Ever notice how women who are planning to have a homebirth feel the need to justify it to the entire world?
There are literally hundreds of blog posts and web articles entitled “Why I’m having a homebirth” or some variation thereof. I’m not really sure why homebirth advocates think the rest of us care why they are having a homebirth, and for the life of me, I don’t understand why on earth they think their reasons are original. The posts and articles are always the same; indeed, I could write it for them.
Why you are having a homebirth:
1. For bragging rights.
You are inordinately proud of yourself as if you are planning to something that more than 90% of women who have ever existed haven’t already done, and are doing around the world every single day or dying in the attempt. Nonetheless, you feel the need to share this with the entire world as if you think we are going to be impressed.
You can save it for your crunchy friends who are competing with you for most risk-filled outlandish homebirth. To the extent that the rest of us care, it’s only to note that you are a fool.
2. To proclaim that you are “educated.”
This may come as a surprise to homebirth advocates, but most people who have real education do not refer to themselves as “educated.” In the world of the internet, that adjective is reserved for the ignorant who think they can actually do “research” online. Anyone with real education knows that it cannot be acquired by reading books and blogs written by lay people for other lay people.
3. You are ignorant of history.
Only a fool looks at the modern world and believes that childbirth is inherently safe. It’s like looking at the modern world and believing that highways are “natural” because you can’t remember a time when highways didn’t exist. Anyone with a modicum of historical knowledge knows that childbirth is and has always been, in every time, place and culture, one of the leading causes of death of young women and the leading cause of death of babies.
4. You are gullible.
You believe the racist, sexist claptrap made up by Grantly Dick-Read that “primitive” women don’t have pain in childbirth because they don’t have fear. In the first place, it’s not true; secondly, you seem to have confused correlation for causation. Fear doesn’t cause childbirth pain; the agonizing pain of childbirth causes fear.
5. You are selfish.
You seem to think that birth is about your experience instead of about your baby’s safety. You are dead wrong about that.
So the next time you are tempted to justify to the rest of the world your decision to have a homebirth, don’t bother. We already know why and we don’t care.
Huh. Is this true for the women in Scandinavia, where home birth is a normal occurrence and supported by the government? Your condescending and tone deaf attitude is the reason women choose home births. You’re the Ann Coulter of obstetric practice. Or former obstetric practice.
Typical parachuter: four-year-old post, ad hominem attack, fuzzy on facts. Sigh
Being gay is normal, but no where near as common as being straight. Besides, the midwives who do home births in the US (which Dr. T is usually talking about) would not be considered educated enough to practice in any of the Scandinavian countries.
I was expecting my pre-schooler when this post was written and wasn’t a reader of this blog yet, had only seen positive things about homebirth, and was still convinced that having a baby at home was dumb, because of the what-ifs. I studied history; it doesn’t take much time trolling through plain old histories to see how many women and babies used to die at home
I don’t think Dr. T. was even blogging yet when I was pregnant with my first, and before I started having complications. Even then, I read about home birth and out of hospital birth centers and thought to myself those people were crazy. I couldn’t get past the lack of education the people attending those births had.
You should probably read the blog a little before you jump in and make a fool of yourself like this. Then again, you have given me a much needed laugh.
There is something very wrong with you if you decide to home birth just because you found someone condescending on the internet.
Thank you for verifying how rediculous your medical profession can be!! From pitocin induced birth in a hospital with our first baby. Long painful labor, blood shot eyes and a nurse saying “don’t push the doctor isn’t here yet”… to a home birth with our second one I can say the natural birth was so easy. No pain medication or IV nor did I need any.. No intervention at all just me and my little one.. Amazing!! Loved it!!!
Ridiculous has an “I,” sweetheart.
And yes, your rant (which in case you didn’t read the post above, we don’t give a shit about) is indeed rid *I* culous.
And five, count them five, references in that little grammatically haphazard paragraph about YOU and how YOUR home birth choice made YOU feel.
God it gets old…
…and I am betting Power Ball money on the following:
1. PD recently had her amazeballs home birth and she’s high as a kite on how awesome she did, so she feels compelled to share.
2. PD Googles, “why I chose home birth” to look for an outlet to write about her awesomeness.
3. She types “choose” instead of “chose” – a common error given the writing skills she’s already displayed above.
4. Google takes some key words and finds her Dr. Amy’s post from years ago.
5. She reads.
6. Wait, this is not what she intended. This shit is whacked. It pisses her off. People actually have disdain for home birth and her awesomeness?! Whatttt?!
7. In her fury she decides, eh, might as well post anyway. Anything she can contribute here might one day spare another woman from the blind decision to birth in a hospital with a doctor.
8. She pens the pretty little gem above.
9. She is now back to Google-ing “why I choose/chose – shit just let Google correct it for you – home birth,” ready to “share her birth story” in a much more inviting environment.
And don’t forget that other part of Bingo – “Oh, my second was so much easier than my first! It was definitely being at home that made the difference!”
Despite having really good blood pressure all pregnancy and gaining only as much weight as my child+amniotic fluid+placenta, after being in labor for 4 hours (sans pitocin), my blood pressure suddenly soared into the 200s. If I’d have been home, I probably would have had a stroke and died. Amazing!! Loved not dying!!! After that I was too loopy to give a shit!!! ‘though I think i did when i was pushing. Love the not having to clean poopy sheets!!
It was generally recognized all throughout history – seen in both fictional and nonfictional writing – that childbirth was a pain-free, safe process, and it was only the advent of modern obstetrics that made it dangerous and uncomfortable.
Oh, wait, no, the other way around.
Second births are generally shorter and easier than first births. I’m glad things went well for you, but you would have had the same outcome in a hospital as well, just with the safety net of trained staff and equipment in the event of an emergency.
-First babies often cause long painful labor, no matter where you are.
-Nurse didn’t want to catch the baby her/himself.
-Second babies are famous for being easier to deliver, no matter where you are.
-*ridiculous
-Here’s your cookie for no pain medication/IV/intervention.
For what it’s worth, I’m glad your story had a happy ending.
“No pain medication or IV nor did I need any…”
Oh, pro tip, if you don’t need ’em, you won’t get ’em at the hospital. Two of my friends had med-free intervention-free births at the hospital (one had two of them) because they had trouble-free low-pain births. Winning the genetic lottery is winning the genetic lottery, no matter where you are. Doing it at the hospital is the equivalent of wearing your seatbelt and then not crashing.
What a shame that you couldn’t manage to do it right the first time. I guess I’m the most amazing birth goddess ever (trademark pending) since I had an unmedicated, totally natural childbirth in the hospital the very first time.
so did my mother
The reason people justify their home births is because of ignorant people like you! It isn’t for the mom! It’s to avoid the intervention that is our health care system! Maybe those that live in Europe or the UK are safe in hospitals but we here in North America are not. Whether or not you believe it. Way to go… Way to pass judgment and think you know every mom out there. You’ve just made yourself look like an idiot who doesn’t know how to think critically and is only a judgemental bitch. I bet your surrounded by people who strongly dislike your personality.
