Article about Risks of Home Births in the US

[Foxy37]

I have no idea why people are getting so offended by someone sharing an article? She hasn't expressed her opinion on anything, she's just presented an article and a few statements from within it.

You don't have to agree with the article. I think it's a well known fact that home births are not as well supported in the US than anywhere else, and that hospital births carry their own set of risks. But that wasn't the point of this specific article.

i completally agree xxx. im uk so im unsure of u s insurances but it brakes my heart to hear women worry about seeing the clinics due to finances .

 

[Blob]

Op I'm sorry, I dont mean to be arsey about this and its not directed at you. Lots of women have had to fight hard to get the birth that they want and have to deal with stigma and negative opinions from people everyday because of their choices. X

 

[Buttercup2]

Buttercup you should read Ina May Gaskin's book a guide to childbirth. Honestly I would read this article with a huge grain of salt coming from the AJOG, not because you can't trust them but because they have a lot to lose from people deciding to do a homebirth, or go to a birthing center.

I have read this book.

The AJOG is just a journal (it's not an organization or anything), it doesn't actually have any financial stake in births at all. That would be like saying BabyAndBump or the New York Times has some kind of stake in whether or not people make certain choices about where to have their babies.

AJOG is actually one of my favorites because they are so balanced in the kinds of articles they accept. All the articles are "good science" and they're peer-reviewed and everything, so they're pretty trustworthy. Right now on the front page of the AJOG website they have an abstract for an article talking about the risks of early induction.

 

[PreggyEggy]

Also i can never understand why when a women has been told there high risk and a home birth is not recommended why they would fight it and put them and baby at risk

Because that woman has researched into the reasons why she is considered high risk and has made an informed choice to take those risks?

I am high risk. With my first birth, I had a retained placenta, a bleed, and I am overweight which means I am at risk of shoulder dystocia.

Firstly, R.E. shoulder dystocia, I have already given birth to a largish baby normally and easily. In the event of baby getting a little stuck, midwives are trained in maneuverers that free the baby. Often there will be signs that the midwife will be looking for, and she may feel the baby will get stuck and advise me to transfer to hospital, and I would certainly take her concerns seriously.

For the retained placenta, I am at risk of having one again. However, nobody can say for sure WHY I had one in the first place. They just happen. What I do know is I had an epidural (that failed), a managed third stage, and my labour was augmented with a drip. ALL of these things increase the risk of retained placenta. I have chosen to reduce my risk by having a homebirth away from these things, and at least trying for a physiological third stage.

As for my bleed, as I have been told by the consultant midwife at my hospital while we talked through my birth plan, it is very rare for a woman to bleed to death indeed. I lost a litre of blood after my first blood, and was quite poorly afterwards. Still, I had to wait 5 hours to get to theatre for them to sort it out. If I had another retained placenta, transfer to hospital would take half an hour, in which case I am still far more likely to have it sorted out before the point I did with my first.

First time mums in my area are actively encouraged to have a home birth. because they are far more likely to have a successful natural birth then if they were to attempt it in hospital, which in the long run saves money for the local health trust.

Risk is not as black and white as you believe it to be. It is important to go through those risks and access what is acceptable to you as an individual. There is no "you shouldn't do it if you're high risk"!

Risk is very objective, depending on how it is presented. For example, I can tell you that the risk of stillbirth doubles if you give birth after 42 weeks. Sounds horrendous, right? But would you feel the same way if I was to tell you that the risk of still birth after 42 weeks increases from 1% to 3%?

Each and every one of us makes decisions involving risk everyday. Birth is no different.

