What’s the difference between homebirth and leaving your newborn home alone?

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How would you feel if you heard that a woman left her newborn home alone for several hours to get together with friends?

Shocked? Horrified? Worried for the safety of the baby? Bewildered at the terrible risk the mother is running merely for a few hours of enjoyment? Stunned that anyone could risk the life of their precious baby for an experience?

Why are most people horrified? Because it strikes them as gambling of the most indefensible sort: gambling that the baby will not encounter a life threatening event, like a fire, or choking, or someone invading the house and kidnapping the baby, while you are enjoying yourself.

But let’s be realistic here. What are the chances that your baby will die if you leave him or her for a few hours of adult entertainment? The chances are vanishingly small. How often does the house burn down? How often does a newborn choke in the middle of a nap? How often does someone invade a home to kidnap a child? Not very often at all, yet we still consider it incomprehensibly selfish to abandon a baby just to get out for a little while.

What’s the difference between leaving a newborn home alone for a few hours and choosing homebirth?

Leaving a newborn alone for a few hours is MUCH safer than homebirth. After all, the chance of a life threatening event occurring to a newborn in an average day is tiny. In contrast, the odds of a life threatening event occurring to a newborn during childbirth is orders of magnitude higher. A woman who chooses homebirth is basically gambling that such a life threatening event will not happen to her baby, because if it does, she’s deliberately left the baby alone without the people and equipment who could save him or her. From the medical point of view, the baby is home alone.

This is not merely a theoretical argument. In the past week alone, 3 infants sustained fatal injuries at homebirths (2 I have written about, 1 that I have not yet written about). Those babies would almost certainly be alive if their mothers hadn’t gambled their lives at homebirth.

Yes, gambled is the appropriate word. Their mothers gambled that a life threatening emergency wouldn’t happen during childbirth and they were wrong. They took a chance and their babies died as a result.

So much of homebirth advocacy is devoted to convincing women that the gamble is smaller than it really is:

“Women were designed to give birth.” But that doesn’t decrease the chances that the baby will die in the process.

Birth affirmations are quoted to convince women that they can decrease the risks if they just pretend hard enough.

“The hospital is only 10 minutes away.” Maybe, but then maybe the bar down the street is 10 minutes away, but if you are there partying while your baby is home alone, your baby will still die if he or she experiences a threat to its life while you are away.

Women who choose homebirth are gambling that their babies won’t experience life threatening emergencies during childbirth. Since there is no evidence that the rate of life threatening emergencies is any lower at home than the hospital, they are simply gambling that those life threatening emergencies will occur to someone else’s babies, not theirs. If they win the gamble, it’s awesome. If they lose the gamble, the baby is dead, and they are left with crushing guilt and grief for the rest of their lives.

The bottom line is that if you wouldn’t gamble your baby’s life by leaving him or her alone for a few hours to enjoy yourself, why would you gamble your baby’s life by abandoning him or her to a undereducated, undertrained lay person masquerading as a homebirth “midwife,” and trusting that nothing bad will happen?

The only substantive difference between the two situations is that leaving your newborn home for a few hours so you can go out and party is SAFER than choosing homebirth.

  • http://www.pediatricinsider.com/ Roy Benaroch MD

    Leaving your newborn alone would also be an apt comparison with birthing your baby underwater. It just shouldn’t be done.

    http://pediatricinsider.wordpress.com/2014/04/21/human-babies-should-not-be-born-underwater/

    • Young CC Prof

      Nice post! Thanks for sharing.

  • AnnaC

    More than twenty years ago I lived in a street of terraced houses. I came home one day to find fire engines in the street, fire fighters working on a blazing house and neighbours comforting a distraught woman. She had nipped out to the corner shop (a few yards from her front door) leaving her sleeping baby in its cot and some laundry drying in front of a gas fire. Whilst she was out, the laundry fell into the fire setting the house ablaze. The baby did not survive. Maybe she was out for longer than expected (perhaps chatting with someone in the shop) but, even so, it was a freak accident. I imagine that, even now, not a day goes by when that poor mother does not wish she had taken the baby with her. The house would still have caught fire but the baby would have lived.

    To follow Dr Amy’s argument… giving birth in hospital is like taking the baby to the shop. The freak occurence might still happen but the consequences would be different.

  • CanDoc

    Yes. Yes. Yes.

  • The Computer Ate My Nym

    The thing is, there is no major industry dedicated to convincing mothers that they should leave their babies at home unattended, that it’s healthier and more natural to leave their babies unattended, that only loser mothers who can’t take it hang out with their babies all day.

  • http://whatifsandfears.blogspot.com/2012/12/the-business-of-being-misled.html Doula Dani

    Mothers *are* gambling when they choose home birth. It is a shame so many don’t know it. They see the hospital as the bigger gamble.

    • http://www.antigonos.blogspot.com/ Antigonos CNM

      I’m not sure they see hospitals as a “bigger gamble”. I think they see both home and hospital as not being gambles at all, but home is “nicer”.

      • http://whatifsandfears.blogspot.com/2012/12/the-business-of-being-misled.html Doula Dani

        For myself, I was very scared of the hospital. I was convinced hospital would mean a fight and unnecessary interventions. Unnecessary interventions were the real danger and were hurting too many babies. Etc etc. If I shared my thoughts with you all back then, you’d all be saying “bingo!” like crazy. ;)

      • Stacy21629

        They see hospitals as the bigger gamble where things like episiotomies, epidurals and C-sections are concerned. For many of them (I know this was true when I was a woo-er) the possible death of myself or my baby never crosses their mind. Or at least, that happens to *other* women.

  • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

    http://exhomebirthers.wordpress.com/2014/04/21/dr-amy-tuteur-hypocrite-and-rape-apologist/ hard for a rape apologist to take the moral highground, but whatever.

  • Carolina

    OT: http://www.mommyish.com/2014/04/21/midwife-or-obgyn/
    She sounds like a typical HB loon, but I appreciate how the majority of the commenters are calling BS.

    • PrimaryCareDoc

      Well, her midwife “knows the route to the hospital if need be.”

      Great. So now my Garmin is also qualified to be a home birth midwife.

      • Young CC Prof

        Another way in which a taxi driver is just as good as a midwife. Oh, and my taxi driver only charged $15 or $20!