You’ve just made me look brilliant by confirming that homebirth is about the mother and her self image. Thanks!
Incorrect.. It is to avoid people like YOU!
“The reason people justify their home births is because of ignorant people like you! It isn’t for the mom! It’s to avoid the intervention that is our health care system! ”
…which happens to…the mom and baby! Who else were you thinking it happens to?
I wish no one felt the need to justify their birth. Pregnancy and birth are a different experience for every woman, and we should all have the choice to give birth where we feel most safe and comfortable, whether that place is home or hospital. I’m really disheartened by a hateful post like this written by a woman.
This is the most judgemental and ignorant article I have ever read. Who are you to lump an entire group of women into some sort of narcissistic, pseudo hippie group of idiots? I came across this article while researching my options, and I was honestly hoping at first that there was some sort of joke I was missing. First of all, ANYONE who gives birth, whether in a hospital or at home, should be able to feel empowered. Good for them, they just pushed a human out of their body. Secondly, maybe women wouldn’t have to explain their decisions constantly if hateful people like you weren’t out there telling them how stupid you think they are. I’m sure a lot of women have to deal with that. I dealt with judgement from my own mother for even considering it (she also shot down my decision to not circumcise my future son or sons because it “looks weird”) . This was the only article I’ve ever read on your site, and I don’t think I will be wasting my time reading any more
If you did, you might get some worthwhile education.
Wow what a terribly judgemental and arrogant article. Hopefully prospective mothers will read this before going to Amy Tuteur for care!!!
The writer of this article just SOUNDS like an absolute bitch. Okay, maybe people write “why I did a homebirth” because people like A) Me, are curious about how they go or why people choose them, or B) Pregnant women are weighing the pros and cons of a homebirth for themselves. You sound so convoluted and fucking pretentious, I don’t see how all this even affects you at all. Jesus christ. Take it down a notch.
What a well thought out response. So, you don’t mind babies dying at homebirth because of the crap spewed by NCB nutjobs?
America’s birth culture is highly polarised, and as such you will find extreme and lunatic views at both ends of the spectrum. The skeptical OB is part of that extreme fringe. I personally find this blog and the views of posters here very interesting. However, it does make me glad to live in the UK where midwives and doctors are trying hard to work together to deliver optimal care for mums and babies. The difference in the UK is that we have a system where evidence based care is promoted and where the vast majority of doctors have no financial or professional interest in delivering low risk mothers as this is seen as the business of midwives. The NHS is very thrifty (sometimes too much so) but the one thing it is good at is not wasting the talents and training of doctors on work that can generally be done better and cheaper by midwives.
Being an OB RN I see a lot of either home birth patients or patients who come from the freestanding birth center get rushed in via ambulance because something is going wrong with the birth. We help them, by either vaginal delivery in the hospital or by cesarean, usually it’s a stat section. These folks that come in are the most thankless, most arrogant, defensive people I’ve ever encountered. Why?! Because you’re coming to an inner city hospital? Because we couldn’t adhere to every single point on your precious 4 page birth plan, because we didn’t discuss each and every action we took with your doula/bodyguard? We just saved your baby’s life- we just saved your life- and you’re going to complain that we’re too invasive? Happens about 98% of the time we get someone in from the freestanding birth center. I can be sympathetic, you wanted your birth to be the way you wanted it, and it didn’t end up that way. This happened with our first child too- we bought into all the Ricki Lake and all the Lay Midwife, Doula business. Came up with a “great” birth plan (that now that I’m a nurse working in this field I’m ashamed to have authored) and we ended up with a stat section, and our son was in the special care nursery for 2 days! If I had continued to refuse a section, if I had continued to refuse internal fetal monitoring, we wouldn’t be planning his 5th birthday party next month. Last night at work, a woman chose a section- turns out she had a placenta accreta- she ended up going up to the ICU, got 5+ units of blood and FFP, and was headed for DIC. How would that have been handled in a home birth setting? I know it was a catastrophe in the hospital…
Short answer: Yup!
Long answer: thanks for saying this. It’s real easy for these folks to ignore Dr Amy or criticize her (come on, the best most of them come up with is “she isn’t a licensed doctor”), but I’d really like to hear the comeback to your post, which relates your personal experience. What are they going to say, that you don’t find the patients to be thankless, arrogant and rude?
I think it’s always different when you’re on the other side of things- I had no idea how things went when I was a patient myself- now I’m working at that very same hospital and it’s really sad. I know who these people have read, I know their childbirth educator (the same one we had who basically told us that getting an epidural will lead to a c/s and that’s what the docs want because it’s a teaching hospital) and these people who aren’t even nurses or doctors or even nursing assistants have this gall to insult us. Like we’re sitting there twirling our pencil mustaches and rubbing our hands together just waiting for fresh meat to chop open. Guess what? We didn’t go into this field to be invasive or excessive. You don’t like me coming in your room every two hours and telling you not to co-sleep with your baby in the hospital? Okay, then you sleep with your baby and I’ll tell you a little sleepy time story: once upon a time there was a new mom here in room 5 who fell asleep with her baby, she woke up to find her baby on the floor, dead from a massive head trauma from hitting it’s head on the tiled floor. The end. Happy co-sleeping. I’m not saying don’t co-sleep when you get home- you might have a good arrangement at home but hospital beds are NOT ideal setups. So sorry. And for the record, I have no trouble with doulas, as long as they know their place and don’t tell this new mom that their 42/2 weeker is CLEARLY only around 36 or so weeks based on the amount of vernix on the baby. That’s just crazy talk there.
“I have no trouble with doulas, as long as they know their place and don’t tell this new mom that their 42/2 weeker is CLEARLY only around 36 or so weeks based on the amount of vernix on the baby.”
Someone actually tried to say that??
When I ended up in the hospital after trying at a birth center, I was in a lot of pain, of course, but happy to be there! I needed an epidural and a c section. If I knew then what I know now, I never would’ve went to that birth center. They nearly killed us! I made the choice to go to the hospital when they should’ve. Nearly a year later I’m still mad, and I read these blogs hoping to hear good news of change. This was in portland, OR. I’m glad that I can tell people my story, so they can make a better decision
Re: placenta accreta – the very high rates of primary c-section are making this once rare obstetric emergency far more common. It’s one of the reasons that NICE in the UK are recommending midwife led settings for first births – to cut the primary c-section rate. UK evidence appears to show better outcomes in free standing midwife led units even for primiparous mothers *and* their babies. The unplanned c-section rate for primips deemed ‘low risk’ at the start of labour in the 2011 Birth Place study (which forms the central evidence plank for current NHS recommendations on place of birth) was doubled in the comparison group of low risk mothers labouring in hospital, with no improvement in neonatal outcomes and a higher rate of admission of women to HDU.
