Would you consider a home birth?

Gompers, BSN, RN · Apr 9, 2006

As a NICU nurse? I personally would not (on purpose that is) given my experiences in the NICU. The homebirths we see are the ones with severe MAS who end up on ECMO or on cooling blankets. I know our view is skewed. Wondering what others thought.

Pretty much the same - a NICU nurse's exposure to home births is usually not great, so we're pretty biased.

No way in heck would I ever deliver a baby outside of a hospital.

In my mind, the delivery is for the BABY, not for me. It's the baby's safe arrival that matters most. My "birth experience" is not nearly as important as that baby's health.

Just my humble, biased opinion.

fergus51 · Apr 9, 2006

As a nicu nurse and a former L&D nurse, no I wouldn't. It's more the L&D side of me speaking, but I have seen too many low risk deliveries turn high risk to ever feel comfortable giving birth at home. I know it is a safe option for a lot of women and I respect their decisions. It would just not be something for me.

iceNICUnurse · Apr 9, 2006

No way in heck would I ever deliver a baby outside of a hospital.
In my mind, the delivery is for the BABY, not for me. It's the baby's safe arrival that matters most. My "birth experience" is not nearly as important as that baby's health.

I totally agree with you on this one!

I would never have a home birth. I have seen too many things go wrong.

JeanettePNP, MSN, RN, NP · Apr 9, 2006

In my mind, the delivery is for the BABY, not for me. It's the baby's safe arrival that matters most. My "birth experience" is not nearly as important as that baby's health.

I'm not going to debate you, but as a homebirthing mother, I feel that giving birth where I feel safest and most comfortable is better for my baby's long-term health. A relaxed mother who is prepared and in control of her own birth has a far lower rate of complications and interventions. Babies go in distress when their mothers do! Not saying that there are no other causes for distress but you cannot deny that it's a factor.

Plus I am not exposing my baby to hospital germs and multiple strange caregivers, many unnecessary invasive tests and procedures, taking my baby outdoors at a very young age, exposing my baby to exhaust fumes and traffic, etc... Don't think that homebirthing mothers do it only for their own comfort and baby be damned. My two homebirthed babies were much healthier and I had far better nursing experience with them than with their hospital-born siblings. Of course I was also a more experienced mother by then but that was part of my reason for choosing homebirth.

Jolie, BSN · Apr 9, 2006

I would not choose a homebirth myself, but support the right of others to do so. Both of my deliveries "went south" at the last minute. One with a complex presentation (both hands up to the face), making the actual delivery quite challenging. The other with an occult prolapsed cord.

I would strongly advise parents who desire a homebirth to find a CNM who has an assistant present at all deliveries. Most emergencies can be initially managed at home, if there are sufficient qualified attendants present.

One of the saddest situations I ever encountered in the NICU was an infant with brain damage due to MAS. The mother hemorrhaged at delivery and the home birth attendant (I'm not sure what her qualifications were) could not care for both the mother and baby at the same time. The father, untrained in CPR had to try to attend to his infant son until the paramedics arrived. Had a second care-giver been present to clear and manage the baby's airway, he probably would have been OK.

Jolie, BSN · Apr 9, 2006

Plus I am not exposing my baby to hospital germs and multiple strange caregivers, many unnecessary invasive tests and procedures, taking my baby outdoors at a very young age, exposing my baby to exhaust fumes and traffic, etc...

I'm not sure what you mean regarding exposing the baby to exhaust fumes and traffic.

JeanettePNP, MSN, RN, NP · Apr 9, 2006

I don't believe in taking a baby

JeanettePNP, MSN, RN, NP · Apr 9, 2006

I would strongly advise parents who desire a homebirth to find a CNM who has an assistant present at all deliveries. Most emergencies can be initially managed at home, if there are sufficient qualified attendants present.
One of the saddest situations I ever encountered in the NICU was an infant with brain damage due to MAS. The mother hemorrhaged at delivery and the home birth attendant (I'm not sure what her qualifications were) could not care for both the mother and baby at the same time. The father, untrained in CPR had to try to attend to his infant son until the paramedics arrived. Had a second care-giver been present to clear and manage the baby's airway, he probably would have been OK.

