Conflicting Reasoning of Homebirth and Anti Vaccination

[surprised]

Interesting thread - it's nice to see intelligent discussion about this, rather than the name-calling that it sometimes descends into.

But you know what strikes me? How incredibly lucky I am to live in a part of the world where I have these choices. To actually have a nearby hospital I can choose to go to. Or to have trained midwives to come to my home, knowing that help is not far if I do need a hospital. To know that, vaccinated or not, if my child were to come down with any of these illnesses, they would have some of the best healthcare in the world to help them. I am blessed to stress about what my toddler will eat for dinner. Because in so many parts of the world, mothers only get to stress about whether their toddler will eat dinner. For all its faults, Australia is a great place to live.

[Em_325]

I am still TTC #1 so I will start by saying I am posting purely from an outsiders perspective as I have no first hand experience

BB has been a great learning experience for me since starting TTC. I have learnt a lot from threads about things I never knew existed and have been able to research options I wouldnt have considered otherwise

If you had asked me before I found this site what my future birth and vax choice would be my response would have been in hospital and vaccinated. I never considered possibilities of a home birth and I fully admit I was shocked when I first read people chose not to vaccinate their children because I had the mentality of but you have to everyone does it. These days however I have done a lot of research about both home births and vaccinations (I like to be prepared) and am great full I have been able to make informed decisions after researching the pros and cons for both options

That being said my occupation is a Safety Advisor. I am always analysing risk and trying to lower the exposure I work out risk based on worst credible outcome vs likelihood. In the home birth situation death is the worst credible outcome and the likelihood is slightly higher than a hospital birth however once control measures are implemented the likelihood is significantly reduced so I don't think this is a decision that can be made based on risk alone. It is a personal choice that every woman has the right to make and we are very lucky that we have the option to do this.

[spenceee]

@ eutra_phalia - thanks for coming in on this, When I was talking about being at our most fragile I was talking about the baby and not the mother, meaning that emergency situations with an infant are usually much more urgent than any other stage of life. Also FWIW I have 2 close friends who have 3 HB's between them, while my Wife and I were TTC she actually was lucky enough to be a helper at one HB for our close friend whose partner suffers from a chronic disease and needed a backup person. She was there for the whole thing and thought that it was very intimate and amazing but she was definitely afraid for our friend based on the "what if". Regardless we supported their decision and wanted to help. So my Wife's decison to birth at hospital actually came with some first hand perspective that is not normally possible for many. The reason that I raise this here and not with my friends is a simple one, it is defnintely a very touchy subject, debating the thought process with them could drive a wedge into our friendship that would not be worth the intellectual pursuit of knowledge. An anonymous forum is the perfect place to have this discussion as we can all be bruatally honest without worrying about breaking down long term friendships due to differences of opinions. (same reason we dont discuss religion with most of our friends)

The impetus to need to defend your choice to HB is a simple one if you look at it from a high level being that so few mothers chose to HB making it a very alternative lifestyle choice compared to the mainstream. Added to that is ignorance and the countless thousands who ask indelicate questions. At a basic level people want to understand other people.

I am really glad that 99% of the posts here have furthered the conversation and yes, I think am starting to see and understand the viewpoint. Honestly, I do still feel that for my wife her choice was the right one for her but I am understanding how that choice comes to be made.

If I can try to summarise what I am seeing here (being my viewpoint and not the final word on this!) and link it back to my OP. The concept of minimising risk to the child and chosing HB and non Vax together does not hold for people who chose both as minimising risk is not the primary objective. Minimising risk is of course still a priority but not #1. the feeling is that Hospital birth somewhat discounts the emotional experience of the mother in birth and is rather an undestanding and decision that medical intervention can be overblown in these matters and that you would rather keep more control over the decision for your self and will seek medical intervention when you feel it is needed. As it is this that provides the greater peice of mind over being statistically slightly marginally safer.

The counter point to this viewpoint is that for some mothers, like my own wife, feel that they would actually be more comfortable birthing in an environment where if needed, professional medical help was but metres away and the input and attention of medical professionals was comforting. Vaccination adds to this peace of mind of knowing that our child is protected from illnesses that they may not come into contact with but could once out in the world.