I don’t see my reason on this list. We had several children in the hospital and had good experiences each time, but the last two babies I did give birth to at home and it had nothing to do with granola and bragging rights. I’d say our decision was almost completely financially driven. Without insurance a home birth was a fraction of the cost of a hospital birth. We paid $2000 as compared to . . . a lot more. I felt blessed to find two midwives I felt very comfortable with who laid my many concerns to rest and answered all my questions. What surprised me was how much more relaxed I was laboring and delivering at home than I had been in a hospital and I loved how less invasive the whole process was. I was sold. However, I definately don’t advertise my decision because of all the negative perceptions and controversy surrounding home birth. I’d say the only draw back is there is no option for an epidural : ) but since I’d only tried that route with one of my hospital deliveries, with less than wonderful results, I knew I could handle it. As far as the safety issue, one of my midwives taught neonatal resusitation to doctors, and if something had gone wrong during delivery I was ten minutes from the hospital where with a warning phone call they would be ready for my emergency just as quickly as if I had been in their birthing center. I don’t feel like I was gullible or selfish in my decision and had no other agenda than to have a healthy baby without going into great debt.
” I was ten minutes from the hospital where with a warning phone call they would be ready for my emergency just as quickly as if I had been in their birthing center” I have been at home births and I have seen emergency transfers. I have also been there to receive those transfers in a hospital. It’s never “just as quick” when you are waiting for an ambulance to roll in so you can frantically try and assess a patient and hope that there are adequate notes and a good H&P AND the home birth midwife there to give report.
Oh yes, laboring women with emergent issues dumped at the ER or brought in by ambulance with no provider and no history. The midwives who provide a good history and an excellent report are usually the ones who have good judgement, risk out appropriately, and have educated their clients that the hospital is there to help not to be the enemy.
Not entirely OT: I am seven minutes from the “free standing” ER in the area. There is another one being built that is about three more minutes away. The midwives who justify home birth in areas like Black Diamond, Enumclaw, Ravensdale or Maple Valley (if you are from the Seattle area you know what i mean) use this ER as “the hospital is 10 minutes away”. Guess what? Today it was 20 minutes away, because I hit every red light between here and there.
You just hit my pet peeve! Freestanding ER is NOT NOT NOT a hospital and should not be a backup for homebirth. The freestanding ER is not equipped to handle OB emergencies like a hospital! Of course you know that:). That is one hell of an ER if they have an operating room and an OB/NICU team present.
You know those midwives are telling their patients that since there are OB practices in the building that is attached to the ER that if something happens one of them can come and check out the situation. It always makes me laugh to hear these women and their midwives insist that they know so much about what will happen in a hospital that home is better, but have literally no idea what the process really involves.
the presence of freestanding ERs in the area complicates things for patients. Freestanding ER gets obstetrical emergency, calls EMS for transport. EMS takes the patient to nearest hospital equipped to handle said emergency. Hospital that owns freestanding ER complains patient not taken to their hospital. EMS crew tells them to stuff it. One poor lady we got in had no idea where she had been taken after the ambulance dropped her off!
“if something had gone wrong during delivery I was ten minutes from the hospital where with a warning phone call they would be ready for my emergency just as quickly as if I had been in their birthing center.”
Can you hold your breath for ten minutes? Neither can your baby.
The debt thing….how is that realistic? Babies cost money once they’re born.
In my personal experience, I’ve found that it’s these women that obsess over birth and the details of it, or proceed to criticize/bully others or attack their births, that most often are in need of serious professional mental health assistance.
I thought about this last night. To have a homebirth suggests on SOME level that the birther is in exceptional health. As humans we are wired to be attracted to the healthiest of our species, so with this in mind, the home birther is saying, “look at me, I’m so healthy I can pop this baby out with no medication or unnatural assistance.” If this is true then the opposite is also true in that those women requiring birth interventions are not the healthiest of our species and would die without the medical intervention. This is why homebirthers and especially those doing it alone (unassisted) shout from the highest mountain, have blogs and post shit all over youtube and facebook. IMHO
amen to this post, heard every single one of these.
Or maybe some of these women are scared? Maybe some of them have experienced something that was frightening or traumatic in the hospital and are scared to return. I just don’t understand why advocacy for hospital birth needs to be laced with so much vitriol and so little compassion or understanding.
Based on my experience in the hospital with my first, I understand why women would not want to deliver in the hospital. It was a scary situation, made worse by doctors who treated me as if my every question or concern was a nuisance, an obstacle to a healthy baby, or even neuroses. I wasn’t advocating for natural birth, mind you, and I was so overwhelmed by the whole situation and had so much respect for my doctors and nurses, I never challenged anything they did or told me to do. Any question about what was happening to me, what procedures or medication they were using, or why things were happening as they were was met with rolled eyes, exasperation, and occasionally yelling. It was awful. My reaction to this has been to find a different OB and hospital, but for many women, these sorts of situations, which thankfully are rare but DO exist, send them running from hospitals forever.
I think the argument you are making is dismissive of and discompassionate toward these women, their thoughts, feelings, and fears, and treats them in the same cold and callous way that they are afraid of experiencing (in some cases for the second time) in a hospital setting. While your approach will be very compelling for those who agree with you, for those who do not or who are on the fence, it will only convince them that some doctors are not very nice people, are more than willing to be nasty with mothers who ask questions or ask to do things differently, and are likely to give them a repeat of what they’ve already experienced. Emotional trauma is not rational and it does not respond to rational arguments, like that home birth has 3 times the rate of infant mortality as hospital birth, and it most definitely does not respond to irrational and confrontational arguments where someone bitterly ensures them they are selfish, egotistical jerks without any redeeming qualities.
You aren’t going to win anyone over like this. It may make you feel better, but alienating the very people you are trying to reach by telling them how horrible they are is a wildly inappropriate and counterproductive to getting women to choose safe birthing situations.
Thanks for parachuting in from whatever homebirth site you came from. Speaking as someone who’s spent plenty of time in an ER, let me try to explain to you how things really work.
If you didn’t like your OB’s bedside manner, you could have changed doctors before the baby was born. OBs, based on my experience aren’t “Jekyl and Hyde” personalities. OBs are professionals. Sadly, it sounds like you were going in there like so many homebirth transfers that I’ve seen. OBs aren’t dismissive but might get snippy especially if the patient is arguing with them while trying to save the baby. I know, I’ve been standing there when it happened.
When my wife and I had our first, it was footling breech. Fortunately, our skilled OB was right there to save the child, and she was born healthy and happy. I’ve never been so terrified in my life. The only thing I remember focusing on was my wife asking me, in Chinese, what the doctor was doing. She was more terrified than I was. I just remember telling her “she’s a professional, let her work.”
Please elaborate a little as to what questions you were asking that were being met with rolling eyes. I’ve only seen that behavior when someone comes in with a crunchy birth plan and second-guesses everything the doctors are doing since they googled birth and read some websites.
I actually came here from another OB’s site where Dr. Amy commented, not from a homebirth site. I wasn’t a homebirth transfer. I saw an OB for all of my prenatal care, planned a hospital birth, and was induced at the hospital (post due at 41 weeks) on my OB’s recommendation. I am not a homebirth advocate and will deliver in a hospital again if I have more children.
