I’m often accused of being a homebirth hater, as if that means that what I write about homebirth should be discounted. Apparently homebirth advocates believe only those who love it should be allowed to write about it.

The truth is, though, that I don’t hate homebirth. Homebirth is a choice that every women is entitled to make and I would never ban the choice even if I could.

I don’t hate homebirth, but here’s what I do hate:

1. I hate preventable deaths of babies.

I freely admit that I have a soft spot for babies and I absolutely abhor the idea that some babies are dying because their mothers have been convinced that homebirth is safe when it is not.

How many babies are dying?

If you look at the data from Oregon on planned homebirth with licensed midwives (the most comprehensive data ever collected on American homebirth), we find that the death rate at homebirth is 800% high than comparable risk hospital birth. While 0.6 babies/1000 die at hospital birth, fully 5.6/1000 die at homebirth. That means for every 1000 babies whose mothers choose homebirth, 5 will die preventable deaths. Even though homebirth is a fringe practice, that means that more than 100 babies die each year simply because their mothers chose to deliver them far from the expert personnel and emergency services that would have saved their lives. I hate that.

2. I hate preventable brain injuries.

While death is, of course, the worst thing that can happen to babies whose mothers choose homebirth, it’s not the only disaster to befall them. A poster to be presented at next month’s meeting of the Society of Maternal-Fetal Medicine demonstrates that the risk of brain damage due to lack of oxygen is 18 times higher at homebirth than in the hospital.

Yes, babies born in the hospital do suffer brain damage, too. But for every 100 babies who suffer brain damage in the hospital, 1800 suffer brain damage at home. I hate that!

3. I hate that the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, has been hiding their own death rates for the past 5 years.

(MANA) has assembled a database of over 27,000 homebirths attended by their members. They publicly boasted about a low C-section rate, low intervention rate and a low prematurity rate. How many babies have died to achieve that low C-section rate? For the past 5 years, MANA has REFUSED to release the death rate. You don’t have to be a rocket scientist to suspect that those death rates are hideous.

Even MANA knows that homebirth kills. They just don’t want American women to find out.

I hate that.

4. I hate that homebirth midwives (CPMs, LMs) aren’t real midwives, just lay people who couldn’t be bothered getting a real midwifery education.

The CPM and LM designations were made up by laypeople and awarded to themselves, despite the fact that they lack the education and training of all other midwives in the industrialized world. In the UK, the Netherlands, Canada, Australia, etc., you need a university level degree to practice midwifery. In the US, you need a master’s degree in midwifery. In contrast, the requirements of the CPM were “strengthened” in September 2012 to require a high school diploma.

Most women have no idea of the vast difference between real midwives (certified nurse midwives) and self-proclaimed “midwives.” I hate that.

5. I hate the fact homebirth advocates lie about the safety of homebirth in other countries.

Homebirth advocates are forever proclaiming that homebirth and midwifery in other countries leads to lower mortality rates. They point to the Netherlands, but the Netherlands has one of the highest mortality rates in Western Europe, and the perinatal mortality rate for Dutch midwives attending low risk births (home or hospital) is HIGHER than the mortality rate for Dutch obstetricians caring for high risk women.

They point to the UK where the system is led by midwives, but that system is experiencing a terrible crisis. A recent government report was scathing in its assessment that UK midwives put the lives of mothers and babies at risk.

They point to Australia where midwives published a study claiming to show that homebirth is safe even though their study found that homebirth had a death rate 5X HIGHER than comparable risk hospital birth.

I hate those lies.

I could go on and on, but I suspect that I have made my point.

I don’t hate homebirth, but I do hate that babies die preventable death and sustain preventable brain damage all because their mothers were fed lies about the safety of American homebirth, the safety of international homebirth, and the vast differences between American homebirth midwives and midwives everywhere else in the first world.

The only thing that surprises me is that homebirth advocates don’t hate those things, too.

Ruth Fowler Iorio is shocked, shocked that anyone could question the safety of her near-death homebirth experience. All she did was nearly exsanguinate. What’s the big deal?

Ruth is like the drunk driver who claims that drunk driving is perfectly safe because she survived her own spectacular crash with just a few blood transfusions and a 2 day hospital stay. She exhibits approximately the same level of insight of that drunk driver.

Ruth parachuted into an awesome homebirth discussion (hosted by Iola Kostrezewski) to offer typical homebirth nonsense and flounced off before she could be question on it. It instructive to look at what she wrote and address the myriad mistruths, half truths and lies she invoked.

