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Home Birth

Any topic related to science can be discussed here.
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Maria Mac
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Home Birth

#1 Post by Maria Mac » September 4th, 2008, 1:07 pm

gcb01 wrote:
Alan C. wrote:I was directed to this website by a link in one of the NSS articles.
What's the harm?
A site called What’s the Harm? has collected together thousands of stories of what happens when people suspend critical thinking. It makes fascinating reading.
useful debunker of some of the weirder stuff we get here, home birthing, vaccine denial, homeopathy, etc.

There's nothing weird about home birthing. My younger child was born at home and it was a million times better than being in hospital. I would recommend it to anyone for a second or subsequent child provided their GP surgery supports it as mine did.

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Alan C.
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Re: Complementary therapies

#2 Post by Alan C. » September 4th, 2008, 1:41 pm

Maria
There's nothing weird about home birthing. My younger child was born at home and it was a million times better than being in hospital.
My mother had her first six at home and her seventh (now deceased) in hospital.
Fortunately the midwife lived just around the corner from us :smile:
Abstinence Makes the Church Grow Fondlers.

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gcb01
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Re: Complementary therapies

#3 Post by gcb01 » September 5th, 2008, 2:10 pm

Maria wrote:There's nothing weird about home birthing. My younger child was born at home and it was a million times better than being in hospital. I would recommend it to anyone for a second or subsequent child provided their GP surgery supports it as mine did.

Maria

oh dear, it's that old sample size = 1 problem. I thought your husband would have put you straight on this one. :exit:
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Campbell

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Alan C.
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Home Birth

#4 Post by Alan C. » September 5th, 2008, 5:08 pm

Ah but what about my mothers sample size gcb01? 6 out of seven aint bad.
Abstinence Makes the Church Grow Fondlers.

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gcb01
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Re: Complementary therapies

#5 Post by gcb01 » September 6th, 2008, 11:41 am

right. That's our sample size up to 7 - only 993 to go.
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Campbell

Fia
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Re: Complementary therapies

#6 Post by Fia » September 6th, 2008, 11:36 pm

I'll add three - not mine sadly - but I was there at some stage of labour at three planned homebirths.

990

Maria Mac
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Home Birth

#7 Post by Maria Mac » September 7th, 2008, 2:35 pm

gcb01 wrote:right. That's our sample size up to 7 - only 993 to go.
If the contention we are trying to prove here is that home birthing is not 'weird' and if this can be proven by the fact that a significant proportion of women actively choose it and don't regret it, then the 15,000 or so women who successfully give birth at home in the UK annually should surely suffice but perhaps the fact that home birthing (unlike vaccine denial) has UK government support adds some weight to the argument?
The Department of Health says it wants to end assumptions that a hospital is always the best place to have a baby.
Or can that just be dismissed as blatant vote-catching? :wink:

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gcb01
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Re: Complementary therapies

#8 Post by gcb01 » September 7th, 2008, 3:14 pm

Maria wrote:Or can that just be dismissed as blatant vote-catching? :wink:
Well, like most things this government does then yes. If it is so safe then how come independent midwives can't get insurance cover? I don't deny that the experience if everything goes ok is hugely better than stuck in a hospital.
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Campbell

Maria Mac
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Re: Complementary therapies

#9 Post by Maria Mac » September 7th, 2008, 4:52 pm

I see we've moved from whether it's weird to whether it's safe.
gcb01 wrote:If it is so safe then how come independent midwives can't get insurance cover? I don't deny that the experience if everything goes ok is hugely better than stuck in a hospital.
Is this a serious argument? That independent midwives can't get insurance cover tells us nothing about the safety or otherwise of home births any more than does the fact that the Department of Health are encouraging it and increasing numbers of NHS Trusts are providing for it.

