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Old 02-05-2014, 11:56 AM   #21
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Re: Homebirth increases adverse outcomes and death

I was discussing this with a friend and she is of the opinion that we cannot compare hospital with home births because of the lack of regulations across the board. I don't understand this reasoning and we both had screaming kids so we had to get off the phone and I couldn't ask her yet

Isn't that WHY we should be comparing them? We can't just throw out numbers because we don't like them. If the choice is there to birth at home with a little-educated midwife who chooses to pray and not carry meds, that's a choice that needs to be included. The point is to compare all births. Lack of education and experience at a birth and whatever happens at the end need to be included because that experience happens, and thus needs to be included in the reporting. Don't we have to compare what happens in reality?

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Old 02-05-2014, 11:58 AM   #22
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Re: Homebirth increases adverse outcomes and death

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Originally Posted by Hungry Caterpillar View Post
I was discussing this with a friend and she is of the opinion that we cannot compare hospital with home births because of the lack of regulations across the board. I don't understand this reasoning and we both had screaming kids so we had to get off the phone and I couldn't ask her yet

Isn't that WHY we should be comparing them? We can't just throw out numbers because we don't like them. If the choice is there to birth at home with a little-educated midwife who chooses to pray and not carry meds, that's a choice that needs to be included. The point is to compare all births. Lack of education and experience at a birth and whatever happens at the end need to be included because that experience happens, and thus needs to be included in the reporting. Don't we have to compare what happens in reality?
I think it would be a better comparison between low risk hospital birth and low risk homebirth with a trained midwife. Not just low risk hospital birth with homebirth with any type of midwife. Some midwives just don't know what they're doing and some homebirths are unassisted. So comparing an unassited homebirth with a low risk hospital birth with a Doctor is not the same. To get an accurate view of risks you would need to compare 2 like outcomes. And they never do that with hospital vs homebirth, they add in so many different things you just cannot get a clear picture
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Old 02-05-2014, 12:00 PM   #23
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Re: Homebirth increases adverse outcomes and death

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It's actually really hard to come up with good stats in the US because each state's requirements, or the lack of, differs. You cannot compare homebirth and hospital birth in the US. Hospital births must be attended by a Doctor, at home it can be any number of people trained and untrained. That right there completely skews the findings. You also cannot compare homebirth in the US to other countries because they are just not the same at all.

Me personally. I had a bad hospital birth so I am already biased. I chose to have my second 2 children at home with trained Midwives (both are college educated in medicine).

I do wish the US would regulate Midwifery like they do with every other medical profession. I know that is not a common thought amongst homebirthers, but I think that in the end it would benefit the country and homebirthers greatly if there was a regulation.
How funny, I just asked this downthread

Do you mean we should only be comparing CNM, regulated-and-trained midwives with hospital births? Because that's the only fair comparison to a "safe" birth? I don't understand this, because it's throwing out all the people who shouldn't be doing it, and those things happen. Wouldn't this be like my claiming that we shouldn't count any hospital birth as a bad experience if their OB didn't listen because they weren't upholding Hippocratic Oath to keep them from harm and injustice?
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Old 02-05-2014, 12:01 PM   #24
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Re: Homebirth increases adverse outcomes and death

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Originally Posted by Hungry Caterpillar View Post
I was discussing this with a friend and she is of the opinion that we cannot compare hospital with home births because of the lack of regulations across the board. I don't understand this reasoning and we both had screaming kids so we had to get off the phone and I couldn't ask her yet

Isn't that WHY we should be comparing them? We can't just throw out numbers because we don't like them. If the choice is there to birth at home with a little-educated midwife who chooses to pray and not carry meds, that's a choice that needs to be included. The point is to compare all births. Lack of education and experience at a birth and whatever happens at the end need to be included because that experience happens, and thus needs to be included in the reporting. Don't we have to compare what happens in reality?
I think the reason you cannot compare is because some planned home births are unattended, some are attended by a family member or friend. Think my mother with her 3rd child or my aunt in the 70's. Some are attended by poorly trained 'midwives'. All these do not reflect the birth outcome for a responsible person who chooses a well trained midwife whether that midwife is a CNM, CPM, or direct entry midwife. Yes, I do think a direct entry midwife if properly trained can be a good option.
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Old 02-05-2014, 12:05 PM   #25
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Re: Homebirth increases adverse outcomes and death

