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.

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To be fair to the poster, an experienced peadiatrician or neonatologist can generally diagnose a diaphragmatic hernia quite quickly with an xray used for confirmation. Yes bag and mask ventilation can be uaed, but it is extremely difficult and not generally very effective on these babies and intubation is required ASAP. Most of the time this condition is picked up antenatally from scans, very rarely fixed in utero, but, again, can be missed on scans if the lesion is very small at the time or in a certain position.

This is not a reason to ban homebirth at all, or really a reason not to consider one as this condition is so rare. It is just unfortunate that this is one of those conditions where having a bag and mask and oxygen may not be enough.

I do agree with berenice that maybe we need to look at just why women are not happy with the hospital system as well as advocating to keep the homebirthing system.