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Home births 'as safe as hospital'

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FireStarterRN has 15 years experience as a BSN, RN and specializes in LTC, Med/Surg, Peds, ICU, Tele.

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FireStarterRN has 15 years experience as a BSN, RN and specializes in LTC, Med/Surg, Peds, ICU, Tele.

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For every story of an unforeseen event such as described above, there are other stories of pitocin induced fetal distress, or other complications created by modern obstetrics. There are risks and benefits of everything in life. According to the Dutch study, however, the overall risk of a planned homebirth for low risk mothers is the same as for a planned hospital birth.

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ivanh3 specializes in ER and family advanced nursing practice.

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My wife and I used a certified nurse midwife for our son. She was great. If we had that same midwife at home I would be a single parent due to post partum hemorrhaging. My wife would be dead. That is no exaggeration. This came down to minutes if not seconds. All of our prenatal care indicated there would be no problem. Maybe we are statistical outliers, but that is a hell of a thing to put on a tombstone: Here lies my wife, she was my best friend, the love of my life, my soulmate, and a statistical outlier. Some things have a foreseeable risk. Childbirth is one of them. We loved the attention we got from the midwife and we loved the skill of the surgeon that there when the midwife had the good sense to call them. Lay midwife? I won’t even touch that topic.

To compare this study to deliveries in the US seems very flawed to me. Our infant mortality rate is higher than the country in the study. I am not going to make a blanket statement that Europeans are healthier than their US counterparts, but as a nation we have some pretty unhealthy lifestyle factors including obesity, high numbers of uninsured/underinsured, and rampant violence.

Edited by ivanh3

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AOX4RN has 7 years experience as a MSN, RN, NP and specializes in Emergency Department.

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My wife and I used a certified nurse midwife for our son. She was great. If we had that same midwife at home I would be a single parent due to post partum hemorrhaging.

How was the hemorrhaging resolved?

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ivanh3 specializes in ER and family advanced nursing practice.

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How was the hemorrhaging resolved?
Surgeon/emergent surgery. We really had the best of both worlds. We used a midwife group that operated in the hospital. We knew if we needed physician backup it would be there. And so it was.

Edited by ivanh3

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AOX4RN has 7 years experience as a MSN, RN, NP and specializes in Emergency Department.

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I should have asked about the steps between the resolution but it's not important. I was only hoping to provide insight as to what might happen from home to hospital in a case of emergency since any reference to home birth usually receives an anecdote of the mother/baby who almost died.

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ivanh3 specializes in ER and family advanced nursing practice.

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i should have asked about the steps between the resolution but it's not important. i was only hoping to provide insight as to what might happen from home to hospital in a case of emergency since any reference to home birth usually receives an anecdote of the mother/baby who almost died.

well as a paramedic with 15 plus years of experience in high volume areas, what would you like to know about what happens from the home to the hospital? because, i have been on that call too. several times. i can tell you what paramedics think, but you probably wouldn’t like it. that might not be a fair statement, but i am telling you that there have been utterances made by medics in the back of an ambulance more than once. i am not talking about a patient that labor crept up on. i am talking about planned at home births. fortunately, all had positive outcomes.

like i said, we might be statistical outliers, and i was definitely speaking anecdotally. but guess what? my wife is still here, and i am thankful she is not a statistic. it is not just about physician backup. it is about team backup in a setting that has all the proper working conditions, equipment, etc. the surgeon had a team that rushed in and whisked my wife away and saved her life. some on that team were nurses, rts, etc. even the midwife was helping out. i understand about statistical outcomes, but these are lives we are talking about.

Edited by ivanh3

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AOX4RN has 7 years experience as a MSN, RN, NP and specializes in Emergency Department.

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well as a paramedic with 15 plus years of experience in high volume areas, what would you like to know about what happens from the home to the hospital? because, i have been on that call too. several times. i can tell you what the paramedics think, but you probably wouldn't like it. that might not be a fair statement, but i am telling you that there have been utterances in the back of an ambulance more than once. i am not talking about a patient that labor crept up on. i am talking about planned at home births. fortunately, all had positive outcomes.

i've read this a couple of times and it may be the difficult transition from reading algebra to reading english but i don't understand what you're staying here.

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fmwf specializes in Women's Health, L&D,hi risk OB.

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It's also critical to note that standards of practice for Dutch midwives are very clear. All multiples, breech presentation, previous cesarean must be managed by OBs in the hospital. Home birth can be safe with clear risk criteria, early transport if troubles arise, collaborative relationships between home and hospital birth providers. Sadly, the safe stats quoted from studies done in the Netherlands or BC do not apply to home birth practice in the US.

Hmm. Is this really the case...that these stats don't apply or relate? Of course they do relate in the context of the universal standards that you mentioned. [bTW: And many midwives globally who are competent can and will manage multiples, breeches and VBACs.] I believe that the stats are probably consistent within the Netherlands. Comparatively these stats do not consistenty relate across the states, because standards and scopes of practice vary (as well as demographics and landscape) within the states. (some may not be getting this.) But they do apply b/c some areas of the US have the same or comparable standard.

I think....am I right?

fmwf

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HeartsOpenWide is a RN and specializes in Ante-Intra-Postpartum, Post Gyne.

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The Gaskin Maneuver was developed by Ina Mae Gaskin, a Certified Professional Midwife who practiced at a commune known as "The Farm" in Southern Middle Tennessee. Mrs. Gaskin taught this maneuver to the OB?GYN residents at Vanderbilt University Medical Center many years ago. Hmmm...medical doctors learned something very helpful from a CPM. Cool!

Actually she learned it from a Guatemalan midwife who learned it from some indigenous midwives in Guatemala...doctors at Vanderbilt learned something helpful that came from illiterate indigenous midwives. Now THAT is cool.

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... This is true, but on the flip side of that- no one has a crystal ball for the potential risks due to interventions that aren't absolutely essential in a hospital setting either... Hospital births carry their own risks...

But no one has a crystal ball and knows when an unexpected a crash c-section will be necessary; even a quick transfer to a hospital may then be too late to prevent brain damage in the infant (or worse)*. If you're among the tiny percentage who do have an unfavorable outcome, would you not always wonder what might have been? (Of course, the same might be said about women who choose vaginal birth in a hospital when a c-section had been advised and problems occur).

Of course, everyone is comfortable with a different level of risk. I just wonder if women always understand the unexpected complications that can arise at a "low risk" birth.

DeLana

*In Germany in the 50's and 60's, home births were standard for all "normal" pregnancies. However, of the 8 children in the family of a good friend of mine, all born at home during these decades, 2 are MR (most likely caused by hypoxia during the birth process).

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I'm a L&D RN and over the years have had three mothers w/ vasa previa that was not detected by US. When each one of the mothers water was broken by the OB, a stream of the babies blood would shoot out of the vagina. One was so strong that it hit the wall across the room. We rushed them to the OR and performed stat C/S and started transfusions on babies. One mother underwent the C/S via local w/ lidocaine until Anesthesia arrived from the other OR.

All three of them survived.. This was carried out by a Neo team and Hemotoligists that responded to the stat calls. This would not have been the case of a home birth or in a small rural hospital. It is something to think about when considering a home birth.

... Or a birth in a smaller more rural area...

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