Homebirths no more... (1 Viewer)

[billygannon]

What if, god forbid, the hospital people browbeat you into delivering on the flat of your back and it was excrutiatingly painful and you tore inside and bled to death cos the doctor hadn't slept for 36 hours and wasn't on the ball?

Deaths/near misses happen in hospital too. No point making claims one way or the other (Billy!) unless you got the facts to back it up. The UK has a lower infant mortality rate than Ireland (http://globalis.gvu.unu.edu/indicator.cfm?IndicatorID=25&country=IE#rowIE), and around 2% of births there are at home (http://www.birthchoiceuk.com/Tables/TableHB_AO2.htm). Dunno what the percentage is here, but I expect it's lower

It's quite hard to get definite statistics on deaths/near misses on planned home births. It's also fairly pointless trying to compare hospitals and planned home births using this measure.

The health services will compel you to have a hospital birth if there is anything remotely wrong with the pregnancy or if they can genuinely foresee any problems that may occur at birth. They will also compel you to have a hospital birth if you're living in too a remote area or there simply isn't the midwifery staff available to provide sufficient care.

This means that the chances of a planned home birth leading to a tragic outcome are always going to be a lot slimmer than the chances of a hospital based birth.

What needs to be compared are low-risk pregnancies. So everything has gone well with the pregnancy and the doctors and midwives can't foresee any problem with the birth.
I don't have loads of statistics to back this up, but I did come across this:
http://www.bmj.com/cgi/content/full/330/7505/1416?ehom.
and this:
http://www.independentbirth.com/stats.html#Homehosplink
(but just pulling stats of websites returned by a Google search is hardly thorough).

Planned home births are genuinely safer than hospital births.

Firstly you are guaranteed the full attention of a midwife (and two where the baby is about to be delivered). This is not always the case in hospitals (although it differs from hospital to hospital). By having a midwife with you constantly, it means she can immediately identify any problems and escalate it to a consultancy unit. This happened for us. The ambulance arrived five minutes later and we were in the consultancy unit within twenty minutes. If we had the birth in the hospital there would have been no difference in time (because they would need to prepare a bed or the operating theatre - which will take twenty minutes or so).

Secondly, by planning to have the birth at home, the woman (and man, if he's involved) are far more prepared for the birth.

Thirdly the woman is far more likely to be comfortable and at ease for the birth. By being prepared and being in a relaxed environment, it will mean the birth will be far more successful and safer.
What happens at birth for a lot of women is, because they are shocked by the intensity of the contractions, their bodies adopt a fight or flight response. This means all the blood goes to their vital organs needed for survival - and all the blood leaves the uterus. This is the equivalent of a heart attack for the uterus - right at the time when it will be doing it's more intense work.
So add in the pressures of having to be bundled in to a car, rush through heavy traffic and then put in an environment you normally associate with sickness and injury which is usually hot and uncomfortable.. well the woman hardly has a chance to relax. She can't relax. The fight or flight response is exacerbated. The labour then stalls because the pelvic floor can't be relaxed. The womb muscles aren't working. So it leads to some sort of medical intervention. And the whole thing is simply traumatic - and more dangerous for the woman and baby.
The percentage of normal births in hospitals are decreasing every year. And traumatic births can lead to all sorts of problems.

If the environment is right... it's relaxed.. the woman feels at ease in it... then she will relax her body, thereby ending the fight or flight response and allowing her uterus to work properly. This in turn lets the whole birth happen naturally. Which is a lot safer. The percentage of normal births at home far outweighs the percentage of normal births in hospital.

There's no difference in the mortality rates between planned home births and hospital births.

The percentages of home births are still very low. They will continue to be. It's difficult, sometimes impossible, for the health services to easily provide midwives to come out to a person's home and provide care.

When it is available, the pregnancy is going well and medical advice supports it, a home birth is the most sensible option.

