Q for a Midwife.

[meow]

HB midwives can't get insurance because their collective pool is so small- certainly not because its not good insurance sense IYKWIM. The safety of HB is so high and the incidence of something going wrong so low that they are certainly insurable.

I'm aware ongoing medical care would be expensive but I can only see that happening in a HB for something that is natural (ie. baby born with disability) rather than something involving malpractice. HBs don't involve all the procedures that cause incidents, as happens in hospital. If something was going badly we would transfer to hospital anyway and in that case if they muck up a c-sect or something then sure, we'll be covered for that libility.

Just to clarify the point I made about this being my choice- I don't want to give the impression that my H is not involved or against the idea. He's all for it- he's just pretty laid back about it is all. The decision went something like this:
Me: I want a HB
Him: Okay
Me: Maybe I shouldn't have a HB- it costs so much
Him: I think you should have the HB
Me: Yay we're having a HB! I want this midwife
Him: Okay

[Livinthedream]

OG, I was thinking about the whole "go wrong" issue, and what I would consider a "go wrong" to be, I mean, if you need a CS, you are going to need one whether you are HB or hosp right?
I guess the reason I started this thread was because I must be one of the few people who is pretty much ambivalent about the whole issue. And I wanted to know why there was no insurance (didnt realise not all middies supported HB)
If you want to HB, then hell, good luck to you, I really cant see why you shouldnt be allowed, even free birth for that matter, I mean, its probably not always the greatest idea, but so long as you are prepared to live with the consequences of your actions, then why not?
For me, after having 1 bubs, I certainly wouldnt be scared to HB, but i dont know if it would be my preffered option.
Meow, LOL your DH sounds like mine, he wouldnt mind either way, though, I lost a ton of blood last time and I am pretty sure he was glad that of the hosp staff to clean up that mess. LOL

[Oorki Galoorki]

but are you happy to live with the consequences of a hospital birth? are you happy to be forced in to induction, forced to have VEs, forced to a C/S.. this is what happens in hospital there is a HUGE risk of all these happening compared to a homebirth.
babies die any where. there are very few occasions where a baby has to be out under 30 minutes (average time for an "emergency" cs to be prepped) but dont forget it is the midwives who notice problems anyway.. not doctors.. due to the fragmented care in hospitals it takes longer for problems to be picked up compared to one on one care in a HB..

[meow]

but are you happy to live with the consequences of a hospital birth?

Exactly. Babies and mothers are at much higher risk in hospital due to the interventions than they are home anyway.

[Mildez]

As a middy I am all for homebirths but not freebirthing.

Livinthedream is right. After 30something days in hospital unless your in intensive care or something you do have to start to pay and it is not covered by medicare. It includes includes rehab, palative care etc basically anything deamed as chronic illness over acute. Its based in your income or a percent of your pension so depending on your financial circumstances your amount you pay changes. It doesn't apply for premmie babies etc as they are classed as acute.

You also have to remember 99.5% of babies are born in hospital or birthing centre compared to 0.25-0.5% at home. I know a woman who had a HB for twins as the hospital told her they did not support her having a VBAC. She almost lost her life, lost her ability to conceive again and both her babies. And that went on the hospital statistics although she was transferred mid rupture to hospital from home. It seems to me that homebirth statisics only show the positive outcomes, the ones that are born at home and don't take any responsibility for the negative ones that then occur in hospital from transfer when things aren't going smoothly. Homebirths are only going to get good statistics when anything really wrong then gets transferred to hosital.

I recently read (and don't know how true it could possible be) that almost 50% of planned homebirths are transferred to hospital. Statistics from homebirth often says the number of transfers to hospital but not then the outcome as then its the hospitals responsibility who then cops the slack for poor outcomes and intervention. Yes there is alot of intervention but your looking at over 99% of Australias population. In the last 20-50years we have seen such a huge reduction in SBs, diasbility and maternal death and that is due to intervention. Was it 1 in 10 women died during childbirth and 30% of babies 100years ago? We now live in a time when its not acceptable for things to go wrong and when it does someone has to be blamed. Sort of getting of the topic of HomeB vs Hosbirth but working in the hospital setting sometimes intervention is neccessary to ensure a healthy baby or mother physically even if not mentally.

[Mildez]

Livinthedream if I were an IM I would be happy to attend homebirths. I'd prefer them over hospital births anyday. Although I must admit there would be a few very select women I wouldn't be happy to attend a HB for knowing the chance of a positive outcome at home would be unlikely. I'd be happy for breech, VBAC etc. I wold probably still support their decision although have to be honest that I was very concerned that the birth would not go well at home and document that I did not support it. I wont mention it on here incase a friend reads it and knows I am thinking of her situation recently.

[meow]

I recently read (and don't know how true it could possible be) that almost 50% of planned homebirths are transferred to hospital.

You probably read it in all the recent trash that has been quoted in the papers lately. It's not true at all. The ob who said is quoting birth centre transfers rates saying "50% of first time mothers transfer to hospital" when discussing HB. 50% of first time mothers who are home birthing do not transfer. IMs have their transfer rates and it is less than this.

[Mildez]

Hence why I wrote I don't know how it could be possible true. At the time of writing my above post I did not have the time to go find out what the transfer rate was.

[dialectica]

About suing midwives, I guess it depends for what - right? My homebirth midwife applied fundal pressure to expel my first baby, because she thought it was dangerous for the baby to be in the birth canal for longer than five minutes. Would I sue her for that? No. Would a hospital birth have been better? No. The outcome was fine, but applying fundal pressure is a dubious practice.

I don't think suing a homebirth midwife for not being able to do anything in cases where she truly can't do anything, when complications arise. However, causing harm though dubious medical practice is something else, I think.

[onthefly]

You probably read it in all the recent trash that has been quoted in the papers lately. It's not true at all. The ob who said is quoting birth centre transfers rates saying "50% of first time mothers transfer to hospital" when discussing HB. 50% of first time mothers who are home birthing do not transfer. IMs have their transfer rates and it is less than this.

Ah. I was wondering about that. I heard the KEMH BC has a 50%-ish transfer rate and wondered if someone had their wires crossed.

[HotI]

but are you happy to live with the consequences of a hospital birth? are you happy to be forced in to induction, forced to have VEs, forced to a C/S.. this is what happens in hospital there is a HUGE risk of all these happening compared to a homebirth.

And very little chance of successfully suing the hospital if these happen, or if disability results from the actions or non actions of medical staff.