Here’s what Ruth had to say:

Myth #1 Midwives in other countries have fantastic outcomes.

…There’s no studies on the safety of home birth in the US, nor can we compare the system here with Europe, disrupted by the medical industry and disabled by legislation and quackery which limits midwives from performing necessary procedures to the best of their ability.

Ruth is apparently unaware that the midwives in other parts of the world have nothing to brag about. Dutch midwives caring for low risk women (home or hospital) have a HIGHER rate of perinatal death than Dutch obstetricians caring for HIGH risk women.

UK midwives were recently chastised for putting the lives of babies and mothers at risk, and then attempting to cover up the resulting deaths.

Myth #2 Obstetricians are motivated by money but homebirth midwives work for free.

The system here is punitive and money based, and midwives are demonized by the medical industry because they do not earn money for insurance companies or hospitals, and they do not rush women into hospital for c sections in order to increase their profits. Women are profit here. Birth is profit. Not all obgyns work on this basis, but their training is geared towards limiting liability and earning money.

There is copious evidence that salaried obstetricians have intervention and C-section rates no different than those who are compensated on the basis of procedures. Moreover, homebirth represents a potential loss of obstetric income for obstetricians of 1/2% (and, of course, no threat to GYN income). On the other hand it represents 100% of the income homebirth midwives, who charge thousands of dollars to attend a birth. You tell me who has a greater financial motivation to lie about the death rates at homebirth.

Myth #3 High infant mortality is an indictment of obstetric practice.

Remove the profit motive from medicine and put midwifery care back into birthing, offering the same kind of care as Europe, and the US will see a marked improvement in its frankly shocking infant and maternal mortality rates, and the ridiculous rates of unnecessary medical interventions.

Typical of most homebirth advocates, Ruth is clueless that infant mortality (death from birth to one YEAR of age) is a measure of pediatric care, not obstetric care. The correct measure of obstetric care is perinatal mortality (late stillbirths + deaths to age one month). According to the World Health Organization, the US has one of the lowest perinatal mortality rates in the world.

Ruth also appears to be clueless about what happened to her.

And no, I didn’t nearly die. Placenta accreta is not detectable before birth and it’s a simple malfunctioning of ones body.

Sigh; so much misinformation, so few words! Ruth, you didn’t have a placenta accreta. You had a retained placenta. There’s a world of difference.

A retained placenta is just a placenta that doesn’t come away from the wall of the uterus. It often leads to postpartum hemorrhage because postpartum bleeding stops when uterine contractions close down the blood vessels, not by clotting. If the uterus can’t contract because the placenta is in the way, the bleeding can approach the flow of a faucet, resulting in the death of the mother. In 3rd world countries, this is a major cause of death.

The placenta is not a part of the mother’s body and has nothing to do with the mother’s body “malfunctioning.”

Placenta accreta, in contrast, is an obstetric disaster of the first order. Placenta accreta occurs when the placenta grows INTO the uterine lining, instead of remaining separate from the mother’s body. Placenta accreta CAN be detected before birth by ultrasound, although that does not always occur. Placenta accreta often results in an immediate C-section because that is the only way to stop the bleeding. Most accreta patients wind up in the ICU, and a few blood transfusions is the least of the interventions they experience. Women with placenta accreta can and do die.

But blood transfusions are nothing to scoff at, Ruth. They don’t give blood out to anyone who walks in the door, ONLY to people in danger of dying without it.

Ruth does nail the flounce, however.

Now i am off to bed. Amy, retrain. Your knowledge is from 1985 and you sound like Nestle sponsor you. Even my dad as a GP is more up to date with OBGYN practices and current medical studies than you.

If Ruth wants to advertise naked pictures across the internet to promote herself and her homebirth, that’s her business. But when she starts spreading misinformation about the safety of homebirth in general, and the “safety” of her own near-death experience in particular that’s my business.

Ruth nearly killed herself; those who try to copy her risk not only their own lives, but the lives of their babies, too. They DESERVE to know the truth, not the made up rationalizations of a narcissist desperate for social media celebrity.

Ruth Fowler Iorio‘s 15 minutes of fame are winding down in classic homebirth narcissist fashion, with Ruth wailing about those mean people at Facebook who won’t host her exhibitionism:

But before she’s replaced by a new homebirth narcissist, I have some questions for her:

Ruth, why did you sanitize the photos are that are supposed to show the “messy reality” of homebirth?