I liked my OB’s bedside manner, but my hospital had a hospitalist set-up where the OB you get is the one who is on call. I didn’t get to choose the doctors who helped me, and because my induction lasted 40 hours, I had 5 different OBs, most of whom were very nice. Even if it had been a situation where I could have asked my OB to come in attend me, it’s unlikely she could have been there for the full 40 hours of my induction. I also had 5 L&D nurses, most of whom were very nice.
Most of my problem were with a night shift nurse on my second night of being induced. On my first night, when I’d started having painful contractions, the nurse had removed the cervidil right away and explained she was removing it because I was having painful contractions. So on the second night, when I started having not only very painful, but very long contractions–4 minutes long and coming right on top of each other–I asked the nurse if she could remove the cervidil. She said she couldn’t without talking to the doctor, and when I asked if she could ask the doctor, she said she wasn’t going to bother the doctor. I then asked if there was anything she could do for the pain, but she told me she couldn’t do anything, because I wasn’t in labor. My contractions weren’t productive, because I wasn’t dilating. (I hadn’t been checked for dilation in over 6 hours at that point, but I didn’t press the subject.) I then asked if anything else could be wrong, because it seemed weird to be in so much pain if I wasn’t actually in labor. She rolled her eyes at me, and said, “It’s just minor uterine irritation,” and left. And for the rest of the night, when she came into my room, she was rude to me. When I was in so much pain, I couldn’t answer her questions or move into the positions she was asking me to move into fast enough, she rolled her eyes and sighed at me. As it turns out, I was in labor. My water broke shortly after she went off duty. But the whole night, I was treated as if I were hallucinating the pain.
When the OB came in to check me that morning, she said everything looked great and I was on track to deliver that afternoon. She cleared me to request an epidural, and I received an epidural and slept for the first time in 2 days. I woke up to a nurse requesting that I move into another position because something was wrong with the baby’s heartbeat, which I complied with. A few seconds later, the OB came in screaming abuses at me and the nurse and shoving a consent form in my face. My previous exchange with her had been pleasant. I’d had no opportunity to say anything to her or question her. In fact, the only thing I said to her the whole time was, “Okay,” after I looked at the heartrate monitor and saw why she was screaming. I know it was a serious situation, but that is no reason to yell at someone or say the things she said to me. Even if I had in some way provoked it, which I had had no opportunity to, I don’t think you should yell at someone like that. It was awful.
I was not a crunchy mom. In fact, at the time I thought it was silly that women cared so much about how they gave birth. After what I experienced, though, I understand why some women decide after one hospital birth that they won’t deliver in a hospital again. Most doctors and nurses are wonderful…but some aren’t and some do not react well under pressure. There is no excuse for how I was treated, and I know some people who experienced much worse. I know nurses and doctors who have talked about nurses and doctors they work with who treat their patients in ways they personally are offended by.
I still believe that hospital birth is the safest choice, and I try to gently steer people into making that choice when it comes up. However, I try to approach the situation with compassion and understanding, because I know some people are choosing not to give birth in a hospital precisely because their experience was so sorely lacking in compassion and understanding. If your assessment of all homebirth advocates is that they’re a bunch of ego maniacs out to prove something, then you are missing a large and growing part of those drawn to homebirth and this confrontational, berating approach will have exactly the opposite effect you are hoping for. That’s not to say it won’t work on some, but for those who are choosing homebirth out of an irrational response to trauma, this isn’t helpful.
It’s very difficult to be an assertive patient (not aggressive) when you are in pain, not to mention advocating for yourself. Been there, done that. Hugs.
I can only imagine how much more terrifying an emergency is when there is a language barrier.
I’m looking at birth statistics in Canada (rough, rough numbers) – and it looks like the risk of having a stillbirth (never mind early neonatal death or those who transferred to hospital and had a subsequent still birth) – is nearly double with home birth (81/6247 = .01296) compared to hospital birth (2734/380454). So much for it being different here….source: http://www5.statcan.gc.ca/cansim/pick-choisir?lang=eng&p2=33&id=1024516
“So much for it being different here” How so? The link you provided does not prove your point. Out of hospital = car births, street births, nursing station births, unplanned homebirths, planned homebirths, etc. I would bet at least a dozen of the 81 OOH stillbirths occurred in nursing stations throughout northern Canada. A handful more were probably “in transit”. Many of these stillbirths could have been infants on the edge of viability.
Data comparing planned home versus planned hospital is much more useful to draw those types of conclusions.
The mothers I know who have had homebirths fell for the psychological manipulation of biologic essentialists.
This is bizarre (and disturbing):
http://www.bbc.co.uk/news/technology-23693460
Holy cow…I know this is weird to say, but I’m kind of glad the little girl was deaf and didn’t hear all those things.
my sister-in-law had a home birth, claiming she didn’t want to be in the hospital, and while we thought she was crazy for doing this with her first birth because she has no clue how she labors (and they live on the 4th floor of a walk-up), she definitely got all the requisite prenatal care from ob/gyns, had ultrasounds, and was not the slightest bit high-risk. her midwife (american CPM, sigh) did plenty of fetal monitoring, came with resuscitation equipment, and was ready to transfer at the first need. all went textbook, and my nephew was born in their apartment. where we live there is a strong financial disincentive to homebirth, and they lost money and had to clean up a messy apartment, but she got what she wanted. i don’t think she was egotistically motivated, but she definitely made me very excited to go back to the hospital for my next one.
In some countries where homebirth is more popular, your SIL would have been risked out for being a first time mother. Low risk is not zero risk and the risk is high consequence. Glad your nephew is okay.
As far as whether she was egotistically motivated, you stated “she didn’t want to be in the hospital.” Presumably she was informed of the risks and decided to mitigate them as best she could, but ultimately she went with the plan she wanted, not the plan that was the most safe.
i agree with all of you, and think they dodged a bullet, and they’re definitely getting ego mileage from their story, but let them figure that out.
But isn’t there ego involved in choosing something that is more expensive and less safe?
As a first time mother, it’s not true that she was ” was not the slightest bit high-risk”. First time mothers are at greater risk of needing to transfer. And transfers by necessity add an element of risk. The “fetal monitoring” and “resuscitation equipment” a homebirth midwife would have is not comparable to hospital equipment.
I’m very glad she had an uneventful delivery and a healthy outcome. She is one of the lucky ones.
Really? Where do you live? Must be far from civilization. Have you ever seen/compared the equipment? In the state of Massachusetts, you are incorrect regarding comparisons over home birth midwives VS hospital midwives equipment> Ever wonder why so many CNM’S have home births?
Really? The midwives carry a fully equipped operating room, blood for transfusions and a neonatologist with them?
I’d settle for the ability to start IV fluids, give meds and intubate a neonate.
That will buy some time to CALL FOR TRANSPORT, which is something that more than a few HB midwives appear reluctant to do promptly.