Here's an article giving the most up to date information: http://scotlandonsunday.scotsman.com/nh ... 4251839.jp

It's not just about being better than stuck in a hospital. It's about having less unecessary medical intervention and, as a result, an easier birth and post-partum experience which, in turn, can make for a more successful mother-baby relationship in those crucial early days. The reason my first labour lasted 22 hours and ended up in a forceps delivery and a baby who wouldn't take to the breast for several days was because I was given an epidural. The reason I was given an epidural was because in the hospital environment I found it impossible to relax and be in control of myself. I screamed the place down and assaulted medical staff and that just wouldn't do! The pain was no less during my 9-hour second labour but, without a team of medical staff around me stressing me out, I was able to manage my own labour without pain relief, give birth normally to a baby who was alert and fed immediately and enthusiastically.

Around 15,000 women a year will have had a similar experience.

I'll split off the posts about home birth as they don't belong in the CAM thread.

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gcb01
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Re: Complementary therapies

#10 Post by gcb01 » September 7th, 2008, 8:34 pm

Maria wrote:I see we've moved from whether it's weird to whether it's safe.
I'll give you that one - I had lumped home births in with "weird" given the propensity of those advocating the other "weird" items to go for home births. I don't consider home births weird, just relatively less safe.
Maria wrote:
gcb01 wrote:If it is so safe then how come independent midwives can't get insurance cover? I don't deny that the experience if everything goes ok is hugely better than stuck in a hospital.
Is this a serious argument? That independent midwives can't get insurance cover tells us nothing about the safety or otherwise of home births any more than does the fact that the Department of Health are encouraging it and increasing numbers of NHS Trusts are providing for it.
Why wouldn't independent midwives be able to get insurance cover if home birthing was safe?

The NHS's enthusiasm for home births may be due to it being much cheaper as saving money always seems to be more important than outcomes.
Maria wrote:Here's an article giving the most up to date information: http://scotlandonsunday.scotsman.com/nh ... 4251839.jp
This seems to say that home births are safe if you don't need to transfer to hospital and the report did not appear to cover maternal complications. I'm not sure how it advances things.
Maria wrote:It's not just about being better than stuck in a hospital. It's about having less unecessary medical intervention and, as a result, an easier birth and post-partum experience which, in turn, can make for a more successful mother-baby relationship in those crucial early days. The reason my first labour lasted 22 hours and ended up in a forceps delivery and a baby who wouldn't take to the breast for several days was because I was given an epidural. The reason I was given an epidural was because in the hospital environment I found it impossible to relax and be in control of myself. I screamed the place down and assaulted medical staff and that just wouldn't do! The pain was no less during my 9-hour second labour but, without a team of medical staff around me stressing me out, I was able to manage my own labour without pain relief, give birth normally to a baby who was alert and fed immediately and enthusiastically.

Around 15,000 women a year will have had a similar experience.
I hope their outcomes are as good as your home birth was.
Regards

Campbell

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Re: Complementary therapies

#11 Post by kbell » September 7th, 2008, 11:06 pm

gcb01 wrote: Why wouldn't independent midwives be able to get insurance cover if home birthing was safe?
Because insurance companies have nothing much to lose by erring on the side of over-caution. It's not as if there are huge numbers independent midwives - most work in the NHS. Anyway, it's a curious yardstick by which to measure the safety or otherwise of home births. Isn't it better just to look at the available statistics? This site contains a page with links to summaries of all research carried out on the subject in the 1990s: http://www.homebirth.org.uk/

Here, for example, is the summary of a meta-analysis carried out in Denmark:
Olsen O (Department of Social Medicine, University of Copenhagen, Denmark.)
Birth, 24(1):4-13; discussion 14-6 1997 Mar