Yes, I agree with this. Problem is that the people bashing homebirths don't make any distinction between mothers who are uneducated and have no prenatal care giving birth at home, versus mothers who have done their research and and are well-prepared and made an educated decision to give birth at home with a professional caregiver.

Gompers, BSN, RN · Apr 9, 2006

I'm not going to debate you, but as a homebirthing mother, I feel that giving birth where I feel safest and most comfortable is better for my baby's long-term health. A relaxed mother who is prepared and in control of her own birth has a far lower rate of complications and interventions. Babies go in distress when their mothers do! Not saying that there are no other causes for distress but you cannot deny that it's a factor.
Plus I am not exposing my baby to hospital germs and multiple strange caregivers, many unnecessary invasive tests and procedures, taking my baby outdoors at a very young age, exposing my baby to exhaust fumes and traffic, etc... Don't think that homebirthing mothers do it only for their own comfort and baby be damned. My two homebirthed babies were much healthier and I had far better nursing experience with them than with their hospital-born siblings. Of course I was also a more experienced mother by then but that was part of my reason for choosing homebirth.

Remember that this thread was directed towards NICU nurses and our thoughts on homebirths. We're not trying to bash it - it's just that our experience with it has always been the BAD side of homebirths. Most of the babies that we see who have been the result of a homebirth are in the NICU for a reason - most of the time asphyxia. Most of the babies we see would have been fine had they been delivered in a hospital. Most of the time we're shaking our heads, saying, "If only they hadn't been at home..." And I have to say, the particular parents I've encountered who did a homebirth gone wrong never mentioned doing it for the baby's sake - they have always listed reasons that directly applied to the mother's satisfaction with the birthing experience. Again, my view has been completely skewed because of my own expereiences. I have the right to my own opinion.

So remember, we're not just regular women here talking about this - we're NICU nurses who have seen the worst of the worst. We're going to be biased as a result.

BittyBabyGrower, MSN, RN · Apr 9, 2006

Gompers is right, this thread was asking us from our NICU side. Personally, if you want to do it and take the chance something is going to go down the tubes, that is your business, but as a NICU person that sees at least 2 home births gone bad a year it makes me leery. If people want to do it, then they should live within X miles a tertiary care center and make sure that they have a good midwife, not just a doula. Each time we get these kids, the parents said that they never thought this could happen...well, no, no one thinks that they aren't going to get the perfect Gerber baby.

As for some of the other things you said, I gave birth at a level 3 center and I was very glad because my DD got caught up in the cord and was in deep trouble...I had a picture perfect pregnancy, etc, so how would we have known that at home? I also had the same nurses for the days I was there, the same nurse practitioner, I turned down the Hep B shot until she was older because she was going to be home with me for the first 6 months, she did have her newborn screenings, she drove home in the car after she was outside for 2 minutes and then 1 minute on the way back in the house. After all this stress, this kid has a genius IQ, excels at everything she does and never seemed to be harmed in any way. On the other hand, had I delivered at home, she would most likely be gorked out, lucky to have an IQ and would have been exposed to exhaust fumes and outside air as the ambulance took her 30 minutes away to the level 3 hospital. So I guess you have to look at it both ways and see how our minds tick. Many things kind of make us look at things in a whole nother light, not thru rose colored glasses.

fergus51 · Apr 9, 2006

Yes, I agree with this. Problem is that the people bashing homebirths don't make any distinction between mothers who are uneducated and have no prenatal care giving birth at home, versus mothers who have done their research and and are well-prepared and made an educated decision to give birth at home with a professional caregiver.

I don't think anyone is bashing homebirths. It's just that for every oddball story I hear about a man crashing his car and being killed on the way to the hospital (this is actually the first for me), I SEE several bad outcomes related to homebirths with my own eyes. I see those parents needlessly grieving. I see the baby needlessly suffering and even dying. That changes your perspective. I used to think I would consider a homebirth before going into the NICU. Then I worked there and looked after a baby we let die because she was so brain damaged from her home delivery. It changed me. Now, I see several a year and they aren't from uneducated or high risk women. Most of them are low risk and had a good birth attendant, but sometimes that doesn't make up for the fact that a home just doesn't have the resources of a hospital. I've seen some really bad outcomes with prolapsed cords and MAS.