Posts Tagged "homebirth"

Open Letter to BC Homebirth Study Critics

Posted on Sep 3, 2009 in Birthing, Childbirth Options, Maternity Care Options | 3 comments

Open Letter to BC Homebirth Study Critics

Dear Uniformed Commenter After reading the newest study on the safety of homebirth, I sat back to read some reactions from the press and the public. I had a look at the CTV coverage and the CBC coverage and I read over the comments in reply to each story. Imagine my dismay when I read some of your reactions! I was rather glad that the comments were closed because I was too upset to post anything coherent or cool-headed. Frustrated, I can not stop thinking about your replies. First, I shake my head as it appears that you’ve neither read the study nor understood the very article you’ve responded to. You seem to have missed the point entirely. Your arguments fall into one of several categories: 1. The Personal Anecdote Rebuttal This is some variation of “I can only imagine how horrible our child’s birth would have turned out if we had tried to have a home birth” and then launching into your personal story where everything was touch-and-go but thankfully the medical staff at the hospital saved your baby. First of all, this is not a logical rebuttal to a scientific study. This is an emotional reaction known as a pathetic appeal. You are rejecting “a claim based on how it makes you feel without fully analyzing the rationale behind the claim”. You are appealing to people’s very real emotions about the health and safety of a tiny baby at the expense of being able to actually hear what the study’s authors are trying to tell you. While it is totally understandable that this is an emotionally sensitive topic for many, the problem is that you are overemphasizing the emotional component at the expense of the message (the logical component) – this is a flawed argument. Effective, yes – ad campaigns do it all the time, but flawed nonetheless. Secondly, while my heart goes out to you that you had a difficult and scary time at the birth of your baby and while I’m glad that modern medicine was able to save your baby, we can’t actually compare your situation with that of the study subjects. We have no way of knowing with the few details you’ve given if your particular circumstances would have made you an eligible sample for the hospital group. Perhaps you had complications or a high-risk pregnancy that would have excluded you from the study. Therefore, sadly, your situation is not a relevant point of comparison for a study that was looking at births fitting very specific criteria. If that is the case, even the study’s authors, home birth advocates, the BC College of Midwives etc. would all agree with you: your child’s birth should not have occurred at home because it did not meet the criteria to have a home birth safely. 2. The What If Question This argument boils down to “Yes, homebirth is fine as long as nothing goes wrong. But why chance it?” You have missed the point completely; the study concluded that home birth is as safe as hospital birth because in all the cases studied, virtually nothing did go wrong. The perinatal death rate was the same as for both hospital groups (in fact, it was marginally lower in the homebirth group). This what-if-something-goes-wrong argument was essentially what the study was trying to find out – how often does something go wrong at home? And the conclusion was, provided certain guidelines are followed: no more often than something goes wrong in the hospital. 3. The Get With The Times Blow Off This argument is the most uninformed of the bunch. You demonstrate your complete lack of understanding of maternity care and midwifery with variations of “Midwives are old hippies with no training and would be useless in an emergency” or “Stop being so full of yourself and your need to prove something – modern medicine is here for a reason, use it.” This brand of reaction is intended to silence anyone supportive of homebirth by insulting and denigrating but it only demonstrates your own ignorance. Midwives, in BC...

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Birth Choices – what is right for you?

Posted on May 19, 2009 in Birthing, Childbirth Options, Featured, Maternity Care Options | 0 comments

Birth Choices – what is right for you?

Today we have more choices than ever about how we birth. We have the choice of using a doctor or midwife for our practitioner. We have the choice of birthing in the hospital or at home. We can choose who is present at the birth. We can choose to hire a doula. We can choose between a multitude of prenatal classes ranging from hospital-run classes to private classes in Lamaze, the Bradley method or Birthing From Within. We can enroll our older children in Sibling Preparation classes, we can take prenatal yoga or prenatal pilates, we can bring music, pillows and massage oil to the hospital. We can choose to labour in the tub or the shower or on a birth ball. We can play cards or go for a walk. We can birth squatting or standing or via elective cesarean. We can even write up elaborate detailed lists of all of our preferences and give this Birth Plan to our practitioners. Faced with all of these choices, how do you know what is right for you? How do you know that the choices you made before the big day will still be right when labour starts – especially if you are a first time mom? Choice, in general, can be a double-edged sword. On the one hand, it is empowering and enriching to be given the opportunity to have a say in what happens to us. On the other, given too many choices or inadequate information to help in our decisions, the process of choosing can cause stress, anxiety and even guilt and depression. And when it comes to birth, it can give the misguided impression of control. Relinquish Control (even those subconscious thoughts…) The first thing you can do on your journey towards the right birth for you is to forget about those fantasies of your ideal birth. We all do it: we all have a vision in our heads of the way we hope our birth will proceed. These visions are rarely realistic (unless you imagined in your ideal birth that you would be half-naked on your hands and knees in a roomful of strangers). Birth is a dynamic process and we cannot control what happens. The woman who is determined to get her epidural before she’s finished with the hospital admitting desk may deliver baby at home in the bathroom attended by her partner. The woman who preaches natural birth from before conception may end up with a complication, or labour induction and a cesarean delivery. We’ve all read these stories and hoped it wouldn’t be us. But it could be. So the first step is to let go. Read everything you can get your hands on Knowledge is power. If you aren’t a reader, ask questions. Ask all the mothers you know what their experience was like. Ask your practioner all those nagging questions you’re afraid to speak out loud. Explore all the birth possibilities there are. Don’t shy away from those topics that you hope you won’t have to face (like having a long, drawn out back-labour or requiring a cesarean). Don’t write off ideas that are new to you (like homebirth, or hiring a doula). The more you can understand about the way labour progresses (or sometimes doesn’t) and the way labour is managed (or sometimes mis-managed), the better the chance that you will be able to play an active part in the process. Be Flexible (but know your limits) That is, be prepared to change your mind. Something that seemed right before birth may no longer be fitting during birth. Hell, something you asked for during one contraction, may not be what you want during the next. Accept the fact that you may need to revise your thinking in the face of new information. However, if at any time, you are uncomfortable with the care you are receiving, be confident that it is okay to assert yourself or have some intervene on your behalf. By trusting your instincts and your birth team, you’ll know when to stand your ground and when...

