C Jane - unassisted homebirth - thoughts?

[Bella99]

I have known 2 women who had unassisted homebirths and everyone came out fine. A dear friend (who did not have maternity insurance) had a midwife attend her birth for a 3 day labor (my friend was 43), and she and her son came out fine. I cannot be pro-choice when it comes to terminating a pregnancy without being pro-choice about the culmination of one. That being said, if I had my way all births (at home or hospital) would be attended by a licensed midwife who was also an RN. Also, a nanny would come by once a day for the first 3 weeks so you could take a nap while she put in a load of laundry and brought dinners - my mother was so busy with getting ready for a "project" that I had no help after Mr. 99 had to return to work. It sucked and I am still bitter about the extreme sleep deprivation and no one bringing me food.

Please do not mistake my advocacy of choice for promoting DIY healthcare. I actually lean towards anti-homebirth after a Christian midwife let my almost 44 year old dear friend give birth at home (and she was in labor for almost 3 days). I am not a medical professional, but isn't there some sort of age cutoff where giving birth in a hospital is recommended?

[countressrascal]

Because I feel that it is degrading to the women.

[Beeks]

Well, lots of people would call you a nutjob for not going to the hospital and getting hopped up on drugs at the first hint of labour. What of that?

Yep, lots of people have. I'm ok with that.

[mirele]

I don't care if people skip medical care for themselves for some reason. I do care when they are willing to risk their unborn baby's life.

This. This. THIS.

Some women seem to think that the birthing experience is all about THEM and their experience. The baby is secondary. I think C. Jane is very irresponsible, first for failing to go for prenatal appointments and then for the unassisted home birth. She is such a BAD EXAMPLE, yet she will be held up among some LDS women as a great example to follow--LOOK, C. Jane did it for cheap--and I can predict that tragedy will also follow. I'm going to be pissed off if I hear of some woman who felt pressured into a home birth or unassisted birth because of C. Jane.

The attitude among some unassisted home birthers and other home birthers in general is that home birthing is natural and something that every woman--no matter her medical history--should strive for.. Death is also natural. I can't even count the number of women in my own family tree who, before the modern era, did not live past their childbirthing years because they died in childbirth. Nowadays, death in childbirth is a relatively rare occurrence in developed countries and it is not because of unassisted childbirth or home birth. It's because of the developments in medicine that allow for better outcomes for mother and baby.

Y'all can do what you want, I'm just glad that when my mother (then, age 20) started having seizures during labor because of eclampsia, she was in a hospital. She lived. As did I.

tl;dr: Childbirth is not about YOU, it's about YOUR BABY. You need to do what is going to bring the best outcome and if that is an ebil medicalized birth, complete with epidural or c-section, then do it. Don't be stupid.

[Mama Mia]

I think people could trade stories all day long about how they heard about /had this messed up birth experience / bad outcome at a home OR at the hospital.

It doesn't make sense to me that unassisted home births are lumped in statistically with attended home births. Those don't seem to be the same thing at all.

[Mommy22alyns]

I think unassisted homebirth is crazy and irresponsible. And doing it with no prenatal care is even worse. I say this as someone who had a completely unforseen complication in my second pregnancy that could have resulted in death of me and baby without proper medical care. Even with proper medical care things were touchy.

[Beeks]

Lily...because I know you're still reading this thread: nobody ever said FJ "tolerated" all viewpoints and all actions, everywhere. The whole reason this board EXISTS is to call out dangerous fundie behavior. What CJane did was dangerous and irresponsible and put the life of her baby in danger. Then she blogged about it, which, in my mind, puts it out there for anyone to discuss. It's not much different than other fundie behavior we talk about here. Pretty much everyone here agrees that personal choices are personal choices, but when they negatively affect others, especially helpless children, that's when people start getting antsy about it.

I'm sort of blown away that you're so up in arms in us commenting on this situation.