 

[Foxy37]

Also i can never understand why when a women has been told there high risk and a home birth is not recommended why they would fight it and put them and baby at risk

I am high risk. With my first birth, I had a retained placenta, a bleed, and I am overweight which means I am at risk of shoulder dystocia

Wow a brave desision then . I know after my 1st labour if i had that same pain and feeling i had then i would not be able to move at all but thats my choice AS I KNOW how i react to things .
Just like i love the idear of water birth yet i shake horrifically after giving birth so i wouldn't put myself through it.
A home birth does seem a wonderfull idea and i can see the benefits and amazingness that it must be , But for a high risk mum i cant see why they would even take that chance .
Why would you put yourself through the chance of something happening to you or baby ?? Has your specialists said its fine or did they say it was not recomended ?
How close are you to the hospital ?
Im not being argumentative i just am curious xx

 

[PreggyEggy]

Also i can never understand why when a women has been told there high risk and a home birth is not recommended why they would fight it and put them and baby at risk

I am high risk. With my first birth, I had a retained placenta, a bleed, and I am overweight which means I am at risk of shoulder dystocia

Wow a brave desision then . I know after my 1st labour if i had that same pain and feeling i had then i would not be able to move at all but thats my choice AS I KNOW how i react to things .
Just like i love the idear of water birth yet i shake horrifically after giving birth so i wouldn't put myself through it.
A home birth does seem a wonderfull idea and i can see the benefits and amazingness that it must be , But for a high risk mum i cant see why they would even take that chance .
Why would you put yourself through the chance of something happening to you or baby ?? Has your specialists said its fine or did they say it was not recomended ?
How close are you to the hospital ?
Im not being argumentative i just am curious xx

I explained why I would take those risks in my post, but the bottom line is I believe I am more likely to achieve normal birth at home without the risks that intervention bring, and therefore will be safer at home.

If things DO go wrong, which of course I am not naive enough to believe everything will be perfectly fine just because I believe it will be! The chances of me transferring to hospital and baby and I being perfectly fine are very high and worth taking, versus the risk of stalled labour, and failed epidurals again. I was lucky to give birth normally last time, I could very well have ended up with instruments and csections due to the interventions I received.

My consultants bottom line was they would not recommend home birth, but all they can do is advise me. My community midwife team are more then happy to support me in my choice. I am 15 minutes away from my hospital if I were to jump in my car, half an hour is a conservative estimate allowing for an ambulance to arrive.

 

[Blob]

Saying someone's is being brave in having a homebirth is like saying they are doing something that is dangerous? Preggyeggy isn't going to have made the choice of a home birth without knowing the 'risks'. Like my midwife said to me.. "You are all warned about the 'risks' of having a baby at home but nobody is informed of the risks of having a baby in hospital?"
I've never had issues, I'm not in a high risk category and my community midwife also has had her babies at home
It also depends why you are called high risk?

 

[special_kala]

Also i can never understand why when a women has been told there high risk and a home birth is not recommended why they would fight it and put them and baby at risk

I am high risk. With my first birth, I had a retained placenta, a bleed, and I am overweight which means I am at risk of shoulder dystocia

Wow a brave desision then . I know after my 1st labour if i had that same pain and feeling i had then i would not be able to move at all but thats my choice AS I KNOW how i react to things .
Just like i love the idear of water birth yet i shake horrifically after giving birth so i wouldn't put myself through it.
A home birth does seem a wonderfull idea and i can see the benefits and amazingness that it must be , But for a high risk mum i cant see why they would even take that chance .
Why would you put yourself through the chance of something happening to you or baby ?? Has your specialists said its fine or did they say it was not recomended ?
How close are you to the hospital ?
Im not being argumentative i just am curious xx

The same could be said for choosing a hospital birth.

 

[Creative]

Originally Posted by Foxy37 View Post
Also i can never understand why when a women has been told there high risk and a home birth is not recommended why they would fight it and put them and baby at risk

I too am considered to be in a high risk group. I was told that my age (44) puts me in the high risk camp.

I went to see the consultant and had a frank discussion with him because I said it was wrong to categorise me as such due to one single number as opposed to the fact that I have an obstetric history of three normal vaginal deliveries, a low BMI, low BP, good health, none drinker, none smoker, fit and healthy and he had to agree that there was nothing other than my age that would go against me. In the end he gave me his blessing, signed my birth plan and said he'd love to hear how it all goes.