Serioulsy though - the luxury of choice is the ultimate and FWIW I do think that there should be insurance and govt support made available for trained and qualified Midwifes to be able to offer this choice to mothers.

[meow]

If I can try to summarise what I am seeing here (being my viewpoint and not the final word on this!) and link it back to my OP. The concept of minimising risk to the child and chosing HB and non Vax together does not hold for people who chose both as minimising risk is not the primary objective. Minimising risk is of course still a priority but not #1. the feeling is that Hospital birth somewhat discounts the emotional experience of the mother in birth and is rather an undestanding and decision that medical intervention can be overblown in these matters and that you would rather keep more control over the decision for your self and will seek medical intervention when you feel it is needed. As it is this that provides the greater peice of mind over being statistically slightly marginally safer.

The counter point to this viewpoint is that for some mothers, like my own wife, feel that they would actually be more comfortable birthing in an environment where if needed, professional medical help was but metres away and the input and attention of medical professionals was comforting. Vaccination adds to this peace of mind of knowing that our child is protected from illnesses that they may not come into contact with but could once out in the world.

Almost. Risk to my child is the ONLY reason I choose not to vaccinate. And risk to my child is the primary reason I avoid medical interventions during birth. Having the input and attention of medical professionals being LESS than a metre away was a very significant part of my choice to HB with a midwife.

I don't think you're getting it still.

[AnyDream]

First up I will take a quick second to respond to the comments that my aguments are flippant and arrogant and ignorant. Im sorry that you saw my question that way but I asked it in order to seek out information about the mindset and to try and understand the situation better. From everything that this site claims to be about this is absolutely the place to ask a question like this and to expect discussion and education rather than dismissal. This type of response merely conveys that the people responding in such manner have made a decision about their beliefs and wish to challenge and counter opinion to validate their own belief system. Again if I offended with my initial question I apologise but please know that I was not seeking to offend but to learn. Personal attacks are not helping nor does my gender disqualify me from asking a question.

Thankfully for the large part the majority who have responded have been very open and I thank you for that.

@Sushee Thanks for the support on my intentions - I think you hit the nail on the head - But also.. im a dude

@Meow you raised an interesting point about maternal death rates being high in the US - from what I could find on the Unicef Website the rate was 12/100,000 (0.65% rate of home birth) an Australia's was 8/100,000 (0.3% rate of home birth) by contrast NZ has a rate of 25/100,000 (2.75% rate of home birth). these numbers would seem to show a correlation that home birth rates increase odds of maternal mortality. However I am not making this argument, I am only trying to show that statistics are made to manipulate. I would also expect that a trained and qualified midwife would be able to identifiy life threatening situations and would organise for a hospital transfer. Meaning of course that a potential tragic outcome of a home birth would officially be recorded under the "hospital" column. Looking further into the data I found obvious results over representing third world countries like Sierra Leone and Afghanistan where home birth is the norm but so is terrible hygenie and health. Ultimately I dont think that it is possbile to effectively compare the numbers from country to country as there are just too many environmental factors to consider. Even in Australia Indigenous people are more likely to have a home birth but they are over represented in our mortality figures due to poor living conditions and health etc.

Outside of this I seem to get the overall feel that for many of the people who chose to vax and HB is that there is at some level a mindset of distrust in our medical system in that it is inherently designed to interfere and charge forwards while accepting collateral damage.

How does this mindset exist? I am really honestly asking this question, not accusing, please dont jump on me for asking. I mean to say that the medical services industry seems to be designed to minimise risk and doctors train for 10+ years to be legally allowed to deliver medical advice would why they not be acting to achieve the best outcome possible? Surely an OB doesnt get up in the morning and rub their hands together at the thought of the trouble that they will cause that day..?

To be clear Im not trying to say that doctors are perfect, not at all, you find arrogance and fools in all walks of life in the same way that there must be bad midwifes as not all can be good. At what level do you trust the doctor, You probably wouldnt argue with a heart surgeon if he told you that you had a heart attack and needed a bypass to live? Would you have faith in your heart's ability to come good on its own?