      • Carolina

        Literal out loud laughter at that one.

    • T.

      They are ripping her apart in the comment. Good.
      And they seem to know the difference between a CPM an a CNM! Good :D

    • Jessica S.

      “When my first child was born she was immediately taken away to be poked and prodded instead of being held by her mother.” Oh noes!!! The horror!! Won’t somebody think of the children?? (Oh, wait. That’s what the poking and prodding is for!)

  • tumbling

    OT, but an interesting historic note: at one point in US history (early colonial period), it actually was normal to leave small children alone. Years ago I read a diary extract of the governor of one of the early colonies (way back in the 1600s), who went out with his wife to visit friends. They left the 5-year-old in charge of the infant, who had just learned to crawl–into the fireplace. The poor little lad lived for several days before dying of his burns. The consensus at the time was that this was a sad, but practically speaking unavoidable accident; parents couldn’t possibly be expected to spend all of their time looking after children, and there weren’t servants (yet) in that colony.

    • Trixie

      Or later, they’d dose the babies with laudanum and leave while they went to their factory jobs.

      • http://www.antigonos.blogspot.com/ Antigonos CNM

        Or gin.

      • KarenJJ

        And their ankles tied to the bed so they couldn’t get out if they woke.

        • anion

          My mom and I have a BH&G cookbook from 1925, and in the back it has lots of Helpful Home Tips, including using large safety pins to pin the baby into the bed so it doesn’t kick off the covers, and cleaning stains in those sheets with kerosene. Because that is in no way a fire hazard.

          • AmyP

            So THAT’S what the big pins are for!

    • anon

      A German friend of mine said when her kids were babies (1970s) she used to leave them at home napping while she ran to the store or up the street to visit with friends. Her daughter now has small children and my friend commented to me how difficult it is to be a mother these days because the baby can’t be left at home alone but has to go with mom everywhere!

      • http://kumquatwriter.wordpress.com/ Kq

        From what I understand it’s pretty common in the UK to leave babies in strollers unattended outside cafés and shops.

        • Dr Kitty

          My husband’s sister is 11 year older than him.
          She and her friend went to get sweets from the sweet shop, and left him in his pram outside (because small shop, narrow door, no room).
          But because they were 11, and not used to looking after a newborn, they forgot about him entirely, until they got back home and my MIL asked where the baby was…

          My mother used to leave our pram outside shops…with a Pyrenean Mountain Dog tied to the handle.

          Different times…

          • Bomb

            When I was a kid I started babysitting toddlers when I was 8 (1991) and was left unsupervised in my own home at 5. Most of my friends were left alone at 6 or 7. Now in 2014 I regularly babysit 12 and 13 year olds that are “too young” to be left unsupervised.

            I officially have absolutely no idea what age leaving kids alone isn’t child neglect now.

          • Bomb

            Note: the toddlers I was watching weren’t even my siblings. They were neighbor kids!

          • Amazed

            Why, the Intruder still introduces a friend of mine (and one time neighbour of ours) as the one “who spanked me almost as much as my sis did!”. The three of us were left alone for hours – parents were working and nannies were virtually non-existent in our world.

          • Dr Kitty

            The UK doesn’t actually have a law which specifies age, but leaving children alone “likely to cause injury or unnecessary harm to health” is illegal.

            Guidelines say sixteen is usually old enough to be left alone overnight, and under 12s shouldn’t be left alone for prolonged periods, and babies and toddlers should never be left alone.

            Most people in the UK wouldn’t consider “alone” to include asleep in a car on a garage forecourt while you pay for petrol, for example.

            https://www.gov.uk/law-on-leaving-your-child-home-alone

          • Amazed

            “Most people in the UK wouldn’t consider “alone” to include asleep in a car on a garage forecourt while you pay for petrol, for example.”

            In my experience, they’d better consider it! I was left alone for a few hours since I was 5. When I was 10, they started to leave me alone with the Intruder who was 6 then. For hours. Tens of times. The closest we came to an accident was when my mother’s favourite crystal glasses went down in history.

            Now, about this time we were left alone in the car for 3 minutes? It was three, literally, only until mom and dad said goodbye to the friends we were visiting. That was all the time the Intruder (then 5, I think) needed to lift the hand brake and down the street we went. Fortunately, it was only a few meters or so but scared the shit out of my mom.

            You never know where trouble will come from.

          • Mishimoo

            I raised my siblings from when I was about 7 or so (when I started being homeschooled) and I remember being blamed for not paying enough attention to my brother when he went from fine to having a swollen neck (mumps) when I was 5-6. I was once left with two toddlers at night during a storm, and was yelled at for taping the window that had cracked when hail hit it and wasting the batteries by using a torch after the power went out. When we moved and both parents ended up working, I often ended up with several extra kids at our house because my mother had volunteered me to babysit.

            I couldn’t imagine leaving my eldest daughter in charge of her siblings. She’s 7 and she should be playing, not worrying. She does keep asking when she’ll be old enough to babysit and our preference is 14 or so.

          • http://kumquatwriter.wordpress.com/ Kq

            Yeah, 8 year olds are better suited to being “little doulas” dontchaknow /sarcasm

          • Mishimoo

            Exactly! Those tiny hands are just right for applying the perfect amount of counterpressure and they’re small enough to not crowd Teh Birthing Goddess in her sacred pool. /sarcasm

          • Siri

            I’m sorry you were treated that way, Mishimoo. :-( Very unfair and neglectful, not to say abusive. And yet you’ve managed to rise above it and be a good and loving mother to your own children – not everyone is able to do that, and I hope you give yourself all the credit you’re due. Much <3 to you (again – I'm not stalking you, honest!).

          • Mishimoo

            Thanks <3 I definitely think pretty hard about what I do and how I react, and its nice to have that recognised.

          • Hannah

            I am so sorry you had to do that :(

          • FormerPhysicist

            13 in many states. By law.

          • Hannah

            I think it is 12 in California – I don’t think you can even let kids play outside without adult supervision until 12 here. I was being paid $2.50 an hour to babysit at 11 in 1997…

            In retrospect, it was too young. A toddler I was sitting at 13 got croup and it was really terrifying – for some reason I knew steam would be helpful so I went in the bathroom and blasted the shower, but in reality I was not prepared for an actual emergency.

