This Is Why I Won’t… Part 2

I received a comment on my post from yesterday that got me thinking…

I don’t have any illusions of absolute safety in the hospital because bad things can happen in childbirth that have nothing to do with where you give birth. I do think that hospitals and OBs are better equipped to deal with the bad things that might happen. That is why I wouldn’t have a homebirth. On the off chance that I am the one with rare complication, I’d rather take my chances with the hospital and an OB.

As far as statistics, hospitals might get a bad rap because they serve a higher risk population where things are likely to go wrong. If a doctor loses 20 mothers but has delivered 4000 babies including many high risk babies he shouldn’t be compared with a midwife who has delivered 500 babies in from a low risk population. It is my understanding that most homebirth midwives don’t take the higher risk patients. To compare the two sort of seems like apples to oranges.

The one thing that jumps out to me is “hospitals might get a bad rap because they serve a higher risk population”.

Last time I checked, at least 80% of the women that have their babies in the hospital were low risk….

So, here’s another thought. Does going to the hospital automatically make you a high risk case?

And, since when does a woman’s life mean nothing? Why shouldn’t every death be compared? That is a baby without a mother and a husband without a wife. Regardless of whether it was an OB that was covering or a midwife.

I wasn’t comparing the two, but I do think they should be treated equally. I know that most OBs take most low risk patients and a few high risk patients. So, because OBs are trained to handle the high risk cases, even when they cover the low risk, they shouldn’t be asked how many women have died because they see the larger population?

That just seems like no one cares about the women that do die, regardless of whether they had true problems, or died from complications from their care in the hospital. Why does one death from a homebirth not equal one death from the hospital? Because at the hospital they are prepared for the high risk? Or because the hospital is seen as the place where angels fly and miracles happen?

Every woman counts. Regardless of whether the caregiver has delivered 90,000 babies, or just 10. When will we realize that some of these women could have been saved if they had delivered at home? When will their deaths truly matter?

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6 Responses

  1. I read both of your posts before I came back to comment. I see both sides of the homebirth vs. hospital birth debate. When asked my opinion, I would support anyone's choice on how or where to have their child. However, it seems you are really stretching here. You are taking your opinions and spinning them as fact. Is some of it truthful? Absolutely. Is all of it? No. I came to your blog when I saw a tweet of yours asking if it is less of a big deal for a Dr to lose a patient than a midwife/doula? No. It's a big deal either way. Emotionally it is damaging and it can be harmful to the practice of either. I admit that I know very, very little about midwives and doulas so I can't comment on any medical insurance they have, but I do know that OBs have among the highest malpractice rates in the field of medicine. Many, many OBs have stopped delivering babies because they can not afford the malpractice. Is this the same for midwives/doulas? Somehow I don't imagine so. Your statement that the home is the safest place to have a baby isn't true. It isn't the safest choice for many, many women. I think that you are forgetting a key point in that midwives/doulas get to choose who thier patients are and if they feel comfortable assisting that person with a homebirth. Doctors unfortunately aren't given that option. Yes they can "fire" a patient from their practice, but a hospital can not deny care to a woman in active labor who shows up there. Whichever doctor that is on call has to deliver that baby and accept the risks that are coming with that case. That is a major difference. I support you and your beliefs in regards to homebirth. I would encourage you to step back for a second and see if what you are saying is in actuality fact or just your opinion.

  2. I'm not saying its fact. Unless I site things, its my personal take on things. Its my blog. so its my opinion.I don't think homebirth is safe for every woman. If you had read more than these two posts, you would know that. I think it is safe for the majority of women that are low risk. Everything else is why OBs and hospitals exist.Midwives and doulas do carry insurance and the reason they don't have high malpractice percents is because they are there with their patients the entre time, and also have their clients choose things for themselves. There is a huge difference between having ur doc just come to catch a baby and having your midwife there for your entire labor.I understand where you're coming from, but before you start saying I think everything is fact, grow some balls and don't comment anonymously. And maybe read some other posts too.

