Home birth vs. hospital

keeper · May 13, 2003

Dawngloves,

I'm sure it depends on the woman and the birth, lol! My midwife actually gave us a shopping list that included a cheap shower curtain liner we could drape on the floor and then roll all the stuff up in it and discard it that way. We never even got it out of the package, and all the mess was contained on one chux pad. We have the shower curtain hanging up in our downstairs bathroom now.

Sarah

ktwlpn, LPN · May 13, 2003

Hmmm-let me think...Home appendectomy or surgery in the hospital?...Birthing center or hosptal for me-with a NICU.You just never know-Imagine having your baby at home and watching it die because you selfishly choose to go that route?Just because you had the idea in your head of the "perfect birth"

keeper · May 13, 2003

ktwlpn,

I choose to keep my comments on this board as civil as possible because I know I don't really belong as an aspiring midwife and not a nurse. Suffice it to say, your remarks painting me as selfish were uncalled for and rude. I have read enough from the nurses here to know that in birthing at home, I am protecting my child from practices which I believe are not based in science and often unnecessary.

Sarah

roxannekkb · May 13, 2003

I don't want to get into any personal arguments either, but I have to agree with Keeper. It is not selfish to choose a homebirth, considering that despite our technology and almost 100% hospital birth rate, we have the highest incidence of neonatal mortality/morbidity of developed nations. That is something to consider.

Yes, sometimes disasters happen and it helps to have a NICU a few seconds away. But provided a mom is low risk, most unexpected events can be attended to by an experienced midwife. And oftentimes the birth process goes easier and is less stressful when the mother is at home, and away from all of the intervention and discomfort of the hospital.

Another example is the Amish is the US, who also have very good outcomes, have their babies for the most part at home, and have a far lower C-section rate than the population at large.

Again, homebirth vs. hospital--one is not better than the other when there are no extenuating circumstances. It really is a matter of choice. And we cannot compare maternal mortality/morbidity in third world home births to our society, nor can we look at the rates from 100 years ago when most births took place at home.

ktwlpn, LPN · May 13, 2003

Originally posted by keeper
ktwlpn,

I choose to keep my comments on this board as civil as possible because I know I don't really belong as an aspiring midwife and not a nurse. Suffice it to say, your remarks painting me as selfish were uncalled for and rude. I have read enough from the nurses here to know that in birthing at home, I am protecting my child from practices which I believe are not based in science and often unnecessary.

Sarah

Dood! sorry for the misunderstanding but I was not specifically referring to you-you have spilled paint on yourself.........JUst voicing my opinion to all in general-and I feel very strongly that women often set themselves up for disappointment when they have a birth plan and try to strictly adhere to it without realizing that the baby can not be controlled...Then they feel like they have "failed" And ruin a happy time with all of their angst.Birthing centers and hospitals contain the best medical equipment and it is immediately available should I or my baby need it-and I would settle for nothing less...But you are certainly entitled to your opinion,too...Home birthing,home schooling-what is next?I did not call YOU selfish in particular-but I feel that often these decisions are made for selfish and foolish reasons-just like I said...I happen to believe in and trust doctors,nurses,midwives,etc...and believe that hospitals are the best place to begin life....And the point has been made that one can protect their birthing process from what they feel is unneccasary interference(spell check-I know THAT is not right) in the hospital...so-in closing-I did not say that anyone in particular was a selfish fool-but I do believe that anyone taking that chance is. (posted in as civil a manner as possible-but I calls them as I sees them) This is a public forum-anyone with an interest is welcome to post..:kiss

SmilingBluEyes · May 13, 2003

OH please let's don't let this discussion go the ugly way of BREASTFEEDING and other hot debates. Both sides have merit so let's agree to disagree w/o getting militant on either side!

ktwlpn, LPN · May 14, 2003

Originally posted by SmilingBluEyes
OH please let's don't let this discussion go the ugly way of BREASTFEEDING and other hot debates. Both sides have merit so let's agree to disagree w/o getting militant on either side!

True-and the reason why we often can't have a good debate is because many of us tend to take anothers disagreement personally.....and that clouds the issue.Let's list the pros and cons...Give me some good reasons to choose home birth over hospital-convince me...

keeper · May 14, 2003

Okay, sorry for the mix up. Call me hormonal, but this is an issue I can't debate without emotion, because this is a huge part of me, and to hear that anyone thinks it is a selfish decision is very hurtful.

I don't think I can convince anyone that I feel homebirth is better. I agree with Roxanne....in a low risk pregnancy, it really is about personal choice.

It was mentioned that there are ways for women to avoid the unnecessary interventions that occur in the hospital. One of those ways is through a birth plan, but I see how many are received. They can be perceived as confrontational or the mom can be called a "control freak" and there are nurses hell bent on proving that labor will not follow the plan, to the point that the C section paperwork is put on the chart the moment the mother walks in the door.

I have a hard time with anyone who thinks that a mother thinking of her end of the experience and what she wants from it is selfish. I choose to birth where I am most comfortable, where labor can progress at a natural pace. I do that because I need to be relaxed and focused to succeed at natural childbirth. I do that for my baby, but also for me. I see birth as a rite of passage, a momentous and empowering experience. But some feel I am selfish for considering the experience of it at all.......and yet, I don't think anyone would call a mother who chooses an epidural selfish, when she's doing the exact same thing.