            Interestingly enough, even in the 80s my parents never left us with anyone under the age of 16 and my parents sat by the phone ready to swoop in whenever I babysat (they were less than 5 minutes drive away).

          • AmyP

            Yeah–I’ve got an 11 (almost 12-year-old) and while she is pretty good with her 18-month-old sister, I don’t entirely trust her judgment. There’s just the developmental issue of not being able to think three steps ahead as a competent adult does.

          • Renee Martin

            It is ridiculous, that is all I know.

          • AmyP

            If something bad happens, it was neglect.

            (I don’t agree with that–that’s just my understanding of how this works out in practice.)

          • http://www.antigonos.blogspot.com/ Antigonos CNM

            Leaving a child, “forgotten”, in a car seat in a parked and locked car [in the heat] seems to be happening more and more, with tragic results. In almost all cases, it seems the father was driving, and, in Israel at least, the child was one of many in a large family and Daddy had his mind on other things.

          • Young CC Prof

            I’ve heard it’s an unintended consequence of rear-facing infant seats in the back seat. The presence or absence of the baby is just not obvious when you get out of the car. I suppose, at least if you have a capsule-seat, one solution is to make sure that the capsule doesn’t live in the car and instead travels with the baby.

          • LovleAnjel

            That’s what we do – we take the bucket seat out of the car when we get where we are going. It “lives” in the family room.

          • AmyP

            Yes–I agree about taking out the baby carrier. It’s easier to install the baby outside, anyway.

          • VeritasLiberat

            There are signs at the entrance of our local WalMart to remind people not to forget their children in the car.

          • Susan

            Makes me wonder who might have come looking for his shadow.

        • Kay

          What?? No it’s not!

        • Laural

          I lived in rural France in the 80′s and babies in buggies parked outside a shop were a common sight. I was in Paris in the 90′s and don’t remember seeing it as often.

        • Renee Martin

          I think this is great, and don’t have a problem with this.

        • Me in uk

          I live in the uk. This is illegal!

      • yugaya

        That is culturally acceptable behaviour around where I live even nowadays. I did run to the store while my baby was taking a nap sleeping in her bed a couple of times, but I was only comfortable with doing so because the store was located on the ground floor of the same building, and with major running up the stairs back to our flat chased by the guilt and all the worse scenario what ifs.

        • anion

          I used to do the same when mine were little. I’d make sure the baby was sleeping securely in her swing and run out to the corner store, which was literally three doors down. And yeah, I’d hurry. I was back within five minutes (if there was a line at the counter I’d go home and come back later).

          I never felt like it was no big deal, but I didn’t think it was hugely dangerous, either, in our safe little neighborhood with the doors locked. I was just as out-of-hearing when doing laundry in our back-porch laundry room, really.

          And I completely agree with anon there; it was so much easier for our mothers, who could leave us hanging out in the car or sleeping in the house and no one thought anything of it. (I’d never leave mine in the car unless it was at the dry cleaner, because the guy there knew me and would meet me at the door so I didn’t have to go inside.)

    • The Computer Ate My Nym

      For that matter, I strongly suspect a lot of working poor people leave their children at home alone now because they have to: they can either leave their child at home alone or have no home to leave their child in.

  • Montserrat Blanco

    OT: a couple of disasters waiting to happen at mothering.com unassisted childbirth forum

    http://www.mothering.com/community/t/1399842/nervous-ftm-wanting-a-uc

    http://www.mothering.com/community/t/1400663/update-on-my-pregnancy

    I don´t even know what to say…

    • Trulyunbelievable2020

      I love the advice they give to the first time mom who is at 38 weeks and just beginning to contemplate an unassisted birth. These loons are always talking about how well-prepared and knowledgable they are and how that makes it safe for them to do something really stupid. But then along comes this genius and suddenly everyone’s pretty sure that it will be just fine. Jesus Christ.

      • Jessica S.

        I just cannot wrap my mind around how nonchalant these women come across about the possibility of major disability or even the death of their baby. I can’t imagine risking the slightest thing, even if I’m being paranoid, after putting in nine months of housing a child! Maybe it’s just me, but I really REALLY do not like being pregnant, so not only is there the bond or whatever that you develop over that time but suffering through all that pregnancy nonsense – I would NOT want to do it again, especially if it was due to some selfish decision about I wanted things to be, ignoring the risks. I know they don’t look at it that way, but that’s how I see it.

        • http://kumquatwriter.wordpress.com/ Kq

          Not just you.

        • Hannah

          Not just you. Pregnancy has been pretty unpleasant for me, I can’t imagine doing through all that just to throw caution to the wind in the final mile.

        • moto_librarian

          My second pregnancy sucked. Full-day nausea through the fifth month (no vomiting, but there were times when I truly wished that I could in the hopes that I would start feeling better). Once that subsided, SPD set in and I was in agony until I delivered. Ten days of prodromal labor before the CNM took pity on me and stripped my membranes to put me in active labor at 38 + 5. Absolutely NO WAY that I would privilege the birth “experience” over a healthy, living child after going through all of that.

        • PitocinPatty

          Not just you – I hated every second of being pregnant both times, although we desperately wanted children. I even got called out for maybe referring to the fetus as a “parasite.”

          • Jessica S.

            Ha! That’s exactly what my mom said, when I was complaining about my iron deficiency in pregnancy. She said it’s like having a parasite living inside you! And frankly, living with a three year old is often like living with a terrorist. :) It’s worth it when the moments are good, or at least tolerable. :)

    • Bomb

      Fear affects whether you can have a natural birth? Yeah no. Try Pain. Most births in the history of time happened under the veil of fear, writing out wills, and getting your death shroud ready just in case. Yet, they were natural births always!

      I’m supportive of this fool (only read the first one). Without a midwife telling her everything is nominal she will likely run to the hospital when contractions get real.

    • T.

      The second is frightening. Twins and they are her 7 and 8 and she is a hour from the hospital.
      I am shivering.

    • yugaya

      “I’m of the mindset that women don’t generally produce babies they can’t give birth to”

      True. All that she needs now is a crystal ball that will tell her if she specifically is part of that complication-free scenario that happens generally. Or not.
      :(

      • The Bofa on the Sofa

        “I’m of the mindset that women don’t generally produce babies they can’t give birth to”

        “Generally” being the key word. Even if I agreed, how often does something have to happen to not be considered “generally.” I would contend that 90% is well within the realm of “generally” true. But damn, I’m not up for a 10% chance of it not working out for me.

