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Nov 24 2012

Home birth Anecdotes

The following material pertains to this thread.

I wasn’t expecting the kind of backlash against a genuine problem that women face. Not just the denunciation of women who utilise real medicine but the spread of anti-obstetrician rumours. The idea that somehow a woman entering the hospital enters a hell hole of IV lines, things that go “BING” and doctors who claim they know more than women about the physiology…

Jokes aside. The link has stories and photos of babies and families who have suffered through home births. These are the casualties of this hidden quackery. A trigger warning therefore applies. As is a not safe for children without adults warning.

All the articles are provided by the families who suffered. Not by a third party. These are people who want their story to be heard. These are people who bought into the same comments on the original thread. These are people who looking for answers from the Midwives were ostracised and shunned and censored.

http://hurtbyhomebirth.blogspot.in/

There is a human cost to quackery. Buying into the bullshit that a home birth is feminist or empowering kills. Buying into the notion that it is safer or as safe as a hospital kills. Buying into the notion that hospitals are in it for some magic money kills.

I kept these stories out of the previous discussion because anecdotes do tarnish the discussion. We were discussing statistics there. Statistics are people but when you decide whether something is good or bad you have to look at statistics rather than individuals. Once we determined what is so bad about home births (The triple to quadruple mortality rate) you can start to see what really happened.

57 comments

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  1. 1
    Sophia, Michelin-starred General of the First Mediterranean Iron Chef Batallion

    I’m very glad you posted about home birthing, and by extension the woo that gets fed to pregnant mothers in general.

    From reading the comments opposed to what you wrote, I see far more complaining about how women are treated in hospital rather than any evidence of it not being as safe. Anyone saying a home birth is SAFER than a hospital birth is delusional. I can definitely see how it would be more pleasant and comforting, but certainly not safer.

    Yes, birthing at home may give you a personal feeling of safety, in that you are within your comfort zone with people around to support you. This is a good thing, for your brain. The rest of your body, however, and the body of your hopefully-soon-to-be-neonate require a lot more than a feeling of personal safety to deal with anything that isn’t a textbook delivery. Have the medical intervention at hand. If you don’t use it, then that’s fabulous. If you do need it, then you’ll have most likely saved the life of yourself and/or your baby.

    Birthing is an intensely physical, possibly very dangerous thing. Take care of the parts of you that are in the most danger, ok?

  2. 2
    Psychopomp Gecko

    Thank you for continuing to take the fight to the deluded and the deceived. It’s great to have someone countering “it’s not like we’re hurting anybody even if we’re wrong” with showing just how much all this quackery of theirs really does hurt people. That’s the part people don’t often understand when they pass along the information or promote it. More information will only help regular people who don’t mean any harm but have just heard from so and so that this alternative view is a great idea.

    I just hope you don’t get too caught up in the suffering to spend a little while on something that makes you smile. It can really take its toll on you to spend too much time diving into crap.

    At the very least take a snorkel and pair of goggles.

  3. 3
    Parsley Victorious

    It’s fantastic to see those educated in medical science speaking up against the woo that’s out there. Thank you for writing this.

  4. 4
    Syzorr

    If you’re not going to give sources for all the figures you keep pulling out, you could at least do us the service of keeping them consistent. In the previous thread you were stating an increased mortality rate of 2-3x… and now it is 3-4x?

    Keep the hyperbole coming…

  5. 5
    Crunchy Renee

    THANK YOU
    THANK YOU
    THANK YOU
    I have been waiting for someone in this community to notice all the deaths from this form of quackery!

    It is baffling to me how anyone can think HB is safe. IF you want to say “I know it is more dangerous, but I feel it is worth it”, thats fine with me. But that’s NOT what is happening. It *is* quackery because everything HB advocates promote is misinformation, so much of it Im not even sure where to start. You can see it anytime a HB advocate comes in and spreads their lies about how modern OB care is about cutting women and doesn’t save lives. they seem to think 1850 was great…..

    And calling NCB or HB feminist is the most awful misuse of the word. NCB IS Biological essentialism, which has nothing to do with feminism.

    ***I will say that I have TWELVE friends that LOST babies to HB, and another 3 with severely brain damaged babies (never walk, talk, eat or potty alone), and one that was so damaged she needed full reconstructive surgery- and lost her uterus. ALL from HB negligence. ALL were healthy, full term babies and the moms were healthy too.

    The stats are out there if you want them. Some states keep dats, like CO, WI, CA, MI, and you can see a very high rate of death. CDC wonder also shows the death rate between different providers and HB. The weakness lies in the fact that most data collected puts transfer deaths in the hospital category, which makes HB deaths even worse (and they are bad, 3-12x more deadly!).

    In my experience, Hb advocates don’t care for stats. They think they are wrong and love to quote the 2 papers that show HB as kinda safe (not in USA, and not without a 40% transfer rate and serious risk out criteria, but I digress…), but they ignore everything else.

  6. 6
    Crunchy Renee

    When I said above that the way most data is collected makes HB deaths worse, I meant that it seriously UNDER counts them. This is because often times if a baby died at the hospital after transfer, due to a bad incident at home, it goes into the hospitals stats. So the number of HB deaths is often shown as LESS than it really is.
    Even so, it’s so much higher than hospital birth.

    It’s late, so I won’t even get into the poor “education” of NON CNM/CM MWs. Let’s just say that before this year, you didn’t even need a HS diploma to be a CPM, and in Oregon, anyone can call themselves a MW and be one. And there is NO WAY to know if the MW you are hiring is dangerous, and many have multiple negligent deaths to their name (Brenda Scarpino Newport in Ohio has killed EIGHT babies, for example).

    Then, when something goes wrong, you cannot sue them, as they dont carry insurance. Kristine Andrews IS trying to sue Motherwise BC and the State of Oregon, as she now has to foot the bill for a child with severe CP, who will never walk, talk, eat or potty alone (and taxpayers pay too). (Moderated: The link that goes here was for the wrong site – Crunch Renee can you repost the link?)

    Their licensing group (NARM) wont revoke a license even when a MW is found to have killed due to negligence. One example is Faith Beltz, CPM in Austin, that killed Aquila Papparella. NARM took almost 2 years to do nothing, and in that time, she killed another baby and caused the mom to need a hysterectomy.

    Ancedotal, I know, but HB advocates always rely on them to show safety, as in “my baby was a footling breech HB, and he’s fine, so it’s totally safe!”. So I figured it was OK to add them here.

    (Moderated – Link didn’t work)

  7. 7
    Avicenna

    @No. 4 – Syzorr

    Not really. Your mathematics is just terrible.

    For every 3 home birth deaths, 2 would not have died in a hospital.

    AKA If you have 30 Home births, you would have 10 Hospital Deaths if those mothers delivered in a hospital.

    AKA Three Times Higher.

    Now. New readers will probably demand a paper for this…

    The CORA open record petition in Colorado gave us these figures…

    http://3.bp.blogspot.com/-0O74HqZ3CsY/T9Jzp69bs4I/AAAAAAAAB6I/UzyxAxAZBPY/s400/Colorado%2Bhomebirth%2Bmidwives%2B2010.jpg

    Look at the 2010 stats. That’s… Huge. That’s not proper PMR too. That’s just deaths of delivered babies. If you went to a medical site you would see PMR which includes stillbirths. The midwives don’t include those. There are countries out there whose IMR (birth to a year) mortality is lower than that…

    The NMR in the USA is 4.19 per 1000. This is more than 15. We are using NMR to compare to this because PMR includes still births.

    http://www2.cfpc.ca/local/user/files/%7BF8052A68-D510-401A-B323-0D9DA912C58C%7D/planned%20place%20birthj.1523-536X.2010.00458.x.pdf

    This is from a pro-home birth website.

