5 reasons why I chose hospital birth

hospital birth

Homebirth advocates often feel a burning need to explain their motivation for giving birth at home. It seems only fair that those who give birth in the hospital should offer an explanation.

5 reasons why I chose hospital birth:

1. I wanted a live baby
2. I had no desire to even take even the tiniest risk to my baby’s brain function
3. I had no need to impress other privileged Western white women with faux “achievements,”
4. I actually read the scientific literature, not some lay blogger’s “interpretation” of it
5. I don’t get my medical advice from washed up talk show hosts

PS: Did I mention I wanted a live baby?

That’s why I chose hospital birth. How about you?

  • are you serious?

    wow, we get your for hospital births, BIG whoop. Geeze lady…you claim to be this well educated so-called medical guru. yet youre completely ONE sided! in ALL your posts, blogs, arguments, etc. if this is YOUR personal reason so be, but are you trying to manipulate and brain wash the rest of civilization? this is pretty harsh! “did I mention I want a live baby? do you?” that’s pretty fucked up in my opinion!! you are OBVIOUSLY blind and cognitively challenged if you deny the millions of natural births done outside a hospital that resulted in LIVE WELL AMAZING babies!?? -__- really though. these “5 reasons for a hospital birth” are actually just 5 reasons to dislike arrogant, ignorant and close minded people, such as yourself.

    • Stacy48918

      Wow, what a “ONE sided” response. You realize this is a personal blog. She’s under no obligation to present both sides, especially since the other side kills babies. NCB blogs, boards and forums are rather ONE sided too. How much time for differing opinions did Ricki Lake include in the Business of Being Born?

  • Mark Ramsey

    What a piece of fear mongering propaganda…just fathered a beautiful baby boy with two highly trained midwives and a doula. I have a brother in law whose learning disabilities are directly caused by the use of forceps. There was another story recently where a doctor shattered a baby’s skull with the same method. I understand as an OB you have a reason to post such one sided and rude dialog. If more families had the wonderful experience I just had with my amazing wife and son, fewer and fewer will use status quo OBs who do not respect their patients’ birth plans and scare them into doing things their way (the “safe or right” way) and make their desire for a natural and intervention-free birth into a selfish decision that puts their children in peril, which is sick. Our OB was very open with us of the true reality that home births are a valid birthing decision. This post is crass and clearly self-serving.

    • Houston Mom

      You fathered a baby boy with two midwives AND a doula? And your wife doesn’t mind?

      • Mark Ramsey

        Im not sure what your post means, it probably has to do with some politically correct way I’m supposed to talk about the birthing experience, which I do not get caught up in. If there is any confusion, the baby came out of my wife’s vagina and she did 110% of the work. If that is somehow meant to diminish my post, I must say it does not have much salience.

        • PrimaryCareDoc

          When you say you “fathered” a child, it means that you got a woman pregnant. You said you “just fathered a beautiful baby boy with two highly trained midwives and a doula.”

          Poor choice of words, unless you’ve been very, very busy and have a very tolerant wife!

          • Mark Ramsey

            Why do I need to choose them carefully? Was there really confusion in whether or not I was referring to having children with all my care practitioners? It seems just like a cheap way to try and discredit my post.

          • PrimaryCareDoc

            Words matter and you need to choose them carefully because this is a written forum. You can’t rely on facial expression, tone of voice or body language to make your point. Sometimes you can’t even rely on context.

            Of course there was no confusion about your actual meaning. It was just unintentionally very, very funny.

          • i agree with you

            I completely agree, you’d have to have a cognitive functioning and way of thinking of a little child to not have understood what you were saying, just because you didn’t use commas or certain linking words doesn’t make your post any less valid and accurate. these people were just too much

        • Amy Tuteur, MD

          I’m not sure what you think your story means. So you had a baby at home and no one died. No doubt you could drive to the grocery store with the baby in your lap instead of a car seat and no one would die then either. Would that make driving with a baby in your lap safe or a good idea?

          • please stop already

            although your statement is accurate, its ignorant. the deaths of babies born at home to low risk moms are about the same as babies born in a hospital

          • Stacy48918

            Care to back that up with some research? The CDC numbers perhaps? MANA study? Anything recent by Amos Grunebaum?

            Oh, wait. They all show that homebirth has a higher death rate than hospital birth.

            Got some research we haven’t seen? Please, educate us.

      • Trixie

        OH SNAP!

      • Mark Ramsey

        And I did not have any children with the lovely women who helped my wife and I give birth.

        • PrimaryCareDoc

          See, but you said you did. Words matter. Choose them carefully.

          • grammar police?

            god your an idiot.

          • Box of Salt

            grammar police?
            Did you mean “you’re an idiot?”

            Thanks for the laugh.

          • Stacy48918

            “god YOUR an idiot.”

            And YOUR screen name is “grammar police?” YOU’RE a riot!

      • The Computer Ate My Nym

        Also, one baby, three women (or maybe two women and another man–no one says a doula has to be female)? That doesn’t sound very natural to me. Then again, if Mark has the proper equipment to form a single baby out of 4 gametes, maybe he also does have an OR and NICU at his house, in which case we may be criticizing unfairly…

    • guest

      So you had two midwives, a doula AND an OB – who said that home births are “a valid birthing decision”? Would you mind sharing the name of this OB who is so willing to work with midwives and supportive of home birth?

    • The Computer Ate My Nym

      Use of forceps does carry danger. That’s why most OBs prefer c-section to instrumental delivery when there’s an obstetric emergency and the baby is minutes away from death or brain damage. What would your midwives have done if your wife was in obstructed labor or began hemorrhaging or suddenly started gasping for breath?

  • Dria Taylor

    The reason women believe that you must birth is hospital is due to the fear doctors instill in us. With medical intervention and induction you are far more likely to have a c section and need to be in s hospital. If you have a midwife who is experienced and knowledgable it is safe to birth at home. Honestly most midwives have delivered more babies and helped more Laboring mothers then most doctors. My midwife has delivered over 3,000 babies. In the 2 years I have known her she has had only 1 mother go to the hospital for a cesarian and both mother and baby are healthy and happy. She delivers about 100-150 babies a year which means out of the 250+ babies she has delivered only one needed a c-section. That is much better odds then any hospital I’ve ever been too. Most have a c-section rate of about 1/5. The one thing about hospitals that bothers me the most is that they push induction. Induction should be reserved for medical nessecity. Not because you are uncomfortable or are in a hurry to meet your baby. Most doctors offer induction at 39 weeks. Most women naturally go into labor at 41 weeks 3 days. Which mean you could be having your baby almost 3 weeks early. This can cause jaundice and trouble with breastfeeding. Being induced increases risk of c section by 50%. I do not judge you if you choose to birth in a hospital. Do not judge me for birthing at home. Do not assume that I get my facts from business of being born. I didn’t even see this documentary till after my son was born. Be informed, educate yourself, be your own advocate and most of all birth without fear!!!

    • PrimaryCareDoc

      Please read some of the posts over the past 2 weeks specifically addressing the MANA stats and the safety of home birth,

    • AllieFoyle

      Well, would you mind sharing where you did get your information? Specifically the claim that being induced increases your chances of c-section by 50%?

      The posts on this site for the last week have been mainly related to the death of a baby who was allowed to go dangerously postdates. A timely induction or c-section probably would have saved his life.

      Fwiw, I had my children in the hospital. I had to beg for inductions at 42 weeks and 41+. No one pushed one on me, though in retrospect they probably should have because the 42 weeker showed signs that things were deteriorating. I would not like to know what might have happened if we had waited.

      You seem very concerned about the dangers of c-sections and inductions, but please consider that going postdates raises the risk of stillbirth considerably. This is a very real and serious risk, and it makes elective delivery at 39 or 40 weeks seem like a very reasonable decision.

  • Emily

    Your constant reference to “white women” is racist and offensive.

  • Thee Cherish

    You sound most unplesant. You win more flies with Honey dear!

    • Lisa Murakami

      That’s actually not true. People aren’t won over by honey; they are won over by knowledge and facts. Moreover, it’s dishonest to “make nice” about choices that cause babies to die every single year, and still more to be brain damaged. Facts and honesty are what will win over the people who are actually considering the choice. The rest of the people aren’t worth bothering with; they won’t be won over by anything, and certainly not by honey.

    • LibrarianSarah

      You win the most flies with a rotting corpse. Poop works too! It really isn’t that hard to win over flies.

  • gtrslinger

    Here is why I chose hospital birth and just gave birth to a healthy and vivacious 8 lb 4 oz girl named Minowa…

    First, a little background. I had had a very uncomplicated low risk pregnancy. I tested neg for step B, no preeclampsia, no diabetes, baby was head down facing my back, she was on point for her size w/ re to how far along she was, I was not overweight, there was virtually no risks whatsoever for me. If I had been into the home birth movement they probably would have considered me a perfect candidate. Fortunately, I know that things can go wrong very quickly and I was NOT willing to risk my baby’s life for some stupid she-goddess hippy dippy experience.

    So I missed my due date and my OBGYN being the awesome Dr she was said she would not let me go past 41 weeks BC of the stillbirth risks to my baby so we chose to induce with cytotec the night of July 17th. I went to the hospital with my husband, checked into our own room where a wonderful nurse administered cytotec along with some mild pain relievers they hooked me up to the fetal/contraction monitors and I went to sleep. The next morning they started me on pitossin and monitored my progress ever hr or so. I was slow and went from 1 cm forever to 3 cm over the course of several hrs. The contractions wear bearable at first but as soon as they started to really hurt I asked for my epidural BEST DECISION EVER!!!!!!! I got my epidural which really wasn’t terrible and took a nap. During the course of my one hour nap I went from 3cm to 9cm IN MY SLEEP and did not feel a thing! Whoever said that epidurals delay or complicate labor are nuts! Let’s see take a nap and not endure the worst pain ever or needlessly suffer for no apparent reason? I will take the epidural and not look back. My Dr came in and said I was almost dully dilated and would probably be ready to push in about 20 min. So we wanted until I was fully dilated and pushed for over an be and a half. It did not hurt, it just felt like a lot of rectal/bladder pressure (like you really have to go #1 and #2). My Dr monitored me the whole time and it was clear after about an hr and half that the baby’s head was not descending. She was stuck! Then my Dr said I had a choice and could either keep pushing for another 2 or 3 hrs with little progress or they could wheel me down the hall and cut me open and I would have my sweet little girl in 20 minutes. Given that the baby’s heart rate started to go up meaning she was getting stressed from being stuck I gave it no second thought and said “give me the c section”! Only thing was my epidural wore off at this point and I had to get another one at a higher dose for a c/s. So there I was at a 10 trying not to push with contractions every 3 minutes waiting for the anesthesiologist to come and he seemed to be out to lunch (my only complaint) but he finally did show up I was prepped and ready to go and he gave me my 2nd epidural which was magical. I did not feel a thing! My Dr worked very fast and within 20 minutes my baby was born perfectly healthy with a full team of neonatologists ready to administer any help she could possibly need. My husband got to hold her first after they cleaned her up and then they brought her to me. 🙂 I was cleaned up and sewed up very fast and was overjoyed! Honestly the c section was the best part of the whole thing! My Dr. Said my pelvis was just too narrow and baby’s head was too big. Had I been at a home birth I shudder to think what could have happened to her! The nurses were super helpful and I lived that I did not have to clean any sheets!

  • Ashley Wilson

    Can I list all five reasons as “A catheter”? I live in a split level house with no bathroom on the main floor and I had a small bladder infection for most of my pregnancy, plus the normal needing to pee every 5 minutes that occurs with pregnancy. I wanted pain relief anyway, but the second I found out I would be getting a catheter I was sold. It was frequently put in the negative side of pain relief but I didn’t care. I was so sad when it went away. 🙁

    • Lizzie Dee

      I have said something like this before with regard to enemas, but it it is amazing – and as far as I am concerned liberating – to discover how all the scary things get a lot less scary when the alternative is worse. I am a wimp, and didn’t much like the sound of any of the interventions in advance (But come to think of it, wasn’t too excited at the thought of natural, either.) I came round from a GA to two nurses struggling with a catheter. Hearing one saying that she was running into a brick wall, I startled both of them by remarking that THAT was a funny place to find a brick wall! Me, I felt rather empowered by my ability to make a joke in adverse circumstances. I would feel a lot more shamed by finding out I was a delicate little flower. I may be unusual in believing that part of the rite of passage is finding out what you can deal with and come up smiling.

  • Jessica Atchison

    You know, my great, great aunt was a homebirth midwife, back in the mid to late 1800’s. She would look at the women choosing woo over actual medicine today as absolute lunatics. She was a midwife in poor communities where they had no access to hospitals and even if they had, conditions in hospitals were poor. Had those people had access to today’s medicine she’d have been shooing them to the hospital as fast as she could.

  • I think that should be born in a hospital is a job best, safe for both mother and child.

  • yentavegan

    the top 5 reasons I had a hospital birth
    1. My grandmother had my mother in a hospital, my mother had me in a hospital so for me, a hospital birth was traditional and culturally correct
    2. Hospitals are where all the life saving technology is kept and the trained personnel hang-out.
    3. I wanted breakfast in bed and someone else to clean the sheets
    4. My husband had no interest in being trendy or thinking outside the box when it came to birth and I respected his clear-headedness.
    5.although I had the choice to forgo pain medication I would never risk my infants life by giving birth in a location that did not have medications at the ready

  • Impeding Lies

    Check out some of this new bullshit. Putting ‘risk free’ together with childbirth is an oxymoron. Foolish author. huffpo seems 2 have a hate boner 4 science. http://www.huffingtonpost.com/2012/08/08/natural-birth-protein_n_1756911.html

  • I don’t have a creative name

    OT: The mothering thread I mentioned, with the woman who was attempting a UC after bright yellow amniotic fluid. Just looked at her FB and there is a pic of a fat, healthy looking baby boy, being held by the little girl in the rest of the pics. Thank GOD.

    • I don’t have a creative name

      Okay, I swear I’m not a stalker, just really good at snooping on FB. He appears to have been born in a hospital. She did the right thing, and I hope learned a powerful lesson about the dangers of woo as well. He’s FAT!!! 🙂 Almost makes me want another one… but then I look at my crowded tiny house and come back to my senses….

    • Squillo

      Yay! Thanks for letting us know.

      • I don’t have a creative name

        did you see that some moron posted this as “proof” that discolored amnio fluid is best handled at home??? http://www.unhinderedliving.com/intuition.html the stupidity, it burns.

        • araikwao

          More an exercise in bullet-dodging and denial. I read that mostly with my jaw dropped in horror.

  • blueyedtexan

    Just when I think I can’t find any more woo filled websites, one pops up….http://www.indiebirth.com/dear-amazing-pregnant-woman/

  • Dan

    Dr. Tuteur, in a recent blog post, you wrote, “If I’ve learned anything at all from 25+ years as a mother, it’s that there are a lot of different ways to successfully mother children.” And you concluded, “I would say that the right choice is the one that works for you.”

    I feel compelled to write, because while there may be many different ways to successfully mother children, you (and most of the commenters below) appear to believe there is also only one right way to safely/successfully bear children: in the hospital, supervised by a medically trained obstetrician.

    I read your blog even before my daughter was born, and I thought I would share why, despite what I read here, I still supported my wife’s decision to have a homebirth. And it seems apt to share why we felt this was the choice that would work for us. My goal here is to not to persuade you that I’m right, but to share five consideration that you might be able to address more persuasively in the future.

