Dr John Crippen
The decision to have a home birth occurs (by definition) in the antenatal period.
As things stand, the foetus is not recognised as a person by UK law.
Consequently, I don't see legally how a mother can owe a duty of care to her unborn child?
Setting that aside and assuming a duty of care, you'd then have to demonstrate breach of that duty and causality with respect to damage caused to the baby.
I don't see this happening anytime soon.
But, according to that UC website, women have an "instinstive knowledge of birth".
Of course. How silly. Someone who's never done it before, has been labouring for hours upon end has a clear head and the instinct to give birth without any difficulty.
I have no personal experience but from what I've heard the NHS does not deliver good maternity care. That doesn't mean you should shun it entirely though.
I'm just keeping my fingers crossed that I'll be guaranteed a doctor in with me when I have my babies (as hopefully he'll be the father 
). Before I found him, I was terrified of having a baby on the NHS - being left, not having things explained to you, your own feelings ignored etc (all the horror stories I'd heard). Isn't it bad that I only feel happy now I have the hope of my own personal physician on the scene?!
I saw Horizon (I think it was Horizon) the other day where the head honcho midwife was talking about how women we not longer being "cherished". Bugger cherishing, I want a doctor on hand.
In some US states, a mother can be prosecuted for repeated antenatal use of illicit drugs that harm the fetus (cocaine, alcohol, etc.). It is an interesting idea, arrested for repeat home birth. Sounds a little like China doesn't it?
On the other hand, I'm with you. I can't stand homebirth's either. It only takes one bad case for you to realize how many ways a woman or her child can die at home but be saved in the hospital.
A couple of further thoughts:
As long as the mother is the 'patient' and has capacity, she has the legal right to refuse any and all treatments including the provision of a hospital delivery.
"St George's Healthcare NHS Trust v S" and "R v Collins" both clearly establish that the autonomy of a competent pregnant woman is not diminished by the best interests of the foetus.
And what about Bolam?
Doctors are held to the standard of 'reasonable care' as determined by their peers. As long as the vast majority of women who choose homebirths suffer no adverse consequences, who can legitimately argue that they are not acting reasonably?
Even if the homebirth goes uneventfully, I personally think that child protective services should follow that family for a while, because the mother values some kind of fantasy "experience" over the well-being of her baby.
These stupid people who think that everything that is "natural" is somehow good should remember that half of all babies died before the age of 5 before modern medicine, and that the "natural" thing is that after giving birth the mother would have to transport and nurse this child while avoiding predation in a primitive environment, not that she would be ensconced in her climate-controlled house with her refrigerator stocked with food. So this has nothing to do with what is "natural" and everything to do with some kind of perversity.
A wild animal that could gain some kind of advantage for her young would do it, and not think of any kind of "experience." A truly primal wild animal would eat its mate if it would confer an adaptive advantage -- it would have no moral problem with giving birth in a tertiary hospital with all of the life-saving technology at its disposal for herself and her offspring, and would not seek out an "experience." An animal maximizes its ability to survive -- and the ability of its offspring to survive -- any way it can. It doesn't contemplate anything. Humans seeking out a "natural" experience, on the other hand, are intentionally putting themselves and their babies at unnecessary risk, for a totally unnatural reason -- "the experience"? for some kind of philosophical reason? A mistrust of medical care?! Because yeah, if I have placenta previa, I absolutely trust in nature...to turn me and the baby into fertilizer.
And remember, ladies, rotavirus, diphtheria, influenza and tooth abscesses are natural too.
Although I wouldn't undergo a homebirth or UC, I do understand why some of the women's reasons are for having them, particularly some experiences of past birth trauma and the disrespect that some docs (especially US ones) give to their clients - I've seen doctors roll their eyes at labouring women, a couple of students stare at a woman's vulva while she's pushing, one saying to the other, "What's that? That's weird." And that's on birth shows on TV!
I want to specialise in OB/GYN and I fully respect medical intervention where it's needed, as in your experiences as a medic. But a lot of women steer towards home and free births because of unwanted or unnecessary medical intervention (I know you greatly admire Dr Amy - she gives me the shudders) and until we understand why women choose to turn away and make steps towards improving maternity services, and respecting women who are birthing rather than seeing as birth as a process that automatically needs to be 'fixed' - homebirth numbers will not drop. A lot of people won't agree with me, but I look towards people like Michel Odent and FPMama's blog - they are the people who mix biomedicine with this level of respect and it has great results - see FPMama's entry on the 17 year old who delivered vaginally, without drugs.
I absolutely disagree with charging women who have tragic homebirths with manslaughter. I think that would only drive it underground and increase mistrust of biomedicine and the profession. I really don't want to see the UK evolve into the US obstetric system, I always wince when I watch those birthing shows of what the 'standard' is like - and I fully intend on birthing in hospital when the time comes.
If you read Rachel Roth's book on maternal and foetal rights, pushing for this kind of thing takes the woman out of the spotlight. Do we really want things like c-sections to be forced on women for the 'good' of the baby? As much as I disagree that homebirth is safe, I fully agree with the woman's freedom to make these choices - at home or otherwise - even if it's at the detriment to the foetus.
But for now, I don't see much progression: on the surface it'll just be another hospital vs homebirth debate.
For a little light relief/satire if this hasn't been done already:
http://www.youtube.com/watch?v=a...h?
v=arCITMfxvEc
"Humans seeking out a "natural" experience, on the other hand, are intentionally putting themselves and their babies at unnecessary risk, for a totally unnatural reason -- "the experience"?"
Out of genuine interest, do you count women who want to have drug free deliveries in hospitals with minimal intervention in this? I'd sure appreciate the technology if I needed it, but I sure as hell wouldn't want it if I don't.
I have a friend who had 2 of her 3 children in a London hospital. For her 3rd, she chose a home birth attended by NHS midwives. Her verdict - she preferred it to being in hospital - mostly because you get two midwives and they stay with you throughout your labour.
The recent documentary on womens' experiences of birthing in the NHS was 'Panorama'.
In contrast, I have to say that my experience of both my births in the NHS couldn't have been better - granted I would have preferred my 1st son's breech presentation to have been picked up before I pitched up just before the 2nd stage of labour, but you can't have everything. The section I had would have been elective, rather than the emergency it turned out to be. Second child was born very quickly (in Dec 2005) and easily naturally with gas and air. The midwife was great and my postnatal care in hospital was excellent.
To the poster who says they want a Doctor in the room - to be honest, my view would be the less people the better, if things are going OK.
I agree with naughtymedic re FPMama - it's an excellent blog - she sounds like an brilliant Doctor and her approach is very non-interventionalist.
I delivered my son. In a hospital with a consultant and the obs reg in the next room. Yhe midwife was in the romm - he was male by the way. My wife found him excellent. I would not have delivered him if the threatened vontouse (i think that's ho it is spelt) had been needed and rightly so.
We do not live in a totalitarian state and as people within...ahem...a democracy we are allowed a degree of choice. But we also have a social responsibility within that society. If I see a patient with a gun, pissed and driving, epileptic and driving etc then I have a duty of care to the wider population who are not YET my patients to try and stop that person (mainly by judicious use of the police force/DVLA). Surely in a similar way we, as doctors, have a duty of care to that child about to be born?
You are allowed choice but not if that choice harms another. If that other is your child - how does your head work?
I am aware that NHS obs care leaves a lot o be desired but it is an order of magnitude safer than being at home when things go wrong.
Dr Sniper
Does a mother not owe a duty of care to her baby?
No.
Should a mother not take reasonable care to protect the baby when she gives birth?
Morally arguably yes. Legally no. A foetus does not become a person until he or she has been born. The mother's right as a competent adult to chose which medical treatment to accept and which to refuse, however irrational her choice, overrides any interests the foetus has. (http://www.aims.org.uk/Journal/Vol10No2/
trustGuilty.htm = good starting point in illustrating the case law).
However much one might like people to make rational decisions that accord with the science such choices cannot be forced on them. Yes, I can see how this may be frustrating for you. It still doesn't remove the right of competent adults to refuse their consent to medical treatment they don't want
And if she does not take reasonable care – and the standard should be objective not subjective – why should a baby who has sustained avoidable brain damage due to the mother's negligence not take action against his mother?
Because there's a public policy principle against allowing children to sue their parents in this way. The case law on negligence didn't end in 1922...
"Surely in a similar way we, as doctors, have a duty of care to that child about to be born?
You are allowed choice but not if that choice harms another. If that other is your child - how does your head work?
"
But then it isn't limited to childbirth. We could say goodbye to abortion rights, and would start monitoring women during their pregnancies to check they were doing 'all the right things' to ensure baby's health was at an optimum. Crack cocaine? Jail. Coffee that's not decaff? How could you do that to your baby you monster!
Similarly, does that mean then, if for instance, a doctor scratches a baby's head during a c-section with a scalpel - would the woman (or baby later on in life) be within their rights to sue?
I'm by no means poo-pooing the technology, but we should be cautious and think about what that technology does and how it can affect both parties involved.
Prosecute a mother for manslaughter after a home birth ends tragically ?
Suppose it were to happen - if the distraught mother was found 'guilty', would the next step be jail ?
If she were a lone parent what would happen to any other children in her care ?
And would the I-told-you-so prosecutions be rolled out to other patient groups who refuse to comply with medical advice, even when there is no such thing as a risk free option ?
Lets say a mother refuses MMR. Her child contracts German measles and transmits rubella to a foetus who is born blind with severe heart defects - what then ?
In my judgment the biggest problem with homebirth (and "freebirth") advocacy is that it is based premises that run the gamut from inane to factually false.
The inane premises include:
Childbirth is safe because it is natural. Ignoring the fact that natural substances (cocaine, tobacco) and events (earthquakes, hurricanes) are among the most dangerous and destructive on earth.
Childbirth is not a disease. Obviously it isn't. That doesn't change the fact that it is and has always been one of the leading causes of death of young women and infants in every time, place and culture right up to modern day first world countries.
And my personal favorite inanity:
Trust birth. Birth is no more "trustworthy" than pregnancy and 1 in 5 established pregnancies end in miscarriage. Human reproduction has a tremendous amount of wastage. Each woman has millions of ova that will never be used. Each man produces billions of sperm that will never be used. More than 1 in 5 conceptions end in miscarriage. Maternal and neonatal mortality are just part of the natural wastage of human reproduction.
The factual falsehoods are even more egregious:
Birth in nature is safe. Birth in nature claims hundreds of thousands of maternal lives and millions of infant lives each year.
If birth weren't inherently safe, we wouldn't be here. This is a profound misunderstanding of the basics of population growth. In order for the population to grow, the number of people in the next generation need only be slightly more than in the previous generation. The population can experience massive amounts of mortality of all kinds (including maternal and neonatal mortality) and still grow.
Studies show that homebirth is as safe or safer than hospital birth. No study has every shown homebirth to be as safe as hospital birth for women of comparable risk. The most widely quoted study (Johnson and Daviss, BMJ 2005) has a neonatal mortality rate of 2.7/1000 (including congenital anomalies). The hospital neonatal death rate for low risk white women at term in the same year was 0.72/1000. Johson and Daviss neglect to mention that in their study.
I could go on, but I think people get the idea. Homebirth advocacy is based on premises that are factually false. Homebirth has an excess rate of preventable neonatal death in the range of 1-2/1000 and "freebirth" in undoubtedly higher.
Come on guys its (or should be) a free world. If people want to ahve their babies at home, let them. We don't say asthmatic children should sue their parents for smoking, or that fat kids should take action for the junk food.
Life is ful of risk. The risk in a home birth is small (all be it significant). It is not a risk that I would ever take with my family, but there you are.
The main thing is that women and families are given the correct information on which to make their decision. At the moment there is a danger that all they will hear is independent madwives and hospital centred doctors
Does a mother not owe a duty of care to her baby?
No.
Should a mother not take reasonable care to protect the baby when she gives birth?
Morally arguably yes. Legally no. A foetus does not become a person until he or she has been born. The mother's right as a competent adult to chose which medical treatment to accept and which to refuse, however irrational her choice, overrides any interests the foetus has. (http://www.aims.org.uk/Journal/Vol10No2/ trustGuilty.htm = good starting point in illustrating the case law).
However much one might like people to make rational decisions that accord with the science such choices cannot be forced on them. Yes, I can see how this may be frustrating for you. It still doesn't remove the right of competent adults to refuse their consent to medical treatment they don't want
And if she does not take reasonable care – and the standard should be objective not subjective – why should a baby who has sustained avoidable brain damage due to the mother's negligence not take action against his mother?
Because there's a public policy principle against allowing children to sue their parents in this way. The case law on negligence didn't end in 1922...
Karen McAtamney |
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Karen, thanks for that, and great stuff. Yes, I am familiar with that case - the facts of which were an outrage - and understandably the courts supported a woman's right to control her own medical treatment. I know the law of negligence did not end with Atkin and snails in ginger beer bottles. Just a trip down memory drain.
I can understand why AIMS is so pleased with the case but this is not an exhaustive and final statement of the law on the subject, and one can postulate all sorts of circumstances in which the courts might distinguish the case.
All sorts of questions. What exactly and precisely is the legal definition of “being born”? When does the baby become independent? When the head crowns? When the head is delivered? When the whole baby is delivered? When the cord is cut, finally severing the baby from the mother?
Suppose a mother, in the second stage of labour, deliberately inserted a carving knife into her vagina with the full intent of killing the baby. What, if any, offence has been committed.
Supposing a mother refused to have the cord cut, refused to let anyone touch the baby and refused to look after it herself and allowed it to die of dehydration and cold whilst the cord was intact. Suppose the mother insisted on a water birth and refused to get out of the birthing pool and allowed the baby, cord still attached, to drown.
Let us postulate circumstances in which a women insists on a free birth, allows the baby to be born, cuts the cord herself. The baby is not breathing. The mother makes no effort to resuscitate the baby, allows nature to take its course, and the baby dies. You will, I suspect say there is no legal duty to intervene.
I think that one day – possibly in the USA rather than the UK – a case will be brought on behalf of a brain damaged baby against a mother. After all, a brain damaged baby has a right of action against an obstetrician. I could easily foresee the courts chipping away at this.
I may have to dig up Lord Denning.
There may be no compulsion upon a mother to accept medical advice as to the kind of delivery she should have but, if her attitude and behaviour is so objectively outrageous that no reasonable mother would behave in that fashion and provided always that she is not mentally incapacitated, and if her action results in avoidable brain damage…………… etc etc
You know how it goes. The House of Lords could over-rule the C of A, indeed might over rule themselves. “Public policy” is a blunt instrument and changes with time. And with fashion. And then there is the question of human rights, European Law and so on. The American Supreme Court, particular one appointed by George W. is well capable of creating such rights for an about to be born baby.
Who knows.
John
Naughtymedic, if you want to have a birth in a hospital with no painkiller, have at it. You know there is a huge difference between putting yourself out of the way of medical intervention by having a kid at home and denying yourself an epidural if you don't want one.
I sympathize with people who don't like some doctors or nurses. There is a major hospital in my area where the nurses are just plain thugs -- whether you are delivering a baby or are recovering from lithotripsy or a cholecystectomy. They treat someone recovering from major surgery with less respect than they'd treat a combative drug-seeking faker. Some doctors are arrogant jerks who don't like their patients. I get all that.
They can be as nasty as they want to to me if they'll just bag my APGAR 4 newborn, thanks.
You charge someone with manslaughter, by the way, when she or he exhibits a particular degree of criminal negligence. In auto terms, there's the negligence where you look down for a minute, look up, and cause a fender-bender with barely any damage. That's ordinary negligence. You'll get convicted of a minor traffic offense. Then there's the kind of negligence where you get drunk, or, having stayed up all night, fall asleep, behind the wheel of a car. Or you drive 100 miles an hour. That's criminal negligence.
Because of the misinformation out there, without more, I'd be uncomfortable with someone who had a home birth being prosecuted for manslaughter. They're'd have to be more.
That doesn't change my position that it's tremendously irresponsible.
"A truly primal wild animal would ... have no moral problem with giving birth in a tertiary hospital with all of the life-saving technology at its disposal for herself and her offspring, and would not seek out an 'experience.'"
Farmers and animal breeders, particularly the infamous American Kennel Club, have tested that hypothesis in many independent trials. Each trial has resulted in a breed of sickly, deformed animals. These breeds commonly require agressive medical and surgical intervention during birth merely to not go extinct.
If you reward weakness, evolution obliges by producing weak organisms. The same laws apply to human evolution. The spare-no-expense interventions Dr. Crippen proposes will have the same result as with animals: a race of sickly humans that require radical intervention to be born, because their genes are not compatible with live birth.
Vigor requires a certain amount of death. The future belongs to the descendents of those who expose themself to the risk.
"Vigor requires a certain amount of death"
---
How much? 50% as it was in my great-grandfather's village?
Mark
OK Dr. Crippen, what's the story with this case?
http://tinyurl.com/2y48ve
When else could a child sue a parent for a bad decision? Here in the US, most male children are circumcised shortly after birth. I would love to see them suing their parents and the responsible physician for this damage.
And just to throw in my anecdote, which you won't appreciate anyhow...
I had a homebirth with a complication, which my midwife rectified. The baby was badly positioned and I was in a lot of undue pain (my second baby, so I knew what labor should feel like). The midwife moved the baby up out of my pelvis and the pain stopped, almost instantly. I had been in so much pain, if I had been in a hospital I would have requested pain meds, and if she hadn't stopped the pain, I was ready to request transfer to the hospital. A badly positioned baby doesn't generally move after an epidural is administered to the mother, who is then prone or nearly prone. I envision a c-section if not for my very knowledgeable midwife, who knew to lay me on a blanket and shake the baby out of my pelvis. I know you doctors will scoff, and think voodoo thoughts or other such rubbish, but the truth is that I gave birth two hours later with only normal labor pain accompanying my progress.
Um, you're floating the idea that giving medical treatment to animals creates sickly animals? Or could it be that your weak sickly animals were probably that way because *they* didn't do the breeding selection. You were breeding for a specific characteristic unrelated to vigor. When you select for big noses and fat breasts and tails that don't curve up, don't yammer about "nature." When you artificially inseminate a cow with the bull semen of your choice, don't yammer about "nature" there, either.
By your logic, though, home births should be mandatory because people dying because of bad luck (breech positioning) or geography (Rh disease) is good for the race, not because nature is good. Sure, be up front with that: Ladies, when you stay at home to have a home birth, a lot of you and your babies will probably die. Some people confuse mishap with genetic weakness, find victims of both unworthy of life, and are ready to select Stephen Hawking out of the gene pool. So, by all means give birth at home. Not exactly an advertisement for home birth, but probably an accurate assessment of the risk.
Then go out in the wild and watch the animals artificially inseminate each other in order to select for a really meaty bee-hind, instead of, say, speed.
>>A badly positioned baby doesn't generally move after an epidural is administered to the mother, who is then prone or nearly prone.
Supine.
Prone is face (or ventral surface) down. Supine is face (or ventral surface) up.
oops, sorry about that. thanks for the correction.
How much death does it take to keep the genes from evolving in bad directions? Not much, but significantly more than Dr. Crippen's goal of zero.
A good estimate would be the death rate for untreated eclampsia in a population whose ancestors were never exposed to modern eclampsia treatments. (Because the selection for and against eclampsia is a pretty pure example of maternal-fetal competition. Selection favors genes that let the fetus grab lots of nutrients, but disfavors ones that take a good thing too far. There's an eternal tug-of-war between the fetal and maternal blood supply genes.)
"Um, you're floating the idea that giving medical treatment to animals creates sickly animals?"
Yes. If resources for raising the animals are finite, agressive treatment of the sickly not only increases their numbers, it takes resources away from the vigorous ones decreasing their numbers. Successive generations will have an increasing proportion of sickly individuals.
"When you select for big noses and fat breasts and tails that don't curve up, don't yammer about 'nature.'"
The words "nature" and "natural selection" are conspicuously absent in my comment, as are "inbreeding" and "frivolous characteristics". I was discussing what survival through medical intervention does to evolution, regardless of how or why the selection occurs.
"By your logic, though, home births should be mandatory ..."
You are putting words in my mouth. I want people to be able to make informed decisions. If someone values highest the health of their great-great-great-grandchildren that they will never see, then maximum medical and surgical intervention is not what they need. Nor need it mean simply dying at home if the fates will it. Other possibilities include abortion, embryo screening, and assortive mating. (The latter being acceptable even to many conservative religions.)
I'm being flamed right now because of comments I made to the blog of a woman who attempted a home birth, was eventually delivered by C/S in hospital of a stillborn, and who can't understand why: http://erinnewmanlong.blogspot.com/
When WILL women begin to realize that childbirth isn't a matter to take lightly? This "freebirth" movement is breathtakingly irresponsible--but then, letting unqualified midwives practice is, too.
BTW, the worst hemorrhage I ever had to deal with was in a home birth in the UK--sudden, total abruptio placentae. The Flying Squad arrived in time to save the mother; the baby didn't. And that was the end of that mother's fertility--because of Couvelaire uterus, it was necessary to do a hysterectomy. If she'd delivered in hospital, she probably would have kept it.
I had a "freebirth" in my home in December and it was a wonderful, safe experience. Barring any medical necessity, I plan on having all my future children this way. For anyone interested in learning more, e-mail me and I will be more than happy to tell you what normal, healthy birth is like.
I think it is important to note that the example used in your blog post is misleading. Cord traction has been shown to be of little or no benefit or even potentially harmful in medical literature. It is known that it increases the risk of severe bleeding in post-partum. I seem to recall Gregory White, M.D. writing in his book "Emergency Childbirth" that attendants should "NEVER pull on the cord to deliver the afterbirth" and that it "may deliver only part of the afterbirth and increase, rather than diminish, the blood loss." It is very possible that the post-partum bleeding you describe in your case against homebirth was dangerous BECAUSE of the medical professionals attending her.
As far as saying that chilbirth is "the most dangerous thing that most women will do in their lives," this is also glaringly false. There are many things that women do that are much more dangerous than childbirth on a regular basis. One obvious instance of this is driving a car. Nobody supposes that women should stop driving cars any time soon. Nobody suggests that any woman whose child is injured in a car accident ought to be sued or charged with manslaughter for putting him/her through the needless risk of driving.
I am quite dismayed to read that a physician finds it necessary to further encourage this campaign against childbirth as natural. The biological fact remains that childbirth was a process that nature decided in evolutionary terms would be the safest and best way for humans to give birth. It is not generally dangerous, though medical assistance is needed in a very small percentage of cases. Generally, pre-determined risk factors that present themselves well before delivery make clear to physicians which cases are the ones which will require medical attention at delivery.
