Home births a major risk- *DEBATE today on the herald sun website*

[PumpkinZulu]

First and foremost, this is an opinion piece. It is one woman's opinion. It cites no evidence, and make claims that are at best fanciful, and as such, it is terrifying to think that some people might use it to guide their decisions with regards to their place of birth and their choice of care provider.

Secondly, there are some major inconsistencies in what is at its heart ah very sad story of a hospital birth gone wrong. True cephalopelvic disproportion is a very rare occurrence - the usual causes of an "obstucted labour" are poor maternal positioning or interventions which reduce the ability of the woman to labour effectively - the most common one being epidural pain relief, which in relieving the pain of labour, also limits the ability of the woman to push. Unfortunately, Ms O'Brien does not discuss how her labour was managed in her story, which makes it difficult to draw any inferences on whether her place of birth or choice of care provider might have had any effect on her outcomes. It certainly seems unlikely that true CPD would be the cause of Ms O'Brien's obstructed labour given the birth weight of her baby - 2.5kg is very small. And if there had truly been a cephalopelvic disproportion, than the use of forceps would have been contraindicated, and in fact quite dangerous to the baby. All of this indicates that Ms O'Brien most likely has not been fully informed by her obstetrician on exactly what went wrong during her birth. This comes down to an issue of trust, and trust is one of the greatest motivators for women who choose to birth at home - their desire to choose a care provider who they can trust to keep them informed during the birth process, to keep them involved, to respect their desires and their wishes, and to make the best and safest decisions for both the mother and the unborn child.

When we turn to the research, however, a much clearer picture of the relative risks and benefits of homebirth emerges. Multiple research studies from various countries indicate that homebirth is as safe an option as hospital birth for women who are appropriately screened. The problems outlines above - poor maternal positioning, poor maternal preparation, and epidural pain relief - are limited or non-existent during a homebirth. Women who are preparing for a homebirth with an appropriately trained practitioner - a midwife - receieve comprehensiove preparation for birth. Homebirths are almost always "active" births, where maternal positioning and mobility are encouraged to prevent obstructed labour. Midwifery practitioners are well-trained and experienced enough to recognise potential complications an to transfer their clients to a hospital setting if necessary, and I do not personally know of any midwife who does not require her clients to be booked in at their chosen hospital in the event that a transfer is necessary.

So, while Ms O'Brien's story is a sad one, it is certainly not without it's inconsistencies, and it is most definitely not representative of the outcomes of babies born at home across this country. A recent study by the Australian Medical Association on homebirth in Australia in the last decade was only able to find a single child who had poor outcomes that were suspected to be due to their place of birth, and even in that one case, they were unable to prove that the child's death was definitely due to their homebirth.

Decisions about place of birth, and choice of carer, should not be guided by the opinion of one woman. They should not be guided by the opinion of an organisation with a vested interest in medicalising the "industry" of birth. They should be guided by the evidence available, evidence which overwhelmingly supports the safety of homebirth, regardless of the sad birth story of one woman, or the spin of the Australian Medical Association. Until the government understands this, they will continue to discriminate against the women of this country who choose to birth at home.

Thankyou so much for posting all of this Schmik

I can't even formulate a reply right now, the old brain isn't working...but I'll be back

[BellyBelly]

So true Schmick, true CPD is very rare indeed. More likely in the days and times we had malnutrition and living in unsanitary conditions, or unless the mother has had substantial pelvic damage. Pelvis' were designed to work!!! Just like our digestive system. I bet it's a rare thing that a gastrointestinal surgeon hears of emergency surgery because the small intestine was too small for food to pass!

[~clover~]

The sad thing is that so many women out there considering a home birth will read this & hear the obvious emotion this woman feels & will take this article hugely into account if they don't do their own research & do it properly.
As mentioned, this woman obviously was mis-led IMO with the way her birth actually went.
I wish some people would keep their oppinions to themselves until they had done all the same research most home birthers do, so they can make a factual argument.

ETA - I wonder if she has given birth to any other, bigger babies? Surely that would show that things don't add up?

[Roryrory]

The sad thing is that so many women out there considering a home birth will read this & hear the obvious emotion this woman feels & will take this article hugely into account if they don't do their own research & do it properly.