Specifically:

Where is the photo of the postpartum hemorrhage with the blood pouring from between your legs?

Where is the photo of you deathly pale and slipping in and out of consciousness as you head toward hemorrhagic shock?

Where is the photo of your husband’s face, horrified and frightened, as it dawns on him that you may bleed to death and leave him as a widower with a new baby?

Where is the photo of the EMTs hustling you out the door, racing against time to save your life?

Where is the photo of you in the emergency room, with doctors and nurses struggling to start large bore IVs before you bleed to death?

Where is the photo of the obstetrician with his gloved arm in your vagina up to his elbow peeling off the remains of the placenta from your uterine wall, averting your certain death?

Where is the photo of you, not bonding with your newborn, but totally out of it from large doses of fentanyl?

I could go on and on, but I think you get the idea: where are the photos of the REALITY of homebirth?

Did you refuse to include them because they didn’t tell the story as you wanted it told, allowing you to make it seem like your near death was just a minor moment in your piece of birth performance art?

Did you refuse to include them as part of the never ending effort of homebirth advocates to hide the dangers of homebirth?

Or did you fail to include them because they didn’t exist, because near death has a way of clarifying things for all participants, so that they finally drop the cameras? Even narcissists and the friends and family of narcissists tend to put the camera down when they are sliding on your blood pouring out on the floor.

It doesn’t really matter why you failed to include the pictures that tell the REAL story of your homebirth and near death experience, but it is critically important for everyone to understand that those pictures, the most important pictures, are missing.

The REAL story of homebirth is that childbirth is inherently dangerous, that death is always only moments away, that giving birth at home is taking a terrible risk, and homebirth can never be safe.

Enjoy your 15 minutes of fame while it lasts, but I wonder:

What does it say about you, homebirth and narcissism that you are spending the first weeks of your newborn’s life, not nurturing him, but giving interviews, accepting accolades and tweeting endlessly … in other words, nurturing your own self image?

How about thinking about him as a newborn for a moment, not merely as a prop in your endless efforts to publicize yourself?

Some days I feel like this blog writes itself. I don’t have to scout for examples of dangerous homebirths or ignorant, deluded homebirth advocates. They are everywhere I look.

Consider The Feminist Breeder’s take on Ruth Fowler’s homebirth that nearly ended in her death:

I love that Ruth’s birth is the textbook perfect example of a safe, planned homebirth wherein the midwives transferred to hospital care at the right time and helped this mother and baby finish out the job safely and happily. THIS is homebirth done right and this is the care that should be available to anyone who wants it.

Sure, just like a massive car accident that results in blood transfusions, surgery, anesthesia and a two day hospitalization is a perfect example of safe drunk driving!

No sooner had I caught my breath from laughing so hard at the entire concept that a homebirth that required blood products, removal of retained placenta, antibiotics for infection, “loads” of fentanyl and a 2 day hospitalization is safe, and before I even had time to wonder what these clowns think is an unsafe homebirth, I came across a perfect example. The comment comes from a homebirth advocate who is a nurse at St. Louis’ Barnes Jewish Hospital:

Apparently, THIS is what passes for an unsafe homebirth:

It’s really hard to defend to my coworkers whose only frame of reference for home birth is (for one example) the patient who had been pushing for 5-6 hours on a not completely dilated cervix with a breech boy effectively in “scrotum” presentation. Thanks to her irresponsible and untrained “lay midwife” it Ended in genitalia amputation because they had necrotized.

I’ll bet it’s hard to defend homebirth when the end result is a necrotic scrotum and total genital amputation.

But you know what? It ought to be hard to defend homebirth even when nothing is amputated and no one dies and the end result is “merely” the near death of the mother.

What is wrong with homebirth advocates that their definition of “safety” includes near death experiences?

I can’t explain it, but this should serve as a cautionary tale to any woman contemplating homebirth:

When a “safe” homebirth includes blood transfusions, removal of retained placenta, antibiotics for infection, “loads” of fentanyl and a 2 day hospitalization, you know that homebirth is not and can never be safe.

Naricissm and stupidity, it’s a winning combination for homebirth advocates.

Only a homebirth advocate could be impressed with herself for surviving a life threatening homebirth disaster that didn’t have to happen, thank the midwife who nearly killed her, ignore the hospital staff who saved her life AND blare her stupidity and narcissism to the whole world on Twitter.

