all the raw, untreated feces that gets thrown into our landfills from disposable diapers? I'd consider that much worse than what is essentially just raw organ meat.

    posted by : think about it on 12/18/2008 at 1:18 AM Flag For Abuse

100. OMG, I'm reading all this feedback in horror. No universal access to prenatal care, routine episiotomies, not being able to eat/drink/move around while in labour, being forced to lie down while labouring, semi-routine epidurals, babies being taken away from their mothers immediately following birth, one of the highest infant mortality rates in the developed world... you could not pay me enough to have a baby in the United States.

     posted by : NotAnAmerican on 1/4/2009 at 2:02 AM Flag For Abuse

101. Maybe this would have been a more responsible choice if the parents had of moved to a state where home birth was legal especially after they found out it was illegal.

     posted by : babyowl on 1/30/2009 at 9:57 AM Flag For Abuse

102. Babies have been born at home for millions of years.... Only in the last 150 years or so have women been having babies in hospitals.... It's a natural, normal experience and unless there are specific complications a hospital is not necessary.... Trust me, I'm a nurse and I've seen how they do it in hospitals.... I've actually seen doctors intentionally rushing labor.... Try having an open mind about home birth... It's a personal decision with many rewards. Another note.... For those of you worried about the saftey of home births..... Midwives are trained in pediatric advanced life support.... Babies and moms are in good hands with them.... They can handle life threatening emergencies.... And they do not have home births with mothers who are considered high risk.

     posted by : not a registered user on 2/10/2009 at 7:43 PM Flag For Abuse

103. I really enjoyed the article!  I am a postpartum nurse and chose to give birth at home, legally.  It was a wonderful experience.  I would have done the same as the author if it was illegal in my state.  Everyone gets worried about out-of-hopital birth--it's a wonder the human race has survived considering hospitals are a relatively new phenomena!  As far as the placenta in the trash in concerned, I am wondering if the people who are grossed out by that medically dispose of their period pads?  Even in the hospital postpartum moms throw their HEAVILY saturated pads into the regular trash.  And who exactly would find a placenta at the dump?  People who are going through the dump probably find grosser things than a heavily wrapped placenta, and probably have more things to worry about than finding one.  Congrats on your birth and healthy baby!

     posted by : gro on 3/5/2009 at 10:36 AM Flag For Abuse

104. I WISH I would've done a home birth. My babe was whipped away--cord, cord blood, placenta all in the trash instead of saved as I requested--for intense monitoring immediately after birth. Why? His pulse had slowed a few hours before birth. Why? According to the hospital, it was the results of the drugs they had given me.
     My story's not extreme, but there are many other cases of much more serious harm caused by modern hospital medicine that could've been avoided in a home birth.
     
     I had prepared for a natural birth, was woefully unprepared for the onslaught of drugs when my water broke before I felt contractions. (During this time of "no contractions" I somehow dialated several centimeters). My child's father was having a hard time dealing with his role in the hospital, so would not have been able to support me in a home birth.
     
     So happy home births like this story--wonderful! But with the hospital being the back-up plan, you must research all the drugs you hope to avoid, so you'll be prepared to make better choices.
     
     BTW, my favorite home birth story is from friends who had gotten the tub and everything else, were just waiting for contractions to begin. Once they did, there was no time for anything. Daddy called the midwife--she arrived just in time for tea after the babe was born!
     

     posted by : saacs mama on 3/6/2009 at 3:57 AM Flag For Abuse

105. I support and acknowledge that midwives are probably a better option than OBs for non high risk women. That would be women who have given birth before with no problems, perfectly healthy, babies were perfectly healthly, mother is young etc  I think a midwive in a birthing center next to a hospital or in a hospital would be okay and not considered "putting your life and your child's life in danger".  Anything else kinda is.  Whether or not it came out okay is not the point, it could not have turned out okay and how could you ever forgive yourself? I couldn't.  How would your husband feel knowing he is raising that baby alone because you died when if you had been in a hospital it might have been different?  I am not a risk taker and I do see it as risky.
     
     However I do sympathize. I hated a lot about the birth of my twins like the intrusive nurses and constant interruptions and protocol. But I loved the large amounts of blood on hand which I came close to needing, NICU which I came close to needing, the OR I did need, etc. No way my babies or I would have survived at home. Of course I was the highest of the high risk, but still......not taking chances. I suggest women do their research and be demanding with doctors and hospitals and nurses to get good care and have their friends and relatives do the same on their behalf, but still be there in the hospital.  They back off if you yell at them I have found.....ingenious.
     
     

     posted by : aprils on 3/14/2009 at 10:42 PM Flag For Abuse

106. I think that it was a good decision. I myself had a bad experiance with a bad doctor. I am on my second child and I am very satisfied with the male doctor that i have now, before that i had a female doctor who wanted to control my birth and pregnancy, she was very rude, and I could never understand a thing she said. While I was in the office with her one time she asked me if i had a birth control that I wanted to get on.....thing was that I wasn't even a month along in my pregnancy and it is not like I am a child, I am 23 and the baby was planned with my fiance who has stuck with me through everything. If in the future I go for a third child I will have a home birth. But for now I'm having this one in a jacuzzi at the hospital. I think that it's pregnancy, your decision, your life. Whos to control how you want to give birth.

