Article about Risks of Home Births in the US

[overcomer79]

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.)

And then if something went wrong and you or baby needed medical attention...insurance could deny charges for going "against medical advice"...Hell I threatened to walk out of the hospital (I was verbally discharged) with dd but was told insurance would buck the charges because the dr didn't discharge me from the system so it would show I left "AMA". I had to wait 3 hours because he was caught up in delivery.

I have had too many complications to even consider a homebirth. I had a friend to have a homebirth and that was her choice. Clearly out of my comfort zone.

 

[MrsKyliePaton]

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.)

I am reading a book at the moment 'confessions of a midwife' it's fictional but is all about illegal midwifes, very interesting read haven't read it all yet though.

I'm in the uk but I found my hospital birth really distressing and vowed never to give birth there again. Was gearing towards a home birth but chickened out and went to a midwife led unit instead and it was a much faster more relaxing and easy birth compared to my first. Healed within days instead of 5 weeks like dd1.

 

[MandaAnda]

I have a question as I know nothing of home births and my sister is considering one. What happens if you are birthing at home and the baby's heart rate begins to drop and you discover that in the circumstances you can't deliver naturally as you had originally hoped and need an emergency c-section ASAP to get the baby out safely? Can the midwife perform a c-section in this case?

Source;https://www.homebirth.org.uk/ (under the head but what if on the left hand side)

The term 'emergency caesarean' can be confusing, because in fact an 'emergency' caesarean just means one which was not planned at the start of labour, regardless of whether mother or baby was in immediate danger. What most people worry about is a 'crash' or 'true emergency' caesarean, where the baby needs to be delivered urgently. This is rare in a low-risk pregnancy which ends in a physiological (natural, spontaneous) labour. Nonetheless, it can happen. The baby's heart rate might indicate to the midwife that the baby is in severe distress. Perhaps the cord is around its neck - this happens in about a third of all births and does not usually cause a major problem, but in some cases the baby does get severely deprived of oxygen. Perhaps the cord has become compressed inside the womb. The mother could be bleeding from a partial placental separation or, very rarely, a ruptured uterus.

In a dire emergency situation like this, the midwife would call an ambulance immediately, and would telephone ahead to the hospital and ask them to have the operating theatre made ready and the surgical team assembled. The ambulance team would take the mother straight to the operating theatre. While waiting for the ambulance and during transfer, the midwife might insert an intravenous drip or a Venflon needle, which would allow a drip to be put up straight away in the ambulance or in hospital.

In the past, obstetric 'flying squads' have sometimes been used to take emergency assistance to a home birth. However, these have been phased out in the UK as they were found to be, overall, less safe and effective than transferring people to hospital.

So how much time would you lose by having to transfer from home? Obviously it depends on your distance from the hospital, and traffic conditions, but even if you started off in hospital, the operating theatre would have to be prepared and a surgical team assembled. There is an interesting table in the paper by Tuffnell et al (see refs, below) listing steps from decision to delivery in a caesarean section. If you were labouring in hospital when your baby went into distress, you might be surprised at how long it could take from 'call to cut', ie the time it took the surgeon to actually begin operating.

The UK target for delivery by emergency caesarean is 30 minutes from decision to delivery, but research suggests that this target is not usually achieved. For example, MacKenzie and Cooke (2001) found that the average time from decision to delivery in emergency caesareans where there was fetal distress was 42.9 minutes in their large Oxford teaching hospital. Tuffnell et al (2001) found that:

"66.3% women were delivered in 30 minutes and 88.3% within 40 minutes; 29 (4.0%) were undelivered at 50 minutes. If the woman was taken to theatre in 10 minutes, 409 of 500 (81.8%) were delivered in 30 minutes and 495 (97%) in 40 minutes."
An interesting read on this subject is the National Sentinel audit of Caesarean Sections in the UK, published by the Royal College of Obstetricians and Gynaecologists (www.rcog.org.uk). To be reviewed for this article at a later date.