With my hospital births, I dealt with substandard prenatal care (uh you're anemic, just keep taking those vitamins......), hostile nurses, repeated offers of medication though I asked not to be offered, impossible pushing positions, third stage pitocin, and separation from my babies.

With my home births, I had excellent prenatal care with a firm basis in proper nutrition. I have chronic anemia which puts me at risk for pph, so my midwives were always very strict about my getting my levels up. I was threatened with hospital birth more than a few times. During the birth, I experience calm and relaxed faces and voices. Everyone is very reverant and in tune to me and what I need. I am never left alone, and no one is watching a monitor strip instead of me. I am able to push in any position I choose (all fours is absolutely wonderful!) and I push when I'm ready without any coaching (read YELLING! and counting to ten). My baby is born in love and placed in my arms to stay for at least an hour before checks are done. I am able to sleep in my own bed....with no one waking me up at six am to check vitals, and at no time is baby separated from me.

I also want to say that women need to be allowed to feel disappointment, and yes angst, over disappointing birth experiences. I know of no more hurtful and unsupportive phrase than, "At least you have a healthy baby." That is everyone's goal, but most women do also have other preferrences for their births (like an intact perineum or drug free labor) and when things don't go their way, there is a grieving that needs to occur.

Birth is something nurses see everyday, but to the families involved, this is huge.

Sarah

Dayray, RN · May 14, 2003

I won't get to far into it but it always surprises me that most the ugliness is started by people who don't even work in L&D. Yes I know you have had a baby but that doesn't make you an expert or entitle you come here and tell people who work the area on a daily basis that they are fools. My aunt is currently living in a LTC facility but I don't go to that forum and call you names ktwlpn.

Pros and cons: (I won't call them reasons to have a home birth over a hospital birth because that boils down to choice)

1. The data shows that births at home even here in the US actually have better outcomes for both mom and baby. I tired to find a link for this but got bored =P someone plz post one.

2. Mother is in control, Most patients experience fear, and loss of dignity and privacy in the hospital. It's just the nature of hospitals. No matter how many people I chew out I still get people walking in the delivery room, looking for the patient that was there the day before and walking in on mom in stur ups (really ticks me off)

3. Comfort, It makes things so much easier, delivery is faster and less painful if the patient is at ease.

4. You know who will be at your birth, you pick your midwife and meet there assistant and they are it, no on call doc, no shift change right as you transition. Very nice

5. Don't have to worry about interventions aimed at the docs convenience no failure to progress (what I call failure to wait for the baby to come out) C/S.

6. The biggest reason (and most unselfish) is that the outcomes tend to be better.

Cons

1. There are some wackos out there that take natural child birth way out into new age lala land and convince patients to take some scary risks (choose your midwife carefully)

2. There isn't a NICU in your closet. (I think 2 things offset this risk)

a. The numbers show that home birth is safer and less stressful on the baby so you are less likely to need a NICU.

b. 3 things kill babes They can't breath (make sure the midwife has a BVM and o2) they are cold, (warm blankets and moms belly put radiant warmers to shame) and finally congenital abnormalities cause infant death but this really goes back to 1 and 2.

To sum up the NICU argument, there isn't much more that can be done to stabilize a neonate in a NICU that a sharp midwife can't handle.. Generally if a baby has to go to NICU its to go on a vent, but there is no reason that baby couldn't be supported with bag valve mask until they got to the hospital.

You have to realize that in the hospital we hear the horror stories and not the good stuff. Next time you hear one of those scary tales of a home birth gone bad, find out how long ago it happened, my experience has been that they are so few and far between that people cant remember when it actually last happened.

Another point Id like to make is that having not worked in L&D you wouldn't know how really easy babes are to recess. 2 days ago I had a baby with apgars of 4 at 1 min and 9 at 5 min. a little o2 some stimulation maybe bag them a little and give narcan (which wouldn't be needed at a home birth) and they perk right up. If they don't then we ship them 30 miles to a NICU to be put on a vent. No reason that can't be done from home.

Adults have a much higher rate of survival if they can get to the hospital within 5 min but thats becuase of defibulation and you dont defibb babyies anyway.

As I said before I need more experience before I can make a solid decision on my opinon of home birth but the more I read the more I like it. Think Ill look up a midwife and see if I can tail them at a home birth.

allnurses Guide · May 14, 2003

I think homebirths should be an option with all the above considerations for safety. However, those who are upset at the characterizations of homebirths need to not stereotype hospital births. IE . . Nurses "hell-bent" on proving a birth plan is unrealistic, forceps-happy docs, epidural pushing CRNA's, surgery crews trying to sniff out cesareans, hospital employees walking in while a woman is in stirrups . . . geez. :confused:

Our birthing room is set up to be comfortable like your own bedroom, I've never seen a forceps delivery, we let women push using their own rhythm, we don't force epidurals on anyone and cesareans are not done for "too posh to push" reasons or for docs convenience. Hospital and OB nurses are not evil.

Thanks.

steph

Dayray, RN · May 14, 2003

stevielynn

I agree, I dont want to vilify hospitals or staff. I like working in L&D. I just wonder if things couldent be done better.

Btw I was talking about visitors walking into rooms not staff. happens offten but was only mentioned to demonstrait how the hospital experance compromizes patient privacy. I should also mention this happens on any hospital floor not just L&D

allnurses Guide · May 14, 2003

ok . . .thanks.