Hi, I recently read about the closure of St Vincents hospital in NY, and it started a debate on another forum I'm a member of about the different attitudes to home birth between the UK and the US. Below is the reply I posted on another allnurses thread about the closure -
Originally Posted by mree
I just found this post when searching for info on the closure, as it was mentioned on a UK nurses' forum I frequent. It was brought up as, in the UK, it's encouraged for women to consider home birth if they are considered low risk, but apparently in the US it's discouraged as apparently the US healthcare system seems to think birth is only safe if supervised by a doctor?!!! Is this right, or has someone got it wrong on the UK forum? Here, you only SEE a doctor if there's a problem with your pregnancy, otherwise pregnancy and birth services are midwife-led.
You're right that homebirths in the US are discouraged, generally.
There's lots more to say on the topic but I suggest starting a new thread, in the OB or midwifery forum.
So, I'm starting a new topic as suggested! What does everyone think? Is the medical resistance to home birth and midwifery real in the US, or are we in the UK being mislead on the topic by the media? Why are resistant attitudes developed among medics (if they are)?
Specializes in Nurse Leader specializing in Labor & Delivery.
When I use the term "lay midwife" I mean a midwife who has no credentials whatsoever. A certified public midwife has education and training in midwifery.
CPM stands for "certified professional midwife" not "certified public midwife."
To the OP: the vast majority of US MDs are vehemently opposed to homebirth. There is a lot of research that suggests that for *low risk* pregnancies, homebirth is as safe as hospital birth. I am a huge fan of homebirth, with a qualified caregiver, for women who are low risk (I am very opposed to UA, though).
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I am curious, Apgar10, what are you seeking to do when you graduate nursing school? I know this is a hijack, but the curiosity got the better of me.
I hope the OP can see just by this thread, how controversial and difficult the subjects of midwifery (which hase multiple entry points/schools of study to none at all) and the choice of home birth are in the USA. It should NOT be this way, IMO. I think normal, healthy birth can be done at home if a family chooses it and no one should make them feel badly over this choice.
I also feel once this choice is made, the family should take RESPONSIBILITY for it as well. I also feel unattended homebirth is risky and dangerous.
That is all I will say. Others said everything better than I could have.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
There are some GREAT books out there that describe the history of midwifery in the USA, particularly in the South (the Granny midwives) and how the medical establishment really sought to, and succeeded in, pushing them out of their ministry. It's tragic, really. They were amazing, gifted and had unbelievably good instincts and skill.
I am an OB nurse and I will be having a HB. I work in a hospital that low risk women can get away without even having to get a S.L. if they request it. We have low induction rates; many of our women deliver after 40 weeks. We do VBACS, water births, and our C/S rate is well below the national average. Several of our clinics do parallel care with HB licensed midwife groups. I trust birth but know you have to always be prepared for "just in-case", which is seen a lot more as you add on interventions.
Just down the road it is a different story. No water births, no VBACS (despite the fact that they are the only hospital in the area that has an actual surgical suit right on the unit) and the highest C/S rate in the county...try to get away without at least a S.L.? you'll be laughed at. It is not as bad as other area's and you still can have a natural birth if you are low risk, but I am a little spoiled where I work.
Most nurses that speak negatively have never been to a home birth, have only seen the product of a home birth gone bad come in their doors, and have only experienced hospital births with interventions that are usually the cause of those "oh sh*t moments"
Let us bring them into harsh rooms with bright lights. Let us make them lie on their backs on hard narrow beds. Let us tether them o machines so they cannot move. Let us make them stay silent and make no noise with their pains. Let us expose their most private parts and threaten them with cold steel. Let us make them push their babies upwards, against the pull of the earth…In these conditions, labour swiftly becomes unbearable and pain relief becomes a woman’s only hope…This is not the natural cry of a woman in labour bringing a child to birth., although if you have only ever witnessed childbirth in a medicalized setting you might be forgiven for thinking so. This is the screaming plea of a tethered animal in pain.
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klone, MSN, RN
14,857 Posts
CPM stands for "certified professional midwife" not "certified public midwife."
To the OP: the vast majority of US MDs are vehemently opposed to homebirth. There is a lot of research that suggests that for *low risk* pregnancies, homebirth is as safe as hospital birth. I am a huge fan of homebirth, with a qualified caregiver, for women who are low risk (I am very opposed to UA, though).