Homebirth disasters: just imagine

Two days ago, I commented that unassisted birth advocate Rixa Freeze has inadvertently produced the ideal teaching video for demonstrating how and why babies die in increased numbers at homebirth. (See the video here). The video includes the immediate aftermath of the birth when baby Inga became profoundly blue and lost all muscle tone due to lack of oxygen. Ultimately Rixa was forced to provide mouth to mouth resuscitation and fortunately, the baby responded.

Many people commented to tell me that Rixa herself was spinning the near disaster as though it was nothing serious and that she had educated herself to handle the situation calmly and with ease. Rixa seems to imply that what happened to Inga is the worst emergency that can happen at homebirth and all you have to do is take a neonatal resuscitation course and you will be adequately prepared to save your baby’s life.

The reality is quite different. It’s not the worst situation; not even close. And in viewing the video and using our imaginations, we can conjure very different outcomes in which other women attempting to emulate Rixa precipitate disaster instead.

Just imagine that the baby was born alive but without a pulse.

The mother would have to get herself out of the tub, find a hard surface on which to place the baby, begin CPR and continue mouth to mouth until an ambulance arrived. It would take time to start effective CPR and a lot of time for the ambulance to arrive. The chance of the baby surviving? Very low.

Just imagine if the baby had gotten stuck?

There’s the mother, straining and pushing away in the fecally contaminated tub and the head emerges … then nothing happens. How long would it be before the mother realized that the shoulders were stuck? How would she get herself out of the tub with a baby’s head wedged between her inner thighs? Homebirth advocates like to pretend that the Gaskin maneuver would save the day, but the scientific evidence shows that the Gaskin maneuver is no more effective than any other position for releasing a shoulder dystocia. Who would apply the maneuvers that are the ONLY way to resolve a severe shoulder dystocia? How long would the mother wait, with the baby’s head between her legs, and the baby’s brain being deprived of oxygen until help arrived? Chance of the baby surviving? Even lower.

Just imagine if the baby had been breech with a trapped head?

Once again the mother would be pushing and straining away in the fecally contaminated tub and the baby’s body would emerge but the head would be stuck behind the public bone. Once again she would have to lever herself out of the head with a baby’s body hanging between her legs. No amount of position change is going to resolve the trapped head. A trained attendant would need to apply the correct maneuvers and be vert lucky in order to save that baby. Chance of the baby surviving? Miniscule.

There are many more scenarios that we can imagine, and almost none of them would have ended happily.

Lately a typically goofy mantra has been circulating in the NCB Twitterverse: “Babies know how to be born.” Really? The same babies who aren’t smart enough to take a breath are smart enough to be born? And if the babies “know” how to be born, they also “know” how to die, and they are pretty good doing so, generally when you least expect it.

Rixa and her minions are not going to change their minds. How could they? It would mean admitting that they risk their babies’ lives for a piece of performance art, and they will never admit it.

Nonetheless, the video remains a priceless teaching tool for anyone wondering what it looks like when something goes wrong at a homebirth. Parents contemplating homebirth should watch the video and consider these questions:

Would you be able to live with yourself if your baby did not survive despite your (or the midwife’s resuscitation efforts?

Do you really want to risk the horror of trying to get out of the birth pool with a baby’s head or body between your legs?

Having watched how quickly baby Inga became hypoxic, cyanotic and floppy, do you really think there is enough time to get to a hospital before the baby becomes brain damaged?

Just imagine, and then decide.

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