I would strongly encourage you and anybody else reading this to read on the World Health Organization's website their medical findings about birth. As a doctor, you must provide EVIDENCE-BASED care that is in the best interest of your patients. If you don't take the time to actually read the evidence, shame on you!
"If you don't take the time to actually read the evidence, shame on you!"
Once you've read this site for a while, you'll get used to that.
Maybe soon we can divorce our parents in utero?
Aside from the ethical debate about what constitutes as a human life or not, there is the mind-bending "What if...?"
When a child dies in childbirth there are many questions. If a mother feels it could have been prevented if she had a doctor nearby she will spend her life thinking "What if..?" That is one hell of a Q&A to live with. One the McCanns in Portugal know only too well.
The biological fact remains that childbirth was a process that nature decided in evolutionary terms would be the safest and best way for humans to give birth.
This, as stated, is a complete misunderstanding of the way evovution works. It is not (pace IDers) a design process. It selects the best available at the time, from the range of options available to it (which may be very limited), in the set of circumstances which pertain at the time (which may have changed.
Human beings give birth the way they do because they evolved from the mammalian line. When we acquired an upright stance and a big head (both of which make birth much more likely to go wrong than for, say, a shrew), nature couldn't redesign the whole process, only work with what it had to mitigate matters. Any engineer to could invent a much better way of giving birth, given free reign with the design.
breaking news, the selective effects you posit may exist but are probably immaterial.
Dog breeds are notorious for having various physical problems not because of lots of medical intervention at birth, but because they are very highly inbred and therefore homozygous at too many loci). There is plenty of evidence that animals in the wild (mostly females) actively choose both to avoid inbreeding and to mate with particularly heterozygous males. Maybe some dodgy puppies survive because of medicine (though I suspect this would not mostly be during the birth process) but there are a lot of them mostly because of this artificial constraint on breeding choices.
Also, whilst medical intervention at birth undoubtedly has some effect on the genepool, I very much doubt it is significant. Most non-viable foetuses abort spontaneously (miscarry) well before they get to the birth stage. Also, a high proportion of babies with serious problems which are rescued at or near birth by modern medical technology will never themselves become parents, for a variety of reasons. Or, to put it the other way around, lots of the "rescued" babies are rescued from accideents (such as breach presentation) and aren't more likely to have genetic problems than babies born without being rescued.
Delivering in hospital - or at least with some medical care about - is like driving wearing a seatbelt.
Had I not worn a seatbelt for the last twenty years I would be just fine and probably a huge advocate of "Freedriving"
Had I not worn a seatbelt for the last twenty five years I would be dead.
I'd just like to agree with MissBliss at the top - the whole idea of giving birth has always been really scary to me (reading this site hasn't helped!) so I'm really glad that my boyfriend is soon to be - fingers crossed for finals next week! - a doctor. I mean, I'd want to be with him even if he'd chosen a different career, but it's a definite bonus to think that if we ever have children, he'll be there to help me negotiate the medical minefield of pregnancy and birth. That's along way into the future though, of course (in case you're reading this darling)
OK Dr. Crippen, what's the story with this case?
http://tinyurl.com/2y48ve
arf | 10.05.07 - 1:47 am | #
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Yes, that is a really interesting one. But it is one for the lawyers, not for the doctors. Even if there was a mistake and negligence, I am not sure that a spending spree would be under the heads of damage.
Can a lawyer advise?
John
"If you don't take the time to actually read the evidence, shame on you!"
Once you've read this site for a while, you'll get used to that.
Incandenza | 10.05.07 - 9:38 am | #
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Oh tush, incandenza, tush. To whom do you refer? Not me, I trust!!
Or are you assuming that anyone who disagrees with you must be badly briefed?
Tush, tush!
John
The decision to have a home birth occurs (by definition) in the antenatal period.
As things stand, the foetus is not recognised as a person by UK law.
Consequently, I don't see legally how a mother can owe a duty of care to her unborn child?
Setting that aside and assuming a duty of care, you'd then have to demonstrate breach of that duty and causality with respect to damage caused to the baby.
I don't see this happening anytime soon.
Incandenza | 09.05.07 - 6:11 pm | #
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Missed that.
Yes, I know about the current state of the law, and public policy. That could be changed by legistaltion of course, but it could also be changed by the House of Lords (in their judicail capacity)
At present, if a brain damaged child brought an action against its mother, the action might be struck out at first instance, but then the legal point could go up to the house of lords, and they could review the whole matter.
If a mother had conducted her labour in an utterly ludicrous way, a way in which no sensible person would behave, and that action had resulted in serious damage to the child, it is open to the House of Lords (in the absence of legislation to the contrary - and correct me if I am wrong, but there is no such legislation - to reverse previous decisions and grant the child a right of action.
The House of Lords would not do that lightly. The American Supreme Court, on the other hand, could very easily do it.
So there are two questions
(1) Is it legally possible? Answer, yes it is.
(2) Is it morally appropriate to give a brain damaged child such a right? Well, why not?
Of course, these leads on to all sorts of questions (abortion being one) ... but an interesting one above. The American's still favour chopping off baby's foreskins. Supposing a child was damaged during this operation. Could he sue the parents for subjecting him to unnecessary surgery? If not, why not?
John
I was thinking about the freebirthing story yesterday, and about home births in general, in the context of the abduction of Madelaine McCann from her bed in Portugal. I wondered which, statistically speaking, is more dangerous: (a)leaving your baby at home in bed while you go out to dinner nearby, making half hourly checks on her, or (b) opting for a home birth, when there are no advance contra-indications. Are unexpected complications in home birth more, or less, common than unexpected domestic events such as abduction by a predatory paedophile, fire, etc? Does Dr Crippen know the answer to this?
One thing I just cannot get around to understand here is that all these assumtions made about the safety of homebirth do not take any of the multiple studies made about the safety of (attended) homebirth into consideration. It is appearently assumed by a great number of people posting here that homebirth presents a higher mortalityrate for women and their babies than hospital births. It is simply untrue. Every study I have read loooking into homebirth safety has the same conclusion. Homebirth by women having a low-risk pregnancy and expecting a normal birth is as safe as hospital birth. That is fact. The rest is fear-based prejudice. Not evidence based. So come on - show us some evidence. Show me a single valid clinical study that concludes hospital birth to be the safer option!
Oh - and how about the babies that die or are injured in hospital. Who should they sue?
Is it possible to identify those low-risk pregnancies that develop into high-risk deliveries ?
Relying on a flawed evidence base doesn't really help mum's assessment of her risks.
Oh - and how about the babies that die or are injured in hospital. Who should they sue?
Inca | Edit comment Delete comment | Email | 10.05.07 - 1:03 pm | #
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They can, should and do
John
I was thinking about the freebirthing story yesterday, and about home births in general, in the context of the abduction of Madelaine McCann from her bed in Portugal. I wondered which, statistically speaking, is more dangerous: (a)leaving your baby at home in bed while you go out to dinner nearby, making half hourly checks on her, or (b) opting for a home birth, when there are no advance contra-indications. Are unexpected complications in home birth more, or less, common than unexpected domestic events such as abduction by a predatory paedophile, fire, etc? Does Dr Crippen know the answer to this?
isabella
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Yes, I do.
The STATISTICAL change of having you baby abucted by anyone, including a paedophile, is infinitly tiny - the Times yesterday did an article on this. It is far more likely, for example, that your child will be struck by lightening.
So, yes, far more dangerous to have a so called "low risk" home birth - but that initself does not prove that home births are dangerous (though they are) . It is, for example, more dangerous to let your child ride a bike on the main road than it is to have a home birth.
But, oh dear me, those poor parents, that poor child. Evey time this happens, like all parents, I feel that (a little bit) it is happening to me too.
Absolutely dreadful.
John
Inca:
"Every study I have read loooking into homebirth safety has the same conclusion. Homebirth by women having a low-risk pregnancy and expecting a normal birth is as safe as hospital birth."
This is one of the biggest problems with homebirth advocacy. It is based on mistruths, half truths and deceptions. There are no studies that show homebirth to be as safe as hospital birth. There are only studies that CLAIM to show that, but rely on deception. Generally, the deception is to compare the neonatal death rate at homebirth (which comprises low risk white women at term) with the hospital neonatal mortality rate for women of all races, all gestational ages, with pre-existing medical problems and with pregnancy complications.
Take the Johnson and Daviss study (BMJ 2005), for example. It is quite disingenuous. It compares the neonatal death rate at homebirth in 2000 with the neonatal death rate for hospital birth in OUT OF DATE HOMEBIRTH STUDIES. That is an inappropriate comparison. The only valid comparison is to compare the homebirth neonatal death rate in 2000 to the hospital neonatal death rate for low risk, white women at term in 2000. You can look in vain for that statistic in the paper. The authors left it out, because it makes it clear that homebirth is not as safe as hospital birth. The hospital neonatal mortality rate of low risk white women at term in 2000 was approximately 0.72/1000, substantially less than the homebirth neonatal mortality rate.
In order for women to make an informed decision about homebirth, they must have accurate information. Virtually every study to date has shown that homebirth has an excess risk of preventable neonatal mortality. This is hardly surprising. Unanticipated life threatening complications can occur at home, and when they do, the result is often the death of the baby. Again, the Johnson and Daviss provides confirmation.
Look at the reported complications and the reported neonatal deaths:
Thick meconium 13
Sustained fetal distress 31 - 2 deaths
Poor neonatal condition 5 - 4 deaths
Placenta abruptio or placenta previa 5
Cord prolapse 3 - 1 death
Breech 1 - 1 death
So the death rate at home for babies needing expert resuscitation was 80%! The death rate for cord prolapse was 33% and the death rate for unanticipated breech was 100%.
First Dr. Crippen, as an American Mother birthing at home alone after doing my prenatals and also promoting freebirth on the web, I have to applaud you for your blog. I recently did a blog entry on a post you wrote.
http://www.naturalfamilyblog.com...ves/
000725.html
I thought you were an honest and open minded individual. Yet in this post you are dismissing UC birth.
WHY? Don't you know we are the answer to the madness of socialized medicine?
An american Paper did a story on UC birth this week too.
http://www.westword.com/2007-05-...-s-day-out/
full
As one of the moms profiled in the article, I am thrilled with this recent media exposure. Parents should have the right to birth where they feel comfortable. And as medicine gets socialized in America, we who are watching the whole mess evolve into the DANGEROUS experience that you so effectively articulated as being problematic DESERVE to have the right to do risk analysis of the situation and then make an intelligent decision based on the facts.
I have done so and will never birth in an american hospital ever again. Too dangerous to me and my baby. Does this mean I am unaware of the risks involved? Nope. I just choose to give birth where I feel most comfortable.
Please do some more reading about UC birth. We are the future, not collectivism in the maternity wards.
Jenny Hatch
Why, Dr. Crippen, you seem to have softened your stance toward NHS midwives somewhat. How so?
Why, Dr. Crippen, you seem to have softened your stance toward NHS midwives somewhat. How so?
Louise | Edit comment Delete comment | 10.05.07 - 3:33 pm | #
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Purely accidental, I am sure!!
I am not completely rabid, you know. But what makes you say that?
Incidentally, if you go over to Mothering.com, particularly here:
http://www.mothering.com/discuss...splay.php?
f=306
you will see some views that make me seem like the most reasonable person on earth. Which of course I am
John
Just to add appoint to the question of the House of Lords (Supreme Court as of next year) recognizing the existence of a Childs rights while inside the womb look at Attorney-General’s (no. 3 of 1994)[1996] 2 WLR 412. A case where it was decided that an injury inflicted before birth could amount to manslaughter, as long as the child survived long enough to be born.
"Midwives working within the NHS who attend and supervise home deliveries are properly insured. They are properly trained too."
I thought you thought all midwives undereducated and overconfident to the point of being dangerous?
Dr Crippen,
The fact that some people are equally rabid on the other side of the debate does not render you less so.
Louise
"So the death rate at home for babies needing expert resuscitation was 80%! The death rate for cord prolapse was 33% and the death rate for unanticipated breech was 100%."
Point of scientific/statistical style: Those are very small sample sizes to be doing percentages on. One less breech or cord prolapse and the respective mortality rate would be zero.
Just to add appoint to the question of the House of Lords (Supreme Court as of next year) recognizing the existence of a Childs rights while inside the womb look at Attorney-General’s (no. 3 of 1994)[1996] 2 WLR 412. A case where it was decided that an injury inflicted before birth could amount to manslaughter, as long as the child survived long enough to be born.
Joseph K | Edit comment Delete comment | 10.05.07 - 3:58 pm | #
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Aaah, fascinating.
My case law stopped a good few years ago, so I shall have to ask Karen how she distinguishes this case
John
"Parents should have the right to birth where they feel comfortable."
Now THAT is one of the silliest things I've read. They should have the right to a safe labor and delivery for both the mother and baby.
I liked the seat belt analogy. I once had a patient who was Rh negative and who refused to get Anti-D, and pointed out to me after each birth that avoiding the shot hadn't done her any harm. Until she was sensitized during the 4th birth. Since she was an devout Catholic, she kept on getting pregnant, and the babies kept getting sicker, until, after the 6th birth, she only gave birth to stillborns. "God's Will" she said. No, her will.
In my experience of home birth, in Cambridge, women were so exhausted afterward that they begged to be admitted to hospital with the next pregnancy ("for the full 10 day stay if possible, Nurse"). My midwife tutor and I had to call the Flying Squad on 3 occasions within a 3 month period, despite very stringent criteria for home births because the complications were entirely unforeseeable. The time gap between the complication developing and the delivery was critical, and if the woman had been at Mill Road Maternity Hospital, the necessary C/S could have been done several times over. A baby died because a mother thought hospitals "cold".
The foremost proponents of home birth have seen none but their own. Perhaps I was lucky to see a lot of catastrophes early in my obstetric career (hospital catering to inner city women without antenatal care in NY) It has given me a big sense of caution.
Something about Antigonos and her comments. She apparently thinks the best way to get her message across that homebirths are dangerous is to go to the blog of a deeply grieving mother whose baby died just over two months ago and write comments like:
"You want to talk about EVIL? Choosing a method of birth that puts a baby at undue risk is EVIL. You can flame me all you like--ANYONE WHO CHOOSES TO AVOID MEDICALLY ACCEPTABLE PRACTICES ON BEHALF OF A HELPLESS PERSON IS GUILTY OF MANSLAUGHTER.
Of course babies die in hospital! But not for "unknown" reasons."
The last statement is, of course, utterly false.
"Now THAT is one of the silliest things I've read. They should have the right to a safe labor and delivery for both the mother and baby."
Amen, and that is why I choose to give birth at home in the sanctity and safety of my own bedroom.
Question: Why do you care so much where I give birth?
Jenny Hatch
http://WWW.NaturalFamilyCO.com
Rosepetal thinks the bluntness with which I state unpalatable truths is unacceptable. How would you make it plain to a woman that home birth is dangerous? Or wouldn't you, and just decide that it was karma or God's Will that the baby died?
A birth is only safe for the mother and child in retrospective. But why maximize the risk deliberately?
Why do I care so much where you have the baby? Because I think that the baby needs an advocate, and not just a couple of ignorant people who want to be "comfortable" and have a "birth experience"--and if you'd seen what I've seen, you'd agree with me.
Amazingly, in the so-called "primitive world" women literally walk, often in labor, for days to get to a hospital because they want a safe delivery so badly. Check out "Babycatcher" who works in Malawi.
Ah well, this can go on forever. Oddly enough, I am not opposed to home birth WHEN THERE IS ADEQUATE BACKUP. In the 70s, in Cambridge, there was. I don't know what the state of things is in the UK now. The Cambridge area didn't use the Domino system, where a woman only spends the latter part of her labor in hospital, and goes home after 6 hours, thereby being able to get emergency care for the critical period. In America, there has never been any backup for home birth at all, and too many midwives aren't even professional.
Antigonos,
You don't need to spend any of your precious time educating me on anything related to mothering. And you are welcome to be as blunt and condemning as you choose.
I honestly don't care what you or people like you think of our decision to welcome the babies at home unassisted. Even hearing that the good doctor believes Mothers who birth at home should be prosecuted for manslaughter in case of a death does not sway my choice to birth alone without professional assistance.
You both are entitled to your views and assumptions about Allopathic Birth. I was just curious to understand WHY you care so much how I birth. Advocate? Pulleeese.
In terms of advocating for children, Recently I read that in the UK a certain percentage of aborted babies are born alive. Why don't you go advocate for those children and their botched murders?
I will claim my rights of self determination and give birth at home in my bedroom for the simple reason that I believe it is best for the baby!
And I don't need some nanny state bully advocating for my child. He has his parents to watch over and protect him from Big Pharma conspiracies and agendas to medicate the planet into extinction, cha ching, cha chinging their way to A globalized, top down control over the minds and hearts of mothers, fathers, and children.
You can take your "but I'm for home birth if...." fear based condemnation and put it where the sun don't shine as far as I'm concerned.
The UC Birth movement was born in America, where revolutions against tyrannical systems of captivity have flourished. This movement is just a coninuation of the American Revolution. To quote a Patriot, Jefferson eloquently said:
"I swear upon the alter of God, eternal hostility to every form of tyranny over the mind of men".
I swear eternal hostility to any professional who would seek to deny me my rights of self determination as a mother.
Jenny Hatch
Jenny@NaturalFamilyCo.com
My questions to the freebirth and homebirth advocates are simple.
Question 1 - Would you let your child sit on your knee and play 'Russian Roulette' with a loaded revolver?
No? Why ever not? It's far less risky for you both than giving birth out of reach of immediate expert medical intervention!
Question 2 - Consider your 2 week old baby - would you squeeze him until he turns blue, put a rope around his neck and pull hard or pull him through a narrow pipe with one leg doubled up behind his back?
No? Why ever not? You were willing to do it 2 weeks ago?
The case I referred to is an unusual one, it concerned an assault on the mother of the child. The womb was pierced by a knife but it was thought that the child was unharmed, it was only after birth and the subsequent post mortem that a wound in the child’s abdomen was found. The discussion in the House of Lord was on transferred malice, but the judgment did go some way to recognizing the right of the child, even if initially it was only through the body of the mother.
Rosepetal,
What do you think happens at a failed homebirth? The baby dies. That's exactly what happened to the women who is blogging about her baby's death. Her sad story is EXACTLY what happens when life threatening fetal distress occurs at home. The delay in delivering the baby made the baby's death virtually inevitable.
The situation is analagous to the seatbelt example descibed above. Can we guarantee that an infant will survive a car crash if strapped into an infant seat? No, we cannot, but we can conclude that failing to put an infant in a car seat and having it flung head first through the windshield would probably lead to its death? Can we guarantee that every baby will survive in the hospital. No we cannot. However, we can say that true fetal distress cannot be successfully treated at home and is very likely to result in the death of the baby. And, of course, that's what happened.
The mother involved (as well as the many homebirth advocates who offered sympathetic comments) are in denial about what really happened here. A baby died a completely preventable neonatal death because an unanticipated life threatening emergency occured at home. There was no malpractice. The midwife apparently followed all relevant protocols. However, in a crisis, the midwife could not do the one and only thing that was needed, perform an emergency C-section.
We should have a great deal of sympathy for the mother, but we should have more sympathy for the child. A baby died because her mother bought into the mistruths, half truths and lies that characterize homebirth advocacy. She didn't know that homebirth has an excess risk of preventable neonatal death. No homebirth advocate told her the truth; most homebirth advocates are not knowledgeable enough about childbirth to even know the truth.
What happened in this situation was not unforseeable or karma. It is a known consequence of homebirth. This is an object lesson in how homebirth can kill babies through medical negligence. Would I tell the mother that to her face? I wouldn't, but that does not change the fact that homebirth led to the preventable death of that baby.
If a woman could be sued or imprisoned for choosing a homebirth and the baby is born with injuries, then a woman who chooses to give birth in a hospital should also be subject to the same possible penalties for injury to the baby. There should be no difference if the injuries are caused by a midwife in a bedroom or a doctor in a delivery room. The woman made the choice to subject her child to risk, thus she is ultimately responsible for any and all harm that comes to it.
Sounds a bit silly when you include hospital births with home births, doesn't it? There is always the chance of a baby dying, or being injured, or the mother dying or being injured, during childbirth. Different things can be done to reduce those risks (changing positions, providng an IV drip, a C/S when it is truly needed, etc), but the risks are always there. It comes down to a matter of personal risk taking; for some a hospital is riskier than a home, and thus the home is safer.
I plan on giving birth at home, not because I want some flowery hippy experience, but because my position (one of those low risk women used in those statistics) makes homebirth a reasonable option. The first half of my prenatal care took place with a midwife in a hospital, the current outside of a hospital, and the difference is profound. I've received more information and more attention outside of the hospital. The continuity of care is there. We've discussed contingency plans for the "what if" scenarios (breech, prolapsed cord, hemoraghing, etc), they are trained in resuscitation for the baby and putting in an IV for me (among other things), and have never ever tried to make home birth sound safer/superior to hospital birth (unlike the people at the hospital, who talked and acted like the hospital birth was perfectly safe).
To Amy Tuteur and Antigonos:
You will note that I did not make any comments about homebirth. I only wish to point out that going to the website of a grieving mother to write such a message about how she is gulity of manslaughter is pointless and achieves nothing. If you believe she is in denial what do you think writing "You want to talk about EVIL? Choosing a method of birth that puts a baby at undue risk is EVIL. You can flame me all you like--ANYONE WHO CHOOSES TO AVOID MEDICALLY ACCEPTABLE PRACTICES ON BEHALF OF A HELPLESS PERSON IS GUILTY OF MANSLAUGHTER." is actually going to achieve?
Advocate for whatever kind of birth you want in whatever tone of bluntness you want. It's your right. Here is a good place to do it. Please don't do it on websites which are expressing deep grief. The mother in question does not use her website to advocate homebirth but to express her grief at losing her child.
Finally Antigonos has the nerve in her comments to this woman to say her baby would have survived had she been in hospital. She absolutely cannot know this. No-one can know what would have happened in hospital since she wasn't there.
My first baby died after a well-monitored low risk pregnancy. He died before labour started. I did not plan a homebirth, my induction day (5 days after my due date) was scheduled in hospital for the next day). I had a full check-up with ultrasound and heart rate monitoring 3 days beforehand. His death is unexplained despite a full autopsy on the placenta, the cord and him and multiple tests on me. I personally know the deep grief of losing a child and I know that accusing a mother of manslaughter once her baby has already died is just vindictive and cruel and does not serve to get any sort of message across. It only serves to hurt someone further who is already experiencing the deepest of hurts.