    Go See The Actual Bloody Statistics they Use. It’s designed to make them look good. They compare only tertiary hospital deaths where all the hospital related deaths would occur because that’s where the most difficult births go.

    You are comparing hospitals to home birth. The hospital total deaths is there. The total hospital births are there. Work it out. Do some real science. This is as empirical as it gets. It’s not rigged, it’s actually stats from your side just being interpretted correctly.

    The mortality given for home births is fine, but they use the wrong denominator for their hospital births. AKA only tertiary care hospitals which is where the most difficult pregancies are dealt with. It’s bound to have the highest mortality rate. This is due to the fact that you cannot determine the quality of a doctor by mortality rate (In some cases really good doctors may have high mortality rates because they take very difficult cases). The tertiary care hospitals in NZ are usually for serious cases.

    The figures are astounding. You have a 0.11% mortality rate for home birth. And a 0.03% rate for a hospital one if you work it out. Even in New Zealand the numbers hold true. The PMR in hospitals is a third of the PMR in home birth at the very least.

    My figures are actually steady throughout. The issue is you are confusing 2 out of 3 homebirth deaths would survive in a hospital with the mortality rate is 3 times as high (Or if you want to be suitably scary… The mortality rate is 200% higher for homebirth than hospital…)

  8. 8
    Syzorr

    @Crunchy – as we know, the only real science happens in the USA… *rolls eyes*

    Science, you’re doing it wrong.

    Almost all the papers and reviews from the US that I have found over the past couple of days, while attempting (unsuccessfully) to locate Avicenna’s uncited figures, come to conclusions that actually mirror my opinion on the subject. The following link

    http://www.ama-assn.org/amednews/2012/02/13/prsa0213.htm

    reports on a finding that neonatal mortality is 2-3x greater for home births but that it comes at the cost of increased medical intervention (much that is unnecessary). The reasons why increased neonatal mortality is such a problem in the US (and doesn’t show up as statistically important in studies outside of there) is more likely to be due to the poor and inconsistent quality of the US health system and allowing unqualified (I consider qualified to be the equivalent of “NPM” which is what every midwife in NZ has to be to be registered) midwives to operate through becoming certified.

    Remember, the world doesn’t end once you hit an ocean…

    Heck, the reason the baby survived in the (currently) 2nd story (http://hurtbyhomebirth.blogspot.in/2011/08/sheppards-story.html) on the link posted by Avicenna was because the doula was sane and the *certified* midwife wasn’t. Once again, it couldn’t possibly be a system that allows unqualified midwives to operate at fault, right?

  9. 9
    Syzorr

    @Avicenna – please link to the paper for that jpg

    An image of stats with absolutely no context does not make a citation…

  10. 10
    Syzorr

    Let me get this straight… the reason that there is a higher rate of neonatal mortality in the US is because of untrained/poorly trained midwives able to become certified/registered that are unable to provide proper health care to their clients… and the fact that midwives don’t collaborate with the ob/gyn seems absolutely insane to me (because here you have BOTH a registered midwife and an ob/gyn all paid for by our socialist health system)…

    Funny how that sounds so much more like an issue with the health system rather than home births…

  11. 11
    Crunchy Renee

    The link was suppose to be:
    (Moderated: link is super busted still! It just goes to a domain host page rather than anything related)

    sorry about that!

  12. 12
    Avicenna

    It’s data released by a “Release of Data” to Dr. Amy from Colorado. American homebirth and midwifery associations do not publish their stats unless you force them to.

    Why are we taking only american stats into account? New Zealand has better medical care and if their stats are the same then surely the same applies to America.

    http://www.smfmnewsroom.org/wp-content/uploads/2012/01/Abstracts-62-70.pdf

    Paper no. 65

    C-section rate is lower in home births (because those who need C-sections tend to go to hospitals ANYWAYS) the APGAR scores lower than 7 and the neonatal seizure rate are significantly higher.

    http://www.smfmnewsroom.org/wp-content/uploads/2012/01/Abstracts-537-686.pdf

    Paper 563

    Odds Ratio of 2.3 for home birth mortality. Wow.

    Ignoring the CORA stats I have posted information from 2 American Papers, 1 NZ Paper (which was lauded as better than the smelly decadent amerikaners) and one BMJ paper on the Netherlands.

  13. 13
    Avicenna

    And I put up New Zealand’s statistics where people assured me the midwives can kill orcs and destroy evil rings and aren’t not like the american ones who cannot do any of those things. And the Dutch one too. Are you suggesting that the CPM paradise that is Holland also has incompetent midwives?

    Are you suggesting that the USA’s, Netherlands and New Zealand’s midwives are all not that well trained and educated? Compared to doctors who spend more than a decade training in those skills?

  14. 14
    baryogenesis

    Not a doctor; not a scientist. Was an artist, a New Ager. I was involved in two relationships which resulted in children, one in the 70′s and one in the 80′s. Both were home births. We had a doctor who would attend home births; the same doctor 11 yrs. apart before he retired. The first birth, my daughter, in 1971, was fine. My son, born in 1982, was a bit more of a problem. He stopped breathing after 2 days at home. My wife had nursing training She resusitated him, then we rushed him to the hospital.Antibiotics helped him recover from a type of bacterial meningitis.
    Around the same time a friend delivered all four of his wife’s children by himself, once having to unwrap the umbilical cord from the neck.
    Different times.

  15. 15
    Syzorr

    From the first paper linked:
    In response to your “C-section rate is lower in home births (because those who need C-sections tend to go to hospitals ANYWAYS)”, I would point out that only 1.01% of births used for the study were intended to happen in home or at a birthing centre. Somehow I doubt 98.9% of pregnant women are high risk cases and that 24% of them need c-sections…

    From the second paper linked:
    “The following variables were included as covariates in the final regression model: age, race, marital status, education, prenatal care, tobacco use, composite medical comorbidities” – would love to see the full paper to see how he used those particular variables and what they covered. After the previous points I have raised above, would also love to see a US paper that uses two additional variables “access to health care” (taking in to account the varying quality of health care available all over the US) and “qualification level of prenatal care” (considering my cat could possibly be a midwife in the US).

    Care to take it from the top again?

  16. 16
    Syzorr

    @baryogenesis – you do what is required based on the situation presented in my mind and if a woman wants a home birth because the indications are that it will be safe, then they should not only be allowed to but should receive support to make sure it is as safe as possible and that if medical intervention is required that it is accessed as soon as indicated.

    I think this would fit with your experience? ^_~

    If we attempt to dissuade them from having a home birth by forcing them in to hospitals against their will, we run in to the same issue that women seeking abortion used to. That by forcing them outside the system to seek what should be a reasonable request (to be able to give birth at home with minimal intervention unless necessary) we are increasing the mortality rate because when issues occur they can’t easily access the level of medical care they need.

  17. 17
    Crunchy Renee

    Of course real science isn’t just in USA, but there are major differences in how HB is handled in different nations. THIS is why it is not useful to use a HB study from the UK (Birthplace study)’ or from Canada (don’t recall the name) to prove that HB is safe everywhere. What works in UK does not work in the USA. I also don’t think that 2 studies prove anything for everyone, but HB advocates are using this data to convince moms that it’s safe to HB.

