We’re having a bit of a kerfuffle in the comments right now, concerning the question of home birth v. hospital birth. And I have to tell you, it’s another time in my life when I realize how amazingly lucky I am to be married to Grrl, and not to any number of previous wives or girlfriends who lack her basic good sense.
When we were preparing to have our first child, there was no debate about a hospital birth. There was no agonizing about the joys and wonders of childbirth. Grrl–rightly in my mind–saw childbirth as a job she had to do, the focus of the job being a healthy, safe baby. Nothing else was particularly interesting to her.
In direct contrast to the picture being painted by the pro-home birth advocates on this site and others, the establishment actually tried to persuade her the other way. The dangers of an epidural were duly explained. The joys of a “natural” childbirth were extolled in our preparatory classes. To all of this, the Grrl simply raised her chin and stuck with her birth plan, as worked out between her and her OB.
The birthing room was quite nice, the bed extremely comfortable, the nurses very pleasant and affable. I had a wifi connection and a bench to sleep on, she was constantly monitored for any signs of danger, helped up if she needed or wanted to walk. We were never treated in any way that was not pleasant and accommodating and respectful.
In other words, the nightmare scenario that some home-birth advocates project, where women are–apparently–strapped down to beds and force fed drugs before being C-sectioned for no reason, is not an accurate portrayal of modern medicine at a decent hospital.
It helps that Grrl works in the NICU (Neonatal Intensive Care Unit). She knows the kinds of things that can go wrong in a birth. She knows what can happen to a baby during a trip to a hospital, how a baby that should be fine can end up on life support, fighting lung infections in it’s first week of life. She swims in that sea.
So there was never any question of where we would be having the baby. Home birth, birthing center… these options were simply ignored. She stayed a focused, dedicated, and fierce advocate for her children.
Grrl worries, now, whether she should have gone natural. She has occasionally admitted to a tinge of regret that she was so businesslike about the whole matter. But we only have the opportunity to have that conversation, and worry about that sort of trivial detail, because we have two beautiful, healthy children. It is a luxury to be able to worry our heads about “fulfillment” or whatever, because the job of bringing the babies into the world is done.
It’s not like we could possibly love them more than we already do!
Ticktock
philosodad
Rob T
Jason
November 9, 2009 at 4:06 am |
I was so excited to read the kerfuffle that I scrolled right down to the comments. It’s really a very polite kerfuffle. Everyone is being very civil.
I have to say that I was kinda the same as your wife. I never even considered alternative locations. It was hospital or nothing for me. And no birthing classes. I read a lot of books. Just seemed cheaper than taking classes.
November 9, 2009 at 3:26 pm |
I’m curious as to whether you also had a positive experience with the hospital, in terms of treatment, attention, sense of control, and so forth.
November 9, 2009 at 2:12 pm |
I think there’s a lot of guilt wrapped up in parenthood no matter what you do. I admire your wife for being business-like and making sure you ended up with a healthy baby and a healthy wife. That’s nothing to regret.
November 10, 2009 at 12:55 pm |
Well, I guess the hospital I was in was neither modern nor decent. I was one of those strapped-down, drugged (while having a plan that stated I’d rather not be), “sectioned by fear mongering” mommies. I’m a fair skeptic myself, but that experience was so close to what your critics describe that I find it hard to believe it’s not commonplace.
My only goal was a healthy baby, and we got that, but I don’t think you can discount the emotional trauma of such an experience on the Mom. It makes those first weeks torture, instead of just hard work.
Contrast that to the excellent state of the art care my son got when he needed heart surgery at the regional children’s hospital, and you realize that there is a real problem in the birthing business.
November 10, 2009 at 11:13 pm |
“I’m a fair skeptic myself, but that experience was so close to what your critics describe that I find it hard to believe it’s not commonplace.”
—————-
How does that follow? You’re a sample of one. I’m a sample of one. There’s no skeptical reason to conclude that your experience was commonplace and mine was not. There is a reason to conclude that our experiences were different.
I’m curious, though… were you consulted about the c-section prior to surgery? Were you given a list of options? Were you only drugged because they were about to cut into you and otherwise the shock would probably kill you, or were you drugged without your consent prior to that point?
November 10, 2009 at 3:26 pm |
I find the whole natural/home birth stuff just one more way to get a woman to beat herself up, no different in strategy from women’s magazines and the beauty industry. Your not skinny enough, not made up enough and NOW you didn’t even give birth the right way. It’s so pernicious.