Katie, the suggestion is that the child of a mother who chooses freebirth (i.e. no doctors or midwives present, DIY) should have a legal remedy. In the instances you cite, there is already a legal remedy (against the medical staff involved/the Trust).
Fascinating debate as always. The status of the unborn or part born child under the law is one that I am sure will exercise a great many people.
To home birth. I have not read much of the evidence quoted above. So many things, so little time. However as a student (part time) of history and literature, let me ask a question.
Why is the 'wicked stepmother' such a dominant feature in the literature of the past?
Becuase so many women died in childbirth.
And what has changed this?
Antisepsis. Semmelweiss, one of John's heroes. Better diet? To some extent. Contraception? Certainly. Women now not exhausted and destroyed from continuous pregnancy. Antibiotics? Of course, but late complications rather than birth.
So what are we left with?
Obstetrics and anaesthetics. The ability to monitor, and then intervene in comparative safety.
I believe the expression is 'res ipse loquitur' In the same way that I do not need a controlled trial to show that using ventilator to treat someone who can't breathe is a good thing (what would I do with the control group, fan them with the protocol?) you do not need a trial of emergency intervention in severe haemorrhage or foetal distress to show a good outcome.
It's obvious.
So let's have a happy medium. Birthing units which are friendly, welcoming, and have emergency medical facilities on tap.
PS wicked stepmothers now increasing again, but divorce this time, not dead people.
Jenny Hatch unwittingly sums up the whole situation perfectly. Her posting is packed full of talk of her rights, doing what she thinks best and not giving too hoots what anyone else thinks, seemingly because she doesn’t trust formalised medicine.
Then she joins a discussion board and says she doesn’t care to discuss it! Of course, she doesn’t she has already made her mind up, she just wants to come and be bolshie to people who don’t agree with her.
There’s no reasoning with people who have such closed minds, and who assert that their rights are more important than any other consideration.
Can someone answer a couple of straight-forward questions -
Why do women decide to give birth alone?
Why do women choose a home birth?
Having read some of the posts on the mothering.com site, which didn't seem that way out to me, there was a common theme. The women there didn't want an excess of medical intervention. In my view, that's why they made the decision they did.
Given that this seems a perfectly logical and reasonable need/request, why don't hospitals provide women what they want? Because if they did, some women wouldn't want to go it alone or have their babies at home.
It is wrong to say that a hospital birth is 'risk free' - people make mistakes. The large hospital near me, where I know lots of people have had positive experiences, had a member of staff who had a baby, die. This copied from the BBC website (she) 'suffered a heart attack after an epidural was fed into her arm instead of her spine.'
Childbirth is not without risks - if you watched Panorama recently, a rather grim picture was painted of the situation within 2 large UK maternity units. And some readers here wonder why some women want to birth at home? A home birth wouldn't be for me, but I can understand why some women make that choice.
Rosepetal,
I am extremely sorry for your loss and the exceptionally difficult situation that you are writing about now on your own blog.
You are currently discussing one thing, and I am discussing something else entirely. You are talking about etiquette. I am talking about the known risks of homebirth and the way that homebirth advocates fail to understand those risks.
No doubt a psychiatrist could have a field day with the website in question. It is a public website that dwells at great length on the mother's need to deny that she has any responsibility for what happened. She is soliciting public support for that view and she is receiving it. Interestingly, the mother who has appropriately asked many questions about the cause of fetal distress, has never asked the doctor what role the delay in getting emergency treatment played in making the baby's death practically inevitable. She doesn't want to know and neither do the women who write to support her in her extremely implausible claim that homebirth had nothing to do with the baby's death.
Women who are contemplating homebirth deserve to know that homebirth has an excess risk of preventable neonatal death.
Sorry, ‘two’ hoots…
Anthea, I’m sure you’re right but doesn’t this fear of hospitals and maternity units owe more to the occasional scare story in the media than to any actual risk?
Anthea:
"Why do women decide to give birth alone?"
In large measure, homebirth and "freebirth" are not about birth or the baby at all. The desire to avoid technology or rude treatment in the hospital, while often invoked as the reason, has very little to do with homebirth, either.
Homebirth is about the mother. Her needs, her desires, her image of herself. Afterall, many women want to avoid technology, and most want to avoid rude treatment, but in the US only 0.6% take the drastic step of risking their baby's life in order to do so.
The language used to describe the favored options is very revealing on that point. Homebirth advocates and "natural" childbirth advocates insist on using terms like "natural" birth and "normal" birth. The same people who would recoil in horror if someone set up a website for mothers of "normal" children happily espouse the virtues of "normal" birth. The language is intended to celebrate the mother and to denigrate other mothers.
Furthermore "natural" childbirth is not natural and bears little if any relationship to childbirth as it occurs in nature. As far as I know, there were no prenatal vitamins, special diets, fetal heart rate checks, prenatal care, blood pressure monitoring etc. etc in nature. "Natural" childbirth is just the elevation of a cultural subgroup's personal predilections above the needs and desires of other women.
Another figure of speech is the tendency for women to describe the homebirth of their child as "my homebirth" as in, "I was so happy that I got my homebirth." Other women will refer to the birth as belonging to the baby, but homebirth advocates are unwittingly revealing that it is all about them.
Rob: I have a friend in London who had 2 children in hospital, she had her 3rd at home. She says the care she got at home was 'better' than the care she got in hospital. 'Better' for her was being attended to all through her labour by midwives. Women talk alot about their experiences - many women I know talk about there not being enough staff - being left for long periods of time, having to wait for an epitural. I know someone who discharged herself the day after her section as she was so unhappy in hospital. I couldn't walk after mine so that wouldn't have been an option for me! I think there's more comment about bad experiences than there are about good ones. Certainly the set up in an average delivery room is rather uninspiring - a bed - and some of the rooms are actually quite small.
Amy - removing the possible outcome from the equation, what's wrong with a woman trying to satisfy her needs?
Won't there always be individuals who want to do things their own way?
Amy Tuteur,
Thank you for your empathy, at least towards me.
I agree that we are talking about different things. This will be my last comment here since I'm not going to write about my own views on homebirth or freebirth and so my comments are off topic from Dr. Crippen's original post. I commented here as Antigonos referred the mother in question here and I read her comment complaining about how she was getting flamed, after leaving such incredibly insensitive and cruel comments on a grieving mother's website. She actually told the mother in question to "stop whining."
You say that mothers contemplating homebirth deserve to know the truth about it. I can't disagree with that. Everyone deserves to know the truth about the medical choices they make, for themselves and their children. Not everyone agrees on what the truth is. What is a layperson, a patient, supposed to do?
My point is that Antigonos' comments served absolutely no purpose other than to hurt an already grieving mother.
For the sake of argument let's assume that the mother in question, made the wrong choice in good faith (I do not accept she made it in bad faith which is what Antigonos is saying by calling her evil and accusing her of manslaughter). Has she not paid the ultimate price for her mistake? Do you think that advocates of homebirth who do not change their minds after the death of a baby which you attribute to a homebirth choice are going to change their minds after reading such comments? All this has achieved, on her blog, anyway, is to entrench people in their positions and to damage the fragile, tentative mental recovery of a grieving mother. No good has come of it whatsoever.
One thing I am fortunate in is that I have an OB able to demonstrate compassion whilst remaining professional. Compassion is important in medical professionals who need to interact with patients. It has been instrumental in my own small steps to mental recovery. Unfortunately for Antigonos' patients, it is something she either never had or has lost along the way in her "40 years of experience."
Like I said before, people need to choose the right forum for making their views heard and making them useful in achieving goals. Here is a good forum. A grieving mother's blog whose baby died a mere 8 weeks ago is not.
I also asked, why why why? for my own son's death. I could have realised sooner that he was slowing down, I could have gone to the hospital sooner, and maybe he could have been saved. And maybe not. No-one, ever, can ever tell me for sure that he could have been saved or could not have been saved, since no-one knows what happened to him. The last part took me many months to understand. It seems that some people still don't understand.
Augusta
You are lying. Cord traction as part of the active management in the third stage reduces blood loss.
http://www.aafp.org/afp/20030515...5/
cochrane.html
Piss off with your lies. Your rubbish is dangerous to other women who might believe your bollocks.
Ince
http://www.cochrane.org/reviews/...n/
ab000012.html
Some real evidence for you, not subject to the biases in the studies that you read.
It isn't that "unsafe" to have your baby at home if you are low risk. But it's not as safe as hospital.
For such a disastrous outcome as death or severe brain damage, most won't take the small additional risk of a home birth, because they want a healthy child. Those that homebirth are self-centred and often damaged people.
Jenny Hatch,
I care about where you give birth, because if the baby is brain damaged because of your crappy choices, I and everyone else as tax payers have to pay for your ignorance to the tune of several million pounds for lifetime care for the baby that you'll probably turn over to full-time nursing care, because you're selfish.
One point regarding Independent Midwives. If we get rid of them, there will be far more "freebirthers" in the UK.
Also with regards to Amy Tuteur. The woman is no longer a doctor and has not been for years. She is OBSESSED with the homebirth argument and is not to be taken seriously!
Is it any wonder that some women choose to shun the medical paradigm and opt for a home birth when they're confronted with people capable of such hostility and arrogance?
I don't think it's unreasonable that a mother to be would want a stress-free delivery and to feel in control of what's going on, rather than feeling bullied and harrassed. Perhaps if those people who were so keen on hospital births were more open to these kinds of ideas, we'd have less women wanting to give birth at home?
Hmm. Dr. Crippen, did you really decide that home birth was unsafe after seeing a near-disaster? Isn't that anecdote-based reasoning the opposite to evidence-based medicine? How does it differ from the people who saw or experienced some horror in the hospital and decided to opt for home birth?
No one ever offers children a life where the lowest risk option is always chosen. Children who can't sleep on their backs are put to sleep on their tummies. Pediatricians demand that parents risk their babies on the roads rather than making home visits. Doctors making unreasonable and silly claims about home birth do not help parents make rational decisions.
Women talk alot about their experiences - many women I know talk about there not being enough staff - being left for long periods of time, having to wait for an epitural. I know someone who discharged herself the day after her section as she was so unhappy in hospital. I couldn't walk after mine so that wouldn't have been an option for me! I think there's more comment about bad experiences than there are about good ones.
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Anthea,
My wife had two very difficult births, both requiring extended stays in hospital and resulting in C-sections, so our experiences were probably not typical but we both felt the level of care was pretty good. I agree with you that the surroundings weren’t that salubrious, but is that really a bigger concern than the health of mother or child?
Anon says that Amy Tuteur has an agenda, and I have no reason to doubt that, but her posts have nevertheless been cogently argued and I agree with the view that a lot of freebirth advocates are putting their desires and ‘rights’ ahead of the baby’s.
Also I’m profoundly offended by their implication that children who require medical intervention at birth are somehow less ‘natural’.
A couple of interesting facts--make of them what you will. The lady who lost her baby went into labor on a Thursday. I went into labor on a Thursday. On Saturday, the homebirth baby's heart rate dropped. I have to presume this was discovered by auscultation with a fetascope. On Saturday, since I was being continually monitored in hospital, it was noticed that my baby's heart beat had become non-reactive. (No decelerations). I had not dilated at all since Thursday. Because of these two facts, I was delivered by C/S of a 4.1 kilo boy, apgar 7-9 at 4.a.m. Saturday morning. He's now 27 and perfectly healthy.
I do not know how far dilated this lady was when her baby began having decelerations. I also do not know how long it took her to get to the hospital, or how long after that the C/S was done. Her daughter, weighing 9 lbs 5 oz, however, was stillborn.
But of course, choosing a homebirth, with all its risks and the inevitable delays, had nothing to do with the outcome, did it?
I like Dr. Crippen's last statement in the article: the baby does not have a choice and must be protected.
A pregnant woman has the absolute right to kill her unborn baby, whether by abortion, reckless living, stupid decisions regarding the delivery or whatever method she prefers.
How dare anybody argue against it.
As regards paying dearly for the results out of your taxes - tough! Pay up and shut up.
The arguement was lost in 1967 in this country.
Antigonos: "I'm being flamed right now because of comments I made to the blog of a woman who attempted a home birth, was eventually delivered by C/S in hospital of a stillborn, and who can't understand why"
Uh, yeah, you ARE being flamed. And rightly so "Lady". What you are posting on her website is absolutely inappropriate...no, that is an understatement. This blog may be an appropriate place to post your opinions and views. Her blog is not.
And, if you cannot understand the difference, shame on you (and I am being polite here with my language).
A pregnant woman has the absolute right to kill her unborn baby,
but what if a "freebirth baby" is born disabled, disabled because of an emergency or maternal negligence during labour? If a baby were born disabled because of some form of neglect by an attending professional then s/he would have redress (does the parent sue?). It seems inequitable that the latter child can be compensated, however poorly, the former, not.
The arguement was lost in 1967 in this country.
the Act does not in fact allow for abortion on demand. "Reckless living", well, I encounter many people (usually, it happens, men) who insist on dictating into digital recorders while driving. I give them my views and refuse to recommend recorders and software, but others will help them on their dangerous path. Then there are the drunken drivers, and so on. All run the risk of harming people who are both real and legal persons, and of course, should they harm a pregnant woman, a foetus too. I do think pregnant women should try to live in a way that avoids harm to their forthcoming baby (insofar as they can), but 1. don't see how that can be legislated for 2. don't see how a failure to do so is sanctioned by the Act.
"Jenny Hatch,
I care about where you give birth, because if the baby is brain damaged because of your crappy choices, I and everyone else as tax payers have to pay for your ignorance to the tune of several million pounds for lifetime care for the baby that you'll probably turn over to full-time nursing care, because you're selfish."
OK, I'll own that argument. And by your reasoning, if I pay out of pocket for all of my prenatal care, and post natal care - which cost our family upwards of $7,000.00 American dollars and we came up with a child who has been exceptionally healthy, fun to be around, smart, and a wonderful contribution to society. Do I get to own a successful outcome, or do we only deserve your scorn???
Here are a few links sharing our stories, family life, and a video of my four year old singing for your perusal:
http://
www.unassistedchildbirth....jennyhatch.html
http://www.youtube.com/watch?v=w...h?
v=wwf39Sje1ng
http://
www.naturalfamilyblog.com...amily_life.html
Thanks for your concern, but at this point in our worlds history, you as a taxpayer should be MUCH more concerned about the brain damaged children being produced daily by overdoses of medicine.
After ten months of hard work during pregnancy the last thing I want is for my perfectly formed child to be rendered permanently damaged by a botched hospital birth, vaccines, or any of the many pitfalls that accompany the current practice of medicine.
And for the record, I would never allow one of my children to be turned over to anyone for any sort of lifetime care. But I have serious doubts about our American Societies ability to care for the brain damaged children who are being diagnosed here in America every twenty minutes with autism.
Jenny Hatch
It seems like all the debating about the rights and wrong of how to give birth comes down to "what if" statements. What if the nurse/doctor drops the baby on the floor or gives the newborn the wrong medication and causes permanent, major brain damage? What if the midwife doesn't know how to rescusitate a new born and the newborn dies because of it? What if the attendants (be them in a hospital or in a home) lack experience and rush into procedures which cause harm to mother or child? What if....
Hindsite is 20/20. Once a decision is made, attacking the person for that decision because the outcome wasn't perfect is a waste of energy. It's too late! Harsh or extreme language (on either side) does very little to help the next time as it polarizes the groups. Choosing a situation which reduces access to various treatments is not the same as malpractice. If that were the case, then anyone who resists water fluoridation, circumcision, and only organic food is guilty of exposing their child to excessive risk and should be penalized for any harm that comes of it (cavities, getting HIV from unprotected sex, and cancer from pesticides).
Risk, and the personal choice of how much risk to take, is part of the freedoms we get to enjoy in Western society. Ideally, the two groups here (anti hospital and anti home birth), would come together and find ways of implimenting less stressful and more accomodating techniques for aiding a woman in childbirth.
And to furth answer another poster's question about "why homebirth," there is one part which has everything to do with me and not the baby: fear. I fear an epidural more than the pain of childbirth. I fear the lack of control over the situation I would have in a hospital. I fear being separated from my baby at any point, where I would be helpless to protect her. At least at home I know all the participants, and where everything is.
Hatch,
You have provided no argument. Pictures of your kids to "prove" your argument. Are you for real?!
"...I want is for my perfectly formed child to be rendered permanently damaged by a botched hospital birth, vaccines"
You sad sad person... all your advantages in life and you reject the benefits of living in a modern society with up-to-date public healthcare. A veritable 21st century superstitious witch, no less. Shame on you for your lies.
This discussion, in all its forms, drives me mad. Both sides are entrenched in the positions and unlikely to budge. I am myself very opposed to the arguments of the “natural” brigade (having had one “low risk” pregnancy end in disaster, and a “high risk” that ended well – thanks to superb hospital care) but can easily see why women would dislike the sometimes miserable and scary surroundings of the hospital. Women do have bad experiences at the hands of indifferent, insensitive and sometimes downright hostile staff. But the argument gets muddied between a good/bad experience, and a safe delivery. The homebirthers seem to be focused on the first, and profoundly ignorant about the second. Their rhetoric relies on the assumption that “low risk” is a real, easily identifiable category, and that women can be in it by the force of their will, good genes, or superior intelligence. Dream on! Low risk is statistical, not medical, and can change to “impending disaster” in a blink. The conditions that kill babies and (still) mothers are those that can come unexpectedly out of nowhere. Mostly, of course, they don’t. Most babies arrive safely despite the nuttiest of mothers. – which is not the same as saying that most women have a “good experience”. Are there no terrifying, painful “I’ll never go through this again” home births? And if disaster strikes? Well, you have a long time to live with the “If only…”
jayann says "but what if a "freebirth baby" is born disabled/"
The mother has no legal responsibility for what happens and the State picks up the bill.
"It seems inequitable that the latter child can be compensated, however poorly, the former, not."
Yup!
"the Act does not in fact allow for abortion on demand."
The Act may not allow it, but it's what happens in practice. If the NHS won't do it (and in my 20 years as a GP I have yet to come across a case where they refused), then the private sector will happily take your money.
The law allows you to kill your unborn baby in any way you choose.
Sorry, the last bit should be "The law allows you to kill or harm your unborn baby in any way you choose."
Anon, why don't you come out of the closet and tell me your name, and please, while you are at it, share some photos of the healthy children you have created using modern medicine.
You said:
"You have provided no argument. Pictures of your kids to "prove" your argument. Are you for real?!"
I would suggest that my healthy family is in fact my BEST argument for sovereign family living. At the end of the day it is all the proof I have to offer that my theories and daily practices are working.
You take that away, and all I have to defend myself against your scorn and societies threats of prosecution for medical neglect are my eighteen years of research.
And in what public, political, or even legal forum would my foundation of factual study hold weight against the scorn of people like you backed up by the mountain of 200 years of allopathic birth research and Medical money and power?
None whatsoever. You know it and I know it too. So for me to even attempt to engage in that debate without being able to use the "anecdotal" evidence of my healthy family, the sacredness of our UC birth experience (not allowed because as a woman claiming an "experience" I have just proved myself to be the most selfish superstitious witch on the planet), or claiming my rights of self determination as a human being (also not allowed because...actually....I never heard the argument for why I am not allowed to stand up to the tyranny of Allopathic Birth and claim sovereignty over my own body.)
No, instead what I must do is live with the scorn of society (and pathetic anonymous commenters like you who do not even have the courage of your convictions to attach your name with your strong opinion) and keep plugging away making decisions for and in bahalf of my family until they are old enough to make health care decisions for themselves.
I give birth at home alone because I BELIEVE IT IS BEST FOR THE BABY!!!
End of debate. I am entitled to my opinion and I will give birth at home alone. If that means at some point I go to jail, fine. I am prepared to go the distance in this lifestyle. I am looking forward to the day when we have an amendment to the US Constitution that provides for a plurality of health care choices in my country.
Until that day arrives, I will continue to write, birth, fight, and promote what I believe is a valid alternative to current medical dogma around birth.
Finally, I am not a sad person. Giving birth to my two youngest sons in the privacy and sanctity of our bedroom has empowered me like few things in life to live a happy life. You sound like a sad and joyless sort of person though. Why don't you grasp your own happiness without trying to interfere with what makes me happy as a mother?
jenny
Jenny Hatch says "I give birth at home alone because I BELIEVE IT IS BEST FOR THE BABY!!!"
Your baby doesn't give a shit!
"I am prepared to go the distance in this lifestyle."
Says it all! Your lifestyle - we pay!
"the sacredness of our UC birth experience"
Jesus!
"I am looking forward to the day when we have an amendment to the US Constitution that provides for a plurality of health care choices in my country."
I can think of some other amendments which should come first!
The UC Birth movement was born in America, where revolutions against tyrannical systems of captivity have flourished. This movement is just a coninuation of the American Revolution. To quote a Patriot, Jefferson eloquently said:
"I swear upon the alter of God, eternal hostility to every form of tyranny over the mind of men".
+++++++++++++++++++++++++++++
Holy crap!
That is a statement that I could have lived without reading.
As much as I believe that there are systems that are created to keep people down, I do not think that a hospital birth is the worst thing EVER... I had three, hated the first two and loved the last one. The doctor was the key, as was the level of professional care. I researched midwifery with my last birth, but decided against it because we live too far from a hospital to get there in case of emergency. And here it costs a lot of cash. And my S.O. thought I was mad.
Funny thing that- this was a "cord wrapped around neck" kid, who scared the attending ob quite a bit because it was from 0-60 that things went bad. I was horrified when I found out afterwards.
Had I been at home I would have had a funeral or a special needs kid. Neither seems like a good option. The 19 hours I was at the hospital(from labour to discharge) was well worth the last decade and some of "healthy kid".
I think this reminds me of those breast feeding organizations, where those who are convinced of the merits of their cause are absolutely and utterly hell bent on screaming at the top of their lungs that there way is right and everyone else can shut up. Even to the mothers who are desperately trying to breastfeed, but can't. I can relay second hand that having three women in your living room hooking you up to a pump that takes two people to put on---BECAUSE IT IS BEST FOR MOTHER AND CHILD YOU KNOW-------- are more off-putting than any male ob or pediatrician (who apparently want to control women).
People who are as militant as this over the right to choose are going to make it so that there will be no choice, because they are the loudest in the room. (And the scariest).