    Those above mentioned studies are the only two studies in the entire world that ever came up with any positive stats for HB, and the safety is for such specific groups, and no, the Wax study doesn’t show Hb is safe at all. So, you *could* say that HB is reasonably safe for a small subset of moms: healthy low risk women, on their 2-4th baby, with no risk factors, no medical issues, all past births uncomplicated VBs, being cared for my highly skilled, university trained, regulated, evidence based MWs, in a nation with a health system where they are fully integrated, getting evidence based, regular prenatal care, and risked out and transferred at a high rate. Emergencies do happen, and you may not get to help in time. However, in this very specific scenario, you can say it’s safe enough.

    This still does not prove HB is safe for anyone but that subset, in that one study, especially as HB is typically, routinely, practiced in ways that are nothing like those that made it safer in the study. Here in USA, HB is a very scary proposition, as we have MWs with no training, who are basically faith healers that believe things that are totally absurd, no regulation, and moms of all types wanting HB with MWs taking them on (breech, VBAC, twins, etc). These MWs don’t follow rules, there are no protocols that are mandatory, and no accountability if bad things happen.

    The BIG problem with Hb and NCB *is* ideological, more than the location of the birth. I would have no problem w HB if the above protocols were common and moms were fully informed. Sadly, US MWs and moms both believe so much nonsense that they aren’t actually informed about the risks. Or about pregnancy at all. This causes them to make bad choices and dangerous judgement calls, all due to their ideology.

    Some examples are: OBs will just cut you and don’t care about you, “you cant make a baby to big to birth vaginally”, the cervix is a sphinctor (?), GBS is no big deal and can be cured with garlic in the vag, GD is not worth testing for, postdates is not a problem as babies aren’t library books, epidurals are very bad for babies, induction leads to Cs and is never useful, pitocin is horrible, you won’t be able to bond with your baby if you don’t have a NCB, OBs have never seen a NCB, breech is a variation of normal, herbs will stop a PPH, eating placenta raw will stop a PPH, and on and on and on.

    I didn’t save the links to the HB stats from CO, CA, WI, and MS, but they are online. COs are even collected by HB MWs- and they are horrible. It’s super late here (almost 3am EST! I’m out of town) but I will dig them up and post them for you tomorrow.

  18. 18
    Avicenna

    Syzorr –

    That’s a bad argument.

    We have pre-natal screening. It’s not a random assortment of women who go to home births or obstetricians. They recieve pre-natal care. No obstetrician in their right mind would allow a woman with indications for C-section to go for a home delivery on their responsibility. That’s like running with scissors stupid.

    Women have ultrasounds to see if their births are progressing normally. Those that aren’t go to the hospital because there are some things for which C-section is heavily indicated. Pre-Eclampsia, Hypertension, High Risk Foetus, Macrosomia, Abnormal Presentation, Placental abruptions. These are all detectable BEFORE the decision even comes about. We can straight up say “No, your plan to have a home birth is not medically advisable.” Most midwives won’t take these cases lest they die and mess up their stats.

    You don’t get C-Sections in home births because the people who need them go to the hospital because midwives CANNOT do them. Not without killing you.

    It’s like saying that you are less likely to suffer a broken bone if you stay at home than go to a orthopaedics ward. Most people in the Orthopaedics ward have broken bone. Most people at home don’t. Ergo Orthopaedics wards break bones.

    And those are odds ratios. It means that they are being compared to the base line which is hospital births. A 2.3 odds ratio means 2.3 deaths to 1.

    Have you got any papers to back up your nonsense? I have posted more than one…

  19. 19
    Syzorr

    http://hurtbyhomebirth.blogspot.in/2011/03/zens-story.html

    Have you even bothered to read the website you linked to? A lot of these women are not receiving the medical care they need (like medically indicated, necessary C-sections and antibiotics) because of a health system that is failing them. In the case of this story it is because of, AGAIN, another of these “certified” midwives. Also to note in this story is that it happens in Colorado (where you get your home birth death stats from most of the time) and that after transferring from obstetrician to midwife she never had another appointment with the OB.

    Oh wait. “It’s not a random assortment of women who go to home births or obstetricians. They recieve pre-natal care. No obstetrician in their right mind would allow a woman with indications for C-section to go for a home delivery on their responsibility. That’s like running with scissors stupid.” So the Colorado health system is running with scissors now? These stories are the evidence of a system that is failing it’s people and isn’t an argument for preventing home births.

    One funny thing I noticed while reading through all the stats for Colorado is that, apparently, being black and pregnant has a neonatal mortality rate double that of *ANY OTHER* ethnic group. I have no idea why this is, low socio-economic status? I don’t know but, just maybe, the old chestnut “correlation doesn’t imply causation” is appropriate here and is one of the reasons that studys investigating the topic of home births are unwilling to label the location of birth as a deciding factor in neonatal mortality – because they cannot prove it off the data they have.

    In my opinion, more likely, the variance (as in, uncertainty of quality of care) in available quality of care by location of intended delivery is much more an indicator of neonatal mortality outcomes. Standardize the quality of available care for all and have a single, high qualification “bar” that all practitioners must pass rather than this stupid “certified midwife” bullshit.

    Fix what’s known to be broke (and don’t try to claim the US health system is anything but) before going after women for making choices for themselves.

  20. 20
    Syzorr

    http://www.coloradohealth.org/ReportCar/2010/subdefault.aspx?id=4921

    This is where I got the figure for the increased neonatal mortality for blacks. However, just noticed the chart at the bottom that details average neonatal mortality across all 50 states – and Louisiana and Mississippi have >10 per 1000 as an average. I guess socio-economic prosperity has nothing to do with medical outcomes…

  21. 21
    Avicenna

    Can you please re-read that story. This woman is not indicated for a C-Section. This woman is indicated for an Antibiotic drip.

    It starts with…

    “Half way through my pregnancy, I made the mistake of watching The Business of Being Born. It absolutely terrified me. I was convinced that should I allow the hospital to be a part of my birthing experience, I would be given Pitocin. The Pitocin would make the contractions unbearable. I would then be given an epidural, forced to labor on my back with a fetal monitor attached to me, unable to move or feel my first child come into the world.”

    Sounds familiar… I seem to have heard these comments before

    “When I asked my obstetrician about natural, active childbirth, she said, “We’ll see.” That was not good enough for me. We’ll see?! Was it the folly of youth that gave me such a strong desire to need a guarantee of safe passage into motherhood? The fear of the unknown? Being alone without a partner to ease into the rhythm of parenthood alongside me? I did not want whatever obstetrician who happened to be on call to deliver my child- I was looking for a wise, experienced shaman to guide me safely through the oceans of fear, pain, and uncertainty and dock me safely in the harbor motherhood- a journey, rite of passage, centuries of women took before me.

    I transferred care to a midwife. Towards the end of an uneventful pregnancy, my midwife asked if I wanted to be tested for Group B Strep. She said not many midwives tested for it- that OB’s had just begun, within the last 5 years to routinely test for it. Since my prenatal care had begun with an OB, I had been tested for everything under the sun and the results gave me a very a strong peace of mind. Knowledge is power- of course I would take the simple swab for more knowledge.”

    Oh…

    “The result was more than a hiccup in my birth plan. I was GBS positive. Which meant, according to my research, that I would need at least four hours of antibiotics before the birth of my child. IV antibiotics my midwife could not provide. I was heartbroken and began mentally preparing for a hospital birth. My family was relieved. However, my midwife was unconcerned. She kept repeating over and over, “According to state regs, it does not rule you out of homebirth. So many midwives don’t test for it- their clients have GBS and don’t even know it. They still birth perfectly healthy babies. We can use garlic and a clorohexidine douche during labor. It just means after your water breaks, you only have about 12 hours to deliver the baby.” After a while, the repetition of that mantra placated me. I trusted her deeply.”