I think a key reason that you are missing is fear, as well as loss of autonomy. Women feel the moment they enter a hospital they will be strapped to a bed, pitted, and end up with either an episiotomy cut or a c/s cut for reasons that will have little to do with their safety or their baby’s. And the truth is, depending on who their doctor is they wouldn’t be entirely wrong. Until ob’s begin to address this and offer alternatives, I think the homebirth numbers will just keep going up. I am an OB who fully supports natural labor in the safety of the hospital. I would adamently try to discourage any patient seeking a home birth, but I really feel OB’s are the ones who created this mess and they need to open their minds a little to fix it or the crazies will win. Ob’s are the root cause, not women simply looking for something better who get caught up in a crazy movement. You can’t blame the cult members, you blame the cult leaders.
You just hit it on the head AutonomyOB!! There is a lot of room for improvement! let’s make hospitals more welcoming, let’s create Birthing centers within hospitals staffed with CNMs and a hall away from an OR just in case! The care AND the environement counts, It will get a lot of fence sitters on the safe side.
How many birth centers have you been to? Hospitals make the comfort of the birth centers priority. There are plenty of CNM practices who deliver at hospitals. The norm for birth centers is a cozy, family friendly setting with things like soaking tubs and fold out couches. So many have light dimmers, iPod players, TVs with Internet connection. The problem is not the hospital and a great deal of the time not the staff.
Unfortunately, while some cities in the US — like mine — have so many hospital beds that the hospitals need to offer nice amenities to attract normal patients but many, many others have hospitals with little competition and little incentive to make things more comfortable for their captive patients. What is true here isn’t true in the next state over.
You know, I have been on both sides of this. I think that we are so far removed from the ugly realities of birth that we focus on having “pretty”, “cozy”, “comfortable” rather than on what being able to have access to care really means. A hospital doesn’t have to have fold out couches and light dimmers to be safe. I have noticed more and more that patients are mistaking a hospital for a hotel and expecting to have a resort experience as they stay there.
That’s so true. When I was reading reviews and trying to decide on a hospital most of the reviews said something like “the birth suites were really too small”, “they only had one labor tub for the whole floor”, “the food was terrible”. Very few said anything about the actual medical care. You could easily have taken many of the reviews and posted them on trip advisor where they would be mistaken for hotel reviews.
Uh that is how a lot of hospitals are. The maternity area is off away from the other more icky parts of the hospital. The rooms are nice and have all kinds of bells and whistles. The hospitals want the maternity care to be top notch because that is the first time many people encounter a hospital and they want patients to come back for all their healthcare needs.
Actually, I think the opposite is true. NCB advocates promote fear.
“Natural childbirth originated with the publication of Grantly Dick-Read’s book, Childbirth Without Fear, but in the intervening years, NCB advocates have made fear the centerpiece of their philosophy. Not fear of childbirth, despite the fact that is is inherently dangerous for babies and mothers. And not fear of pain; evidently only losers, the weak and the unempowered, fear pain. No, the centerpiece of natural childbirth philosophy, and its chosen and most potent marketing tool, is fear of doctors.”
http://www.skepticalob.com/2010/11/childbirth-with-fear.html
I 100% agree. But nonetheless these women are afraid and so they do insane things like VBAC twins in their bathtub. Until OB’s as a group address these women’s fears, the NCB advocates win because they are addressing the fear and providing “solutions.”
I absolutely agree with you, AutonomyOB – but one of the chronic problems faced in many areas is provider shortage. I’m an OB in a single payer system (Canada), do about 250 deliveries per year (myself), have a full Gyn consultation practice with a wait list (well) over a year long for non-urgent conditions. At what point has health care transitioned from managing disease into holding hands and coddling? I would love to spend buckets of time discussing the nuances of every woman’s birth plan and and providing the care that women want – but there is only so much of me to go around if we want to keep health care costs manageable AND see the truly sick or suffering patients in a timely fashion.
I totally agree that NCB movement promotes fear, but I also agree with AutonomyOB. Many OBs are not giving women enough information, and they are not checking their mental health and well being, which is very important. So if a woman is scared or anxious they are not doing anything to make her less scared and anxious. I am sure there are OBs that do that, but not in my experience. I understand that current insurance system just doesn’t allow them time for patient “coddling.” Scared and anxious women are really good targets for NCB crowd. My doctor was great, he saved my son’s life by performing a C section, but he didn’t seem particularly compassionate during my pregnancy. I was very anxious during my pregnancy, and I told several docs in my practice. They kind of shrugged it off. I remember one specific moment very well, and it is a good illustration of how important it is to view patients as grown ups. I changed practices when i was 6 months pregnant. My new doctor checked my chart and noticed that some genetic tests were missing. He explained that the hospital he was affiliated with found 2 new genes that caused birth defects, and this test was too new to be a part of the standard Ashkenazi Jewish ancestry screening. I got anxious immediately and started asking about these birth defects, and he said that we should just wait for the results. I ended up asking a nurse for the names of these conditions and looking them up online. Both of them were fatal and horrible, but, thankfully, very rare. I had to wait for my results for 3 weeks, those 3 weeks were terribly stressful. The information I found comforted me, but I really wish it came from my doctor.
I am glad I found this blog which helped me with my anxiety and allowed me to trust my doctor. He is very knowledgeable, but, unfortunately, is not keen on sharing this knowledge with me…
By the way, people should know that you are not an OB, but a NCB advocate.
No, I am certainly an OB and I practice and was trained at a hospital where the “scare stories” actually do happen. Again, very provider dependent but to claim there is no truth in NCB claims is to stick your head in the sand. Above all, I believe grown women should be able to have their babies however they want as long as it’s safe. I will do a primary elective C/S just as happily as support a woman in her natural birth. There is a difference between being a NCB advocate and simply supporting women’s health care decisions.
I apologize. I followed your internet trail further and found that you are an OB.
“You can’t blame the cult members, you blame the cult leaders.”
The cult leaders are the homebirth midwives who profit off all this. Ina May Gaskin is their Supreme Cult Leader. Sorry, but…duh. And they’re followed by everyone else who profits in one way or another off of keeping women and babies out of hospitals.
OB’s? Nah.
You misinterpreted my post. I was referring to the home birth midwives as the cult leaders. Dr. Amy was directing her post at the women themselves. I was pointing at that I feel they are the least to blame.
Ironically, the closest “baby friendly” hospital to where I live has a nearly 50% c-section rate. Huh. And they expect all those mothers to room in regardless of their surgery recovery. I am kind of confused by fear of episiotomy. I’m probably weird since I’d prefer a c-section over that, but the rate is something like 10% have an episiotomy in most of the hospitals in my state which doesn’t indicate pressure to have one, to me…
It’s reasonable to not want pain and stitches in your genitals. If men gave birth, all births would be c-sections. No man would risk his future sexual pleasure, why should women? Elective c-sections should be a choice for all women.
My hospital has a C/S rate hovering around 40 percent. If we recalculate the rate to only include moms with cephalic presentation, singleton pregnancies, and no prior C section or high risk our rate is is about 25-29 percent. Then our numbers compete with everyone else in our region. It does Tick me off when there is no extra help for the c/S moms, we discharge them all at 48 hours or less , and expect them to get up and come to our outpatient clinic less than 24 hours later. I would love to have a few techs available to bring moms the baby and help them with care if needed but nope, they only had a baby what’s the big deal about that?
