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The largest proponent for home birth in the thread has openly stated they are essentially foresaking all diagnostic medical procedures and will elect a home birth.
I assume you are talking about me. If so you and others are seriously lacking in reading comprehension and making some pretty major leaps and jumping to conclusions that aren't true. I already stated that my midwife offers all of the same testing as an OB. I also stated that ultrasounds were meant for high risk pregnancies and specific situations and were not meant to be used for low risk women as a routine part of prenatal care. This is not something that I made up nor is it even my opinion. It is a fact. I even posted links showing where the experts said this. Why people are having such a difficult time comprehending this information is beyond me.
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I would never go so far as saying people shouldn't be allowed to choose what they want and I also believe that all hospitals should be more open to allowing women to have the type of birth they want, but there are things that are simply just unnecessary risks and this is one of them. Of course, in this scenario, the mother is not just risking her life, but that of the child as well.
Again, I see you as well as others are having a difficult time with reading comprehension. The risks are essentially the same for low risk women who have planned home births as they are for low risk women who have planned hospital births. The same!
Historically, the average of maternal death is around 1 per 100 births. That figure is based on all available recorded data. Maternal mortality peaked through the 1700's and 1800's at up to 40 per 100 births in some areas. Since the beginning of the 20th Century, modern medical techniques have reduced this ratio in the United States down to a rate of 11 per 100,000. Given that the prevailing method of past deliveries was home birth with no medical intervention, outside of all your "current stats" I think the above numbers speak for themselves.
So, would you choose to have a 1% chance of dying during childbirth or .01% chance of dying? The difference is on the order of magnitudes.
In terms of infant mortality, in the early 1900's, when the primary method of child birth was the home birth, the infant mortality rate in the United States was 135 per 1,000. Today the rate is 6.3 per 1,000.
So, do you prefer a 13.5% chance of a perinatal death or a .63% chance of a perinatal death? The difference is again on the order of magnitudes.
There are far too many variables involved to be able to compare rates from 1900 to today. Besides, you don't have to because there are plenty of recent stats that show the rates of today compared to just a decade ago. There are also plenty of studies that compare homebirth to hospital birth in modern times and all of the credible ones show that the risk to both mother and baby is the same as long as they are low risk and the place of birth was planned in advance.
A cesarean section poses documented medical risks to the mother's health, including infections, hemorrhage, transfusion, injury to other organs, anesthesia complications, psychological complications, and a maternal mortality two to four times greater than that for a vaginal birth
International studies have found that the optimal Caesarean rate for a country is between 10 percent and 15 percent, Wagner said. “If the rate is below 10 percent, maternal mortality goes up,†he said. “If it’s over 15 percent, maternal mortality goes up.â€The risk of death is also is dramatically higher for C-sections than natural births, Wagner added, even when one takes into account those times when the procedure is medically necessary. “There’s a doubled risk the woman will die even if it’s an elective Caesarean she’s requested with no medical emergency,†Wagner said.
I had a midwife attended birth in a hospital with my dd and had all kinds of interventions that were not medically necessary. If someone wants a natural birth but also wants to be in the hospital I would advise them to interview a few different midwifery practices and check the hospital C-section rates prior to making a decision. I didn't do that but I should have. I believe it would have made a difference in my care.
[quote=Dorthy;17289262. I also stated that ultrasounds were meant for high risk pregnancies and specific situations and were not meant to be used for low risk women as a routine part of prenatal care[/QUOTE]
Are midwifes trained in NSTs (non stress tests)?
Reason I ask is that umbilical cord accidents are the leading cause of stillbirth & NSTs, which have never been shown/proven, to cause a stillbirth or premature labor, give a mother/nurse/OB amble information about the baby.
I know NSTs in my area are only for high risk & women 35yrs+. Have done much research that the "hiccups" many women feel can also be a sign of increased hyperactivity in the baby which could be due to umbilical cord issues.
Are midwifes trained in NSTs (non stress tests)?
Reason I ask is that umbilical cord accidents are the leading cause of stillbirth & NSTs, which have never been shown/proven, to cause a stillbirth or premature labor, give a mother/nurse/OB amble information about the baby.
I know NSTs in my area are only for high risk & women 35yrs+. Have done much research that the "hiccups" many women feel can also be a sign of increased hyperactivity in the baby which could be due to umbilical cord issues.
A midwife wouldn't be providing care for someone in the high risk category so there would be no routine NST testing. If something came up and there was a need for an NST the midwife would refer to a doc for NST testing. If the NST test showed any problems the patient would no longer be a candidate for homebirth and would transfer care to an OBGYN.