[StarrieEyedKat]

Another one that wants us to stop name calling and be nicer to people making dangerous decisions. Nope, sorry, still going to call out stupidity, just like the fundies have the right to bash us.

[Maul the Koala]

Thanks for playing, ladies. I can see when I'm in a circular situation and not getting anywhere. I don't want to burn any bridges or have this spin even more out of its original intent, so I'm quitting this now. In the future, I'll have to stay out of any FJ topic in which my opinion is not a mainstream one. Instead, I'll try getting ZsuZsu to see multiple sides of things and be reasonably accepting of others' choices without bashing - I might have better luck.

This isn't mothering.com, people are actually going to call you out when you make statements on practices that have the extreme potential to be dangerous.

[Vex]

Uhh, look at all her self-portraits on the side-bar of her blog. No shit she's conceited! ;)

God, yes. She comes across as so self absorbed. That Mary/Jesus photo was disgusting and so self-indulgent that I actually laughed when I saw it. I am horrified that her selfishness put her baby in danger... no prenatal care, no midwife or doula or doctor. She is really tempting fate.

I have no issue with home births. I think that if you're healthy and confident and have a great midwife/doula, it seems like it can be a great thing. Nobody likes going to hospital (except maybe Mckmama), and I can totally understand not wanting strangers crowding around you and telling you what you can and can't do when you're giving birth.

It seems to me that the most important thing is getting a healthy baby out of pregnancy and birth, and having no prenatal care and no professional to care for the baby during labour is criminally stupid. I'm sorry, but it is. Thank goodness it wasn't terminally stupid for her or the baby.

[Clementine]

Soo... you're all in favour of evidence when it supports your personal axe to grind, but have no problem throwing it out the window when it doesnt?

Why is this such a familiar idea... could it be... exactly what most of us find hypocritical about fundies?

I have a friend who's a doula and has had exactly one hospital transfer resulting in emergency c-section in 7 years of practice. See? I can use anecdata too!

So why even take the risk? Most of the times, things will go just fine. But when they don't, don't you want to know that you did everything in your power to be safe? I just don't understand why anybody would want to take the risk when the worst case scenarion is a dead baby, just because YOU prefer to deliver it in your own home. Do you do the same with your kids in the car?

"It's such a hassle to use the seat belts, so we just skip that".

I don't know how you deliver babies in the US, but here the delivery rooms are rather homely and you choose how much or how little intervention or medical help you want. If you want to sit in a warm bathtub with candles and listen to dolphins and chant hymns and have no pain relief, that's just fine. Every mother decides what kind of delivery she wants and the midwife is just there to assist and make sure that everything goes smooth and safe. The parents are asked to write a letter to the clinic before the delivery, where they write how they want it to be.

Nobody is wearing green scrubs and screaming "PUSH PUSH!". (Unless the mother wants to.) There are also just two people attending the delivery: one midwife, one nurse as long as it is a normal delivery. I've seen a lot of programs from delivery rooms on tv and the whole thing seems to be fairly undramatic and the attending staff are very respectful to the parent's wishes.

[violeta]

In my experience many UCers have an antiquated view of hospital birth or many misconceptions.

[treemom]

No. I'm not opposed to anything, except forcing and pressuring anyone to do things against their will. If you want constant monitoring and intervention and machines and surgeries and drugs, fine by me. If you want to do things on your own, fine by me too.

My first was a necessary emergency c-section. I was extremely ill and went into preterm labour, and I'm thankful every day that medical technology was there when I needed it, otherwise she might not be here. My second pregnancy, I chose to have a c-section because of a twin pregnancy and though it was a bad experience, I don't regret it, since I know the extra risk of a twin pregnancy is compounded by it being closely spaced with my first. I'm by no means against any of this. I'm just not against birth in a natural setting either.

So you think parental care is superfluous?

[treemom]

No legitimate study has shown that home birth or UC carries any greater risk of death for the baby. Some different risks, yes, but overall homebirth (which UC is lumped in with) has been shown to have fewer complications and lower incidence of neonatal death.