It seems inevitable that transferring from home for a crash caesarean will usually result in some time being lost, compared to a planned hospital birth. However, depending on your transfer times, the difference might not be as large as you would expect. If you could be in the operating theatre within 20 minutes, for instance, the difference is likely to be very small indeed.

The issue for most women is how likely it really is that they would require a 'crash' caesarean section. If you do not fall into a high-risk group, and you have not had interventions in your labour which increase risk (eg induction, augmentation of labour), the chances are very small indeed. Only you can decide which combination of risks is acceptable for your family.

Here are some birth stories from women who transferred from a home birth for caesarean sections: Kiara, Laura, Mel .

Thank you for that info Creative- very interesting stuff. Am passing it on to my sister. How about in a rare instance where oxygen is cut to the baby, how much time would someone have before permanent damage is done to the baby? (I.e. brain damage due to lack of oxygen).

As others have said, midwives carry resus equipment, have the same training as those in hospital. But oxygen cut how? As long as the cord is left intact, baby is very likely to still be getting their supply of oxygen. A problem often seen in hospitals, and not nearly as often at a home birth, is the cutting of the cord because of a nuchal cord (almost never an emergency and rather a variation of normal) before the shoulders are born. Then, if there is a shoulder dystocia, the lifeline to the placenta is already severed. https://cord-clamping.com/2011/11/04/cord-around-the-neck-what-parents-practitioners-should-know/ As far as shoulder dystocia goes, oftent the most effective thing is using certain positions, which can equally be done at home as it can in hospital. Midwives are also trained to recognise problems early on, and they will recommend transfer in good time should they perceive a problem developing. In fact, many issues a hospital birth "saved" a woman from can be caused by being in hospital in the first place, as management and intervention are so much more common in hospital.

I strongly support women birthing where they feel safest. If they feel safe, their labour is likely to progress more normally. That said, I do hope all advocates of hospital birth do realise that a decision to home birth is not one entered into lightly. A mother is less likely to hand over all responsibility to healthcare providers and assumes a lot herself, having heavily researched her decision. You will see many mums who planned a homebirth, but transferred to hospital for a variety of possible reasons, say that they are still glad they had planned a home birth, as it meant they knew what they wanted from the birth, understood what was going on more, were in a better state of mind because they "took" that with them when they transferred. I'm one of those mums.

 

[JASMAK]

So basically your saying anyone on here and there are a few , who are choosing to have a home birth not a hospital birth are not "smart" ladies.

I find this utterly offensive, they have obviously done their own research and don't get on here starting threads poo pooing those of us who choose to have hospital births so why should they have their choices criticised?

Simply if someone is not comfortable having a home birth they should go to the hospital and have THEIR child there. And leave other people's choices alone.

Gee, I read the same post and I don't think she said that at all!

 

[JASMAK]

Hi ladies , i love a good debate and as we are all hormonal im sure here is the best place for us to all speak out complete opinion .
I am not against home births as i think every one should have the choice however , My first born i hemorrhaged very bad and had i been home i would have died and that is the bottom line , for first born i think it can be risky as we never know how its going to go as there's nothing to compare it by, also we don't know how we will feel as we have never been through labour before .
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 .
If for that split second something goes wrong on delivery or during then its going to take longer to deal with and possibly could be life or death .
I do believe that women who have had a successful birth previous then home birth i can understand xx

This is me too. Firstly, I was never eligible for a home birth. At 13 weeks pregnant, with my first, I hemmoraged as I had complete previa. I had to have a section, which, in my province, in Canada, made me in-eligible to ever have a HB. But, when I delivered my son (my first), I hemorraged again, this time because he was so big, my uterus was so stretched, it wouldn't contract. They told me I would be dead at home.

My good friend had a homebirth, which I attended, and it made me nervous, but it went great. Her baby was born with a fever though, but all seemed okay after awhile. No other issues, and she was very happy with it.

