Afraid of homebirth? You should be!

Grieving family with an infant's coffin

Yesterday’s Washington Post contained a puff piece on homebirth. It’s entitled Afraid of a home birth? These two first-person accounts will give you a new perspective, and is followed by two anecdotes, one of a mother who had a homebirth in the US, and another of a mother who had a homebirth in the Netherlands. But neither story will give you new perspective for two important reasons.

First, although anecdotes may reassure you or frighten you, by their very nature they can’t give you perspective. If you’re afraid of homebirth, you want to know the risk to YOUR baby, not two women’s personal experiences. Imagine, for example, that you want to know whether you should buckle your infant into a carseat when driving to the store. The fact that a random mother drove to the store with her infant unbuckled and the baby survived tells you nothing about what is likely to happen to YOUR baby. The fact that another mother drove with her infant unbuckled in a different country with very different rules of the road and using a car with a plethora of safety features that we don’t have in the US tells you nothing about what might happen to YOUR baby. And the fact that both babies survived does not change the fact that not buckling your infant into a carseat is a very bad idea.

Second, the Post reporter leaves out two critical facts when relating the anecdotes:

Homebirth dramatically increases the risk of neonatal death.

Dutch midwives caring for low risk women (home or hospital) have a HIGHER perinatal mortality rate than Dutch obstetricians caring for HIGH risk patients in the hospital. That’s a scathing indictment of Dutch midwifery care.

Afraid of homebirth? You should be. It raises the odds that YOUR baby will die during childbirth.

The anecdotes themselves, while meant to be reassuring are anything but.

You know you have a problem when the title of your piece promoting homebirth is I had a home birth and I’m not stupid. Or brave. It’s an even bigger problem when the piece demonstrates that you are stupid and reckless.

When I began really looking into what evidence based birth meant, it seemed like the exact opposite of what I had received. It turns out laboring on your back is not conducive to letting your body open and your baby come down. While I knew it was best to stay out of bed, I hadn’t known how listening to the nursing staff like a good patient might alter the course of my birth. It seems like commonsense now, to make use of gravity, one of the most natural forces in the world. But at the time, I was trying, against my better judgment, to listen to my care providers. I should’ve been listening to my body.

I can’t comment on Sarah Bregel’s native intelligence, but I can tell you that it is monumentally stupid to believe that you can educate yourself by reading homebirth books, websites and message boards. Would you trust a money manager with your life savings if he told you that he is sure that he can increase the value of your portfolio because he read about it on the internet? Would you trust a pilot to fly you safely to your destination if she told you she had researched flying by reading a bunch of websites? No, and no. Why not? Because anyone who isn’t living under a rock is aware that the internet is packed with bogus “experts” peddling bogus products and taking your money in exchange. Reading homebirth websites to find out if homebirth is safe is like reading Big Oil websites to find out if solar power is a good way to heat your home. You’d be a fool to think you could find the truth by doing so.

While the most common reactions to having a home birth are either that it is very stupid or very brave, I’m here to tell you that for me (and many others) it’s neither. Home birth is a safe option for many women. While hospital transfers do happen, the midwifery model of care typically means being monitored very closely. So in the case of an emergency, it’s not often the dramatic, rush to the hospital, last minute C-section, tearing the baby out in the nick-of-time fiasco that you’d imagine…

And I’m here to tell you, Sarah, that if you believe that you are foolish and gullible.

Who am I? I’m an obstetrician and mother who has spent years cataloging the literally hundreds of babies who have died preventable deaths at homebirth, because their mother’s were hoodwinked and flattered into believing that they know more about childbirth safety than obstetricians who have spent years studying, training, practicing and routinely saving infant lives. Just last night I was informed of two more babies who died at homebirth this past weekend, and within the last month I learned of two MOTHERS who had died at homebirth in Texas within days of each other in December.

Homebirth is NOT a safe option, though I doubt any homebirth advocates would tell you that. In the most comprehensive collection of homebirth statistics ever analyzed, Judith Rooks, CNM MPH (and homebirth advocate) looked at PLANNED homebirths with a LICENSED homebirth midwife in Oregon in 2012. She found that the perinatal death rate at homebirth was 800% (that’s right, EIGHT HUNDRED PERCENT) higher than comparable risk hospital birth. That data was released in March 2013, and if you didn’t know that, Sarah Bregel, than you didn’t know anything about the safety of homebirth.

I happen to know the details of many of these deaths and I can tell you that these babies died in fiascoes DESPITE dramatic rushes to the hospital, last minute C-sections and tearing the baby out NOT in the nick of time, but after it was already dead or so profoundly brain damaged that it could not survive.

And they died in fiascoes where they were born not breathing or even dead because clueless midwives weren’t monitoring the babies’ heart rates appropriately or didn’t understand what they were hearing.

Homebirth is NOT a safe option, and the organization that represents homebirth midwives (the Midwives Alliance of North America) is well aware of that fact and DELIBERATELY, and UNETHICALLY lying about it. Their own paper (actually a voluntary survey completed by only 25% of members) shows that homebirth increases the risk of death by 450%! They know that; they lie about that: and they trick gullible women like Sarah Bregel so they can make money attending births despite being so unqualified that they would not be eligible to work as midwives in ANY other first world country, (not the Netherlands, not the UK, not Canada, not Australia, not any industrialized country).

The second anecdote, How pregnancy and birth overseas is so different than in the U.S., is hardly an endorsement of homebirth, and that’s despite the fact that the author is unaware of the terrible perinatal mortality rates of Dutch midwives.

Over the course of my pregnancy, however, I started to see the appeal of giving birth outside of a hospital setting. It was comforting (and, in retrospect, highly delusional) to think that I wouldn’t experience any pain my body couldn’t handle, that childbirth was fail-safe process engineered by Mother Nature for peak results…

I’ll spare you the details of my delivery. Suffice it to say, it was not quite the pool party I had hoped for. By the time I finally broke down and demanded to transferred [sic] to a hospital so that a real doctor could administer an epidural, it was too late.

But childbirth is hardly a fail-safe process engineered by Mother Nature for peak results (and both infertility and miscarriages are evidence of that). The insistence by Dutch midwives that it is fail-safe has led to the Netherlands having one of the worst perinatal mortality rates in Western Europe, and the appalling reality that high risk babies delivered by obstetricians are actually MORE likely to survive than low risk babies delivered by midwives.

Afraid of homebirth? You should be. It’s promoters and practitioners, both in the US and in other countries are not honest about the death toll at homebirth.

Hospital birth is like a carseat. Don’t use it and your baby will probably survive anyway … no thanks to you or your midwife.