There will always be a few who won't seek care no matter what and put their lives and their baby's life at unnecessary risk, but of everyone I've known who has done homebirth or UC, that's not the case and I don't think it is with the vast majority. Most, including myself, would go to the hospital if there were some kind of complication they felt they were unequipped to handle. I was devastated with my first to have to go to the hospital, but I knew it needed to be done and have no regrets.

There are a FEW women who will insist upon c-sections because they don't want to give birth naturally and want to have their birth scheduled, and they don't want to push. Do we base our opinions of all who have or choose c-sections for medical reasons on the few who take it to the extreme? I'd hope not.

Might I suggest that the problem with the studies is that those who uc are unlikely to consent to a study? Or be in a place where they are aware of the study?

But there are lots of studies about prenatal visits and how outcomes improve with them.

[eohiken]

The biggest advances in medicine that increase the survival rate for women and children during birth are; improved nutrition, handwashing and overall better maternal health. The practice of obstetrics did not make advances in birth outcomes through any sort technological achievement of medicine. Of all the medical fields, it's actually one of the least evidence-based practices. Routine procedures in L&D have less to do with better outcomes than protecting the doctor and hopital, giving at least the appearance that they act in the best interest of the baby (they really don't give a hoot about mothers, *physically*, I'm not talking about lovely birth experience here, she can be hacked to pieces and held together with catgut as long as her heart beats and the child lives she should be greatful @@).

Three procedures specifically have been found to not only NOT improve outcomes but actually increase maternal morbidity (injury); continuous fetal monitoring, manditory IVs and misoprostol as a labour inducing drug. Continous fetal monitoring and manditory IVs only increase the number of c/s, bringing us to the all time high of, what is it now? 35%? Ridiculous. Misoprostol is a medication for stomach ulcers used off label, it's cheaper than the prostaglandins it's replaced. It works great to contract the uterus, wonderful for missed miscarriages, abortions and postpartum hemmorage. For a uterus full of baby at term, it can actually cause over-stimulation and rupture. In healthy non-scarred uteri. Often OBs are saving the day and rescuing babies from problem they themselves caused, looking like heros all the while.

Having said all of that, I'm a huge proponent for assisted homebirth. What makes homebirth so safe is the midwife, it's her training and experience that backs the decision to transfer. The hospital is always there, if necessary, "call to cut" times are actually very similar for emergent c/s from home or in hospital, given the home is within a ~20 minute radius. Midwives are the key. UC is not the same, at all.

[formergothardite]

I can't read the mothering.com birth boards because it is all people saying things like "That evil doctor and nurse were talking so I couldn't clearly hear the music I was planning to hear the moment I gave birth. The whole birth is just RUINED!" I always want to reply, "My baby ended up brain damaged, so fuck you."

[eohiken]

There's experience and then there is experience. For many people, saying the experience matters for the mother means she doesn't need to end up shitting out her vagina.

[Austin]

There's experience and then there is experience. For many people, saying the experience matters for the mother means she doesn't need to end up shitting out her vagina.

I haven't a clue that that is supposed to mean.

*Some* mothers (homebirthers and not homebirthers) seem to put the *experience* before the well-being of their baby. To me, those priorities are clearly effed up. So yeah, those are the experientialists I have a problem with. Why would someone wanted a completely unassisted (by a medical provider such as certified nurse midwife) except that they've decided they want that particular experience? Do you not agree that the state of things in childbirth can go south very quickly? Who is going to have the medical expertise to say to the mother, "Look, you're hemorrhaging and you need to go to the hospital."? (You know, where they have blood on hand and all that). Who is going to resuscitate a newborn who does not breathe?