Olsen looked at six controlled studies covering 24,092 mainly low-risk women planning home or hospital births. Outcomes were compared for mortality, morbidity (injury and illness), Apgar scores, maternal lacerations (perineal and vaginal tears etc.), and intervention rates. Perinatal mortality was not significantly different between the planned home and planned hospital groups, but the planned home birth group had fewer low Apgar scores, and fewer severe maternal lacerations. There was less medical intervention in the planned home birth group: fewer inductions, fewer episiotomies, fewer assisted deliveries, and fewer caesareans. Unfortunately, the abstract does not give transfer rates, but these outcomes do compare planned home births with hospital births. Olsen concluded: 'Home birth is an acceptable alternative to hospital confinement for selected pregnant women, and leads to reduced medical interventions.'
From what I've read, there does not appear to be any evidence that home births are any more or less safe than hospital births but there are a number of reasons why home birth might be preferable.
The NHS's enthusiasm for home births may be due to it being much cheaper as saving money always seems to be more important than outcomes.
Indeed a home birth costs about 70% of a hospital birth but do you seriously think the NHS would be promoting home births if they were significantly less safe than hospital births?
gcb01 wrote:
Maria wrote:Here's an article giving the most up to date information: http://scotlandonsunday.scotsman.com/nh ... 4251839.jp
This seems to say that home births are safe if you don't need to transfer to hospital and the report did not appear to cover maternal complications. I'm not sure how it advances things.
Well, you started by lumping home birth in with vaccine denial and homeopathy implying that home birth is just as potentially dangerous. The article says that "The reports are based on a large UK study which has calculated national death rates following home births over a 10-year period. The study found that home births were generally safe and not associated with an increased risk of death," which would seem to undermine your original suggestion.

I don't think anything radical is being claimed here: simply that home confinement is at least as good an option as hospital confinement, if not better, for women who are in good health, have normal pregnancies and are supported by competent medical practitioners. Doesn't sound weird to me.
Kathryn

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Alan H
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Re: Home Birth

#12 Post by Alan H » September 7th, 2008, 11:15 pm

I certainly accept the thrust of the arguments for home births, but I suspect the data are skewed a bit. It is likely that if the Doctor/midwife thought that a birth is obviously going to be difficult (some existing condition, previous difficult births, etc), he/she would advise the mother to have it in hospital (and many would take this advice) and the ones where there is no evidence of possible difficulties would be home births.
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1. What, precisely, are the significant and tangible benefits of leaving the EU?
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Re: Home Birth

#13 Post by Maria Mac » September 8th, 2008, 12:16 am

Alan H wrote:I certainly accept the thrust of the arguments for home births, but I suspect the data are skewed a bit. It is likely that if the Doctor/midwife thought that a birth is obviously going to be difficult (some existing condition, previous difficult births, etc), he/she would advise the mother to have it in hospital (and many would take this advice) and the ones where there is no evidence of possible difficulties would be home births.
Absolutely!

Nobody is claiming that home births are always better than hospital births. My contention is that, provided there are no contra-indications, home births are a perfectly reasonable alternative to hospital births and there is nothing weird about this contention.

I realise that the kind of people who are heavily into weird stuff like complimentary therapies may also be the kind of people who are sympathetic to home births but this shouldn't blinker people to the advantages of home births. In fact, the majority of women who use complimentary therapies choose hospital births. There is no connection between home births and CAM.

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LilacHamster
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Re: Home Birth

#14 Post by LilacHamster » September 8th, 2008, 7:20 pm

There certainly seems to be a high rate of complications with human births, maybe something to do with the size of babies heads. Many women CANNOT give birth naturally, in my case I was told it was due to a high pelvic arch that I had problems. You are lucky Maria, I envy you a bit that it worked out for you.
I tried the whole home birth thing, didn't work out, I had to be taken to hospital as baby was stuck and needed the ventouse (two out of three of my children's births this happened), so it's always important to be prepared for sudden transfer to hospital if it goes wrong and medical intervention is needed.
As for Freebirthing and the ideas of Laura Shanley, one of whose babies died, unlike many of my likeminded "CAM" friends even I think that's totally dangerous and bonkers to try to give birth with no-one else present.
Even after my experience I am not totally against homebirth but one has to know when it's time to need assistance and to be honest in my case the dr and midwife did let it go on too long before getting me to hospital. It was my first baby and I did not know how long was acceptable to be pushing before having help to get the baby out, they should have known though! I certainly would have been happy to go to hospital earlier for help but I was not sure what was normal and I feel now that my trust was misplaced.
Hospital caterers generally have no idea about vegans which was yet another reason I had wanted to avoid hospital but actually ended up in there 4 days due to complications caused by a long extended 2nd stage with my first baby, and this was all because of trying to have a home birth.
I was severely anaemic (not because of being vegan but blood loss as I was not anaemic at all before the birth) and had to have a catheter in for several days due to muscle or nerve damage to the waterworks from extended pushing, so I could not wee even when bladder was full.
If I had been in hospital they would have got my son out earlier with the ventouse and avoided some of these problems. The ventouse is not nice but it is a lifesaver and less nasty than forceps.
I was at Northwick Park which actually has a bad record and has had a higher than average rate of deaths after caesareans but it was not the hospital's fault things went wrong, it was the dr and midwife dealing with the homebirth not getting me in as early as they should have done.
I didn't make a complaint as I was not sure I would have had a case and there was no longterm damage although I still wonder if my son's Aspergers has anything to do with the difficult birth. He is bright and not learning disabled so would be impossible to prove a link.
My last of three childen was induced a few days early due to concerns about antibodies (I have A rhesus negative blood type and despite having had the recommended anti-D injections after the other births I still produced some antibodies which I was told could be attacking my baby) but came out more naturally without the ventouse, and although I thought an induced birth would be worse it was actually not any more painful or unpleasant than those I tried to have more naturally.