I hope this does not come back to bite me in the ass. I am so far past having any more kids that this is a non-issue for me, but I do hope that some common sense is used when deciding what is best for mother and child.
BTW, here where I am from, a mother who was involved in an accident that caused her fetus to be damaged was successfully sued by the "child" -- in other words, the mother's insurance company has to pay a whack of cash for damages to the child. I wonder if insurance companies could ever up insuranace rates for pregnant women, because of this precedent???
Matt,
How do you pay for my lifestyle? As stated before my husband and I have paid out of pocket for all of the expenses related to my last two pregnancies. Our insurance does not cover the sorts of prenatal care I obtained. (mostly pre and post natal massage)
Both of my UC born sons are healthy and growing up to be contributing members of society. We have never taken a dime of government money to care for our children. We feed, clothe, and provide for them as our finances permit.
How exactly do you pay?
As for the babies....do you know any children who have been born at home? I know dozens of them. I can spot them in a crowd of children. They are filled with light and have a fearless look in their eyes.
Conversely I know children who have been brain damaged by birth, vaccines, and medical interventions. These children have a fragmented look about them. They are mistrustful, tend to have attachment disorders, and many are medicated on psychoactive drugs because of anger/lack of control issues.
I believe children care very much how, where, and in what manner they are born. And as a mother I gave the medical profession three chances to do right by me and my family. One of my births was a c-section, two were drug free vaginal births. Are my other three children permanently damaged by the hospital experience? No.
After my third birth, where I had to claw my way to a VBAC, I decided that I had had enough fights in the delivery room and was not going to go back. I can promise you this decision was not made lightly. It was after years of painstaking research. To say that free birthers are uneducated and naive is simply not true. The many woman in my circle of homebirth friends are some of the most educated, open minded, wonderful mothers I have ever met.
I would be happy to have a debate with any credentialed professional about birth in any forum.
Yet when I start talking online in the various chat rooms I have participated in, debating health care issues, it always ends the same way. With people calling me names and/or dismissing me as a dangerous anecdote, And suggesting I be locked up and/or have my children taken away.
I honestly don't care how your children are born, why do you care so much how mine are born if we pay all the bills and live with the consequences of our choices?
Consequences so far being two wonderful children added to our family and Momma healing some damaged places in my soul.
Jenny
Impatient,
What is your definition of tyranny?
I know of a mother who had a c-section with her first, was told she would not be able to have a VBAC with the next, decided to give birth at home alone, and the police showed up at her door (here in America) to escort her to the hospital where her child was forcibly pulled out in another section even though she was nine centimeters dialated.
I call that tyranny.
When 300,000 Americans are being murdered every year by drugs that are properly being used and prescribed...something is very, very off in so called "health care".
Who gets to choose? Who is right? What are the long term consequences for these choices??
And if you as a parent allow current medical dogma to make your decisions for you and you are one of the ones who come out of the hospital without a uterus, or without a healthy baby, or so traumetized by the experience that you never again want to have another baby....don't you think then, that something, somewhere needs to change?
I question ALL of the assumptions of Medical Birth. ALL of them.
Assumptions being:
1. Birth is inherently dangerous.
2. That babies who are born under a chemical cloud and with multiple interventions are somehow healthier than babies born without chemicals.
3. That doctors actually know something practical and real about prenatal nutrition.
4. That doctors always have the patients interest at heart when they make health care decisions during a birth.
5. That doctors who diagnose women with Toxemia and Gestational Diabetes educate the women with evidence based care that helps the woman to heal.
I am working hard to heal birth and help create a model of parenting that is divorced from the allopathic model because I believe it is killing us and our healthy future. And I am not doing it for myself.
I am doing it for my daughters and grandaughters who will be birthing in the decades to come. As we approach the day in America when the choice is to either have a knife in the belly or give birth at home alone, I want them to have a safe place to land, grounded in factual and evidence based mothering.
With a firm foundation of nutrition, exercise, and relaxation being the keys to healthy pregnancy. Learning to overcome fear and master practical labor skills that will enable them to give birth alone or with just family members present.
Dr. Michael Odent, a famous French obstetrician, has been most complimentary of the mothers in the fringe who are birthing unassisted. While he has not endorsed us outright, he has challenged the medical profession to listen to our stories, hear our experiences, and even be humble enough to learn from us.
I'm not sure yet why our lifestyle is so threatening to the medical people. They get downright defensive when we open our mouths or have an article show up in a newspaper. But I will persist in believing that the system they have set up for me to give birth in is tyrannical, controling, and potentially deadly to me and my baby.
And that is why I have opted out and promote Freebirth as a valid and potentially beautiful way to give birth to a child.
Jenny
ps TO anyone else reading this, I have been accused of not wanting to debate. I WANT to debate. There is a big difference in me stating I believe UC birth is best for the child, end of debate, meaning there is little you can write in your comment that is going to make a difference in what I believe contrasted with the need for society at large to have a debate about how best to create healthy children.
I am very much looking forward to that debate taking place. It is long overdue. We can't have a cogent debate if most people ASSUME that babies are being well served by allopathic birth, end of story - which is where many policy makers, parents, doctors, and the citizenry are at in regards to childbirth.
All I would say is question your assumptions.
Matt, I see we agree on the legal situation (my "what happens" was rhetorical) and the inequity entailed.
"the Act does not in fact allow for abortion on demand."
The Act may not allow it, but it's what happens in practice.
then the law should be enforced (and doctors should adhere to its letter and spirit). But actually, Matt, there are women who are refused abortions here because of the law (some go to clinics in other European countries, advisory agencies here inform them of the possibilities there).
Jenny, Matt means he's paying (as I am, I pay taxes too) for the NHS (and other publicly funded) treatment of women and children harmed during pregnancy and in particular during labour. Some of this harm, he says -- and I must agree in part -- is caused by women's failure to appreciate the possible dangers of home birth. (I have pointed out to him that there are many other forms of "recklessness".) He assumed, I think, that you were among the people who are (as are he and I) covered in case of need by welfare state mechanisms.
Jenny Hatch:
"I WANT to debate."
You may want to debate, but you lack even the most basic knowledge required to participate in a debate. Your claim that the inherent danger of childbirth is an "assumption" indicates a profound lack of knowledge about childbirth and profound lack of knowledge about history.
In order to debate, you need a background in basic scientific facts, basic facts about childbirth and at least a minimal understanding of statistics. The problem with social movements like UC advocacy and vaccine rejection is that they are based on ignorance. I am not referring to lack of intelligence; I mean lack of knowledge of the basic facts.
You need to read, study and learn more about science, childbirth and statistics before you are in a position to debate.
Jenny,
Everyone pays for mess-ups in childbirth. Homebirthers / freebirthers are more likely to have them. Fetal distress, flat babies etc etc. These problems aren't rare.
It costs $10 million to look after a brain damaged kid. Would you pay that? I don't think so. You'd more likely leave the kid in a home because it's unlikely you could afford that sum or deal with the stress of looking after such a child 24 hours a day, particularly with your other kids. They would suffer too, believe me. And your relationship would be destroyed. The breakdown rate in cerebral palsy families nears 100%.
And you risk that for what? A "lifestyle". How dare you, with your responsibilities?
to answer your challenges
1. Of course birth is inherently dangerous. Look at the third world for heaven's sake. Look at the improvements in mortality over the last 50 years in Western countries (so that nutrition is not the issue - it's medical care)
2. No-one's saying this, silly. But the "chemical cloud" you refer to is actually controlling the pain of childbirth. Women WANT this. No-one forces an epidural on you do they? Generally we avoid medication as much as possible in the pregnant. Sometimes though it's needed.
3. Er hello. We at least have been educated in this at medical school and usually at postgrad level. What are you talking about?
4. An interesting one this, and I'll concede that in private systems you're more likely to get an intervention. So that's an argument for social healthcare where remuneration isn't predicated on intervention ie European models, not refusing healthcare on an innocent's behalf.
5. Women will heal medically after the pregnancy. There's always more emotional support to give during. This all costs in terms of staff resources though doesn't it?
And Odent is a maverick himself. Some of his views are interesting. But, if he's so great why hasn't he published his own outcome data on waterbirth after all his experience. After all he likes publishing on other topics doesn't he?
And your reflections on the children's personalities being affected by birth mode are utter bollocks. Do you not think being brought up by a radical feminist would likely affect their personality? This is why you've noticed a difference, not whether a C-section was performed.
Anon,
You are still not sharing your name...why is that?? Chicken??? bawk bawk bawk....
Please provide proof that UCBirth causes brain damage. To date I have been affiliated with dozens of families who have had perfect outcomes time after time after time. I wrote a book called Elijah Birth where I shared stories and quotes from these families and wrote a newsletter that contained a survey of UC moms and birt outcomes. This was done back in 2000 and none of the babies had died or been damaged in any way. No inductions, no c-sections, no problems. Just one transfer for a retained placenta.
I only personally know two families who had a baby die during a solo birth. one was Laura Shanleys son who was premature, and the other was a nine pound girl who died three days before she was born by section. Nobody can say those babes would have made it in the hospital.
Please go out looking and find me one story of a baby who was brain damaged during a UC. I would really like to hear about it.
Cerebral palsy has been tied to forceps deliveries. I can promise you that my husband had no interest in pulling out some over sized salad tongs and yanking my sons head out. no need anyway, as I was standing up while I birthed both of my sons.
They both were over nine pounds and each had a head circumfrance of 15 inches. Bens was 15 and 1/4 inch and yeah I felt it as he was being born...ouch...but he came out without being yanked on at the other end.
As stated before I would NEVER leave one of my children in a home, nor do I live in terror of my marriage exploding because of a botched home birth.
I did have a point in my marriage when I was ready to leave because my husband kept expecting me to birth in the hospital though. And I know plenty of couples who have divorced after a messy hospital birth.
you can fling the poo both ways...and yes I dare...even with our large family. We are talking about having baby number six next year.
Jenny
Anon,
As a taxpayer and someone with medical insurance, I have to pay for overweight people who refuse to lose weight/eat junk food/etc, develop diabetes, and go on disability. Their "lifestyle" takes money out of my pocket. Why should I pay for them? Partially because I know that if my homebirth results in a damaged baby, they will pay for me. What about drunks, drug users, people who ride motorcycles without helmets, smokers, etc? Their lifestyle will very likely end up with me paying some part of their care. Perhaps we should end all medical insurance for everyone so everyone needs to bear the costs of their own decisions, their own lifestyles. Or perhaps the money taken out of my check every month for Medicade can get put into an account just for me to use if I need it.
Attacking a lifestyle because of potential public medical costs is dumb. There are too many lifestyles out there which have a much higher regular, actual cost than homebirth, to argue that homebirth puts such a burden on everyone else that it should be banned. Besides, banning homebirth does not make the possibility of having a damaged child disappear. If anything, it could make things more expense for everyone as the doctor and hospital gets sued for malpractice, who then pass on the costs to the rest of us through less accessability and higher insurance costs.
Jenny Hatch says "As for the babies....do you know any children who have been born at home? I know dozens of them."
So do I.
"I can spot them in a crowd of children. They are filled with light and have a fearless look in their eyes."
Sentimental, emotional, unscientific claptrap. So children born in hospital are filled wth darkness and have a frightened look in their eyes?
"To say that free birthers are uneducated and naive is simply not true."
The uneducated and naive don't have exclusive rights to stupidity!
jayann says "there are women who are refused abortions here because of the law (some go to clinics in other European countries, advisory agencies here inform them of the possibilities there)."
These are usually the really late ones.
"then the law should be enforced (and doctors should adhere to its letter and spirit)."
You can't enforce Spirit!
Throw this into the mix. Not everyone gets their "two midwives providing personalised care".
Matt, I didn't say the spirit of the law should be enforced, I said doctors should adhere to its letter and spirit.
Damn, sorry about the fake home page, haloscan strikes again.. I'll put it right now.
jayann says "I didn't say the spirit of the law should be enforced, I said doctors should adhere to its letter and spirit."
Accepted. There is no such thing as spirit when it comes to the Law however. I don't think you can reasonably expect doctors to adhere to the Spirit when lawyers and judges don't and won't!
This debate has long entered the realms of the bizarre, but I have to say that I am both amused and disturbed by Jenny Hatch's apparent belief that having "created healthy children" is the only signifier of moral worth and rightness of argument.
I also continue to be frightened at the severely effed-up understanding many people have of the word "chemical". EVERYTHING is made of chemicals! Willow bark is just an impure and less effective form of aspirin.
Accepted. There is no such thing as spirit when it comes to the Law however. I don't think you can reasonably expect doctors to adhere to the Spirit when lawyers and judges don't and won't!
I wasn't getting at you and your medical colleagues, Matt! But I do think the better lawyers, judges and doctors (and indeed, other citizens) do try to adhere to the spirit, as well as the letter, of the law (lawyers, insofar as the adversary system allows).
Jenny
I had three completely non- interventionist births. Except for a shot of Demerol for my first (which resulted in a very bad reaction), and my second I had laughing gas. There was NOTHING interventionist about my third birth. Yes, there were monitors. Those were obviously important, as my kids heartbeat was zig-zagging, because of having the cord wrapped around the neck...
I refused drugs, c-sections and anything that seemed to be not exactly in line with being young and healthy and able to do things as much on my own as possible. Mostly because of my demerol experience.
I guess I was lucky to give birth when I did.
But, if you want to really and truly lay blame for the tyranny that you believe women are put through during birth, you are putting it in the wrong place in my estimation.
Blame the insurance companies first for this tyranny. Blame the lawyers second. Blame hospital administrators third. Blame a society of people who are afraid of their own shadows and do what the experts say without questioning anything. And then maybe you can blame doctors.
Here in North America we have a crated a culture of liability avoidance. Risk averse insurers look to cut costs in one area. (Of course, the costs of medical interventions that may be unnecessary must be passed on later, but that is a whole other arena for debate.) No-one wants to get sued for the death of a baby, so the lawyers and the admin and the insurers end up in a "risk management" head space, and they essentially end up putting in rules and regulations that make it conducive for doctors to follow their guidelines, or they don't get insured, which means they cannot practice. (VERY BASIC UNDERSTANDING!!!)
As well, as a society, we have come to think it is our right to do things on our terms. So, there are a subset of women who may wish to schedule their C-sections for whatever reasons, or doctors who do so, for their reasons, thus normalizing an invasive procedure on the grounds of efficiency.
Some women are less fit. So, for safety reasons, they are advised that it would be easier to have a C-section than give birth.
And, we as a species have an aversion to pain. So, we are offered whup-ass drugs that go into our spines to make sure that we do not feel things. Which in turn MAY make labour really long for some women, which may cause fetal distress, which may end up in an emergency c-section.
Like I said, I absolutely avoided all of those things. I never even had conversations about those things. It was not even in the realm of possibility, such was the naivety of youth.
Nowadays, here in North America, it does seem that birth is more medicalized than even 13 years ago when I last did it. I have heard stories of scheduled C-sections, and spinal drugs, and the risks of vaginal births after a C-section.
But, I think that an at home birth is still more frightening if a mother hemmorages (which a close friend did) , or there is a cord wrapped around a neck, or the baby goes into unexplained fetal distress (again another friend).
I think that if wome are truly serious about being in charge of their birth experience, then there should be a concerted effort to lobby for change. If every woman who had a traumatic experience that was related to an intervention that was felt to be unnecessary actually wrote their hospitals, and their doctors and the governing bodies of the profession, maybe some women would not feel it necessary to "go underground" and give birth at home. Maybe if hospitals were not experienced as baby factories where a woman is told, like I was, that out of all the woman labouring at that moment, they were giving birth first, and women were respectfully treated, there would not be this backlash. (I am thinking that there is a section in the book, A PERFECT MESS by Abrahamson and Freedman that goes into some detail about how a responsive environment in a maternity ward was created by the Griffin Hospitalin Conneticut.pp 183-18
Trust me, my first two births were awful. I switched doctors and hospitals with my youngest, because I had a religious nut with attitude as my physician. He was more concerned with my use of foul language (during my reaction to demerol which made me want to jump out of my window) than he was about the reaction to the drug. The next time he all but called me a witch. For real. And then I had an on call doctor during that birth, that sucked ass. During that birth I got out of bed and threatened to leave if they did not shut my door so I did not have to hear the woman next to me shriek in pain while I was supposed to be delivering my kid. I absolutely flipped out. Being younger than most people in there just made me look like an unreasonable child, but I was damned if I would have a bunch of strangers in control. I got the door closed. I got to keep my laughing gas mask (just for spite). I retained some control and dignity in the midst of chaos.
And I was dead serious that I would leave if no-one would listen. Probably not the most mature reaction, but absolutely necessary to my sanity at that point. I was tired of being shouted at by nurses for taking too long. Yeah. My entire hospital stay at that point was 3 and a half hours. My water had broken at 6:30, and I went to the hospital at about 8:30 and it was noon. I delivered at 12:30ish.
So, i decided that there was no way in Hell that I would ever repeat that gongshow.
The next birthing experience was a one on one nurse, a doctor, my hubby and me. Not one other person in the room. It took two and a half hours from the time I went to the hospital until I delivered. There was no fuss, no muss, it was a beautiful room with a television and books and tastefully decorated. I could shower or bathe if I wished while in labour. The end. Even with the scare. I got my child in my room with me immediately, and I left as soon as I wished to.
The same doctor delivered vaginally, a relatives breech baby after being told in no uncertain terms that that person did not want a c-section. (and after signing the appropriate paperwork that relieved him and the hospital of liability in the event of an unfortunate outcome, of course.)
Now, if doctors could be a responsive as patients would like them to be and treat a birth as an important time, rather than just a job that had a time limit, and do some serious work on explaining options and getting proper consent.... and provide an unhurried and beautiful environment... then I think that it would do much to encourage women to birth in a hospital where things are available if necessary.
And, have you read Misconceptions, by Naomi Wolf? Not a bad read and she pretty much sums up why wome are pissed off by the patronizing behaviour of many experts.
Still do not think home birth is an option I would consider again, based on my reasons in my post above. And despite my bad experiences, it seems that there ARE people and places that preserve a woman's dignity during birth and those should be encouraged long before home birth should be offered as a solution.
My thoughts only....
And yes I did look up tyranny. Still too strong of a word in this context. Makes women victims without recourse, or hope of recourse. Again, my opinion. I will try to come up with a suitable option. Must go to work now.
impatientpatient,
The USA is beyond redemption in my opinion. What's the statistic, is it 10% of the world's population and 90% of it's laywers?
You deserve critisism you get!
In this blizzard of disputed statistics, I'm a bit fascinated by the "you have a brain damaged child, I have to pay for it" thread. Ooops - I have a brain damaged "child" - now 30 - do I have to add guilt about being a burden to the "taxpayer" to everything else? Hang on, I'm a taxpayer, so is my husband. We have been paying taxes - direct and indirect - for rather a long time. In what way are we a burden? Health care - minimal, to tell the truth - her general health is good. Social services? Ditto. They are, generally speaking, a joke. She went to school - so do other children. She does get some disability benefits - probably should feel guilty about that. She cannot work - yep probably should add that. She consumes, though, so supports the economy in that way, and her living expenses are borne by us, her working parents. Is she more costly than, say, a heart transplant patient or a young man who falls off a motorcycle? Haven't a clue. I know she's a lot less popular, and not seen as particularly deserving. Maybe I should apologise to all those (other)tax payers out there. Born in a high tech hospital, by the way. Accidents will happen.
Mo says "I'm a bit fascinated by the "you have a brain damaged child, I have to pay for it" thread."
If your child is brain damaged because of stupidity on your part, then people have a right to comment on paying for it. We are not generalising here however.
Actually, if stupidity caused brain damage, there would be a lot more of it!
And, of course, people have a right to comment on absolutely anything.
To claim that there is a cost to society is one thing. To PERSONALLY feel aggrieved about where YOUR taxes go struck me as comic.
Mo says "To PERSONALLY feel aggrieved about where YOUR taxes go struck me as comic."
It's not funny at all - who's laughing?
I feel personally aggrieved by my taxes being ploughed into the war in Iraq.
I feel personally aggrieved by my taxes being given to feckless people so that they can be more feckless.
I feel personally aggrieved when children are harmed by their parents stupidity and I have to pick up the bill.
I call it a concience!
It's comic because all that feeling aggrieved gets you precisely nowhere.
I learned a fact yesterday that may impress some people who oppose all "chemicals"--prior to 1921, when insulin was discovered, 50% of women who had diabetes and were pregnant DIED IN PREGNANCY OR CHILDBIRTH. (Of course, diabetes is also a cause of infertility, so many didn't even get pregnant).
Anyone who wants to see just how dangerous a little knowledge, coupled with a home birth is, read the "Vegetarian Mama, Vegan Baby" blog. Among other things, the mother declined a test for gestational diabetes, had obvious polyhydramnios, went overdue, was not attended by professionals. The outcome was tragic.
To Matt: You can't call disaproval of others "conscience". If your conscience tells you it is wrong to pay taxes to the "feckless", then your rememdy is to stop paying taxes, and go to jail. My taxes can then be used to support your conscience.
Generally speaking, it isn't the feckless poor who go for fads like this, it's the feckless well off. The outcome is, generally, a healthy baby or a dead baby. I expect some of the healthy ones grow up to be the kind of people who resent paying taxes for the less fortunate, because it delays the purchase of their second Porsche. Personally, if people feel they dislike a minuscule fraction of their tax going to support people like my daughter, I would like them to shove it where the sun don't shine. Unfortunately, the system doesn't work like that.
Mo,
I don't understand what you are on about.
I have no problem with any proportion of my taxes going to "people like your daughter." The point that I and others are making is that in our welfare system here in the UK, the state picks up the pieces when pregnant women make stupid decisions about their babies who have no legal rights whatever when in the womb.
The arguement is abouts rights and responsibilities.
Just to support Matt *in part* (I never use the word "feckless", how about "reckless"?) we are not talking about people like your daughter, or objecting to part of our taxes being used for disabled people. (I certainly don't, I get DLA!, it's pretty clear Matt doesn't either.) I'm sorry you thought you were being got at, it must have been rather distressing. You weren't.
Impatient,
Thanks for sharing your stories, I always appreciate a good birth story.
I feel like all of my pregnancies and births have been happy experiences, even my C-section. I gave birth to the most beautiful daughter with surgery. Everyone in my locale told me she was the cutest baby they had ever seen. Did the surgery hurt her and I? Yes it did. But it was still a happy day because my child was born.