It's an utterly stupid and needless risk. You don't trust doctors and think they wake up every morning thinking of new ways to "hack" you up? Fine. Then get a qualified midwife and stay away from those nasty doctors. :roll:

[Turtle]

The biggest advances in medicine that increase the survival rate for women and children during birth are; improved nutrition, handwashing and overall better maternal health. The practice of obstetrics did not make advances in birth outcomes through any sort technological achievement of medicine. Of all the medical fields, it's actually one of the least evidence-based practices. Routine procedures in L&D have less to do with better outcomes than protecting the doctor and hopital, giving at least the appearance that they act in the best interest of the baby (they really don't give a hoot about mothers, *physically*, I'm not talking about lovely birth experience here, she can be hacked to pieces and held together with catgut as long as her heart beats and the child lives she should be greatful @@).

Three procedures specifically have been found to not only NOT improve outcomes but actually increase maternal morbidity (injury); continuous fetal monitoring, manditory IVs and misoprostol as a labour inducing drug. Continous fetal monitoring and manditory IVs only increase the number of c/s, bringing us to the all time high of, what is it now? 35%? Ridiculous. Misoprostol is a medication for stomach ulcers used off label, it's cheaper than the prostaglandins it's replaced. It works great to contract the uterus, wonderful for missed miscarriages, abortions and postpartum hemmorage. For a uterus full of baby at term, it can actually cause over-stimulation and rupture. In healthy non-scarred uteri. Often OBs are saving the day and rescuing babies from problem they themselves caused, looking like heros all the while.

Having said all of that, I'm a huge proponent for assisted homebirth. What makes homebirth so safe is the midwife, it's her training and experience that backs the decision to transfer. The hospital is always there, if necessary, "call to cut" times are actually very similar for emergent c/s from home or in hospital, given the home is within a ~20 minute radius. Midwives are the key. UC is not the same, at all.

Sometimes an increase in morbidity is necessary for a decrease in mortality. It is a complicated balancing act, but since most people agree that mortality is far worse than morbidity, doctors and patients tend to err on the side of caution. So, mom has an episiotomy but survives birth with a living baby. Continuous fetal monitoring leads to c/s because it detects when a baby is in distress and allows time for a c/s before damage occurs to the baby. Just because you don't deliver a blue baby via c/s doesn't mean it wasn't necessary, it means you caught the problem in time. A 30% c/s rate isn't ridiculous at all.

And yes, generally there is a 20/30 minute decision to incision. But only if you are in the hospital to start with. Problem is detected early, doctor is able to take his/her time evaluating the situationa and performing a calm c/s before baby goes into more serious distress. Say you are at home. 5 minutes away from the hospital=call for ambulance transport, wait for it to arrive, load you up and then transport. Arrive at the ER, get accessed by ER physicians or the OB on call, who doesn't know you or your medical history. Prep the OR, call the anasthesiologist, prep you for surgury. Since you didn't have CFM, you don't know how long baby has been in distress. So now you have an extremely scary, rushed, emergency situation with doctors (who were previously accused of not giving a shit about maternal care) are doing their absolute best/relying on their years of medical training to save the life of the mother and baby.

So yeah, I believe a woman can make whatever choice she wants when deciding when/how to birth a baby. But I also think women need to be accurately informed of the risks...and that includes more than a mothering.com/google "education".

[eohiken]

it means avoiding a rectovaginal fistula caused by a 4th degree tear/episiotomy. 4th tears don't happen without episiotomies, and episiotomies have been standard practice for a long time but are rarely ever warranted.

Women's health and well being is too often framed as oppositional to the infant's health and well being, when this is simply not necessary. A mother is not a blood and bone obstacle in the way of child's safe landing, to be sacrificed at the least minor worry. She is a whole person to be respected, not for her desire for candles and music, but as a active participant in her own medical decisions. In obstetrics, too often informed consent is nothing but lip service, if it's acknowledged at all. Instead every decision is laced with the deadbaby threat when it's simply not the case. A healthy whole mother should be as much of a priority as a healthy whole baby. A child is far better apt to thrive when its mother is also thriving during those first few days and weeks.