        • http://kumquatwriter.wordpress.com/ Kq

          I’d say “mindset” too, since it’s only in her mind that it is true.

          • The Bofa on the Sofa

            I’d say “mindset” too, since it’s only in her mind that it is true.

            I thought of that, too, but then figured to hedge on the word “generally.” I think it could be true, for some values of “generally.” However, as I point out, since when is “generally” acceptable?

        • mythsayer

          And here’s a good question. She hasn’t been online for a week now. Where is she? Was the baby born? Is it alright? You’d think she’d be crowing about her amazing UC by now, right? Or, if the baby wasn’t born yet, that she’d still be asking for advice. I’m a little worried.

      • carr528

        Hmm, my body must not have gotten her memo. Or, at least my third child didn’t considering he was born with craniosynostosis. It wouldn’t have mattered what goofy position I put myself in. Without the open sutures, his head wouldn’t have molded. But, you know, some babies (or their moms) just aren’t meant to live. Personally, I’m glad he and I are still around.

      • mama g

        I am 5 foot and all of 90 lbs when I’m not pregnant. My daughter was 21 1/2 inches long and 9 lbs 3 oz at birth (with a big ol head, I can’t remember the diameter). They were not going to let me push that baby out through my size 00 hips! I’m darn glad I had my C-Section or neither of us might be where we are today.

      • Stacy21629

        “I’m of the mindset that women don’t generally produce babies they can’t give birth to”
        Funny how often the dogs and cats I treat miss that memo.
        Animals grow babies “too big for them” ALL.THE.TIME. Why would women be any different?

        • The Computer Ate My Nym

          It’s not just size, but position. I’m average size and my small one was only 7.5 pounds or so at birth, but she was head deflexed and simply couldn’t fit through my pelvis that way.

          • Young CC Prof

            As the tall, sturdy mother of a c-sectioned five-pounder, I agree. There’s a lot more than size going on.

          • Siri

            How is your little mannie, Prof? Any updates?

          • Young CC Prof

            He’s fantastic. At his 2-month checkup, he was over 10 pounds, so he’s already within the normal size range. And he’s definitely on track with his developmental milestones, interacting with the world with all five senses and smiling great big toothless smiles at his favorite people.

          • Stacy21629

            Absolutely. The first C-section I ever did was a little Chihuahua. She got the first 3 babies out no problem. Malpositioning +/- maternal exhaustion +/- hypoglycemia +/- hypocalcemia and she was going septic with a dead baby inside her. Good thing her owners decided to stop “trusting birth” and bring her to me for a C-section.

        • Kazia

          My friend’s goat had twins last week. Both were large babies, and the first was breech. The umbilical cord broke while she was pushing. If my friend hadn’t been there to assist, it definitely would have died–and perhaps all the other kid and the mother as well. But she was there, and all three are fine (and adorable).

          Nature screws up.

      • Helen

        This line is maddening. I feel like saying to her “Yeah and of course we don’t have eyes that don’t give us 20-20 vision either. All those people you see wearing glasses didn’t trust their eyes enough and have just given into the fear.”

    • Mishimoo

      I can’t get over the part where her sister’s M-I-L is a nurse and seems to think that UCs are perfectly okay with an untried cervix and pelvis.

      One of my extended family members is a retired nurse and is absolutely horrified by the homebirth trend even though they’re not as popular here yet. (She watches 19 and Counting) Her daughter is about to go on placement to a rural area and made the comment of “I hope I get to catch some babies.”, to which she replied “I sure hope not, because if something goes wrong out there, it’s likely to go really wrong very quickly and it is not pleasant at all.”

      • The Computer Ate My Nym

        My step-mother (retired OB nurse) has made comments about home birth. One particular story she tells is of a woman with a history of a classical c-section, now pregnant with twins, who stopped coming to her appointments. SM thought, “That’s odd, I’d better check on her, make sure she’s ok.” She called the patient who apparently had decided to give birth at home with no attendant but a doula or maybe one could call her a CPM (though really I don’t think she’d had enough training to officially be either) who had been present at something like 3 births and decided that she was fine for this high risk birth. SM’s comment was, “Do you want live babies or a dead babies?” Patient decided that, put like that, she’d go ahead with the repeat C. Which was done shortly before term revealing partial dehiscence and placentas that looked too sickly to be worth eating, but live babies.

        • fiftyfifty1

          Bah, placentas are never “too sickly to be worth eating”.

          • The Computer Ate My Nym

            Eh, I was trying for a properly NCB description of a placenta that was failing. I’ll work on it.

          • Lion

            No, it was just right. Very funny.

    • The Computer Ate My Nym

      That first one hasn’t been updated in 10 days. I hope that’s because the birth went well and the mother’s too busy with the new baby to have time to update, but…she was already 38 weeks at the beginning of April and was rejecting the idea of an induction for post-dates, even after being explicitly told that the baby could die if she wasn’t induced. I hope she didn’t find that out the hard way.

      • PrimaryCareDoc

        My bet is that she had a nice hospital birth and is ashamed to go back and post.

        • Young CC Prof

          I sincerely hope so.

          • The Computer Ate My Nym

            Me too.

    • chickabiddy

      Here’s another. If she can’t get a volunteer midwife she will have an unassisted VBA3C, after three sections for “no reason”.

  • Trixie

    It was many months before I worked up the courage to sit in the back yard, with the baby monitor in range and on full blast, during nap time. It just felt strange to be outside while he was inside.

  • k_cayte

    I know this article is not advocating leaving babies unattended, but it is interesting to think about the juxtaposition of mother and baby in each situation.

    Before NCBer birth, mother is paramount. Baby isn’t paramount until after mom’s birth experience is complete.

    • Young CC Prof

      Well said!

      Don’t get a blood test or an ultrasound if it will cause you anxiety, or if you find it uncomfortable or inconvenient. (Never mind the fact that many pregnant women enjoy seeing their baby thrash around and find that testing relieves some of their unavoidable anxiety.)