I wasn't aware we were only discussing one person's home birth options. Most who opt for a home birth would have had prenatal care equal to that of prospective mothers opting for a hospital birth. It's not fair to say that just because ONE person forgoes diagnostic procedures prior to a home birth that therefore all women who have home births are irresponsibly putting their childs' lives at risk.
As for equipment that modern CNM's carry, here are exactly the tools they possess that were not available then:
Extra Emergency Equipment: Extra-Long Sterile Surgical Gloves for manual placenta removal, 2 ring forceps, mosquito forceps and episiotomy scissors.
First steps in Neonatal Resuscitation: Heating pad, sterile pack of baby blankets with extra newborn cap, Res-Q-Vac suction pump w/sterile tubes and mucous trap, DeLee suction device w/mucous trap, blue bulb syringe, Oxygen tanks and Oxygen masks.
Pretty sure with the exception of the smelling salts, most of this equipment was not taken to home births in the early 1900's. Now I understand that this list is not equal to hospital equipment, but there's no need to pretend that home births are the same as they were early last century. I doubt they had SUV's to transport them to the hospital should something go awry then, either. So it's not a fair comparison.
No, but the scenario you are depicting is one in which some woman, even though she may be a bit more educated than in the 1900's, comes to your door while you're in labor with some towels and tells you to boil some water, and that's all the help you're going to get. (well not quite, but close. )
You can't compare homebirths now to homebirths then just as you would not be able to compare hospital births then to hospital births now.
Conspicuously absent from the list is any means to ventilate a baby who is not breathing.
A midwife wouldn't be providing care for someone in the high risk category so there would be no routine NST testing. If something came up and there was a need for an NST the midwife would refer to a doc for NST testing. If the NST test showed any problems the patient would no longer be a candidate for homebirth and would transfer care to an OBGYN.
So do midwifery stop at age 35, which is considered high risk?
I do not completely agree that an NST should be solely for high risk. Personally, I believe it should be part of all prenatal care.
Sometimes NSTs are done for monitoring. Would a woman under midwife care thus have to stop planning a homebirth & rely on the hospital?
I actually find the topic quite interesting thus the questions.
And if someone can answer this, I would appreciate it just for my own knowledge. I had a midwife w/ #1 but she was through the hospital. We were military & I did not get to choose nor did I really know if I should be "choosing" per se.
With #3, I had to be triaged & the nurse, who lacked any bedside manner (a shame under the circumstances) & told me I was about 5 cm. When she left to get a wheelchair to get me to a room, there was a midwife who came in & said that she bet I was further along. She examined me & I was around 8 cm. She followed me into the room & was next to me until they had to take me into the OR.
Wondering what the difference is b/w midwifes who practice in the hospital compared to homebirths. I assume those through the hospital are req'd to follow hospital procedure, which at times, has proven to not be necessarily the best for a laboring mother.
Hi My name is Linda and in regards to home births I am for them I have been a coach for many years and the only problem I have seen was the fact that the Hospital is always trying to hurry the births along by giving everyone Patosin to increase the labor pains and try to force the baby down. The problem with this is they want to also give epidurals to kill the pain not allowing the normal function of the body to do its work. In the end the majority of the woman results in haveing to have a C-Section because the babies head gets stuck in the birthing canal causing the baby to go into distress the heart rate dropping and the Mom losing oxygen needing to have a emergency C-Section. Forcing her to have to have an epidural causing a longer recovery period for the mother. I try to talk the mother out of the Patosin and an epidural and the pain last through the birth and then is gone leaving the mother and baby in a normal state and less complications. Yes with birth comes pain but the pleasure came before the pregnancy and during the pregnancy try Neubain for pain it takes the edge off but it allows you to push naturally during the delivery. You will feel an intense burning through the push but it si done when the baby passes through the cervix. YOu may try explaining to each mother during the prenatal care what exactly to expect from the beginning of the pains to the actual birth of the baby. I kinow we think that it is explained but if they can't explain it back so that you understand what they during labor expect then they still have no idea.
Last edited by Linda M.P.; 01-06-2011 at 04:06 PM..
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If so you and others are seriously lacking in reading comprehension and making some pretty major leaps and jumping to conclusions that aren't true. I already stated that my midwife offers all of the same testing as an OB. I also stated that ultrasounds were meant for high risk pregnancies and specific situations and were not meant to be used for low risk women as a routine part of prenatal care. This is not something that I made up nor is it even my opinion. It is a fact. I even posted links showing where the experts said this. Why people are having such a difficult time comprehending this information is beyond me. 
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Home Births