I think what surprised me the most about my first unassisted birth was that by claiming the experience of doing my own prenatal care and taking personal responsibility for the outcome, I was so much more proactive with nutrition and exercise than I had been with my three previous births. I had not been aware of how much I let slide figuring the docs would pick up the pieces.
The other thing that surprised me was how I had not realized that giving birth on my back put me in a very vulnerable position emotionally. I had not realized this vulnerability until I gave birth standing on my own two feet.
Here is the You Tube CLip of the final moments after my VBAC.
http://www.youtube.com/watch?v=e...h?v=eNi-
72Lx0EU
It was a very empowering moment, but as stated, I did not understand the difference until I experienced Freebirth.
I have heard this same claim made by many many women in the birth stories I have read.
Laura Shanley sent me an email this morning. I guess the national canadian newspaper also did a major story on UC Birth this week.
http://www.theglobeandmail.com/s...15/TPStory/
Life
Laura and I have been talking about, promoting, and teaching families about UC Birth for since 1994. It is nice to finally see some media exposure after all these years of effort.
Here is a link to a mother who spoke at the Homebirth conference I organized in 2001. Perhaps listening to her story will help you to understand what motivates me to not only give birth alone, but also promote it.
http://www.naturalfamilyblog.com...ves/
000649.html
Thanks for such a thoughtful response to my question about tyranny.
Jenny Hatch
Woman who have babies at home take a risk - in my opinion an unnecessary risk, and I don't believe that considering the cost to the individual tax payer is going to stop them, if the risk to their child isn't. I don't believe anyone else believes it would, either, so why introduce it? I wasn't "distressed" - I've had thirty years to come across every negative attitude to the disabled - merely irritated. I'll stop now.
Mo,
Thanks for sharing a little of your story with those of us who are commenting.
I'll tell you why taxpayer funding of disabled children was brought into this conversation.
The reason is because at the end of the day it is about the only argument against UC Birth, at least from a political and legal perspective.
Argument being "we have all these crazy parents who have to be saved from themselves, and someone has to advocate for the poor children".
My brother Jim, who is an attorney is the one who first threw that one at me when he was in law school in 1994.
I've spent many years thinking about the debate. And it all comes back to assumptions. Here is an essay I wrote about this fight titled "The Freedom to Fail and Thoughts on death", it is an excerpt from my book A Lotus Birth:
http://www.naturalfamilyco.com/
a...fail_print.html
I'm curious to know if your daughter was disabled by a specific event in the delivery room? If it is too personal to share in a public forum would you email me the story?
Jenny Hatch
Jenny@NaturalFamilyCo.com
Antigonos wrote: Rosepetal thinks the bluntness with which I state unpalatable truths is unacceptable. How would you make it plain to a woman that home birth is dangerous? Or wouldn't you, and just decide that it was karma or God's Will that the baby died?
What you did in the blog had nothing to do with "stating unpalateable truths." It had to do with trying to score points on a grieving woman in order to validate your position.
I'm sure the late Jerry Falwell considered himself to be telling "unpalateable truths" when he claimed Hurricane Katrina was God's retribution for New Orleans hosting pro-gay events.
I'm sure Pat Robertson considered himself to be telling "unpalateable truths" when he blamed "gays, abortionists, and the ACLU" for 9/11.
I'm sure the Westboro Baptist Church (http://www.godhatesfags.com/main/index.html) thinks they are simply telling "unpalateable truths" when they go protest the funerals of soldiers killed in Iraq.
But the truth is, it has nothing to do with truth. All they are doing is traumatizing grieving families for the sake of polishing their own over-inflated sense of moral rectitude by rubbing the bereaved's noses in their loss and telling them it's somehow all their fault.
When they do this, the WBC is committing emotional terrorism, and so were you in harassing that poor woman in her time of grief. You ought to be deeply ashamed at your utter lack of human compassion and your total willingness to cash in on another person's grief to score "See how right I am?" points.
You are an utterly reprehensible person for putting one-upsmanship above basic human decency.
To Jenny Hatch
I'm afraid I cannot agree with you either that "I don't want to foot the bill" is the only argument against home birth. I am the best argument against home birth, as both me and my first child would've died if I had attempted it. Of course then my second, healthy daughter would not have been born, but that was another pregnancy that would have ended in disaster without intervention. I am, personally, horrified at the risks home birthers take - but I can also understand the fear and dislike of hospitals, and can see that the majority of births are straightforward. Having thought about it, I can see that it is possible that, statistically, more dead babies are born at home, and more brain-damaged babies are born in hospital. The kind of damage my daughter sustained is caused when disaster is averted, but still not quickly enough. What saddens me about the "taxes" debate are those who would think that a dead baby is cheaper and "better". As far as I am concerned though, some babies who would die at home are saved in hospitals - like my second. The very sad lady on Vegan Mother will have a long time to question her choice.
Mo says "What saddens me about the "taxes" debate are those who would think that a dead baby is cheaper and "better"."
This is the knub of this whole debate as far as I am concerned. If a pregnant woman is going to play Russian Roulette with her unborn baby's life through her own stupidity (i.e against professional advice), then a dead baby is cheaper (in this circumstance).
You may think that harsh but life is harsh as you and I well know.
I am not the one advocating putting unborn babie's lives at risk any more than they already are.
Cheaper of course. Better? Well, we will have to disagree on that. Earlier, you said you had a Down's child. Many "life is tough" realists would say people who don't abort Down's babies are "stupid". You and I both know it isn't that simple.
so were you in harassing that poor woman in her time of grief
+++++
I have the utmost sympathy for anyone who has just lost a child, but if you must indulge in such a public display of grief as to blog about it – which is a bizarre approach – on a public forum, you have to expect people to respond.
That some of those responses will be negative is, I’m sorry to say, inevitable.
Mo,
I did not say that taxpayer costs were the only argument against home birth. Belive me, after 13 years of actively promoting this, I have heard every single possible angle of why I should not give birth at home.
As you stated in your last post, some babies who would have died at home are saved in hospital, and my converse argument is that some babies who die or are permanently damaged in the hospital would have been just fine at home.
But the ultimate question is....who gets to decide where babies are born?
I would argue that the Medical Establishment, represented by ACOG (American College of Obstetricians and Gynecologists here in America) are a trade union. Marsden Wagner has been most articulate on this subject. Here are a couple of links and quotes:
http://www.midwiferytoday.com/
ar...ivescytotec.asp
"Recent articles in prestigious medical journals such as The Lancet have questioned the validity of standards of practice from professional organizations like ACOG, because their goal of protecting the health of women through using scientific evidence to guide members toward best practices too often conflicts with their other role as a trade union representing the interest of their members. As a result of this "trade union" role, ACOG recommendations are too often compromised by the needs of the obstetricians."
http://www.midwiferytoday.com/
ar...ivescytotec.asp
"ACOG is not a college in the sense of an institution of higher learning, nor is it a scientific body. It is a “professional organization” that in reality is one kind of trade union. Like every trade union, ACOG has two goals: promote the interests of its members, and promote a better product (in this case, well-being of women). But if there is conflict between these two goals, the interests of obstetricians come first."
Why as a mother should I take the advice of such professionals at face value and trust that they are living the mandate to first do no harm when all of the empirical evidence points to the fact that they are looking out for number one?
Now, Impatient had a nice post where she outlined the troubling sides to birth as demonstrated by Insurance Companies, Attorneys, Malpractice claims, lack of personal responsibility on the part of families, the women who do not want to feel any pain and in the socialized countries, the government itself who is paying the bills.
I am very aware of those fights and my bottom line question is this. If I as a mother understand the current fights that are raging in the delivery rooms, the courts, and the medical associations and if we as a family decide that all things considered, we are not very interested in getting in the middle of that fight while we welcome our child to the earth, why should we be prevented legally from giving birth at home in the way we choose?
Dr. Crippen has been most articulate outlining the various increases in "side effects" from medicated births. And the stats in America are equally alarming, with more ruptures, more death, more prematurity, and more interventions like inductions, c-sections, and NICU care.
I claim my rights as a consumer, and if allopathic birth is just one of the many ways that children can be born, and I choose not to spend our precious resources or my limited time adhering to every bit of prenatal care, and every unsound and unproven medical practice around birth, then I am just a consumer saying "NO thanks, I am not interested in buying what you have to sell."
The medical profession is so full of itself. They are so convinced that the way they deliver babies is best, and there is so much money at stake, so much power at stake, that for us UC Moms to look at them and say "no thanks, not interested"....well, you have seen the sort of verbiage that is tossed at us in this very chat.
Yet, I still don't care what they say. I know what I know and I am all about making healthy babies. At this point in the game, they don't have anything I am interested in purchasing and they are just going to have to accept that an increasing number of parents have also decided that they do not want to spend money on "what if?" prenatal care and birth.
I need to run, but man, hasn't this been just an awesome discussion?
Jenny
Mo,
I'm not saying that it is better that babies die because of birth trauma in avoidable circumstances. I'm just saying that it is cheaper if they do. That is a fact.
I am using this harsh arguement as a a counter to those women who want to put their unborn babies at unnessessary risk. If they can be cavalier, so can I.
Jenny,
Women can have their babies where, when and how they wish. I don't think anybody here is disputing that right. You disagree - fine!
You really ought to be ashamed of yourself for how you treated that grieving woman. Blaming and accusing her doesn't help the situation at all. The last thing she needs is your finger pointed in her teary-eyed face. I'm so glad you aren't a practicing, liscensed doctor anymore, because you have absolutely no compassion. And that is something a doctor should never lack.
Jenny Hatch:
"my converse argument is that some babies who die or are permanently damaged in the hospital would have been just fine at home."
There's a problem with that argument, though. All the existing scientific evidence shows that the risk of preventable neonatal death at homebirth is HIGHER than the risk of preventable neonatal death in the hospital. I'm not sure why this point is so difficult for homebirth advocates to understand. Even if you include medical errors and malpractice in the hospital, homebirth STILL has a higher rate of neonatal death.
"If I as a mother understand the current fights that are raging in the delivery rooms ..."
But clearly you don't. You don't seem to understand the most important point. Homebirth is more dangerous for babies. That's what all the existing scientific evidence shows.
"At this point in the game, they don't have anything I am interested in purchasing and they are just going to have to accept that an increasing number of parents have also decided that they do not want to spend money on "what if?" prenatal care and birth."
You may not be interested in purchasing a lower chance of death for your baby. That's your right to value your experience above the small but real chance of neonatal death.
Amy Tuter, MD
I'm surprised that you can still argue your case against such vehement opposition!
It's clear to anyone with a brain that hospital delivery is safer. Those in favour of home delivery will not be disuaded whatever the arguement. Fine, I say. Let them do what they want. Just don't involve me in the consequences of their actions, and certainly don't expect me to pay for it (in the UK)
Amy and Matt,
Did you ever think for a minute how life would change is we went through some difficult times in our western society?
In the west we have had relative peace for so long, several generations of families have come and gone using the modern technologies for family life that have sprung up to help women with birth, feeding, and healing children.
I wonder if either of you have spent even five minutes wondering how life would change if all of that infrastructure was gone. No electricity, no epidurals, no baby formula, no vaccines, no anti-biotics, no food in the grocery stores, no clean water, no gas to put in our cars.
I have spent many hours figuring out which skills would be necessary for our family life should that infrastructure for birth, healing, feeding babies, and providing the necessities of life for my family were all of a sudden gone. Unassisted Childbirth is one of the skills for women in their child bearing years that would be very necessary.
To that end we have gradually weaned from the doctors and now only use them for emergency care, like broken bones or sprained ankles.
I wrote a piece for an American News Service a few weeks after 9-11 titled A Mother thinks about Nuclear Survival in which I attempted to make the case that natural mothering fits perfectly into the provident living model of life.
Here is the link:
http://www.newsmax.com/archives/...16/
150143.shtml
Now I know it is easy to believe that medical birth and allopathic medicine will always be there for us. However, given the current climate in our world with terrorism and natural disasters, I'm not so certain I would always be able to get to a hospital in order to have professionals help me give birth.
Giving birth perfectly to our son in 2002 satisfied something very deep in my heart. I felt absolutely confident that should society come to a screaming halt, perhaps because of the middle east oil being shut off for some reason, war, or just something as crazy as a huge pandemic, I KNOW that everything will be just fine while I give birth, breastfeed, and take care of a newborn under survival conditions.
Your assumptions that The Medical Birth Machine will always be completely available to those of us who are pregnant are really some of the most short sighted and in some ways, naive thinking, about current reality.
Americas economy runs on oil. If for some reason that oil were to stop flowing, a ripple would start that would be felt around the world in terms of societal infrastructure disruptions. I am not willing to live assuming that the status quo will always be with us.
This is just one reason that I am into UC Birth, but in my mind, it is the main reason and the most important. I felt prompted by God over 17 years ago to become self sufficient in my Mothering. At the time I had no idea how controversial a choice that would turn out to be.
But after all these years of effort and going from a young mom to a teacher and then promoter of Sovereign Family Living, something real and powerful is happening in the lives of the families who have adopted this lifestyle.
Read the story of this mom profiled in a USA Today story...
http://www.usatoday.com/news/hea...on-
battle_x.htm
The harder the medicos clamp down on moms and babies, and the more archane the practice of medicine, the more women will jump ship and just go it alone.
Amy, I would challenge you to read this article by Henci Goer, a prolific writer here in America, you said:
"Even if you include medical errors and malpractice in the hospital, homebirth STILL has a higher rate of neonatal death."
http://www.midwiferytoday.com/
ar...information.asp
She finished the article with these words:
"The overwhelming dominance of the obstetric paradigm has further ensured the virtual silencing of dissent. When organizations or individuals opposing obstetric management try to get their point of view before the public, where do the reporters and editors go to evaluate the merits of the criticisms? You guessed it—those same experts and studies. In a game of "he said/she said," the one with MD after his or her name wins.
As for articles, nearly all article proposals that don't toe the party line will be rejected out of hand. The few that slip through will be gutted or killed. I don't exaggerate. I am aware of cases where this has happened, including my own. After three revisions to satisfy the editor that an article I wrote on Cytotec was bulletproof, the piece was killed because the magazine's lawyers decided there might be liability issues. From whom? Searle, Cytotec's manufacturer, which sent a letter to OBs warning against using Cytotec, would doubtless jump for joy at anything publicizing Cytotec's dangers. I'd take bets that the magazine's obstetrician advisor tipped off the lawyers.
So, have I made my case? In one sense, it doesn't matter. Conspiracy or not, the results are the same. You can fool most of the people all of the time. In another sense, it does matter. You can't begin to craft a strategy to fight back until you know what you're up against."
My strategy for fighting back is to simply walk away from the medical people while I am pregnant and giving birth. As a mother very aware of the risks, (read Andy's birth story here: http://www.naturalfamilyblog.com...es/000055.html)
I still choose to give birth in the sanctity of my own bedroom, alone.
Jenny Hatch
Greetings Folks,
Another voice from the colonies here.
I would just like to point out a few things.
1) The setting for labor and delivery is just one aspect of the maternity model that is embraced by the home birth community. A key aspect is the gold standard of prenatal care provided by the midwife. We tend to embrace the notion that a healthy mom is helpful in promoting good outcomes and successful parenting.
2) Safety Analysis - this thread, like many others, highlights the deficiencies in the assessment of safety. From a purely technical, and analytical, perspective it is easy to conclude that planned home birth is safer than the current model of hospital birth. There are myriad defects and failure modes associated with excessive interventions that are wrapped up in the euphemistic bucket called morbidity. With the rate of bad outcomes very low, and appropriately described as indifferent, a more comprehensive view of safety will favor the midwife attended home birth model. I say this while celebrating and applauding our ability to solve obstetrical problems, but the excessive application degrades safety.
3) Technical Errors in Amy’s Numbers - This has been pointed out in the past, but Amy is fond of comparing the (neonatal + intrapartum) mortality rate in the BMJ study to the US national average neonatal only mortality rate. Furthermore, over 10% of the home birth group in the Johnson and Daviss study consisted of Old Order Amish and Mennonite folks who would be expected to have higher congenital anomalies incompatible with life than her favorite cohort (low risk white women at 37 weeks gestation). There is no cohort appropriate for calculating percent differences relative to J&D’s home birth group. We simply know that the rate of bad outcomes is very low.
4) Schlenzka articulated the situation well in his thesis that the discussion of perinatal mortality is simply a distraction to meaningful discourse on improving the quality of maternity care and the validity of maternity models. As an aside, he observed consistently better outcomes with midwife attended Out Of Hospital birth even with more elevated risk factors.
Cheers,
Russ
Jenny Hatch:
"I wonder if either of you have spent even five minutes wondering how life would change if all of that infrastructure was gone. No electricity, no epidurals, no baby formula, no vaccines, no anti-biotics, no food in the grocery stores, no clean water, no gas to put in our cars."
That is one of the more inane questions I have heard. We already know what would happen because there are plenty of places in the world where those things don't exist (perhaps you didn't realize that most people don't live in the US and UK). What happens is that people die in massive numbers. The only thing standing between us and that fate is modern technology. There is nothing you know or could learn that could make any difference at all in that sad fact.
Birth in nature is INHERENTLY dangerous. There has never been a place, time or culture in which it has not caused tremendous maternal and neonatal mortality EXCEPT in cultures where modern obstetrics is available. That's why the whole notion of "trusting" birth is absurd.
"The overwhelming dominance of the obstetric paradigm has further ensured the virtual silencing of dissent. When organizations or individuals opposing obstetric management try to get their point of view before the public, where do the reporters and editors go to evaluate the merits of the criticisms? You guessed it—those same experts and studies. In a game of "he said/she said," the one with MD after his or her name wins."
Really? Well, here we are, an international audience. You have your chance. Present your data. Oh, wait, you don't have any data.
The obstetric "paradigm" is dominant because it works. The midwifery, homebirth and unassisted childbirth "paradigms" have been tried for hundreds of thousands of years and they result in lots of dead people.
Lot's of words, Russ, but not a single piece of scientific evidence showing that homebirth is as safe as hospital birth, not even one. Why is that?
Why don't direct entry midwives do research? Why don't they publish their statistics? Why is MANA refusing to release data on 30,000 homebirths to anyone except those who first prove they will use the data for the "benefit of midwifery" and ALSO sign a legal document agree not to reveal the data to anyone else? What does the data show that isn't for the "benefit of midwifery"? Why does it need to be kept secret?
Surely if homebirth midwifery is safe, homebirth advocates should be able to provide data to demonstrate it.
"Really? Well, here we are, an international audience. You have your chance. Present your data. Oh, wait, you don't have any data."
I have a study for you. It is the study of my own family. Two home births=two healthy babies.
Ultimately it is the only "scientific study" that means anything to me personally.
Amy, when the autism rate hits 50% and the c-section rate hits 90% and the future is a bunch of chemically damaged children who have no ability to bond with anyone, and everyone is scratching their heads going "whatsup with the kids?" Would you do me a favor and think of this conversation?
You might as well purchase a couple of straight jackets for when your grandkids come to visit.
Just know that I will be enjoying my holistically fed, birthed, and breastfed grandchildren and reveling in the Joy of an organic, healthy, family.
And then all of your scientific studies will stand rotting on the shelves while certain family lines end in dysfunction and disability.
You answered my last post quickly enough that I know you did not read the Henci Goer article. Would you please take a sec to read it and then ponder her claims.
Then would you watch this video, and take a minute again to ponder the speakers message?
http://www.naturalfamilyblog.com...ves/
000829.html
I know it is alot to ask a busy doctor to get out of the box in your scientific thinking. But until you docs are able to step back and look at the big picture we are never going to come to a meeting of the minds.
Jenny Hatch
Jenny Hatch:
"I have a study for you. It is the study of my own family."
That's not a study. That's your personal experience. This is what I mean about homebirth advocates lacking even the most basic understanding of science. Personal experience is not science. Indeed, one of the fundamental principles of scientific analysis is that a limited experience (or a limited number of observations) cannot be the basis of scientific predictions.
Simply put, the fact that you had two babies unassisted at home and both lived tells us NOTHING about the safety of homebirth. Homebirth could be 10 times as dangerous as hospital birth or even 100 times as dangerous as hospital birth and the majority of babies would still live. No one can extrapolate from your experience to calculate what might happen to them.
"You answered my last post quickly enough that I know you did not read the Henci Goer article."
Not only have I read it in the past, but I have publicly challenged her to a debate about her claims. My challenge:
"... [T]he true spirit of science is the willingness to present, and the ability to defend, your positions publicly. I believe that your public announcement, in advance, that you will deliberately delete scientific criticism (from her website), rather than respond to it, is the ultimate confirmation that you cannot defend the positions that you present to lay people. I believe that your unwillingness to defend your positions is the ultimate confirmation that there is no evidence to show that homebirth is as safe as hospital birth. There is also no evidence to support the smear tactics that you use against modern obstetrics and obstetricians.
So I am offering a public challenge to debate and defend your positions and the scientific papers you depend on for those positions...
You write for lay people who cannot really evaluate the scientific validity of your arguments. If your claims are really true, it should not be difficult to defend them in a debate with me. Indeed, it could only increase respect for your point of view, if you could defend your positions."
Of course, she immediately backed away:
"Well, at least we agree on something: The true spirit of science does, indeed, include willingness to defend one's position publicly, as I have been doing here and have said I am willing to continue doing. To repeat what I have written before, you are welcome to post a criticism to any analysis of mine. I will respond. That will make our positions both clear and public. Readers will then have everything they need to decide which one of us suffers from a case of "my mind is made up; don't confuse me with the facts." But I won't be baited. Your posts on this Forum--including this one--and the Lamaze blog make it abundantly clear that you want a fair, fact-based debate on birth issues about as much as Bill O'Reilly wants one on political issues. I won't play that game. You have your own blog for your rants. You will get no platform for them here or from me."
(You can read the full discussion here.)
Ironic, isn't? She asked, in the article you cited, "Have you wondered, as I have, what is going on? Why is our side of the story nowhere to be heard?" And yet, when offered an opportunity to present her side in a debate, she refused to participate.
So why did Henci Goer back down? Why did she publicly announce that she won't participate in any debate unless it is rigged to favor her? What does she have to fear?
I know what she has to fear: the exposure of many of her claims as nothing more than misinformation, half truths and in some cases, outright lies, and the inability to defend the shoddy scientific papers on which they are based. Her claims are "junk science". She uses the veneer of scientific language and statistics to mislead women who are looking for accurate information. As she said in the article, "If you "talk the talk," few will look behind the facade to see the weaknesses in logic or reasoning"
In a way, I don't blame her. Her claims would be eviscerated in short order, and that must be prevented, even at the cost of publically acknowledging that she is afraid of any debate that she can't control.