I don't think it's weird, or unsafe for everyone, but reports about it need to honestly deal with what happens when it does go wrong.

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Re: Home Birth

#15 Post by Bryn » September 8th, 2008, 8:16 pm

LilacHamster wrote: Even after my experience I am not totally against homebirth but one has to know when it's time to need assistance and to be honest in my case the dr and midwife did let it go on too long before getting me to hospital. It was my first baby and I did not know how long was acceptable to be pushing before having help to get the baby out, they should have known though! I certainly would have been happy to go to hospital earlier for help but I was not sure what was normal and I feel now that my trust was misplaced.
I'm astonished that they let you have your first baby at home. Maria recommended it for a second or subsequent child and I agree. It was only after having a straightforward first pregnancy and birth that my wife and I decided our second child would be born at home. One of the factors in our decision was that we really didn't have anyone to look after our toddler. If things had gone wrong he would have had to come to hospital with us but as it was, the entire labour and birth took place at night and were over in a few hours. He slept through the whole thing.
I don't think it's weird, or unsafe for everyone, but reports about it need to honestly deal with what happens when it does go wrong.
I'm sure nobody would disagree with you. We did a hell of a lot research before making our decision and were fully aware of the risks both of giving birth at home and of giving birth in hospital. The latter isn't risk free and sometimes bad things happen during hospital births that wouldn't have happened at home.

Honestly, I'm really shocked at your story, LilacHamster. Our midwife team would definitely have erred on the side of over-caution and got you into hospital sooner rather than later. I hope they learned from the experience. Home births are set to continue increasing: Huge rise in number of home births
One home-birth hotspot is Bridgend, South Wales, where one in four babies were born at home last year. Although home births in England shot up by 10 per cent in 2006 against 2005, at 16,923 they were still just 2.5 per cent of all births. Mums-to-be in the South-west lead the way: West Somerset has the highest proportion of home births in the UK at 14.2 per cent, due to strong local midwife teams.
Link between home births and suicide anyone? :shock:

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Alan H
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Re: Home Birth