No, I don't agree that things go badly quickly in birth. A good attendent, physically in the room with a labouring woman, doing periodical fetal health checks can see problems developing in plenty of time to take action, intervene and transfer if necessary. Don't get me wrong, I'm not advocating in the least for unattended childbirth, only that hospital birth has it's own risk factors and no moral superiority to home birth.

[eohiken]

Studies don't support that mortality inproves with increased morbidity.

Decision to incision time includes the midwife calling the hospital in advance from the home, and doesn't include waiting for an ambulance, because they get into a car and drive there themselves.

[Katiebug]

I can't read the mothering.com birth boards because it is all people saying things like "That evil doctor and nurse were talking so I couldn't clearly hear the music I was planning to hear the moment I gave birth. The whole birth is just RUINED!"

A-freaking-men. A little perspective is helpful. There are parts of the world where mothers will lose half of their children in childbirth or infancy, and run a shockingly high risk of dying themselves. There's also this thing called obstetric fistula that is devastating, common in certain areas of the world, and is easily preventable with proper midwifery and obstetric care.

OBGYNs in the US are in a highly litigious practice environment, and CNMs are not immune to the same problems. Read "Baby Catcher" by Peggy Vincent for just one example of an experienced CNM who had one homebirth go wrong (due to the patient's actions!) and her career of doing homebirths was over. She went to the hospital environment and eventually retired. Care providers don't get sued and families don't get destroyed when a doctor does a successful emergency C-section, or when a homebirth midwife transports a patient when things are headed south. I've read several OBGYNs' blogs about how an "unnecessary" C-section is really a retrospective diagnosis and not one that can really be made by a layperson. There is no easy answer to reducing the C-section rate or focusing intervention on evidence-based options, but demonizing hospital birth and OBGYNs is not the solution.

I had a pretty highly-interventive birth...induction, IV fluids and medicines, continuous (external) monitoring, being on mag sulfate in active labor and for 24 hours postpartum, etc. Yet every intervention that was done was explained, including the benefit to me and/or the baby and the potential risks. The start of my induction was with Cervidil, not Cytotec (which is not used at all by any of the doctors at this hospital). I didn't want AROM, so they didn't do it (my water broke on its own early in my induction). I preferred external monitoring so that I could move more freely, and that's standard procedure unless the baby is showing signs of distress. I wanted to avoid or delay pain meds and an epidural for fear of failure to progress, and no one pushed me to get any pain medication that I didn't want, and in fact did everything they could consistent with my condition to help me deal with the contractions in a non-pharmaceutical way. I got to have the music that I wanted on the CD player, I got to keep the lights dim when I wanted them that way, I got to use a rocking chair and a birth ball and a hot shower (the Jacuzzi rooms were already occupied). My OB flat-out doesn't do routine episiotomy. The baby roomed in with me, everyone helped me breastfeed successfully, and at no time did I feel like what was happening to me or our child was being done without my consent. Yeah, it would have been nice to go into labor on my own, to have arrived at the hospital with contractions 3 minutes apart, had only a heplock, and delivered med free within a few hours. That's what we wanted and that's what my OB was on board with, but it couldn't happen that way because I got sick. It's not my fault, it's not anyone's fault, and I am incredibly thankful that those necessary interventions were what helped protect my life and health and our child's life - if this was 100 years ago perhaps neither of us would have made it.

Yet if you listen to the MDC crowd, you might believe that every single pregnant woman who steps foot in a hospital is tied down, has her water broken and Pitocin administered, is forcibly given an epidural and then gets whisked off for an "unnecessarean" so the doctor can make his tee time, after which her baby is given formula behind the mother's back. While I have no doubt that unwanted interventions sometimes do happen, I think that the overwhelming majority of doctors/nurses/hospitals don't operate like that.