    1. We assumed a live baby.

    We live in the U.S. In absolute terms, childbirth deaths are extremely unlikely—both in a hospital and at home. I don’t know if this information is current, but the statistics that Dr. Amy has previously cited about perinatal mortality rates in the U.S. are as follows: 4 in 10,000 babies do not survive birth in a hospital. 12 in 10,000 babies do not survive birth at home. Because my wife was low-risk, if we’re talking about rates around 12 in 10,000 vs. 4 in 10,000, I really liked our odds of being in the top 9,980.

    1A. Absolute statistics mattered more to my wife and I than relative ones.This blog prefers to quantify the risk in relative, not absolute terms: using the above statistics, it is clear (and, to my mind, not manipulative, not misleading) that homebirth is 3 times more likely to result in a dead baby.

    When you write “I want a live baby, therefore hospital,” I understand you to be encouraging expecting parents to focus on the possibility that their baby will be one of those 8 out of every 10,000—the number that could be saved by an OB but not by a midwife at home. (Please correct me if I’ve misread the statistics you cited, or if more current numbers are available.)

    1B. I think that the way you convey the statistics is honest. I also think it reflects an unconscious bias that fails to account for the Weber-Fechner law: if you add a couple grams to a kilogram, person doesn’t notice the difference. But if you’re only holding a feather and you add a couple grams, you notice. As an OB with several years of experience, I assume that you, Dr. Amy, have yourself attended hundreds of “normal” births, scores of “abnormal/risky” births, and a small handful of tragedies. I also assume that for you, those tragedies are salient. The bad outcomes weigh on you when you attempt to persuade using statistics: You are“holding” the 4 babies who die in hospitals and looking at the 12 babies who die with midwives. (out of 10,000) As a new parent, who will only get to do this a couple times, tops, I’m looking less at those rare tragedies, and more at the broad middle where we seem likely to land. In short, the reason 300% is unpersuasive FOR ME, is that I’m holding a kilogram and (I suspect) you’re holding a feather.

    Basically, despite how damning “300% more dangerous” sounds, we did not feel that this factor alone dictated our decision, when it addresses a circumstance that occurs less than .1 percent of the time.

    2. Really. We really didn’t stress about death. We believed, and continue to believe, that the benefits FOR US of attempting to procreate outweigh the risks TO US—which include the risk of Mom dying or the risk of being devastated by our baby’s death. According to your blog, everyone who has a child must make peace with this, because “childbirth is inherently unsafe.” According to your stats, the risks abate, but are not eliminated, in a hospital. Most Americans, including, I think, Dr. Tuteur, do not make peace with the possibility of death and instead attempt to make everyone completely safe at all times. Our culture has grown to be risk-averse to an unhealthy degree. The point that I want to make here is made better on the FreeRangeKids blog. Resiliency and vitality come from taking calculated risks. To us, the focus on perinatal death rates to the exclusion of ALL other factors was one of the things that drove us away from the hospital (see below).

    3. My wife wanted to deliver vaginally. I did not consider this an unreasonable thing for her to want.

    In the United States, she would have a 70% chance of being able to get what she wanted at a hospital. At the hospital we would have used, the cesarean rate is marginally higher – she would have a 1 in 3 chance of a cesarean. Now we’re talking about actually rolling dice.

    We had a hospital backup plan. If an emergency arose, we planned to transfer to a hospital and have a cesarean if it was called for. If that had occurred, I know that our joy about our child would have been tempered somewhat by grieving the inability to have the birth experience she craved. Choices are important.

    At risk of opening myself up to ridicule, I’ll dig into this a bit. First, local factors played into our decision. New moms in our community who also went into the hospital with vaginal birth plans and medical staff unwilling to be flexible. I’m not going to argue that anything that happened to those women wasn’t completely medically necessary. What I’m getting at is the fact that the hospital’s birth plan so completely overwhelmed theirs. The medical providers did not value the mothers’ participation in childbirth, against explicit requests. Women frequently report feeling bullied into giving consent. We concluded that the policies that led to intervention cascades for these women were less related to protecting children, and more related to protecting the hospital from lawsuits.

    For my wife, I think that her vision of her ideal birth probably has spiritual and emotional roots (c.f. The Red Tent). That is to say, my wife’s reasons for wanting vaginal birth probably differ from those who want a vaginal birth “to impress other privileged white women.” Irrational of her to want this? Maybe. But I think you’d have to concede that the decision to have children at all can never be wholly rational; a large part of the motivation is primal. I can only report that the power of the idea that her own body could both make and deliver a child resonated for her. She wanted to birth the baby, not to have a doctor “deliver” her from the baby. Maybe there are other cultural pressures that create this desire (“Macduff was from his mother’s womb / Untimely ripped”), but there it is.

    And let me be clear, I am absolutely saying that for us, the experience of welcoming our child at home was worth the increased (by 8/10,000 or a factor of 3) risk to our child’s life. My wife actually looked forward to the experience of giving birth. I look forward to teaching my child to ride a bike. These are not activities that are without risks to the child, but the risks can be quantified and contained (e.g. by helmets or nearby surgical facilities). And they are activities that we hope to take enormous personal satisfaction from. For us, parenting is something we want to experience without sacrificing all of our desires for our children. That’s selfish of us, obviously, but we also feel it’s important (again, only speaking for my wife and I) to model for our child. The alternative, in our view, creates a culture of entitlement in the next generation. According to Dr. Amy, the right choice is the one that works for us.

    Every parenting activity, from childbirth onward, is a risky proposition. We (humans) do it anyway, despite the risk of being devastated by loss, because the potential upsides are so rewarding. And we heard from too many new moms who had unrewarding experiences with hospital childbirth—where the hospital had the baby and they were just in attendance. If you want evidence-based practice, as it is currently practiced in our nearest hospital, to persuade women like my wife, then that practice needs to take into account individualized circumstances.

    4. My wife felt the hospital atmosphere would make labor more difficult for her. While hospitals may be less deadly by a tiny margin, they are more intrusive and inflexible by a huge margin, even for low-risk women. (No food or drink during the first or second stage? Really?) I don’t know if there’s any benefit to the idea that mammals prefer to give birth in dark, secluded places, but there probably isn’t any harm, and my wife thought it was preferable. Our hospital has accommodated women who want to labor in a dim/darkened room, so this was actually neutral in our case, but may not be the case everywhere. It seems intuitively correct that a woman under lower stress will have an easier labor. My wife felt the hospital environment, on the whole, would impose additional stress on her (someone asking how she’s doing every 10 minutes, putting her “on the clock” after her water broke, etc.) We spoke to other women who felt the opposite: a hospital is a place where cool-headed rational people take care of you, and just walking into that environment reduced stress for them. Individuals can have different reactions to different stimuli. We felt a hospital was not the right choice for us.

    5. We believed the best place for the baby after birth was in Mom’s arms. Maybe that’s too “woo” or “nature-based” for this blog. But it was important to us. We concluded that immediate closeness and bonding after birth was probably beneficial in terms of reducing risk of PPD, whereas there was likely no benefit to immediately towelling off the child, administering eye drops (why take Mom’s word for it that she’s STD-free?) weighing the baby, taking blood, etc. Our hospital has since begun to accommodate this even for cesarean births, and it’s good to see hospitals focusing on customer service.

    Broadly, we felt that the hospital had a myopic view of risk (to the baby and to the doctor’s insurer) that made infant mortality the only factor that should influence decision-making. Because my wife was healthy, we didn’t feel we had to sacrifice a live baby to have a homebirth: we decided on a trial of labor at home, with a hospital transfer backup plan. This was What Worked For Us.

    I consider myself facile with statistics, but not an expert. At risk of being called out, I’m going to cite one authority I believe in, Samuel Arbesman: A sizeable percentage of medical research ends up being later completely erroneous or substantially revised. And this is a good thing.

    • The Bofa on the Sofa

      Absolute statistics mattered more to my wife and I than relative ones.

      I take it then that you and your wife have no problem with drunk driving? Because in absolute terms, it’s a lot safer than giving birth. Your chance of dying in an 8 mile drive while drunk is 50 times less than your wife’s chance of dying in childbirth.

      But wait, you say! It’s illegal! And lots of other bad things can happen besides dying, right?

      Yes, but the chances of them happening are pretty small. The chances of you getting in an accident, or even getting DUI on that drive is 10 times smaller than the chance of your baby dying in childbirth. And that all refers to childbirth in a hospital. Childbirth at home is riskier.

      So if the absolute risks of homebirth do not concern you, then that means you must be ok with drunk driving, right?

    • Amy Tuteur, MD

      You will get no disagreement from me that homebirth was the right choice for you. My disagreement is with those who claim that homebirth is the safest choice.

      I will say, thought, that “assuming a live baby” is like “assuming that you don’t need to wear a seat belt because you won’t get into an auto accident. You probably won’t, but does it really make sense to assume that you won’t.

      I also have a question. If your baby died, would homebirth still have been the “right” decision?

      • AmyP

        And how would you feel explaining your choice to family and friends after your baby died?

      • Bombshellrisa

        Also, if the mother had died due to complications that were treated too late because she was in an out of hospital setting, would that still be the “right” setting?

    • Allie P

      I held my baby right after birth and any time I wanted for months after. I still got PPD. “Holding” the baby has nothing to do with how your brain responds to chemical and hormonal changes.

      • amazonmom

        I wouldn’t let anyone but myself hold the baby for a long time. Still had severe PPD.

        • Lizzie Dee

          I assumed, on logical and statistical grounds that I WOULD get PPD. I didn’t. So much for assumptions.

          • Happy Sheep

            I was also convinced that I would have ppd after my second, I had every single risk factor and I was dealing with the recent death of my mother, somehow no ppd.
            Due to my son’s super fast delivery I didn’t hold him right away either, and *gasp* they hatted him! Somehow we are still bonded like glue and I due to the luck of the draw and chemistry don’t have ppd.
            On top of all that, we had competent help, and OR and a NICU.

      • theadequatemother

        This idea that PPD can be prevented by a certain type of birth and certain actions is just the age old discriminatory idea that people with mental illness are that way because they are “weak” and “choose” to be ill. Mental illnesses are mental illnesses. You can no more bring them on or prevent them than you can pneumonia.

    • fiftyfifty1

      You lost me at the part where your wife wanted to emulate The Red Tent yet somehow wasn’t like all those other privileged white women…

      • Box of Salt

        He lost me at “We assumed a live baby.” He may understand numbers, but he doesn’t understand what the numbers mean.

      • Clarissa Darling

        I didn’t read The Red Tent but, I looked at the synopsis online. From what I know of history, it’s not likely that all the women of the tribe got together and decided to host an ancient female empowerment fest during their time of the month. More relaistically, they were bansihed during this time because the men of the tribe were mysoginists (what men weren’t back then) and viewed women and their bodily functions as dirty, shameful and something they needed to be protected from. Why anyone would want to emulate this in the 21st century is beyond me. Attributing ancient practices (or current practices in underdeveloped countries) to some sort of idealized vision of primative cultures and their spirutal nobility and then and bemonaning the fact that we in the west have lost touch with these practices (when a lot of women who are still subjected to them would give their right arm not to be) screams privliged out of touch white lady to me.

        • Bombshellrisa

          I read the book and it basically goes with the biblical thought that women are unclean during their time of the month and that since anything that they touch, anything they sit on and any place they are is unclean as well, they aren’t fit to be around. I don’t know what is supposed to be so empowering about sitting around with other women bleeding into a bowl.

          • Lizzie Dee

            I haven’t read it, and after that synopsis don’t plan to. What insights are supposed to be gained from this procedure? The Wonderfulness of w.omen? Being At One with nature?

            I seem to have missed out on the Mystical Mumbo Jumbo gene. Does this mean I am a failure as a woman? Will I make the initiates Sad? I find it an advantage in normal everyday life myself.

          • Clarissa Darling

            Maybe Dan’s wife is the kind of person who would read Gone With the Wind and then be sorry that we can’t return to the genteel and graceful pre civil war south where a population of benevolent plantation owners were happily served by singing, smiling slaves. Seriously, a popular fictional story romanticizing the much more unpleasant reality of history isn’t a new idea –and it doesn’t make the realities any less harsh. I have read and enjoyed historical fictions but, I try never to lose sight of the fact that they are fiction first and foremost. Nothing I’ve heard about The Red Tent makes me think women were more empowered or in touch with their womanhood during biblical times when I know from history 101 that the reverse is true.

    • fiftyfifty1

      “In the United States, she would have a 70% chance of being able to get what she wanted at a hospital”
      The overall C-section rate is not what applies to your wife because over half of c-sections in the U.S. are planned c-sections for reasons such as breech, twins, herpes, repeat, maternal request etc. What matters to your wife is the chance of having an unplanned c-section after a trial of labor. That chance at most hospitals is around 15%. It is even lower for low-risk women (young, non-diabetic, healthy weight, no chronic health problems).

      • Karen in SC

        And many of the procedures done in the hospital are done precisely so the mother can STILL give birth vaginally. They work better if done before there is an emergency, of course.

      • The Bofa on the Sofa

        “In the United States, she would have a 70% chance of being able to get what she wanted at a hospital”

        I missed this part.

        As fiftyfifty1 notes, the only reason she would be getting a c-section is if there were some indications of risk. Seriously Dan, would you still be calling it the “right decision for you” if the baby was breech or twins? Because, as noted, if you don’t have some complication, then the chances of a c-section are much, much lower than 30%.

        So Dan, you have been mis-informed. And you went on and made your decision based on mis-information.

        You story crumbles more and more.

    • Maire

      Dan, as a mother of 3, 2 of whom were very traumatic births,(1st & 3rd) let me add some insight. Because the 2 traumatic births were indeed traumatic, for years I concentrated on the “me” factor and how I felt so emotionally damaged after those experiences. Because I did not have the birth experience that I wanted. Now, both were labors were very painful (back labor, as were all). You can argue that if I’d had a homebirth with a competent Midwife & Doula, I may have been able to have a more comfortable labor. That may well be. And aside from possibly having a too narrow pelvis, (which was ruled out) no problems were detected with the babies while i was in labor.
      But here’s the thing: Both babies experienced distress during the pushing phase, one had to be born using forceps, the other was born in respitory distress, with a ton of Meconium in my amniotic fluid.
      My point is that over time, I realized that yes, I had a totally crappy “birth experience” but I also had 2 living children. My second birth was also fraught with back labor & was also extremely painful, but I had a different Dr. & it was a much more “Mother Friendly” experience (sadly, he was very ill & wasn’t seeing patients for my 3rd birth).
      Your fantasy of being able be able to magically transport to the hospital & be in the OR in how many minutes? To immediately have a C-Section would be laughable, but it’s not. It speaks of arrogance, the exact thing that kills babies. And before you get your back up, read the tragic stories of parents who’ve been through the experience.
      BTW, what are/were the credentials of your homebirth team?

      • Marguerita

        Yeah, I was wondering about the credentials too. Also if the mother was FTM.

    • Lizzie Dee

      We assumed a live baby.

      Doesn’t everyone? And of course most people get one, and can happily go on with their new lives – though not necessarily as smug and oblivious as they were when they started.

      It isn’t your wife who is “delivered” from the baby, but the other way round. It does seem like an anachronistic term these days, and certainly unpopular with those who value control and empowerment. That it was ever current is an indication of the potential peril that existed before the statistics improved – and it wasn’t homebirth and midwives that changed them. I am glad things went well for you – though to be honest I don’t really understand the thinking of those who fear an unnatural birth more than they fear a natural potential disaster. If one is convinced that everything will go well at home, why so convinced that it will go badly in hospital?