Of course, Huffington Post, a veritable sewer of alt health nonsense, venerates Ruth Fowler Iorio with a piece entitled New Mom’s Uncensored Photos Reveal The Beautiful, Messy Reality Of Home Birth.

What’s next HuffPo? Drunk Woman’s Uncensored Photos Reveal the Beautiful, Messy Reality of Accidents Cause By Intoxication?

Ruth shared her homebirth disaster in real time, because what’s the point of risking your baby’s life and brain function if you aren’t going to brag about it to the entire world?

This is her “beautiful” homebirth in her own words:

… Nye was occidental [sic] posterior. He flipped to come out but shoulder dystocia ripped me apart. Then the placenta wouldn’t come out – some medical termI don’t know – which basically mean, it tried to detach and ripped more of me out! So I lost over half my blood and got transferred by great emt’s [sic] after the birth.

Felt awful but now recovering in UCLA Santa Monica on a TON of fentany1 (it kicks ass!) and blood transfusions and will be back home with Jared and Nye Soledad Iorio tomorrow. This mad experience Just reiterated how goddamn crazy birth is…

I don’t want to be an ass but this experience has taught me birth is beautiful and primal and mysterious and painful as ****. Thanks to my amazing midwife Racha Tahani Lawler for getting me through that, and her assistant Tanya and my brilliant doula Allegra Hill.*

Birth is goddam crazy? No shit, Sherlock. Any obstetrician could have told Ruth that, but she, like all homebirth advocates, was too full of herself to listen.

So instead Ruth had a “beautiful” homebirth that included a shoulder dystocia, large perineal tear, retained placenta and massive postpartum hemorrhage that would have killed except for the …

doctors
hospital
nurses
intravenous access
blood products
removal of retained placenta
antibiotics for infection
loads of fentanyl (which will appear in her breast milk)
2 day hospitalization

See why it makes perfect sense to give birth at home without IV access, without blood products, without antibiotics, without obstetricians, nurses, anesthesiologists, operating rooms, etc. etc.? See why homebirth is beautiful?

No, I don’t see it, either.

* Extra crunchy bonus points for thanking by name the midwife, assistant, and doula who couldn’t have saved her life, and ignoring the names of the many people who actually did save her life.

Here’s a riddle:

When is a hospital like a restaurant?

The riddle came to mind after reading yet another idiotic piece on the festival of stupidity known as Mothering.com. The piece is entitled Breech Birth: Why Can’t Women Have it Their Way?, written by Lauren McClain, “one of the most passionate and knowledgeable breech experts out there”.

Under what rock do the clowns of Mothering.com live where giving birth to a breech baby and reading junk from other lay people makes you one of the most passionate and knowledgeable breech experts out there?

Pro tip for the folks at Mothering.com: In order to be an expert on breech birth, you must:

• have advanced medical training
• have delivered hundreds or thousands of babies
• have delivered breech babies
• be experienced with the Mariceau-Smellie-Veit maneuver
• know how to prevent and resolve nuchal arms
• know how to apply Piper forceps to a trapped after-coming head.

How many of these qualifications does Lauren McClain have? Funny you should ask; she has ZERO. Claiming she is an expert on breech is like claiming that she is an expert on structural engineering because she once crossed a bridge.

Lauren apparently believes that hospitals are like restaurants:

… [I]t’s silly to walk into a McDonald’s and ask for a salad Niçoise, almost as silly as asking for a vaginal breech birth at a major medical center…

In any good restaurant, you can have things a number of different ways. In excellent restaurants, you can even say, “I’m vegetarian, I don’t see anything that strikes me on the menu. Have the chef create something.” They want to serve you, they want to get you the best possible care and nourishment they can, and they care what you think when you leave.

Lauren then proceeds to whine in alliteration, insisting that hospital care of breech babies suffers from impatience, ineptitude, and impersonal care.

According to Lauren:

Though there are certainly exceptional doctors working within the establishment, the general truth is that the choices in childbirth are abysmal. Almost no one does twin or breech births. Few doctors can perform ECV or have much useful knowledge of fetal positioning. They can’t (or won’t) help turn a posterior. Since they make liberal use of sonogram, their ability to palpate the abdomen has gone out the window. Many have never even witnessed a planned un-medicated, un-induced and un-augmented birth, much less an active birth.

How does Lauren know this?

Duh! She knows this the same way all natural childbirth advocates “know” anything. Another equally ignorant natural childbirth advocate made it up and told her.

