Home Births

Specialties Ob/Gyn

Published

I'd like to hear some opinions on home birth. If the woman is healthy, has had great prenatal care, and has previously delivered healthy babies with no difficulties, would you say that this still is an absolute no-no? Attitudes about childbirth seem to change on a regular basis, but it seems to me that more and more lately one rarely even hears of a natural birth.

So, any comments?

Specializes in Educator.

It's always worthwhile to remember that problems/emergencies in the hospital are sometimes precipitated by all the interventions that happen.

It's always worthwhile to remember that problems/emergencies in the hospital are sometimes precipitated by all the interventions that happen.

It certainly is and you are 100% correct. However, that is not always the case. Often with HB transfers, the lady has been in labor for hours and as good as she has been to herself, she is NOT always in good shape. That takes a toll on both Mom and baby.

It is important to pick a back-up HCP IN ADVANCE (and not depend on some on call doc). All those available interventions do NOT have to be used, but often the situation warrants it because the HB mother has waited too long to get help. Not always, mind you, but unfortunately often enough, making some of those interventions necessary.

Specializes in Educator.

I agree that interventions are sometimes necessary for a homebirth transfer- indeed that is why transfer usually happens. I would say though, that in the 150 or so homebirths I have attended (in a variety of capacities) it was infrequent that we "waited too long".

You bring up a valuable point:)

I did neglect though to indicate in my post that I was responding to the individuals who wrote about planned hospital births and then had rough experiences. There are of course any number of events that happen because they will happen- at home, hospital or in the elevator, :) And before anyone gets their ire up let me hasten to point out I mean no disrespect to anyone.

One place where I worked, using a midwife was very discouraged. If you had used a CNM throughout your entire pregnancy, then had a complication and needed to deliver at the hospital, or just decided when it was time to deliver to show up at the hospital, then you were dubbed a drop-in, and labeled as having no PNC, even when they had records in hand. The CNM's in the area were NOT recognized as competant caregivers. I had one nurse tell me that there was no useful information in the midwives' prenatal records, and that the pts. would have been better not to have brought them. There were also a great deal of lay midwives in the area, and there patients were treated the same way...as drop-in's with NO PNC.

The pts. who did come to us in an emergency were a train wreck. You never know when an unexpected complication could arise. Personally, I feel better about having a CNM who delivers in a hospital that has a LEVEL III NICU. As a NICU nurse by trade, I'd be way too terrified to deliver anywhere that did NOT have a NICU.

:stone Having a homebirth is selfish, needlessly puts the child at risk, and is never, ever a good idea.

It doesn't matter how many uncomplicated births you have had or how experienced the people attending to you are - birth is the most difficult and risky event of life (for the infant - not the mother) and something could go wrong at any moment.

If you want your baby to have the best chance possible, don't have your baby at home. A few days of having to be in the hospital is nothing compared to the permanant injury that can be caused by even seconds of delay in the birthing process.

I have seen this from both the clinical aspect (working postpartum) and from the legal side, working on cases where children have permanant impairments related to birth events.

It does not benefit the infant. :stone

:stone Having a homebirth is selfish, needlessly puts the child at risk, and is never, ever a good idea.

It doesn't matter how many uncomplicated births you have had or how experienced the people attending to you are - birth is the most difficult and risky event of life (for the infant - not the mother) and something could go wrong at any moment.

If you want your baby to have the best chance possible, don't have your baby at home. A few days of having to be in the hospital is nothing compared to the permanant injury that can be caused by even seconds of delay in the birthing process.

I have seen this from both the clinical aspect (working postpartum) and from the legal side, working on cases where children have permanant impairments related to birth events.

It does not benefit the infant. :stone

You're right about one thing. I don't agree with you.

Sarah

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I do NOT see it as selfish, but if very informed, and in a low risk situation, a VERY good choice for some. I think all people should be able to choose the venue for birth, as long as they what they are entering into. Selfish? Not even close.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Having a homebirth is selfish, needlessly puts the child at risk, and is never, ever a good idea.

It doesn't matter how many uncomplicated births you have had or how experienced the people attending to you are - birth is the most difficult and risky event of life (for the infant - not the mother) and something could go wrong at any moment.

If you want your baby to have the best chance possible, don't have your baby at home. A few days of having to be in the hospital is nothing compared to the permanant injury that can be caused by even seconds of delay in the birthing process.

I have seen this from both the clinical aspect (working postpartum) and from the legal side, working on cases where children have permanant impairments related to birth events.

It does not benefit the infant.

There's pros and cons to either one, but i'd never say that a home birth is selfish. I think that's stretching a bit far .

I think it's important to remember that if you work pp and from the legal side of things, you're only going to see the bad cases. That tends to warp perceptions.

One place where I worked, using a midwife was very discouraged. If you had used a CNM throughout your entire pregnancy, then had a complication and needed to deliver at the hospital, or just decided when it was time to deliver to show up at the hospital, then you were dubbed a drop-in, and labeled as having no PNC, even when they had records in hand. The CNM's in the area were NOT recognized as competant caregivers. I had one nurse tell me that there was no useful information in the midwives' prenatal records, and that the pts. would have been better not to have brought them. There were also a great deal of lay midwives in the area, and there patients were treated the same way...as drop-in's with NO PNC.

The pts. who did come to us in an emergency were a train wreck. You never know when an unexpected complication could arise. Personally, I feel better about having a CNM who delivers in a hospital that has a LEVEL III NICU. As a NICU nurse by trade, I'd be way too terrified to deliver anywhere that did NOT have a NICU.

Then you have not experienced some nice level 1 hospitals. You know, those of us who work in level 1's have anesthesiologists, pediatricians and even nurses who are skilled in neonatal resuscitation. A leve three is great for a preemie or a sick baby but most babies do NOT need that level of care.

Specializes in Educator.
There's pros and cons to either one, but i'd never say that a home birth is selfish. I think that's stretching a bit far .

and there are numerous studies supporting the safety of homebirth.

I do NOT see it as selfish, but if very informed, and in a low risk situation, a VERY good choice for some. I think all people should be able to choose the venue for birth, as long as they what they are entering into. Selfish? Not even close.

I totally agree SmilingBlueEyes.

IMO medical intervention can sometimes be the selfish action that starts a rollercoaster of intervention, which then leads to an adverse outcome.

I have attended many home deliveries as a Midwife and think they have so many plus points. Machinery and technology have a place in some circumstances, but using some basic midwifery skills can sometimes tell a whole lot more than technology alone.

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