As someone who had a great hospital and epidural experience, I fully accept that my way is not for everyone. Why don’t the people in the natural birth realm have the imagination to conceive that not everyone is interested in what they’re peddling? We’re not poorly informed, we’re not afraid we’re just not interested. Move along.
I would also point out that there is a lot of misrepresentation about birth in many books and classes, even mainstream ones seem to have the natural philosophy creeping in. The one that bugs the heck out of me is this 1st stage of labor thing. I was told (and many I know were told) that there’d be this period of up to 24 hours where contractions would be 15-20 apart and very manageable. In this time, I could watch a movie, do some yoga and make a frittata. This was also the time when I guess you can slip into this fabulous mind over matter state where you can cope with the pain. Well guess what? No frittata for me. I went from zero to five minute apart contractions (more like convulsions and vomiting)within the space of about 20 minutes, maybe that 20 minutes was my first stage. Turns out my experience is just as common as the slow labor experience, but somehow no one mentions it as ‘normal’, because it doesn’t fit the narrative we’re supposed to buy into.
I also don’t do regret and guilt about my parenting, whether it’s birth, feeding, diapering, or sleeping, none of that. I feel bad if I screw up and could have prevented something, opening a car door too fast and accidentally knocking it into her or promising a playdate with a friend without having confirmed that we’re still on. But wondering if I gave birth the right way? no way.
November 11, 2009 at 12:33 pm |
I think you’re engaging in some fallacies here. You seem to draw a false dichotomy between women who do non-hospital birth, and therefore must be doing because of some hippy-dippy “spiritual” beliefs or something, and women who use hospitals, who are “businesslike.”
I chose a birthing center because the best scientific research supports a low-intervention approach to normal births (and yes, I thank goodness for the medical expertise we have to handle non-normal ones), as the safest and healthiest choice for both mothers and babies. And it is most likely that you will get practitioners who adhere to that approach outside a hospital, though of course it is perfectly possible to get lucky and find them in a hospital setting as well.
There’s also the old fallacy “at least we have a healthy/alive baby.” I for one was aiming for more than that – I wanted an optimally healthy baby, an optimally healthy mom, and low stress about whether someone would try to sell me (or force me!) into something unnecessary and possibly detrimental at a moment of crisis. So many babies have be “rescued” by heroic OBs doing c-sections, when in fact the interventions ordered by the same OB probably caused the crisis that made the surgery necessary. It’s not as black and white as “the baby survived, therefore it is the best option.”
November 11, 2009 at 1:57 pm |
This is just more of the same hospital phobia. The idea that you can’t find a low-intervention OB except “outside of a hospital” is just ludicrous. You don’t have to “get lucky”. The way it works is this: you find an OB you’re comfortable with. Then you give birth at the hospital they hold their privileges at. It isn’t like you get a random stranger for your OB when you go to the hospital.
Also, what evidence do you have to suggest that the interventions ordered by an OB (whatever those might be) cause any significant number or crises? What is this “so many” number you speak of, and where are you getting it?
Speaking only of our experience, the only intervention that we were offered was an epidural. And even that won’t be offered past a certain point, certainly not at a moment of ‘crisis’. Past a certain point, you’re going au natural whether you like it or not. Listening to the “natural” childbirth in the next room pretty much settled any doubt about that question in Grrl’s mind.
November 11, 2009 at 3:24 pm |
I’m really glad you had a good hospital experience! Sadly, I have heard plenty of stories from friends on the other side of the coin too. My point was merely that if you want a natural birth, going to an environment designed to support them is a better guarantee than going to a hospital, where epidurals, pitocin, and EFM are standard procedures.
And yes, you do wind up with random strangers attending your birth in the hospital – you are at the mercy of the nursing shifts, with the doctor typically arriving to catch the baby at the very end, if s/he is avaialable.
One instance of interventions increasing c-sections and failing to improve outcomes is continuous electronic fetal monitoring. It seems to make sense, but the research shows it results in worse outcomes: http://parenting.ivillage.com/pregnancy/plabor/0,,8wvj-4,00.html
And yeah, naturally laboring women yell a lot sometimes – how is that an argument for using drugs that carry risks?
November 11, 2009 at 4:09 pm |
“One instance of interventions increasing c-sections and failing to improve outcomes is continuous electronic fetal monitoring. It seems to make sense, but the research shows it results in worse outcomes:”
I checked the research. The article that your source cites (or rather, the article that the review that your source cites reviews) found that there was a decreased risk of infant seizure, but an increased risk of C-section or surgical intervention. So this outcome isn’t “worse” in the unambiguous sense that you suggest. It is possible that some number of c-sections were performed that is higher than needed, and possible that some infant injury was avoided as well. The literature you cite does not support the point you wish to make.