    OH!!!

    “That night, I went into labor. When my midwife arrived, I was 5 cm. All I wanted was to be on my hands and knees, but she kept forcing me up, forcing herself behind me and pulling my belly up with her hands. It was beyond painful. After nine hours, she broke my water, something we had agreed that based on the GBS, she would not do. She told me there was “slight meconium,” and I learned days later from my family who had witness the gush, that it was all meconium. She cleaned up the soiled Chux pads so quickly, I did not see them. We repeatedly did clorohexidine rinses.”

    WTF???

    “she even began separating my mother and sister (people whom I wanted with me!) from me, accusing them of “negative energy and keeping the baby from being born.”"

    Really? Stop blaming the electrons.

    “After three grueling hours of being yelled into pushing every ten seconds, I was exhausted. I had not been offered food, water, or any breaks. I remember saying that I was going to pass out, so my midwife put oxygen tubes in my nose and left the room. I was thrashing around the bed, beyond frustrated and in extreme pain. “I can’t do it…something is wrong,” I remember saying. My mom looked at the oxygen tank. It was not on. When my mom told my midwife that she did not turn the oxygen on, she laughed and replied, “Oh, I forgot.” At this point, I wanted to transfer to the hospital.”

    *head desk* If you remember correctly the mother bought into the same bullshit you sprouted and picked a midwife. Not a doctor. But a midwife. The Obs in this case didn’t want her to go for this. Instead she got stuck at home with someone who isn’t fit to deliver a cow let alone a human being.

    Your actual statement is that “Well clearly this is the doctor’s fault” despite the fact the mother bought into the Natural Birth/Home Birth line that it’s perfectly safe. Even when indicated against it, midwives told her that it’s perfectly safe. She bought into this entire piece of quackery hook, line and sinker.

    By all indications this woman refused to see her Obs after they were vague about homebirth possibilities. I have been to the USA repeatedly. If the standard of Obstetric care in the USA is the same as Indias (A third world nation where there is nearly a 100 times the medical burden on the practitioner due to the population) then the obstetrician would have stopped her from going for this stupid endeavour.

    All indications suggest she ignored experts and listened to the quacks. She was misinformed. She refused medical care, refused to listen to common sense and only listened to home birth midwives and practitioners. A routine variation on birth got turned into this song and dance because of the ineptness of the midwife.

    A CM midwife who claimed that she could treat GBS with garlic. 99% of NPMs (Who I keep telling you EXIST) work in hospitals. They are trained medical professionals. They are skilled enough and sane enough to do so. They base their skills on science. They are a post graduate NURSE. They are a Nurse Practitioner Midwives. I keep telling you that they fucking exist but you don’t listen. These are CMs. Certified Midwives. They are diploma holders out of highschool. (An obstetrician is a double postgraduate). The level of education difference is massive. CMs are the idiots telling people to have home births. Obstetricians and NPMs are telling you to go to the hospital. I think I have explained this simple concept over and over again to death.

    Garlic? And you think these people’s ethos is appropriate for your healthcare? They aren’t feminists. They are quacks and idiots who prey on people’s fears under the guise of feminism.

    This sort of thing happens in India, I can say “Well they didn’t have the education to realise it”. In the USA? There is no excuse for an ethos this stupid.

  22. 22
    Syzorr

    Are you bothering to read what I am saying? That I said “like medically indicated, necessary C-sections and antibiotics” and that my entire continuing point is that the US health system is fucked and one of the WORST symptoms of its fucked-uppedness is these certified midwife morons. Most countries *ONLY* have what you refer to as NPMs.

    Also, I am not blaming the doctor, I am blaming the health care provider who was the midwife.

    Next time, please try to read more carefully. It would help. You are building beautiful straw men to rail against but, sadly, they aren’t real and what I have said previously is clearly available for everyone to read here.

    Also, you still haven’t posted an original link for that little jpg of yours. Would still like to read that study or it’s source just to see the context… (because I notice it was hosted on BlogSpot)

  23. 23
    Avicenna

    CMs are not part of the american medical system. At all. The AMA’s gynaecology wing don’t recommend them at all. The CDC doesn’t recommend them. Remember we talked about “freedom”. There is an entire group of them called “Women in chains” that tries to portray them fighting for birth freedom against a system that seeks to destroy them rather than trying to keep practicing despite facing investigations for deaths.

    And there are quacks who have NPM and even MD status. Mayer Eisenstein ran a natural birth centre…

    Where his incompetence killed people. And the worst bit is he is still walking around telling people that the reason those babies died was because their mothers killed them (Because mothers have the power to lyse all their babies blood simultaneously. Think about that the next time you forget Mothering Sunday). The entire ETHOS is faulty. That’s why these idiots exist. If an NPM believed in this she would be just as lethal as these clowns.

    Even if you had an obstetrician in a home birth you would have these stats. The obstetrician’s skills come from his equipment. It’s like expecting a formula one pit mechanic who can change a tyre on a car in 20 seconds flat to do so without a jack or a wrench. It doesn’t matter how skilled you are and how knowledgable you are if you are trying to work at home. You cannot McGuyver a Labour Room.

    Your colorado link is down. When it is back up I will deal with it. My Colorado stats are from Dr. Amy Tuteur who was supplied the CORA. I have generally argued the non american stats due to that. However I do possess the stats for California which requires some processing.

    We can argue with those if you like.

    http://www.mbc.ca.gov/allied/midwives_2010_annual_report.pdf

  24. 24
    Syzorr

    Not really, no.

    Those stats are still based in the US and no matter how much you may like to argue over numbers, without appropriate context they are worthless. My feeling that the inadequacies of the US health system won’t be assuaged just by going over more numbers without being able to, at least, analyze it in context of the level of health care the mothers were receiving. Also, if we were to play at statistical analysis, would also want the hospital data for that period too.

    Also, the chart from the previous link I posted from the AMA shows the break down of attendees at a home birth. When nearly 20% are these certified midwives, then that is showing a serious issue. Despite you saying that they aren’t recognized, they are. Somehow they are becoming certified and are being recognized under some system – if not under the health system then how?

    If your bugbear was to shut down peddlers of poor health advice and certified midwives, you would have my full support but currently you are tilting against home births. There is no actual scientific evidence to support your attestation that they are significantly more dangerous than hospital births.

  25. 25
    Avicenna

    Except my NZ stats were for all home births. I keep pointing it out to you. No responsible physician thinks a home birth is superior to a hospital birth. No responsible NPM does that too. Because when you require a NICU time is of the essence. An ambulance ride may be too long. If a trolley push of a few dozen metres is sometimes too far why do you think a 10 to 15 minute ambulance ride is acceptable?

    Ultimately home births will never be as safe as a hospital birth. It’s because available technology is vital. If you get an instrument birth at home then all you can do is hope you can get to the hospital before anoxia hits the baby… If you get one of the myriad complications of VB that require special equipment you have to travel to the hospital and hope that the mother’s contractions don’t harm the baby. Rather than going to the hospital without duress delivering the baby and going home you are actually increasing the risk of having to waste time in a hospital treating a pointless issue.

    It’s simple. You have a shoulder presentation owing to foetal movements. You need an ER C-section. How long do you need to wait in a hospital? (It takes minutes to induce anasthesia if you have an IV in. A skilled practitioner can deliver in under 10 minutes. If you are under epidural it can be as low as 5 minutes.)