Clover one thing I think HBing has going for it is that while women who want to HB will probably get riled up emotionally and maybe scared by the "what ifs", I think that most who choose HB are actually very good at doing their own research. Sadly, though, I think the op piece will cement the fears of many others, though.

[Little Chicken]

While homebirth is not for me, I think everyone should have the choice and access to those resources. What ever happened to balanced journalism? The thing is if you only look for bad experiences that is all you will find, same as if you only look for good. As for making home births 'illegal'. what are they going to do, fine you if you give birth at home? Take you to court? I feel sorry for the IM's who will lose their careers over this, or risk de-registration if they continue. I don't know if I would want to go back to the hospital system after working in the community. Seriously though the whole system needs a complete overhaul. Wouldn't it be great if these midwives could work out of a hospital and so be covered by the hospital but still provide the same service they did before? Insurance companies have a lot to answer for in my opinion. AAAHHHH I'm rambling, sorry about that, but this whole situation is slightly absurd. I do agree that I think the piece was publish purely to generate traffic to the website and create controversy rather then inform.

[BellyBelly]

Home births a major risk | Herald Sun

Jump onto the site now - LIVE CHAT with Susie and you can post comments.... QUICK!!!

[Olive]

OMG this chick has my blood boiling...shes there simply to argue her stupid points

[miss kris]

I have never had a home birth, let alone been pregnant ... but this womans article just makes my blood boil!! I mean sure she had a traumatic experience, and (thanks to belly belly) i can say that it was probaby due to the cascade of intervention she recieved; however ... its not her place to push her feelings on homebirth onto everyone else. She is using the same scare tactics some stupid OBs use to get women to be induced that end up being the traumatic births we hear about ... just like hers!!

It makes me mad because although i personally don't think i will have a homebirth, i will fully support any woman who choses to! They shouldn't be banning it and driving it underground, the government should be nurturing it and studying it, bringing updated and current information to the hundreds of thousands of birthing women in Australia!

Its a woman's choice and her perogative ... don't push your beliefs onto someone else, haven't we learnt that from history? Its our right as humans to believe in what we want, and to birth how we want.

[Freya]

Im horrified. For Susie and at her ignorant opinions. I was 5lb 4oz at 39wks and my mother birthed me just fine vaginally - and she was 4ft11 and a size 4! So I fail to see how she could have a pelvis so small that a 5lb 5oz baby couldnt fit out, then they can manage to fit forceps in there to pull him out. For a 37wker I would think 5-6lb would be a good weight? My 37wker was 6lb 8oz. My OB told me he was a pretty decent size for his gestation.

[Bathsheba]

I remember a time when journalists at least pretended they were well read Susie claims to have done her research but she clearly hasn't.

[Ilithyia]

Oh here we go again!

I am flabbergasted that this woman after having her "small" baby RIPPED from her body which mind you had a "default" of it own, can still think that giving birth at home is the unsafe way to give birth!!!! Doesn't she see that something is not right there?!?!

I don't see how people who have absolutely no interest in the subject can bash the $hit out of it with such naievity and uneducation!

I can only hope that women are becoming just as tired of these stories and are educated enough to make a decision for themselves regardless of what some whats-her-name thinks!

And I for one am one of those Women! I am proud to say that I am nurturing a child within whom I plan to birth into his/her's Daddy's hands in the safety and comfort of our home.

[Bathsheba]

Maybe this is a case of how people so often make the loudest fuss JUST before changing their mind about a subject. I have heard that this is what people do when they come up against an argument that is strong but which they are emotionally against. They resist and resist and get very passionate about it.... seemingly... but then the penny drops... they have their light-bulb moment... and then very often become the MOST passionate about the opposing argument, the very one they rejected!!! Seen it time and time again and recently read about it... trying to remember where... Same thing as how ex smokers are the ones that are the most passionately anti-smoking IYKWIM. As long as the "pro" argument has a good basis in logic... as this one does if you do the research.

[Cassius2]

It's a sad reflection on our society that some women will probably base their birth decisions on an opinion piece from a hack journalist. She can't even properly explain what happened at her own birth and yet she deems herself qualified to condem other women's educated decisions. Shameful.