In fact, the paper you point to seems to directly contradict your earlier point that “natural” childbirth is more healthy for infants.
November 14, 2009 at 11:51 pm |
“And yeah, naturally laboring women yell a lot sometimes – how is that an argument for using drugs that carry risks?”
There’s a strong social influence that discourages yelling. I was once hit by a car, and while I wasn’t injured in any definable way (no broken bones, just a lot of bruises and this weird weakness that made it hard to cross a room, but cleared up within a few days), it was excruciatingly painful. I yelled and moaned because I felt what I can only describe as a biologic imperative to make noise. I felt bad for the people that saw me get hit, and everyone seemed very shaken. When I got to the hospital, I could tell it bothered people that I was moaning. But I had to. I really wanted to stop, but I had to. It didn’t make me feel better, I just had to make those noises. It was the only thing that made breathing worth it. I felt like I was sub-human, like I wasn’t myself anymore, but instead had been reincarnated as Pain. I was just Pain, and nothing else, and it was horrible.
At the same time, I was terrified that I was seriously injured. When I got to the hospital, I desperately wanted pain medicine, but I didn’t ask for it, because I didn’t want to distract anyone from finding that my spleen was bleeding (it wasn’t). So I can understand that if you’re afraid enough of the medicine hurting you or the baby, you can forgo it. You just have to be very afraid.
Pain is a very good reason to take drugs that carry risks. A very good reason. I understand that sometimes labor is too fast, or the anesthesiologist is too unavailable, or your spinal cord is too unusual to get an epidural. And I’ve heard of people undergoing natural childbirth after getting a headache after the epidural. But pain is everything. Just because it ends, doesn’t mean you can forget.
November 16, 2009 at 11:52 pm |
@philososodad
This study pretty much blows most of your reasoning out of the water. http://www.nhs.uk/news/2009/04April/Pages/HomeBirthSafe.aspx
While we’d have to account for some variations in training of homebirth midwives (in the US some are CNMs while other are not), this really undercuts your 1% argument.
On a side note, that line of reasoning, is the same as my neighbor’s who makes her kid wear a helmet to the park. If he did fall and fracture his skull, he would be better off wearing helmet. Bravo to you for sounding only slightly less ridculous that her.
The rancor with which you argue this topic makes me think there is something more personal going on, like you are attempting to make yourself believe you made the right decisions about your wife’s births. Ultimately, these decisions are personal and while a homebirth might be the right choice for one couple, for another it might not. Be comfortable with your decision but don’t demonize those who think differently than you.
November 17, 2009 at 12:55 pm |
From your link: “It is important to note that this analysis excluded a large number of women with pregnancy and labour complications, as well as those who had premature onset of labour, required induction or who had additional risk factors such as a previous caesarean or twin pregnancy.”
———–
Step 1: Read the link.
Step 2: Post the link.
You’re doing this “research” thing backwards.
And I’m not employing any rancor, or demonizing anybody. All I said was that if you choose home birth, you are betting on a complication free birth. That’s it. You’re being rancorous and insulting.
November 17, 2009 at 6:02 pm |
Not at all, the part you quoted is saying the study compares apples to apples which proves my point. Those with complications don’t/cannot attempt homebirths in the Netherlands. Try to understand and comprehend the basis for my quotes before becoming unduly pedantic. Take your time. Shooting off like you just did makes you look bad.
November 17, 2009 at 6:17 pm |
“Not at all, the part you quoted is saying the study compares apples to apples which proves my point.”
———–
Let’s try this again: my point was that if you choose home birth, you are betting on a lack of complications. The study you quoted excludes all cases where there were complications. So if it proves your point, your point is completely unrelated to my point.
Step 1: Understand what you are going to criticize.
Step 2: Understand the research that you are going to use as support for your position.
Step 3: Use the research to support your critique.
Your critique is tangential to my point. In addition, even if it were targeted to my point, it would not even apply to US homebirth, which takes place in a completely different health care system with different standards, especially for midwife training and certification.
In other words, your “torpedo” is so far from blowing my argument out of the water that it would barely register on my arguments sonar.