    Your ambulance won’t even get there in 10 minutes… You would literally burn 30 minutes of precious time when seconds count just travelling to the place and getting prepped and running tests.

    In stead you could show up early, be comfortable, deliver the baby with no issues and be recuperating. Hell if you want a LA C-Section you can hold and feed your baby while they are stitching you up… Unless NICU is needed most mothers get sent home in a few hours. If you need to stay in a hospital then the baby is usually kept in the same room as you.

    You are painting the american medical system as worse than a third world nation. It’s simply not true. American Obs/Gynae is one of the best systems on the planet. The problem in the USA is that people are free to do stupid nonsense.

    Your own beliefs would have you ignore a doctor who said that Home births are worse for outcomes. You are hunting a mysterious “Safe Pregnancy” that is 100% safe. You cannot predict 100%, usually these pregnancies go well. Sometimes they do not.

  26. 26
    Syzorr

    Currently I only stand at 1 C-section because the last one was the only planned C-section, it was lower abdominal and despite the fact that it was purely straight forward, my wife was kept still the entire time while they were stitching her back up and was somewhat out of it with the epidural. It was nice that she got to see and have contact with the baby almost immediately, but holding her (let alone feeding her) was out of the question. That was left until she was back out of the operating room.

    If I can ask, how many C-sections have you actually been present at? How many deliveries have you been present at? It may seem a little trite to ask these questions but your posts read like someone who has never actually had to be there because you are constantly glossing over a lot of the valid issues that many people have with the medical profession and hospital treatment…

  27. 27
    Avicenna

    18… 15 planned 3 emergency.

    The issues a lot of people have are ones of perception. You are constantly being told that the needle is painful or the IV is unnecessary or the pain is good. You have a problem of perception. You are buying into the notion that somehow all the advancements of childbirth are bad.

  28. 28
    Syzorr

    It’s good to know that. And no. If anything I am buying in to the belief that women should have choice and that improving the inadequacies of health systems would allow them to have greater choice rather than closing an avenue such as having a home/natural birth to them. There are *many* factors that lead to increased neonatal mortality and judging from the research, intended birth location is not that high on the list of contributing factors.

    Many of the studies cite a reason why it is difficult to investigate this adequately. There is a complete lack of control group. The only possible analysis is merely statistical analysis of the results with no ability to test a hypothesis. And as a quote I had pointed at tonight read, if there isn’t money to be made from the research, the medical establishment won’t get funding to do it.

    And what does *any* of those things listed have to do with whether home birth is scientifically provable as related to higher neonatal mortality?

  29. 29
    Avicenna

    You aren’t understanding the point. The inadequacy of the american health system is pertaining to the fact that it is privatised and is publically subsidised rather than publically funded. However women’s health is one of the things

    You are plain ignoring the data from New Zealand which shows that in a system with universal healthcare system. The socio-economic status of care doesn’t bloody change. Everyone has access to the best medical care available if they need it. The same in the Netherlands. Across Every Single Demographic the care is the same. They just have to show up to it. And there the stats hold true…

    The majority of home birthers are rich, middle class/upper middle class women. Predominantly white. The only people I know off who have had home births and aren’t “white” are three asians (one of the women whose child died at Mayer Eisenstein’s clinic and Taslima. And one of the women from the OP Link).

    The majority seem to be women who simply will not believe anything you say about medicine and who think they know their bodies better than the people who study them. I understand it’s great rhetoric when you face down republicans who want to stop abortions but you have legs right? Does that mean you are an orthopaedic surgeon?

    People love comparing this to abortion. It’s not. Abortion’s argument is between legal and non-legal status.

    This is like saying I don’t want an abortion in a cold clinical hospital. I want one presided over by a traditional massage abortionist. Choice…

    You can never make home birth as safe as a hospital birth. There are just so many things that can vary and cause deaths even in a healthy woman with a healthy baby and a skilled obstetrician without the equipment and support staff that are required.

    You may have the most amazing radiologist in the world but he cannot detect diseases without his tools. If you separate him from his tools his tools just become expensive pieces of art and he becomes an undergraduate doctor… With his tools however he turns into a completely different beast. For the same reason that even if you had a NPM or a Obs doing a home birth, you could never ever beat an Obs or a NPM in a hospital.

  30. 30
    N. Nescio

    Home birthing nearly killed a friend of mine.

    After the midwife let her go through 45 hours of labor, she finally went to the hospital, had a c-section, days of emergency surgery (ruptured colon), and left with a healthy baby and a stack of medical bills she’ll never be able to pay off in her lifetime.

    This is why every time I hear a ‘pro-life’ supporter talk like pregnancy is this easy-peasy walk in the park that couldn’t possibly cause any harm to the woman carrying it, I have to work hard to suppress the urge to punch them in the face.

  31. 31
    maxdwolf

    I posted your original article on my Facebook page and, as I expected, got one of the most negative responses ever to one of my posts. I may lose a friend. Oh well, sometimes the truth hurts.

    Where I disagree with you is in your assertion that this is not a matter of choice, like abortion is. I’m afraid that it is. I’m all for informing a woman of the risks she faces if she chooses home birth. Want to call her a fool for choosing it? That’s fine. But it is still her choice.

    How I personally would like to see the problem addressed is through an improvement of the birthing experience at those hospitals where it may be a problem and, more importantly, a strong public education campaign on the risks of home birth.

  32. 32
    SallyStrange

    It is very much like abortion, in that outlawing it will not cause the practice to disappear, as has been proven from previous experience. And that will serve to make it even less safe. Which is why I think providing resources to make home birth as safe as possible, rather than forbidding it outright, is the best option. I asked you before what your preferred solution was but you never responded.

  33. 33
    Avicenna

    No. But we should stop treating it as an option or as a choice. Homeopathy is not a choice but we call it’s proponents and users out as stupid. And homeopathy doesn’t kill as many people as this does.

    It’s an inferior and dangerous way of giving birth. It is not recommended. It’s proponents are highly untrained and are outright hiding stats and engaged in an active campaign to discredit real medicine. Not vaccinating your kids is choice too… But we treat those who don’t as ignorant imbeciles.

    Read through the comments. There are plenty of people who have suffered at the hands of these quacks who don’t have voices and are simply ignored. They aren’t a choice. Comparing them to the abortion struggle is doing a great disservice to those who fight for women’s rights. This is an entirely different struggle to reduce the effect of a novel form of quackery from harming children.

    One of the papers mentions that the odds ratio for deaths and morbidity in childbirth are lower in women who smoke than women who go for homebirth. If we campaign against women smoking then we must campaign against this form of quackery. It really is that simple. It’s proponents to this day still are wandering around saying that doctors just like to cut people open and that deaths are higher in hospitals than at homes.