Again Im trying to understand and not challenge your thinking or attack your decisions. please be kind with me

I'm seeing some parallels in your train of thought with similar attitudes and debates in the world of cancer treatment - conventional vs alternative treatments. Part of the heat of the debate comes because there is so much riding on it, it's one of the few times in our lives that we confront the coalface of life/death. I don't want to go off on a whole different tangent, but I would like to say that the thing that makes the medical system so robust - the evidence-based population study model - is also what makes it weak. By deriving best practice across large populations, the "system" forgets the idiosyncracies of each person and what he/she brings to the table in terms of their knowledge, experience, lifestyle, and ability to create their own healing/state of wellbeing. It's the one thing that the system has never learnt to measure and frequently fails to recognise in any given medical encounter.

[HotI]

If I can try to summarise what I am seeing here (being my viewpoint and not the final word on this!) and link it back to my OP. The concept of minimising risk to the child and chosing HB and non Vax together does not hold for people who chose both as minimising risk is not the primary objective. Minimising risk is of course still a priority but not #1. the feeling is that Hospital birth somewhat discounts the emotional experience of the mother in birth and is rather an undestanding and decision that medical intervention can be overblown in these matters and that you would rather keep more control over the decision for your self and will seek medical intervention when you feel it is needed. As it is this that provides the greater peice of mind over being statistically slightly marginally safer.

No, the reason i chose homebirth was it is the safest way to bring my baby into the world. It was my way of minimising the risk of injury to me and my baby.

[spenceee]

No, the reason i chose homebirth was it is the safest way to bring my baby into the world. It was my way of minimising the risk of injury to me and my baby.

This is probably a point that many who chose hospital birth fundamentally disagree with, it is known that home birth has a strong evidence of positive outcomes but this is (for the most part and what I understad of the situation) due to the fact that the majority of midwifes only accept pregnancies that are low risk or manageable low risk for home birth referring high risk cases for hospital birth. This would in my eyes skew any statistic in favour of home birth. Is this a fair observation?

[Miss.September]

This is probably a point that many who chose hospital birth fundamentally disagree with, it is known that home birth has a strong evidence of positive outcomes but this is (for the most part and what I understad of the situation) due to the fact that the majority of midwifes only accept pregnancies that are low risk or manageable low risk for home birth referring high risk cases for hospital birth. This would in my eyes skew any statistic in favour of home birth. Is this a fair observation?

No. As a someone who has chosen a hospital birth, I accept that this is HotI's choice and has absolutely nothing to do with the way I feel about anything. If she feels that the risk was less for her being at home than being in a hospital then who is to tell her otherwise? Nobody has that right. In this day and age (cliche much!) with so much information readily available, it is easy to do some research and weigh up the odds for yourself.

This pregnancy I've been told that my placenta is covering my cervix. If I had decided that I wanted a homebirth, I would give it up in a second because it's not what is best for my baby or me. It's a simple decision. I think you'd find it difficult to find someone in circumstances like this or similar to this that would continue on and just hope for the best. But if I had continued on the path I was on just a couple of appointments ago, with my ob predicting that I'd continue to have a stress free pregnancy (based on what I was going through at that time), that he had faith my body could do what it needed to without intervention, then that would have made me completely confident in having a homebirth, should I have chosen one.

[e_p]

No, the reason i chose homebirth was it is the safest way to bring my baby into the world. It was my way of minimising the risk of injury to me and my baby.

yeah - what HotI said. That's what I was getting at in a very, very long winded, inarticulate way

[sushee]

I agree that those who chose to hospital birth would disagree with the homebirth being better for them and their child, otherwise why would they chose to birth in hospital? Lol. It's a moot point.

The fact is, when birth becomes a medical emergency, that's absolutely when hospitals have a place. Just as when you get pneumonia, you'd go to hospital. It doesn't necessarily mean that just because you're asthmatic (and therefore more at risk of developing pneumonia) that you should live in a hospital just in case. And that's how many homebirthers feel like. Their births are not a medical emergency, until it becomes one, and very often, it doesn't.