      I once, with a degree of wincing horror and sympathy, read a blog – Elm City Dad. Someone rather like you, who shared all your convictions and certainties, but who was not so fortunate. That couple assumed a live baby as well. Their pain and disillusion was terrible and long lasting.

    • Susan

      Interesting post Dan. Especially the part about having “held” dead babies. I had a truly almost perfect homebirth with my second baby. After that, I was inspired to become a RN hoping to then become a CNM, like my midwives. For me, hold a “dead” baby as a nurse did completely change the idea of whether that very small risk mattered. Maybe it doesn’t for everyone but I believe many people would just not see the things you see as worthwhile trade offs for that very small risk as worthwhile if the “risk” was real to them. Sure its small, but it is real and it’s going to happen to someone, it’s magical thinking to believe it won’t be you. The argument there sounds like you only say that because death is REAL to you. Death is real and that baby is never coming back, no second chances, and the pain involved is unbelievable. Well worth the trade off for me and I am ashamed that my fear of looking clearly at the reality of the risk of death caused me to risk my daughters life for an “experience”.

      • fiftyfifty1

        Very well put, Susan. Dan is doing some major intellectualizing about the risks he took: Blah Blah Blah Weber-Fechner, blah blah blah grams and feathers, Blah blah blah “holding” babies. No seriously, Dan. This isn’t about “holding” dead babies. It is about actually *holding dead babies*. The baby is DEAD and you are holding its still-warm dead body in your own living hands.

      • amazonmom

        People accuse me of playing the dead baby card when I point out the flaws in some of their birth plans, such as HBAC. I tell them I earned the right to play that card when as the NICU RN I had to hold the dead babies , waiting for their mothers to return from the OR.

    • EllenL

      Have you taken into consideration that your baby could be brain damaged by a labor and delivery at home gone wrong? Because that’s a possibility, too.

      Would you be satisfied with your choice if your baby ended up (needlessly) in the NICU, having seizures, or with a lifelong disability because of your decision?

      That would haunt me.

      • Clarissa Darling

        My thoughts exactly. I don’t care how small the risk is of having a baby die or have a serious health complication at home, it’s still is and always will be a greater risk than in a hosptial. If something happened to my child, it would haunt me forever knowing that my decision to birth at home had contributed to it. After hearing the stories of women who have lost babies and even stories like my own mom’s difficult labor and subsequent c-section, I am just not comfortable with additional risk during birth in exchange for the so called benefits of being at home. I know the hospital experience is not going to be a stay at the Ritz Carlton but, who cares? If 2 or 3 days out of my life dealing with flourecent lights, IV needles, bossy nurses and bad food will increase safety for my baby, I’m fine with that.

        • Amazed

          Again, we’re talking about two or three freaking days of a woman’s life. Two or three days to minimize the risk to your baby. No one ask mothers to move permanently to the hospital or marry their OBs. Two or three days, and mothers and fathers like Dan speak as if it’s too much.

          I call bullshit.

        • Lizzie Dee

          Well said. And maybe we should remind ourselves that that is the majority view. And that most of us turn out to be OK mothers without the need to turn it into a self-centred performance.

    • Elizabeth A

      Dan, you use the weight analogy almost exactly backwards from the way I think most people would.

      An OB will handle thousands of deliveries in the course of a career. Any one outcome is a tiny part of their total. If they preside over a preventable death, the consequences will be awful – hospital MMR review, possible retraining, possible loss of professional privileges and professional standing – but chances are good that an OB who delivers a dead baby delivered a live one just a few hours ago, and will deliver another living child quite soon. A death is a featherweight, and they already hold many many kilos.

      I have two living children and had one miscarriage (at 11 weeks). That’s a total of three pregnancies for me. In the event of loss, it will be months before I deliver a living child, if I ever manage it (my loss was random chance, with no resulting physical injury – not everyone has such a clear slate for the next try). I hold a single feather, I notice every change in the wind direction.

      Your larger argument seems to be that you decided in advance that nothing bad was going to happen to you. Fortunately for you, things turned out well. But many people make the same decision every day, and it is no guarantee of good results.

      • AmyP

        “I have two living children and had one miscarriage (at 11 weeks). That’s a total of three pregnancies for me. In the event of loss, it will be months before I deliver a living child, if I ever manage it (my loss was random chance, with no resulting physical injury – not everyone has such a clear slate for the next try).”

        I had two living children, then a miscarriage at 13 weeks (found out at 14 weeks, induced at 15), then a live baby this past fall. With my last baby, I got pregnant pretty much the minute I got the medical green light. Unfortunately, after the miscarriage, there was well over a year (until the new baby was safely born and I was well out of the hormonal post-partum stage) where I was walking in the dark and any unattended train of thought would go very, very bad places. Even when I was improving, I’d think, “I’m not thinking about the miscarriage! I’m OK!” and then that would be enough to drag me down again (think the Balrog from Fellowship of the Ring). And that was all for something that was not my fault at all, probably just the random result of being an older mother. There was no component of guilt. If there had been guilt, if I had known that it was all my selfish fault, I might be there still in the dark.

        I’d add–Dan thinks he would be OK with a death. I don’t know about that. I am pretty sure, though, that his wife would not be OK.

        • KarenJJ

          “I’d add–Dan thinks he would be OK with a death. I don’t know about that. I am pretty sure, though, that his wife would not be OK.”

          Yeah I don’t know about that either. My grandmother lost three babies due to be RH negative and speaks of her loss and sadness. A friend (from Sri Lanka) lost a sibling at birth and her parents never forgot and speak about her sibling and include the sibling in their prayers every week.

    • Elizabeth A

      I think, Dr. Tuteur, do not make peace with the possibility of death and
      instead attempt to make everyone completely safe at all times.

      Forgive me for hitting the same reply key twice here.

      You’ve made this interesting equation here: not making peace with the possibility of death = attempting to make everyone completely safe at all times.

      As a parent, my daily prayer is “simple, greenstick fractures.” We have pets and roller skates and stairs. We have never covered an electrical outlet. My kids can climb anything with a fingerhold. IF the fingerhold is above their heads, toeholds are unnecessary. OUr embrace of risk has led us to agree that the kids can start parkour classes as soon as the instructors say they’re tall enough.

      But I am not at peace with the possibility of death. I’ve had some near brushes (one with pregnancy complications, one with cancer) and I am just not at peace. Not at peace with death seems to me to be a survival trait. Even if I were at peace with death in some kind of general sense, I might well fail to be at peace with my own death. Lots of people seem very uncomfortable with the idea of their children dying, and I can’t lay any claim to feeling at peace with that either. Avoiding death has bought unnumbered medical advances. There is a point where peace needs to be made, but that point is generally not in labor and delivery.

      • Susan

        Peace with the possibility of death. Somehow I missed that. Sure, our own, but our children’s? It made me think of that little girl who died being the first child to set some flight record…. seems like children should get to be adults before someone makes peace with the possibility of their death who is morally bound to care for them.

        • Clarissa Darling

          If being at peace with death means that death from
          preventable disease, war, famine, lack of clean water, and yes childbirth once again becomes so common in this country that people become desensitized to it, I’m fine with not being at peace.

          Dan’s reasoning sounds way too much like the disgusting NCB meme “noble savages in “other cultures” accept some deaths in child birth as inevible blah blah blah”. If they are more “at peace” with death I don’t think it’s because there is something inherently noble about it Dan, it’s because unlike those of us who readily have access to money and modern medical care, they can’t hope to do anything about it.

          And I think that while a society may be considered to be more “at peace” with death as a whole, this does not translate to peace being felt by mothers who are actually staring into the faces of their own dead children.

      • Lizzie Dee

        It is easy to make peace with death when it is a very abstract concept you do not expect to have to deal with.

        If it becomes a reality, then making peace with it is a terrible process that takes a very long time. Anyone who can say “Well, at least I got my natural homebirth” has got something very wrong with them.

    • Lizzie Dee

      It seems intuitively correct that a woman under lower stress will have an easier labor.

      Has anyone ever done much to examine this hypothesis? Because it seems anything but intuitively correct to me. Back when I read MDC with horrified fascination, and the odd time I have winced through You Tube videos, not all these blissful homebirths fitted my definition of easy. Some women do seem to have easy births – anybody know what proportion? And what, if anything, accounts for it? I am fairly convinced it is anatomical not psychological. My definition would be short-ish and low on pain, and I would be a bit disinclined to take a mother’s own estimate of how “easy” it was after the event, as I suspect that mid-labour would be the time to ask!

      Dan certainly does give us a thoughtful and plausible account of his reasoning, which boils down to “Won’t happen to us”, but not much information about the actual birth.

    • Marguerita

      “I feel compelled to write, because while there may be many different ways to successfully mother children, you (and most of the commenters below) appear to believe there is also only one right way to safely/successfully bear children: in the hospital, supervised by a medically trained obstetrician.”

      The day of birth is the most dangerous day in 18 years of childhood. That’s the difference. Most of us here are not at peace with death. Most of us would die for our children.

      I think you are not as comfortable with your decision as you would like to be. Why write here otherwise?

      • The Bofa on the Sofa

        The day of birth is the most dangerous day in 18 years of childhood.
        That’s the difference. Most of us here are not at peace with death. Most
        of us would die for our children.

        As far as I can tell, being born is the most dangerous day in probably 100 years of life. I don’t think there is anything anyone does that has that kind of risk. “Having a heart attack” is certainly more risky, but that is not something everyone does. And giving birth is right up there, although there could be things more dangerous by a little (not anything obvious, though)

      • Jennifer2

        There are multiple right ways to raise a child (and it’s not just mothers who do that). But when it comes to certain, specific aspects of child care, I do think there are some baseline criteria for “doing it right.” For example, the right way to drive with a small child in the car includes using an age/size appropriate car seat, installing it properly, etc. That said, there’s no one “right” brand of car seat or of car to buy. The right way to give birth includes being at a hospital, with properly trained medical providers. Within that framework, there is room for potentially dozens of differences. Unmedicated vs. epidural right away. Vaginal vs. c-section vs. forceps or ventouse. Cut the cord right away or don’t. Labor standing, sitting, walking, or in a tub. Which of these is “right” will depend on the health of the mom and baby, the facilities available at the hospital, and the preferences of the parents. But we don’t go back in time and say “I think we shouldn’t use car seats because when our parents were little they didn’t ride in car seats, and it seems unnatural to strap a baby in like that.” So why should we say that sort of think about birth?

    • yentavegan

      BINGO

    • Leila

      Very very well put and exactly reflects my own feelings. I wanted a home birth, was dissuaded multiple times by midwives for poor reasons and in the end had my baby in hospital. I am at peace with this, but definitely intend to deliver our next baby (God-willing) at home, without clock-watchers and targets to meet! This is certainly not to brag to other privileged white women about (a statement I find offensive) and nor is it because I don’t care about or value the life of my unborn child (also an offensive assumption). It is because I trust my body to be able to do what it is designed for.

      • Wren

        Designed? Babies and women dying in childbirth was ridiculously commonplace until the advent of modern medicine. Has the design changed since then? You were dissuaded by midwives? Doesn’t that tell you something?

      • An Actual Attorney

        Who designed your body?

        • KarenJJ

          Yes please. I want names and addresses. I have a few technical issues I’d like explained, an ongoing warranty problem and a serious, potentially life-limiting flaw that requires ongoing expensive maintenance. Plus some idiot gave me uncontrollable curly hair, when I prefer the straight and shiny variety.

  • GiddyUpGo123

    As for number 4, I didn’t even read the scientific literature. That’s my OB’s job, and I trust him to do that for me.

  • guest

    Of course I want my babies to be safe, and from that standpoint there’s no question I have chosen hospital birth. But even if somehow it would be just as safe to give birth at home, I would choose a hospital birth. I would choose that because I think I deserve for my pain to be adequately managed by professionals. I refuse to accept that I should suffer the pain of childbirth without access to the excellent, safe methods of pain control available. I reject the notion that this pain is beneficial, and I think the idea that mothers should be forced to endure it derives entirely from old misogynistic ideas about labor pain being a just punishment for women – an idea thought up by men who hated and feared women’s bodies. I had an epidural and a lovely birth.

  • AlexisRT

    With #1 I was not offered the option of anything BUT a hospital birth and if I had asked I would have been risked out due to hypertension. Good job too, since I wound up severely preeclamptic.

    With #2 I knew all about my options, and chose an OB led hospital birth that left open the possibilities of VBAC and RCS (chose RCS). (In this context, “options” mean “OB and hospital,” or “untrained home birth midwife who is stupid enough to take care of a woman on antihypertensives.”)

    But, of course, I am “high risk,” a category completely ignored by NCB people except to head-pat after delivering their spiel about birth being a normal, healthy event.

  • GrlWonder

    I chose a hospital birth because I know that human physiology can be imperfect and unpredictable. I needed to know that if there were unforseen complications, they could be dealt with in the shortest possible time, using the best current scientific understandings and advice.

    Why gamble with your baby’s life and your own?

  • Pie13

    I chose hospital birth because I gain absolutely no satisfaction from the pretended beauty and nobility the woo blogosphere would attribute to the death of myself or my child after a stunt birth. I much more prefer the satisfaction I get from, you know, living and having live children.

  • Bombshellrisa

    OT: Remember Raeanne and her birth plan? http://www.mothering.com/community/t/1385303/my-1st-unassisted-homebirth
    I think I will leave the cervical exams to the experts, the idea of my husband or myself trying to assess that is just too much.

    • I don’t have a creative name

      She is two things. Stupid is the main one. Lucky is the second one.

  • I don’t have a creative name
    • Jocelyn

      Oh, my gosh. I hope she went in. I hope the baby is okay.

      • Bombshellrisa

        Did you see her other threads? Here is one of her posts:

        “I am 35 weeks with my son, and he has been consistently measuring 2 weeks large. My daughter was born 14 months ago via c-section at 39 weeks, and was 9lbs 5oz. (Not an emergency section, just the doctor playing boss and me being uneducated) I am planning a UC, and I have so many questions! I have read that you are more likely to rupture your uterus in the hospital, but I am still a little worried about it. Is 14 months enough healing time for this to be safe? I am concerned about tearing, as he might be large like my daughter. I have read that if you are very relaxed and don’t push very hard, then you won’t tear as bad. Is it possible for me to just sit back and let him come out on his own with no pushing? How long is too long in the birth canal? Once he is born, how will I weigh him? When should I take him to the doctor? At a few days old? How do I get a birthcertificate? How do I manage postpartum pain? I have looked into sitz baths but I haven’t found a whole lot, except adding TONS of herbs. Is there any ONE thing I can add to a sitz bath? I have heard that ice packs are vital to reduce swelling and promote healing, but I have also heard that swelling is natural and brings the skin together to heal easier. I have been going to an OBGYN for prenatal care, but I haven’t told her about my UC plans. I don’t want any negative opinions going into this, so I plan to just tell her once I give birth. Do I just call up and say “Hey, I had him at home, I need a postnatal check-up”? Any other helpful words of advice? I plan to give birth in a tub with no one except for my husband there.”

        • I don’t have a creative name

          For “unassisted”, she sure has a lot of questions. I thought the point of UC was to show that you don’t need anybody and that you can do it yourself.