Professional homebirth advocates never present at medical conferences, never take questions from medical professionals and never debate with medical professionals. That's the surest sign that their claims don't stand up to scientific scrutiny. They only write for and speak to lay people, who cannot independently evaluate their claims and are not familiar with the existing scientific literature.
Jenny: "I know it is alot to ask a busy doctor to get out of the box in your scientific thinking."
You all do realize that Amy Tuteur, MD is NOT a practicing MD. She has not been practicing for YEARS and when she did practice it was for a very limited time.
Point: She ain't BUSY!
Jenny Hatch says "I have a study for you. It is the study of my own family. Two home births=two healthy babies." & "when the autism rate hits 50% and the c-section rate hits 90% and the future is a bunch of chemically damaged children who have no ability to bond with anyone, and everyone is scratching their heads going "whatsup with the kids?"
If this is the basis of your arguements then I certainly am staying in my box.
Bye!
"Point: She ain't BUSY!"
I wonder how much she gets paid by someone in big pharma to go out and diss the homebirth movement on the web. They have a whole army of internet doctors who go into chat rooms, engage individuals like me in on line debate and try to score points with the very debate tactics she has used here, which boil down to....Heads I win, Tails you loose. Or are otherwise interpreted as "You aint' a doc, so SHUT UP!"
Doctor Amy, we are talking apples and oranges, and you are just going to have to realize that families are not interested in bogus science. Did you watch the vaccine movie?
I can understand why Henci refused to talk to someone like you. First you tell me I have no ability to be able to debate, then you watch me continue to talk on this thread with other people and you keep yelling science, science, science....while I am sharing quotes, links, stories, having a nice conversation, and then you come back into the discussion and say that our foremost natural birth researcher, writer, and articulate analyzer of the data of birth is "only writing for and speaking to lay people, who cannot independently evaluate their claims and are not familiar with the existing scientific literature."
All that I have to do to see that mothers and babies are not being served by allopathic birth is to look at the statistics that are being gathered from all over the world on C-section rates, autism rates, rates of intervention during hospital birth, prematurity, low birth weight, and the less quantifiable but equally alarming, rates of mothers with Post Partum Depression. Throw into the mix the number of young women choosing not to become mothers because it is just too dang risky and you have a big stinkin' mess around allopathic birth.
As stated above, more women than ever before are getting prenatal care in America. Yet the rates of disability and dysfunction continue to soar, more dead babies, more dead mothers. Your "scientific" A Plus B Equals C does not compute. And that is why I look at your hands over your ears shout down and ask myself, "what is wrong with this woman that she has such a vested interest in the status quo of babies being damaged and family life being disrupted by allopathic torture of moms and babies?
All that I can conclude is that you are being paid a heavy sum to bully parents into the status quo and I will have none of it.
I'll stick with evidence based care and take personal responsibility for the outcome of our births. Yeah, You know, and Henci knows, and I know that any of us showing up at a snooty medical conference would be "eviscerated" in short order by the myriad "scientific studies" that have been conducted to shut us up and shut us down....What individual family or independent researcher could EVER stand up to such a wall of self righteous indignation and mountain of studies, research dollars, and flood of money?
Certainly not me. And I don't blame Henci for not taking the time to debate someone like you. You are just a tad frightening and somewhat scary in your demeanor.
At the end of the day I will claim my rights of self determination and keep my body away from the knives, forceps, needles, and drugs. And I pray other mothers will do the same and preserve a legacy of health for our posterity. Lord knows it is not to be found in the drugs of the pharma companies.
Have a NICE day!
Jenny Hatch
Jenny
You’ve made some interesting and thought-provoking points on here but as someone whose wife and baby would not have survived but for an emergency C-section I strongly, strongly resent the implication that because they needed a life-saving operation they are somehow inferior to your “holistically fed, birthed, and breastfed grandchildren.”
If you’re really the advocate of choice that you purport to be, you should accept that other people choose to give birth in other ways. This does NOT make them in any sense lesser beings.
Precisely what evidence do you have that births involving “knives, forceps, needles and drugs” are likely to lead to less healthy children? It is how we bring our children up rather than how they arrive in this world that is the crucial factor.
The argument that because modern medicine might not always be with us, we should prepare for a time without it is the single biggest piece of rubbish I have ever heard, and your ad hominem argument that anyone who disagrees with you must be part of a medical conspiracy or in the pay of big pharma is just too ‘conspiracy theory’ for me.
PS I have no connection with the medical profession in any way, shape or form.
Rob,
It is the pre and perinatal psychologists who are gathering the evidence that technocratic birth is causing problems in our children.
You said:
"Precisely what evidence do you have that births involving “knives, forceps, needles and drugs” are likely to lead to less healthy children? It is how we bring our children up rather than how they arrive in this world that is the crucial factor."
One more time I will say it, Question your assumptions.
http://www.birthpsychology.com/
Some interesting links and quotes:
The literature: http://www.birthpsychology.com/books/
Here are the books on Birth:
http://www.birthpsychology.com/b...om/books/
2.html
The Birth Scene:
http://www.birthpsychology.com/b...com/birthscene/
Introduction to the Birth Scene
By David Chamberlain, Ph.D., Editor
"The 20th Century was a time of momentous change in childbirth. We must not overlook the lessons of this extraordinary period in the history of birth.
From the beginning of human birth until very recently--a span of millions of years--babies were born at home with the assistance of an experienced relative or midwife. Women supported other women in birthing. Suddenly, in the 20th century, the situation was reversed: birth away from home, without family, in hospitals, and under the supervision of men!
In the United States, 1939 was the turning point when more babies were born in hospitals than at home. Since then, the percentage has risen steadily to about 98%. During the same period, the percentage of births attended by midwives had plummeted to 10% by 1935. Historically, the profession of midwifery was decimated by a campaign waged by American medicine. In the sixty years left in the 20th century, as midwifery shrank, obstetrics expanded to dominate birth. As a consequence, mothers lost both intimate knowledge and confidence about giving birth, and the personal meaning and quality of childbirth was radically altered.
The psychological problems created by this new way of American birth, although scarcely acknowledged, have been legion. Babies born in hospitals found themselves in a high-tech environment that was too cold, too noisy, too bright, and too big for them. Handling of babies was efficient but aggressive, pain was inflicted routinely; babies were separated--or isolated--from their mothers, while caregivers introduced the babies to bottles instead of breasts! Medical priorities were different from, and often in conflict with those of mothers, fathers, and babies. The majority belief among medical professionals was that babies came into the world with no sense of pain, no real emotion, and no real mind to interpret anything happening to them. This tragic miscalculation still taints the rituals of obstetrical birth in many parts of the world today."
Birth and the origins of Violence:
http://www.birthpsychology.com/violence/
What Babies Are Teaching Us About Violence
"Research has followed these dramatic innovations at a great distance, warning of danger long after the damage was done. The results of this new way of birth may finally be calculated in the angry behavior of generations of men and women born in violence. We have been impregnated with drugs from the first moment of life. Are we so fascinated with drugs and the altered states they evoke because we were introduced to them at birth? Research findings point to these connections.
Evidence of this kind led us to organize the conference held at Cathedral Hill Hotel in San Francisco in the Fall of 1995. The conference brought together experts from many disciplines who regularly probe the early origins of violence and who have made the connection between trauma and violence."
http://www.birthpsychology.com/
v...amberlain1.html
Babies tell us that even "normal" birth is violent
"Babies communicate this with their strong voices, their anguished facial expressions, and by vigorous movements of arms and legs. Are they not famous for crying fiercely at birth? Both parents and professionals expect this, smile nervously, and call it "healthy." Birth cries are not yet taken seriously, although most of them are clearly a reaction to violence. Screaming babies tell us that something is wrong."
Jenny Hatch
Jenny Hatch,
Birth "psychology" is another pseudo-science completely fabricated by its proponents. In other words, they make it up as they go along, always with the intention of supporting a predetermined agenda.
"I wonder how much she gets paid by someone in big pharma ..."
Obviously it is impossible to debate your position when the facts are arrayed against you. It is so much easier to resort to smear and innuendo. You just made that accusation up off the top of your head, but it is revealing nonetheless. It demonstrates how homebirth advocates fantastically overestimate their own importance and influence. Why would any drug company care about the propaganda spewed forth by a fringe movement. In the US, homebirth is chosen by less than 1% of women and that percentage has not changed in 25 years.
As long as we are discussing motivation, though, it is worth pointing out the homebirth is not about birth, and vaccine rejectionism is not about vaccines; they are a deliberate effort for advocates to claim superiority over other people by insisting that their arbitrary personal preferences are somehow better than those of other people and by denigrating women who disagree.
Many authors, particularly feminists, have been addressing this issue of the need of homebirth advocates to boost their own self esteem at the expense of other women and at the expense of the truth. Abby Arnold's article, The Rhetoric of Motherhood, is particularly compelling. From the article:
"The image of the laboring mother maintaining her power and control, where the pain remains manageable and support surrounds her like a warm bath, where medical intervention is solely devoted to enhancing the mother's birth experience ... is held out to be the ideal, what all women not only should strive for but naturally,
automatically want... Susan Maushart, the author of The Mask of Motherhood, says that the relentless focus on the woman's 'performance' during the 'birth experience', rather than the child it produces, creates the greatest shift of all in our social construction of childbirth: that the 'object' of the enterprise is no longer seen to be the end product (the baby) but the process itself. (my emphasis)
... American women go into labor with an almost 100 percent statistical certainty that both they and their child will survive. This is the first time this has been true in human history and is in large part due to medical intervention. Yet the language of natural childbirth would have us believe that medical intervention is itself the danger."
Make no mistake, homebirth and "freebirth" are entirely about the mother, her needs her desires, her view of herself. The baby is just an minor actor in the mother's struggle to demonstrate that she is better than other women. If you want to have unassisted homebirths, go right ahead, but be aware that we are not fooled. It's all about you. Increasing the risk of neonatal death is evidently a small price to pay to create the birth "performance" that is supposed to impress everyone else.
Amy Tuteur, how can you say that EVERY SINGLE mother who gives birth at home is doing it to demonstrate that she is better than other women?
You keep harping on evidence. Where is your EVIDENCE for that statement?
Oh, I forgot. You don't have any. Evidence is only required when it's someone you disagree with.
What if I said that people who become doctors don't do it to help and heal people, but to use the letters MD after their names to demonstrate that they are smarter than other people? Would I be any more incorrect than you? Again, you'll have to prove me wrong with EVIDENCE.
Julie, CNM:
"Where is your EVIDENCE for that statement?"
Well, let's start with the basics. Look at the choice of language. "Natural" childbirth? "Normal" birth? Can you imagine if someone set up a message board restricted to parents of "normal" children? Can you imagine if someone said, "I had a normal baby, how about you?" Most people would be appropriately horrified by an attempt of a mother to assert that her children were normal and yours were not. Is it any more acceptable for a woman to claim that her birth was "normal" and yours was not?
Moreover, "natural" childbirth is, in itself, a misnomer. It has little or nothing to do with childbirth in nature. As far as I know, childbirth in nature doesn't have prenatal vitamins, prenatal visits, blood pressure checks, fetal heart checks, etc. etc. etc. There is very little that is natural about "natural" childbirth. It is simply the arbitrary preference of some women to avoid pain medication. It is not better or superior in any way. It certainly does not merit the designation "natural", yet that designation is applied in a deliberate attempt to assert superiority.
How about the vicious lies propagated by natural childbirth advocates like Michel Odent. Women who don't have labor don't bond as well to their babies? Totally made up to deliberately vilify women who make different choices. Less pain = less joy? Another vicious lie.
Barbara Harper, best known for her advocacy of waterbirth (which is completely unnatural and deadly for babies) is quite up front about how many proponents of "natural" childbirth feel. She was quoted in the Oregonian as saying:
"Medical childbirth inhibits bonding, ... creating emotional scars for mother and child -- and should be avoided if possible. "Babies know how to be born, and mothers know how to give birth," she says. "Centuries of feminine wisdom are lost when it is turned over to doctors."
"I do enjoy making women feel guilty," she says. "They are so natural the whole pregnancy, eating only organic food and not touching a drop of alcohol, and they'll throw it all down the minute they step into a hospital.""
She starts with the typical vicious and gratiutious slur on the relationships of other mothers and their babies. At least she's honest about the motivations for her contempt of women who make different choices. She enjoys making women feel guilty. No big surprise there. That's half the fun of natural childbirth advocacy: feeling good about yourself by making other women feel bad.
That's just the beginning. A look at the philosophical underpinnings of "natural" childbirth and homebirth advocacy sheds light on the desire of advocates to feel superior to other women. Here's just one of many examples. From Katherine Beckett, Choosing Cesarean: Feminism and the politics of childbirth in the United States, (Feminist Theory, 2005, vol. 6(3): 251–275):
"In short, some feminists perceive the alternative birth movement as rigid and moralistic, insistent that giving birth ‘naturally’ is superior and, indeed, is a measure of a ‘good mother’. The perceived moralism of this stance is quite troubling to some; according to one feminist critic, the ‘natural’ philosophy ... is as tyrannical and prescriptive as the medical model, but pretends not to be by emphasizing women’s right to individualized and alternative births."
Amy Tuteur:
"Well, let's start with the basics. Look at the choice of language."
And this is evidence how...? Have you done some sort of analysis where you quantified every webpage out there and done word counts and semantic charts? That's what you'd need to do to get numbers available. Selective reading of a few people you've already decided to hate won't cut it.
"As far as I know, childbirth in nature doesn't have prenatal vitamins, prenatal visits, blood pressure checks, fetal heart checks, etc. etc. etc."
As far as I know, childbirth NOT in nature doesn't have prenatal vitamins and all the rest. That's what we call prenatal care. Which happens in the months before the birth.
"There is very little that is natural about "natural" childbirth. It is simply the arbitrary preference of some women to avoid pain medication. It is not better or superior in any way. It certainly does not merit the designation "natural", yet that designation is applied in a deliberate attempt to assert superiority."
Let's go through each one of your assertions. First of all, many, many people disagree on what natural childbirth really encompasses. Due to the unfortunate cesarean rate in the US, some women are starting to call any vaginal birth "natural." Some say a little Demerol or Nubain but nothing else is "natural." You've obviously come up with your own definition of "natural," which appears to be "out in the wild," and therefore any birth that takes place where indoor plumbing is present wouldn't be natural. Fine.
I'm still not seeing this "deliberate attempt to assert superiority."
You quote two natural childbirth advocates, who certainly don't speak for every woman who's ever had or planned a natural birth, and one feminist scholar. As far as I can tell, your whining about women having natural births only doing it to feel superior is just one more voice added to the mix. One scholar's opinion is not evidence.
You've personally blogged about having had at least one natural birth, and that natural birth should be called "philosophically driven." Does this apply to you, too? Were your natural births philosophically driven by the desire to feel superior to other women? If they were, don't you think it's the teeniest bit possible that not every woman is like you? If they weren't, then isn't that evidence that NOT all women are having natural births in order to feel superior?
Julie, CNM:
"You quote two natural childbirth advocates, who certainly don't speak for every woman who's ever had or planned a natural birth, and one feminist scholar."
Yes, and you quote no one. You simply offer your personal beliefs.
"You've personally blogged about having had at least one natural birth, and that natural birth should be called "philosophically driven."
I have had childbirth without medication. My personal experience is consistent with the existing scientific evidence. The choice to have unmedicated childbirth is just that, a choice. It's like choosing vanilla over chocolate. One flavor is not superior to the other.
A woman can choose to forgo pain medication because she doesn't have much pain. That's not philosophically driven. Such a woman would consider herself lucky, not better, not superior, not "empowered", not any different from anyone else.
On the other hand, philosophically driven childbirth ("natural" childbirth) is a social construct that has existed for only the last 70 years or so, was formulated entirely by men (Grantly Dick-Read, Lamaze, Bradley), is based on premises that are factually false (primitive women do not have painless labor, labor pain is not a social construct) and postulates that the arbitrary preferences of a few are superior to other womens' choices.
Amy Tuteur:
"You simply offer your personal beliefs."
You have no idea what I believe. I stated the FACT that cherry-picking two people who illustrate your point isn't the same as providing evidence. Two isn't all, and it isn't most. I don't need to quote anyone for that to be true. You can look up the words "two," "most," and "all," in the dictionary to verify.
"I have had childbirth without medication. My personal experience is consistent with the existing scientific evidence. The choice to have unmedicated childbirth is just that, a choice. It's like choosing vanilla over chocolate. One flavor is not superior to the other.
A woman can choose to forgo pain medication because she doesn't have much pain. That's not philosophically driven. Such a woman would consider herself lucky, not better, not superior, not "empowered", not any different from anyone else.
On the other hand, philosophically driven childbirth ("natural" childbirth) is a social construct that has existed for only the last 70 years or so, was formulated entirely by men (Grantly Dick-Read, Lamaze, Bradley), is based on premises that are factually false (primitive women do not have painless labor, labor pain is not a social construct) and postulates that the arbitrary preferences of a few are superior to other womens' choices."
And how is it that you know that everyone else who has an unmedicated birth is doing to feel superior? Or are you changing the definition of natural birth to mean a birth where the mother agrees with Dick-Read, Lamaze and Bradley? If they agree with you, then they're not doing it to feel superior?
Do you realize that this whole thing is coming back again and again to your making up definitions to suit your needs?
You're the only person I see in any of these birth debates/forums who's claiming to know the motivations of EVERY OTHER WOMAN giving birth. If that's not your intention, maybe you should reconsider your language.
Julie, CNM,
Critizing my claims is not an alternative argument. Until you offer an alternative explanation and some evidence to back it up, I'll stand by what I have written.
I wish you would offer an alternative argument. I'd like to see you explain away the myriad claims of superiority, the deliberate use of judgmental language ("normal" birth?), the factually false assertions about the benefits, and the denigration of women who make other choices that are integral to "natural" childbirth and homebirth advocacy.
The entire social construct of homebirth advocacy is especially ironic when one considers that the scientific evidence shows that no only is homebirth not beneficial for babies, it actually contributes to preventable neonatal death.
Amy,
Your language against the home birth movement is such a load of self righteous horse puckey. Here is what the doctors are taught in medical school about women who choose to give birth "naturally".
http://www.naturalfamilyblog.com...ves/
000054.html
Doctors are taught in the 2nd edition 1965 - Medical, Surgical, and Gynecological Complications of Pregnancy, which is still much in use, that assertive women are “dangerous”. “Those patients who consider themselves ‘socially aware’ ...are not necessarily more mature but are trying, by their active interest in everything ‘avant garde’ socially as well as medically, to persuade themselves and others that they are...This is the patient who is interested in such methods as ‘natural childbirth,’ hypnosis, or using childbirth as an ‘experience.’
The intensity of the demands of the occasional woman who is fanatical in her zeal for ‘natural childbirth’...and her uncompromising attitude on the subject are danger signals, frequently indicating severe psychopathology...A patient of this sort is not a candidate for natural childbirth, and requires close and constant psychiatric support.”
And with this quote we go back to the pretzel like quality of current medical dogma as outlined by Dr. Amy's arguments.
First, if you want a natural childbirth, you are nuts.
Second, if you demand a natural childbirth, you require close and constant psychiatric support.
Third, even desiring a natural childbirth means that you in fact are not worthy of a drug free birth, you are simply crazy.
Four, if you are one of those women who happen to give birth before we administer our plethora of drugs available for you and your baby, fine, but if you actively want to keep those drugs out of your childs brain....YOU ARE CRAZY!!!
Amy, when I said that we were talking apples and oranges, I meant that with my whole heart. Medicine concerns itself with the physical realm. The weight, blood, and urine tests during pregnancy. The electronic fetal monitor during labor, and the myriad machines that are used to evaluate the baby after birth.
This fleshy realm is all that is considered when mothers give birth, and if a baby dies despite the focus on the physical, the attitude of the docs, is "well, we did everything we could" and they are justified and absolved of all responsibility. Yet the scriptures have quite a bit to say about those who trust in the arm of flesh. http://scriptures.lds.org/en/2_n...en/2_ne/4/
34#34
http://scriptures.lds.org/en/
sea...ch=arm+of+flesh
Freebirthers work in the faith realm. We look at birth as a spiritual EXPERIENCE and words like belief, miracles, angels, faith, or "trust in the Lord with all thine heart and lean not unto thy own understanding" are part of the language of home birth. Freebirthers spend quality time working on beliefs and conciously changing our thoughts around birth.
My personal creed during my last birth was:"Whatsoever thing ye shall ask the Father in my name, which is good, in faith believing that ye shall receive, behold, it shall be done unto you." http://scriptures.lds.org/en/mor...en/moro/7/
26#26
When I organized the husband wife homebirth conference in 2001, I chose the hymn When Faith Endures for our theme. Here are the words: "I will not doubt, I will not fear. God's love and strength are always near.
His promised gift helps me to find, an inner strength and peace of mind.
I give the father willingly, my trust, my prayers, humility.
His spirit guides, his love assures that fear departs when faith endures."
Now, all kinds of verbiage have been tossed at this movement and at me in this comment section, and I admit to flinging some of it right back. But to say that we mothers are selfish and are not thinking about our babies and what is best for them is the most unfair claim that you have made.
I am always asking myself how I can be a better mother and do a better job with the souls entrusted to my care. And I claim that Heavenly Father has guided my paths as a mother and led me to UC Birth. I want to testify that something real and healthy and whole is happening in our family life and in the lives of the famlies who have adopted certain practices that are out of the mainstream. I don't have a scientific study to back up my claim, with five kids, I have a hard time keeping up with the laundry for our family of seven. And for you to ask that I as a mother back up my claims with a scientific study is completely unfair and unreasonable. You know I could never do it, and why bother anyway, it would never be given a bit of acceptance by the medical people.
What I do have is my testimony. I testify in the name of Jesus Christ that God has led me to UC birth as the vehicle for our family to experience intense JOY around the births of our children. My husband was overwhelmed with that joy when Ben was born in 2002 and right after the birth he JUMPED FOR JOY after he handed Ben to me. The joy in our bedroom at midnight on October 25th was real and palpable. This is my personal witness and testimony. Beyond my witness I don't have much except my web sites, a very grass roots birth conference where the children outnumbered the adults two to one, and my blog which has been passionately dedicated to the cause of home birth.