Lauren wants salad Niçoise (breech vaginal birth). Her local restaurant, Chez Amy, doesn’t serve salad Niçoise. Unbeknownst to Lauren, that’s because improperly prepared salad Niçoise can cause illness and death and Chez Amy doesn’t want to take the chance of killing anyone.

=Chez Amy offers filet mignon, but Lauren doesn’t want that. Lauren wants salad Niçoise. and, dammit, she’s going to get salad Niçoise. Therefore, she heads off to a self-proclaimed “restaurant” in her neighbor’s basement, Wize Wimmen Resterent. I say self-proclaimed because Wize Wimmen Resterent doesn’t adhere to any of the regulations governing restaurants and doesn’t even allow health inspections to ensure that the restaurant is safe, let alone high quality. But that’s okay with Lauren because she’s “done her research” and “knows” that she won’t get sick from improperly prepared salad Niçoise.

For Lauren, that’s the beginning and the end of the analogy. She goes to Wize Wimmen Resterent, gets salad Niçoise and lives happily ever after, empowered by the knowledge that she got what she wanted.

But let’s take Lauren at her word for a moment and extend her restaurant analogy.

Let’s imagine that Lauren eats her salad Niçoise at Wize Wimmen Resterent and gets food poisoning from contaminated tuna in the salad.

What does she do? She does the equivalent of what women do when their breech baby gets stuck at homebirth:

She has one of the wize wimmen drive her to Chez Amy, appears on the doorstep and demands entry. She insists that all other patrons of Chez Amy be ignored while her needs are met first. She demands that the chef at Chez Amy do something to immediately stop her nausea and vomiting, although she has no idea what that might be or if such a treatment even exists. Then she demands that the chef immediately produce a filet mignon since she is hungry because she vomited up her salad Niçoise.

Lauren “knows” that restaurants who care about providing good service would, of course, immediately usher in a patron spewing vomit and diarrhea who had acquired food poisoning elsewhere, prepare a remedy and offer a perfectly cooked filet mignon. And that’s despite the fact that Lauren is planning to sue Chez Amy because 1. the filet mignon was not the exact degree of medium rare that Lauren prefers, and 2. she only got sick because Chez Amy forced her to go to Wize Wimmen Resterent by refusing to carry salad Niçoise on its menu in the first place.

That’s what happens in the world of restaurants, right?

Wrong! As we all know, not only would no restaurant would cater to behavior like that, and no remotely reasonable person would expect them to do so.

We appear to have found the answer to our riddle. When is a hospital like a restaurant?

NEVER, and only a fool would think otherwise.

Please join me in a big round of applause for Abel Andrews, Superhero!!!

Many small children dream of being superheroes, but Abel really is one. Even at his young age, Abel has saved lives and will continue to do so far into the future.

Who is Abel and how did he come to be a superhero?

Abel suffered permanent brain injury due to oxygen deprivation during his out of hospital birth. Abel’s mom Kristine told the story to a local Oregon TV reporter:

On the night her contractions started, Andrews said the licensed midwife with her at the time (Motherwise has a number of midwives on staff) was distracted by her own baby. That midwife sent her home, saying she had a urinary tract infection. Immense pain brought her back to Motherwise clinic that night.

The next day, when Abel was finally born, he wasn’t breathing.

Andrews said the midwives, licensed and unlicensed both, didn’t know what to do with a newborn that wasn’t breathing.

“They just had the look on their face of like trying to remember what they’d read in a book somewhere, like ‘umm, what do we do now?'”

After frantic 911 calls, the baby went to the hospital. Doctors warned, because Abel had gone so long without oxygen during labor, he might be brain damaged. The official diagnosis came a year later: cerebral palsy.

“They didn’t know if he’ll be able to walk, they don’t know if he’ll be able to talk, they don’t know if he’ll be able to sit up, he can’t do that now still.”

It’s a tragic story, all too familiar to those of us who track the increased rate of death and disability due to homebirth.

But it didn’t end there. Abel’s parents, Kristine and Greg, created a foundation, We Are Abel, to “protect and strengthen others” who face brain injury. And they filed a $50 million lawsuit, seeking to hold both midwives and state regulators responsible. They sued the state for failure to use evidence based standards in licensing and regulating homebirth midwives.

Ultimately, the suit against the state was unsuccessful, because the law ensures that most states cannot be sued for reasons like this.

