Home birth vs. hospital

Specialties Ob/Gyn

Published

I belong to another parenting board & one of the debates that surfaces every so often is home birth vs. hospital birth. There are so many pro-home birthers that talk about how natural home birth is. I understand that the many interventions used in hospitals can turn a mom off to birthing there, but I still cringe at the idea of a prolapse, abruption, previa, etc. happening at home. Also, in the short time I've had clinicals in a postpartum unit at the hospital, I've seen two babies turn blue from lack of oxygen and been rushed to the special care nursery.

Would any of you care to share incidences where a home birth would have resulted in serious harm? Thanks for your time!

I agree! On most points, I agree. I guess, you can see, some people are either hurt or take exception to the accusations (implied or real) that we enjoy pushing interventions on our patients---or that most OBs are knife-wielding draculas. Just not true! I felt I had to reiterate that.

I have many days where my actions or advocacy contributed to favorable, and joyful outcomes. That is what energizes me and keeps me going as a nurse, or else I would have quit LONG ago. It ain't the money or "easy" job as a nurse I have that keep me coming back, I assure you.

Perhaps, some words would be better-received if we encouraged proactivity on the parts of nurses, (e.g. seeking to change legislation) rather than implying we simply don't care about outcomes or what our patients need and want. I guess that is my real point here.

I worked in a hospital in Grants Pass, Oregon Three Rivers, and they were CIMS certified Coalition for Improving Maternity Services. To become certified they had to have a low section rate, low intervention rate over 98% breastfeeding when they walked out the door and all of that. Their nurse manager was a CNM who had a clinic in Florida before she took the job in Oregon. This hospital was fantastic. All women were up and in the halls, we had jacuzzi bathtubs, had waterbirth options and they were having the most amazing outcomes as far as stats were concerned. It was the funniest place I've ever worked. Everyone was hyped when a laboring woman came in and if there were epidurals or interventions it was always after the woman was at least 5 cm dilated which cute the rate of cesarean.

I guess I miss that coming to Calif. especially SD they just don't think like that here. They are in a hurry to get the babies delivered before 11pm. and it just breaks my heart. I guess if I had never seen the other side, like also doing homebirths, I wouldn't notice as much.

Up Vote Up Vote ×

Where I work, inductions are the rule. VERY few spontaneous labors, and even then they are augmented. It is the women that are demanding them and not waiting anywhere near 40 weeks. They are "uncomfortable", "can't sleep", "depressed", "have a baby sitter this week, but won't be able to get one near their due date", "don't want stretch marks", " don't want a big baby" "am tired of being pregnant" etc. etc. They see early preemies surviving and don't see the harm in having one. Elective C-sections are becoming very common as well.......in PRIMIPS. They want to "avoid labor", "preserve the integrity of the perineum". Now, mind you, they are coming in with these pre-arrangements with their physicians. As long as they feel NO discomfort, they DON'T CARE about the monitors, IVs, Foleys, Internal Leads, IUPCs or any possible affect that this will have on their babies. They are #1, they put themseves first and this is how I fear they will raise their kids. Society is just now starting to recognize this generation's self-preoccupation and wondering what caused it. I don't think I will see the pendulum swing back to natural birth in my lifetime. I have talked til I am blue in the face with some of my neices etc. They have no respect for my education or experitise...........TOPS on their priority list is that they FEEL NOTHING during their "birth". ( To me, it more like an extraction ). Just WHAT would anyone suggest to counteract this growing mentality????????? I would like to hear it !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

A countercultural change in society is the only cure to those ills. Period.

Up Vote Up Vote ×
Specializes in Pediatric Pulmonology and Allergy.
Where I work, inductions are the rule. VERY few spontaneous labors, and even then they are augmented. It is the women that are demanding them and not waiting anywhere near 40 weeks. They are "uncomfortable", "can't sleep", "depressed", "have a baby sitter this week, but won't be able to get one near their due date", "don't want stretch marks", " don't want a big baby" "am tired of being pregnant" etc. etc. They see early preemies surviving and don't see the harm in having one. Elective C-sections are becoming very common as well.......in PRIMIPS. They want to "avoid labor", "preserve the integrity of the perineum". Now, mind you, they are coming in with these pre-arrangements with their physicians. As long as they feel NO discomfort, they DON'T CARE about the monitors, IVs, Foleys, Internal Leads, IUPCs or any possible affect that this will have on their babies. They are #1, they put themseves first and this is how I fear they will raise their kids. Society is just now starting to recognize this generation's self-preoccupation and wondering what caused it. I don't think I will see the pendulum swing back to natural birth in my lifetime. I have talked til I am blue in the face with some of my neices etc. They have no respect for my education or experitise...........TOPS on their priority list is that they FEEL NOTHING during their "birth". ( To me, it more like an extraction ). Just WHAT would anyone suggest to counteract this growing mentality????????? I would like to hear it !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I get this in reverse.... I care nothing about the safety of my baby and only care about my own comfort and birth experience because I choose to have my baby naturally at home. Some people will just never get it.

Up Vote Up Vote ×
Specializes in NICU.
I get this in reverse.... I care nothing about the safety of my baby and only care about my own comfort and birth experience because I choose to have my baby naturally at home. Some people will just never get it.