I recently read an article which stated that a state wide
survey of patient care indicated that 90% of patients were highly satisfied with the communication they had with their medical providers. Not just OK with but, highly satisfied (ranking 9 or 10 on a scale of 10). Yes, this is just one state and not OB specific but, I was floored by these numbers given all the negative press you hear about doctors that dismiss patient concerns and have terrible bedside manner. The negative stories of bad doctors are what show up most in the news and in online forums. In any business, those customers who are dissatisfied are the ones more likely to give feedback. Even speaking for myself, I would be lying if I said I didn’t go into a new doctor’s office expecting them to be cold and condescending. Yes, I’ve actually run into this a few times but, looking over the course of my medical history it’s really been a very few. Yet, I’ve somehow come to expect it EVERY time because the negative experiences are what stick out most in my mind (I apologize to all you good Docs out there).
So, is the problem really that we have a lot of bad doctors or is the
problem that we have a few bad doctors and that their impact is magnified by the media and NCB proponents focusing on them and reinforcing negative stereotypes. I’m not saying we should
dismiss patient concerns because dissatisfied patients are in the minority. However, I think that in many cases these concerns
can be dealt with on a case by case basis and don’t necessarily require sweeping policy changes (the exception would be where safety is an issue) which may come at the expense of other women.
For every patient that had a negative experience because she
was “forced” to have an epidural there is a patient who had a negative experience because her epidural was denied or delayed. For every woman who is unhappy with her unnecessarian there is a woman or baby who was harmed because a C-section wasn’t performed soon enough. So, how do we decide which group of women most deserves to have their collective concerns addressed? Hospitals should focus on quality medical care first and customer service complaints second. I’m all for providing a better patient experience but, allowing ideological creep from NCB ideologues in the name of providing a better experience—I’m not so comfortable with that.
Please share with us when an OB performs a ceserian or an episiotomy when there isn’t a reason. We would all like to see evidence of this.
A bit late but just because i have to reply, many, many physicians that I work with perform routine episiotomy (30% was the last rate quoted I my state) and there is good evidence that goes against this practice…. so yes I would consider that unnecessary. I gave also observed a number of physicians at my institution that will do a c/s by 12 noon if the cervical ripening of their patient who’s induction started at 12MN was not successful. I would consider that unnecessary.
And you wondered why you were put on the Sanctimommy page? I would never choose a HB for myself but i think implying someone’s birthing choice is because they are selfish or for bragging rights is wrong. I would be upset if someone said the same about my caesarean. Poorly done Dr Amy. Attacking women like this does nothing to improve safety in homebirth. I suspect women considering a homebirth won’t read what you have written due to the snark and sanctimony.
Why is it wrong if it’s true?
It is not true though. I don’t think women choose a hb to brag anymore than someone chooses an expensive hospital and ob to brag. Certainly none of the women i know who had homebirths through our tertiary hospital bragged about it. In regards to selfishness, i think given birth involves a mother and baby dyad, it is inevitable that a mother *may* at times do something for her own benefit that has some risk to the baby. She may have caffeine, wine, deli meat, etc because it suits her. She may choose cvs to check for abnomalities. She may choose a social induction so her partner can be at the birth. She may choose pain relief so she is comfortable. All of these have varying risk to bub but benefits to mum. As does homebirth. It is ok to be a little bit selfish if the risks are understood and mitigation is in place. I guess different people have different acceptable levels of risk and benefit. I don’t think calling someone selfish because they have a different level to youis ok.
Are you from Australia? I noticed you said “bub”. A home birth in the UK or Australia (with a few notable exceptions) is usually available only to women who have been approved for it by their well trained midwives, and there is a strict risking out process. So women there can’t brag that despite being pregnant with twins, they are attempting a hba3c at 43 weeks.
I gave birth in the US. Attempted a homebirth, ended up at a hospital. Very strict criteria with our homebirth midwives too. No GD (and you had to be tested), no high blood pressure or pre-E, no premies, no post-dates (after 41 weeks, required testing to see if you needed to be induced ASAP, after you hit 42 weeks, mandatory induction no matter what), no pre-existing medical conditions for mom, no anticipation of problems for baby, no HIV+ or Heb B+ moms. Certainly NO previous c-sections. And super conservative about hospital transfer… 25% of first-time moms got transferred. And 6% of women who did give birth at home transferred to the hospital for PPH, because if they had to give you a pit shot at home, it was a mandatory 911 call and post-partum hospital transfer.
That is the level of care every midwife should be giving-but sadly is not the norm. I suspect if more midwives who attended home births were strict about protocols, Dr Amy would have less to write about.
Yes, *less* to write about, but far from nothing. Homebirth is still less safe than hospital birth, it is just that the gap would be less if protocols were stricter.
What I disagree with our clinic about in retrospect is that: a) I think induction at 41 weeks should be mandatory no matter what; and b) if homebirth is going to be a reality, it should only be after you have established that you have a proven uterus, pelvis, etc…and if you had an absolutely “natural” birth in the hospital with ZERO interventions and complications. First babies should be born in hospitals, period.
I know that our clinic did treat GBS patients, but that’s because they were allowed to give the antibiotics at home.
I also wish that, if homebirth were to continue to be legal, CPMs would be alllowed to carry cytotec for PPH, not just a pit shot. I was getting a pit drip in the hospital, they cranked it for the PPH and I *still* needed the cytotec. With just a pit shot, I likely would’ve bled to death in the 10 minutes it would’ve taken to get to the ER.
But again, I still think that even with the best of protocols, homebirth risks the lives of babies and moms that would’ve survived in the hospital. It just risks a whole lot fewer of them.
I agree with all, especially about the first baby being born in the hospital! I have wondered about that in UK, why primips can choose a home birth. I know it’s a totally different system, but still it’s uncharted territory in so many ways.
Yes, i am Australian. Hospital run HB has very rigorous selection and transfer criteria. There is also the option to hb through an independent Midwife. Still same training as the hospital hb midwives but less strict criteria (allow women to refuse scans and gd test). In some hospitals IM’s have the option of admitting a patient so there can be continuity of care in a hospital setting.
I had a friend who had wanted to do a home birth with some midwives in Penrith because they offer water birth at home. She ended up not being able to do that, but her same midwives attended her in hospital.
Addi,
I have to disagree. If you look, for example, on YouTube, you will see endless videos of naked women delivering at home, some who live stream, etc. In my searches I see way more women bragging online about home birth than you ever see about hospital birth, epidurals, c sections, etc. I’ve never understood women who put their home birth on the Internet for everyone to see and then claim that being home in calm surroundings is what it is all about. There most certainly is lots of evidence of home birth bragging rights, and it isn’t just the woo crunchy set.
Another point, which you may not have considered is that pain relief is also a benefit to baby in that a mother who is traumatized by the pain of childbirth may have post partum issues that will affect baby. I know I would have, were it not for my epidural.