 

[JASMAK]

Not a dangerous one, but I was a nurse. I have seen so many women giving birth lying on their backs, strapped to machines etc. I had two hospital births and then finally a home birth (and this one will also be a homebirth)
FOR ME I lost all power and choice in both hospital births.
I hate to be told to do this and do that
lets moniter you
lets time you
Boss, boss, boss
I want to listen to my body, do what my body tells me and have the power to make decisions. My homebirth was the most amazing and empowering situation. I could have my children there and call all the shots. My midwives were totally supportive and not once did they "instruct me".

Yikes! No wonder you dont want to give brth in a hospital! Sounds dreadful there!!! Women here have private rooms with big tubs/showers, husbands can sleep there (cots for dads), babies sleep with their moms, no transfer of rooms, family can be there, and you dont hav to be in your bed, unless you have medication, by choice. Birth plans are huge here. This is just my city. I had all sections, but before I had my diagnosis, I had my birth all planned out! lol! But, if it sounded like what you described, I would run the other way....and fast!!

 

[JASMAK]

I havent done any research into homebirth, because from my personal experience I know its definitely not something I want. I have worked in a delivery suite and have seen things turn in the blink of an eye, where we had to get the baby out asap...and I mean from peaceful natural birth to crash csection and baby out in less than 10 minutes. I know it doesnt happen often, but once you have witnessed it, it stays with you and realise it can happen to anyone. I respect other people's decision to have a homebirth, but I feel much safer in hospital.

I dont think the op meant any offence by starting this thread. She was just sharing an article she found interesting. I think people took it the wrong way.

At the end of the day people birth best where they feel safest, people forget the psychological impact on our own emotions during labour, I too felt safest at hospital for my first birth and I believe this contributed to my good labour, this time around I do not trust the hospital in the area I am in and having already had an experience of labour I feel I will labour better at home. The reason women get annoyed by comments such as what you have made (as an example not picking on you lots of women have these valid opinions and I felt the same for my first) is the assumption birth is safest in hospital when in actual fact if you want to talk about statistics, for second time mums who are low risk (in the UK) home birth actually beats hospital birth for safety, so by saying hospital birth is safer is not only a moot point because you're as safe as you feel but it is also technically speaking, wrong.

But I agree, I wasn't offended by the OP's post or the article, I like discussing topics such as this, just don't ask me to back every statement with a stat because most of my info comes from One Born Every Minute and BBC news articles

I wouldnt say home birth birth is safer as a generalization for all countries. Maybe for the UK, but the midwife that came to my friends birth came with barely a thing. They arent allowed to take 'high risk' here, and I wonder if that skews results in studies. Of course hospitals are going to have the worst case scenarios. Doesn't that just make sense?

 

[JASMAK]

Seems about the same for physician attended and home birth ones in my province:

https://www.cmaj.ca/content/181/6-7/377.abstract

 

[Pearls18]

I havent done any research into homebirth, because from my personal experience I know its definitely not something I want. I have worked in a delivery suite and have seen things turn in the blink of an eye, where we had to get the baby out asap...and I mean from peaceful natural birth to crash csection and baby out in less than 10 minutes. I know it doesnt happen often, but once you have witnessed it, it stays with you and realise it can happen to anyone. I respect other people's decision to have a homebirth, but I feel much safer in hospital.

I dont think the op meant any offence by starting this thread. She was just sharing an article she found interesting. I think people took it the wrong way.

At the end of the day people birth best where they feel safest, people forget the psychological impact on our own emotions during labour, I too felt safest at hospital for my first birth and I believe this contributed to my good labour, this time around I do not trust the hospital in the area I am in and having already had an experience of labour I feel I will labour better at home. The reason women get annoyed by comments such as what you have made (as an example not picking on you lots of women have these valid opinions and I felt the same for my first) is the assumption birth is safest in hospital when in actual fact if you want to talk about statistics, for second time mums who are low risk (in the UK) home birth actually beats hospital birth for safety, so by saying hospital birth is safer is not only a moot point because you're as safe as you feel but it is also technically speaking, wrong.