Anyone who chooses a home birth is not ignoring risk. They are saying they believe they have less risk by birthing at home. Less risk of unnecessary intervention, less risk of birthing 'by the clock', less risk of the stress of being in a clinical environment, less risk of delivering a child to a mother who is somewhere she doesn't want to be. Birth can be a profoundly private, intimate and empowering experience to a woman. For her, her child and her family. You cannot quantify that with surface logic about statistical outcomes no matter how you try.

[e_p]

This is probably a point that many who chose hospital birth fundamentally disagree with, it is known that home birth has a strong evidence of positive outcomes but this is (for the most part and what I understad of the situation) due to the fact that the majority of midwifes only accept pregnancies that are low risk or manageable low risk for home birth referring high risk cases for hospital birth. This would in my eyes skew any statistic in favour of home birth. Is this a fair observation?

Whose definition of 'high risk'? Do you consider breech, vaginal birth after caesarean, twins, 'older' mothers, 'overweight' mothers or mothers taking anti-depressants to be high risk? Plenty of midwives that support women to homebirth will support women that have these 'risk' factors and don't consider them to be high risk, where a GP, OB, hospital midwife or birth centre policy might.

If you're suggesting that stats that demonstrate the safety of homebirth are skewed because women who may have complications are out of the scope of a homebirth midwifes practice are transferred to hospital, I'd argue that when that happens, with the woman's consent, it is a perfect example of why homebirth is safe!!! Continuity of care, advice and referral. Sadly lots of hospital midwives, GPs and OBs will not work collaboratively with homebirth midwives so women lose their continuity of care (most homebirth midwives do not have admitting rights in hospitals, despite efforts to obtain these rights).

Like I said before, for all the homebirthing women I've ever met, the idea of 'safety' is more than just being alive.

[Rouge]

I get the feeling spence that you are implying that one women's choice directly implies that her belief is that all women should follow that path. The point you are missing and is quite obvious to me, is that in this community everyone does what is best for them and no one here has demonstrated to me that they believe that a choice should be taken away from another mother because it is not the same as theirs. I think trying to determine that one way is the only way is always going to cause problems.

Can I ask you this do you personally believe that home births are the wrong way to birth? And I don't want you to answer for other women or your wife, I want you to answer honestly what you believe.

[PumpkinZulu]

Ugh. Show me a homebirth advocate who suggests a *truly* high risk woman birth at home, and I'll show you a total minority. It happens, for whatever reasons, but it's bot the norm and certainly does not represent the homebirth movement as a whole. Advocates don't push the mentality of homebirth or die, like you seem to think.

[spenceee]

Can I ask you this do you personally believe that home births are the wrong way to birth? And I don't want you to answer for other women or your wife, I want you to answer honestly what you believe.

Fair question, I think it is reasonably obvious through the questions I raised and my comments so far that I do beleive that Hospital birth and vaccinations are the safer option not to say the HB is wrong but not as safe if there is an emergency making HB a less desirable option if Hospital birth is an option. I do give more weight to the opinion of a doctor to that of a nurse or a midwife. Not over my wife's choice but as her support person I would be asking questions to make sure that any potential intervention of the natural process was truly necessary and encouraging her to listen to the advice offered (she would anyway). I did ask my wife how she wanted to deliver before voicing my opinion and it just so happend that we were already in agreeance so I supported her choice. My view is heavily influenced considering that as a group Obstetricians almost universally reccomend medically attended birth due to the immediate nature of some potential birth complications. While there has to be an element of the OB community that is trying to protect their livelyhood I do not accept that they merely charge forth on a medical path ignoring natural processes nor do they see a CS as a band aid solution or convenient option.