You obviously feel just as passionate on the other side, as the title of your blog illustrates. And thats cool. No problem. I don't have an emotional need to change your mind or convince you to my way of thinking. Overall I have enjoyed debating it a little here on Dr. C's blog and appreciate his willingness to let us speak. In the past when I have started writing my thoughts in chat rooms and other peoples blogs, by this time I have generally had my commenting ability cut off and people calling for my head on a plate. And I appreciate having a chance to hash it out without being silenced.
Here is a slide show of a mom who recently gave birth at home after three c-sections. http://www.onetruemedia.com/
otm_...bf0f66accb8afce
If you dismiss our experiences and summarily call them selfish, you are messing with our very souls as women and mothers. And that is not a very nice thing to do. I honestly don't care how other people give birth. Most of my dearest friends happily give birth in the hospital with drugs dripping into their veins and being shot into their spinal column. I love my friends and their children. I don't feel that I am superior to them, but I do want women who would like to have a choice other than the hospital to be able to happily welcome their children at home without someone screaming "Manslaughter" if something were to go wrong as it sometimes does.
Jenny Hatch
Jenny Hatch,
If you want to ascribe your preference for UC birth as stemming from your religious faith, that is your right. Many people before you have ascribed their erroneous beliefs about science to religion (the earth is the center of the universe) and many people continue to do so (the "theory" of creationism). Interestingly, whenever science and religion have historically been in conflict, religion has ALWAYS been wrong. I can't think of a single example where religion has been shown to be correct.
I am talking about empirical facts. As I said days ago in my response to your claim that you want to debate, you are not knowledgeable enough to debate this subject. There are no empirical facts that support your position. Ultimately you will always come back to the belief that your personal preferences are the same as those of God. To me, that it utterly absurd.
Those who studied the Bible know that God generally asked people to do what they otherwise would not have chosen to do. God did not ask people to do what they were planning to do anyway, and certainly did not speak to people in order to ratify their personal preferences. Only in contemporary America have we turned God into a Being that exists to make us feel good about our personal choices.
Amy,
And this is where we have to agree to disagree.
"certainly did not speak to people in order to ratify their personal preferences."
He talks to me every day. I spend quality time talking to him in prayer, often several times a day.
He has not only ratified my personal choice, he has given me the courage, strength, and clarity to attempt to articulate it for other families on the web.
He is my Father in Heaven, and I want to testify that he cares very much how his children are born and how they come into the world.
It is my testimony that he always intended for babies to be born into the hands of their fathers. And it is my testimony that healthy babies are the fullness of the gospel of Jesus Christ.
I think it is time to stop talking to you. I have given much time, emotional energy, and effort to this conversation in an attempt to defend Freebirth. Hopefully those who feel drawn to read this conversation will have a chance to quietly view the opposite sides and make an informed choice about who they think makes the better case for birth and what is best for babies and who gets to decide the location for that birth.
Please know that I understand you are advocating for babies and life, and are filled with anguish at the thought of even on baby dying needlessly. And I praise you for that concern.
Jenny Hatch
Babies born in hospitals found themselves in a high-tech environment that was too cold, too noisy, too bright, and too big for them. Handling of babies was efficient but aggressive, pain was inflicted routinely; babies were separated--or isolated--from their mothers, while caregivers introduced the babies to bottles instead of breasts!
++++++
Jenny,
I’m sorry if this was your experience, but it certainly wasn’t mine. In fact, what you say here is so far removed from my experience that I can’t really identify with it at all.
Which brings us back to the argument that your birthing choice is just that, a choice. It’s one I absolutely support your right to make.
What I object to is the way you seem to assume that your choice is somehow superior to mine, or that it is better for the baby – neither of which you have remotely begun to prove.
I would like to ask Jenny--those of us who are Jewish, do we have to suffer in childbirth and have unhealthy babies because we haven't got Jesus to help us, nor, by Jewish law, be touched by a man during labor? "It is my testimony that he always intended for babies to be born into the hands of their fathers. And it is my testimony that healthy babies are the fullness of the gospel of Jesus Christ."
Gee whiz.
All this stuff about bonding: let us remember that in Queen Victoria's day it was axiomatic that a woman who didn't "suffer" in childbirth wouldn't love her child--until, of course, the Queen had cloroform with her 7th child. If the pundits of the day had been right, how many millions and millions of children born since the mid-19th century wouldn't love their parents since then and be loved by them?
Tosh.
I grieve to read what Dr. Crippen is writing about maternity unit closure. The type of maternity care I witnessed at the Mill Road Maternity Hospital, and on the district, in Cambridge in the mid-70s was superlative and has been an inspiration to me ever since.
Just to add my two pence, with my second baby I badly wanted a home birth but was told the trust didn't have the resources (this was 14 years ago, some things don't change), nor could I afford a private midwife. I am now so glad that was the case. Had I been at home I wouldn't have known anything was amiss, he was suffering from cord compression and had he not had fetal blood sampling the scale of his distress would likely have been unknown. Even with intervention he was born with an agpar of 4 and to this day he is a bit ... odd compared with his peers. I can't say if that's due to his arrival, all I know is that he probably wouldn't be here if I'd insisted on having a home birth.
Diane campaigns for better education for black children in London but her son went to the City of London School, current fees £3816 a term.
----------------------------------
But to be fair, you campaign for better NHS services but pay for private medical insurance.
Principles go out of the window when it comes to one's loved ones.
Jenny-
I resent the assumption that as a person who was delivered with forceps that I am 'damaged goods' . Who are you to assume that any intervention is bad and mothers who require assistance are lesser people.
Hey DundeeMedStudent, some of us DO get damaged from forceps. I have a deep gash in my cheekbone from being hauled out during my birth. Doc told my mom it would go away... (he was wrong).
Wow - it's hot in here. Personally, I don't think I would opt for a home birth, but I must say I have no sympathy for those of you who feel the need to dictate the way another person ought to act or behave. It seems that those of you who are advocating for home births simply want the option to make your own decision whereas those pushing for hospitals want to choose for everyone. By what right do you get to tell someone else how to live their life? Life is a risky business. There are no guarantees. Women who want to birth in hospitals end up having babies in taxis and a friend of mine who wanted home birth got caught out unexpectedly and wound up birthing in the hospital. Maybe it's safer to have a baby in the hospital. Maybe it's safer not to work on a skyscraper washing windows. Or walk on a road with no sidewalk. Or swim in the ocean. It's just one more choice one makes out of thousands.
But I have to say I'm quite disturbed by Matt's emphasis on the monetary aspects - correct me if I'm wrong (and I have no doubt you will) but you do not wish to pay, through taxes, for children damaged by botched birth procedures or choices, right? To follow your logic out - since certain birth defects can now be assessed in the womb do you think women ought to be forced to abort imperfect fetuses so you won't have to pay for their care? You do know the direction your arguments are headed in, right?
Personally, I don't think I would opt for a home birth, but I must say I have no sympathy for those of you who feel the need to dictate the way another person ought to act or behave.
one problem I see with home births is that the NHS will not be able to provide either adequate domiciliary care for all who choose it. or (nearby) hospital services in case of sudden need.
Dictating how people should behave, well, I support smoking bans, on the whole (but dislike the really nasty way some people treat smokers), I am adamantly opposed to drunk driving, also to the use of mobile 'phones and dictation machines while driving. (Etc.)
But perhaps we should discuss the closure of maternity units!, I imagine we could more easily agree that that is undesirable.
Damaged.
jenny was implying psychological trauma, yes I am aware that some people gain physical trauma from forceps, I myself have a little bump on my head- but I am NOT damaged. I'm fairly certain if I hadn't been assisted both myself and my mum would have died. Small physical trauma does not compare with the implication that I am 'wrong in the head' or more likely to be a violent murder (from birthpsychology.com) is what I object too.
hmm I also object to my questionable use of grammar.
www.birthpsychology.com/violence/
Has anyone done brains scans or studied the birth history of the people who actually BELIEVE this codswallop?
Just to add in my 2 pennies worth - I watched the slide show suggested by Jenny Hatch and found it inspiring and very moving. I think the key to that woman's successful delivery was the fact that she looked so much fitter. I swam regularly right up to the day before both births and I'm convinced that the fitter you are, the easier it is.
I think it's worth commenting on what Rob Clark has said. Broadly speaking, the US model of hospital post natal care sounds different to that in the UK. Babies are kept with the mother and the staff support you. I could have gone home shortly after the birth of my 2nd, but I was a Step B carrier in my first pregnancy so I stayed for 2 nights. Apart from the sleep depravation induced by a baby who fed non-stop for hours on end, it was a 'normal' hospital experience
In Japan, if a woman has C/S, she is in hospital for 10 days (4 -5 days in the UK) and the babies are cared for by staff in a nursery - ie not kept with the mother. So much for encouraging 'bonding' and at the end of the day you have to look after your baby on your own when you leave so you might as well get on with it, IMHO!
Regarding the suggestion that individuals brain damaged at birth as a result of being born at home would take action against their mother, how could such an individual have the 'capacity' to make such a claim? Presumably, this would all hinge on the degree of damage? I'm not really sure what this kind of action would achieve apart from destroying the relationship between the mother and child and shifting all of the responsibility of care onto the state.
Regarding the suggestion that individuals brain damaged at birth as a result of being born at home would take action against their mother, how could such an individual have the 'capacity' to make such a claim?
the way they have now if they sue someone else for negligence; someone else sues on their behalf.
(I don't think children suing their parents is in fact the answer.)
"I wish you would offer an alternative argument."
I'm really sorry, but if you're asking me to come up with a reason that EVERY SINGLE WOMAN has a natural birth, I can't and I won't. Unlike you, I don't think that they all do so for the same reasons. I also don't really care what the reasons are-- they don't matter. What matters is that she be given the opportunity if she wants to forgo the painkillers.
"I'd like to see you explain away the myriad claims of superiority,"
First, you need to provide some. How many claims constitute "myriad"?
You mentioned Michel Odent. He's a man so the whole superiority thing doesn't really fly, since he can't claim he's superior by having had a natural birth.
You mentioned Barbara Harper. So now we're up to one. The word myriad and the s at the end of claimS implies more than one.
So I'm afraid you'll have to do a little better before I can attempt to explain the "myriad claims of superiority." I simply haven't seen them.
"the deliberate use of judgmental language ("normal" birth?)"
Again, one example. That's easy enough to explain. It's Henci Goer's personal opinion. She's entitled to her opinion, just as you're entitled to yours. That doesn't mean she speaks for everyone who has a natural birth or calls it a natural birth. It doesn't even mean that everyone who admires her agrees with her every statement.
"the factually false assertions about the benefits,"
Could you provide some examples? Plural. One website won't cut it.
"and the denigration of women who make other choices"
You're as guilty of that as the next person. I think this would be an area that would merit some statistical study. How many books, web pages, etc are out there, and then what percentage of them denigrate women who make other choices? Personally, I don't have the time to do it-- I have a job. But surely if the above is true, you'd be able to back it up with numbers.
"that are integral to "natural" childbirth and homebirth advocacy."
Clearly, they are not. It's quite possible for a woman to want to give birth out of the hospital for any number of reasons. My own job is to provide medical expertise in the context of SUPPORT for the duration of a woman's labor so that she will be less likely to need or want painkillers. Of course I tout the advantages! Are you saying there are no trade-offs when a woman gets an epidural? But if a woman chooses an epidural anyways, I don't sit there and insult her.
Julie, CNM:
"It's quite possible for a woman to want to give birth out of the hospital for any number of reasons."
Okay, then provide us with some plausible reasons and some documentation that women are choosing homebirth for these reasons.
"Are you saying there are no trade-offs when a woman gets an epidural?"
They certainly don't compare in risk to the trade-offs of homebirth: a maternal "experience" in trade for an increased risk that the baby will die of preventable causes. It's difficult not to be cynical about "natural" childbirth advocates' ostentatious concern about the "risks" of epidural when they don't seem to be concerned that the baby is at an increased risk of dying at homebirth.
The bottom line is that homebirth is much more dangerous than an epidural. The increased risk of preventable neonatal death at homebirth appears to be 1-2/1000. The increased risk of neonatal death from epidural appears to be 0.
Again, you are very critical, but criticism is not an argument and it is not even a substitute for an argument. You don't seem to be able to offer any justification for homebirth beyond a woman's personal preference. That seems very disingenous. You know as well as I do that homebirth advocacy is about its purported benefits and your attempts to deny that are not very believable.
What is most distressing about homebirth advocacy is its patent dishonesty. Can you find any homebirth websites or publications that are honest about the increased risk of neonatal death at homebirth? How is a woman supposed to make an informed decision when the most important piece of information is withheld?
Amy wrote:
What is most distressing about homebirth advocacy is its patent dishonesty
This is hilarious coming from you, Amy, considering you have admitted multiple times that you cooked up your 1-2/1000 statistic all on your own. You didn't like the numbers J&D came up with, so you decided to manipulate them and create your own numbers by fudging what is a neonatal and what is an intrapartum death. And let's not forget your laughable "childbirth in nature" estimate. Or your claim that "no one ever died from an epidural."
When it comes to lying (with and without numbers) you're the high grand poobah.
Dr. Tuteur, you're now doing the same thing that you do so well on your own blog: changing the point of the argument when you've lost the old argument.
Your original claim, the one I was challenging, was that the only draw for an unmedicated birth (and I attend births IN the hospital, not out, so it's not like you can accuse me of being a "homebirth advocate") was the need to feel superior. You based this on one homebirth midwife, one natural birth advocate, and one feminist scholar.
Now you're changing it and making it about the honesty of "homebirth advocates," whoever they are. That's not a way to convince the rest of us that feeling superior is the only reason why women want a natural birth.
You DO realize, I hope, that the epidural question (which is what we were ORIGNALLY discussing, NOT homebirth) can be considered entirely irrespective of the homebirth issue (though the converse is of course not true). A woman can plan on a hospital birth, attended by either a midwife or an OB, and totally rule out having an epidural. The thought of a large-bore needle being inserted into one's back bothers some people, you know.
As to why women would want an out of hospital birth...YOU are the one who made the original claim that the only reason is to feel superior. Therefore, it's YOUR responsibility to prove that claim. Remember all those months ago on your blog when you used the analogy of the person claming the moon was made of green cheese being the one whose responsibility it was to prove the claim? That person is you.
shade says "correct me if I'm wrong (and I have no doubt you will)"
You bet I will! My comment was tounge in cheek. As I said in a reply to Mo, if pregnant women can be cavalier with the lives and health of their unborn babies then so can I with the result.
"You do know the direction your arguments are headed in, right?"
I certainly am not taking the arguement there!
There is, however, a difference between having an "imperfect foetus" by chance and a baby brain damaged through stupidity.
I have no objection to my taxes helping the disabled.
I had retired from this particular blog. Congratulations on getting me to comment again!
I came to this discussion relatively late.
The object of birth is to get the baby out of the mother as safely as possible. All things being equal, it's best not to put the baby into a position where he could die a preventable death. Something goes wrong at home, the baby dies a preventable death. Baby has distress in a hospital, his odds increase dramatically. I don't care what the mother's "experience" is. Going into a birth to have an "experience" totally misses the point of the birth in the first place (that was -- to get the baby out of the mother as safely as possible).
The natural-is-good arguments are just a distraction from the essential premise that the duty of the mother is to get the baby out of her. Otherwise she would be fully in a position to shrug it off after she gave birth just beyond the campfire and, while she was tugging the placenta out of herself, her baby was carried off by a hungry wombat. That is nature. Spreading newspapers all around your bed isn't a procedure from pre-technological times.
Pregnancy is not an illness in the same way that diphtheria is, but you can die from both. As a matter of fact, before all these tiresome doctors and nurses came along, a lot more of us -- and our babies -- died as a matter of routine, in childbirth. They died wretched, preventable deaths. Not the accidental kind where Og the Chief Hunter tripped on a mastodon bone and landed spear-first into the mother. The kind where the baby is transverse, or the placenta was previa, or the mother was unvaccinated and exposed to rubella.
It reminds me of the people who say that if someone is having wretched symptoms and they do exploratory surgery, the cancer they discover was caused by the exploratory surgery. If the patient simply never went to the doctor, goes that rationale, everything would be fine.
How were my birth experiences? Well, I really don't care. I got to go home with two healthy babies, so I'm really not interested in the spiritual angle of the thing. I'm pretty clear that those days in the hospital were only very peripherally about me.
I think that seeking staged "experiences" is an overrated process. I mean, other than the ones that happen to us by accident while we are minding our own business. I don't know about you people, but I don't need a stage set to have my accidentally-occurring experiences. But in terms of overrated traumatic nonsense, perhaps what sets the stage for the modern, unnatural freebirth is the modern, unnatural wedding experience. Honestly, if we all could have gone back in time how many women would have had that thing in our house of worship and served cake and champagne there, asked people to please not buy us anything household-related like that stupid wedgewood candy dish we never use, and spared everyone the bridezilla drama from hell about what color the bridesmaids' dresses were going to be.
Yes, I am comparing the decision to have a home birth to insisting that your bridesmaid spend $3000 on just the right cunning little dress for your wedding...but only if, while she stands up at your wedding so you can have your wedding "experience", you insist that she miss dialysis and hope for the best.
Nothing earth-mothery about a tertiary hospital, but the accidental non-staged "experiences" one can have when one isn't using the bodies of one's children to prove some kind of tantrumy point really can really rival the ones you have at the expense of your baby.
Incidentally, the fact that something isn't a crime isn't really the standard for civilized behavior. I mean, personally, I do not feel that my motto is, "I'll do anything if it's not a crime." Getting into a tug-of-war with your own fetus about who has more rights doesn't seem like the rosiest way to begin motherhood to me.
As for the guy that wants to sue because he acted like a jerk after being misdiagnosed, anyone can file a lawsuit. That doesn't mean it won't be dismissed on a demurrer or bounced for failure to state a cause of action or dismissed on summary judgment. In a tort action, not only must there be negligence, but the harm caused by the negligence must be foreseeable, and nexus between negligence and harm must not be remote.
We might also want to stop and think that a 100-word newspaper article probably is dropping a couple of nuances or nine-million, and that it really could be an entirely different case, reading the complaint and the answer. The McDonald's hot coffee verdict sounds like the most frivolous, outrageous suit in the world, until you read that both sides pretty much agreed that they actually served the stuff at the boiling point. Those of you docs who've seen scalding victims probably have a good idea about what boiling water can do to the skin of an elderly individual, and in how few seconds.
But that goes back to the whole "impression" thing, too. The sepia-toned Red Tent sitting around leaking into the straw, birthing into the mud grunting experience seems primal and raw and close-to-nature, until you look closer, and with all the information available.
Rykahna:
"considering you have admitted multiple times that you cooked up your 1-2/1000 statistic all on your own"
Hardly. I have cited multiple sources for the current estimates of preventable neonatal death at homebirth. Have you read the NICE report on antepartum care? Evidently not. I suggest that you master the existing scientific evidence before you accuse people of making things up.
Amy,
How about addressing the "no baby or woman has ever been injured or killed by pain meds used during labor" issue? This is an exact quote of yours.
You ran far from it when its validity was challenged.
So, where do you stand now...has any baby or woman ever been damaged, injured or has died from a the use of pain meds in labor?
I’m finding this thread interesting, thanks Dr. Crippin. However, I would like to see Amy stick to her own blog if she’d like to respond to each and every post. It’s impolite to hijack someone else’s blog. Lets hear from some other people for a change.
I have one thing to say about the ‘experience’ of home birth. I see a lot of people talking negatively about the mother seeking an experience vs just sucking it up at the hospital. I think you’re slightly off track. The experience women seek in avoiding excess intervention at the hospital lies within our bodily integrity. I don’t want to be cut open unnecessarily, and this includes Cesarean as well as episiotomys, forceps, cervical and vaginal tears. I don’t want to be forced to lie on my back and push my baby uphill against gravity. I don’t wish to be tied to fetal monitor machines because the nurses are short staffed, especially when the evidence shows that intermittent monitoring results in better outcomes than constant. (Fewer C-sections) I wish to have a single care giver constantly available throughout my labor as the evidence shows this to be safer for both me and my baby. I don’t want to expose myself or my infant to antibiotic resistant infections that are rampant in a hospital. All of these are about the safety of my own body as well as that of my infant. While this is all about my experience, yes... it’s seeking an experience of safety and body integrity, not the experience that requires quotation marks around the word.
I’m in the US, so this may not reflect UK hospitals.
One other thought about those oft-quoted words ‘but my baby (or I) would have died had we not been in the hospital because.....’ Sometimes this may be true. But often I hear the sentence end with things like ‘the cord was around the neck’ or ‘I bled after the birth’. These statements come from ignorance. A cord around the neck is treated at home exactly as in a hospital, the same drugs are given at home to stop bleeding, same as in a hospital. Babies are resuscitated at home, and a transfer plan is always in place in case of further treatment being necessary. A transfer from home to hospital means the health care team is being responsible and cautious. A good thing to always have a plan B.
It sounds like the UK has problems offering home birth because of lack of resources. The US has problems setting standards for all midwives across the country. Some states do, some don’t. The conditions from one state to another are so different as to make it impossible to generalize the safety factor. Some states allow direct entry midwives to conduct home births, but restrict nurse midwives from doing so. Some midwives are practicing legally, but are not allowed to so much as carry oxygen to a birth, much less other lifesaving drugs. How safe is that? Some home births take place within 5 minutes of a fully staffed hospital, others 20 minutes from the nearest community hospital where there is no anesthesiologist on staff. The safety of birth at home is contingent upon many variables, and it should be up to the parents to decide what risks they are willing to take in their particular living situation.
Lets hear from someone other than Amy.
Referring back to the 'Closing maternity units issue', Kings Fund are currently conducting a survey amongst Health Professionals into the safety of maternity services
http://www.medicalnewstoday.com/...hp?
newsid=71327
perhaps any midwife, nurse, Doctor out there who believes that the service is unsatisfactory should complete the survey.
Coming in a bit late in the day, but to follow up the legal comments earlier:
Karen said
Does a mother not owe a duty of care to her baby?
No.
+++
once the baby has been born, though, there is a clear criminal liability for failure to provide / get 'adequate...medical aid' for a child (s2(a) Children and young persons act 1933). Although this is classically for long-term neglect, it could apply to a stubborn insistence on new-age remedies rather than calling an ambulance in the short term.