Deli meat and caffeine are not fair comparisons to the risks of home birth. It makes your argument sound ridiculous. Dr. Amy is clearly referring to the women who go online and brag about their home birth and put all of the details out there in the public domain. Then, they seem genuinely surprised that someone dare comment on their choices. It baffles me. Given the subset of women she is referring to, I think her post is bang on.
I have to say that Addi has a point here. I attempted a homebirth. Posted about it here many times under the name SkepticalGuest but then a technical snafu has me posting another a different name.
Anyone, I attempted a homebirth because: a) I believed it was at least as safe as a hospital birth…I believed not the online wing-nuts, who I knew nothing about, but those misleading Dutch studies that have since been debunked; b) I thought I’d be less at risk of a c-section at home (wrong, but again, misled by the Dutch data) and I was terrified of surgery for reasons that are complicated to explain but having nothing to do with NCB woo; and c) I was having mild panic attacks in hospitals after witnessing, as a child, both of my parents almost dying in hospitals (yes, I know that correlation is not causation, but the young brain I had when I experienced all this didn’t grasp that and some deep-seated reactions were formed).
Fortunately, we transferred to the hospital, and my son was born, safely, there. I would never, ever attempt a homebirth again. I advise anyone who is interested against it. And I don’t need my flawed reasoning for choosing a homebirth picked apart. I get it.
BUT…none of the reasons you mentioned were even remotely true for me.
#1: Bragging rights. Huh? Who would I brag to? Who would care?
#2: To proclaim I was educated. Why would I need to have a homebirth for that? I’m a highly educated professional, thank you very much, and if I ever feel the need to proclaim anything about my education, I have a real one to tout.
#3. Ignorant of history. Yes, I knew women and children died in childbirth in the past. I figured (wrongly, I now know) that that was the whole point of risking women out of homebirth and into a hospital. The HB group we went with was super conservative about who they would deliver. In fact, the only risk they didn’t include was “first-time birth” (i.e. non-proven uterus, pelvis, etc.)
#4. Gullible. OK, perhaps…but what I fell for was published studies about the Dutch. I think “misled” is a better term, because gullible really only applies, I think, if you are following the NCB nuts. This seemed like serious research.
#5. Selfish. But if you started down this path believing the Dutch studies, you didn’t think you were doing anything that was risky for your baby. So how could it be selfish? Again, very different from those who KNOW the risks and DO IT ANYWAY. Like those women who have a dead homebirth baby on their hands and then plan the next one at home.
Dr. Amy, I wanted to follow up. What’s wrong with a blanket statement about *why* women choose homebirth is that the ones who really are as you describe are unreachable. Those whose reasons are different are reachable, but not if you assume they had twisted, messed-up reasons for choosing what they did.
I have generally found you much more persuasive when you address the reasons why otherwise sane women, who haven’t drunk the NCB kool-aid, are mistaken in chosing homebirth.
Just an idea about how to continue to reach the persuadable.
That is what i wanted to say.
I am referring to the women who write long internet screeds about why they are choosing homebirth,
Ha. That’s about the last thing that would’ve occurred to me to do while I was busy trying not to puke, sleeping upmteen hours a day, and getting ready to become a family of three!
What I really wanted to say that it’s really important to recognize the non-crazy population of those who are planning a homebirth. We’re reachable, persuadable if you explain the evidence, and couldn’t care less about the crazy woo BS. If I’m ever lucky enough to have a # 2, I would go directly to an OB in a heartbeat, and I thank you for that!
Not entirely fair to say you can’t do research online – google scholar is a pretty amazing tool.
Only if you actually read the papers.
And understand them!
And I’ll go so far as to say, actually contribute to the body of knowledge with your own research…
A lot of the research papers on google scholar are either not available for free, or are published without permission and thus violating copyright. Google scholar is better than google but it isn’t all it’s cracked up to be. Your best bet when looking for papers is to head to your local library. Visit your local librarian while your there. S/he gets lonely sometimes.
OT: I love our local library and the librarians and pages who work there. They have been incredibly helpful to our family-and considering we live within walking distance and visit a couple times a week that is saying a lot.
Some libraries have databases you can access at the library or remotely that include research papers. Worth a try.
Correct and they might be able to get them through inter-library loan. Especially if they are a main branch library. Also, many hospitals have a medical library inside them and they might let the general public use them (it depends on the hospital). Again, talk with the librarian before starting your research s/he could tell you the best place to start. Some college libraries also let the public come in and use their facilities. Our library let’s the public in but reserves the computers/databases for student access but you could still make copies of our print journals or microfilm/fiche.
It also depends what you mean by “research.” Isn’t what you’re describing really a review of research others have done?
I actually think that those who publicly state their reasons are doing policy makers and the such a great service – it makes it really easy to address those reasons – whereas if they were quiet about their motivations there would be little that could be done to try to sway those considering home birth. Further, I think it is a remarkable opportunity to debunk the myths that might be motivating the choice…
Dr. Tuteur, I really must object to pretty much nothing in your article, except the crunchy part. I must say I get pretty angry at homebirthers who think they are crunchy. (and also who think they are feminist.)
I am a crunchy environmentalist. I admire the Lorax, Rachel Carson and the Intergovernmental Panel on Climate Change, vaccination, pasteurization and filtration of “natural” drinking water… among other promoters and great advancements in human health. Homebirth has nothing to do with being crunchy. So speaking as one crunchy believer in modern medicine, I’d like to ask homebirthers to save their annoying proclaimations for other arrogant fools and to stop giving crunchy people a black eye.
Youtube is well populated with footage of “crunchy” homebirthers laboring in their air conditioned bedrooms.
Or jacuzzi tubs.
I prefer people chewy. It gives my mouth a workout.
I can’t help but wonder if the sheer number of blogs justifying it is really the women trying to justify it to *themselves*. You can’t walk by an old graveyard without seeing at least one if not more graves of young women next to their baby/babies. It’s common knowledge that somewhere, deep down, I wonder if they’re really just forcing themselves into denial, and passing it off as “I’m better because of this” due to pressure from what I’ve started calling “the cult of the natural”.
I know it’s cruel to think this but when I see blog posts proclaiming their AWESUM homebirth plans I think “job security”.
Herbs and oils cure all!
You forgot the new age beliefs!
http://losangeles.cbslocal.com/2013/08/13/newly-passed-california-newborn-screening-law-likely-saves-childs-life/
But interventions are bad, you know.
To play devil’s advocate for a moment, homebirth midwives in NH are doing pulse ox screening now on all their newborns now. They actually have a lot of sensible laws in NH regarding conditions that rule out midwife delivery altogether, and conditions that require supervision of the pregnancy by an OB who makes the final determination of whether or not the mother can proceed with a homebirth or not. I know we hear a lot here on Dr Amy’s site about the clowns in a lot of places in the US where it seems laws re: Midwifery are wild wild west style, but there are places where it’s been setup sensibly and there are practitioners who are as responsible as possible.