Let me caveat that with the view that hospitals like the RBH in Brisbane do have a birthing centre that allows for the natural birth experience with a midwife however it is outside of the home. I think that this is an excellent service as it offers almost all the same level of choice regarding experience although outside of the home but with the backup of an expericenced medical staff and world class NICU on site if things dont go as planned. I consider this to be the effective equivalent of hospital birth on terms of my perceived level of safety. I also recognise that not everyone has this as an option due to location of services and the centre itself has a long waiting list and strict admission guidelines regarding their assesment of risk with the pregnancy. I also believe that they do not accept VBAC patients or patients with any history of serious birth complications either (I could be wrong here).

I do also think that vaccination is the right thing to do for my child, I actually felt that vax was even more important now due to the rise of non vaxxing parents and what I perceived to be an increased chance to be exposed to other children with these illnesses. I think that the anti-vax movement is potentially more harmful to children than the potential side effects of vaccination which are truly tiny (according to WHO 1:1,000,000 have an adverse event following measels immunisation (AEFI)).

Here is an excerpt from vaccination.org,au

The risks of vaccination compared to the risks of the disease have been calculated several times (Galazka 1984, Velimirovic 1991, Koplan 1985, Holden 1987, etc). A typical vaccination program in a developing country will prevent about 45 childhood deaths and 12 serious handicaps a month, while causing one death in 22 years and one serious handicap in 7.5 years.

Advocates don't push the mentality of homebirth or die, like you seem to think.

I don't think that - never said I did - this is putting words in my mouth, wrong ones. I really dont feel like this adds to the conversation and it feels quite close to a personal attack. If I have offended you personally PumpkinZulu I apologise, if my opinions on birth and vax make you angry then so be it but i am just as entitled to them as you are to yours and I would not see you persecuted for them or deprived of them. Counter to this view of my opinion i do however believe that Obstetricians dont go around looking for opportunities to take decisions out of mothers hands and pressure them in to being cut open upon dire threats of perinatal mortality.

I hope that my personal standpoint does not come as a suprise to anyone and further to that I hope that I am not attacked for holding this belief. I also want to make clear that I have not attempted to veil this opion in the name of surreptitiously discrediting or being disaproving of anyone elses choices or to influence anyones future choices. I have however tried to restrain my point of view somewhat to prevent this thread turning into another HB vs Hospital thread/Vax vs NoVax that goes nowhere inviting angry posts etc... I have thourougly enjoyed this thread and the conversation within. I still maintain overall that choice is paramount and I do simply wish to try and gain some actual understanding for those who chose different to me. I genuinely mean this.

[PumpkinZulu]

Look, my opinion is that to hold any credibility in this discussion, you need to do a LOT more research and reading on homebirths. I don't feel like I can enter into a decent discussion with someone who clearly knows the bare minimum about a subject. Vaccinations, while we disagree, you are extremely well versed in. Homebirth, however, you are really not doing yourself many favours.

I'll ignore for the moment the incredibly arrogant and blasé way you chose to dismiss the very real reality of birth rape, which btw is a very accurate term for what can happen in ANY birth scenario, but let's face it, more commonly in a hospital. Instead, I'll focus on the major part of your argument that left me with no doubt that you need to do more research on this topic before you start spouting stats.

You mentioned that 100% of babies that die in a hospital would have met the same fate at home. So incredibly untrue that it makes my head spin to read it. You also said that the babies that did die at home would have had a better chance of survival at a hospital. Not always so! And what about the babies that were born at home, that may have died in hospital due to interventions? I cannot see how you can make such bold statements tbh.

[meow]

Let me caveat that with the view that hospitals like the RBH in Brisbane do have a birthing centre that allows for the natural birth experience with a midwife however it is outside of the home. I think that this is an excellent service as it offers almost all the same level of choice regarding experience although outside of the home but with the backup of an expericenced medical staff and world class NICU on site if things dont go as planned. I consider this to be the effective equivalent of hospital birth on terms of my perceived level of safety. I also recognise that not everyone has this as an option due to location of services and the centre itself has a long waiting list and strict admission guidelines regarding their assesment of risk with the pregnancy. I also believe that they do not accept VBAC patients or patients with any history of serious birth complications either (I could be wrong here).