And that woman Dip referred to was just stupid. If the pregnancy has gone over 43 weeks, then inducement is the only option.

 

[Umfufu]

Homebirths are fine as long as there are no complications.
If there are, you'll be lying on your back waiting for an ambulance to take you into one of the cesspits for proper medical care.

Those private hospitals (Mount Carmel & the like) are the same.
Done up lovely to make you feel nice & relaxed but if anything goes wrong they'll stick you in ambulance & ship you off to a real hospital.

 

[billygannon]

Homebirths are fine as long as there are no complications.
If there are, you'll be lying on your back waiting for an ambulance to take you into one of the cesspits for proper medical care.

Those private hospitals (Mount Carmel & the like) are the same.
Done up lovely to make you feel nice & relaxed but if anything goes wrong they'll stick you in ambulance & ship you off to a real hospital.

The chances of complications in a planned home birth are far less likely than a hospital based birth.
If you feel nice and relaxed than the chances of the birth being normal are far more likely.

Of course complications can happen - but they're just as likely to happen if you have it in hospital. It's like saying you shouldn't drive a car because you might crash it.

 

[Umfufu]

Of course complications can happen - but they're just as likely to happen if you have it in hospital.

Obviously.

The point is, when complications happen in hospital you get treated by a doctor immediately.
If they happen at home you have to wait for an ambulance & then travel to the hospital before you can be treated.

I'm not even commenting on the giving birth/driving a car analogy.

Also, I don't think you can compare mortality rates of home births to hospital births.
Anyone with any risk factors at all would be advised against a home birth.
So the home birth stats are the people with the lowest perceived risk factors while the hospitals have to deal with everyone else.

 

[billygannon]

Obviously.

The point is, when complications happen in hospital you get treated by a doctor immediately.
If they happen at home you have to wait for an ambulance & then travel to the hospital before you can be treated.

In many hospitals there isn't a midwife present right throughout the birth. You often have one midwife looking after more than one birth simultaneously.
This means that problems often don't get detected early at a hospital.

At a home birth, you have the full attention of a midwife who can escalate it to an emergency immediately.

You also won't be treated by a doctor immediately in a hospital. If surgery is required, the operating theatre has to be prepared. This can take up to half an hour.
If you're at home, the operating theatre is prepared while you're in the ambulance - it will take an ambulance about half an hour to get to the hospital.
The midwife staff at a hospital have the same emergency equipment as paramedics.

You only need to give birth in a hospital if there are genuine risks that could arise at birth. If the pregnancy has gone normally, then it's better to have the baby at home.

 

[whathappen?]

as someone who knows nothing about this birth thing.is it possible to have that same level of pain relief at home.thats what would worry me.that i just wouldnt be able to handle it. if you can get that at home than if i ever have a baby than i would prefer to be at home where you can relax .

 

[magicbastarder]

The chances of complications in a planned home birth are far less likely than a hospital based birth.
If you feel nice and relaxed than the chances of the birth being normal are far more likely.

Of course complications can happen - but they're just as likely to happen if you have it in hospital. It's like saying you shouldn't drive a car because you might crash it.

as umfufu pointed out, it's completely false to claim that home birthing is safer than hospital birthing.
it's like claiming that renaults are safer cars than peugeots, after you've banned anyone with a couple of penalty points from driving renaults.

whathappen: there's no anaesthetist available during a home birth. so no epidural.

 

[magicbastarder]

If you're at home, the operating theatre is prepared while you're in the ambulance - it will take an ambulance about half an hour to get to the hospital.

and half an hour to get to your house?

 

[SONYMEGADRIVE]

has anyone ever given birth in work?

 

[billygannon]

as someone who knows nothing about this birth thing.is it possible to have that same level of pain relief at home.thats what would worry me.that i just wouldnt be able to handle it. if you can get that at home than if i ever have a baby than i would prefer to be at home where you can relax .

There are two types of medication that are available in the hospital that are not available at home. These are petadine and an epidural.