#16 Post by Alan H » April 15th, 2009, 10:37 am

In today's Times:
********************************************************************************
Births at home as safe as hospital, study suggests - Times Online
http://www.timesonline.co.uk/tol/life_a ... 094366.ece
~~~~~~~~~~~~~~~~~~~

Births at home as safe as hospital, study suggests
David Rose

Midwives are calling for a “seismic shift” to enable more women to give birth at home after a study suggesting that home deliveries can be as safe as those in hospital.

Research covering nearly 530,000 births in the Netherlands found that women had a no greater risk of their baby dying or becoming ill if they gave birth at home rather than in hospital.

The Royal College of Midwives said that the study was a “major step forward” in showing that home births were safe for women with low risk of complications, but added that the NHS would need a fundamental reorganisation to support more home births.

The Government has promised all women in England a choice of where they would prefer to give birth by the end of this year, but experts say that a lack of community midwives could make this unrealistic in many areas. According to the RCM Royal College of Midwives an extra 5,000 full-time midwives are needed urgently to fulfil this and other pledges on maternity, but ministers have promised only to recruit an extra 3,400 full-time midwives by 2012.

Louise Silverton, the deputy general secretary of the college, said that “to begin providing more home births there has to be a seismic shift in the way maternity services are organised.

“The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital. There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

Celebrity mothers including Davina McCall and Charlotte Church are credited with making home births more popular, but less than 3 per cent of all births in England and Wales took place at home in 2006, the latest figures show.

This compares with nearly one in three (30 per cent) of all births taking place at home in Holland.

Standing up early in labour 'speeds birth'

Lying down during the early stages of childbirth may prolong the agony of labour, a review of medical evidence by the Cochrane Collaboration suggests. Researchers found that the first stage of labour was significantly shorter for women who kneel, stand up, walk around or sit upright.

The review by the Cochrane Collaboration, the organisation that promotes evidence-based medicine, used data from 21 studies involving 3,706 women in developed countries since the 1960s. The first stage of labour was about an hour shorter in those who adopted upright positions compared to those who lay down, the researchers said.

Annemarie Lawrence, of the Institute of Women’s and Children’s Health at the Townsville Hospital in Queensland, Australia, commented: “In most developing countries, women stand up or walk around as they wish during the early stages of birth with no ill effects. Based on these results, we would recommend that women are encouraged to use whichever positions they find most comfortable, but are specifically advised to avoid lying flat.”

[Retrieved: Wed Apr 15 2009 10:36:32 GMT+0100 (GMT Standard Time)]

###################
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

Maria Mac
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Re: Home Birth

#17 Post by Maria Mac » April 17th, 2009, 12:57 am

With a few adjustments to the stats (e.g. I think it was only 2% of births happened at home) that report could've been lifted from the mid-1980s. Back then all the evidence said the same thing both about the safety of home births and the desirability of being upright when delivering.

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Paolo
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Re: Home Birth

#18 Post by Paolo » April 20th, 2009, 1:53 pm

Primary research data are available for free from PubMed on this issue.

Safety:
http://www.pubmedcentral.nih.gov/picren ... obtype=pdf
http://www.pubmedcentral.nih.gov/picren ... obtype=pdf

Desirability:
http://www.pubmedcentral.nih.gov/picren ... obtype=pdf
http://www.pubmedcentral.nih.gov/picren ... obtype=pdf

Discussion:
http://www.pubmedcentral.nih.gov/picren ... obtype=pdf

Home birthing appears to be safe and desirable for normal pregnancies, based on a quick literature search. Obviously if there are problems identified during the pregnancy it is better to have a fully equipped medical institution on hand.

I would point out that humans have been giving birth without hospitals or pre/post natal care for quite a long time. The fact that hospitalisation has played a role in helping in difficult births shouldn't be taken to mean that it is a prerequisite for all healthy births.

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Re: Home Birth

#19 Post by Nick » April 20th, 2009, 6:26 pm

Paolo wrote:I would point out that humans have been giving birth without hospitals or pre/post natal care for quite a long time.
...but a huge proportion of women and babies died as a result of lack of modern medical care.

I say that for completeness, not because I have a strong position to maintain. I have no scientific or statistical evidence, but it seems to me that if there is no medical requirement for a hospital, then home birth is likely to be less stressful, and that seems to be what the stats say too.

The question that needs to be answered, it seems to me, is what is the probability of an expected 'normal' delivery going wrong, necessitating a move to hospital, and to what extent would that cause medical problems or worse for the mother and/or baby, through delay in receiving treatment for example?

I'm well out of my depth on this topic, so I'm happy to leave it to those closer to the issue.

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Paolo
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Re: Home Birth

#20 Post by Paolo » April 20th, 2009, 7:13 pm

Nick wrote:...but a huge proportion of women and babies died as a result of lack of modern medical care.
Yes, but such deaths were/are probably due to problems that would be identified by modern pre natal examinations. I don't think anyone is arguing that medical care shouldn't be available, simply that hospitalisation is not a necessity.

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