:yeahthat:

and i think Freya has made a valid point re the birth classes that are generally provided by hospitals. I remember the ones we had at the private hospital that i birthed my DD in. although i enjoyed them and enjoyed the tours and felt quietly confident in my ability to achieve a birth without intervention there was NO information given regarding intervention risk vs. no intervention. it was not until i just recently finished my calmbirth class and we had an involved session on what it can actually mean to be induced (as an example) and reading Susie's OPINION piece really had the penny drop for me. in our calmbirth class our midwife explained that there is a common trend with posterior births with first time mums for babies to want to turn (ie come out face down as opposed to sunny side up). she explained that this can take a LONG time as the birth progresses 'normally' within time-limits until the baby gets to the point where they want to turn. here she explained is where things can really slow down as bubs makes the move to turn around and come out. AND it is here that she explained (as an experienced hossy midwife) that pressure is placed on a woman to intervene and augment the birth process (ie through induction measures of breaking waters/syntocin etc). she said that when this happens it increases the risk of obstructed birth as bubba's head has not been given enough time to turn and becomes 'stuck'...this is when it then is declared an emergency c-section as there is no other option for baby to come out. (from this she explained that there can be room to negotiate for more time with hossy staff if this happening before accepting augmentation...just for contextualisation!). this made so much sense when reading susie's piece, and I wonder if something similar was happening with her bubba? unfortunately i guess there is no way to ever fully know, as she probably doesnt know herself...it's just such a shame that she was made to feel so disempowered and 'broken' in her body. cause my gosh, 2.5kgs at 37 weeks is pretty frikkin' awesome! DD was 2.7 at 38+2!

[mybabyboy]

I, like alot of people wanted a natural birth. At my local hospital they have a team of midwives called, 'the birth centre team' who largely support the women throghout their pregnancy and delivery in the most natural way. To be a part of this team you need to apply quite early in your pregnancy to secure a position. The birth centre is part of the major hopsital so that if something god forbid was to happen or the mother required intervention such as analgesia, then she could easily transfer to the delivery suite. The pregnant mother needs to be of an extreemly low risk category, therfore all scans and ante natal testing must have been completed and passed. AS I did.
HOwever our darkest day had arrived with the birth of our son. 10 mins after he arrived he was diagnosed with a diaphramatic hernia, something that can only be diagnosed with x ray, something that could not be done at home. The only way the dr's knew something was wrong was because he had resipiratory distress, and the treatment for that is positive airway pressure, so even if it was avail at home, (and it's not) It is not the treatment for a diaphramatic hernia. Initially this made his condition worse. All i can only say is that , if this was your birth story from home then your outcome would be very different to mine. No amount of hypnotherapy, accupunture or all the positive thinking in the world could have diagnosed or help your innocent child
There is always the chance that something can go wrong, no matter how great and low risk your pregnancy has been deemed! Just as mine was. PLease, dont risk your childs life!
I will thank the professionals at that hospital every day for the rest of my life, and then still will never forget how they saved my sons life. My son is a happy healthy 4 and a half month old, and i cherrish every day.

[Schmickers]

mybabyboy, that is such a sad story. I am glad that your boy has had such a good outcome.

For all those that are wondering, diaphragmatic hernias actually can be diagnosed prenatally. They are detected on the routine ultrasound that is offered to all pregnant women. In some cases, they can even operate before the baby is born to repair one! I agree that having a baby with a diaphragmatic hernia is a very good reason not to have a homebirth. And even if someone were unlucky enough to have a baby with an undiagnosed diphragmatic hernia, it is unlikely it would have been diagnosed and x-rayed in 10 minutes - the 10-minute Apgar score hasn't even been completed at that point.

Positive airway pressure, using a bag valve and mask, is readily available in the home setting, and all reputable independent midwives carry resuscitation equipment and portable oxygen with them. While it may not look like the fancy equipment in hospital, it is the same and does the same job.

Like it or not, homebirth is safe. This pattern - from the media, or from the general public - of people decrying homebirth as "unsafe" and then justifying their beliefs with dubious anecdotal evidence or implausible medical horror stories - has to stop. If you don't agree with our decision, then that is okay, but don't try and portray us as unsafe when the evidence is overwhelmingly in our favour.