 

[PreggyEggy]

Saying someone's is being brave in having a homebirth is like saying they are doing something that is dangerous? Preggyeggy isn't going to have made the choice of a home birth without knowing the 'risks'. Like my midwife said to me.. "You are all warned about the 'risks' of having a baby at home but nobody is informed of the risks of having a baby in hospital?"
I've never had issues, I'm not in a high risk category and my community midwife also has had her babies at home
It also depends why you are called high risk?

Exactly! There are plenty of risks that come with giving birth at hospital, but very few people even realise they are there.

Some hospitals in the US even have csection rates up to 40%! I've never had one, but I'm sure those that have will agree that they are no walk in the park. In other countries, the rates are much lower then that. If you're trying for a home birth, you are so much less likely to have a csection, and are therefore likely to have a better recovery from birth.

 

[Foxy37]

Saying someone's is being brave in having a homebirth is like saying they are doing something that is dangerous? Preggyeggy isn't going to have made the choice of a home birth without knowing the 'risks'. Like my midwife said to me.. "You are all warned about the 'risks' of having a baby at home but nobody is informed of the risks of having a baby in hospital?"
I've never had issues, I'm not in a high risk category and my community midwife also has had her babies at home
It also depends why you are called high risk?

I think any one chosing to have a home birth is brave and thats just my opinion due to my experience of a bad birth in a hospital .
Just my way of saying good for any women that follows her desision to do so .
Like i said in previous posts i think they seem an amazing way to give birth .
Im not being funny or sarcastic or nasty by saying someones brave its just a fact that in my eyes they are .
I dont take offence when people say im brave for having a 4th child after a huge gap i just see that its a desiosion that others wish they could do but dont

 

[PreggyEggy]

Saying someone's is being brave in having a homebirth is like saying they are doing something that is dangerous? Preggyeggy isn't going to have made the choice of a home birth without knowing the 'risks'. Like my midwife said to me.. "You are all warned about the 'risks' of having a baby at home but nobody is informed of the risks of having a baby in hospital?"
I've never had issues, I'm not in a high risk category and my community midwife also has had her babies at home
It also depends why you are called high risk?

I think any one chosing to have a home birth is brave and thats just my opinion due to my experience of a bad birth in a hospital .
Just my way of saying good for any women that follows her desision to do so .
Like i said in previous posts i think they seem an amazing way to give birth .
Im not being funny or sarcastic or nasty by saying someones brave its just a fact that in my eyes they are .
I dont take offence when people say im brave for having a 4th child after a huge gap i just see that its a desiosion that others wish they could do but dont

But theoretically (and I hope you don't take offence that this, as it's definitely not intended), it is perfectly possible that some of the things you experienced in your bad hospital birth were down to being in hospital and having interventions that may not have been totally necessary.

Nobody can say for sure, of course, and I have no idea of the circumstances of your first birth, but there's always that chance. I'm so sorry about your experience, and that it scared you off homebirth.

 

[txbiscuit]

It's an interesting paper, but I don't (personally, based on my limited understanding of this type of study) think it's conclusive. There were significantly fewer mothers in the home birthing and birth center groups. They were also quite a bit older and more likely to be 1-2 weeks past their due date, which could correlate with more negative outcomes. The authors seemed to draw conclusions about CNM and physician-attended home births, but I did not see the data for those births separated out (although I may have missed it). Several of the authors work at teaching hospitals with high-risk populations and equally high (35-38%) c-section rates, which may have colored their views on the safety/naturalness of birth in general. Also, according to ACOG, up to 25% of U.S. home births are unplanned. The authors said they attempted to exclude unplanned home births, but that leaves room for subconscious or conscious bias to affect the data. I'd like to know whether they compared data from states where home birth is illegal with states where it is legal, and if so, if there were differences in birth outcomes. I did find it interesting that hospital births attended by midwives had the best outcomes. (I wonder how births attended by both midwives and doctors are recorded on birth certificates?)