But I agree, I wasn't offended by the OP's post or the article, I like discussing topics such as this, just don't ask me to back every statement with a stat because most of my info comes from One Born Every Minute and BBC news articles

I wouldnt say home birth birth is safer as a generalization for all countries. Maybe for the UK, but the midwife that came to my friends birth came with barely a thing. They arent allowed to take 'high risk' here, and I wonder if that skews results in studies. Of course hospitals are going to have the worst case scenarios. Doesn't that just make sense?

Yeah I only really meant the UK I don't know a thing about other countries, in the UK home births are something they are really trying to encourage more of so the MWs and equipment are becoming much more equipped and prepared for it, technically home births are only advised for low risk women here too. Statistics are always going to be difficult to correlate between such two different scenarios, I think it is just about showing people that it isn't irresponsible to give birth at home if it is what the woman wants, here we have very good provisions for getting woman and baby to hospital if need be. I read a good quote the other day that people stress too much about the 1% of women who have serious birth complications and forget about the majority who don't, I totally understand the mentality of wanting to be in the "right" place if something does go terribly wrong, but I personally having had a very low risk pregnancy and birth last time have faith in myself, my MW do not think about a worst case scenario that is not likely to happen, but if something does go wrong I trust the system to be able to help us, and hate being made to feel like my trust is some how jeopardising my baby's safety. I genuinely believe it is safer for my baby and I to be at home because I know I will feel safer there, if something changes I will happily head straight to hospital. Birth for the majority of women doesn't HAVE to become this big medicalised emergency that needs to be managed.

 

[JASMAK]

I havent done any research into homebirth, because from my personal experience I know its definitely not something I want. I have worked in a delivery suite and have seen things turn in the blink of an eye, where we had to get the baby out asap...and I mean from peaceful natural birth to crash csection and baby out in less than 10 minutes. I know it doesnt happen often, but once you have witnessed it, it stays with you and realise it can happen to anyone. I respect other people's decision to have a homebirth, but I feel much safer in hospital.

I dont think the op meant any offence by starting this thread. She was just sharing an article she found interesting. I think people took it the wrong way.

At the end of the day people birth best where they feel safest, people forget the psychological impact on our own emotions during labour, I too felt safest at hospital for my first birth and I believe this contributed to my good labour, this time around I do not trust the hospital in the area I am in and having already had an experience of labour I feel I will labour better at home. The reason women get annoyed by comments such as what you have made (as an example not picking on you lots of women have these valid opinions and I felt the same for my first) is the assumption birth is safest in hospital when in actual fact if you want to talk about statistics, for second time mums who are low risk (in the UK) home birth actually beats hospital birth for safety, so by saying hospital birth is safer is not only a moot point because you're as safe as you feel but it is also technically speaking, wrong.

But I agree, I wasn't offended by the OP's post or the article, I like discussing topics such as this, just don't ask me to back every statement with a stat because most of my info comes from One Born Every Minute and BBC news articles

I wouldnt say home birth birth is safer as a generalization for all countries. Maybe for the UK, but the midwife that came to my friends birth came with barely a thing. They arent allowed to take 'high risk' here, and I wonder if that skews results in studies. Of course hospitals are going to have the worst case scenarios. Doesn't that just make sense?

Yeah I only really meant the UK I don't know a thing about other countries, in the UK home births are something they are really trying to encourage more of so the MWs and equipment are becoming much more equipped and prepared for it, technically home births are only advised for low risk women here too. Statistics are always going to be difficult to correlate between such two different scenarios, I think it is just about showing people that it isn't irresponsible to give birth at home if it is what the woman wants, here we have very good provisions for getting woman and baby to hospital if need be. I read a good quote the other day that people stress too much about the 1% of women who have serious birth complications and forget about the majority who don't, I totally understand the mentality of wanting to be in the "right" place if something does go terribly wrong, but I personally having had a very low risk pregnancy and birth last time have faith in myself, my MW do not think about a worst case scenario that is not likely to happen, but if something does go wrong I trust the system to be able to help us, and hate being made to feel like my trust is some how jeopardising my baby's safety. I genuinely believe it is safer for my baby and I to be at home because I know I will feel safer there, if something changes I will happily head straight to hospital. Birth for the majority of women doesn't HAVE to become this big medicalised emergency that needs to be managed.