We were originally seeking a freestanding birth center experience, and were passed on to obstetric care in a hospital due to my wife going postdates and the BPP ultrasound showing that our daughter was possibly asymmetric IUGR. (In hindsight, she still has a comically oversized head for her height and weight, but her neurologist feels thats familial as everyone in my family has giant heads)
We’re glad for that decision though, because she ended up with critically low blood sugar right away, and then all the ridiculousness that ended up happening after that. I still feel lucky that everything worked out the way it did, even if it was a rollercoaster. I can’t imagine if we had been home when she had her tachypnic episode, because it only lasted a few hours, and if we had slept through it our lives might have been a lot different today.
It’s true that there are a lot of laws about the kind of patients a homebirth midwife can attend. In WA state, CPMs and home birth are covered by Provider One which is the pregnancy Medicaid insurance. The law is specific about who would be considered low risk, when an OB should be consulted and that care has to be turned over to at 42 weeks to an OB even in a woman who hasn’t had as much as heartburn her entire pregnancy. But a lot of the conditions that would risk women out of the care of CPMs and homebirth are found by testing and routine prenatal care. What I have found with homebirth midwives is that they explain each test and always follow that explanation with “testing is your choice, if we find that you have this condition, your care may have to be turned over to an OB or it might be prudent to consult with one”. Often the mothers opt NOT to do the testing, because they want “their home birth” or “their birth center birth”. So when something DOES happen, the attitude is that nobody could have seen it coming. The midwives don’t do things like cervical checks before the woman is in labor, they don’t do NSTs and things like weighing in and UAs are done by the women. There is a lot that can be missed with that kind of prenatal care.
BTW, Sister in Chains founder Katie McCall is now living in New Hampshire. http://www.sacredpregnancy.com/instructors/katie-mccall/
https://www.facebook.com/SacredPregnancyNH
http://www.nhmidwives.org/midwife/Katharine.htm (never mind that she can NEVER practice in CA again, nice touch leaving out her conviction for practicing midwifery without a license)
I fear for every woman in NH now.
The way the law reads in NH, they are required to get most testing done or they can’t attend the birth. (GBS, Blood sugar, RH, etc) – I can’t speak for everyone obviously, but the center we were going to was not discouraging in the least about proper prenatal care and testing. Even u/s was strongly suggested, if not outright required by law (and we had been getting all the regular recommended U/S anyway. The postdates BPP one was required by law)
There may very well be looney tunes who buck the law wrt -required- tests , but if there is laws in place, there should be repercussions if they do and something goes wrong I think.
I just know that the practice we were seeing definitely was responsible regarding all the laws listed, and appropriately risked us out when a problem was noted.
You can read the full list here:
http://www.gencourt.state.nh.us/rules/state_agencies/mid500.html
Obviously, I am no medical professional – so my reading of the requirements is 100% layperson. It seems to cover most of the egregious shenanigans we read about here constantly (to my eyes) but I welcome someone more well versed in the topic to share their opinion.
My crunchy friend had her first at home without troubles- with her second, her iron levels were low enough that she almost risked out of HB, The midwife checked at every appointment. In the end, when her water broke before 36 weeks, my friend asked the midwife to come over and deliver, and the midwife told her to get her butt to the hospital. The midwife was present at the hospital for the delivery, but the hospital’s team handled it all. I don’t know for certain what other testing my friend received prenatally (I know she didn’t get ultrasounds, but I’m unsure about GBS, RH or the like)- but it does sound like her midwife, at least, isn’t a total whackadoodle.
Ours were definitely not whackadoodles like a lot of the stories you see here about using pitocin at home, vbac twins and stuff like that. Two of their students attended at the hospital as doulas (and thank god for that, because I was not in any way shape or form prepared for seeing my wife in that much pain. I thought I’d be cool as a cucumber and I was useless.) , and the OB had them catch & stitch up the small tear with her supervision.
I wonder if your crunchy friend had low iron levels due to a macrobiotic diet (the ultimate vegan diet).
I reread these laws and there is no mention of non nurse midwives or CPMs. These laws mention CNMs only.
It’s just the definitions section defining CNM for the law. The laws are for NHCM (new hampshire certified midwife, the new hampshire CPM cert) and CNMs – this section is just the scope of practice rules, you would have to back up in the law to get to the certification definitions and criteria.
http://www.gencourt.state.nh.us/rules/state_agencies/mid300.html There’s the certification rules.
BTW – that is awful that someone who has been convicted of criminally practicing without a license in another state managed to get admitted to practice. Huge shame – the laws definitely need to be tighter in a lot of ways, especially nationwide rather than state by state. I’m totally in agreement there – I just wanted to share our experience, and I am genuinely curious regarding the laws that do exist in NH now.
http://www.sistersinchains.org/our-sisters-in-chains.html
The list of sisters in chains (aka bad midwives) . I agree the laws need to be more uniform. The problem is home birth midwives are regulated in some states, not recognized in others and there is a real problem getting them prosecuted in any state. Even harder to get them to stop practicing. Although if the laws are as strictly followed as you posted, maybe Katie McCall will be reported before too long.
We can only hope. That really is shameful – and it’s grossly negligent for that website to present practicing without a license like its NBD. Good god.
This is why I feel professional midwifery needs to be regulated on a Federal level, so women claiming to be midwives cannot simply move from a strict state to a lenient one, or practice in a strictly regulated state by claiming licensure in one that is not.
Are you a fellow Granite Stater, Tim?
MA, but we had chosen a birth center in southern NH, and ended up delivering at a hospital in southern NH
Ah. Well, sorry if I’ve ever flipped you off while driving 🙂
It’s ok. Likewise I forgive you for all the years I had to wait like an idiot at the hampton tolls on my way to maine before the smartest person alive decided to put that high speed ezpass lane in.
LOL- I live a good deal north of Hampton, thankfully, so I’ve rarely had to deal with that mess. The Dover tolls on Friday afternoons in the summer were bad enough! That’s why all of us in NH are so damned pleasant all the time… “Welcome to New Hampshire- now go home!”
Were your midwives Certified Nurse Midwives or CPM/LM midwives? I forgot to ask. Because I can totally see a CNM referring care out and insisting on testing.
The makeup of the practice/birth center is a mix of both NHCM (new hampshire version of CPM) and CNM.
Additionally, the practice is heavily involved in the states midwifery council. If you are helping to craft the rules that will give your profession a good image in your community, I think it’s in your best interest to make sure you follow them yourself.
Like I said, I know there are a lot of complete and utter whackjobs out there, doing outlandish things that are horrifically unsafe and lead to deaths that not only could have been prevented, but could have been seen coming a mile off. I just wanted to point out that there IS responsible women out there too.
It is a shame that there is no organized effort to shame and force these women who are so cavalier about their patients lives out of practice, and indeed that there seems to instead be efforts by some to help defend their irresponsible actions. The safe and responsible providers who know their limits and respect them need to stand up and take their image back.
I think that the profession as a whole would be better served to be able to honestly say they had (these are obviously made up numbers)
“10,000 Safe and Responsible Providers Nationwide” rather than to be able to just say “60,000 Providers Nationwide”
it is so true lol!
I need that bib!
Exactly! I was running to get my embroidery basket as soon as I saw it
.