----
Civil liability for independent midwives - in Bolitho the House of Lords made clear that even in clinical negligence the courts can decide that a common professional practice (for the Bolam test) is so illogical that it amounts ot negligence, i.e. a midwife could be found negligent even if all the other independent midwives would have done exactly the same thing. Taking uninsurable unnecessary risks, especially with a weak research base, could be negligent despite any professional body / certification etc. (Compare the finding in Re Herald of Free Enterprise that putting to sea in a ferry with the loading doors open, despite being standard practice in the industry, was so damn silly that it was negligent).
It’s the language that the freebirthers use which I find so objectionable, all that talk about their form of birth being superior to any other.
If I was a freebirth fan I would be very wary about allowing Jenny Hatch to be the advocate as her views are, frankly, distasteful and offensive.
Amy Tuteur may have a personal agenda, but at least her opinions seemed to be supported by science; Jenny Hatch’s views seem to centre on the fact that God speaks to her and has told her she is doing the right thing which is where, for me, her arguments pretty much jumped the shark.
I will always support any mother’s right to choose how she wishes to give birth so long as a) she accepts any and all possible consequences of that choice and b) that she doesn’t go around espousing the view that her choice is in some way better than somebody else’s. It isn’t.
The trouble with threads like this is that so many things get muddled together. Personal opinion or wishful thinking gets muddled with facts – which seem to be a bit thin on the ground anyway. Personal hobby horses get taken out and ridden to death, statements of personal prejudice get left standing as “facts” and argued about. If the risk of adverse outcome in home births really is 1 in 1000, that seems to me quite low. The question is, is it an avoidable, predictable risk? Most mothers are seen as “low risk” – but that is a statistical category, not a medical one. Babies are born damaged – or dead – because things go wrong unpredictably in low risk pregnancies which suddenly become high risk. Personally I wouldn’t dream of a home birth for all sorts of reasons, but I can understand why any woman would want one. Some women do have ghastly, damaging experiences in hospital. It seems to me reasonable to worry about unnecessary interventions, but the risk of, say, drugs or epidurals are being magnified out of all proportion. The homebirth that goes well must indeed be a lovely thing – the homebirth that goes badly doesn’t bear thinking about. Women do get traumatised in hospital – where are the women who have been traumatised by a nightmare home birth? They must exist, but keep very quiet.
And then there is the question of whether “natural” childbirth advocates denigrate other women I don’t think there is any question of that. Does it matter? Not really. What does matter, I think, are the sometimes dangerous myths that are allowed to proliferate. It can be hard for ordinary people to get access to reliable, scientifically proven information. Childbirth CAN be scary, and it can be dangerous. The rhetoric around what is “natural” and “normal” can influence women in negative ways, and add a lot of unnecessary anxieties and feelings of failure to something which is already emotionally fraught. The women who go around convinced they are some kind of Alpha Female because they had an easy birth can be very irritating, but only the vulnerable take them seriously. I can’t help but feel a twinge of worry at the lady who thinks going swimming guarantees a healthy baby. It won’t do any harm, may well do some good. Most babies make it regardless of their mothers beliefs and behaviour, (even actively dangerous behaviour) but the strong implication throughout this thread that normal people always have normal babies, that birth damage or stillbirth only happen to the culpable and can be foreseen is an illusion. Birth can, on rare occasions, go suddenly, catastrophically and irreversibly wrong. Being in hospital isn’t a guarantee that something can be done, but to me, being at home expecting a beautiful experience would be a very scary prospect, and very hard to live with.
Regarding the suggestion that individuals brain damaged at birth as a result of being born at home would take action against their mother, how could such an individual have the 'capacity' to make such a claim?
the way they have now if they sue someone else for negligence; someone else sues on their behalf.
(I don't think children suing their parents is in fact the answer.)
jayann | 18.05.07 - 10:00 pm | #
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But how does a brain-damaged child make the decision to ask someone else to sue on their behalf? How could the law be sure that the child understood what they were doing? I guess in the case of medical negligence, the parent sues on behalf of the child for the cost of continuing care.
The arguments about 'who pays' is a dangerous path to tread, in my opinion, since there are various diagnostic tests which can identify specific conditions, which would affect the child's quality of life, before birth. Absolutely these conditions are 'chance' - some parents prefer not to know about the existance of possible problems and refuse scans etc - are they negligent or simply exercising choice? Is a mother who chooses to birth at home negligent if something were to go wrong, or is she exercising a choice offered by the state? It's a tricky one. Either way, the state - ie tax payer picks up the bill - is one of these bills more 'acceptable' than the other?
In answer to Jayann's question about the "capacity" of brain damaged children, I think another myth is floating around here. Brain damage is a literal description - not a euphemism for "hopelessly incapable" and certinly not for "homicidally inclined" as implied in by the psychologist quoted earlier. Many children with cerebral palsy are not intellectually impaired - some are. Fetal distress, prolonged labour, all kinds of unpredictable events result in the loss of brain cells - even, some recent research seemed to show, a "normal" birth can result in some damage, but the brain is a complex and unpredictable enitity. Presumably, a child could sue a parent in the same way a passenger can sue a driver.
But how does a brain-damaged child make the decision to ask someone else to sue on their behalf? How could the law be sure that the child understood what they were doing?
well of course the law has to make some assumptions but these tend to be, e.g., that the child would want good medical treatment and a suitable place to live. Where a parent cannot represent a child or where it's thought the decision of a parent or parents might not be in the interests of a child, the Official Solicitor acts (and acts for adults too, of course)
http://www.officialsolicitor.gov...k/os/
offsol.htm
http://en.wikipedia.org/wiki/Tony_Bland
The arguments about 'who pays' is a dangerous path to tread,
really you should take that up with Matt, my comment was that it was inequitable that a child disabled by medical negligence could sue (through their parent/s or other qualified person) and recover fairly massive damages (sometimes; it is not easy...) whereas a child disabled by a parent's negligence has no recourse
and must rely on what their parent/s and the state can and will provide, which may not be that much. BTW
Is a mother who chooses to birth at home negligent if something were to go wrong, or is she exercising a choice offered by the state?
my comments applied to "freebirth" (birth at home with no medical care whatsoever) and so did Matt's.
In answer to Jayann's question about the "capacity" of brain damaged children,
not my question, Anthea's (but it's my fault as I didn't put italics round her statement -- that was a slip). My reply didn't address the issue of the capable brain-damaged but let me do that now. Yes, people with cerebral palsy can not only be non-impaired, they can of course be intellectually outstanding.
My 1st child was born in a busy London hospital. I was 2 weeks overdue, so labour was induced first with with prostaglandin, and when that didn't seem to be causing cervical dilation, I had an oxytocin drip. I also had an epidural. The midwives were very busy and I was left alone with my husband (a doctor) much of the time. Eventually when labour was not progressing, and although monitoring showed the baby was fine, some midwives were suggesting that I might need a CS. My husband suddenly realised that I had not had a catheter fitted, in spite of several bags of fluids being inserted. It turned out that my full bladder was stopping the baby's head from descending, and my daughter was delivered soon after. I had an episeotomy and was left for about an hour afterwards, in the labour room, on blood soaked sheets, before the nurse could come and stitch me up. The next night I felt so tired and alone, and desperately wanted my husband to help me look after my daughter and myself.
When I was pregnant again, I registered at a different hospital, which was housed in a dilapidated building, but which offered a community midwife system. I read about home-birth and discussed it at length with my sceptical husband. We agreed to opt for a home-birth, as we lived close to the hospital and the midwife team were very experienced and well equipped to deal with some of the possible emergencies.
I attended a few of the local home-birth support meetings, but they weren't for me as there was too much talk of homeopathy, anti-vaccine chat, and the use of the term 'allopathic medicine' which is so irritating. There was also too much emphasis on the 'natural' talk and a certain smugness among some that their way was something akin to holier. As it happens, I went overdue again and was induced in hospital again, which also happened on my 3rd pregnancy. These times though I left the hospital asap and went home with my baby to recover.
Properly attended home-births, for women at low risk of complications, within set paramaters and who have been monitored carefully and who are fit and well, are a choice I think should be made available. Well run birthing centres should be funded too.
Anonymous | 19.05.07 - 10:43 am | #
++++
Ooops, sorry that was me!
Didn’t mean to post anonymously (don’t really agree with it unless there’s some sound professional reason why you need to keep your identity secret).
http://www.justice.gov.ab.ca/han...05.aspx?
id=4395
+++++++++++++
THIS IS THE EXPLANATORY LINK
http://
injurylawblog.squarespace...ategoryId=16617
Alberta Child wins landmark settlement for injuries suffered while she was a foetus
Pregnant mothers beware! Your unborn child can later sue you, if you injure them in a car accident caused by your recklessness or carelessness (at least in Alberta)
+++++++++++++
Some people asked what this looks like. THe second link describes it succinctly, with reference to a previous Supreme Court of Canada Case that was not ruled in the same way, but from which someone derived that there was a loophole that case law could be made in certain cases.
Yeah- clear as mud, I know.
The point I made before still stands- Will pregnant women have insurance riders on them in the future because of these types of things? Will "driving while pregnant" cost you more as a woman because of the way insurance tends to work?
This has been an interesting, if at times infuriating, thread. But to return to the question of whether infants should be able to sue their mothers, it seems to me that as childbirth has become safer, a certain complacency has set in. The expectation of a safe delivery has replaced the fear of earlier generations. There is a risk in home birth, because there is a risk in any birth - so, rationally, if a child could sue on the basis of that risk, he/she could equally well be able to sue a mother for getting pregnant in the first place. It has been implied here, somehow, that sueing a hospital is a simple matter - but that is very far from the case. Most people don't, and hospitals aren't famous for 'fessing up to blunders. Even mothers who take crazy risks, do everything wrong can have healthy babies. I can't see the tendency sometimes reported from America of regarding women as walking incubators catching on, so I think any future change in the law would only apply in very egregious cases. So any dream of reducing taxes by dividing unfortunate infants into the deserving and the undeserving is likely to go unrealised.
Will pregnant women have insurance riders on them in the future because of these types of things?
Unclear as the settlement was out of court, and the Alberta Act applies only if the mother carries third party driving insurance (as, I'd have thought, she should).
Will "driving while pregnant" cost you more as a woman
Driving recklessly while pregnant should carry the same penalties and liabilities as driving recklessly while not pregnant. (I note that the woman in question wanted to "lose" the case, so she could provide properly for her child.)
As far as whether a child should be able to sue a mother for doing something criminally negligent that caused harm, you might want to look at the (at least American) concept of "sovereign immunity." Government officials are given immunity for decisions they make in the ordinary course of business, because otherwise, it would be absolutely impossible to make a decision because someone is almost always adversely affected by any decision by any person in any setting. Even if I decide that I am going to serve my children macaroni and cheese once a week, I guess in theory the peanut butter industry would have a grounds for complaint.
However, in the US (I don't know anything about UK law), there is a law that allows citizens to sue governmental officials for intentional deprivation of constitutional rights. This is a difficult burden to meet, but it does give redress to innocent civilians wronged by intentional governmental misconduct.
There is probably something to be said for the application of a similar model to parents. The decision to give birth at this hospital rather than that, or the failure to consume enough folic acid before the need for it became public would not be actionable. But the boneheaded insistence of a 42-year-old first-time mother despite the urgings of the ob/gyn to give birth to twins, one of which is in the breech position, at home...?
Yes- she did want to lose the case. Which still makes me ask the question that if this is possible, will the insurance industry eventually want to know when a woman is pregnant, and then adjust premiums accordingly? (Let's say they start with women with a poor driving record first, then work their way down to cover all.)
"Women as walking incubators"
Perfect image!
K C Saul, that's the kind of distinction I had in mind. (Mo, anyone driving a car is a potential risk to other people -- because of the unforeseen -- but we still have laws against dangerous driving, and drunk driving, there's nothing silly or strange about that. Equally there'd be nothing silly or strange about seeing -- e.g. -- freebirth as reckless.) Impatient patient, your guess is as good as mine.
"a 42-year-old first-time mother despite the urgings of the ob/gyn to give birth to twins, one of which is in the breech position, at home...?"
I think in England you would be certified, not sued?
Mo says "I think in England you would be certified, not sued?"
No you wouldn't as thing stand but if NuLab get their way!!!!!!!!
I just noticed that the infamous Dr. Amy has just taken on homebirth at Salon. They did a quickie article on Denver Westwords lengthy piece on UC Birth, and in the comment section the good doctor is spewing her verbiage like a good pharmacuetical soldier.
http://www.salon.com/mwt/broadsh...hing/
index.html
Its funny because she is attempting to take on Rayner, who has conducted research on imprinting and birth for forty years.
http://www.intuit.org.uk/
She just jumped on her merry go round of "its not scientific" to respond to his research, and his personal witness that NO ONE at the pharma companies was the least bit interested in his research for the past few decades or the fact that the past ten years have seen an upswing in private research connecting drugs at birth to drug addiction later in life.
No, she just spews her rhetoric and keeps claiming that homebirth is statistically more dangerous than hospital. Mr. Rayner wondered if she was shilling for big pharma and I still do too.
Jenny Hatch
Jenny
You really are quite loopy aren't you?
I feel anxious for your children. I hope your partner is more in touch with reality than you...
Oh come on Dr. C. It is so obvious you are the infamous Anonymous.
Come out of the closet will you? And quit the sock puppetry.
It's embarassing to watch.
Jen
I know that any of us showing up at a snooty medical conference would be "eviscerated" in short order by the myriad "scientific studies" that have been conducted to shut us up and shut us down....What individual family or independent researcher could EVER stand up to such a wall of self righteous indignation and mountain of studies, research dollars, and flood of money?
Certainly not me. And I don't blame Henci for not taking the time to debate someone like you. I have a similar discussion on the topic with winsetz on web design company. Even I think, You are just a tad frightening and somewhat scary in your demeanor.
Oh come on Dr. C. It is so obvious you are the infamous Anonymous.
Come out of the closet will you? And quit the sock puppetry.
It's embarassing to watch.
Jen
Jenny Hatch | Homepage | 21.05.07 - 6:04 am | #
**********
Jenny, I am ABSOLUTELY NOT the "infamous anonymous".
I never post comments under alternative names; I always sign them.
Like you, I get irritated by "anonymous" comments - not that I mind the use of psuednomyms, but I would prefer them to be recongnisable ones. There are hundreds of comments on lots of topics by anonymous commentators, just as there are lots from "nurse".
I would prefer it if anonymous commentators could individuals their anonymity - "anonymous01" would do.
John
Jenny,
I can say with absolute certainty that my wife and son would now be dead if labour had taken place at home.
‘the good doctor is spewing her verbiage like a good pharmacuetical soldier.’
Jenny Hatch
+++++++
This from the woman who earlier told us that: “I felt prompted by God over 17 years ago to become self sufficient in my Mothering.”
Sorry, Mrs Hatch, but your credibility is already shot.
Rob,
Did you ever think for a minute WHY God may have prompted me to become self sufficient?
Yesterday it hit the wire service that 30 minutes away from my home a monkey at the Denver Zoo died from Plague.
Ever hear of Plague?
As a mom I am not too interested in being in the same hospital where people who are sick with plague are being treated and dying while I am giving birth to my child.
As a christian I have read the prophecies from all of the ancient prophets, and as a mormon I have read all of the prophecies about the end times from the modern prophets, and they all talk about plagues.
Jesus Christ himself eloquently described our day in Matthew 24. Read it and then you may understand why I as a mother, have felt prompted to wean our family from health care. AND claim to have had heavenly help every step of the way!
http://scriptures.lds.org/en/matt/24
Verse 19 talks about mothering and verse 7 mentions pestilences.
The definition of Pestilence in the scriptures is outlined in many chapters of scripture. With the motherload of these diseases taking place in the end times.
">Pestilences
Take a sec to read through it and then you may have a better understanding of why we have made this most important choice to birth at home alone and seek after and find the skills that have helped us feel a little more comfortable with this most controversial of choices.
No one, not one of you can claim that the current birth machine will always function as is for the duration of our earths history. It is crumbling in the UK and after we get fully socialized in the US it will crumble here and have various peaks and valleys around the world, but my self sufficiency will carry the day for our family no matter what is going on outside of of our home.
Jenny Hatch
Oh, and Rob,
Here is a link to an interview I did with Susan Fierro-Baig on Nuclear Survival for Families.
http://www.naturalfamilyblog.com...ves/
000225.html
Know what the number one need is going to be if societal infrastructures collapse?
Breastmilk.
Jenny Hatch
As a mom I am not too interested in being in the same hospital where people who are sick with plague are being treated and dying while I am giving birth to my child.
as a Christian, you might want to feel compassion for those people and even tend them.
Jenny Hatch,
We are trying to base our arguements here on scientific and peer reviewed evidence not subject religous crap.
By the way, I am a practicing Catholic.
I have to agree with jayann, your remarks re the plague are selfish and show that your are only interested in what's best for you and your experience and circle. Fuck everyone else!
Go away and pray for your soul.
Jayann,
I am a very compassionate person and love helping people in my community. But while I am giving birth, I don't have an interest in exposing myself and my newborn to a deadly disease.
Which is why I give birth at home surrounded by family germs.
Bubonic plague is rather deadly and our family is all about life. Oh, and as Americans, The pursuit of Happiness.
What makes me happy as a mother is giving birth to a healthy baby in my own bedroom.
Oh, and Matt, my friends who are also into UC Birth have "peer reviewed" my claims, tried it out for themselves, and we all agree....There is no place like home!!!!
Science does have its limitations when the art of mothering is what is being debated.
Creating a healthy child is a form of art.
In this creation process having an OB directing/producing/acting the starring role/ and then writing the reviews in the newspaper the next morning make this one horse production a farce.
Babies should be the star of the show, with the mother and father direction and producing. And they should be free to hire any production company, costume, makeup, sets, design, choreographer, etc etc to make the show a wonderful experience for the baby.
(Sorry for the theatre analogy, I was a musical theatre major in college)
But it fits.
Time for the OB's to be fired, and all theatrical reviews that they write for themselves held up under the most intense scrutiny as being somewhat self serving. The global audience has been spoon fed a pack of lies about motherhood all in the name of a "really big show".
US Ticket prices $7,000.00 for a healthy mother, if you are a sicko and your baby needs NICU care....well the price goes up $250,000.00 to half a million dollars please. Just mortgage your whole future, house, car, any financial stability you thought you might attain. Doctor Actor/Director/Reviwer has a payment due on the porsche. And we all know how expensive malpractice insurance is...
Jenny
To say that a mother should be tried for manslaughter if her child dies in an unassisted homebirth is the ultimate in hypocrisy! You, Dr. Crippen, I am sure, deal with births daily and yet have no more personal interest in the hundreds of women you see than the person they pass on the street. You have no right to say that a woman who nurtures a baby in her womb for 9 months takes no care for her baby and is not careful of the delivery of that baby. I have never known a mother who wanted her baby and felt it growing in her womb for those 9 months that would ever allow anything to harm her baby willingly.
It is so much hypocrisy for you to say that you know better than the mother of the baby how to care for her delivery. Just because you have had "schooling" in how to deliver a baby does not mean you really can understand it. You, sir, are a man. Until YOU have a baby and understand completely all that a woman's body goes through giving birth, I will thank you not to make broad assertions of your righteousness in your medical prowess. Seeing how well-versed you are in things medical, I think you understand the impossibility of yourself giving birth. Therefore, please do not set yourself up as an expert on a subject with which you have no personal experience.
As for a child's rights in suing their parents for malpractice in freebirth, please give me statistics on how many freebirths have ended this way. Then give me statistics on how much malpractice there is in hospital births. When you have concluded that the vast majority of homebirths are safer than the majority of hospital births, you will see why a mother would choose to have her baby at home. And if such a law was passed to allow children retribution for malpractice in birth, you better be sure you never make another mistake during a birth. For if a mother and father can be sued for malpractice, how much more will the average doctor have to fear than he does now? Beef up your malpractice insurance, Doctor.
I think your tactic, Dr. Crippen, is all about fear. "Keep the women thinking we are the smart ones and that it is impossible to do it on your own without a tragedy occurring. After all, WE never could make a mistake. We are gods (oh, excuse me, I meant doctors)." I will put myself in the hands of an infallible Almighty God instead of fallible man, thank you very much.
Amy Burton:
"You, sir, are a man."
Well, that's ironic. "Natural" childbirth was invented by men. Grantly Dick-Read was the "father" of "natural" childbirth. Lamaze, Odent and Bradley are all important developers of the various schools of "natural" childbirth. Indeed, I can't think of a variation of "natural" childbirth that is named after a woman. You don't seem to have a problem with that. Why not?
I d'like to throw in another thought.
Assuming that freebirthers play the "natural" card, how does that go along with the universal practice (in unmedicated times and places) that women give birth in the presence of other experienced women (the equivalent of midwives), not alone at home with their husbands?
Isn't this aspect of freebirth on the fabricated side?
No, natural childbirth was not invented by a man. A man may have written a book on it, but women have been doing it for eons.
Hospital births are a recent invention, not natural childbirth. Can you really believe that natural childbirth is a recent invention?
To prosecute a woman for birthing at home is the worst abuse of the justice sysstem I can imagine.
Take back our birthing rights. I would never have chosen to birth out of the hospital, if that doctor would have put down his knife when I told him to stop cutting me.
Okay, so the mother who has a home delivery with a baby that ends up in trouble has to be sued, but what about aaalllll those mothers and babies that end up with health problems after something goes wrong in the hospital? Do we have to sue the mother than as well, because she decided to have a hospital birth iso a home birth where the interventions wouldn't have happened?
During the "hippy 1960's" I attended a close friend's home birth - it was supposed to be a spiritual and uplifting event. It wasn't. A breech presentation, confusion, desperation, a trip to the hospital with the baby half out. Result: one dead baby and desolation for the now non-parents. And later a big court case. Not worth the tradeoff - a spiritual event for the mum versus a dead baby. My kids (3) were all born in hospital and we found only kindness and caring and they're great! Oddly enough my friends sister (who had similar leanings) has a brain damaged son - an adult now, sentenced to a half-life due to (I suspect) his mother's self indulgence.
Sometimes, homebirth is the best way to go. I'm not talking about unassisted... I have fast labours, and quite frankly, had I tried to drive to the hospital, the baby would have been born on the highway. I would NEVER have made it. Instead, I had a wonderful midwife who did the driving and helped deliver my almost 10lbs baby. The delivery wasn't without complications but they were taken care of because I had someone there. I would have been alone on the highway if the hospital was where I had planned to deliver!
"Natural" does not mean unattended. Long before doctors were involved in childbirth women had assistance while they were labouring ---experienced attendants helped with the birth. These births were unmedicated and did not take place in a hospital --- presumably that would meet the definition of natural?
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