  34. 34
    Erin McC

    ive spent the better part of the day being highly upset and irritable about this whole topic, and i finally figured out why. its the idea that those who choose homebirth believe in “woo”. certainly for some, there is woo, i wont deny that. some choose homebirth because of religion.

    but a lot choose homebirth because it is the opposite of woo. homebirth is often the complete acceptance that we are biological creatures and part of our biology is procreation. childbirth is a natural part of life. and like sex, natural death, and other notable parts of life, medical intervention is usually not necessary.

    ive known a lot of women who chose homebirth, and not a single one ever said it was because homebirth was safer. for some women, it was because they FELT safer at home, for others, because the hospitals they had access to wouldnt “allow” vaginal birth (vbacs in most part). some wanted a water birth and hospitals wouldnt allow that. others didnt want the routine interventions that are almost mandatory in some hospitals (iv, efm, repeated pelvics, no food/water, confined to bed, etc). some women chose homebirth because of tramautic experiences previously in hospitals, including things like forced exams, sweeping of membranes without consent, or failure of anesthesia in previous cesareans.

    the one thing they all had in common was an acceptance of the risks involved. i never knew a woman who chose homebirth without comparing the risks. ive known some who choose hospital or even cesarean after evaluating those risks. and those who chose homebirth did so knowing that their risks for certain things were higher.

    a better use of the forum and time would be spent on examining WHY women choose homebirth. not assuming why they do, but actually finding out. you wont get those answers by calling homebirthers moronic, quacks, or implying they arent educated enough to make their own medical decisions. you’d likely find that a lot of women are choosing homebirth not because they want what home gives them, but because they DONT want what the hospital requires of them. that means its not something that the homebirthers are doing wrong, its something that the medical profession is doing wrong.

  35. 35
    hemlock

    “a better use of the forum and time would be spent on examining WHY women choose homebirth”

    Haven’t you already covered that by saying they “feel” it’s safer. Those feelings aren’t facts and there is a reason why in the US and in NZ (where I’m from) they want them in hospital for VBAC’s and suchlike – there is an actual, measurable risk of things going wrong.

    Getting told that risk doesn’t exist and expounding on myths about hospitals (i.e. they won’t let you eat and drink, and you aren’t allowed move around, pain relief is an unnecessary and potentially dangerous intervention etc) is the reverse of choice. It’s being lied too, site of birth does matter. Risk profile does matter. What is weird is midwives, even the poorly trained ones in the US check progress by checking the cervix and so on. You’re getting not much different at all, but with more at risk, it’s a baby you want isn’t it? It’s not just about process. The higher risk of perinatal death should be something women are informed about. The high transfer rate another. That if things go wrong, there simply isn’t the advanced care at home and that can sometimes mean the difference between life and death.

    Didn’t think I’d ever quote the Daily Wail, but this is pertinent and addresses some of the issues:

    “I’ll say this for these evangelical anti-obstetric lobbyists: their use of figures is cunningly clever. They will point, for example, to the ‘success rate’ of midwife births, at home or in an midwife-led unit.

    Only in small print do you find this: a full 40 per cent of them, if they are first births, end up being transferred to a hospital midway through labour — half as emergencies, half because the women are scared, in agony and deciding a natural birth doesn’t feel as appealing as it did.

    It would be a heck of a way to enjoy a contraction, I’d have thought: terrified, stuck in a traffic jam, blue light flashing and a whoo-whoo screaming from a siren over your head.

    Which leads to another devilish statistic: if, once you get to the hospital, your poor baby should die, that then counts as a hospital death, not a midwife death.

    This is why the safety of home births is overplayed; research shows that although women do recover more quickly from home births than hospital births, their babies are twice as likely to die.”

    http://www.dailymail.co.uk/femail/article-2236535/Is-NHSs-obsession-doctor-free-births-putting-babies-risk.html#ixzz2CwFncLmn

  36. 36
    Avicenna

    It’s got between 100 to 300% higher mortality and morbidity than hospital births while claiming to be superior. It’s Woo. There is no other word to describe it. You can be as irritable and upset as you like, the stats are clear. It’s empirically terrible for women to do this. It’s dishonest to claim that it is better than a hospital birth. It kills babies who don’t have to die. It kills women who don’t have to die. It misrepresents itself and it uses completely unskilled practitioners to do things while making false claims about the real science. It is classical woo. The only reason it has gotten away with so much is that it claimed to liberate women so no one wanted to take it on lest they get called sexist.

    The entire paragraph on homebirth being the acceptance of you being extremely biological and natural is only acceptable if you shouted it loudly rather than typing it out on a manmade box of melty sand and tame lightning. It is human nature to be unnatural. We are the finest tool users on our planet. We are faster than the fastest fish, mammal and bird. We used to be able to fly at twice the speed of sound. For Fun. (We cannot anymore. Concord doesn’t fly). And saying that “natural” is better is to completely ignore the non medical mortality rate of “nature”. Nigeria has very very poor medicine coverage. Everything is natural there. So natural that 120 out of 1000 children die in the first year of life. It’s natural population control. Dying of disease is completely natural. As is starvation, hypothermia and countless other things that we have done away with through civilisation. Procreation is fine, however you seem to think evolution is great. Evolution is powered by death. Survival of the fittest is a kind way to put it. Evolution is the death of those who are not fit. Humanity doesn’t like those odds. So it uses various tools to intervene to create new evolutionary pressure than the ones nature puts on us. Without medical intervention you would lose 25% of your babies and die aged 35 to 40. You have this very genteel view of nature. Remember… Nature includes the bacteria which kill mummies if you don’t wash your hands.

    Hospitals allow VBACs if the previous C-Section wasn’t the old transverse scar. Because the risk of uterine rupture is extremely high. The modern C-section is placed along the rectus sheath which is thicker and has better healing. If that heals correctly a VBAC is possible. If it doesn’t then under the pressure you can herniate or rupture. Water births are fine. In fact in the UK 65% of hospitals have pools for Water birth. However some people shouldn’t have them. It’s contraindicated in certain conditions because disease can spread through the water.

    The IV line is a safety measure. In case of complication it is easier to start a existing line than put a line in. Especially in a woman who is in pain. The diameter of a vein is less than half a cm and you are aiming through skin. Would you like to try doing it to someone who is in pain and moving around? No. It’s very very hard. You have to hold down the arm while you do it. It also wastes valuable seconds. It’s just plain simpler to have the line and the IV fluids ready. For instance? If there is haemorrhaging? We can flip out the saline for plasma or blood. If there is difficulty in progress we can induce. If there is dehydration we can hydrate. If there is a positive GBS we can administer antibiotics. That’s the point of the line. It’s a seatbelt. EFM halves neonate mortality, not using it is an exercise in idiocy. No food is a precaution for surgery. No water because you can aspirate. Forced Exams? If you are in the hospital and given consent to have a birth any exams pertaining to that birth are not forced. We don’t hire Kryptonians, we don’t have x-ray vision. Pelvic dilation and exams are necessary to gauge birth. And failure of anaesthesia? I doubt that. Anasthesia is tested before procedures are performed. Failure will just get a different system used. Your literal stance is “The Seatbelt is Holding Me Down, I cannot drive naturally with it”.

    Actually. Women use homebirth because hospitals are scary places because people die in hospitals. Because medicine shares its effectiveness with physics. Both have become so specialised and complex that they befuddle the average person. You don’t know how anything works. Doctors in one field don’t know how other fields precisely function. It’s a massive and deep subject. So it is very very easy to make shit up about it. Home birth is the equivalent of the people who say that the LHC will destroy the planet. In addition this piece of woo is aimed at women almost exclusively using feminist terms and coopting them to suit their needs. It also actively harasses any nay sayers particularly mothers who had bad experiences. I specified Mayer Eisenstein who after killing a child (There is no other word for not administering anti Rh in a Rh incompatability) blamed the mother for the child’s death. If you don’t do it like this way you are a bad mother and it’s a competition! Often it flogs natural as the best way and has it’s hand in the anti-vax, homeopathy, supplement and raw milk quack brigade. It portrays itself as natural and wholesome and speaks of big pharma conspiracy and shady money making schemes. It talks about strength where there is none. It is fake empowerment. It is the equivalent of men proving their macho credentials by eating very very spicy curry. It is mums who are proud of delivering harrowing births unnecessarily and an ignorant attitude to disease like eclampsia, diabetes, long labour, cord entanglements and breech births. It’s proponents outright fudge research and refuse to publish safety statistics. It treats life saving equipment as pointless and tries to tell women that. It coopts midwives in third world nation who are a stop gap measure to reduce mortality rates as a model. The only reason it is so widespread as a piece of woo is due to the fact skeptic doctors are rare and most skeptics were unaware how dangerous it really is.