          I think one of two things happened. She either got smart and went in and is now so ashamed of “failing” to do a UC that she won’t come back to that board. Or she killed her baby with her stupidity and stubbornness. I hope and pray it’s the first one.

          • Dr Kitty

            If this is what they mean by “mama do your research” well, no wonder UC in the USA has the safety record it does.

        • Squillo

          This is cognitive dissonance ad absurdum.

          UC has as its basic tenet that birth is safe and that the body knows how to give birth–it’s the interventions that make it unsafe.

          If that’s the case, why would one go to an OB for prenatal care, then eschew any care during labor?

          Why worry about a rupture?

          She clearly knows on some level that UC isn’t safe, but she just doesn’t care.

          • I don’t have a creative name

            What’s extra bothersome about that to me is that I found her on FB, hoping to see a pic of a pink, healthy baby. No such luck, though her page is partially private so who knows. But what IS on her page is tons of links to pro-life stuff. I am pro-life myself so it’s cool with me, but I just want to scream at the contrast here. She has concern for other babies in utero, but is willing to take HUGE risks on the one in her own uterus, all in the name of being able to say she UC’d?

            I still can’t believe that after seeing BRIGHT YELLOW AMNIOTIC FLUID, she didn’t have her ass in the car, zipping to the hospital at top speed. I am really worried that something bad happened.

          • Squillo

            She did go in to the hospital the same day she made the post. They confirmed that she’d been leaking amniotic fluid. Apparently they wanted to keep her, but she insisted on leaving. (She asked on the thread: “they have no way to test for infection, right?”)

            Hopefully, she’s AWOL because she’s too busy caring for a beautiful, healthy baby.

    • Bombshellrisa

      I see everyone helpfully Google’d things for her. Good grief.

    • Squillo

      Hmm. Broken, meconium-stained waters after days of “all-day, every-day” contractions and several days of “thick yellow mucous” discharge. I’m not a doctor or midwife, but doesn’t that suggest infection? And doesn’t meconium generally indicate a baby in some distress? I ask because, like her, I DON’T KNOW.

      And like her, I’m asking a bunch of people on the frikken Internet. Fortunately for me, it isn’t my baby’s life depending on the answer.

      Here’s wishing her baby the best of luck.

      • Renee

        Did the baby make it? I cannot even read it.

        This is very similar to how Shahzad died, btw (on Hurt by Homebirth). Theres a pic of her son crowning (deceased- which no one knew), covered in tons snot green mec. The mec had been seen earlier as well.

        Her MWs called this normal.

        Besides being totally ignorant about MWery, they were criminals: refusing transfer, keeping mom from leaving, taking her phone, and sending away her friends who showed up to check on her should be a jailable offense IMO. Especially since it lead to death.

        Yes, meconium can indicate stress, or postdates. If you see it, you should transfer ASAP, so baby can have the chance for closer monitoring, and an induction, emergency CS, resus, NICU, if needed. At the very least, it is gross, and requires 3 days of NICU observation to make sure none was aspirated and caused an infection. At the worst, it can be the cause of, or sign of, impending death.

        Totes normal, to the HB squad…

        • Squillo

          I don’t know about the baby. I checked the MDC thread this morning, and there’s no news. I don’t have a creative name says below that there’s no news in her public Facebook posts.

          The odds are in her favor, though, so hopefully she’s just too busy with a lovely new baby to post anything.

          • stacey

            I hope all is well. Luck IS on her side, which is why moms think this crap is safe and normal. Lets make sure they are ok.

    • The Computer Ate My Nym

      Crap. That thread was from last week and there’s no follow up. I wonder if she’s even still alive.

  • Bombshellrisa

    1) I wanted my OB the surgeon to repair any tears
    2) the idea of giving birth and being left alone within a few hours at home was overwhelming
    3) having my own stuff around me was NOT a comfort
    4) despite the fact there are CPMs who will drive out here attend home births, we are FAR from the nearest hospital. Traffic in and out of town is a nightmare unless its late at night or very early in the morning. An Ambulance could be at my door in a minute since we are close to two fire stations, but even in an ambulance the ride to a hospital would be 20 minutes if all went well.
    5) my veins are crap. Since there are lots of nurses in a hospital, there is always one who could start an IV. At home, if I was having complications, there is not a chance anyone could do a field start.

    • rh1985

      I would irrationally worry that if I had my own stuff I’d ruin it with blood and fluids… I just got a lovely new mattress

      • Bombshellrisa

        Or all that blood would make my dogs bark like crazy-again, not relaxing. Not sure I could trust the midwives to fire up the carpet cleaner and go over any stains on the rug either.
        The clean up part was actually a point of contention during union negotiations with the housekeeping department at my hospital. The staff who had to clean the birthing suites were saying that NO! This is not like cleaning up a general med/surg room, there is blood/stool/fluids everywhere and it takes a lot of time to clean it up properly. I understand that the midwives clean up after a birth at home, but not like this, not a deep cleaning. Even the CPM run birth center hires special birthing suite cleaners to come in after a birth and clean out the rooms because birth is well, often messy.

        • Antigonos CNM

          Even with waterproof sheets, and a large package of disposable stuff that a woman gets free via the NHS in the UK, my experience with homebirth there was uniformly that, during the first postpartum days, the mother got little or no rest what with cleaning up after the birth, doing the laundry, attending to the other children [who wanted HER, not Granny or Daddy] to take care of them, cooking, feeding the newborn, etc. Not too surprisingly, some husbands called us when their wives fainted — and nearly all the women who had had a previous homebirth declined having another.

      • MomAnd Midwife

        Just FYI….waterproof mattress covers, OLD sheets and towels, a couple of vinyl, flannel backed table cloths will do perfect for preventing 98% of the mess, if mom doesn’t birth in the water. For little drips of carpet or other furniture…peroxide on it ASAP will take care of the rest 😉

        • OBPI Mama

          Well, not for me. After my son getting stuck and midwife having me roll to my feet on the floor, guess where all the amniotic fluid and blood went… soaked in the carpet and it took months of scrubbing to get the smell and stains out.

          And my midwife did not clean up my house/floors or do my laundry (there was at least 5 load). My mother did and it took a week as I peed on the floor in about every room. Not to mention the months of scrubbing that dang bedroom floor.

          • MomAnd Midwife

            How awful! That is not the norm in my birth community…my assistant is a busy bee, cleaning the birth room with mom’s supplies (so we use what SHE wants used on her home), my equipment with Cavicide (same stuff we used in the hospital to clean equipment), and doing laundry.

          • Bombshellrisa

            Yeah, I was going to say you can set up the bed, but unless you put down a drop cloth through out the entire house, clean up isn’t a easy as just doing laundry. We are also assuming that there will be time to do clean up and laundry. If there is a complication with mom or baby, focus will be on them and not housekeeping. I have never seen anyone clean up the house after a hospital transfer, and sometimes there is another birth to attend right after so cleaning up is surface at best.

        • rh1985

          I may look into that anyway just in case my water breaks when I’m in bed.

          Hey, it was a pricey mattress…and it’s so comfortable.

          • Bombshellrisa

            That sounds like a practical move-good mattresses are hard to find!

          • Happy Sheep

            I bought a great waterproof mattress cover for that exact reason.

  • rh1985

    I’m only 5 weeks along so it’s so early, but I definitely want a hospital birth. I would be so, so anxious at home that something would go wrong and it would be too late to do anything by the time I got to the hospital, and I want to be able to have pain relief.

    • best of luck…wishing you health and happiness.

  • Squillo

    Honestly? I chose it the first time because that’s where my midwife delivered. It wouldn’t have occurred to me to look for a homebirth midwife, and if I had, I seriously doubt I would have lasted past the first appointment/interview if the specimens on teh Intertoobz are any indication. Also, my husband would probably have freaked out, and I care about his opinions about our children.

    The second time, I chose a hospital because my first birth demonstrated two things: 1) Sh*t can go very wrong when you don’t expect it, and it’s good to have the cavalry standing by when it does; 2) I could have a perfectly good experience in the hospital.

  • Charlotte

    My next birth is going to be a repeat c-section. I don’t trust a lay surgeon to do it at home, so it’s a hospital for me.

  • Jocelyn

    OT: My friend is having a c-section at 33 weeks today to deliver twins. She’s grateful for the modern medicine that will both deliver her babies and care for them once they arrive.

  • I’m adverse to avoidable pain, life long disability and death for either myself or my child.

  • Hannah

    Hi, longtime reader, first time commenter.

    Babies are at least 2-3 years out for me, but definitely doing hospital birth.
    1) I have lupus, makes me high-risk for almost every pregnancy complication there is.
    2) Live baby. For sure. Already higher stillbirth risk, not willing to increase that in the slightest.
    3) The more I read about homebirth community, the more they scare the bejeezus out of me. There’s some freaky weird $#!& going on there.
    4) I want the option of pain relief. Want to decide then.
    5) My sister’s birth. Totally normal pregnancy, no complications. Yet she labored for 31 hours, had a hole in the sac that required them to break her water for her, baby wouldn’t drop properly. After 31 hours, they came to her and said “he’s not dropping, we can either let you keep laboring, and you’ll have a 50% chance of being in the same place Friday (2 days later), or we can do a C-Section now”. They opted for C-Section now, nephew has no problems coming from his method of birth. Without C-Section, sis could have labored for days, possibly killing them both.

    Thank you Dr. Amy for giving me the knowledge necessary to fight back should anyone start digs at me in future.

    • Zornorph

      You don’t have lupus. It’s never lupus.

      • theadequatemother

        Dr House?

  • Chelsea Frost

    Yes! Agreed! I wanted a healthy, safe baby and pain relief (in that order).

  • Bethany Barry

    On Monday I had a very happy hospital birth. I have a beautiful, 8 lb
    12 oz son squirming a bit next to me right now. He is healthy, hungry,
    and all in one piece. My GBS positivity was effectively neutralized by
    IV antibiotics. A shoulder dystocia provided a very scary moment, but
    was deftly handled by my fantastic OB with no injury to my child. My
    placenta had to be manually extracted, and that was not the most
    pleasant experience of my life either. A significant tear was very well
    repaired. Frankly, most of the elements of my son’s birth, well,
    sucked. But I’m alive and feeling pretty good, and my son is alive and
    feeling great. I’ll take that over the opportunity to labor in a kiddie
    pool any day. I don’t trust birth. I trust science. I trust my
    experienced, educated ob. I trust the team of highly trained nurses in
    the room and in the hallway. I trust my husband to sit there looking
    worried and perplexed by my most basic requests (“Tell the nurse I’m
    having a lot of pain!” “What?” “PAIN!” “What do I tell them?”
    “AAAAAAAAAAAAAAAAAAAAH!”). And I trust reliable, medical pain relief.
    Oh do I.

    • Jessica

      Congratulations!!

    • Congratulations!

    • amazonmom

      Congrats!

    • Amazed

      Congrats on your new acquisition!

    • Jocelyn

      Congratulations! 🙂

    • prolifefeminist

      You had three complications that easily could have caused injury or death had you given birth at home. But thanks to modern medicine, you and your baby are healthy and whole. What could possibly be more important than that?!?

      Congratulations! 🙂

    • Lisa Miller

      <3 congrats!!!

    • Allie P

      Congrats!

    • Frequent Guest

      Congrats!!!! I hope you have a speedy recovery!

  • Anaesthetist

    Because the most important thing to me was access to well trained paediatricians and a level 3 NICU for my baby if he needed it,
    and a fully trained crash team and transfusion service if I needed them

    • Lisa Miller

      I was in the same boat. The meds I was talking posed a small risk of infant withdrawal. i had to leave the midwife who delivered my first two for one at a larger hospital to make sure he was OK. I missed my trusted CNM but she and I both agreed that it was safety over sentiment and I loved my new CNM (and a great pediatric department that took swift care of my son’s needs) just as much.

  • Catch

    Here’s a link to a CBC news article “Home birth with midwife safe as hospital”

    http://www.cbc.ca/news/health/story/2009/08/31/midwife-home-births.html

    Here is a post on a blog that breaks down how Amy’s stats she like to cling to are misinterpreted.

    http://www.homebirth.net.au/2008/06/homebirth-vs-hospital-statistics-to-die.html

    • Amazed

      Lisa Barrett? You cite the notorious babykiller Lisa Barrett as credible source?

      Shame on you, lady. Shame on you.

      Now, run to Lisa and let her kill your own baby. And don’t whine when it happens. Because we’ll think you informed. After all, you read the stats, right?

    • Amy Tuteur, MD

      And here’s why you have no idea what you are talking about:

      http://homebirthdebate.blogspot.com/2008/06/homebirth-midwife-has-problem.html

    • Chelsea Frost

      You can’t be serious.

    • Bombshellrisa

      You had mentioned that you were in Canada before?? The midwives in Canada (with a few notorious exceptions) are university educated and trained, with hospital privileges. I understand that homebirth with those midwives is an option in Canada (and is part of the system, so during a transfer your midwife will remain with you and still be able to attend you). The vast majority of midwives who do homebirths in the US are not university trained, as it is not a requirement for holding the CPM credential. No nursing or medical training is required either. The homebirth midwives Dr Amy talks about here are not the well trained Certified Nurse Midwives, rather those who hold the title CPM or Certified Professional Midwife. The midwives in countries like the Netherlands, the UK, Australia and Canada are educated and trained much like the US CNMs.

      • Catch

        That’s a great post. Yes, being Canadian, I have no knowledge of Midwifery in the U.S. I’m sure there are some midwives that are way out there and are doing things that are concerning. Amy likes to point these ones out and mock the profession as a whole. The few midwives I’ve met in Canada have been astounding professionals. The labels Amy puts on them is damaging to all they work towards.

        • Bombshellrisa

          Keep reading-you would be surprised how common the woo is with US homebirth midwives. I apprenticed with the most well known CPMs in the Seattle area and I can’t believe the stuff that they were doing.

          I understand that in Canada, to be able to call oneself a midwife, there has to be a course of education and training as well as a board exam. The notable exceptions like Gloria Lemay and Moreka Jolar are actually pretty accurate descriptions of what homebirth midwifery is in the US. US homebirth midwives do NOT have hospital privileges.

        • stacey

          Um, NO.
          PLEASE do not talk about the USA if you have no clue what goes on here. This is not Canada.

          The stats for the USA are HORRIBLE. Every.Single,Stat.Ever.Collected! From individual states, to national data, its horrible, Deaths and brain damage are common.

          Maybe you haven’t hears, but we have lay “MWs” that have no actual training, no college, even NO HS! There are states where anyone can call themselves MW and start seeing patients! Its crazy.

          Your beef isn’t with Dr A- you just do not realize it yet. Dr Amy doesn’t hurt MWs, the so-called MWs who PLAY MW and KILL and MAIM hurt MWery. As do the CNMs who back them up.

    • suchende

      You sound like a very foolish person. Not because you don’t know. There’s nothing foolish about not knowing. Because you think you know, from reading sources that are not authorities. If you don’t have knowledge equivalent to formal training in statistics, you can’t interpret studies. If your source (lol mainstream media) doesn’t have formal training in statistics, they also cannot interpret studies. If you or your source has only read the abstract of a study, you know nothing more than that someone has studied the subject of the study.

      If you read a great volume of information written by people who are ignorant of statistics and study design, you’re not any more knowledgable than you were when you started. If you believe that it’s made you more knowledgable, then you are a great fool.