Anyone else take offense to be lumped into random categories?

I don't think I'm selfish because I didn't want to be in excruciating, debiliting pain in labor. People have been trying to relieve labor pain for Eon's. I carried two children to 40 weeks, ate well, took fabulous care of myself, and suddenly, I'm selfish because I want to be relieved of the pain that wouldn't let me relax enough to dilate (I dilated PDQ once the pain was gone 3-10 in an hour, not too shabby) and made me vomit repeatedly. Pain is unacceptable to me in all other areas of life, why should I suck it up in labor?

I don't think HB'ers are selfish, but you can't deny most of you want "an experience" We went on transport to pick up a HB'ed baby with RDS and the house was dark, with candles, orange slices scattered about. That's about "experience" doncha think?

Up Vote Up Vote ×

Why would any woman want to take her life in her hands, and risk the loss of her baby. It is untrue that hospitals carry out interventions that women don't want. A woman has the right to refuse any intervention. If doctors would stop running off the midwives then is it possable that a woman would not mind a hospital dilivery so much?

Up Vote Up Vote ×
Affluent areas tend to equal: too posh to push patients in my experience. I would rather work with inner city, drug using, swearing women than the tptp set.

Me too! Well maybe not the drug using part, but the sweating, the blood, the screaming, the blood, bring it on, I crave it. That's what keeps me from moving to L&D in our hospital, I find it kind of depressing. Most of my moms want their babies removed from them like a bad gallbladder at 38 wks. Some have to be awakened to push, pushing 2-3 hrs is common. It's also common for them not to be able to move their legs or bear weight on them for 12 or more hours, those epidural pumps with self bolusing are so effective. Elective c-sections and elective inductions are very popular, even for first births. Epidural rate is > 95%, c-sect rate I estimate 35-40%. Nearly everyone gets induced, pitted, AROM'ed, epiduraled and cut (or tear badly), starting right at admission. Lots of moms run fevers and get antibiotics, their babies get workups for sepsis as well, many get jaundiced.

It's my dream to work in a birth center, one attached to or next to a hospital would be my ideal choice - just in case.

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I agree that generalizations are not good....but we can all try to read what the posts are saying and not look for offense, too. Let's try to learn from each other.

Up Vote Up Vote ×

Actually my facility is very pro-natural birthing(providing that's what mom wants) with a 40% epidural rate. I love it. There is also a committee trying to get a study off the ground to have the beds taken out of thr rooms so women will have to try something else. Then they would bring it back in for the delivery and pp periode. The logistics of where the beds would go is the big problem but it will be interesting to see if it gets off the ground anytime soon. I must say though I work with a great bunch of staff who is very enthuiastic about med free and low intervention births. The doc are not too bad. We certainly have sections (sometimes they are necessary. I would have to say about 18-20%) and epidurals but I think we do a pretty good job. We also do allow Vbacs but with more controls then a normal vag delivery.

Up Vote Up Vote ×
Specializes in CRNA, Finally retired.
Actually my facility is very pro-natural birthing(providing that's what mom wants) with a 40% epidural rate. I love it. There is also a committee trying to get a study off the ground to have the beds taken out of thr rooms so women will have to try something else. Then they would bring it back in for the delivery and pp periode. The logistics of where the beds would go is the big problem but it will be interesting to see if it gets off the ground anytime soon. I must say though I work with a great bunch of staff who is very enthuiastic about med free and low intervention births. The doc are not too bad. We certainly have sections (sometimes they are necessary. I would have to say about 18-20%) and epidurals but I think we do a pretty good job. We also do allow Vbacs but with more controls then a normal vag delivery.

Murphy beds! I love your facility's creative thinking. As a student I did my OB rotation in a real inner city dump, but the section rate was 10%. Those women were told to walk until they crowned. Its easy to do the right thing when the profit motive is removed. Preventing complications is a very big incentive when you're not generating income from treating those complications. And I know there's hospitals out there that are truly trying to do the right thing by their patients (like the one above) but they seem to be dying off.

Up Vote Up Vote ×
Specializes in Pediatric Pulmonology and Allergy.
Anyone else take offense to be lumped into random categories?

I don't think I'm selfish because I didn't want to be in excruciating, debiliting pain in labor. People have been trying to relieve labor pain for Eon's. I carried two children to 40 weeks, ate well, took fabulous care of myself, and suddenly, I'm selfish because I want to be relieved of the pain that wouldn't let me relax enough to dilate (I dilated PDQ once the pain was gone 3-10 in an hour, not too shabby) and made me vomit repeatedly. Pain is unacceptable to me in all other areas of life, why should I suck it up in labor?

I don't think HB'ers are selfish, but you can't deny most of you want "an experience" We went on transport to pick up a HB'ed baby with RDS and the house was dark, with candles, orange slices scattered about. That's about "experience" doncha think?

Who is "most of you"? Who is being lumped into random categories here?

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Again, maybe we can take the thread in a direction that is neither defensive or offensive? Lumping anyone into a stereotype is not productive. Thank you.

Up Vote Up Vote ×
+ Add a Comment