I think that women should choose whatever feels best for them. HB may be safer in your country, but not all women will feel safe. Also, that 1% is 100% when it happens to you. I just think supplying imfo is great, encouragement for a women interested in HB is great, but those women who want hospital have their own reasons, and those feelings for that should be validated and respected,

 

[Pearls18]

I havent done any research into homebirth, because from my personal experience I know its definitely not something I want. I have worked in a delivery suite and have seen things turn in the blink of an eye, where we had to get the baby out asap...and I mean from peaceful natural birth to crash csection and baby out in less than 10 minutes. I know it doesnt happen often, but once you have witnessed it, it stays with you and realise it can happen to anyone. I respect other people's decision to have a homebirth, but I feel much safer in hospital.

I dont think the op meant any offence by starting this thread. She was just sharing an article she found interesting. I think people took it the wrong way.

At the end of the day people birth best where they feel safest, people forget the psychological impact on our own emotions during labour, I too felt safest at hospital for my first birth and I believe this contributed to my good labour, this time around I do not trust the hospital in the area I am in and having already had an experience of labour I feel I will labour better at home. The reason women get annoyed by comments such as what you have made (as an example not picking on you lots of women have these valid opinions and I felt the same for my first) is the assumption birth is safest in hospital when in actual fact if you want to talk about statistics, for second time mums who are low risk (in the UK) home birth actually beats hospital birth for safety, so by saying hospital birth is safer is not only a moot point because you're as safe as you feel but it is also technically speaking, wrong.

But I agree, I wasn't offended by the OP's post or the article, I like discussing topics such as this, just don't ask me to back every statement with a stat because most of my info comes from One Born Every Minute and BBC news articles

I wouldnt say home birth birth is safer as a generalization for all countries. Maybe for the UK, but the midwife that came to my friends birth came with barely a thing. They arent allowed to take 'high risk' here, and I wonder if that skews results in studies. Of course hospitals are going to have the worst case scenarios. Doesn't that just make sense?

Yeah I only really meant the UK I don't know a thing about other countries, in the UK home births are something they are really trying to encourage more of so the MWs and equipment are becoming much more equipped and prepared for it, technically home births are only advised for low risk women here too. Statistics are always going to be difficult to correlate between such two different scenarios, I think it is just about showing people that it isn't irresponsible to give birth at home if it is what the woman wants, here we have very good provisions for getting woman and baby to hospital if need be. I read a good quote the other day that people stress too much about the 1% of women who have serious birth complications and forget about the majority who don't, I totally understand the mentality of wanting to be in the "right" place if something does go terribly wrong, but I personally having had a very low risk pregnancy and birth last time have faith in myself, my MW do not think about a worst case scenario that is not likely to happen, but if something does go wrong I trust the system to be able to help us, and hate being made to feel like my trust is some how jeopardising my baby's safety. I genuinely believe it is safer for my baby and I to be at home because I know I will feel safer there, if something changes I will happily head straight to hospital. Birth for the majority of women doesn't HAVE to become this big medicalised emergency that needs to be managed.

I think that women should choose whatever feels best for them. HB may be safer in your country, but not all women will feel safe. Also, that 1% is 100% when it happens to you. I just think supplying imfo is great, encouragement for a women interested in HB is great, but those women who want hospital have their own reasons, and those feelings for that should be validated and respected,

Of course I feel exactly the same and I didn't say anywhere that I think any differently to that, that is exactly my point, a woman's choice needs to be respected but for some reason it is often the home birther that isn't, I have no issue with this thread, discussion or the article, my original point was to look at the source of the information and understand biases in different systems but as with everything it goes off point a bit.