When you place the experience over your own health or the baby's health and life, you have gone too far, period. If a woman is low risk and wants to have a home birth with a trained attendant, then she should be able to - just as I personally will choose to deliver in a hospital for my own peace of mind. Having no prenatal care (which is what "unassisted pregnancy" really is) and giving birth at home with no trained attendant is placing the experience over safety. There's a hell of a lot more to it than the MDC line of "Trust your body, mama! Stay away from those evil doctors - Google will tell you if something is wrong!"

[treemom]

it means avoiding a rectovaginal fistula caused by a 4th degree tear/episiotomy. 4th tears don't happen without episiotomies, and episiotomies have been standard practice for a long time but are rarely ever warranted.

Women's health and well being is too often framed as oppositional to the infant's health and well being, when this is simply not necessary. A mother is not a blood and bone obstacle in the way of child's safe landing, to be sacrificed at the least minor worry. She is a whole person to be respected, not for her desire for candles and music, but as a active participant in her own medical decisions. In obstetrics, too often informed consent is nothing but lip service, if it's acknowledged at all. Instead every decision is laced with the deadbaby threat when it's simply not the case. A healthy whole mother should be as much of a priority as a healthy whole baby. A child is far better apt to thrive when its mother is also thriving during those first few days and weeks.

No, I don't agree that things go badly quickly in birth. A good attendent, physically in the room with a labouring woman, doing periodical fetal health checks can see problems developing in plenty of time to take action, intervene and transfer if necessary. Don't get me wrong, I'm not advocating in the least for unattended childbirth, only that hospital birth has it's own risk factors and no moral superiority to home birth.

And by the same logic home birth is not morally superior.

Also, as a human being who survived a dead baby birth and went on to have a live birth...my informed consent was hardly lip service. We can't fault the doctors when patients refuse to press them either.

And yes, when things went bad for us a great majority of things on our birth plan went out the window. Yes, I consented to internal fetal monitoring, and yes I consented to augmented labor, and all antibiotics and all sorts of interventions. But they did explain them to me and I did educate myself. And yet most of the overall part of my birth plan, which was that we were nervous parents who had had two cases of crappy luck back to back and we wanted it to be respected as a time when grief and fear would rear its head were respected.

I have always demanded my doctors treat me as a peer partner in my care. If your doctor can't respect that, then you have the wrong doctor...the procedures aren't wrong.

[Austin]

it means avoiding a rectovaginal fistula caused by a 4th degree tear/episiotomy. 4th tears don't happen without episiotomies, and episiotomies have been standard practice for a long time but are rarely ever warranted.

Women's health and well being is too often framed as oppositional to the infant's health and well being, when this is simply not necessary. A mother is not a blood and bone obstacle in the way of child's safe landing, to be sacrificed at the least minor worry. She is a whole person to be respected, not for her desire for candles and music, but as a active participant in her own medical decisions. In obstetrics, too often informed consent is nothing but lip service, if it's acknowledged at all. Instead every decision is laced with the deadbaby threat when it's simply not the case. A healthy whole mother should be as much of a priority as a healthy whole baby. A child is far better apt to thrive when its mother is also thriving during those first few days and weeks.

No, I don't agree that things go badly quickly in birth. A good attendent, physically in the room with a labouring woman, doing periodical fetal health checks can see problems developing in plenty of time to take action, intervene and transfer if necessary. Don't get me wrong, I'm not advocating in the least for unattended childbirth, only that hospital birth has it's own risk factors and no moral superiority to home birth.

Yes, I know what a fistula is, but I just didn't know what her point was vis-a-vis the birth "experience". I've had plenty of experience with tearing, as I tore terribly delivering a baby who was way too big for me to deliver and I am just glad we both lived to tell about it. Although I didn't sit right for a year. :(

I don't think people are saying that a birth attended by a qualified attendent is particularly problematic for most. We're talking about unattended childbirth. If a woman thinks that's what she really needs to make her "healthy and whole", then I think she has a screw loose and is putting her own pursuit of a certain experience before her own well-being and that of her baby.

[Arielkay]

Where is this blog, btw? What is the address?