    It is pure quackery and woo through and through.

  37. 37
    Beth

    One reason that some women, at least in the US, opt for homebirth is cost. Yes, as one poster above pointed out, if things go badly it can be even more expensive. But for many families, it will reduce the costs.

    As an example, my daughter gave birth last month in a lovely modern birthing center. She’s still on my insurance, so I get copies of the statements. The total bill for her was approximately $16,000. The co-pay, over $1200, must come out of her families already strained budget. I don’t know what the bill is for her baby, but I’m sure it will be considerable as they transferred her daughter to the ‘special needs infant unit’ of the hospital for a few additional days of observation.

    In countries with socialized medicine, women may still opt for homebirth for various reasons, but the costs of treatment are not a factor. Here in the USA, it is.

  38. 38
    Esteleth, [an error occurred while processing this directive]

    Addressing WHY women in the US choose homebirth is actually quite relevant and important. Because otherwise how will the women who choose homebirth be convinced not to? Stricter rules against homebirth will really only serve to shove it further underground, leading to worse outcomes.

    Women who choose homebirth, deluded as they may be about the risks (and I will stipulate that many, if not most, of them are) are doing so, largely, for two reasons:

    1. They are otherwise into woo, and
    2. They are reacting against the paternalistic attitudes evinced by many OB/GYNs and hospitals and feelings of disrespect.

    I have never given birth, and if I ever do, I would probably give birth in a hospital.

    But seriously, of all the American women who I know who have spoken of their experiences giving birth in American hospitals, the #1 complaint is that they feel blatantly disrespected.

    Keep in mind that there is a lengthy history in the US of laboring women in US hospitals being badly mistreated, disrespected, lied to, coerced, etc. And many American women, when presented with the choice between an elevated risk of things going wrong and being treated badly, will choose the former.

    Now, I do not agree with this position for myself. I think that, largely, the science and the stats are good in being against homebirth.

    But quoting stats of how bad homebirths can go – and I agree that they can go bad – does nothing to address why many women choose homebirths in the first place. In fact, stat-quoting may well exacerbate the feeling that the women are being talked down to and told to obey like good girls.

  39. 39
    Avicenna

    It does and is important. One of the main things these women are told is that home births are safer and better.

    And are you honestly suggesting that these women cannot understand statistics? And we have to discuss the topic through grecian debate rather than scientific method? It’s bad. Stats say its bad. Anecdotes say it goes wrong a lot. MW organisations and pro-home birth sites are censorial about data and sometimes outright lie about safety. It’s the hallmark of quackery.

    There are projects by women who had home births and then had issues. They point out that home birth advocates often have photos of the event but they usually are in black and white. They themselves were given greyscale or black and white photos.

    In order to hide the blue babies being born.

    Women literally pick this because they are constantly (And many places still do say this)told that home births are safer and better in every single way to a hospital birth or its some macho bragging rights to suffer through this.

  40. 40
    Ysanne

    Now let’s combine this:

    for some women, it was because they FELT safer at home, for others, because the hospitals they had access to wouldnt “allow” vaginal birth (vbacs in most part). [...]

    with this:

    In fact, stat-quoting may well exacerbate the feeling that the women are being talked down to and told to obey like good girls.

    So basically, the distilled reason to go for a home birth is a misguided and irrational feeling of safety because due to a lack of knowledge some women are scared of the very things that would increase their safety, coupled with an attitude that sees anyone knowing more than oneself as disrespectful and a threat.

    Opionions and worldviews formed on such a basis are what is typically called “woo”.

  41. 41
    Syzorr

    @Avicenna and Ysanne – what you are doing is actually conflating two separate ideas

    1) Hospital births are safer than home births and thusly anyone promoting home birth by claiming it is safer is engaging in woo – fair enough, neonatal mortality statistics support your argument there. I personally think/believe that with appropriate systems, support and midwives that are both qualified and experienced that this difference can be reduced.

    2) Women feeling unsafe in hospitals for reasons unrelated to the act of giving birth to a child. These issues encompass but are not limited to:
    - being placed under pressure by attending physicians to make specific decisions with no discussion
    - acting without consent in a range of situations including ones that would class as sexual assault if a complaint was raised (and, as with all sexual assault, reporting is very low and because the perpetrator is a member of a privileged profession within society and they don’t know their rights within regards this, reporting is potentially much lower)
    - having their autonomy removed or hampered by being in a location where they don’t have as great freedom of choice
    - not being able to choose who attends them in hospital beyond their personal midwife and family
    - having their parenting under scrutiny and having to deal with medical staff that interfere in the way they may be choosing to raise their child after the birth
    - not having their concerns listened to by medical staff that are either unreceptive to them/unwilling to attempt to understand because they know better/etc

    These are all REAL concerns and they don’t come from a place filled with woo. They come from people that were, for a long time, treated as meat bags by the male dominated medical profession. Until you begin addressing their concerns, how can you possibly convince them that it is in their best interests to personally submit themselves to your judgement? To hand over their autonomy to someone that represents a profession they have no reason to trust? During a time in what is possibly the *most* vulnerable moment for women? Once again, these concerns are not woo, this is reality and until it is confronted by health systems worldwide it will continue to be a problem.

    Your continued posting on the matter just serves to highlight the misogyny as you completely ignore the points raised by Esteleth to, instead, focus on just the neonatal mortality stats.

    Personal anecdote time:
    When my first was born, back in the wonderful year that was 2008, my wife had to spend a long period in hospital with our new son due to severe health complications around the delivery. Against our express wishes and without any consent, they stuffed a new born baby full of 40mL of formula. When we raised this concern with them and tried to resolve it, they treated us like we had just landed from Mars and we were almost actively discouraged from making a complaint.

    Fast forward to my latest. Born in September this year, we spent a few days recovering in hospital because of a planned C-section (due to being 42 weeks). One of the hospital midwives we had to regularly deal with would regularly come in and take the baby from my wife despite her explicitly stating not wanting to hand her over (the midwife would literally come in and say “you need a break, hand her here”, grab the child, swaddle it and place it in the bassinet) and then the midwife would proceed to lecture my wife about how she shouldn’t put pressure on herself to be there all the time for the baby.

    Those were our experiences. Others have had similar or worse. They are not woo. They are a systemic problem with hospitals as they are currently run and if you want people to trust hospitals, you need to actually fix those problems.

  42. 42
    Syzorr

    To sum up previous post:
    Stop trying to take autonomy from or denounce women based on a single statistic when there are valid concerns that exist which are directly contributing to them choosing otherwise than you would advise.

    *THAT* is misogyny.

  43. 43
    Ysanne

    Syzorr,
    and how is disregard for parents’ more or less informed choices unique to doctors and nurses? Reading through some home birth accounts, it seems that midwives aren’t necessarily all that concerned about their patients’ actual wishes or well-being.