Petadine is a fairly hardcore drug. Anyone I know who's taken it says it doesn't have a huge effect - indeed, it can make the labour feel like it's taking a lot longer than it is.
An epidural is kind of one of the last resorts before a casearean. For this they basically inject in to your spine and keep it there until the delivery. You're not going to feel a thing from the waste down. It really should be treated as a last resort - only if the baby really is having difficultly coming out.
A problem with epidurals is that the baby will be very dreary when they come out. They'll get hit by the anaesthetic too.

The midwife will have gas and air... in fact she'll have everything that a hospital midwife will have bar the two drugs mentioned above.

The reality is that there is a lot of pain in labour.
But as you said, you would prefer to be at home because you'd feel more relaxed.
Being relaxed and actually letting your body do the job it's meant to do will significantly reduce the pain you'll experience.
It's quite possible to have a birth without any pain relief. In fact, there isn't really any pain relief that has a proper effect if you want the birth to go normally. Gas and air is the most commonly used and that only takes the edge of things. But your body is able to handle it. It's one of the big jobs your womb is designed to do.

 

[whathappen?]

I didnt think an epidural was a last resort.I thought it was standard if you wanted it.

 

[billygannon]

and half an hour to get to your house?

The ambulance service in Ireland is run by the Fire Brigade. They're not located in the hospital. It won't take them as long to get to you as it would for you to get to the hospital.

For us, it took the ambulance five minutes to get to our place. We got to the hospital in twenty minutes.

I should also point out that labour is a pretty long process. It usually takes 12 to 14 hours.

You'll only need an epidural if the labour is taking too long. You'll have loads of time to get to the hospital to get an epidural if it's needed.

 

[magicbastarder]

There is no difference in the mortality rates between planned home births and hospital births.
There is a significant difference in normal births between planned home births and hospital births.

i thought you said statistics weren't available?

also, if i am reading you correctly, all you are saying is that home births are safer simply because the pregnancy must be one without complications. it's a circular argument.

if a woman has a normal pregnancy, and wants to give birth at home, more power to her. i know people who have given birth recently, who said they preferred a hospital birth, because it's reassuring to be doing it in a hospital, if anything goes wrong. i'm extrapolating, but i'd take that to mean that they were more relaxed in a hospital.

 

[billygannon]

i thought you said statistics weren't available?

also, if i am reading you correctly, all you are saying is that home births are safer simply because the pregnancy must be one without complications. it's a circular argument.

Well, here you go:
http://www.bmj.com/cgi/content/full/330/7505/1416?ehom
Conclusion of this research is:

Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

I'm comparing pregnancies with no complications. So pregnancies with no complications where the birth is planned to take place in a hospital are more likely to require intervention than births planned to take place at home.
These interventions are carried out because of an emergency. Because something is going wrong. Therefore it stands up that a planned home birth for no risk pregnancies are better than hospital births.
And it should be said that most pregnancies are no risk pregnancies.

if a woman has a normal pregnancy, and wants to give birth at home, more power to her. i know people who have given birth recently, who said they preferred a hospital birth, because it's reassuring to be doing it in a hospital, if anything goes wrong. i'm extrapolating, but i'd take that to mean that they were more relaxed in a hospital.

Well more power to the women who want to have birth in hospital.
But the reason for this thread is because the INO are withdrawing insurance from independent midwives and therefore further restricting home births.

I'm trying to argue in favour of planned home births because I believe that they are a safer way to give birth.

 

[billygannon]

I didnt think an epidural was a last resort.I thought it was standard if you wanted it.

