.8 / 1000 was the mortality rate for low risk
women at homebirth according to the MANA data.
In other words, there was no difference in severe acute maternal morbidity (SAMM) between home and hospital among nulliparous women and a slightly lower rate of SAMM for parous
women at homebirth.
Not exact matches
Although tragic, cord prolapse and AFE occur rarely
at homebirth, 1/5000 and 1/500, 000 respectively, when balanced with the dozens of acute emergency conditions endangering the health of mother and baby that occur
at planned hospital birth caused by intervening in the birth process, the scales tip easily in favor of planned attended
homebirth for low risk
women.
Simply: If hospital birth were useful, the data would support it, but all
homebirth studies (1 - 20), show better outcomes of low risk
women at planned attended
homebirth.
Instead of excluding the high risk births from both groups, they include the
homebirth outcomes of premature births
at 34 - 37 weeks gestation (13 - 17) breech and twins (13,14) lethal anomalies incompatible with life (13,14) unattended
homebirths (15,16) unplanned
homebirths (15,16) or
women who became risked out of
homebirth by becoming high risk
at the end of pregnancy, had hospital births, but are included in the
homebirth group.
Perinatal mortality rates for hospital births of low risk
women are similar to outcomes of planned
homebirth in general, but the maternal morbidity
at planned hospital births is much higher.
Therefore, it is possible to look specifically
at white
women (almost all
homebirths are to white
women) ages 20 - 44, singleton pregnancies,
at term (37 + weeks), not suffering from intrauterine growth restriction (2500 + gm).
Other
homebirth advocates emphasize that the absolute risk of death is low (true) or that only
women having first babies are
at risk for
homebirth death (false).
Like most Americans, I simply thought you needed medication in the birthing process even though my sister, Amy, is a nurse midwife who specialized in
homebirth and is now working to change this misperception and to empower
women to give birth naturally (check out her blog
at scienceandsensibility.org).
We know it's higher than in hospital, but that is
at least partly due to inadequate midwifery education and to some high risk
women being considered as suitable candidates for
homebirth, so it's a foregone conclusion that the stats will be bad.
Assuming that is true, the following system is feasible: 1) Any
woman desiring
homebirth must be evaluated and examined by
at least a CNM and cleared.
(I am an Australian midwife and also had
homebirths prior to becoming a midwife) Your system in America is quite radically different to ours here in Australia and so we don't have the same problem with poorly trained and undereducated midwives and although we still have ideologically driven midwifery, where process is promoted over outcome, we have strict protocols, guidelines and governance
at all levels to ensure dangerous midwives are prevented from continuing to practice and
women and their families are protected and have recourse for compensation.
Even on Ricki Lake's business of being born, that
woman at the end was trying to have a
homebirth and ended up almost not making it to the hospital.
I don't know any rational
woman who would go ahead with a
homebirth in the knowledge that
at least 1 in 500 babies, even in optimal circumstances, die.
They are
women who lost babies
at homebirth but still trust «Birth.»
I sometimes wonder if these
women, who plan to repeat a
homebirth after having a
homebirth that resulted in a dead baby really want to have living children
at all.
Homebirth is safe or safer than hospital birth because when you exlude women who midwives shouldn't have taken at all and those who doctors and real miwives couldn't save after homebirth clowns botched deliveries — well, it total
Homebirth is safe or safer than hospital birth because when you exlude
women who midwives shouldn't have taken
at all and those who doctors and real miwives couldn't save after
homebirth clowns botched deliveries — well, it total
homebirth clowns botched deliveries — well, it totally works!
They are
women like Janet Fraser who lost babies
at homebirth but still trust «Birth.»
But
women who really trust «Birth» are those who choose
homebirth when they are
at high risk of killing their babies.
I am an ob / gyn working
at a hospital that cares for
women who have attempted a
homebirth in our area and who need tranport to the hospital when things don't work out as planned.
Partly OT: what happens when you have a bad
homebirth story (no lasting consequences, thankfully), see the new studies, look
at yourself and say with certainty that had this data been available, you wouldn't have made a choice to
homebirth but you still support it for low - risk
women in UK and Canada fashion?
I wonder what those authors have to say to «low - risk»
women who have lost their babies
at «maybe equally safe if not safer»
homebirths?
Most studies of
homebirth in other countries have found no statistically significant differences in perinatal outcomes between home and hospital births for
women at low risk of complications.36, 37,39 However, a recent study in the United States showed poorer neonatal outcomes for births occurring
at home or in birth centres.40 A meta - analysis in the same year demonstrated higher perinatal mortality associated with
homebirth41 but has been strongly criticised on methodological grounds.5, 42 The Birthplace in England study, 43 the largest prospective cohort study on place of birth for
women at low risk of complications, analysed a composite outcome, which included stillbirth and early neonatal death among other serious morbidity.
Among 64 538 low - risk
women, of whom more than 16 000 planned a
homebirth at the onset of labour, no difference was found in the adjusted odds between obstetric units and other birthplaces, including
homebirth.
However, you are lashing out
at a community of
women who are working hard to give their babies the best start possible and completely ignoring the huge number of
women and babies that die in hospitals that far exceeds that of
homebirths... Trying to clean the speck out of my eye while you've got a flippin tree in your own eye.