      Don’t go to the hospital, because they will tie you to the bed with a fetal monitor, and wake you in the middle of the night to take your blood pressure, and start nagging you and threatening unnatural interventions if things aren’t progressing as they like. (And bring you any medically appropriate pain treatment you want, and minimize your blood loss, tearing and infection risk, and treat any of those things immediately if needed, and then bring clean sheets and breakfast in bed.)

      But after the baby comes! You HAVE to wear or hold your baby at least 14 hours a day, even if it hurts your back and your baby is perfectly happy lying on a mat kicking toys or getting pushed around in a stroller. You MUST breastfeed for at least two years, no matter how many medical, professional or personal difficulties this causes you. You may NOT sleep through a feeding and let Daddy handle it. Ever.

      Them’s the rules, right?

      • araikwao

        Except that they believe all the prenatal stuff causes autism or interventions or whatever, so it kind of is under the guise that it’s bad for the baby

        • http://kumquatwriter.wordpress.com/ Kq

          Death before autism and lifesaving interventions that might be unpleasant (or very pleasant if they include pain relief)!

          /sarcasm again (in a mood? Perhaps…)

  • guest

    Just to point out, the number one reason most people consider it incomprehensible to leave thier newborn home alone (besides the fact that it’s illegal and child neglect) is not becaue of the miniscule risk of a fire or kidnapping or baby choking but because of the rather large chance that the baby would wake up, crying and alone with no one to comfort it…or poop with no one to change them or spit up with no one to clean them up or be hungry with no one to feed them. None of those things would catastraphic, but they would be extremely unpleasant and even neglectful towards the baby. People don’t leave their babies alone because newborns need constant care…feeding, changing, comforting…not because of the tiny risk of a fire or kidnapping.

    • OBPI Mama

      Um, not for all people. I’d be most concerned with fire or some other catastrophic event happening while I was away. Babies can skip a feeding, stew in a dirty diaper, and cry for quite some time before being damaged (not saying it’s ideal, but it can happen and not cause immediate death).

      • anion

        Agreed. Nobody wants to leave a baby in a dirty diaper for any length of time, but if your baby dirties a diaper in its carseat while you’re driving on the interstate, Baby is just going to have to stew until you reach your destination/a rest stop, right?

        If my baby is alone for any length of time (as they both were on occasion), it’s a short enough time that the delay in changing a diaper won’t be any longer than it would have been if I’d been in the bathroom myself, or in the middle of making dinner and couldn’t leave the food immediately, or if I was asleep. My youngest hated her carseat and screamed from the minute we put it in the car until the minute we took her out, but with one or two exceptions while stuck in standstill traffic, we didn’t take her out of it to stop her crying.

        Unless you wear your baby 24/7, at some point in its little baby life it’s going to wake up and you’re not immediately visible to it.

    • Amy Tuteur, MD

      Probably not as uncomfortable for the baby as lack of oxygen, a major risk of homebirth.

    • fiftyfifty1

      I wonder why we view a baby at home pooping and sitting untended in the diaper as a major problem, but a baby untended at a homebirth passing meconium from birth asphyxiation as “just a variation of normal”.

      • guest

        I never said that I viewed passing meconium and birth asphyxiation as “a variation of normal”. Talk about making assumptions (I’m not homebirth advocate). I view that as a major problem. However, I also view a baby lying alone, unattended, screaming in their own poop as a major problem as well and one which is *very likely* to happen to any baby left home alone unattended for a long period of time. Maybe it’s not as catastraphic as death, but it is still *the* major reason why I would never leave a baby home alone.

        • Young CC Prof

          True. Still, if your baby was just fed and changed and is now sleeping comfortably in a safe crib, and you know he is unlikely to wake or need anything for several hours, even then people would consider it neglectful to leave the baby alone in the house.

          • guest

            I’ve never been lucky enough to have one of those babies that is unlikely to wake or need anything for several hours, but yes most people would consider that neglectful because there is a small risk of something serious happening.. Just like there is a small risk of death from homebirth. The article asked the question what the difference is and I was just pointing that there is more to consider when leaving a baby home alone than just the small risk of death or kidnapping or something catastrophic. There is the very great risk that the baby will be scared/lonely/hungry/upset/dirty diaper. That doesn’t negate the risk of homebirth, however,I did think the comparision was not quite there. A better comparision might have been the risk of not using a carseat or seatbelt (after all the vast, vast, vast majority of times we ride in a car, we don’t get in an accident and all is fine, but we use carseats and seatbelts just in case, same reason why one would give birth in a hospital, in case there is an emergency.

          • Young CC Prof

            Oh, yes, we have made the carseat comparison also.

            The risk to your baby of home birth is not just larger than the risk of leaving the baby unbuckled once, it’s larger than the risk of not buying a car seat at all and just letting the baby ride around on someone’s lap for years.

          • Trixie

            And looking forward instead of historically, a child born today has an even lower chance of dying in a car accident than a child did 18 years ago.

        • Amy H

          I agree with you. That was my thought on starting the article, and I’m totally against homebirth. Good conclusion, faulty illustration for me.

  • mollie

    This is the stupidest article I have read in a long time. Why don’t you turn your attention to fetal deaths in the hospital. I’m sure you would be over run with stories to report.. oh that’s right. You don’t hear of them cause Dr’s peer review themselves and sweep it under the rug. Dumb. You are a complete waste of time.

    • OBPI Mama

      What about the homebirth deaths, Mollie? Who is bringing attention to those? Not the undertrained midwives, that is for sure. Dr. Amy is one of the few who brings attention to the deaths and supports many of us mothers who’s babies were damaged by homebirth to have a voice for our babies… something that is not encouraged in the homebirth community at all.

      • mollie

        In my state homebirth midwives are governed by laws and report to the health dept. This blog would have you believe all homebirth midwives are just doing as they please with no consequences. That’s simply not true. And “dr” Amy thinks all homebirth midwives are undertrained while reporting supposed facts that she has no idea what she is talking about.

        • The Bofa on the Sofa

          Why do you put dr in quotation marks?

          • PrimaryCareDoc

            So that we know to immediately discount anything she says.

          • The Bofa on the Sofa

            I was thinking more of “true colors” but, yeah

        • Trixie

          Do they carry malpractice insurance?

        • Dr Kitty

          Cite?
          I want specifics.