 

[Bambola]

I have a question as I know nothing of home births and my sister is considering one. What happens if you are birthing at home and the baby's heart rate begins to drop and you discover that in the circumstances you can't deliver naturally as you had originally hoped and need an emergency c-section ASAP to get the baby out safely? Can the midwife perform a c-section in this case?

Source;https://www.homebirth.org.uk/ (under the head but what if on the left hand side)

The term 'emergency caesarean' can be confusing, because in fact an 'emergency' caesarean just means one which was not planned at the start of labour, regardless of whether mother or baby was in immediate danger. What most people worry about is a 'crash' or 'true emergency' caesarean, where the baby needs to be delivered urgently. This is rare in a low-risk pregnancy which ends in a physiological (natural, spontaneous) labour. Nonetheless, it can happen. The baby's heart rate might indicate to the midwife that the baby is in severe distress. Perhaps the cord is around its neck - this happens in about a third of all births and does not usually cause a major problem, but in some cases the baby does get severely deprived of oxygen. Perhaps the cord has become compressed inside the womb. The mother could be bleeding from a partial placental separation or, very rarely, a ruptured uterus.

In a dire emergency situation like this, the midwife would call an ambulance immediately, and would telephone ahead to the hospital and ask them to have the operating theatre made ready and the surgical team assembled. The ambulance team would take the mother straight to the operating theatre. While waiting for the ambulance and during transfer, the midwife might insert an intravenous drip or a Venflon needle, which would allow a drip to be put up straight away in the ambulance or in hospital.

In the past, obstetric 'flying squads' have sometimes been used to take emergency assistance to a home birth. However, these have been phased out in the UK as they were found to be, overall, less safe and effective than transferring people to hospital.

So how much time would you lose by having to transfer from home? Obviously it depends on your distance from the hospital, and traffic conditions, but even if you started off in hospital, the operating theatre would have to be prepared and a surgical team assembled. There is an interesting table in the paper by Tuffnell et al (see refs, below) listing steps from decision to delivery in a caesarean section. If you were labouring in hospital when your baby went into distress, you might be surprised at how long it could take from 'call to cut', ie the time it took the surgeon to actually begin operating.

The UK target for delivery by emergency caesarean is 30 minutes from decision to delivery, but research suggests that this target is not usually achieved. For example, MacKenzie and Cooke (2001) found that the average time from decision to delivery in emergency caesareans where there was fetal distress was 42.9 minutes in their large Oxford teaching hospital. Tuffnell et al (2001) found that:

"66.3% women were delivered in 30 minutes and 88.3% within 40 minutes; 29 (4.0%) were undelivered at 50 minutes. If the woman was taken to theatre in 10 minutes, 409 of 500 (81.8%) were delivered in 30 minutes and 495 (97%) in 40 minutes."
An interesting read on this subject is the National Sentinel audit of Caesarean Sections in the UK, published by the Royal College of Obstetricians and Gynaecologists (www.rcog.org.uk). To be reviewed for this article at a later date.

It seems inevitable that transferring from home for a crash caesarean will usually result in some time being lost, compared to a planned hospital birth. However, depending on your transfer times, the difference might not be as large as you would expect. If you could be in the operating theatre within 20 minutes, for instance, the difference is likely to be very small indeed.

The issue for most women is how likely it really is that they would require a 'crash' caesarean section. If you do not fall into a high-risk group, and you have not had interventions in your labour which increase risk (eg induction, augmentation of labour), the chances are very small indeed. Only you can decide which combination of risks is acceptable for your family.

Here are some birth stories from women who transferred from a home birth for caesarean sections: Kiara, Laura, Mel .

Thank you for that info Creative- very interesting stuff. Am passing it on to my sister. How about in a rare instance where oxygen is cut to the baby, how much time would someone have before permanent damage is done to the baby? (I.e. brain damage due to lack of oxygen).