    • Bombshellrisa

      There is a very nice video to the right that talks about the difference between the midwives used in the CBC link and the ones that Dr Amy refers to when she talks about midwives and homebirth on this blog

    • areawomanpdx

      LOL

      • Lisa Miller

        I know , right? *snicker*

    • Fred

      This is very funny. You are citing Lisa Barrett in support of the proposition that home birth with a midwife is as safe as hospital birth. Lisa Barrett’s neonatal stats would be among the worst in the world! 6 dead babies (that we know of) since 2007. Assuming she does 50 births a year (and that would be generous), 1 out of every 50 babies she cares for dies. If any hospital had those stats very serious questions would be being asked. In the article you have linked to she states her US midwifery peers have a death rate of 0.77 per thousand and doctors have a rate of 0.90 per thousand (just pretending for a moment her analysis has any validity and noting that she just excludes any figures that she doesn’t understand). Hers is 20 per thousand. She really does have “statistics to die for” to use the title of her blog post.

      I cannot believe that anyone considers her a credible source on anything but particularly on this subject.

    • theadequatemother

      All the studies done on outcomes with Canadian midwives were underpowered to detect perinatal mortality. So who knows if its safer? If you pool the data from the studies in bc and Ontario and add it to CNM data from the US as they’ve done in a meta-analysis, perinatal death is 3x at home compared to hospital and that was statistically significant. The bc study was also underpowered to look at babies that needed ventilator support and seized after birth and there was a trend for both those things to be higher in the home group. No one looks at HIE in these studies either. So as safe, I don’t think so. Pretty safe? But not equivalent to the hospital.

  • jen

    Because my OB is the most phenomenal lady in the world and I’m guessing that RCS don’t go over so well in one’s living room.

  • Leslie

    My OB (who delivered all three of my children and was fantastic) told me, “Delivering babies is like flying an airplane. 99% of the time, it’s boring and a trained monkey could do it. But that 1% of the time when it goes bad, it goes bad fast and there’s no time to replace the monkey.”

    Did I mention that I loved my OB?

  • Monica

    Yup, live baby topped the list. I considered a home birth for all of 2 seconds with my youngest. When I realized my previous c-section, history of gestational diabetes, and chronic hypertension risked me out the only question became do I stay with my current doctor (who I loved dearly by the way, but the only hospital she delivered in was the hospital I had a still birth at less than 2 years prior) or find a new doctor and therefore a new hospital. I decided my relationship with my current doctor and her already having intimate knowledge of my uterus outweighed any concerns I had of the hospital she worked out of. And for the record, the hospital also greatly accommodated me. When they started to put me in a delivery room that was next to the one where I had delivered my stillborn I requested a new room and they said no problem.

  • me

    I wanted a hospital birth because (in no particular order):

    Insurance paid the entire cost

    Qualified providers to help keep me and my baby as safe as possible

    I didn’t have to do any of the clean up

    Someone else cooked for me for a couple of days (and, no, the food wasn’t too bad :))

    I was elevated risk (went to 42 weeks all three times), and being in the hospital made those risk smaller and more manageable than they would have been at home.

    I realized that no one would be “forcing” me to do anything, particularly get an epidural, which is always optional…. it was nice to know the option was there if I had needed it, and also nice to know the nurses supported me in whatever choice I made (they didn’t have an agenda to push).

    Having help immediately available in the event that me or any of my children need it (fortunately we didn’t, but knowing I wouldn’t have to transport in the vent of an emergency was reassuring).

    Having excellent help and postpartum care (I love nurses!)

    Making sure my baby was healthy enough to go home before leaving.

    I’m sure I could think of more, but that’s my short list 🙂

  • guestK

    I realized that wanting pain relief does not make me less of a woman or a mother.

  • Anothergreatpostbydramy

    Reason 6-10 for having a Hospital Birth…

    6) Ironically, Governments in developing countries are encouraging women to labour in a hospital because it is inherently safer. In the West, our judgement is clouded by non-qualified people (a kind of reverse evolution, if you like) and Home Birth is encouraged.

    7) I didn’t want a water-birth because last time I checked, I was not an amphibian.

    8) I realise that in the 21st century we can achieve painless labours and wanted an epidural. In the old days, people had to suffer through operations by gritting their teeth. Now we have general anaesthetic. We also have epidurals for labour.

    9) I would not dare to tell a general surgeon how to do my appendicectomy/orthopaedic surgeon how to do my hip replacement/etc. but it is entirely expected that obstetricians accept that a patient who has watched a documentary made by a chat show host knows more about obstetrics compared to them.

    10) No labour is ‘low-risk’. Risk assessment is a continual, dynamic process and ‘low-risk’ can become ‘high-risk’ in seconds. It is wise to birth around individuals that not only know how to risk-assess, but also acknowledge that it is required in the first place.

    I could go on and on, but I feel that I am preaching to the converted…!

    • Cellist

      “7) I didn’t want a water-birth because last time I checked, I was not an amphibian” LOL!!!!!!!

  • Catch

    We chose a hospital birth with a Midwife present. I was very happy with the decisions we made. Many hospitals are open and cooperative with Midwives.
    In Canada the entire system is covered in basic medical care as well as Midwives. Some hospitals here have pools ready for water births. This option was not available as my wife had a very quick labour.

    • Lisa Miller

      I loved my CNMs. I loved that they worked in hospitals with physician back up for emergencies too

      • Bombshellrisa

        I have noticed too that if they start veering toward the woo, you can demand a second opinion from their back up physician OR the on call OB. We did this with my sister in law when she was 41w1d and the midwife insisted that “it’s better to do things all naturally” and proceeded to tell a gross story about having her own daughter at 43 weeks 4 days at home. The OB who was there was happy to admit my sister in law and later did her C-section.

        • Lisa Miller

          Oh lawd NO! Neither of mine we like that. They loved some drugs and shots and antibiotics and screening tests.

          • Bombshellrisa

            This was the one hippie of the group, there are six total midwives in the practice. Of course she was the one on duty that day. I can’t imagine what it would be like to do a home birth with a midwife like that, she sounds like the type to take phones away and block cars in. It wasn’t an issue in the hospital, another good reason to have a baby there (btw, my nephew was 10 pounds. His head wasn’t engaging for a reason)

  • Renee

    In addition to whats in the post, I wanted:

    1) Pain relief if needed

    2) Internal CEFM

    3) Nurses to help so I could rest

    4) Good food, on demand, and lots of it, plus someone to clean it all up (this place had the BEST food, even local, organic stuff!)

    5) Level 3 NICU, since I had a preemie

    • Gene

      My hospital’s food is fairly disgusting, but they had FANTASTIC breakfasts. Just about the best french toast I’ve ever had. It’s bizarre. I’ve worked at several hospitals and they run the gamut of awful-decent-good food, but quite a few know how to start the day right!

      • staceyjw

        You would not believe the food at the hospital I was at! SO GOOD! I would eat there if I didn’t have too.

        You could get whatever you wanted, from like 6am-10pm, and limited choices thereafter. It was just like the best of room service room service.

        There was always local, organic selections, as well as vegan and every other possible diet. I had a lovely local salmon with wild rice and some type of greens, garden burgers, grilled cheese with local cheese and tomatoes, and thick sourdough. Burgers made to order, and lasagna. They had all kinds of stuff- thai noodles, pizza, a salad bar, take away snacks, organic trail mix, etc.

        And the desserts! Oh my. I had 5+ pieces of cheesecake every day day. Not kidding, it was amazing. I gorged myself. Now I am hungry 🙂

        (Im not kidding when I say they got me to VBAC by telling me I could eat if I agreed to a TOL!)

  • you can’t win

    I chose hospital birth because I was a reproductive disaster (six consecutive pregnancy losses, gestational diabetes, marginal placenta previa) and any sane out of hospital practice wouldn’t go near me with a ten foot pole. oh, and also because I wanted a live baby. Which fortunately, I got : )

    • Guesteleh

      I’m sorry you went through so much but very glad to hear you now have your baby.

  • EllenL

    Why I chose hospital birth, with an OB:
    It gave me and my baby the best chance of a healthy outcome.

    I wouldn’t have to listen to a bossy midwife telling me “You don’t want an epidural” when I did.

    If I had trouble figuring out how to feed/bathe/burp my baby, nurses would help.

    I could get a RhoGAM shot after giving birth to protect my next baby.

    I could have visitors, and after awhile the hospital staff would make them go away.

    • Catch

      I hope people don’t assume all midwives are bossy. Ours was very accommodating. She didn’t try to push any kind of ideology on us. My wife would have taken the epidural if it was available. We kind of rolled up to the hospital at the last minute.

      • suchende

        What percentage have to be bossy/ideological before people are totally turned off by the idea? That’s the problem. It’s not that people assume they’re *all* like that, it’s just a critical mass of bad stories.

        • The Bofa on the Sofa

          Again, if the defense comes down to “not all of them are like that,” it’s already a sign of a problem.

          • Catch

            I’m sure not all doctors are rude, judgmental, and in a rush during the process of birth.. See how I did that?

          • The Bofa on the Sofa

            Who are you responding to?

            You don’t have a clue at all, do you?

        • Catch

          That seems to be the problem. Bad stories spread more then good stories. At our first appointment we met a couple midwives and it was more of a screening process for us. We settled on a midwife that was amazing.

      • me

        I agree. My CNMs were wonderful!!! Yes, they support natural birth, but none of them ever tried to talk me out of pain relief, it was my choice to forgo it.

      • Lisa Miller

        If you were talking about a CNM then I might agree with you. Maybe she was not bossy, but she’s still not well trained.

        • Catch

          “not well trained”? Hospitals have been bringing in midwives to teach residents and medical students on the floor. They have a critical set of skills that many doctors have not practiced. Techniques in relaxing the mother that leads to less tearing and better baby positioning.

          • Lisa Miller

            What skills could they possibly have that doctors have not practiced? Preventing rug burn on the baby’s head from your living room carpet? Picking the cat hair out of an open vaginal tear? Perhaps they hit the mother over the head so that her body is totally relaxed? So, these OBs have gone to school for 10 plus years, done years of internships and residencies, have been involved in studies and trials…and yet there are techniques used in labor and delivery of human babies, that work at reducing damage to mother and child in a statistically significant way and can be taught, that these people who have studied all the newest and most relevant information in their field are somehow unaware of? You see how ridiculous that sounds , right? If the ancient knowledge your midwife possessed actually worked, then you’d think that doctors, the ones who , throughout history, are responsible for reducing the injury to mother and child during birth down to almost nothing, would know about it. Heh?

          • Catch

            Birthing techniques and positioning is just one to name.
            Midwifes have in most cases delivered just as many (if not more) babies than the average ob/gyn

            Let me point out a few tendencies doctors have been known for:
            Doctors are believed to encourage more invasive procedures and unnecessary medication than a midwife would.
            Many doctors are constantly watching the clock and would rather hurry the whole ordeal up.

          • Amy Tuteur, MD

            Really? How do you know anything about what doctors do and don’t do? Are you a doctor? Have you completed medical education of any kind.

            Oh, wait. I know! You read it on the Internet!

          • Catch

            I’m not experienced in delivering babies, but when my wife became pregnant I started to talking to our friends that had recently given birth. One coworker said her Dr, was increasingly getting frustrated and began pushing on her stomach. Maybe this is normal, maybe midwives do this as well. She ended up tearing horribly. Sure, take from it what you want. Compare it to my wife’s birth and I’m glad we had a Midwife in the hospital. No tearing, little pain. Small sample size I know. Just sharing an experience.

          • Chelsea Frost

            The plural of anecdote is not data.

          • guest

            Have you considered the fact that perhaps the baby’s heart rate was down? And don’t ask your friend, because I’m sure the OB didn’t share that with her. The OB likely acted quickly and did what needed to be done in order to preserve baby’s brain function. Of course, some would prefer a handicapped child over a vaginal tear.

          • Amazed

            Oh god! If this was pitocin or epidural, or even bulling into c-section, I would at least try to understand some women reasoning that their doctors were trying to speed things up. But pressing on her stomach? It’s done when there’s a problem with pushing. It’s a maneuver, man. A maneuver used when there is no time to leave the baby trying to get out on his own because that might mean a damaged baby.

            I am so fed up with Natural Princesses bemoaning the fact that evil doctors pressed on their bellies when said doctors clearly felt that they weren’t pushing effectively and were trying to help the babies.

          • MonaLisa

            Did you not read the title of this post? It’s “5 Reasons why I chose hospital birth.” A midwife in the hospital falls under this category. No one here is saying that CNMs are under qualified or incapable of handling low risk deliveries in the hospital.

            Additionally, “techniques for relaxing the mother” (which you say are now being taught to MDs by midwives) are largely not the responsibility of an Ob/Gyn. A doctor does not personally attend to the comfort the mother during her labor. That is the role of a labor and delivery nurse, as well as her personal support person and doula.

          • Karen in SC

            Catch, perhaps in some cases a midwife could reposition a mother several times over several hours of excruciatingly painful labor. An OB might suspect or even discover a cord problem or an unfavorable presentation and recommend a c-section. Both paths might end up with the same result. Which is better? Who knows? Or they might not end up the same.

          • guest

            Are you kidding me??! The average homebirth midwife delivers maybe 4 babies PER MONTH. The average OB delivers upwards of 1000 per year. You do the math. And don’t forget to include the fact that all known high risk patients (should be) risked out of homebirth, meaning midwives are experienced with babies ANYONE could deliver…even you.

          • Amazed

            “Midwifes have in most cases delivered just as many (if not more) babies than the average ob/gyn”

            Haha, I only needed to read that to know that we’ve got a Google University Master here. They haven’t delivered nearly as many babies as an ob/gyn, genius. They think 1200 babies in 40 years is a lot. They boast about it since this is experience that most of them can never equal. You do the math.

            Unless, of course, you mean CNMs. Antigonos, do you think Catch means you?

          • KarenJJ

            I think it depends where you live. It is possibly true in Australia in public hospitals that midwives deliver as many as obgyns – not sure but I could see it. We don’t have CPMs here.

            And if you are talking skills that midwives might have over obgyns – I’d say perhaps getting an IV in or drawing blood. Obgyns could do it in a pinch, but the midwives were more experienced hands on with that.

          • Amazed

            Well, I did say ‘unless you mean CNMs’. Turned out he did. Too bad he then went to cite Lisa Barrett as a freaking expert who had disseminated Dr Amy’s statistics. I kid you not, it’s right here.

            When I’m talking about comparing skills midwives and doctors have, I do it from one perspective: all other things equal, a doctor can deliver a baby in a birth that has turned problematic without the midwife. The opposite is not always true. When things go out of hospital midwives’ competence, they call the doctor. When things look like they might turn ugly, they call the doctor. While a doctor might call midwives when things look like they might turn out ugly, he rarely does it because things go out of his competence. His is the highest competence right there, that’s why I prefer having him there just in case. And to me, that surpasses all skills in repositioning me and getting an IV on the first try.

          • KarenJJ

            Absolutely. I was picking up on his idea and taking it literally to what I’ve had experience in which is probably not what he was thinking (subverting?). And if I’m not making sense today, I had a rough night with one of the kids, little sleep myself, am also getting sick and have no idea how I’ll be getting through the day…

          • Dr Kitty

            Where I worked the MWs don’t do their own bloods or IVs, that was the Junior Doctor’s job.
            It is SO MUCH FUN to be bleeped at 3 am to come and put a line in and do a cross match, and then be shooed out of the room because “It’s all going so well, we don’t need you”.

