In a study presented at the Society for Maternal - Fetal Medicine's annual meeting, The Pregnancy Meeting ™, in New Orleans, researchers will report that patients delivered at home by midwives had a roughly four times higher risk of neonatal deaths than babies delivered in
the hospital by midwives.
Doctors there reported that babies born at home to midwives have four times the risk of neonatal deaths than those delivered in
the hospital by midwives.
Not exact matches
But labour moved quickly and less than an hour after arriving at the
hospital, she was safely delivered
by our
midwife at 2:16 p.m. after 5 hours of labour.
By now you may have gathered that instead of choosing to have an OB - attended
hospital birth this time around, we are planning to have a
midwife - attended homebirth.
What we need is a maternity care system in which ALL low - risk pregnancies are followed
by midwives - and then we should be offering a choice for home,
hospital or birth centre locations.
The authors do inform readers that when studies are excluded from the analysis that include births attended
by uncertified or non-nurse
midwives that the odds ratio for neonatal death between home and
hospital births is no longer statistically significant (Wax, 2010).
Standards outlined
by the AAP for care of the neonate are possible in an out - of -
hospital settings, including homebirth, although because homebirth practices do not have an accreditation body similar to the American Association of Birth Centers there is no way to assure that any particular homebirth
midwife or practice provides any certain standard of care.
The filmmakers set out to look at alternatives to
hospital births attended
by a doctor, such as
midwife deliveries in
hospitals, homes or birth centers.
Unfortunately, the authors did not reference this statement and the nurse - midwifery profession has grown to the point that it could potentially prove that the majority of out - of -
hospital births today are in fact, attended
by certified nurse -
midwives.
Hutton EK, Reitsma AH, Kaufman K. Outcomes associated with planned home and planned
hospital births in low - risk women attended
by midwives in Ontario, Canada, 2003 — 2006: a retrospective cohort study.
However, a few years later, my daughter was taking an EMT course at the same
hospital and was told
by her mentor that there is a «local
midwife that brings women in from out of state to birth here so she can sell their babies.»
After a diagnostic ultrasound with an OB at the delivery
hospital, I was placed in the group that is low risk enough to be cared for primarily
by midwives during delivery.
These reconstructed «natural facts,» while equally socially embedded relative to more medicalized perspectives, are seen
by midwives as essential components of the foundation needed for «trusting birth outside the
hospital» once labor begins.
That was my experience in
hospital in Australia with my last baby — although my little boy was delivered
by two
midwives and not an OB (he had examined me when i came in for the induction and been consulted on a couple things throughout the labour).
If you choose an accredited birth center, you'll be cared for
by licensed professionals, usually a
midwife and a nurse, with a backup
hospital nearby and a doctor on call in case of an emergency.
We have a birth center that is wildly popular with the younger generation (like in their 20's) it's run
by a lay
midwife, and our
hospital birth center takes in their patients whose births are going wrong.
My wife and I had our first 2 in a
hospital and it almost killed them because of the drugs they forced on my wife the last 2 were born at home in a pool the 1st homebirth we had a
midwife present the 2nd one the
midwife was an hour and a half late so I delivered our daughter
by myself it was awsome and now my wife is PG with our 5th baby we have the same
midwife who was late to our last birth and we already know she is not going to be here ontime mostly because she lives 2 hours away from where we live and we are ok with this.
My healthy baby died because the
midwife at the birth center did not pick up the falling heart rate and
by the time I was blue - lighted to a
hospital, it was too late to resuscitate my boy.
Most
midwives do know when it's time to transfer because something has gone wrong, which
by the way would go wrong at a
hospital.
From 1994 - 2008 she served on the Board of Directors of a Joint Underwriting Association created
by the Washington State legislature to provide medical liability insurance to
midwives providing out - of -
hospital birth services.
I was helped in this
by a couple of phone calls; one from a very eloquent certified nurse
midwife at OHSU, the Oregon Health and Sciences University, who had tried to transfer a patient to one of our
hospitals during labor and received so much flak and criticism and expletives over the phone and there was so much overt hostility that she wound up not pursuing that transfer, which would have been a very important transfer.
Those cafés, which are resourced
by experienced
midwives from King's College
hospital, are a vital resource for new nursing mothers.
And, unlike an epidural which requires a
hospital birth and the presence (and a bill from) an anesthesiologist, nitrous oxide can often be offered at a birth center
by a
midwife.