As others have said, midwives carry resus equipment, have the same training as those in hospital. But oxygen cut how? As long as the cord is left intact, baby is very likely to still be getting their supply of oxygen. A problem often seen in hospitals, and not nearly as often at a home birth, is the cutting of the cord because of a nuchal cord (almost never an emergency and rather a variation of normal) before the shoulders are born. Then, if there is a shoulder dystocia, the lifeline to the placenta is already severed. https://cord-clamping.com/2011/11/04/cord-around-the-neck-what-parents-practitioners-should-know/ As far as shoulder dystocia goes, oftent the most effective thing is using certain positions, which can equally be done at home as it can in hospital. Midwives are also trained to recognise problems early on, and they will recommend transfer in good time should they perceive a problem developing. In fact, many issues a hospital birth "saved" a woman from can be caused by being in hospital in the first place, as management and intervention are so much more common in hospital.

I strongly support women birthing where they feel safest. If they feel safe, their labour is likely to progress more normally. That said, I do hope all advocates of hospital birth do realise that a decision to home birth is not one entered into lightly. A mother is less likely to hand over all responsibility to healthcare providers and assumes a lot herself, having heavily researched her decision. You will see many mums who planned a homebirth, but transferred to hospital for a variety of possible reasons, say that they are still glad they had planned a home birth, as it meant they knew what they wanted from the birth, understood what was going on more, were in a better state of mind because they "took" that with them when they transferred. I'm one of those mums.

I was referring to a loss of oxygen whilst the baby is still inside the mother due to for example, umbilical cord around then neck so heart rate starts to drop etc

 

[MandaAnda]

An umbilical cord around the neck is known as a nuchal cord. It cannot completely compress because of what it is made of. And keep in mind that babies are not breathing. What happens to their windpipe at this stage isn't "strangling", as they oxygen is via the cord. A cord around the neck wouldn't make the heart rate drop necessarily. Cord compression can do that,and some is normal. A cord is rarely, rarely ever tight enough to cause a problem. Healthcare professionals "saving" us from a nuchal cord is often complete rubbish, as it's almost never the problem that they let us believe it is. https://midwifethinking.com/2010/07/29/nuchal-cords/

 

[NoodleSnack]

Please skip this post if you don't want to see anything negative about home birth.

Buttercup: there's a related research (it might be a follow on study from the Dutch study though I'm hazy on that point) that found women transferred from home birth have worse outcome than intended hospital birth, obviously it might be due to the fact that those needing transfers have more serious problems, I'm not sure if that is accounted for. I've read it when I was pregnant so I can't remember the details but thought you might be interested. You should be able to find it with google scholar, I can't do it right now as I'm on the phone.

I found your posts and those with rebuttals specifics to the papers quite a good read. All the best with your labour.

 

[Buttercup2]

Buttercup: there's a related research (it might be a follow on study from the Dutch study though I'm hazy on that point) that found women transferred from home birth have worse outcome than intended hospital birth, obviously it might be due to the fact that those needing transfers have more serious problems, I'm not sure if that is accounted for. I've read it when I was pregnant so I can't remember the details but thought you might be interested. You should be able to find it with google scholar, I can't do it right now as I'm on the phone.

I found your posts and those with rebuttals specifics to the papers quite a good read. All the best with your labour.

Thanks for the tip about that article! I'll definitely take a look at it.

 

[MandaAnda]

It does stand to reason that, if you transferred from home, it'd be for an issue that needed a hospital's attention anyway, so likely an outcome that would've warranted interventions if in hospital in the first place; or once in hospital, if only transferring for non-emergencies, the cascade of intervention started once there could mean the outcome was created by the hospital interventions.

 

[Buttercup2]

It does stand to reason that, if you transferred from home, it'd be for an issue that needed a hospital's attention anyway, so likely an outcome that would've warranted interventions if in hospital in the first place; or once in hospital, if only transferring for non-emergencies, the cascade of intervention started once there could mean the outcome was created by the hospital interventions.