    I’m all for hospitals and doctors making an effort to help women feel comfortable and safe during childbirth (or for that matter, every patient during every procedure they do). We’re talking about fully conscious adults in a vulnerable and potentially dangerous situation here, after all.
    However, this does not include endangering the baby’s life when the parents’ idea of comfortable contradicts basic medical considerations (e.g. refusing an iv because needles are icky). Everybody is entitled to their own bad decisions when it’s just about themselves, but when people start risking their kid’s life or health, it’s not only about themselves any more. Giving birth at home, with no actual medical professionals present, and no immediate access to emergency medical equipment, is exactly such an irresponsible risk, and home birth activists promoting such a setup are exploiting their patients’ fears to lead them into a dangerous situation. There’s nothing safe, caring, empowering or respectful about that.

    The way to prevent negative experiences with hospital births (and there certainly are situations like that) is to develop hospital birth practices where women can feel safe, can make informed decisions, and are able to trust the advice and medical (not “general”) decisions of their doctors. This seems to work in a lot of places already — and it is not helped by the scaremongering and outright lies of typical home birth activists.

  44. 44
    Syzorr

    By disregarding a patients right to feel able to trust their medical team (whether at home or in hospital) you are engaging in the same sort of dishonest argument that the more extreme home birth advocates do, especially when choosing to continue to mischaracterize them with the “iv lines are icky” after all the valid concerns I raised.

    Every patient has the right to feel safe and has the right to be attended by their chosen professional. It is necessary that these professionals have the appropriate training and experience and the health system needs to have a way to appropriately register them and to monitor their medical practice. When you say “just trust us and hand over your body”, you are asking someone to make a leap of faith based on their previous experiences with either yourself or the system you represent. If that experience was overwhelmingly negative, why *should* they trust you?

    I have repeatedly stated I am not of the same mind as the extremes on *either* side and don’t believe that is where the correct path lies. The neonatal mortality rate for home births/birthing centres is only 2-3x that of hospitals once you leave the US (in the NZ/AU/Netherlands studies I have found). We aren’t talking orders of magnitude here nor are we talking large figures – it isn’t 20 deaths per 1000 jumping to 40…

    By disregarding those that desire home births and denigrating them based on a subset of a subset, you will end up forcing them underground and causing even greater rates of that stat you like to follow (neonatal mortality) rather than bringing them in to the fold and saying “sure, it is more dangerous and here are the facts but we will support you if you wish to continue”.

  45. 45
    Avicenna

    Two To Three Times Higher is a massive amount. Seriously? 0.05% is considered to be significant. 200%?

    You cannot simply say “it’s only 2 to 3 times higher”. Particularly when dealing with mortality figures.

    Not many babies are dying because of this because they are still relatively rare. 1% isn’t a huge amount of people. However that number is rising and this is actually killing more babies than say… Chiropractic, Homeopathy or even Anti-Vax. This is the deadliest western piece of quackery.

    Empirically its bad. It pretends to make you a good mother or a feminist when in reality its not. Every single person who seems to have complained about doctors not letting them do what they want has generally wanted to do something moronic. Smoking is also a choice in pregnancy. If you smoked in pregnancy people would treat you as a terrible person. Not a feminist. If we told you not to smoke that’s acceptable. And that’s less dangerous than this per capita. (Odds ratios remember…)

  46. 46
    Syzorr

    0.05% – more like 0.5%… at least get the figures right.

    And still you choose to ignore the real issues that people have with hospitals and arrogant medical professionals…

  47. 47
    Avicenna

    No. I am not ignoring those things. I just don’t think they are pertinent to a topic on whether something is quackery or not. You could treated by Gregory House and this would still be quackery. Because you have repeatedly argued against the usage of the word woo to describe this.

    The only defence you actually are able to have is “People Don’t Like Hospitals for Various Reasons Some Valid and Some Blatantly Caused by Fear Mongering From Anti Medical Luddites”.

    Homeopathy isn’t going to magically function because you don’t like the way drug companies advertise to patients. It’s quackery no matter what.

    This is killing children. Mothers are lied to and end up with dead or injured children. Or they survive due to sometimes incredible medical interventions. The comments are full of mothers who have faced this. Your honest response is “Well it’s worth it because doctors are arrogant”.

    It is unscientific. It kills. It’s quackery. It pretends to give dignity to women by fetishising the pain of child birth and the difficulty of it. Its not empowering. It’s literally trying to give women shittier healthcare and making them think they are getting a great deal.

    If the doctor told you not to smoke in the pregnancy you would think he was being helpful. Yet if he told you not to do this you think he is condescending and arrogant…

    Remember the odds ratio paper. Home Birth has a mortality odds ratio of 2.3 while tobacco us has one of 1.67…

    So we have defined it as quackery beyond a shadow of a doubt? Now we are just trying to find excuses for it.

  48. 48
    Esteleth, [an error occurred while processing this directive]

    Jesus tapdancing Christ.

    I do not agree with homebirth, I think the homebirth advocates are full of shit at best and are guilty of negligent manslaughter at worst.

    But seriously, if you want to actually reduce the incidence of homebirth (and not just by driving it underground, having it only surface in grim news stories), you must address why women are choosing homebirth in the first place.

    A lot of it, yes, is woo-y nonsense about what is “natural.”

    A lot of it, yes, is blatant lying and stats-twisting and scare-mongering by homebirth advocates.

    A lot of it is women (and their families) saying that they cannot afford a hospital birth in the US (and consider the stats on BC availability too…).

    And a lot of it is women who have been horribly treated, or know someone who has been, and (rationally or not, correctly or not, sensibly or not, informed on the stats on homebirth or not) saying, “As bad as homebirth may be, at least I won’t have to endure that.”

    (There is, of course, substantial overlap between the groups)

    Each cohort is responding to a different thing and thus requires a different approach. Education about the risk of homebirth and the benefits of hospital birth will work best on the woo-y types and those who were lied to. Systematic reform of healthcare and insurance will work best on those who cannot afford a hospital birth.

    That leaves the ones reacting against medical mistreatment and paternalism. They will not be reached by education about the risks of homebirth. They may be frightened by it, perhaps enough to give birth in a hospital. They may also be angered by it and dismiss it as propaganda, possibly driving them further away from medicine and into the arms of the woo-y types. Want to reach these women? Start by not dismissing their concerns. No, not everything that a woman chooses is feminist. But the answer to complaints of paternalism is not more paternalism. “You and your baby are alive and healthy” is not an acceptable answer to a woman’s complaint of mistreatment by her hospital birth team.

  49. 49
    Esteleth, [an error occurred while processing this directive]

    And no, “Yes, women being mistreated by hospital staff is bad, but seriously, homebirth is bad too,” does not sound sincere.

    Want to get those women back, and get them to stop convincing their friends/family to homebirth? Be proactive. Address their concerns (actually address them, not say that you are or hanging up a few posters). Show them what you’ve done. Ask them if they’re happy with them. Listen to the response. You’ll have trouble with the full-woo types, true. But the women who aren’t full-woo might be wooed (pun intended :D) back.

    American women may be especially sensitive to (perceived or accurate) paternalism from medical staff nowadays, given how the sharks are circling around our autonomy anyway. The anti-homebirth push may be seen as part and parcel with the fetal-personhood/no BC/”legitimate rape”/women aren’t people shit that’s being spouted.

  50. 50
    Avicenna

    The article is universal, not America centric. I mentioned stats in the original article from across the globe.

    The price argument does not work in NZ or Netherlands. Both have free healthcare.

    A lot of the arguments made are fielded its just that midwives are actually guiltier of being bullies and more controlling than doctors. Read the complaints from injured women. All are pushier than doctors.

    Explain why I should treat homebirthers with care while running roughshod over homeopaths or chiropractic?

    Its Woo. Anything I say is a scam or a lie to them.

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