          Which “supposed facts” are false?
          What are the true facts?
          What are your sources.

          You don’t just get to say things like that without evidence to back it up.
          You want to be believed, make us believe you.

          Oh, and CPMs are undertrained amateur birth junkies who can’t recognise or manage emergencies appropriately, because they lack the basic skills and knowledge to do so.

          What oversight does your state health department provide? Is it on self reported outcome data?

        • Bomb

          In Idaho midwives are licensed by the state and receive Medicaid payments. When my midwife left me alone in a dangerous situation so she could go play soccer, then blocked me in the driveway delaying transfer to the hospital, while screaming obscenities at me, the midwifery board decided a fitting punishment for such blatant and gross negligence was to have her write me an apology (which I never got).

          Tell me again about how midwives face consequences for their actions.

          • Bombshellrisa

            The midwifery board-what a joke. In WA state the board is made up of a bunch of drives who work in the same building and share a birth center. One of the “physicians” on the board is a naturopathic doctor who is also a CPM. It’s more of a club than a board which provides oversight.

        • OBPI Mama

          My former midwife (and quite a few others I know) who has messed up numerous times (deaths and injuries to babies) sure don’t have any consequences. They are still out parading as birth experts and delivering babies… It simply is true.

        • Bombshellrisa

          In my state, home birth midwives are legal and report to the health department. It doesn’t stop them from adhering to the philosophy of trusting birth, which is the catalyst for many a home birth disaster.

        • http://kumquatwriter.wordpress.com/ Kq

          What state is that? It sure isn’t Oregon, Colorado, Michigan, Utah, California, Washington, or a double handful of others. In fact, is any US state enforcing ANY of this?

        • mythsayer

          Why do you all insist on calling her “dr” Amy. She IS a doctor. She has a medical degree. You CAN be a retired doctor. I’m an attorney. I have a JD degree. If I go inactive, I’m not an active attorney, but I’m still an attorney. This just really bothers me. It’s like she suddenly stops know things just because she isn’t actually treating patients. How about if I start calling you a “mom” when your children move out? What if someone is a house painter for years and then goes back to school and becomes an accountant. Does that mean he forgets how to paint houses? Or how about an accountant who decides to become a farmer? Should he stop doing his taxes and the taxes of all his family members because he’s not a working accountant anymore? This is just a dumb argument and it makes the NCB movement look petty.

          • emkay

            “mother” is an AWESOME analogy to “dr”
            ugh

        • Renee Martin

          They have all that stuff in TX.
          That does not mean any accountability. MW KILL, other MWs agree it was negligence, but they get no punishment, no suspensions, nothing.

          I think CA and FL do a pretty good job, but that leaves 48 states with nothing./

    • Bombshellrisa

      Nobody is holding you hostage in front of a computer screen mollie, forcing you to read this blog. If you know about perfectly healthy full term babies dying at an alarming rate in any hospital, please post the links to those stories. Otherwise, please keep reading the blog, it’s an eye opener.

    • Mel

      Is there a specific instance you are thinking of Mollie?

      • The Bofa on the Sofa

        I bet it is the case where the doctor in Texas killed the baby by trying forceps instead of doing a c-section…

        • Siri

          But no one knows about that case, Bofa, because non-disclosure! Silly boy.

          • Young CC Prof

            Actually, the real proof of how unusual that case is (intrapartum baby death clearly caused by doctor error) is that it made national news.

            One thing I was thinking about: Medical errors happen. Deaths from medical errors happen. However, most of the serious or fatal errors involve the failure to treat, like a missed diagnosis or not intervening in time or skillfully enough. It’s pretty darned rare nowadays for someone to die from the botched treatment of a self-limiting condition.

    • OBPI Mama

      Oh and about doctor’s peer reviewing themselves… what about their insurance carriers? Hospital boards? Outside investigations? And oh that’s right… midwives don’t have to carry insurance, they aren’t overseen by anyone, and many are never held accountable because lawyers won’t take the case (because they carry no insurance)… And now I must stop… time to go do my son’s Range of Motion exercises (super bummend MANA didn’t release the amount of babies who were damaged by homebirth midwives because I’d be very interested to see just how high THAT number would be… if it’s anything like their death rates, wowzers).

      • 3loveme

        Keep up those range of motion exercises, my child (HIE, CP, g-tube, legally blind, absolutely adorable) is going in this summer for a major hip surgery :(

        • OBPI Mama

          Oh man! I hope it’s successful. My son had to have tendon releases and a muscle transfer as a toddler due to tightness and deformities happening. I did ROM constantly and the specialists said it can just be the nature of a Brachial Plexus Injury for kiddos to need that surgery. Is there access to an aquatic therapy pool in your area? I know our kids’ injuries are different, but I think my boy always feels much more loose after he does his aquatic session every week. Though I’m sure access into the pool might be tricky with our absolutely adorable kiddo. Hang in there!

          And I hope time flies for you! I always feel like surgeries can just happen the next day so you don’t have to think about it anymore and just focus on recovering from it!

          • 3loveme

            Thanks!! I wanted to wait until after his birthday, but have a feeling that I’m going to regret that decision. The waiting game is torture :( We do have aquatic therapy by us, but unfortunately it’s sensory overload for him. Massage, stretching, baclofen and Botox in legs have been helping….but his adductors have just beat us in the race of trying to stop the effects on his body. Good luck to you!!

    • Monica

      What’s the midwife system when babies die? How is it better than the hospital, where doctors have to answer to yes their peers, hospital administrators, insurance adjusters, and their state licensing board? Such a shame that doctors aren’t being held accountable for negligent actions. Oh wait they are. You got a story of hospital neglect where the doctor only got a stern talking to?

    • 3loveme

      Mollie – I do agree that attention should also to be brought to fact that doctors make mistakes in hospitals, but this blog is about home births and midwives. While peer review of physicians in a hospital setting is confidential, there are still other avenues you can take which are very effective. Reporting to the Board of Medical Examiners in your state is a great first step if you have been injured by medical care. Another step is via making a claim/lawsuit to the physicians insurance company. When a home birth goes goes wrong those options aren’t available, which is why this blog exists.