            I liked to at least stay 10 minutes and have a chat (and you’d hope that bloods and lines were being done in early labour, when chatting between contractions is still an option), in case things “didn’t go well” and I was bleeped back for a disaster- better we’d established some sort of rapport first.

            I think this was seen by the MWs as trying to take over “their” turf sometimes, but I just figured I was up already and in the room, and it is fairly rude to just stick needles in people and run away.

            Most of the MWs didn’t do the cannulation and phlebotomy courses because it was “too medical”, while actually trying to prevent me making MY role LESS medical.

          • MomAnd Midwife

            Do you know that in my decade plus of L&D nursing, I was still not skilled in palpating baby’s position abdominally, or presentation of the presenting part, vaginally, until I became a midwife? NEVER did I see that information, so very critical to the success in a normal labor, documented by an OB or RN, and I saw hundreds of thousands of notes. “Vertex” was all the descriptive it would get. Now, with my skilled hands, I have an excellent grasp (pun intended) of fetal presentation, position, EFW, and estimated AFI. To the place that my OB consultant will trust my numeric assessment of an AFI when I’ve needed to send post dates mamas for decreasing AFIs that are still WNL, but a BFP is warranted. Always within 1 cm of u/s assessments, for the past 4 years now.

            An ROT baby is very likely to rotate posterior during labor, especially in a barely-mobile mother. And LOT babies are at risk for deep transverse arrest. Posterior babies can absolutely be born vaginally, but are much more likely to arrest in descent, leading to surgical births, in an immobile woman, or to significant perineal trauma in the classic lithotomy position due to the altered stretch that this presentation does to the tissues.

            This “art” of midwifery is so very complementary to the science, and is a dying skill today. I have successfully discovered more prenatal, third trimester breech babies with my hands, early enough to nudge them vertex with non-invasive techniques, saving from unnecessary c/s. Breech, in my practice, is NOT a variant of normal but a much riskier birth that I will not attempt at home.

          • Lisa Miller

            Ohhhhkay. So would this be the equivalent of going to a fancy party in LA and name dropping to make people believe that you know all of these famous folks? I get it. You seem to know all your body parts. I’m terribly impressed by your two paragraph jibber jabber. Perhaps someone here will understand what it means. While I don’t understand it (Got a BA , sorry) I’m pretty sure it’s totally irrelevant name dropping.
            One problem is that if I recall, you are not a CNM or CM. You are a lay midwife. You call midwifery an “art” like there is something magically different between real (CNM) midwives and OBs and the education training they get on childbirth. The reality is that Midwives and OBs are taught the same things about labor and delivery. The difference is that OBs take their training further and learn how to treat more complex and serious issues. Nurse midwives learn how to hand over care to OBs when situations are beyond their scope of practice and how to properly identify those situations. Another problem is that as an RN, you seem to be complaining that you never learned certain things. To me it sounds like a doctor saying “Dude, i never learned how to before brain surgery until I was a 5th year resident!” . You were a nurse! If that was information you were supposed to know then either you or your nursing school failed you. If it was not information you were supposed to know then it was out of your scope of practice ( I don’t know it if was or wasn’t but either way there is a crater in your story.)

          • MomAnd Midwife

            What is your background, Lisa? Because clearly you know NOTHING about the training received in nursing school. I loved every bit of my Maternity unit, which was all of a half semester in length, and my practicum in L&D, 2 decades ago. Before EMRs were the standard, and all of that knowledge needed to be taught during any nursing degree program. As such, I would imagine that there is even less time spent learning the basics of normal birth.

            I can see that the point that I was trying to make, that was not crystal clear above, is that all I needed to know about normal birth I did NOT learn in a hospital, where, the “experts” practice. Skilled, licensed midwives ARE the experts in normal birth. I have a <1% c/s rate, and 5% intrapartum (or PP) transport rate. I risk-screen very, very well, before women even interview officially with me. And yet, I am the busiest midwife in the large metro area in which I practice, and quite possibly, the busiest solo home birth provider in my state. The majority of my colleagues, with whom I peer review and such, have similar rates as mine. What we KNOW, about the art of midwifery, is clearly vital information that medicine should be craving, because our outcomes in our state are phenomenal (and yes, we have internal data) while having incredibly low c/s rates and other related co-morbidities.

            FWIW, the art of medicine is also alive, but dying quickly as well. I've seen surgeries spared by a single-bladed forceps rotation of a posterior babe who had arrest of descent with 2nd stage….an artform!

          • Lisa Miller

            My background is in history, but I took some math as well. I learned that 2+2 does not equal 5. You stated above (in my simplification of it) that there were things in L&D that you didn’t know/learn how to do. My point was that a) you either were supposed to know how to do it and didn’t (because your nursing education was off or bad?) or B) because it was above your scope of practice (which you should not have known how to do it because you’re not an OB or midwife). I get that you know how to do it NOW that you are a midwife. But you seemed to be saying that it was some failure on the part of the system that you were unable to learn these things, when logic points to that not being the case.

          • stacey

            ANY IDIOT CAN BE AN EXPERT IN NORMAL BIRTH. “Normal Birth” requires ZERO skills. The baby and mom will be fine, even alone. Seriously, a monkey can catch a baby, if all goes well.

            Regulars- remember that LAST CPM, Kim Mosney, that came in here telling us how wrong we were? Telling us how great she was? Better than an OB? Then a baby DIED at her hands, due to an abruption.! Ooops…..

            Guess that her NORMAL skills didn’t help her catch the abruption early, or fly her to the ER on a golden horse, which is what is needed if you abrupt at HOME with an “expert in NORMAL!”.
            (maybe this is Mosney again!)

            You DO realize that is a ludicrous claim, right? Please tell me that you can see how being an “expert in “normal” means nothing, since the danger is in the ABNORMAL.

            Its the equivalent of saying: “I am an EXPERT in NORMAL AUTO REPAIR!”

            I can see it now:

            “So long as the car doesn’t get crashed, or break down, I am a MASTER! I can even make it pretty by rubbing it with polish, and make you comfy with scented upholstery cleaner. Trust cars, and all will be well.”

            I would laugh, but its not funny that you are a busy MW/ I always thought you were respectable, but todays comments are pretty off the wall.

          • Squillo

            Agreed–it’s quite possibly the stupidest claim a childbirth attendant can make.

            Would you fly an airline if one of its advertising claims was “experts in normal flight?” I don’t want a pilot who’s only capable of flipping the autopilot switch on and off–I want one who can land that sucker with no hydraulics and a radio blackout.

          • Anj Fabian

            The problem with forceps is that used well, they are amazing.

            Used poorly and they’ll tear the mother up – and she’ll be needing surgery that will have far greater recovery time than a nice, clean c-section.

          • Dr Kitty

            Saying that YOU as an L&D nurse didn’t know how to palpate position or presentation and then extrapolating that therefore an OB doesn’t know how to either…wow.

            Also you don’t “nudge” a breech to cephalic, you perform an ECV in a theatre with CEFM, tocolytics and maternal analgesia, preferably after an ultrasound to determine placental and cord positions.

            The admission that you do anything otherwise…wow.

          • MomAnd Midwife

            If and OB was doing it, why wasn’t he/she charting it? When I, as both a nurse and a pregnant mama asked an OB what the baby’s position was, all I would get was, “vertex…duh!” I would always have to clarify, “Oh, no, Dr. Smart E. Pants, I meant the POSITION, not the presentation!” as I began to see a pattern of malpresentation leading to increased surgeries…

            If I gave the impression that I was doing ECV is my small office, my apologies. That would be crazy, as you indicated above. I can identify breech babies with accuracy, and send mom on her merry way with resources to: use her body position and visualization to turn; homeopathic remedies to “right the wrong;” and referrals to skilled chiropractors and acupuncturists in town. I’ve never had to resort to ECV save once…my only c/s in my practice…a very stubborn frank breech in a primip….and this was attempted by two separate MFMs several hours away. They had the highest ECV success rates in the SouthEast, and this babe would just not give in. She sadly realized that a c/s in labor was the safest option for her and baby, and adores that sweet girl so very much ~

          • Dr Kitty

            So you don’t “nudge” at all then, you use non evidence based, magic water to try and turn babies.

            Whilst you castigate OBs for not using evidence based practice, you’re seemingly happy to use placebos.

            Also, why “sadly realised…a CS was safer”- sadly because a CS is safer, or sadly because she waited until she was in labour to realise it?

          • KarenJJ

            Obgyns aren’t evidence based but you use homeopathic remedies?

            You must have access to some freaking good evidence there..

          • MomAnd Midwife

            Busted on that one, although somewhere in my files, I do have a research article regarding the success of chiro and acupuncture/moxa to turn babes.

            No, we knew well-before labor. This was the safest option, so baby received the benefits of laboring for a couple of hours before surgery. This was the absolute suggestion by the MFM dept at my local hospital.

          • Dr Kitty

            And the benefits of being subjected to intermittent hypoxia for a couple of hours would be…

          • Captain Obvious

            Ah yes, allowing a patient to labor a little to allow some stress on the baby to help respiratory effects better after birth. We used this sometimes at the hospital I used to work at. Two anecdotal midwife cases ended up with HIE because of this. One early laboring breech had SROM and a cord prolapse, and another IUGR baby with an unfavorable cervix whose mother was recommended a CS, had fetal distress and thick meconium. A prompt CS would of likely averted such an outcome.
            Midwives are nortorius for surprise breech births, because they are horrible at Leopolds and don’t use an ultrasound to confirm presentation or position. I have never seen a baby “flip” “during labor” in 21 years. It is usually that the midwife labored a breech without knowing it, and then when they realized it, they tell the momma that the baby flipped. That’s malpractice. Breech presentation is common at 20 weeks and then only about 3% at term. I can start praying for the baby to turn beginning at 34 weeks and majority of then will, that doesn’t mean prayer works in turning breeches. And how much money are your clients out for weekly chiropractor, accupuncture, and moxibustion for “turning” the baby. Talk about the Business of Being Born.

          • MomAnd Midwife

            I have to say that my Leopolds’ skills WERE terrible until I chose to become good at them…and quickly out-skilled my senior midwife with my hands. I’ve only had about 3 clients who have needed to get to the level of chiro and acu…and I give them the homeopathy because babies almost always turn after 1-2 doses.

            I’m sure the scenerios described happened to you (see how that works? I trust what you say to be truthful); the only time I ever saw that was…guess where?? Only 2 or 3 times, mind you, but all OBs. One actually called ME into the room, because he knew I would get a kick out of 1) seeing a vag breech birth and 2) the fact that he missed it and screwed a “scalp lead” into the baby girl’s left butt cheek. He is a hoot; still circs my boys whose parents opt for this procedure. Great guy.

          • Squillo

            Can you explain the biological mechanism by which a homeopathic nostrom works to turn a breech baby vertex?

          • MomAnd Midwife

            Nope! We don’t know why homeopathy works! The theory is “like treats like, versus the western medicine concept of say, antibiotics to treat an invading bacterium. The particular remedy that has worked so well for malpresentations is one that “rights the wrong.” And no, I am not saying that homeopathy is replacing very necessary antibiotics, so please don’t go there. When a remedy is the right one, the energetic properties of the person change just enough to correct the issue. It is a VERY different healing modality, that is very hard to explain or understand, until you see a bruise literally disappear before your eyes after a dose of Arnica. Or, my personal, completely dysfunctional ctx pattern with my 3rd, double-peaked ctx that were atrocious…one dose of Caullophyllum, that had not even dissolved in my mouth before the intense energy shift occurred in my laboring body. There are no side effects, the remedy either works or it doesn’t, so no harm done by trying one when something is off.

          • Squillo

            So there’s no plausible mechanism, only a mysterious, unexplained action that would require us to revise our entire understanding of physics in order to understand it.

            …one dose of Caullophyllum, that had not even dissolved in my mouth before the intense energy shift occurred in my laboring body.

            In other words, at best, placebo. Which may work for nonspecific indications like pain in susceptible patients, but has no potential to effect a change in a baby’s position.

            And your clients are paying you for your advice?

          • Box of Salt

            Wrong, MomAnd Midwife “we don’t know why homeopathy works!”

            We don’t know THAT homeopathy works at all beyond the placebo effect. All your handwaving about energetic properties is not science – it’s just magical thinking.

          • Squillo

            If the theory is “like treats like,” can you explain how Arnica is like a bruise? Or how Caullophyllum is like dysfunctional labor?

          • The Bofa on the Sofa

            If the theory is “like treats like,” can you explain how Arnica is like a bruise? Or how Caullophyllum is like dysfunctional labor?

            This is really an interesting question. Hehneman’s Law of Similars that the homeopathic treatment of something is created by proper succession of a solution of an agent that causes the symptoms. Thus, a homeopathic treatment that turns a breech presentation should be created from something that causes a breech presentation. What of it, MomAnd Midwife? Does the success agent in your favorite treatment cause breech presentation? Because if it doesn’t, you aren’t just not doing science, you aren’t even using homeopathy! You are merely invoking a magic of your own creation and hanging a homeopathy label on it to make it sound more convincing to the masses.

          • stacey

            HOMEOPATHY???
            I don’t care what else you say- if you say you use this stuff, seriously, I KLNOW you are ignorant and unskilled.
            Its one thing to realize a placebo may help., it is another to claim magic water works!

          • theadequatemother

            My OB friend is very good at determining position and turning babies to OA. She has a low CS rate and she is very proud of her skills. She works in Canada, alongside university trained midwives, those of which Catch is speaking. Her impression? The midwives know very little about managing dysfunctional labours and malposition and she is eternally frustrated that they do not ask for help earlier – esp when she encounters a baby with arrest of descent that is now jammed in the pelvis too tightly to turn. I do not think your experiences are universal and without doing a survery, a study or some other empirical inquiry, you should avoid making generalizations.

          • MomAnd Midwife

            What a treasure she must be! Again, the art of medicine at work.

            I should do better to avoid doing the exact same thing I get pissed about when others do it to midwives, you are correct, adequatemother ~

          • theadequatemother

            She’s not a “treasure” (ie…although she is a treasure to me personally, she is not an oddity) she is a typical product of Canadian OB/GYN education…trained in the typical manner, having the same experiences during training as her OB/GYN colleagues and having the same attitudes towards maternity care as her colleagues socialized into her over 9 years of medical education.

          • Amazed

            Slow clapping.

            Good act, MomAnd Midwife. Good act. You must be thinking you’re so clever, acting as if you are an evidence-based professional instead of homeopathic loving woo-infected pretender. How clever you are, to pose as if you respect doctors and scientific evidence, You’re even awed by the mere existence of a good doctor because they are so RARE, thus subtly demeaning the whole profession.

            You know what? You’re not so clever. I saw right through your envy and subtle badmouthing.

            I wouldn’t let you come within 10 feet radius of me with your woo.

          • Dr Kitty

            “began to see a pattern of malpresentation leading to increased surgeries…”

            Nice way to subtly imply that if only the women hadn’t had epidurals or had been mobilising more during labour that their babies would have turned and the surgery would have been unnecessary, but that the OB didn’t pick up the malpositions or know what to do about them.

            That is what you’re trying to say, isn’t it?

            That you, as a MW, can fix malpositioned babies with special MW skills OBs don’t have (or don’t use if they do have them) and thus you can avoid CS and they can’t.

            Most of the “skills” seem to involve getting pregnant women to mobilise more, pretending excruciating pain doesn’t exist (hypnobirth, relaxation techniques, massage), or the use of CAM (i.e. expensive placebos). None of these skills appear to have a rigorous evidence base supporting their use.

