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Thread: Childbirth at Home as Safe as Hospital Delivery: Study

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    Childbirth at Home as Safe as Hospital Delivery: Study

    Childbirth at Home as Safe as Hospital Delivery: Study
    Review finds no increased problems for low-risk women

    Women who choose to give birth at home with the help of a certified midwife have deliveries that are as safe as those done in a hospital, Canadian researchers report.

    "Home birth is a reasonable option for low-risk women," said lead researcher Kenneth C. Johnson.

    "In this low-risk group of women who had births with midwives at home, we found that the overall safety was similar to what you would find in a hospital in a similar low-risk group," added Johnson, a senior epidemiologist with the Center for Chronic Disease Prevention and Control at the Public Health Agency of Canada, in Ottawa.

    Moreover, evidence from the study supports the American Public Health Association's recommendation that home deliveries with certified midwives should be increased in the United States, he said.

    The study appears in the June 18 issue of the British Medical Journal.

    Johnson and colleague Betty-Anne Daviss collected data on over 5,400 women who had planned to deliver their babies at home in 2000. These women all had the help of a certified midwife.

    When it came time to deliver, 655 of the women transferred to the hospital instead at the start of labor, the researchers reported. "Only about 3 percent of these women had what the midwife perceived as an urgent transport," Johnson said. "The outcomes of these transfers turned out to be fine, by and large."

    For the remaining women who had a home delivery, the death rate of newborns was 1.7 per 1,000 planned home births. This rate is similar to that of low-risk home and hospital births shown in other studies done in North America, the researchers noted.

    Johnson pointed out that in Canada and Europe, midwives deliver most babies. "It's only in the United States among developed countries that midwives are still involved in only a very small percent of deliveries, and that home birth is rare and unacceptable to the obstetric and gynecology profession," he said.

    Despite these findings, one expert thinks home delivery is not a good idea. "I am not a big fan of home deliveries," said Dr. Rachel Masch, an assistant professor of obstetrics and gynecology at New York University School of Medicine.

    "I understand why women want to have them," she said. "And I understand that the literature we have today supports that there isn't any worse outcome for them versus the low-risk hospital delivery if you are screened properly. Although, as an obstetrician who sees a lot of things that happen bad quickly, I think that I have somewhat of a jaded view," Masch said.

    Masch is concerned that when complications set in, they do so quickly and need immediate attention. Women who appear to be at low-risk can fall prey to problems during birth that weren't anticipated, or may have conditions that were not known, which can affect the delivery. Being in a hospital allows these women to get immediate care, which can save their lives and their babies' lives, she said, adding, "There are examples that I see frequently."

    But another expert finds nothing but positives in increasing the numbers of home deliveries.

    "The data we have so far suggests that over-medicalizing the process of labor and delivery adds cost without improving outcomes," said Dr. David L. Katz, director of the Prevention Research Center and an associate clinical professor of epidemiology and public health at Yale University School of Medicine.

    "Building the option of home birth into the routine of obstetrical care for women at low risk of complications is worthy of serious consideration," he added.


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    Post Re: Childbirth at Home as Safe as Hospital Delivery

    This is a good article. It shows both the positive and the negative side of homebirthing. I have known women who have delivered at home with midwives. I am all in support of women who want to go with a midwife and do the home delivery thing. I can also certainly understand the concerns of Dr. Masch in the article. Sometimes what appears to be a low risk pregnancy can take a turn during labor, and suddenly an emergency c-section is needed. The incidences of this are not very high, but I am not sure about an actual figure. I looked up highrisk pregnancy in order to give an idea of how often this occurs and one site shows it around 6-8 percent of all pregnancies-- so you can see how low this is. (http://www.bestdoctors.com/en/condit...isk_081600.htm) I didn't read the whole site, I just skimmed it, but I didn't see anything regarding the lie of the baby (transverse or breech) which I would also include in with high risk pregnancies because of the problems in labor that can occur. This site says that only about 50% of breech presentations are candidates for vaginal delivery (http://www.emedicine.com/med/topic3272.htm). Transverse lies are extremely rare and breech lie only occurs in about 3% of full term pregnancies (although I have seen some stats that place it more in the 5-8% range). Even still, although they are a small percentage of pregnancies, they do carry high morbidity and mortality rates than normal fetal lie, so I personally feel more comfortable placing them in the higher risk pregnancy over the low risk one. (Maybe others feel differently. But after having one child breech, and a potential second breech, I would rather not take chances.)