It's worth noting that there are other possible negative birth outcomes beyond the (very serious) ones studied here. For example, I personally know two women who contracted MRSA infections during otherwise normal hospital births. Another was almost given an unwanted and unnecessary hysterectomy. (Of course, I'd gladly contract MRSA or have a hysterectomy to ensure the health of my baby, but I don't think that's really something anyone on either side of the debate would ask of me.)

I don't think I'm ready (or ever would be ready) to say one type of birth is always better than another for all women. I'm glad research is being done with the goal of improving birth outcomes for women, but I don't think the "either you care about your baby or your own 'experience'" tenor of some studies does much to improve the level of discourse.

 

[PreggyEggy]

Homebirth is illegal in some states????

 

[Foxy37]

Saying someone's is being brave in having a homebirth is like saying they are doing something that is dangerous? Preggyeggy isn't going to have made the choice of a home birth without knowing the 'risks'. Like my midwife said to me.. "You are all warned about the 'risks' of having a baby at home but nobody is informed of the risks of having a baby in hospital?"
I've never had issues, I'm not in a high risk category and my community midwife also has had her babies at home
It also depends why you are called high risk?

I think any one chosing to have a home birth is brave and thats just my opinion due to my experience of a bad birth in a hospital .
Just my way of saying good for any women that follows her desision to do so .
Like i said in previous posts i think they seem an amazing way to give birth .
Im not being funny or sarcastic or nasty by saying someones brave its just a fact that in my eyes they are .
I dont take offence when people say im brave for having a 4th child after a huge gap i just see that its a desiosion that others wish they could do but dont

But theoretically (and I hope you don't take offence that this, as it's definitely not intended), it is perfectly possible that some of the things you experienced in your bad hospital birth were down to being in hospital and having interventions that may not have been totally necessary.

Nobody can say for sure, of course, and I have no idea of the circumstances of your first birth, but there's always that chance. I'm so sorry about your experience, and that it scared you off homebirth.

No offence taken xx
No i was young , healthy non smoker non drinker low bmi .
Baby came i pushed and she caused a very large bleed (6pints of blood loss).
I think home births must be so tranquil and amazing and cant think of anything more wonderfull , but i would never forgive myself if something happened and would blame myself forever .
We are all different and thats the bottom line and when a women is told that maybe its not a good idea she understands that she is taking a risk if something does happen .
There is no saying it would ever happen again and we all deal with things different xx

 

[Creative]

I think any one chosing to have a home birth is brave and thats just my opinion due to my experience of a bad birth in a hospital .

I'd have to be a lot braver to contemplate giving birth in a hospital!!!

 

[txbiscuit]

Homebirth is illegal in some states????

Home births attended by CNMs and doctors are legal in all 50 states, but (from what I understand) not all those states have CNMs or doctors willing to attend home births, so some women "illegally" give birth at home attended by non-CNM midwives. (I've seen this cited as a reason that unassisted/unplanned home births may be over reported.)

 

[Foxy37]

I think any one chosing to have a home birth is brave and thats just my opinion due to my experience of a bad birth in a hospital .

I'd have to be a lot braver to contemplate giving birth in a hospital!!!

Have you had a bad experience ? x

 

[Blob]

I have to say after my negative hospital birth and my very different home birth it would make me very uneasy to be giving birth in hospital now.

Nobody makes the choice of having a homebirth because they are thinking about themselves. We also make the choice because we think its safer for our babies? I made that decision on research and my experience of hospital birth

 

[Foxy37]

Homebirth is illegal in some states????

Home births attended by CNMs and doctors are legal in all 50 states, but (from what I understand) not all those states have CNMs or doctors willing to attend home births, so some women "illegally" give birth at home attended by non-CNM midwives. (I've seen this cited as a reason that unassisted/unplanned home births may be over reported.)

wow how scarey for the women , i wonder why why they are not willing ?? do you think its due to liability ? xx