    • Jessica

      Years before I started practicing law, there was a med-mal case against an OB and his clinic in a neighboring county. I know quite a few of the lawyers involved in that case. It was what some lawyers cynically call a “bad baby case” – medical negligence that led to a severely injured newborn. I think it’s worth linking to the closing argument that firm has put up on its website: http://thebartonlawfirm.com/UserFiles/File/Hastings%20v_%20Hayton,%20M_D.pdf

      Everything they wrote applies to homebirth midwives. Here’s the difference: that OB, his clinic, and their insurers paid $8,000,000 for their negligence. If you don’t think that will dramatically change what hospitals, clinics, and OBs do, you’re insane. HB midwives, on the other hand, have NO incentive to take similar measures, because they lack insurance and they’re judgment proof. So they keep on keepin’ on, killing and maiming babies in their wake. It’s disgusting.

      When babies are killed or injured by the negligence of an OB and hospital nurses, it doesn’t get swept under the rug.

      • Renee Martin

        Kristine Andrews, Abels mom, could really use that 8 million to care for her kid that now has CP.
        SHe got zero.

    • The Bofa on the Sofa

      You don’t hear of them cause Dr’s peer review themselves and sweep it under the rug.

      How does that prevent parents from telling their stories?

      It’s not like homebirth midwives are running around announcing their disasters. We are getting the stories from the parents involved.

      There is nothing preventing parents of bad hospital outcomes from telling their stories, too. Why do you think we don’t hear them? If hospital were no better than HB, there should be 50 hospital horror stories for every homebirth one.

      • Therese

        Well, to play devil’s advocate, yes, there is something preventing many parents of bad hospital outcomes from telling their stories. Doesn’t the settlement of most lawsuits include non-disclosure agreements?

        • The Bofa on the Sofa

          Do they?

          Even if they do, how does that constitute “Drs sweeping them under the rug”? They do that by paying out a buttload in a lawsuit?

        • Trixie

          I am acquainted with a family that won a very large malpractice settlement related to NICU care, and the amount was certainly public, along with the name of the doctor who screwed up (and was fired).

        • PrimaryCareDoc

          No, because any judgment or settlement gets reported to the National Practitioner Database, which is publicly accessible.

          • Therese

            Yeah, but who goes and checks it? It’s not the same as writing a story on a blog that goes viral.

          • Young CC Prof

            I’d imagine that insurance companies and hospitals check it before they hire or cover people!

          • Therese

            Yeah, but I think we were discussing why we don’t hear all these stories of deaths in hospitals like we’re hearing all these stories of homebirth deaths.

          • http://kumquatwriter.wordpress.com/ Kq

            …Except that we only hear “all these stories of homebirth deaths” *because Dr. Amy is highlighting them and has created sites like Hurt by Homebirth*. And we only hear of a fraction of them – and even fewer stories of damaged babies and mothers.

            edited to correct the quote.

          • yugaya

            The evil medical establishment must be so, so good at keeping the lid on all those thousands of babies that needlessly die intrapartum in hospitals that we never hear of. All of the parents are probably in on it too. And all the relatives. And everyone who was present at these births. And everyone who knows these families. That’s like a million people at least taking part in this huge cover up every year.

            CDC must be helping them too, these thousands of preventable babies deaths from hospitals do not even show up in any of the statistics.

            Aha! That must be why MANA says that CDC birth and death certificate data is unreliable! Except for the CDC birth certificate data which MANA uses in its own studies, only that CDC birth certificate data is like totally reliable. Rest is all lies!

            One day THE REAL TRUTH will come out!!!!!!!!!!!

            ( My head hurts after only contemplating thinking like that. :D)

          • The Bofa on the Sofa

            Yeah, but who goes and checks it? It’s not the same as writing a story on a blog that goes viral.

            But there’s nothing stopping it. All the “hurt by hospital birth” clowns could go there and start listing them.

            Instead, they are content about their stories of how their birth plans didn’t pan out.

          • Therese

            People don’t know about it, so it doesn’t occur to them to go and check it. And trying to check it now myself, it doesn’t seem particularly useful for finding instances of babies dying from medical malpractice. The best I can find is how many instances of malpractice occur per state by MDs. I don’t see anywhere to specify obstetrics. Maybe I’m missing it though. It says they specifically refuse to release information to the public about a particular practitioner, which seems problematic.

          • Renee Martin

            There has been a few posts about negligent hospital births. The fact is, there just are nowhere near as many deaths per 1000 babies at the hhospital, let alone negligent ones!

        • Dr Kitty

          Non disclosure agreements work AFTER the settlement.
          Parents can say what they like before they sign one.

          • 3loveme

            They can, but shouldn’t.

          • Therese

            Don’t lawyers usually advise their clients not to discuss the case? So if there is not a lot of time between the death happening and the parents lawyering up then there might not really be the opportunity to spread the story around online.

          • Dr Kitty

            There’s still the obituary.

            Term intrapartum deaths are vanishingly rare in hospital.
            HIE deaths of term infants are also very, very rare.

            That is what this blog is mostly about-babies who were alive at the start of labour and die during labour, or who suffered such profound damage during labour that they die shortly after delivery.

            The term deaths in hospital tend to be antepartum deaths from cord accidents or placental failure or neonatal deaths from sepsis or congenital anomalies.

            The vast majority of the babies who are distressed by labour in hospitals are delivered expediently and survive.

            That is the difference. The hospital deaths are despite everything possible being done.

          • Dr Kitty

            The Homebirth deaths…because almost nothing could be done.

          • Therese

            Obituaries usually don’t discuss the cause of death, much less blame particular people (like a doctor) for it.

          • Dr Kitty

            But they exist as a tangible record of the loss.

            If babies in hospitals were dying of the same things, at the same rates as Homebirth babies, even without negligence or malpractice, you’d be seeing a LOT more obituaries in the local papers.

            HB losses, well those are “rare, unpredictable complications”. Rarely is the MW blamed by the parents in the obituary.

            My point is, “babies die in hospital too” doesn’t ask how, or how many, or why.

            Malpractice and negligence certainly claims lives in hospitals, but there are processes in place to make perpetrators accountable. At Homebirth, as currently practiced

          • Dr Kitty

            …or should I say, at Homebirth, as currently undertaken in the USA, the oversight and accountability is seriously lacking.

