No, homebirth did not save your baby, either

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As I’ve written many times in the past, there is an apparently irresistible impulse to one-upsmanship among homebirth advocates.

So, for example:

A says, “I had natural childbirth.”
and B says, “Oh, yeah, well I had PAINLESS childbirth”
and C says, “Well, ladies, I can top that. I had an ORGASM during childbirth!”

Evidently the latest iteration is this:

A says, “I had a low risk homebirth and my baby didn’t die”
and B says, “Oh, yeah, well I had a high risk homebirth and my baby didn’t die”
now C says, “Well, ladies, I can top that. I had a high risk homebirth and IT SAVED MY BABY’S LIFE!”

It’s gotten to the point where these women are completely delusional. Last week I wrote about the homebirth advocate who claimed Thank goodness I chose homebirth for the shoulder dystocia that nearly killed my baby.

A woman whose son suffered a severe shoulder dystocia, was born lifeless, waited 25 minutes for an ambulance and had to endure cooling therapy to preserve his brain function and may have sustained developmental impairment is actually crowing that it was the decision to give birth at home that saved his life.

The following story, found on Mothering.com, may actually top it.

The mother had an uncomplicated homebirth, but then had a retained placenta. She was transferred to the hospital for a manual removal of the placenta.

Despite having 6 ultra high-tech ultrasounds in the 2nd and 1 in the 3rd trimesters, 3 OBGYNs (including 1 who hated homebirths and looked for any reason to disqualify you) had ALL missed my son’s life-threatening Velamentous Cord Insertion (VCI).

VCI is when the cord inserts itself into the fetal membranes instead of the placenta. It leaves the blood vessels exposed and most of the time the vessels explode, causing stillbirth. Basically, the cord and placenta are inside-out.

Here, you’re hospitalized immediately after VCI is diagnosed. You get a special CSection at 35 weeks, or whenever labor starts, whichever is first. The CSection is done special to prevent accidental nicking of the exposed vessels.

All 3 OBGYNs agreed that homebirth saved my son’s life. They said that, had I birthed in a hospital, they would have done a CSection for “failure to progress” and wouldn’t have paid close enough attention to realize the VCI, thus killing my son.

Let’s parse these claims:

What is VCI?

The International Vasa Previa Foundation has a page devoted to velamentous cord insertion. All vasa previa involve velamentous cord insertion, but not all VCI are vasa previa. As the mother accurately explained, VCI describes a condition where the blood vessels of the umbilical cord travel across the fetal membranes before inserting into the placenta, instead of inserting directly into the placenta as is typical. Vasa previa happens when the blood vessels of the VCI overly the cervix and are therefore exposed and subject to tearing as the cervix dilates. A ruptured vasa previa causes the baby to exsanguinate within a few minutes.

Is VCI dangerous if there is no vasa previa?

Velamentous cord insertion in the absence of vasa previa usually does not cause problems. If the VCI is above the lower uterine segment, there is little danger that the exposed blood vessels will rupture. You can find an excellent picture of VCI here.

How easy is it to diagnose velamentous cord insertion?

Velamentous insertion has been diagnosed by ultrasonography with a sensitivity of 67% and specificity of 100% in the second trimester;

In one third of cases, VCI is not visible on ultrasound.

What is the treatment if VCI is diagnosed by ultrasound?

If detected, fetal growth may be monitored with ultrasonography in the third trimester. Consider an elective cesarean delivery to avoid a vasa previa rupture or fetal distress if the velamentous insertion is in the lower segment.

In other words, the mother has the story precisely backwards! C-section PREVENTS injury from VCI. It doesn’t cause it.

The idea that a homebirth saved this baby’s life is ludicrous on its face. First, the danger of VCI that does not cross the cervix or lower uterine segment is actually quite small. Second, C-section is the life saving TREATMENT for a worrisome VCI because it reduces the risk of perinatal death to near zero.

I suspect that the mother heard (or pretended to hear) exactly the opposite of what she claims.

No one told her that homebirth saved her baby’s life; they told her that homebirth could have killed her baby. No one told her that C-section would have put her son at risk because C-section does not kill VCI babies; is a treatment for VCI.

They almost certainly told her that she had dodged a bullet. Had the VCI ruptured during homebirth, her baby would have died. This mother is apparently so desperate for extra special bragging rights for her homebirth that she isn’t simply practicing denial. She has actually inverted the admonition of the hospital personnel into praise for herself and her decision. That impulse verges on the delusional.