I had a birth at a birth centre and a birth at home. Both drug free without interventions but both poles apart. A birth centre IS NOT the same as a home birth not at home. It is not a suitable option for those wanting a home birth, a home birth is. Also, you need to recognise that home births DO have experienced medical staff in attendance. Are you confusing homebirth with freebirth perhaps?

I agree that you are clearly lacking in understanding and research, but you seem to have formed an opinion already. So I'm not sure this discussion is even worth the time.

[spenceee]

I'll ignore for the moment the incredibly arrogant and blasé way you chose to dismiss the very real reality of birth rape, which btw is a very accurate term for what can happen in ANY birth scenario, but let's face it, more commonly in a hospital. Instead, I'll focus on the major part of your argument that left me with no doubt that you need to do more research on this topic before you start spouting stats.

You mentioned that 100% of babies that die in a hospital would have met the same fate at home. So incredibly untrue that it makes my head spin to read it. You also said that the babies that did die at home would have had a better chance of survival at a hospital. Not always so! And what about the babies that were born at home, that may have died in hospital due to interventions? I cannot see how you can make such bold statements tbh.

My goodness please - I do not and did not ever dismiss the existence of unwanted intervention in birth. This is just untrue. It makes me upset to be represented in this way

I dont think I need to justify to anyone the amount of reasearch I have done into the homebirthing movement but let me just say that it is just as extensive as my Vax research and in fact moreso due to the vast amount of information available on both sides of the point. Simply put I have read a lot and continue to do so and continue to learn.

Regarding my "bold statement" about emergency situations at home/hospital, based on the information at hand I refuse to accept that a Midwife or Doula in a house regardless of how well experienced, is better equipped to respond to an emergency situation than a hospital with a NICU and OB's and Pediatric specialists and Medicines etc. This is, if you will, part of my belief and it is in my view somewhat narrow minded to not be able to empathise with me and see how anyone could hold this view. This margnalises those who actively chose to birth in hospital.

[sushee]

I have to ask: If your wife had decided for whatever reason she had wanted a homebirth, what would you have done? If she told you that she felt safer in a home environment, that she was scared of having having to fight with drs for what she wanted to happen during her birth, if she didn't want strangers she hadn't met before being there and she felt like she could manage her labour better at home. Would you have asked her to ignore her feelings and listen to her drs?

My husband and I had a few discussions of that nature when I was pregnant. He too, believed that the dr knew better and that I should listen to my ob on everything. Lucky I'm a stubborn woman, because it turns out my ob didn't know better when push came to shove. My ob himself admitted he was wrong. But that's the great thing about the world, we can all still have new experiences and learn from them, even drs.

So I guess it boils down to this: if you're convinced that a hospital birth is a safer option for women, and your wife agrees, then you're both lucky to have common ground. But it doesn't make it the right choice for every woman, and they have the right to look at what constitutes a risk for THEM and make a choice that mitigates against the risks that they are most concerned about eventuating. And what constitues 'risk' to you may not even resemble what a homebirther may consider a risk, yet who is anyone to say that your risk is of more importance than theirs?

Now another question stemming from Rouge's: I think it's pretty clear to me and others I think that you believe that hospital birth is a safer option, based on the value you place on medicine and drs, opposed to the value you place on the woman's needs, beliefs and feelings. So what are your trying to achieve here? I gather you don't expect to have your opinion changed, yet the responses you have received on birth choices have been some of the most articulate and well-explained I've seen on BB (and I've been around a long time, believe me). They have challenged my own thinking, and I have come away believing more than ever that women can be intelligent enough, strong enough and in tune with themselves enough to know what's best for them, more so than a dr, who only sees them for a couple of mins every few weeks, ever could.

Have these women, who have shared their own experiences willingly and openly, even made you question any of your own beliefs? Because if they haven't, then perhaps you might not ever 'get' what they're trying to say, so continuing a discussion that continually leads to impasse with you serves no more value to you, don't you think?

But even if none of your beliefs have been challenged or changed from this discussion, I hope that others reading this thread have drawn value from it, because I sure have.