    So, you can see how the majority of pregnancies are low risk, and I definitely agree if a woman chooses a midwife and a home delivery. I think women should be flexible in case something arises and changes their well made plans. If their pregnancy does take a turn, it is not the end of the world to switch and go with a hospital delivery. So often, newly pregnant women want to plan every last detail of their pregnancy and in reality, you can't. All pregnancies are very different. There is also no way to predict how long your labor will last, or how you will respond to the pain of it. I have known, seen, and heard of many women who swear they will not use any pain relief in delivery, but then by the time they get to the hospital and are well into labor, they are screaming for it. On the flip side, I have heardknown of women who have had very long, very painful labors and did NOT use any pain relief. I have heard/known women who had extremely short and easy labors. My adivce-- just relax and go with what is best for you at the time, afterall YOU are the one having the baby.
    "I do not know what horrified me most at that time: the economic misery of my companions, their moral and ethical coarseness, or the low level of their intellectual development." Adolf Hitler, Mein Kampf

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    my son was born in our home.

    i would hesitate to recommend it to others.

    his mother had her girl-friend there.
    those two had shared a lot of "ovarian massage"
    and extreme "digital dilation",
    which turn-out to be excellent preparation
    for the intensity of child-birth.

    they both swear by our bodies, ourselves
    and where women have no doctor and
    had advanced to a book for midwives.

    they found the books
    because her girl-friend is a dental hygienist
    that utilised where there is no dentist
    in her post-graduate work, south of the border.

    they attended their red cross certification programs together.
    we had all gone to the lamaze classes.

    her girl-friend brought along a school-mate
    from a local hospital.

    some fathers are present for the delivery
    and i had discussed the experience with them.
    i went to the store and harassed my employees.

    i did not wish to hear a loved one screaming
    "you son-of-a-bitch!
    this is all your fault!
    look what you did to me!
    that's never going to work right, again!"

    that might take some of the romance out of our relationship.

    of course, there was the risk of fainting
    in front of the girls
    to consider.

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    Just a quick note here.If i was born at home instead of a hospital i would not have survived due to complications at birth.So i highly recomend that the women here do go to a hospital when they are about to give birth.
    To live is to fight.

    To die is to give up.

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    i agree!

    Quote Originally Posted by Nightmare_Gbg
    I highly recomend
    that the women here do go to a hospital
    when they are about to give birth.
    that is my advice, also.

    but, how do you force
    self-reliant women with like-minded girl-friends
    to do so?

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    Quote Originally Posted by lei.talk
    that is my advice, also.

    but, how do you force
    self-reliant women with like-minded girl-friends
    to do so?
    Show them a pic of me and tell her this is what you'r child going to look like if something goes wrong at birth.
    To live is to fight.

    To die is to give up.

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    I think childbirth should be given in a hospital. After all, anything can happen and something could go wrong, so it's better if there's all things medical science can offer available. That includes proper pain treating methods and surgical procedure if needed.

    Today giving birth to a child is safe. But during the last centuries and millenias countless women and babies have died to delivery.

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    Quote Originally Posted by Nightmare_Gbg
    Just a quick note here.If i was born at home instead of a hospital i would not have survived due to complications at birth.So i highly recomend that the women here do go to a hospital when they are about to give birth.
    Same here. If I had been born 50 years earlier I would not have made it.

    Well, some say that that would just have been Mother Nature's way of weeding out the weak, and that the oxygen tent that saved me was cheating ... :redface:

    Anyway, Finland and Iceland have the lowest child mortality rates in the world, and practically all Finnish and Icelander women give birth to their children in hospitals.

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    Thumbs Down blanc

    I would highly recommend a home birth, given the state our NHS is in at this moment in time MRSA is rife, expectant mothers are required to bring their own cleansing materials ect.

    As babys have very little resistance to bugs and infections, I feel home births should be offered where ever possible. Many years ago the majority of healthy mums gave birth at home with very complications.

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    I wanted to do a homebirth with the birth of my son. I arranged for a midwife and everything looked good. But when the day came to be born and I did labor at home, my midwife was too busy for me, and was with me only once for about 5 minutes. I became fearful around transition, and we drove to the hospital where my midwife later joined. Everything with the actual birth went fine with no problems, and my son was and always has been extremely healthy, but the hospital experience was not at all to my liking.

    It would have been nice to spend my recovery with my husband and son but my son was not allowed in the room for long periods of time, and my husband could rarely visit me.
    It took months afterwards before I could actually bond to my son. I would have rather liked a homebirth, but that is the only midwife in the whole state who does them. So next time it will have to be in a different hospital which is better, and I will be bringing a LOT of food. I was starving and light headed during my whole stay as they did not provide me with anything close to enough food. And the only available drink was this disgusting sparkling mineral water.
    I'm going to get a water birth though, like I also wanted last time. At least for that they won't make you lay flat on your back and treat you like a specimen. My husband was there the whole time holding my hand. You can ask him, I didn't yell anything at him. I was quite happy he was there. It was very encouraging.

    I agree that homebirths should be available to those who want them.

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