The typical scenario would be that something had gone dreadfully wrong and the community
midwives, after exploring their options, would finally, and receiving nothing but hostile response from the various
hospitals, would have the patient transported to the
hospital by ambulance and then they would all bolt and just leave the patient in the emergency room and to the care of whoever was on emergency call.
I came
by natural birth honestly - my mom had unmedicated births and three of those were out - of -
hospital births with
midwives.
My babies tongue tie was diagnosed
by the
Midwife while we were still in the
hospital.
So, I would hope a woman would consider the possibility of complications and choose to deliver her * first * at a birthing center run
by midwives, next to a
hospital.
«The sheer magnitude of numbers in de Jonge et al. — over half a million
midwife - attended low - risk births, either at home or in the
hospital — combined with a true comparison group (low - risk, women who chose
hospital birth but could have chosen a home birth; both home and
hospital groups, attended
by the same group of
midwives) makes this a valuable study (Freeze, 2010, p 8).»
The authors concluded that the decision to plan a birth attended
by a registered
midwife at home versus in the
hospital was associated with very low and comparable rates of perinatal death.
Women who planned a home birth were at reduced risk of all obstetric interventions assessed and were at similar or reduced risk of adverse maternal outcomes compared with women who planned to give birth in
hospital accompanied
by a
midwife or physician.
Independent
midwives are insured and just like the staff you would encounter on the maternity unit in
hospital they are regulated
by the Nursing and Midwifery Council.
By the same token, your independent
midwife can refer you to a consultant if you need it, or arrange for you to be transferred to
hospital should it become necessary during a home birth.
Indeed a paper published earlier this year in the Journal of Perinatology analyzed homebirths attended
by a certified nurse
midwife (CNM) and found that they had double the risk of neonatal death of CNM attended
hospital births, even though the
hospital birth cohort included high risk patients.
If you are cared for
by a
midwife they come and assess you at home when you go into labor even if you are planning on a
hospital birth (unless you choose to go right in and meet them there but most
midwife clients want to be at home as long a possible from what I understand).
I stand
by my assertion that the vast majority of women would choose to give birth in a
hospital if they could not find a
midwife willing to deliver high risk patients at home.
She was being stitched up
by her
midwife at home (the one who wields Super Glue) so her MIL went to the
hospital.
If a
midwife was paid in advance, what extra service is she or he providing
by doing the transfer and / or
by staying with the mother in the
hospital?
Your
midwives saw to it that was maintained as well
by not warning you that all of the data on homebirth in the US show a 3 - 8x higher risk of the baby dying in homebirth than in
hospital birth.
This birth center was unique in that it was completely unattached to a
hospital, or a medical board of directors, and was one of only a handful in the nation to be solely owned and run
by non-nurse
midwives.
The other interesting aspects of this article are the possible anecdotal evidence for one of the benefits of free birth over a birth with an unskilled
midwife, possible resulting in a false sense of security - she realised something was wrong and went to
hospital - and also the description of the birth - the first twin's head essentially becoming trapped
by the second twin - which seems to match something Attitude Devant raised as a possible complication of first twin breech, in one of the Lisa Barrett threads.
There were no significant differences in outcome of home or
hospital births attended
by midwives for the other child health measures.
The second sentence in the abstract does state: «Analysis of combined data from all 8 studies showed a three-fold increase in risk of neonatal deaths for homebirth attended
by midwives, compared to
hospital births.»
It will now be easier for
hospitals, physicians,
midwives, and epidemiologists to sort out the stats and outcomes
by place of birth, intended, and actual.
Nine studies were included in the meta - analysis of child health outcome of births attended
by midwives in homes or in
hospitals.
With my daughter, born in a
hospital with a
midwife, we used the vacuum to get her out and
by that time, there was the OB, the resident, my
midwife and 2 - 3 nurses.
Midwifes that deliver in the
hospital still get the same compensation; only the room has to be paid for
by the expectant mother.
5) even the Johnson & Daviss study in 2000 which is quoted so much
by midwives shows an increased risk when you compare the year 2000 Homebirth stats with the year 2000
hospital low risk deliveries.
Fetal monitoring is done
by both a
midwives and doctors at home births, birth center births or
hospital births.
Plus I'd seen a family member who'd had 9 home births all handled extremely well
by a
midwife, with only one being transferred to the
hospital, early in labor.
The latest example is an analysis prepared
by faculty at the College of Public Health of the University of Arizona, Tucson and the Arizona Public Health Training Center for the Arizona Department of Health Services entitled Outcomes of Home vs.
Hospital Births Attended
by Midwives: A Systematic Review and Meta - analysis.