Homebirth safer then hospital birth????

JZ_RN · Sep 12, 2012

Considering that hospitals take care of all the high-risk pregnancies and very sick mothers and babies, the numbers are skewed, and since any home birth that goes not as planned ends up in a transfer to a hospital, that makes hospitals look worse because those births that go wrong are now "hospital" births. Frankly, I'd prefer all the technology, medications, and emergency interventions right there if I were giving birth and a home birth seems like an immature, irresponsible, and risky endeavor to me. While I respect others' rights to do what they want with their lives, pregnancies, etc., I would never do it, in my opinion, it's too risky and, I feel, a poor choice that women make to buck the "system" yet when something happens, well, they trust the hospital then!

anggelRN · Sep 12, 2012

I think homebirths can be a safe option. I wish it weren't so vilified by the public and even healthcare professionals. Of course, it's not for everyone.

In any medical situation, you must weigh the risks versus the potential benefits. There are no guarantees, whether you are in

the hospital or home setting.

Sometimes all the technology and interventions are a bad thing.

Also, I must add it's not always about bucking the system. The hospital setting is needed for more and more women due to the large amount of high risk pregnancies. I just don't understand why there is such negativity towards wanting the least invasive option in maternity care. If you end up in the hospital, so be it.

Fyreflie · Sep 12, 2012

I'm a fan of home birth for low risk women. Yes, I have some bias--two of my sisters and one of my sister's babies were born at home, and I was present at all three births at different times in my life, and there's a sense of community and calm that I have rarely seen in a hospital birth--even a midwife assisted hospital birth.

That being said, the midwives who cared for my mother in 1982 and 1985 and for my sister in 2011 were thorough, meticulous and careful providers. They had good training and support. My mother had to sign an agreement that stated her willingness to be transferred to hospital at any time the midwives might deem appropriate even if they couldn't verbalize or put their fingers on a good reason--in other words, even if they just had a bad feeling. And my mother was also advised after her second home birth that if she were to have another baby, the hospital would be more appropriate (she had a calcified placenta at just past 37 weeks and a moderate post partum hemorrhage with her second home birth/3rd baby).

Point I'm trying to make is--if you're dealing with a well trained practitioner, your safety level goes up. Instead of squashing home births or water births or whatever we should be focusing on training professionals to a standard and excellent level of care within their scope--OB, MW, or RN etc.

I would love to have a midwife and home birth with my babies but will probably opt for a birthing center or hospital birth because I still believe that North America's home birthing system doesn't have the support for emergencies that would bring it up to the standard of countries with a functional primary home birth system (ie England).

There is definitely a resistance from many health care practitioners when it comes to home birth and I think the L&D nurses I know are the worst--but we also see the worst, and it's harder to separate those things when you work with a higher risk population. When I worked at a rural, low-risk hospital it was much less scary a thought because we saw lower risk, easier deliveries that were mostly natural :)

klone, MSN, RN · Sep 12, 2012

The actual research (done in Europe - I want to say Sweden or Norway?) found that for low risk women, homebirth is AS SAFE as hospital birth.

My second child was born at home with a midwife. I think it's an excellent option for low-risk women.

Wet Noodle · Sep 13, 2012

I have no strong feeling on home versus hospital birth for low-risk pregnancies, but I suspect that home births on the average are safer from an infectious disease perspective, but not so good for the surprise medical problem scenario.

There are birthing facilities that are at or in close proximity to hospitals with obstetrics floors. They sound like a pretty good bet.

mind_body_soul RN · Sep 13, 2012

Most homes are probably cleaner than the hospital. No sick or dying people live in my house...the hospital on the other hand, ew. Wish I could autoclave myself at my doorway after clinicals. I have never had a baby before but I think I would consider a home birth if a.) I had a low risk pregnancy, b.) a very competent, qualified, and well-trained CERTIFIED nurse midwife was present, and c.) I was in close proximity to the hospital "just in case". My maternity textbook states that the United States has the highest amount of cesarean births, highest maternal death rate, highest infant mortality rate, and LOWEST percentages of home births out of industrialized nations. Other industrialized nations in Europe where home births are the norm have MUCH better outcomes. That has to mean something.

CloudySue · Sep 13, 2012

All I know is that if I would have had my first daughter at home (after a low-risk pregnancy) she would have been stillborn. Her umbilical cord was wrapped around twice and she inhaled meconium. She crashed without warning and they sliced me open so fast I still felt the scalpel. Her APGAR score was 1 (she got one point for still having a heartbeat.) Germs? That's what antibiotics are for, if there's an infection. In the 21st century, I believe there is no reason not to be as close to emergency lifesaving resources as possible. Back in the "old days", women and infants routinely died in childbirth at home. Although the US still has not-so-impressive mortality rates, it's still better than it used to be.

chaka_1709 · Sep 13, 2012

Personally, I wouldn't want a home birth. a) in case of emergency, I want to be at a hospital; b) ew; I don't want that mess at my house... or the memories (especially if something goes wrong); c) When I think of delivering a baby, I automatically think of hospital setting

If you want a home birth, go ahead as long as its not contraindicating.

Fyreflie · Sep 13, 2012

All I know is that if I would have had my first daughter at home (after a low-risk pregnancy) she would have been stillborn. Her umbilical cord was wrapped around twice and she inhaled meconium. She crashed without warning and they sliced me open so fast I still felt the scalpel. Her APGAR score was 1 (she got one point for still having a heartbeat.) Germs? That's what antibiotics are for, if there's an infection. In the 21st century, I believe there is no reason not to be as close to emergency lifesaving resources as possible. Back in the "old days", women and infants routinely died in childbirth at home. Although the US still has not-so-impressive mortality rates, it's still better than it used to be.

Up here if there is mec it's an automatic hospital birth for midwifery pts.

passionflower, BSN, MSN, RN · Sep 13, 2012

At my last delivery I walked into my patient's room just as her water broke and lo and behold light green fluid. A quick check and she was also complete. There was no time for anything except getting ready to catch that baby and calling NICU for back-up. Luckily the physician was in-house. How would this situation be handled in a home birth?

Fyreflie · Sep 13, 2012

At my last delivery I walked into my patient's room just as her water broke and lo and behold light green fluid. A quick check and she was also complete. There was no time for anything except getting ready to catch that baby and calling NICU for back-up. Luckily the physician was in-house. How would this situation be handled in a home birth?

Probably the same way we handled it at my last job (rural OBs with no NICU, RT and peds on call only). We suctioned mouth and nose and then oxygenated as necessary. Vigorous babes with mec were stimulated to encourage clearance and left skin to skin. The OB could intubate in a pinch, as could a midwife at home if competent and certified. Not an ideal situation for sure--but I don't see a huge difference between the two provided your practitioners are regulated and well trained (and work in teams).