While this may be true, we probably should read the article before jumping to any conclusions or having a discussion like this. Usually, the authors address this type of question.

 

[MandaAnda]

As the previous poster said she wasn't sure, I was just saying taking that into account would be reasonable. I can hypothesise whatever I like, and I didn't then and do not now have time to read the article. Dipping in and out of a message board like this is easy on busy days, and I'm one who has done extensive reading on the topic anyway, which is why I felt my assumption was a sensible one without looking up the article and digesting it. My statement doesn't prevent you from finding and reading it yourself.

 

[Buttercup2]

My statement doesn't prevent you from finding and reading it yourself.

I did read the paper. I guess by "we" I didn't mean "you and I"--I was trying to be generous/non-accusatory. It sounds like you felt accused tho by the defensive tone of your post, so I'm sorry for that. It was not my intention.

The truth is, even if scientific research papers show home birth is statistically less safe or there is slightly more risk for whatever (and i'm NOT saying that they definitively do), everyone is free to choose whatever they want. We don't have to get defensive or argumentative about it, and we don't have to be judgy.

Here's an example:
I choose to drive on the highway to get to work, even though statistically I have a higher chance of having a fatal car crash at higher speeds. I don't feel defensive about that choice; I own it. Driving on the highway is right for me. But I also don't plug my ears and say "lalala" when someone tries to tell me it's more dangerous. If it's true that it's more dangerous, I need to know that so I can be prepared. I'm still going to drive on the highway! If I am a safe driver with a safe car, my risk of having a fatal car crash is extremely low. I drive to and from work every day on the same highway and have never been in a fatal car crash in 4 years. I don't know anyone who has ever been in a fatal car wreck on that route, or even of any fatal car wrecks that were in the news.

I AM NOT SAYING home birth is automatically more dangerous the way driving on the highway is automatically more dangerous--I have no idea if that is true (prob depends on what country you are in). But if you, for example, have a complete placental abruption (very rare), the chance your baby will die is higher if you are at home. 15% of babies with this complication die even at the hospital where an ECS can be performed. It can take just minutes for baby to die, and there is nothing a midwife is going to be able to do besides call an ambulance. This is a true emergency C-section situation. This rare situation (and situations like it) are the "fatal car crash" of the having-a-baby world. The link below is a BabyandBUmp thread written by a woman who had exactly this happen to her.

https://babyandbump.momtastic.com/gestational-complications/205998-complete-placental-abruption.html

It isn't helpful to pretend these rare complications don't exist. And, it isn't helpful to pretend that these papers don't exist ...or are "not up with the times" or any of the other defensive arguments people have posed. Don't get defensive; you are smart, thoughtful people. Just because it's a wordy scientific paper doesn't mean you can't read it and make your own educated opinion about it. Without guessing. It only takes 10 minutes to read the abstract and the conclusions. That's enough for you to make a decision about whether you agree or disagree with the author's findings. And just because the author has a PhD doesn't mean you have to agree with her.

You can still choose hospital or home birth and neither choice makes you a bad mom. I'm not trying to convince anyone to make either choice (as I've said before, I might be in the home birth group next time around). I am trying to convince you, tho, that whichever choice you choose, please don't just read blog posts and books written by people who have the same opinion as you and then close your mind. Your mind doesn't have to be so open that your brain falls out, but it also shouldn't be so closed that new information can't even be processed.

 

[Noodlebear]

If I'd have given birth at home I'm not sure what would've happened... I was in labour for days, my baby's heart rate was dropping because I was sat at a funny angle and was squashing him, not sure if we'd have picked up on that if I'd stayed at home and then he was stuck and I had ventouse and forceps to get him out (thankfully avoided the c section!) and I had to have a blood transfusion..... for me the hospital was a god send and I think I'd have been totally traumatised trying to go through that at home (even though my labour was far nicer than some I'm sure). After all of that I can't imagine having a baby at home, the idea just frightens me now. I'd never judge someone for having a different view on the subject though, these are just my feelings.