Well, you can. But there side effects:
http://www.childbirth.org/articles/sideeppi.html

 

[Hector Grey]

Quite the expert now, Billy, eh?
Some people, as you quite rightly point out, are too stupid for home births. It's not really an issue with whether it's safer in a hospital or not, some eejits will fuck it up regardless. Hoppitals or home, neither would be a fault if something went wrong, just humans. yeah, what if the doctor hadn't slept in a week, he probably wouldn't be the delivery room anyway. at worst you'd have a consultant, and those cunts sleep on a bed of money, so they're grand.
i much rather there were home births all the time, then you could watch the tv if it went on a bit.

 

[egg_]

as umfufu pointed out, it's completely false to claim that home birthing is safer than hospital birthing.
it's like claiming that renaults are safer cars than peugeots, after you've banned anyone with a couple of penalty points from driving renaults.

Dude, no-one gives a flying fuck whether home birthing in the abstract is as safe as hospital birthing - what people care about is whether it's safe to have a baby at home if there are no contraindications. Nobody in any sort of high risk situation is going to even consider home birth

whahappen? - epidural is fairly standard in some hospitals, not so in others. Something like 90% in Galway, only 20% in Drogheda. The old-school way is put the mother on her back, medicate her when she screams, keep the Da out, give the baby a bottle when it doesn't take to the boob on the first attempt. These days lots of women like the idea of a natural birth and some hospitals facilitate that. Epidural would have been a last resort for Mrs. egg_ when she was having Isabelle, but she had to have an emergency c-section in the end (got sick, baby was in distress before she ever went into labour)

 

[billygannon]

Quite the expert now, Billy, eh?
Some people, as you quite rightly point out, are too stupid for home births. It's not really an issue with whether it's safer in a hospital or not, some eejits will fuck it up regardless. Hoppitals or home, neither would be a fault if something went wrong, just humans. yeah, what if the doctor hadn't slept in a week, he probably wouldn't be the delivery room anyway. at worst you'd have a consultant, and those cunts sleep on a bed of money, so they're grand.
i much rather there were home births all the time, then you could watch the tv if it went on a bit.

Yeah... I've been just a bit too preachy here. It's been the main thing I've been doing and thinking about for the last five or six months. But it's the best thing I've ever done.

Home births are the ideal situation. But it comes down to availability of midwives. The health service just don't have enough midwives - so they're not going to encourage people to have home births. This means that the people who actually really, really want them will actively pursue it. The health services will provide the care needed, but they're not going to advertise it.
A bit like tax breaks I suppose. They're there for people to take advantage of, but the government aren't really going to tell you about them.

 

[Hector Grey]

Home births are the ideal situation. ....

only for some tho. i mean, i'd much prefer that me self, hospitals are awfuls gaffs, but what if the baby i spremature, or you're a heamophiliac or any number of reasons. if you're young and healthy and you've done it before, fire away, but it's not for everyone. some people would rather the hospital. what can you do?

 

[Diddles]

I know. It's an online petition etc etc, but sure just sign it.

The Association for Improvement in the Maternity Services Ireland (AIMSI) are extremely concerned with the current climate surrounding the option of home birth for women in Ireland. Insurance for Independent Midwives is currently due to be suspended after March 31, 2008. This will have a crushing impact on women who choose to give birth at home, the livelihood of hardworking Independent Midwives, and will have a devastating effect on Ireland’s increasingly over-crowded and understaffed maternity hospitals.

AIMSI have included as reference the link to our petition to reinstate insurance for Independent Midwives when this issue first became apparent in 2007. The AIMSI petition received fantastic support, from both a national and international audience, and in July 07 sent the petition to the HSE and INO. The INO quickly responded to inform us that they had decided to extend the insurance cover until March 31st, 2008 and that they were actively in talks with the State Claims Agency for the purpose of having them assume the provision of the insurance after March 08… however, as the deadline approaches, here we are.

Home Birth is a safe and cost effective birth choice for women in Ireland. AIMSI urge you to consider the current circumstances and keep home birth a viable option for all women in Ireland.

Kind Regards,

Jene Kelly
AIMS Ireland


http://www.ipetitions.com/petition/irishindepmidwives/index.html