Kristine writes:

November 27th, 2013 I received a phone call from my lawyer to inform me that The State of Oregon has received Sovereign Immunity in Abel’s lawsuit. Two and a half years of isolation, depositions and hope all crashing down around us. I don’t remember what all was said, and I have yet to read the latest manila envelope of neatly typed legal jargon that followed promptly in the mail. When my husband came home I was wailing, surrounded by my half prepped Thanksgiving dishes. Wailing is not crying. It is deeper. Like a scream and a roar from deep in your gut. Primal and raw, normally for the shower where the sound of the water can drowned it all out. But there my husband found me. He held me and I told him what they had said. He sat for a minute and I studied his face watching. Waiting for him to say.. “We were brave. We told the truth. We are RIGHT. They all know it. Abel MATTERS. What happened to our son should be acknowledged. THIS ISN’T FAIR!!!”

It isn’t fair! I’m sorry that Abel didn’t get the financial compensation he needs and deserves, but Kristine and Greg should not think that they didn’t accomplish anything. There’s nothing like a lawsuit, even an unsuccessful lawsuit, to focus a state’s attention. Single-handedly, they and Abel alerted the officials of the state of Oregon in a way that no one else could.

I suspect that everything from Oregon’s decision to collect their own homebirth statistics (which showed an 800% increase in the risk of death at homebirth) to growing scrutiny of homebirth regulations is rooted in the wake up call that the Andrews sent to state officials. Kristine, Greg, and above all Abel PERSONALLY have saved lives, even though they may never know just whose lives they have saved.

But, then, that’s the nature of superheroes. They protect the public with their extraordinary abilities and often are not properly acknowledged for their sacrifice.

So please join me in expressing heartfelt thanks to Kristine and Greg. You are my heroes!

And Abel? Most people never save anyone’s life and Abel has undoubtedly saved many lives and will continue to do so in every year in the future.

Abel is my superhero!!

The National Center for Health Statistics published Births: Final Data for 2012 last week and homebirth advocates are crowing about the increased rate of homebirths.

From the report:

“Out of hospital deliveries represented 1.4% of births in 2012. Of the more than 50,000 out of hospital births, about two-thirds (65.6%) occurred in a residence (home), and 29.0% occurred in a freestanding birthing center. The number of births occurring at home, 35,184, was the highest since reporting began for this item in 1989.

Jennifer Margulis boasted that Oregon led the nation with the highest percentage of homebirths at 2.4%.

I can’t decide whether these women are clueless or callous or both. There is no cause for smiley faces or pride when an increase in homebirth means an increase in homebirth deaths.

In the last few years, there has been an endless stream of data and scientific papers attesting to the fact that homebirth dramatically increases the risk of newborn death (3-10 fold) and brain damage (18 fold). Nowhere is the scale of the disaster more apparent than in Oregon in 2012 where 5/1000 homebirths ended with babies who died preventable deaths to achieve the nation’s highest percentage of homebirths.

If Oregon is indicative of the toll of homebirth it means that in 2012, approximately 175 babies lost their lives because their mothers were more concerned with where they gave birth than whether their babies lived or died. That doesn’t even count the babies who sustained permanent brain damage or other injuries as a result of their mothers’ decision to give birth far from the medical personnel and equipment that would have saved them.

Let me repeat that: 175 babies DIED and possibly hundreds more were permanent impaired in 2012 alone for no better reason than because their mothers put their desire for a specific birth “experience” ahead of the wellbeing of their babies.

Rather than boasting, Ricki Lake and Jennifer Margulis should be crying tears of shame.

You can’t make this stuff up.

From Mothering.com comes this post entitled I just want to have another baby so I can have a homebirth by YoginiMomma:

I just want to have a nother baby so I can have a homebirth that I was supposed to have, rather than the horrible traumatic hospital transfer I had (see birth stories). I’m sure this is a common sentiment… right?

Wrong!

When deliberately choosing to have another baby, the overwhelming number of women do so because they want another child to love and nurture. One of the most reprehensible aspects of homebirth, however, is that it has nothing to do with the baby and nothing to do with birth. It’s the mother’s chance to star in her own little piece of performance art. Everyone else, medical personnel, her partner, even the baby are nothing more than bit players at “her” birth.

… I feel like I really just need to have that homebirth to heal this SHIT. The problem is… what if the same thing happens (or worse)? I’m just going to keep having babies in search of the homebirth that will never happen? similar to how people keep having kids to get a girl or boy and end up with four of the same sex before they finally call it quits.