     posted by : mamaof2 on 3/24/2009 at 4:46 PM Flag For Abuse

107. I had my daughter at a hospital and like Madeline I decided to have my second(a son) at home. I was nervous at first and my hubby didnt want me to do it but I had made my decision after the birth of my daughter that i wouldnt have any more kids in the hospital. I didnt like the pushy doctors i had, the potocin, the pretty much being forced to have the epidural with the threat of a c-section if i didnt do it. My home birth was the complete opposite. My midwife was amazing. She like Madelines midwife did no testing, no weight checks. It was up to me if i got a sonogram or the glucose test. I was totally in control of my body and my baby. When I had my son I was only in labor 12 hours from first contraction til he came out compared to 20 with my daughter. I watched tv, ate and drank the whole labor. My 18month old daughter was there for the entire labor and was the first one to hold her little brother. I was allowed however many people i wanted there because it was my house. I had a hard labor because his head was faced towards my hips and the midwife knew exactly what to do. She never cut me, i didnt even rip because they massage the area to help ease the head out. I delivered a very healthy 9lbs 3oz 21.5 inch baby boy, Collin Matthew in a pool in my living room and i wouldnt do it any other way. Having a baby is a natural thing, its not a medical emergency. To all you who believe thats endangering your baby and all that. Do your research... more babies die at a hospital and contract infections then they do at home. More interventions are used that can possibly harm the baby and the mother at the hospital and babies who are born at home are proven to be more relaxed and calm.Its a bonding experince for the entire family. My birth i had my husband, my daughter, my 2 younger sisters and my parents there. And to all you who say what if something happened? As long as you have a normal pregnancy and a good certified nurse midwife everything is normally fine. If something would arise all midwives ( in states where its legal) work with a OBGYN and they also call the hospital to tell them youre in labor. They would never try to continue a home birth if something was seriously wrong.

     posted by : homebirthingmommy on 7/1/2009 at 9:52 PM Flag For Abuse

108. I had an absolutely great natural birth at a somewhat urban birthing center (I really didn't want to give birth in our apartment). The time we spent with our midwives was enjoyable and refreshing. These women were some of the most professional healthcare providers I have been in contact with. Their number one concern was safety, to the point that I had to sign a contract stating I would deliver in a hospital during a hurricane watch or warning (they would make an effort to be there and the hospital that they recommended was familiar with their birthing policies and philosophies). The part of the article that I got a bit of a chuckle at was the placenta's demise. We were asked if we wanted to keep the the cord clamp and placenta, my husband and I looked at each and said no, which they thought was kind of weird. How were we going to bury it at our apartment complex, and we live in Florida where about three inches of dirt covers limestone?
         I guess the point is, every woman and her partner need to understand and realize what will be the right birthing plan for them. Ladies, don't forget we have been doing this for quiet some time, unnaided by medical attention until the late 19, early 20 centuries. It might have been more dangerous in a cave or out in the woods or in a farmhouse, but the midwives of today have the best of both worlds. A comfortable and loving facility + modern noninvasive medical technology + knowledgeble midwives = a great natural birth!

     posted by : anonymom on 7/20/2009 at 1:56 PM Flag For Abuse

109. Beautiful story.  Thank you for sharing! 
     
     A note on people talking about how anti-biotics should be administered in case of Strep B.  When I was pg with my son, I had tested + for Strep B and I didn't even KNOW!  My dr never mentioned it to me. 
     
     I woke up 12:30 at night feeling contractions.  I stayed up for a bit to make sure it was really labor and when I was sure (about half an hour later) I woke my husband.  He took a shower and we immediately when to the hospital.  My son was born within an hour of arrival at the hospital - no time for anti-biotics, but he's fine.  So while anti-biotics is "standard" procedure for positive Strep B, I wasn't administered any and I was at a hospital for my delivery.  Therefore I don't feel it's a super horrible thing not to get it.
     
     Some women even decline Strep B testing even though they are seeing an ob and do go to the hospital for delivery. 
     
     Just because current medical technology is available doesn't mean is necessary for everyone.  Plus the article talked about how the mom and midwife discussed how certain emergency situations would be handled. 
     
     Most homebirths DO have a back-up or contingency plan.  Just because things don't always go perfectly doesn't mean everything would have gone so much better in a hospital.  There ARE stories of babies and mothers being lost in hospitals too.  One in particular I can remember is a mom not getting up after a c-section.  She slipped into a coma and died after her son was delivered.  I have no idea what the circumstances surrounding the c-section were, but every time I hear women or dr's scheduling them more for convenience than necessity, I find that more "reckless" than opting to give birth at home with a trained professional there who has tons of experience and can identify and handle problems. 
     

     posted by : stace on 7/21/2009 at 6:06 PM Flag For Abuse

110. It is absurd that homebirth is illegal.  Here is a good analogy, what if eating at home was illegal?
     http://enjoybirth.wordpress.com/2009/08/04/restaurant-wars-and-birth-wars/

     posted by : Enjoy Birth on 8/6/2009 at 12:16 PM Flag For Abuse

111. I don't get homebirthers.  I just don't.

     posted by : fedupmomma on 8/6/2009 at 2:54 PM Flag For Abuse

112. I just don't get people who think their way is the only right way.  I just don't.

     posted by : 4xhomebirthmama on 8/13/2009 at 11:30 AM Flag For Abuse

113. Great article, it's a shame it's so hard to get a homebirth and the midwives in many states have to take so many risks to provide care for homebirthers.   I know this is an old article, but although the article is a good story and has good information, I don't like the title or subtitle.  It just perpetuates the myth that we aren't "allowed" to have homebirths if we wish.  Your homebirth wasn't a felony or illegal.  What your midwife did might be, but that's not the same.

     posted by : 4xhomebirthmama on 8/13/2009 at 11:35 AM Flag For Abuse