November 17, 2009 at 7:48 pm |
You are right, I’m giving you way too much credit. Your point is that people who have homebirths don’t plan on complications? When I go to the park I plan on a injury free trip and don’t have my child wear a helmet, this is your line of reasoning? I am capricious because 5 in 1,000 times there will be a head injury and I don’t take precautions. Really?
Step 1 make a cogent argument that adds to the discussion.
To review what the study findings: Most of the complications associated with bith can be anticipated and the venue (hospital or home) doesn’t impact the outcome of those that cannot be anticipated, in the Netherlands. This does in fact dispute your point…..again, you’ve aquitted yourself rather poorly except in one area:
Your main point, really, seems to be justifying why you and your Grrl (wow, won’t even comment on that) decided for a hospital birth. Hope this exercise has been helpful for you in that regard.
November 17, 2009 at 10:19 pm |
why you and your Grrl (wow, won’t even comment on that)
———–
So, basically, you’ve reduced yourself to making snide comments about my wife’s nickname.
Nice argument. I guess it is about as relevant as the study that is completely and totally irrelevant to American home births, so I can see how you would think it was appropriate.
My main point isn’t justifying our decision. We made the right decision. My main point is that I’m glad I’m married to a woman who views life through reality tinted glasses, rather than someone who sees everything from the narcissistic, reality denying, woo colored glasses I see represented in the pro-home birth literature.
Your posts are an example of what I’m talking about, by the way. You make totally irrelevant points, coupled with personal attacks, and then get all upset because I point that out, and follow it up with the same irrelevant research and new personal attacks.
Why don’t you try finding some new, relevant information instead?
November 18, 2009 at 6:09 pm |
If I had the choice to take my daughters to an enclosed playground with a foam padded floor or a playground with concrete next to a busy street, I would choose the foam padding. Isn’t that analogy more apt than the free range helmet one that you posit? Meh. They’re probably both false analogies, but whatever.
Based on the available evidence, I can’t see a good reason to have a home birth, other than monetary. Let’s face it. Most people choose home birth because of their sense of principles, their comfort, their fear of medicine, or their fear of being put through the processes during labor. On the last point, having a midwife or doula advocating on your behalf is sufficient enough to deal with a medical staff on epidural autopilot; the rest of the reasons are selfish in the context of the evidence.
I still fundamentally agree that expectant parents should just make the decisions that they feel is right for them, as long as the couple is informed and nobody’s life is put in immediate risk (like a home birth far from the hospital). What’s funny is that you both would probably agree on that statement, despite your back and forth. My question is whether home birth parents are well-informed of the risk; if it weren’t for Amy Tuteur, I wonder who would be exposing the cover-up of the evidence.
And please refrain from begging the ad hominem. It spoils your argument.
November 20, 2009 at 1:33 am |
Phioloslosdad,
I did your research for you….looks like Dr. Amy finds the study contextual enought to address here: http://skepticalob.blogspot.com/2009/09/lessons-from-canadian-and-dutch.html
Her primary problem with the studies and their application to American homebirth is that homebirth midwives in the US are trained differently and the screening precluding expectant mothers from delivering at home is substandard, in the US. Of course both points are dependent upon a specific context and, lots of CNMs in the US are also homebirth midwives…and rule out vbacs, breech, and other risky births.
With this in mind, if one were to find a CNM to complete a homebirth and not attempt to deliver their 12 pound breech baby at home, it seems the study would be applicable to the United States.
But to accept this would undermine your personal attacks and ability to feel superior and smug….which seems to be a focus of this blog.
%30 of Dutch women give birth at home, making sweeping generalizations deriding them as selfish seems unnecessary…and wrong. According to the study, a homebirth in the Netherlands is as safe for the baby as a hospital birth. And it does sorta spoil your argument Ticktock.
November 20, 2009 at 2:59 am |
Good link. Here’s a salient quote:
(Emphasis mine)
This does not undercut my argument in any way. You seem to think that I’m making the argument that under no circumstances whatsoever in any health care system in the world could you ever possibly even begin to consider the thought of homebirth. But I’m not. I’m actually making a comment about the philosophy of homebirth advocates in America, so this link of yours reinforces my argument.
I also never derided anyone as selfish for choosing home birth in the netherlands. You are clearly arguing with some other people, on some other blog, and getting them mixed up with me.
November 20, 2009 at 8:46 am |
Which argument is being spoiled, again? I really don’t mind home births if they are safe.
Please point out any personal attacks when you see them. The focus on this blog is evidence, so we’ve failed if you think we are focused on personal attacks. In fact, the comment preceding yours, we both asked you to refrain from personal attacks.