Losing my son (3rd child)
at 43 weeks during labor, was attempting a home birth vba2c, his passing was NOT due to me attempting a vaginal birth or a home birth, in fact when we attempt to have our 4th child I will be going for a vba3c, I am so supported through this by the
women in my local
homebirth group, it has allowed me to see the sun in the storm, I have started a charity in my sons name to help
women get a doula or midwife when they would not be able to afford their services other wise.
Someone, probably, will say seriously, that it's ONLY the
homebirth midwives who are respecting a
woman's right to a vaginal breech, twin, or post dates birth
at home, and HER right to the lower rate of intervention
at home trumps the mythical rights of the baby, and that since it's the sisters in chains that are taking back a
woman's right to physiologic birth where SHE wants it that IF there is an increased risk to the baby it's the mother's right to take that risk.
I wonder how many
women have been supported and encouraged by
homebirth websites to risk their babies» lives
at homebirth and then have those babies die.
Perhaps it will eventually dawn on Bielanko that
women and babies were dying in droves
at those
homebirths, but that's probably too much to hope for.
The two larger hospitals have lower c - section rates than the smaller hospital closest to me and they also boast
women's clinics with multiple midwives on staff, but my
homebirth midwife recommended an OB
at the closer hospital — a personal friend of hers — who had given birth her own child
at The Farm (with Ina May as a back - up midwife!)
Although it appears that the preventable newborn deaths
at home and hospital birth balance out,
homebirth is clearly safer when you take into consideration the risk of maternal death that 20 % of low risk U.S.
women face as a result of avoidable cesareans which became necessary because they went to hospital.
On the very thread where you are blaming yourself, two other
women reveal that their babies died of preventable causes
at homebirth.
When this 20 % risk of death is compared to the 0.02 % rate of cord prolapse during labor
at homebirth that might have a better outcome if it happened in hospital, this means that a low risk
woman has a 1000 times higher chance of having a life threatening complication either to her life or her fetus / newborns life
at planned hospital birth, than if she plans to have an attended
homebirth with a well - trained practitioner.
Logically
at least 3 out of 4 of those deaths occurred in
women who were unsuitable for
homebirth or occurred after the first week, which would amount to a maximum of 1 in 10,000 preventable low risk deaths in the first week after birth.
Even if we just take early and late neonatal stats, leaving out HALF of the
homebirth deaths (22/44) it's 1.29 / 1000 for MANA's almost all white, majority college educated, mostly singleton, mostly low - risk healthy
women in their 20s and 30s, vs. 0.81 for EVERYONE delivering
at term in the hospital.
I don't doubt there are safe and compassionate hospitals out there or even compassionate doctors in hospitals that generally aren't, but when a large portion of
women are looking for
homebirth because their hospital experiences were the antithesis of compassionate, these ethicists need to be looking
at what they are suggesting.
Most
women can deliver most of their babies with minimum intervention, they are less likely to receive unnecessary intervention
at home, and in that sense
homebirths can be safer.
But
at the same time, I have a lot of trouble with the idea of outlawing
homebirth or something like that; I still think
women should be able to choose it.
because a study showing a higher
homebirth death rate should * absolutely * be spun in a way to encourage
women to give birth
at home.
If you go to the Hurt By
Homebirth website, none of these
women were informed of the risks they were taking when they chose to have their babies
at home.
Therefore, it is possible to look specifically
at neonatal mortality (death within 1 hour to within 28 days of age) for babies of white
women (almost all
homebirths are to white
women) ages 20 - 44, singleton pregnancies,
at term (37 + weeks), not suffering from intrauterine growth restriction (2500 + gm).
Do not forget that you are looking
at Homebirth within a very specific cultural milieu, that of predominantly white, well off
women in developed countries, a culture where pregnant
women expect to be the centre of attention during labour and delivery, and to be in control of every aspect of their lives.
Evidently
homebirth midwives want
women to read only the stories with good outcomes; the many stories of
homebirth death shouldn't be published
at all.
When we compare the death rate
at homebirth of 2.06 / 1000 with the CDC death rate for low risk white
women, ages 20 - 44,
at term, with babies that are not growth restricted of 0.38, we find that
homebirth has a death rate 5.5 X higher than hospital birth.
In my experiences with
homebirth midwives that practice in Illinois (there is still a large Mennonite population, and a number of
women who still wish to birth
at home), the recommend having a
homebirth friendly Pediatrician in place because, «there are orders to call CPS if a homebirthed baby or mom transfers to a hospital».
I'm no expert, but in addition to the vast amount of research I did before my 2nd child (
homebirth), my experience with an ob before I switched to a midwife with that same child, my experience with a medicated vaginal hospital birth w / my first child, my experience in talking to dozens of
women that have had surgical births, in addition to all that anecdotal «wisdom», I have taken a graduate level Sociology of Medicine class that was an in depth look
at our current medical system from a sociological perspective and we spent a couple of weeks talking about the medical model of birth and the alternatives.
Like those
women who have a dead
homebirth baby on their hands and then plan the next one
at home.
Rixa, the
woman who and helpfully posted the birth of Inga on YouTube to inadvertently illustrate exactly how babies die
at homebirth.
That horribly frightening image of the
woman delivering
at home in Brazil (I think), photographed by a
homebirth photographer and she's in the shower, crouching down, and all you can see is a bright purple hand emerging - arm presentation,
at home, primigravid mum, and the midwife just watching.