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How funny, I just asked this downthread

Do you mean we should only be comparing CNM, regulated-and-trained midwives with hospital births? Because that's the only fair comparison to a "safe" birth? I don't understand this, because it's throwing out all the people who shouldn't be doing it, and those things happen. Wouldn't this be like my claiming that we shouldn't count any hospital birth as a bad experience if their OB didn't listen because they weren't upholding Hippocratic Oath to keep them from harm and injustice?
I think they should only include stats from properly trained midwives. However as things stand right now that would not be possible simply because that would require more regulation of midwifery than is currently in place in many states.
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Old 02-05-2014, 12:08 PM   #26
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Re: Homebirth increases adverse outcomes and death

Not sure why not all stats. Even with bad midwives. Maybe awareness will help weed out the "bad" uneducated midwives.
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Old 02-05-2014, 12:20 PM   #27
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Re: Homebirth increases adverse outcomes and death

I agree. My mother had 3 unassisted home births (including me) and I've had one (so far ). A friend of mine who has had 2 home births with a midwife was also midwife's assistant for many home births. None of us have ever seen a bad outcome at home, but most of the hospital births we know of involved unnecessary interventions and were overall unpleasant experiences for all involved.

It doesn't matter where a baby is born; birthing is dangerous. Sometimes it does't work out well. Rather than just look at the data regarding babies who live through birth, you should also pay attention to complications that occur to both the mother and the baby due to the nature of hospital birth routines: exposure to hospital germs, drugs, antibiotics, fetal monitoring, premature rupture of the membranes, forced removal of the placenta, elective c-section delivery, etc.
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Old 02-05-2014, 12:23 PM   #28
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I find it to be a bit misleading to say that home birth is more dangerous.

It's not the act of home birth itself that is dangerous, but rather the lack of standardized education and regulations.

Maybe instead of trying to scare people out of home birth, more effort should be put into improving it.

I'm in Ontario Canada, and there has never been a single home birth death.

Our midwives are highly trained and there are safety guidelines as to who can home birth.
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Old 02-05-2014, 12:29 PM   #29
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Not sure why not all stats. Even with bad midwives. Maybe awareness will help weed out the "bad" uneducated midwives.
Kinda my thought too. There are plenty of bad doctors as well and no one is suggesting thier stats not be counted.
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Old 02-05-2014, 12:32 PM   #30
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Re: Homebirth increases adverse outcomes and death

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Originally Posted by Hungry Caterpillar View Post
How funny, I just asked this downthread

Do you mean we should only be comparing CNM, regulated-and-trained midwives with hospital births? Because that's the only fair comparison to a "safe" birth? I don't understand this, because it's throwing out all the people who shouldn't be doing it, and those things happen. Wouldn't this be like my claiming that we shouldn't count any hospital birth as a bad experience if their OB didn't listen because they weren't upholding Hippocratic Oath to keep them from harm and injustice?
Yes. If you're trying to decide if something is safer than the other, you need to compare them with like situations. You cannot compare a low risk hospital birth to ALL homebirths because those are not like situations. Same way you cannot compare high risk hospital births with low risk homebirths with properly trained midwives. It just doesn't work.

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Not sure why not all stats. Even with bad midwives. Maybe awareness will help weed out the "bad" uneducated midwives.
Regulations would weed out the bad midwives. When you compare hosptial births, which are very specific (Doctor attended, etc) to ALL homebirths you are now comparing apples to oranges. The only way you'll get a good comparison of the risks is by comparing two of the same scenarios.
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