Thank you, YoginiMomma, for illustrating the immaturity, self-absorption and selfishness of so many homebirth mothers!

This is a bit much, even for the folks at Mothering.com. Although there are some supportive comments, most commentors appear to be as appalled as I am.

One commentor wrote:

I do not think that any child should be had for any other reason than parent (s) wanting to have another child to raise and to love. It is not this baby’s job to heal you.

You just had a child. Concentrate on your baby. See a therapist. See an attorney. Do not make rush decisions.

Another mother bravely offered this powerful personal experience:

I would say be wary about putting grand expectations on your child and their birth. I did that to my son and realized how unfair it was that I was expecting an innocent baby and his mode of birth to fix something wrong in me and I was so guilt ridden when he got here via failed vbac that became a lifesaving saving emergency (cord issue). He just wanted t to be born and healthy, he didnt care how it happened and I was so disappointed in his birth not being my healing vbac that I grieved for him that he had a mother that was trying to use him for her own emotional needs right off the bat.

Hundreds of years ago, a great philosopher named Immanuel Kant, made a revolutionary pronouncement, “Always treat people as ends in themselves, never as means to an end.” Kant insisted that each individual has intrinsic moral worth that regardless of whether others might or might not benefit from his existence.

In other words, it is nothing short of immmoral to bring a child into the world to meet your own needs. Children are not props whose primary purpose is to bolster your own self-image.

YoginiMomma should run, not walk, to her nearest therapist. She needs to find out why she believes that a specific birth performance is needed for her personal validation. She needs to learn that having children is about what you can do for them, not what they can do for you. Above all, she needs to get control of her overweening narcissism. Children are separate people, with their own needs and identities. They do not exist to boost the self esteem of their mothers.

And natural childbirth and homebirth advocates need to ask themselves where their philosophical movements went so wrong that women have been convinced that they are worthless unless they have a specific birth performance, and that their children are meaningless except insofar as they can bolster their mothers’ self image.

I’ve been struck by the number of stories on this blog of homebirths that ended with the baby receiving cooling therapy. The treatment, known as therapeutic hypothermia, is designed to reduce the brain damage of hypoxic ischemic encephalopathy (HIE) that results when a baby is deprived of oxygen before birth. To my knowledge, no one had looked at the association between homebirth and cooling therapy … until now.

The poster entitled Home birth and risk of neonatal hypoxic ischemic encephalopathy, to be presented at the forthcoming February meeting of the Society of Maternal-Fetal Medicine looks at precisely this issue.

The authors, from Weill Cornell Medical Center, explain:

Since 2007 our institution has been a primary referral center in New York City (NYC) for neonates with suspected HIE that undergo therapeutic hypothermia (cooling). A database of all cooling cases from 2007-2011 at our institution was linked to vital records. Four normal controls per case were then selected from the birth certificate data after matching for year of birth, geographic location (community district), and gestational age in weeks. The odds of HIE for home versus hospital birth was assessed via logistic regression.

What did they find?

Of the 69 infants who received cooling therapy, 5 had been born at homebirth. That represents 7.2% of babies who underwent treatment, an extraordinary number consider that homebirth accounts for only 0.5% of births.

Indeed:

Women who delivered at home had 16.9 times the odds of neonatal HIE compared to women who delivered in a hospital (p <0.01). The odds remained significant after controlling for maternal age, ethnicity, education level, primary payer and prepregnancy weight (aOR 18.7, 95% CI 2.02-172.47). After controlling for mode of delivery the odds of HIE increased for home birth compared to hospital birth (aOR 32.9, 95% CI 3.52-307.45).

In other words, homebirth increased the the odds of a baby needing cooling therapy for brain damage due to lack of oxygen by more than 18 fold!

When compared with babies born vaginally in the hospital, babies born at homebirth had a rate of hypoxic brain damage 32 times higher, suggesting that C-sections dramatically decreased the risk of hypoxic brain injury.

The results are appalling, though hardly surprising. All the existing scientific evidence, as well as state and national statistics shows that American homebirth has an increased risk of death of at least 3-9 times higher than comparable risk hospital birth. Since most of these deaths are due to oxygen deprivation in labor, it is not unexpected that the risk brain damage is also dramatically increased.

This is yet another stunning indictment of American homebirth. Far from being safe, homebirth dramatically increases the risk of brain injury as well as death.