          • Captain Obvious

            Really, with plus size gals you are accurate within 1 cm? Seeing how America has so much increase in obesity you must be caring for many Plus size gals. How accurate are you there with EFW? AFV? even position?
            So many reasons why some babies are breech. Such things as Mullerian defect in the uterus such as bicornate, septate, or unicornate uterus, fibroids, anterior low placenta location, low AFV, nuchal cord entanglement, fetal congenital anomaly. Before MFM consider performing an ECV, they assess the woman and baby by history, exam, and ultrasound to determine if they are even a candidate for attempting to turn the baby safely. Are you suggesting you can turn any breech, and that you only failed once? That’s malpractice. I believe you are a troll here to stir up lies. I don’t believe your tales.

          • MomAnd Midwife

            With my clients who have needed AFI estimates, yes, I have been within 1 cm, and none of them have been morbidly obese. These babes to whom I’m referring have been breech from 32-35 weeks, and with the gentle techniques to turn babies, they have ALL turned before term except for two. One did, one did not. The gentle techniques include maternal positioning, visualization, and homeopathy. Never have I done an ECV, nor would I plan to, because of all of the potential risks listed above.

            Poor Captain O…it must be so hard to dialogue with a real, live, non-flake midwife who actually practices safely. When all else is in doubt, call “LIAR! Troll!” Suits you well ~

          • Amy Tuteur, MD

            Why do you think what you did “caused” the babies to turn?

          • MomAnd Midwife

            I didn’t “do” anything; I educated the mothers how to use their minds, bodies, and a gentle homeopathic remedy to turn their babies. I know, I know, and I can “see” it now…”You just admitted you didn’t ‘do’ anything!!!” Well, my sample size with this approach is only about 40 strong, but I’m seeing a 91% success rate within 48 hours. That’s impressive, even if it is a placebo effect. The placebo effect still means that a mama has peace of mind with a vertex baby, instead of anxiety over a breech one.

          • Karen in SC

            But you need to compare your results with a comparable set of women who also have breech babies at 32-34 weeks and see how many of those turn when nothing is done. Then you can have a plausible theory about the placebo effect on breech presentations. I think Caption Obvious stated that 97% of babies will turn on their own when breech at 20 weeks. Your 9% success rate doesn’t look that good.

          • Karen in SC

            By the way, you do sound like a midwife that risks out appropriately. I don’t like how you seem to dismiss OB experience and risk management skills but that’s your own opinion and it’s a free country. I hope you and your patients never get into one of those very low risk occurence / high consequence scenarios when all you can do is your best and it won’t be good enough.

          • Amy Tuteur, MD

            You seem to have missed the point. 96% of babies will turn to vertex by term even when you do nothing. You couldn’t even manage that.

          • MomAnd Midwife

            Yes, I am well aware of that rate. But to have so many turn within 24-48 hours of starting the active support of the rotation? Come on…! But I get that these are just my personal stats and opinions

          • Amy Tuteur, MD

            I suspect you think you are demonstrating your knowledge, but actually you are demonstrating your ignorance and gullibility.

          • catch

            I plainly pointed out that there are certain skills/techniques that midwives use that doctors don’t.
            One would be ignorant to not see this.

          • Amazed

            Certain skills/techniques. Ah yes. Bringing a priest on when things head south would be one of them. Offering women to eat their placentas would be another.

            Thanks but no, thanks. I’ll take the doctor.

          • Antigonos CNM

            I’ve been a CNM for over 40 years and I’ve yet to teach a doctor. There are NO “critical skills” which midwives have that doctors don’t. This is one of the biggest myths out there, sorry.

    • Charlotte

      My friend’s midwives were pushy about the epidurals too. Unfortunately, the natural childbirth ideology has spread enough to where it’s not uncommon for CNMs to push their beliefs on their patients and let it drive their care. Not all do, but it seems to be a widespread problem.

  • Jessica

    They told me there was room service and I could order milkshakes.

    (In all seriousness – CEFM, NICU, epidural, and the OR down the hall.)

  • Lori

    Is it too snarky to add that I have white carpets??

  • AL

    A live baby and a live ME!

  • Jenna

    Unlike my home, hospitals have:
    1. Unlimited hot water. I like to labor in the shower. A warm shower.
    2. Access to epidurals. I don’t always get one, but I want the option!
    3. The best medical care in the quickest amount of time.
    4. Others to bring food, clean, do laundry.
    5. A nursery at night so that I can get a few hours of sleep.

    • suchende

      Rx meds to manage the pain from your tears. I can’t even imagine trying to get to an office visit for Rx meds the day after birth, sitting on a tear.

    • Lisa Miller

      I roomed in with my first two and used the nursery for my third. It was awesome. Not sure why I felt like taking over full newborn duty withing an hour of labor.

    • Renee

      Too bad lots of hospitals are getting rid of the night nurseries. If you enjoyed having one, PLEASE write letters and let them know.

      • Lisa Miller

        That’s the worst news ever. There were 6+ babies in the one my son went too. All wrapped up like little tacos and the nurses were sweeping one up and getting it settled and moved to the next. They also did everything in their power to sooth the baby before waking Mom up. i got real 2-4 hour stretches of sleep. It was amazing. At when we were done nursing all I had to do was push the button and in they’d come for him. The best part was even though I was released from the hospital, they still let him go to the nursery so I could sleep. Take that time to get some extra sleep after your labor or surgery. Relax. After you get home it’s on like Donkey Kong.

      • Charlotte

        My hospital got rid of it to promote breastfeeding, and the 6 days of not sleeping more than 45 minutes at a stretch (2-day induction followed by 4 days of c-section recovery) turned what should have been one of the happiest times of my life into one of the most miserable. I wrote and complained, but they said there’s nothing they can do because bringing back the nursery would require a remodel of the whole L&D ward.

  • amazonmom

    I chose hospital birth because it is the safest place to deliver. I know my OB and NICU colleagues take great pleasure in seeing births go well. When they don’t go well they try their hardest to make it better. My OB caught my daughter’s breech/cord presentation at one of those EVIL cervical exams at 40 weeks. Her c section birth was uneventful and both of us were fine. I can’t imagine what would have happened with a local homebirth midwife, none of them here ever do vaginal/cervix checks at any time.

    • suchende

      Midwives can tell there’s a cord problem just by looking at you. *roll*

      • Bombshellrisa

        They can also tell how dilated you are by the sounds you are making-the more primal the moan, the more dilated you are.

        • BeatlesFan

          One of the CNMs present when I delivered my daughter informed me, “You sound rather ‘pushy'”- (pushy as in ready to push, not pushy as in do what I say NOW dammit). Personally, I thought I sounded like a dying cow more than anything else.

        • MomAnd Midwife

          This is truly another “art of midwifery ” things…laugh all you want. About 70% of my births occur with a vag exam never being needed.

          • Marguerita

            So 30% occur where you find out it was needed after the fact?

          • MomAnd Midwife

            No, my dear…I do them either when A) they are needed, or B) mom requests it. Most of they time, external signs are all that is necessary to assess. They are very, very uncomfortable, and do NOT predict when a baby will be born! Each time a sterile glove i dragged through the lower vaginal vault into the cervix, the risk of infection increases as well…why on earth would I want to increase the risk to the mamas and babies under my care?

          • Amy Tuteur, MD

            Why? To provide evidence based care that includes assessing prolonged latent phase, protracted labor, arrest of dilatation and arrest of descent.

            I find it oh so ironic that the same midwives who are ever so worried about vaginal exams causing infections seem completely unconcerned about prolonged rupture of membranes causing infection or GBS causing infection.

            Much of contemporary midwifery is an extended temper tantrum; whatever obstetricians do, turn around and due the opposite and pretend that it is better, despite the fact that its never been tested or despite the fact that the scientific evidence shows that obstetricians are right.

          • MomAnd Midwife

            What about those of us who DO worry about all of the above? I spent time over the course of 3-90 minute prenatal visits discussing GBS, and that prolonged rupture is a risk factor. Rowan’s court documents of counseling her client that 4 days was perfectly fine are just ridiculous and quack-a-doodle.

          • MomAnd Midwife

            No, my dear…most of the time, VEs are NEVER needed. I only do them if either: they are needed or if mama requests it. And I always offer.

            Any time a sterile finger is dragged through the lower vaginal vault, the risk for infection increases. They are very, very uncomfortable, and do NOT predict when the baby will be born! So why, on earth, would I do them any more than required?!?

          • Amy Tuteur, MD

            Says who? The clowns who practice midwifery and prefer not to examine women for the intensely idiotic reason that if they examine the woman, they might find that something is wrong?

            Obstetricians practice evidence based medicine. Midwives often practice self-aggrandizing, unscientific crap.

          • MomAnd Midwife

            OBs, in my area, often do NOT practice evidenced-based medicine. “Limited exams” after ROM might mean q 4 hrs instead of q 2…wow. Evidenced based would be NONE unless the benefits outweigh the significant risk. Not following CDC guidelines for unknown GBS status…hang abx ONLY if symptomatic…NO, MA’AM! Abx all around! Then we’ll blame it on Neo, who is also not following CDC guidelines. Evidence-based, my ass. And this is just one set of examples.

          • Amy Tuteur, MD

            “OB, in my area, often do NOT practice evidenced-based medicine.”

            Which tell us what about obstetricians in general? Nothing.

          • Lisa Miller

            The only reason I was ever given for not getting one ( i requested them all the time because I was curious to see how close to over it was , was because it introduced bacteria if you do it too often. Or, I should say, it always introduces bacteria so no reason to risk it by doing them every ten minutes. I still got a lot of them. If you don’t have pain meds it hurts like hell, that’s true.

          • AmyP

            Very, very uncomfortable compared to labor? Really?

          • MomAnd Midwife

            IN labor. They are not pleasant but certainly bearable otherwise

          • Karen in SC

            I had two unmedicated births, one with SROM before labor, one with ROM at 8 cms. The pain with the first one was mind-numbing and the only reason I got through it was the VE’s that proved I was progressing. I don’t remember VE’s as painful at all, the contractions were almost killing me, though. So painful I couldn’t speak so how could I request one?

            With the second, though the pain was more bearable, it was great to understand that my body was “working”, we were following the normal pattern. Until I was stalled at 8 cm. Again, ready to ask for an epidural but nurse suggested that having the doctor do ROM might take it all the way.

            I’d say the vaginal exams were key to my good birth experiences.

          • Dr Kitty

            Question, Mom And Midwife- When IS a VE needed and how do you know IF a VE is needed?

            Inquiring minds wish to know your decision making process.

          • MomAnd Midwife

            1) Mom requests it
            2) All signs point to the onset of pushing, but nothing changes for some time. I don’t really have a set time, although if a multip feels “pushy” but full-on bearing down in 30 minutes, I would want to rule-out an ant lip
            3) Certainly any signs of malpresentation
            4) Certainly any signs of fetal distress (I IA according to ACOG guidelines)
            5) Sometimes, my gut just tells me to do it…and I almost always listen

            May be missing something…am distracted by noisy kids after a sleep-over 🙂

          • amazonmom

            I’m glad I allowed my OB to do that vag check she wanted during my 40 week visit. I guess I could have labored and found out she was breech when her double nuchal arms and stargazing head refused to descend! ( I got ultrasound after the vag check revealed the breech, she was also a cord presentation) Or maybe they would have decended and gotten stuck with the rest of my daughter dangling out of my vagina! Cord prolapse after letting someone labor breech! Been to way too many of those deliveries as part of the NICU team.
            I know I’m a nurse and not a doctor, but I took something to heart in nursing school. The prof said that if you let something become emergent when you could have done something earlier to prevent the emergent situation, YOU WAITED TOO D*** LONG TO ACT. Maybe I should just shut up now.

          • Bombshellrisa

            I am not laughing. I would watch my preceptors let a woman push for hours and hours and upon transfer to the hospital an exam would show that they were never fully dilated in the first place. Same goes for checking the butt crack to predict dilation.

  • slandy09

    I didn’t feel safe with any other option. I confess that I entertained the idea of an out-of-hospital birth, but every time I thought about it, I would be overcome with fear and doubt. I was already seeing a group of hospital-based CNMs for my well-woman care, so I continued seeing them for my pregnancy. When I suspected ICP at 35 weeks, they took me seriously and got me tested right away and I was scheduled for a 37-week induction. I was in good hands the whole way.

    I also like having a continuing relationship with my health care providers. It feels like the out-of-hospital birthing providers are just baby catchers and then you’re on your own for well woman care and the like.

    • Renee

      Yeah, for fear and doubt! Its not always a bad thing to have those fears, they can save your life!

      • slandy09

        In my case, they saved my daughter’s life. I don’t even want to think about what could have happened if I had ignored the fears and doubts.

  • suchende

    My #1 reason is: I trust doctors and hospitals. The biggest relief of my life was being admitted to the hospital to birth my daughter. I was lucky enough to give birth at one of the best L&D hospitals in the country, and all my anxieties about pregnancy and labor just dissolved, because I knew I was getting the best care available.

    One of my parents is a surgeon, another was a NICU nurse for 10 years. I know as well as anyone that hospitals and doctors aren’t perfect. I also have people in my family working in international public health. My FIL is giving a lecture this week on the realities of giving birth attended by those wise “traditional” midwives.

    • I don’t have a creative name

      Oh man!! That is one lecture I’d love to hear. You should get his permission to post his notes somewhere so we can read them. 🙂

      • suchende

        I really should encourage him to write a book on the subject, especially as his career winds down and being politically divisive becomes less important. He’s spent his career mostly building family planning/obstetric clinics in the third world, and he has a lot of stories.

        • Bombshellrisa

          That would be an amazing read. All those cozy stories home birth advocates tell about “birth in other countries” never tell the real stories of what it’s like to deliver where there is no running water, no equipment or medicine and no chance of a hospital being just 10 minutes away if something goes wrong.

          • Certified Hamster Midwife

            If they won’t read Jeevan’s blog, they won’t pick up this doctor’s book.

          • suchende

            He’s not a doctor. Which may actually help his credibility.

  • Happy Mom

    Exactly. When I arrived for my planned C-sections, the last thing on my mind was my ‘goddess’ power. The only thing on my mind was hearing my baby’s first cry and knowing that they arrived safe and sound. I ‘trusted’ medical professionals to make sure we were both fine. And, that, they did 🙂

  • I don’t have a creative name

    All 5 of my answers are live baby. My son wouldn’t be here if I’d taken the squatty little jerk’s snide comments to heart and tried to do it at home.

    Oh, for a world where people with no medical training don’t feel qualified to give others medical advice! Not just advice, but pressure, that you have to to do it this way.

  • LovleAnjel

    Because I’m lazy and don’t like to clean.

  • Lisa Miller

    Drugs drugs and drugs and even some drugs to take home. And all that stuff you said.

  • Dr Kitty

    I chose hospital because I chose a planned pre labour CS, rather than waiting for my dodgy pelvis to decide for me after a long, difficult labour.
    I have ZERO regrets or angst about that choice.

  • Mel

    No babies yet, but here are my reasons:
    1) I’ve watched 100’s of cows give birth. Calves and dams can die so very suddenly. A lot of the problems could be averted if we could monitor the cattle with the technology we have for humans and perform emergency C-sections that have survival rates like the ones for humans.
    2) I’m more important than a cow.
    3) My child is more important than a cow.
    4) I can’t imagine forcing my husband to live with the aftermath of a homebirth where I and/or the child dies. He’s too important for that.
    5) Seriously, birth is really messy. It’s gooey and oozy and bloody. I’ve had microbiology, so I know that giving birth in the barn is not a good idea, but it is much easier to clean the barn than my bedroom. Oh, wait…hospitals have tile and people who can clean up….sweet.

