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  1. #26
    Join Date
    Jul 2013
    Posts
    675
    Quote Originally Posted by lexiem View Post
    The reason why the hospital-midwife statistics are lowest isn't necessarily that they are the "best" but because they only get the numbers for the uncomplicated hospital-births while high-risk pregnancies and complications are immediately transferred to a doctor. (So obviously the doctors numbers are skewed because they include almost all of the hospitals high-risk pregnancies).
    Thanks for making this point. That's what I assumed from the statistics as well. I had both of my children in the hospital with a midwife. I was really happy with the experience and was glad to know that if something had gone wrong I was near an OR, NICU and everything else a hospital has to offer. I also enjoyed my hospital stay following my daughter. It gave me some time to focus on just her before we went home and I had to balance two kids. She also stopped breathing and turned blue on her second day and while she started again on her own and was fine it was reassuring to have a nurse that came running in when it happened and know that if she wasn't OK then we were right there in the hospital.
    Mother to: Patrick Werner (3/10) and Mary Claire (06/12)

  2. #28
    Join Date
    Aug 2009
    Location
    Midwest, US
    Posts
    338
    I have seen studies that are studies that dispute safety of hospital births.
    Here's one that suggests that homebirth is MUCH safer for the mother (particularly 2nd+ time moms) than hospital birth: http://www.bmj.com/press-releases/20...ng-home-births

    I will be having a homebirth with a midwife (certified nurse midwife, not a CPM or DEM). I am well-educated on my options and this is my second low-risk birth. After 2 full days on pitocin in the hospital with an OB for my first (no epidural TYVM), I'm 100% confident that the best place for my baby to be born this time is right at home. I'm a trained doula myself and have attended numerous home births. I have no reservations about them for the right birth and with the proper support. My midwife and her staff are fully trained in neo-natal resuscitation and carry all the necessary supplies such as masks and O2 tanks. I also live about 5 minutes from a major trauma center.

    Women need to know their options and know their health history and risks. I also find it critical that parents-to-be prepare themselves with a comprehensive childbirth course over several weeks such as Bradley Method or Informed Beginnings. Informed consent cannot be given for procedures if mom is not actually informed first and only fear is used to sway her towards the decision that the doctor wants her to make. Hospital classes do not prep new moms as well as they should.

    IMO, Posts like this only breed fear and are biased, particularly when it's unknown what the provider's credentials actually are.
    Last edited by smismar; July 8th, 2013 at 11:17 PM.
    Mom to Sylvia Caron and Linus Roman



  3. #30
    Join Date
    Apr 2011
    Location
    New Zealand
    Posts
    601
    Quote Originally Posted by lexiem View Post

    Yes, these are American statistics but the general findings probably don't change much (at least for hospital-midwives vs hospital-doctors) in any country with a comparable medical-skill level). This has nothing to do with who the midwife is but purely what location the baby is born in. Saying that home-births in New Zealand or Australia are "safer" because it's the same midwife as in the hospital is fallacious. It may very well be the case that they are better trained and have higher professional requirements (which is always awesome), but you can't compare personal numbers to location numbers -> it's like comparing apples and celery.
    I am not sure what you mean by "personal and location numbers", but what I said is not fallacious at all. Blade said homebirth midwives in the US are all completely unqualified (which isn't actually true, there are both lay and qualified midwives who handle homebirths there) vs professional, qualified midwives who work in hospitals. Any country which has lay midwives operating is going to have completely different homebirth stats than countries which don't. And actually, I think it's a big shame they didn't differentiate between the qualified and unqualified midwives. I agree that having an unqualified midwife attend your birth is unsafe (wherever you birth), but that doesn't make *homebirth* intrinsically unsafe, it makes your midwife unsafe.

    From the body of the paper:

    "Patients delivering at home attended by midwives were significantly more likely to be
    multiparous, non-Hispanic white, ≥30 years of age, delivering beyond 41 and 42 weeks,
    and having macrosomic infants over 4,000 and 4,500 grams (p<.0001)."

    It seems biased to me to exclude small and premature babies (more likely to be born in a hospital) but not to exclude large and post-dates babies (more likely to be born at home).

    Also worth noting:

    "The CDC data on seizures or serious neurologic dysfunction include those
    of genetic, prenatal, intrapartum, and neonatal origin that might not be related to birth
    setting."

    Finally... aside from some basic exclusions (premature, low birthweight, multiple gestations) I can't find any qualifier about how many of the births were classed as low risk. Given that nearly all health providers only recommend homebirth for low risk pregnancies - but often homebirth stats include high risk women who birthed at home anyway - that seems like a pretty serious oversight. Studies that compare only low risk births often find little difference in outcome between hospital and home.
    Last edited by milasmama; July 9th, 2013 at 03:56 AM.
    Mother to two lovely kiddos, Mila Arden and Cato Bennett

    Currently dreaming of...
    Atlas Bram, Abel Octavian, Abel Roscoe
    Lyra Blythe, Delphi Winter, Elowen Sage, Inka Blythe, Anouk Thessaly

  4. #32
    Join Date
    Apr 2011
    Location
    New Zealand
    Posts
    601
    Quote Originally Posted by tk. View Post
    I think it's 14 *million*
    Yes, nearly 14 million - although home births made up a (relatively) very small proportion at 0.49% of the sample size. I'd be very curious to know what data more balanced sample sizes would have produced.
    Mother to two lovely kiddos, Mila Arden and Cato Bennett

    Currently dreaming of...
    Atlas Bram, Abel Octavian, Abel Roscoe
    Lyra Blythe, Delphi Winter, Elowen Sage, Inka Blythe, Anouk Thessaly

  5. #34
    Join Date
    Mar 2012
    Posts
    158
    It seems fairly self-evident to me that giving birth in a setting with medical intervention on-hand is going to be "safer" for complicated births (and of course you never know whether this will be the case until it is too late).

    However, I still believe that there are other factors to consider that would sway some mothers towards a home birth, despite the need to travel to hospital if things go horribly wrong: the comfort of being at home, having complete control over the birth setting and the birth. For instance, if you have had an uncomplicated first birth, some women may be willing to trade the risk of a 15 minute ambulance ride for the security of knowing that they won't receive any unnecessary intervention (I've heard that my closest hospital will transfer a woman from the midwife led unit to the delivery suite for medical intervention if her labour is not progressing quickly enough after four hours - I don't like the idea of being on a stop watch, and all medical intervention carries its own risks).

    So, the statistics around safety are only one factor (if arguably the most important) in making a decision about where to give birth.

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