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31 December 2011 @ 02:22 am
We've Forgotten Just How Bad Hospital Birth Was  
Ina May Gaskin on the beginning of the home birth movement and more.

Whether you are for or against home births, there is no doubt that the competition of the home birth movement pushed hospitals to change many of their practices. Hospitals make lots of money on childbirth, money they lose in the ER. Losing those births really hurt them and forced them to be more responsive to the complaints of women who didn't want forceps used routinely, and didn't want surgery unless it was absolutely necessary. Women also wanted a more homey and welcoming environment, not a cold, clinical room. We didn't want scopolamine or even epidurals and we wanted to be treated like the adults we were. If your hospital birth was a pleasant one, you have the home birth movement to thank. You're welcome. :)

I made good use of Ina's book, Spiritual Midwifery when I had my two children at home with a lay midwife in attendance, blocks from a hospital if needed.
 
 
 
litlebananalitlebanana on December 31st, 2011 12:42 pm (UTC)
Usually I agree with you about most things, but I think you know my feelings about homebirth. The most recent CDC data shows that there is a 7 times higher risk of the baby dying from homebirth with a non-nurse midwife (like Gaskin) compared with comparable risk hospital birth, and that's just not something I can get behind. The only data study released from Gaskin's Farm showed that the mortality rates were similar to that in high risk obstetric births, which is a little scary.

I'm not sure if the homebirth movement in some way convinced hospitals to change their practices, considering it makes up such a very tiny percentage of all births. But if it did, it was at the expense of babies' lives. Not worth it for a nicer room.

Just from this year, these are some of the totally preventable and sad deaths from homebirth:

http://skepticalob.blogspot.com/2011/12/homebirth-2011-deaths.html
Tapatitapati on December 31st, 2011 01:58 pm (UTC)
Nowadays women don't have to do home births to have the atmosphere and control that we advocated for, so it is a moot point. But each lost birth was costing them money and the movement was producing books like immaculate deception that put pressure on them.

It's about so much more than a nicer room. Would you have wanted a doc to use forceps on you before giving you a chance to push much? How about automatically cutting your perineum whether you needed it or not? Pushing you to c-section in situations that aren't warranted? Forcing you to stay in bed rather than move around? Treating you, basically, like a piece of meat? Yes it was that bad in the 60s and 70s. My mom was knocked out with gas as I was being delivered with forceps and I wasn't much over 6 lbs.

I'm not saying anything about preferences TODAY but back then, we were pushed to take control of our birthing experience by abuses in the hospitals.
Tapatitapati on December 31st, 2011 01:58 pm (UTC)
and by doctor I mean male in most cases
litlebananalitlebanana on December 31st, 2011 02:26 pm (UTC)
I believe there are some practices that might have changed due to homebirth... like my hospital room had a tub in it. But practices such as use of forceps and episiotomy have changed due to scientific evidence that showed worse outcome with those practices. If research showed any of these things were safer, I would have been okay with them, but it's shown the opposite. Ditto with general anesthesia. And maybe it's helped that most ob/gyns are now female, but I'm not sure it has. (For the record, I was forced to stay in my bed during my birth, since I had an epidural.)
Tapatitapati on December 31st, 2011 04:00 pm (UTC)
I remember the home birth movement was pushing for more data on the efficacy of those practices. Really it was a big movement involving more than just the women who gave birth at home and we challenged all those things and pointed to other countries that weren't routinely doing them and had better success rates.
Mari Adkinsmariadkins on December 31st, 2011 06:25 pm (UTC)
one of my brothers was also frank breech like me and my mom's doctor used forceps on him - didn't try to turn him, just used the forceps and dragged him out. he was black and blue for almost a month. :(
Tapatitapati on December 31st, 2011 02:01 pm (UTC)
Plus I'm reading the first few and they were situations most of us would not have chosen to do home birth in. The books I was reading advocated having risky births in the hospital and many of these moms were in that category (vbac!).
litlebananalitlebanana on December 31st, 2011 02:31 pm (UTC)
It's true, although there are plenty of women who have vbacs at home, if you can believe that. There's one in my month community. I think women who are so strongly against intervention are scared that a vbac at the hospital has a high risk of c-section, so they birth at home.

Frankly, I think while there is a higher risk of mortality from birthing at home, it's probably fine for multips with low risk. But there are enough lay midwives who are willing to oversee more high risk births and the consequences aren't bad enough if something goes wrong. I think any midwife who lets a woman have a vbac at home is criminally negligent. And I worry that lay midwives aren't regulated enough, that clearly dangerous situations can be going on right under their noses and they won't force a hospital transfer.
Mari Adkins: srsly catmariadkins on December 31st, 2011 06:22 pm (UTC)
given tayler was carried frank breech, i can't imagine even thinking about trying to deliver him at home. that would've been just plain idiotic.
(Deleted comment)
Tapatitapati on December 31st, 2011 03:58 pm (UTC)
Yes it does. I'm somewhere in the middle (while still maintaining that ob/gyns of the past weren't so great). It's uncomfortable ground because I can see good things in both sides and bad things in both sides.
Prisspr1ss on December 31st, 2011 11:30 pm (UTC)
The c-section rate is now 40% in some hospitals. Plus, labor is routinely induced early in more and more cases. Doctors may have improved their bedside manner, but premature babies and mothers who have to recover from surgery aren't a good tradeoff.