    • ersmom

      I just delivered a farmer’s wife this week. They raise cattle. Dad was giving me an account of the differences between delivering calves and human babies. It was amusing.

      BTW, he thinks the humans in hospitals is the better way.

      • auntbea

        Was his WIFE amused?

        • Mel

          I can see my husband doing that. It would be his way of dealing with his nerves…..

        • ersmom

          He was telling me this the next day, in the circ room as I was circing his son.

      • Mel

        I honestly don’t know of many livestock farmers who view home-birth as a great option. Calving is generally pretty straight forward, but when it goes wrong, it goes really wrong really fast. I know my husband has had to help out on terminal CS on a cow (worst case scenario – a cow that is dying and in late pregnancy – the vet knocks the cow out and you try to get the calf out before it dies…if it hasn’t died already.) Those really bother him. We both view it as incredibly foolish to risk two human lives for….well, I’ve never really understood the benefit to birthing at home anyways so I’m gonna chalk it up to fear and pride.

        • Certified Hamster Midwife

          As soon as there was a hospital close by, my dairy-farming grandparents, who had a dozen kids, went there to birth ’em.

  • Prudent planner

    I switched to an in hospital ob/cnm practice at 35.5 weeks. It was an excellent choice for me.

    http://motheringwithreason.blogspot.com/2013/05/why-i-choose-home-birth-then-changed-my.html

    • Karen in SC

      Like your blog!

    • PoopDoc

      Your illustrations are great! I especially like the very pregnant stick mom with the stick baby.

    • suchende

      Wonderful story, thanks for sharing. The thing about risk makes a lot of sense to me.

    • Life & Love in the Petri Dish

      I just added your blog to my blog roll. love it : ) I hope you get a lot of traffic from my site.

      Mo

      http://lifeandloveinthepetridish.blogspot.com/

  • PrecipMom

    I choose hospital birth because a group of people are more likely to catch a problem compared to one or two people.

    I choose hospital birth because I would rather have a birth than avoid a pregnancy and baby I would love to have because I do not have the resources to lavish on coping with pain that is avoidable.

    And most importantly I choose hospital birth because I am sick of watching other people’s babies injured or killed from lack of appropriate care, and the bad midwives and the good midwives are often impossible to tell apart. If you spend enough time in the natural birth community, you will see the deaths, and you will know deep down that they’re disproportionately popping up in home birth circles.

    I will not place my life, my baby’s life, or either of our healths on a guess as to whether my midwife really is as good as she portrays herself as being, and even the best midwife will not be able to save the day in the case of the rare but real complications that even low risk births can encounter.

    • PrecipMom

      Oh, and I choose hospital birth because I dealt with the underlying factors that were driving me into a home birth setting in the first place. There are real reasons that people choose home birth. Some are incredibly complex, but that should be dealt with with the appropriate professional: an MD, a psychologist, counselor, psychiatrist, or whatever appropriate discipline is warranted. Those factors aren’t helped by opting further outside of reasonable medical care, and especially when the cost in human life and suffering can be so so so high.

      • melindasue22

        Love this!

  • KarenJJ

    I had one brief moment where I had this romantic vision of giving birth in our lovely home, all peaceful and happy etc etc. My husband’s reply “I’m not comfortable with that. What if something were to happen?” brought me back to earth pretty quickly and I had to admit that I really didn’t know what we’d be in for.

    The second time around, I went to hospital very happily – great food and time to hang out and just enjoy the baby on my own without my toddler also demanding my attention. We spent one afternoon where he spent an hour or two asleep on my chest while I read a book. Once I got home it was chaos and I really treasured those quiet moments in hospital.

  • Anj Fabian

    The usual plus…

    If my DH was uncomfortable in the hospital room during my labor, he’d be even MORE uncomfortable at home, with only a lay/independent midwife to deal with everything.

  • Daniel

    Wonderful and concise – knowledge in sound-bite form. I hope everyone takes a copy of this and emails it, facebook-posts it, and generally plasters the walls of the internet with it.

    Your fan in Montreal,

  • Allie P

    I can’t even think of it as a choice, really. The idea of giving birth anywhere other than a hospital is as foreign and anathema to me as the idea of DIY tooth drilling. It’s inconceivable. Even if I’d had some kind of textbook, picture perfect birth, I couldn’t imagine being at home, where I’d be responsible for the set up and the mess? Even the minor services the hospital offers you, in terms of supplies and support staff and people to bring you stuff and take your baby’s temperature and such every two hours, are far more pleasant than the idea of my husband sloshing a bloody kiddie pool around my living room.

    And then there’s the obvious: induction and other drugs to help me have a nice, safe vaginal birth, pain relief, fetal monitoring, and the safety and peace of mind that comes from knowing someone was watching my baby’s heart rate as I slept (it dropped, and they came in and resolved the issue right away!), and that if anything at any time went wrong, there was a team of experts who had all kinds of high tech means to help me and my baby — medicine, blood products, liquids, surgeries, etc. Right there, often in the room but never more than a quick shot down the hall.

    A family friend asked me if I’d considered homebirth when I was pregnant and I looked at her like she’d sprouted two heads. The whole idea is bizarre. Even if you don’t want pain meds (another idea I find bizarre — who wants to be in pain?) and were GUARANTEED that nothing would go wrong (ha ha ha ha ha!), why in teh world would you want to be responsible for all that crap at your house when you can get someone else to do the laundry, get the supplies, give the sponge baths, have the ice chips… It’s like going to a fancy restaurant versus cooking a huge feast for 20 in your house. While having a baby.

    • LynnetteHafkenIBCLC

      Well, for me the pain was like running a marathon. And I didnt want any of the potential side effects if I could avoid them. I totally would have taken pain relief if I needed it.

      • The Computer Ate My Nym

        Feeling like the pain wasn’t bad enough to warrant the risk of side effects seems to me to be the best possible reason for not getting treatment for the pain. I’ve had (very minor) procedures done without lidocaine because I felt like the numb spot would be more annoying than the transient minor pain. I don’t think anyone would criticize you for this decision. (Well, ok, some people will criticize ANYTHING, but I don’t think it would be in any way justified.)

      • The Bofa on the Sofa

        I don’t understand the comparison to “running a marathon.”

        If running a marathon gets to be too uncomfortable, you have the option of stopping. You can’t do that with labor.

        To me, it seems more like being drug through a marathon behind a motorcycle. Or, probably better, falling down the steps. There are things you can do to make falling down the steps less nasty, but, in the end, you are still at the whim of gravity.

        • LynnetteHafkenIBCLC

          You almost always have the option of stopping the natural childbirth by getting anesthesia. In any case, it doesn’t really matter to me whether other people think it makes sense; I just prefer to approach childbirth that way.

          • The Bofa on the Sofa

            Anesthesia stops the pain, but it doesn’t stop the process of labor.

          • LynnetteHafkenIBCLC

            Yes, of course; the only way of stopping labor is a CS. I was responding to your implication that forgoing pain relief is akin to throwing yourself down the stairs.
            —-
            Lynnette Hafken, MA, IBCLC
            http://www.nurslings.com
            240-888-2123

          • suchende

            Is it really true that you can almost always get an epidural? I thought for most of the ouchy part of labor, it was too late.

          • Guesteleh

            It’s only too late once you’re actively pushing.

          • suchende

            Interesting, thank you. I didn’t stop to ask; after a couple weeks of on-and-off prodromal labor and miserable hip pain I was just ready for any pain management meds I could score.

          • Wren

            I was told it was too late at 10 cm, though I wasn’t actively pushing yet. To be fair, it was a very busy night on the ward and the anaesthetist may have been with someone else and it may have been assumed I’d be pushing before he was available.

        • Guesteleh

          She’s saying the level of pain is comparable to what a runner would experience while completing a marathon. It’s a perfectly appropriate comparison.

      • Mariana Baca

        As someone who has run a marathon — it has occurred to me that this is the mentality homebirthers must have — I saw the appeal while training for the marathon. But a marathon is not just about the race day. It is about the months ahead of time, training and preparing and leading up to the event. It takes perseverance, both mental and physical.

        But pregnancy, although the 9 months of waiting is uncomfortable, you have to watch your diet, etc, is *not* training for labor. If you are tired one weekend and sleep in, you don’t stop being pregnant. If you binge on ice cream you don’t stop being pregnant. If you gain weight or lose weight in normal amounts, it won’t impact your performance in labor. You don’t have longer and longer stretches of labor pain to mentally prepare for birth. Pregnancy by necessity comes before labor, but they are completely different animals. Not so with a 20 mile training run vs. a marathon.

        There is virtue in a marathon — it takes fortitude/perseverance both to train week after week and to keep running to the limits of endurance without just deciding to quit. It takes temperance to eat right and not indulge too much before training. It takes prudence to know when to push through pain and when pain is an indicator of injury, and prudence to quit or rest for your body to recover. I can’t find a role for the virtue of justice here, but few activities are perfect.

        Labor is not the same. A woman doesn’t have a choice but to go through labor once she decides to take a pregnancy to term — although she can “give up” on feeling labor pain or natural birth by *taking action,* if she does nothing, gives into what her body does normally, she will keep laboring despite pain. The pain is not self-induced. The pain does not achieve the goal of giving birth to the baby. “Giving up” does not stop labor. There is no act of will that embodies the virtue of fortitude in natural birth, since the goal is not to go through birth without yelling, for example. Moreover, in a home birth, by the point a laboring woman would want to give up, it would require a great act of will (and fortitude) to make it to a hospital! Home birth does not embody prudence. Choosing a less safe environment in order to ensure you endure pain is not prudence. Home birth is counter to justice: it is one thing to deny yourself healthcare, but to deny it to your baby is not just. Home birth could embody temperance, in that it might promote eating right before birth to ensure a better outcome (although all women regardless of place of birth should do this). Forsaking chemicals unless necessary could be seen as virtuous — but it seems disproportionate to the other virtues given the low risk of meds used in labor, and nobody goes into birth seeking to abuse labor drugs anyway.

        Saying: a marathon is painful and lasts for hours and requires months of preparation doesn’t mean it is analogous to homebirth because it is painful and lasts for hours and requires months of preparation. The goal in a marathon is to run 42.195 km — the pain is incidental and a runner seeks to minimize it by proper training and equipment. The goal of labor is a healthy baby and mama — enduring the pain serves no purpose to the goal other than to avoid unpleasant side effects.

        I can see why women with this mentality feel cheated from a c-section or an epidural. It makes them feel like their months of pregnancy (their “training”) was for naught. But the goal is not to endure pain, but to run the race in a marathon — so should it be with labor. The goal is to deliver the baby.

        If someone said: if you put these shoes on or these compression pants or eat this food, your marathon with be pain-free and your performance/health won’t be affected, 100% of marathoners would take it. Because the goal is to run, not feel pain. If the pain is too bad, one didn’t train enough or is injured.

        Tl;dr, sorry.

        • LynnetteHafkenIBCLC

          I know they’re not exactly the same; it’s an analogy that I used to explain why I preferred to have unmedicated labor in the hospital (I never mentioned home birth). I was responding to Allie P’s comment that she finds the idea of going without pain relief “bizarre.” I’m not offended, but I think it’s as important to respect women’s desires to go without meds as it is to respect the wish for pain relief. I didn’t want the potential side effects of meds, and I thought I could handle the pain. I know I was lucky my babies had good positions and sizes.

          • Renee

            I like hearing peoples reasons for their choices. To me, the idea of dealing with severe pain that can be stopped or lessened is foreign. I have chronic pain, I don’t need to add to my load.
            To each their own.

    • Therese

      Well, to be fair, the midwife is supposed to clean up all the mess. At least that’s how it works in my experience. But one thing she won’t do is stick around for two days postpartum and cook all your meals, so hospital wins there for sure.

      • Renee

        Thats why you spend the extra grand for a PP doula! Duh. Add that to the cost of the MW and you can get a nice used car…

  • Rachel Mills

    I chose hospital birth with my second because

    1. That panicked ride to the hospital after 21 hours labor to go get an emergency csection SUCKED.

    2. I had a few risk factors.

    3. I wanted my care providers to have some accountability

    4. I wanted my care providers to have some competence.

    5. I wanted to rest and be pampered by nurses for a couple of days before heading into the sleepless tunnel of newborn care.

  • expat in germany

    I didn’t want to have go through the initiation rituals (classes) at the birth center.

  • The Computer Ate My Nym

    Some more reasons (for me):

    6. I didn’t know, prior to starting labor, if I would want treatment for pain or not. But I knew that if I did want it I would not want the artificial delay of a transfer to the hospital along with any necessary delays before getting it.

    7. I wanted my health monitored as well as my baby’s.

    8. I wanted someone else to clean up the blood, vomit, and meconium.

    9. If the birth went wrong or just was very painful, I wanted the memory of that pain to be associated with some place other than where I live.

  • Just A Guest

    If someone asks me this would be my answer: I chose CNM attended vaginal birth and narcotic pain relief. And I don’t owe you an explanation.

    • LynnetteHafkenIBCLC

      No one owes anybody an explanation. Except maybe “because I wanted to.”

    • Renee

      I dont think anyone is owed. I do often explain in hopes of helping people see my pointy of view.

  • LynnetteHafkenIBCLC

    My first child chose the hospital by being born at 35 weeks. I chose hospital for my second because I knew I could have just as natural a birth in a hospital AND be taken care of for 2 days. The third I chose a birth center with a CNM and it was a wonderful experience, but I wouldnt do it again, not only because of the risk in labor, but because there’s something to be said for having many nurses and docs observing your baby over a few days.

  • Gene

    I chose hospital birth because I’ve seen what can happen during birth when the shit hits the fan.

  • Amy M

    Pretty much the same.

    1) I wanted 2 live babies, preferably as close to term as possible.

    2) I wanted access to a NICU, as my (twins) were likely to be premature and I wanted them to have the best care as quickly as possibly, should they need it.

    3) I wanted to survive the birth of my children, as well as avoid repeated pelvic floor surgeries from massive tearing and botched/no repair.

    4) I wanted pain relief. There are no anesthesiologists at my house.

    5) No way in hell did I want to clean up that mess, nor worry about about cooking for myself or anyone else, or any other household chores.

  • Courtney84

    This is why I am choosing hospital birth, and still agonizing over which hospital to choose.

    Is it selfish to admit it’s not just the baby? I’d like to minimize my risk of dying, losing my uterus, or hemorrhaging to the point of needing a transfusion.

    • Amy M

      NO.

    • suchende

      Hemorrhaging was a biggie for me, since it nearly killed my mother giving birth to me.

      • Courtney84

        Word. I mean I know people hemmorhage in the hospital. If that happens I wasn’t doctors and nurses and people who can stop the bleeding ASAP and nit sacrifice the care my baby receives. I do not want a goofball to breathe candy breath at me while not calling 9-1-1.

    • amazonmom

      Not selfish at all. Even if you do need transfusion where I work we actually have the blood you need on site. Blood bank substation installed due to the large delivery volume we have.

      • Courtney84

        I’m not opposed to being transfused, but I know requiring transfusion is less than ideal. Thus I’d rather be somewhere that there’s a decent possibility the bleeding can be brought under control before it comes to that, and that if it comes to that there will be blood to be had.