            When MANA can’t get outcome data from 100% of their fee paying members, when CPMs don’t have to have malpractice insurance and when in some states you can call yourself a midwife with NO training or education…

            It is a scandal.
            I was OUTRAGED when I learnt about it.
            The very idea that women would place their life and the life of their child in the hands of someone without training, without insurance, without accountability…
            It is horrific.

            I’m sick of the excuses.

          • Therese

            I don’t know, there is no requirement that anyone publish an obituary, so it doesn’t seem like going by how many obituaries you see is really that accurate. Do people even always get obituaries for stillbirths? The stillbirth rate is actually really high, 1 in 160 according to Wikipedia, but I don’t think I have ever seen a stillbirth obit in my local paper (online, yes, but not in print).

          • bomb

            This is really simple. We can look at cdc wonder and find out how many term babies die in the hospital. We can look at how many die at home birth. Even not accounting for the homebirth transfers that are born dead in the hospital, the homebirth numbers are stupid high by comparison.

            In order for the hospital rate to match the homebirth rate, hundreds and hundreds of extra babies would have to be dying. This would be headline news for no other reason than the sheer loss of life. Committees would be formed, hearings would be had. It would be a total outrage.

            The reality is that isn’t happening at all and homebirthers just believe it is because they don’t understand the industry at all.

          • Therese

            Yeah, I definitely think pointing to the cdc database is a much stronger argument than pointing to the quantity of online stories about hospital deaths and comparing it to number of stories about homebirth deaths.

          • The Bofa on the Sofa

            But when the complaint is about how we don’t hear about hospital death stories (which was the original comment, and that “doctors sweep them under the rug”), the number of stories IS the argument.

    • http://kumquatwriter.wordpress.com/ Kq

      Doctors sweep deaths under the rug? That’s pretty rich, considering you can’t even mention the *possibility* of bad outcomes on *any* homebirth sites without getting deleted. #notburiedtwice

    • yugaya

      There is a recent previous blog about forty ( 40 ) homebirth deaths in US alone that dr. Amy has written and documented over last two couple of years: http://www.skepticalob.com/2014/04/the-most-powerful-arguments-against-homebirth.html

      Now if you really want to prove this article to be as stupid as you claim, you will share your smartness with the rest of us and find 40 equally preventable and preferably intrapartum deaths that happened during that same period in the same geographic locations in hospitals, that would have not happened at all had the babies been born at home.

      Keeping in mind that homebirth is 1-2% of all births, and predominantly to low risk mothers, you would actually have to find a lot larger number of babies who died in hospitals to even begin to argue that hospitals are as dangerous.

    • The Computer Ate My Nym

      The CDC begs to differ with your basic underlying assumptions and conclusions. The risk of death is far higher in home than hospital birth per cdc wonder statistics. Don’t provoke me or I’ll start citing.

    • CanDoc

      I’m an OB in a high-risk (tertiary center) where I personally perform 200-250 deliveries per year (75% of them vaginally), of babies as small as a pound, for almost 10 years, and completed 5 years of residency prior to that. So in the course of 15 years as a physician, over 2500 deliveries, I HAVE NEVER, EVER, EVER, EVER, EVER, EVER, EVER, EVER LOST A BABY OR A MOTHER DURING CHILDBIRTH. There have been some close calls, some VERY close calls. And there is a NICU, a neonatologist, and an anesthesiologist at hand to deal with any situation that comes our way. But this is a far cry from the lay “CPM” practitioners around who leave little piles of small graves behind them.

      • Young CC Prof

        Statistics back that up. There is about 1 maternal death per 10,000 births, and many of those occur suddenly out of the hospital in women who didn’t even go into labor. Intrapartum deaths are not specifically counted (although some public health statisticians would like to change that) and estimates of the rate vary, but it’s almost certainly less than 1 in 3,000.

    • Renee Martin

      AND YET, HERE YOU ARE!

  • Mel

    “Women were designed to give birth.”

    No, they aren’t. I mean that in all honesty because it hinges on a common – but faulty- understanding of evolution.

    Evolution is NOT directional. Evolution is caused by random mutations over time. Most mutations will be neutral, some will be negative and some will be positive. This matters because just because all of your maternal ancestors gave birth successfully does not mean that you personally have ‘evolved’ to give birth successfully. You may well be the mutation that moves away from the optimal birthing anatomy/physiology.

    This is also why I get irritated when people use the “Well, farm animals don’t evolve / have been affected by human choices” to minimize those examples because the basic principle of random mutations still apply. For example, cattle breeds raised for beef generally have easier birthing than dairy cattle. This is because beef breeds give birth unattended in pastures with little medical attention. Under the NCB standards of birthing evolution, no beef breeds should have any birth problems due to evolution….but they still do. The individual cows who have mutations – or developmental differences but that’s another can of worms – die or live without having calves which keeps her genes out of the next round.

    Plus, this understanding ignores developmental problems – think “Good genes, but no Vitamin D gave me a pelvis with rickets” and selection for other traits – “Good genes for big muscles mean 5% of male calves will suffocate during delivery but the 95% that survive will reproduce more babies….” which throw a huge wrench in the basic fallacy of “Trust birth and you and your baby will be fine…”

    The real question: Which do you trust more – random mutations or an OB?

    • T.

      Not to mention that your ancestors may, for example, always had chosen for one reason or another to have children with men with smaller heads. Or your mother/grandmother may have your same mutation but got lucky. Evolution works in long, long time, rarely one or two generations.

    • Carrie Looney

      Yes, all of these things. And also – evolution doesn’t care about _you_, your own particular circumstance. As a very simplified example, suppose evolution has come to a balance where some mutations have persisted because the combination of big heads to contain brains that can plan ahead, and hips that allow you to climb trees and avoid predators, give you a better chance of surviving to reproductive age, enough to balance the 10% additional babies that won’t survive birth due to these changes. If you’re in that 10%, so what, ‘Nature’ won’t care. Only humans with their medicine and nasty interventions will.

    • http://www.antigonos.blogspot.com/ Antigonos CNM

      “Women are designed to give birth”

      Those who aren’t never get a second chance to do so. [Rules of Evolution]

  • fiftyfifty1

    It’s safer, even if you drive back home from the bar drunk.

    • yugaya

      It is even safer if you then drive back to the bar drunk with your baby on your lap.