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Is homebirth safe?

Posted on Apr 15, 2009 in Birthing, Childbirth Options | 3 comments

Is homebirth safe?

The most recent studies have shown that with healthy pregnancies free of complications, planned home births attended by trained midwives are as safe as hospital births. There are some VERY important distinctions made in the above statement. Studies of home birth look at: Low Risk women Families who have planned ahead of time to have their birth at home and prepared for it. This does NOT include births that happened so fast that paramedics were called or mom delivered at home alone. Home births attended by trained professional midwives. These studies make no claim as to the safety of unassisted home birth, precipitous home birth or home birth for women who do not meet the criteria for being low risk. Please note the overall findings of a study on home birth reported in the Canadian Medical Association Journal, including some very important benefits of home birth: “there were fewer interventions during labour, including electronic fetal monitoring, induction of labour, episiotomy and cesarean section; women were more likely to have an intact perineum and fewer maternal infections and were no more likely to have third-degree or fourth-degree tears or postpartum hemorrhage; and there were no significant differences in perinatal mortality, 5-minute Apgar scores and meconium aspiration syndrome, as compared with women intending to deliver in hospital who were assisted by physicians or midwives.” – Régis Blais, Are home births safe? CMAJ 2002;166(3):335-6 There is a wealth of information available on this subject: Check out our articles & research...

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Rebirth: Maternity Care Alternatives

Posted on Feb 3, 2009 in Birthing, Childbirth Options, Featured, Maternity Care Options | 0 comments

Rebirth: Maternity Care Alternatives

Planning to have your baby in the hospital? You might have to contend with some of the symptoms of an over-burdened healthcare system. Maternity wards can be over-crowded and under-staffed. Hospital stays are getting shorter. And if you happen to go into labour at the wrong time, you could be sent to another city’s hospital because all of the hospitals nearby are at capacity. What if our maternity care system could be over-hauled to relieve the burden? What are the realities? Fewer doctors and nurses Besides the well-publicized shortage of nurses, Canada also faces a shortage of physicians who attend births. Between 1992 and 2004, the percentage of general practitioners who attended births fell from 28% to only 13%. Rising Costs Having a baby in these technological times is not cheap. The average cost for a vaginal delivery is $2,800. For a caesarean, it is closer to $5,000. This does not include the added costs associated with length of hospital stay or neonatal care. With every epidural, there is an added expense for the anesthesiologist and with a BC cesarean rate approaching 30%, costs are rising for maternity care. Shorter Stays An obvious cost-cutting measure is to shorten hospital stays. The average length of stay for a vaginal birth in BC has fallen to only two days. For a cesarean birth, it is less than four days. Women are being sent home to care for newborns within a couple of days of major abdominal surgery. What happened to resting and recovering from birth? How would a new system look? Midwives Midwives are trained specialists in birth. They have usually completed four years of practical training. Their appointments run about fifty minutes (as opposed to the standard ten minutes with your family doctor). They often do home visits in the first week after baby is born to help initiate breastfeeding and to monitor mom and baby. Mothers report excellent continuity of care and higher levels of satisfaction with their births and their care. The midwifery model of care tends to be cheaper than the current medical model. Midwives believe that birth is a natural physiological process. Though trained to spot and mitigate problems, midwives adopt a fairly hands-off approach as caregivers. Births attended by midwives show a lower incidence of epidural use, episiotomy, and cesarean section. The benefits are not just higher maternal satisfaction, but also much lower costs. Homebirth & Birth Centres In the last two hundred years, medicine has managed to pull birth firmly into its clutches. Contrary to all logic, with birth, we take women who are healthy and place them in the hospital as a preventative measure (in case something goes wrong) and then we treat them the same way we treat the sick and injured. Since when is pregnancy a disease? Modern medicine can be thanked for the low incidence of infant and mother mortality associated with birth today. We know more about the human body, more about birth, more about infection. We know to keep wounds clean. We have antibiotics and other modern drugs. We can save moms and babies from situations that would have claimed their lives only 100 years ago. But that does not necessarily mean that birth belongs in hospital. We can transfer our medical knowledge to other places, like the home. Recent studies show that with healthy pregnancies free of complications, planned homebirths attended by trained midwives are as safe as hospital births. For low risk women, we can achieve safe birth at home and reap a dual benefit because there are advantages to birthing where a mother feels safest and most comfortable. We can also find a middle ground instead of polarizing between hospital and home. Imagine the power of a birth centre: birthing in a homelike setting with a midwife, a birth pool, medical equipment tucked out of sight and the potential of a quick transfer to hospital if need be. On the flip side, imagine the benefits for our rural and northern communities that don’t have hospitals have their own. Mothers would no longer have to travel...

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