  3. I think the major problem here is the perception of birth in this country. The majority of women giving birth WOULD be safe with a home birth. The majority of women giving birth don't NEED a doctor, a midwife would be just fine. But all we are taught and all we see on TV and in movies is babies in hospitals with women screaming and pitocin and epidurals and c-sections.Since I had my first son, I have been doing much more research, which has led to my decision to have a natural birth this time. I don't think I had a terrible experience last time. It was a "normal" hospital birth. Water broke, went there, labored for a while, docs gave me pitocin (and I didn't know any differently), had an epidural, had a baby. No problem. But looking back, with what I know now, I would have done it differently.I think the strangest thing is that NO ONE talks about women dying in childbirth. You almost never hear about it, in fact I have no idea how often it even happens anymore. I actually never even thought to ask my midwife if she's ever lost a baby or mother, I have it on good authority she's great and she's been practicing for 30 years. I don't think it would make me feel any better to know if she had or hadn't lost someone, because my opinion is that it probably wasn't her fault. Same with an OB, what are the circumstances? I know docs make mistakes, but that doesn't necessarily mean that it was a mistake that caused a patients death. Maybe it was just medically going to happen.Anyhow, I feel like I'm rambling, but I will say that I just found your blog a couple of days ago and I really love it. I don't have many friends who are homebirth or natural birth 'fanatics', and it's nice to read your opinions and thoughts!

  4. Whoever made that comment is just blinded by the medical community. Sadly these people do not realize most of the emergencies are CAUSED by being in the hospital, and the hospital protocol and interventions.FYI, I am a 2xC-section mom too!

  5. I made the comment and I would not say that I am blinded by the medical community AT ALL. I had a goal of having a natural birth and took Birthing From Within classes and read the Ina May books, saw Business of Being Born etc, etc. Heck, I've been reading this blog for a long time so that should illustrate more of where my sentiments lie.I did not intend to reduce the significance of any woman's death. The death of a mother or child during what should be such a happy event is a horrible tragedy – whether that occurs at home or in the hospital. What I was responding to was your statement that "women die in childbirth more in the hospital than anywhere else". That seems to imply that maybe if these women gave birth at home they would have lived. I don't know if anyone can say if that is true. Some of the kinds of tragedies that happen at home or in the hospital could not be prevented. Do we really know what percentage of these deaths are directly attributable to hospital interventions (which is sort of a vague idea) or what percentage happen "just because"?And I do still think it is tricky to make direct comparisons with the OBs. Ask an OB how many patients they've lost is a valid question for an OB or a midwife. But like the first poster pointed out, doctors don't pick and choose their patients so it would be expected that they would have higher losses IMO.And I absolutely think that at the hospital they are more prepared for the high risk situation that could require emergency surgery. That's why people transfer if something goes wrong in a homebirth.I just don't think the hospital is this total evil empire and having a homebirth is all light and goodness. There are good and bad things that come with either choice. I consider myself fairly well-informed and after weighing the options, I simply would not choose a homebirth. That is what is right for me and I am willing to accept (and well-aware of) the risks that come with hospital birth. What anyone else does really doesn't matter to me.Sorry for blogging in your comments! 🙂

  6. HEY! I have a happy middle ground for y'all.I had a natural birth with a midwife and a doula AT A HOSPITAL.I absolutely love my hospital's perspective: They have midwives rounding and on call and I saw a midwife for all of my prenatal visits, but they have an OB clinic just down the street that they call in case of emergency. My midwife and delivery nurse were with me for my entire labor and delivery (well, for the few hours of it that I was at the hospital).I think THIS is the direction that hospitals should head. START with the less interventative route. Staff midwives who are trained in natural birth. Allow women to choose their position and use birth tubs. Do everything that is medically proven to help birth occur naturally (not inducing, no internal monitoring etc.). BUT have the back ups available as just that, BACK UPS.How's that for a happy medium? Can we all be friends now?

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