MAYD to Birth: At Your Doorstep

Promoting gentle, empowering mother journies…

Arguing with myself

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So I’m on an email list for a website called Mamasource. It is a clever idea, women, mostly mothers, send in questions. The website sends an email every day to all the women who are signed up with them with a sampling of some that day’s posted questions. Also it is setup based on your local community so the questions actually go out to women who live near you, which is nice because you can get some actual recommendations for a good pediatrician or whatever.

There are lots of questions about babies sleeping through the night, potty training, discipline, all the myriad things that women often want advice about. I’m not a big contributor but the format of the emails and website makes it really easy to just click once and give another woman your $0.02 worth of advice. It seems great to me, I know I used my other women’s email groups in a similar fashion when I was a new mom and still do when life throws a challenge at me.

So obviously I couldn’t resist sending in a response when I saw the following question in the daily Mamasource email:

im not really asking for advice im more curious on the opinion about this subject since its an interesting one. i have been having some conversations with a friend about having home births. i know people have strong feelings about this and many people would never consider it because the hospital seems like the best place right? but im starting to wonder why people are so against having a baby at home with a midwife? or if there not. I think people think that women who want to have their baby at home are crazy. i don’t see why. i probably would never do a home birth but i know people who would like to. I think it sounds interesting and i can see why some people would prefer to have a birth where they are able to do things more naturally and have a little more choice in how they want to have their baby. anyways just wondering on what the opinion of parents are about this subject.
A little about me:
i have had two babies (yes at hospitals)and no im not pregnant or thinking about having a home birth, but dont see anything wrong with it.

Well that is an easy question for me to answer so I posted the following response:

I have had both a home and a hospital birth. The decision to choose home birth for my second child was made over a very long period of time after an EXTENSIVE amount of research. My first birth was traumatic for me, it was so different than what I had hoped for, even though the hospital gave me good care. The reading that I did trying to understand and process that birth led me to a new way of thinking about birth and changed the way I wanted to handle my second birth. I became aware of the risk that came with hospital interventions and I knew that at the very least I would have to have continuous monitoring at the hospital (women having a VBAC are required to) and I didn’t want that. I found a midwife who was extensively trained and extremely competent, the studies all said that homebirth is just as safe as the hospital, but only with a well trained midwife. In the end my home birth was a deeply healing experience and truly one of the best days of my life. I suffered with the pain of labor in the hospital with no support and the feeling that I had to stay in bed, which was extremely painful. In my homebirth I never laid down at all and used water for comfort. It wasn’t painful for me (I used self-hypnosis techniques), but it was intense and powerful.

Well I’m not dumb, I know that these sorts of discussions on the internet are always ridiculous, but I went ahead and started reading the other responses anyway. It was the usual mix of about half home birth advocates or supporters and half posts from women who ‘surely would have died had they been at home’. These messages are frustrating because you don’t want to discount an experience that may have been serious and traumatic to them, but really most of them are totally bogus. True life and death emergencies during childbirth are pretty rare.

Many of the problems that these women experienced were caused by the things that were being done to them at the hospital. Yes, epidurals do cause extreme drops in blood pressure and babies go into distress, yes they will die if you don’t intervene. But that is why we don’t do epidurals at home! A lot of these women just don’t really understand all the repercussions of medical management and how different things are at home.

Some of the women also don’t understand they had truly high risk births that sensible midwives and home birth advocates would never attempt at home either.

Other women had true problems with their births that either the midwives would have been able to solve themselves or that they would have transferred the woman to the hospital for, but really are not life threatening. A lot of times women don’t understand that people attempting a home birth don’t just stay home and die if they aren’t able to deliver the babies, they actually go the hospital and get help when they need it.

It is impossible to respond to each and every woman, you just have to hope that the collective responses of the home birth advocates will penetrate a few people’s consciousness and open their minds a bit.

This one response though, boy it really got to me. I actually felt like crying after I read it, the sentiment was so hateful. So here is what I read that got me so upset:

Why would anyone who cared about their unborn child even consider doing a home birth??? Even if you have had a routine pregnancy, given birth before, or any other reason that people will give you…there is ALWAYS the chance of complications. And no midwife, no matter how experienced can give your child the care that they would recieve in an NICU where they have machines, and medications, and serveral staff to take care of them. Plus, what if you needed an emergency C-section? Do you think a midwife is just gonna cut you open? Nope!

Okay, deep breathing. This person is obviously pretty ignorant about birth, but boy was that judgmental. I pondered it for awhile, but I just couldn’t stop thinking about it, so I sent the woman the following private response:

Your response was pretty insulting to those of us who did massive amounts of research before we choose home birth? How much research did you do about the hospital you went to? Do you know their rates of medical mistakes? What about hospital acquired infection? Do you realize that women have lost uteruses, limbs, their babies and their own lives after acquiring antibiotic-resistant infections at hospitals? There is no way to eliminate all risks from life. Statistics show that both home and hospital are both very safe, but there is no way to guarantee that everyone will have a perfect outcome in either setting. I’m sorry if this is harsh, but it is extremely upsetting when people insinuate that I don’t care about my baby because I chose a different set of risks than you did.

Ugh, I even had typos I was so mad! But I felt better. I thought well at least this person has been called on her nasty comments. Maybe she would think differently, maybe she would realize that I am a human being and a mother just like her- that I love my baby just as much.

*sigh*

No. Today I received the following response:

if you want to live the way of the third world, perhaps you should move to africa, live in the bush, a starve. You have been blessed to live in a time and place where you can benefit from a great advancement in medicine, and its ungrateful to throw that out the window. If your baby HAD needed medical intervention, how would you feel today, if she/he had died because you wanted to be at home instead of a hospital where thet could be properly cared for?

I didn’t get anywhere with her did I? Well I’m steaming mad that someone could be so hateful. She didn’t address any of the questions I had in my response to her, so she obviously isn’t really educated or wanting to engage in a real dialogue. I don’t really see the point in continuing to engage her, but really I want her to get her head screwed on straight! Instead of responding to her I figured I’d just rant on my blog.

First of all she doesn’t understand the difference between the choice to have a home birth here in the United States where I am well-nourished and healthy and choosing to live the life of someone in the third world. She basically tells me that I should think like her or I deserve to starve to death! Wow!

She assumes that just because I chose to give birth at home that I am not grateful for medical advancements! How presumptuous! I love medical technology when it is used appropriately. I’m thrilled that we have so many options. But I’m also quite aware that medical technology is not perfect that there are false positives, misuses, side effects and some downright serious dangers that come with them. We need to remember that a woman is three times more likely to die from a caesarean birth than a vaginal birth. That is not an amusing statistic when you live in a country with skyrocketing c-section rates.

And finally the big thing that really makes me nuts. “how would you feel today, if she/he had died because you wanted to be at home instead of a hospital where thet could be properly cared for?” Why is it that if a baby dies in the hospital it is ‘an act of god’ or ‘it wasn’t meant to be’, but if the baby dies at home then it is all the mother’s fault? I know a woman who lost her baby days after he was born in the hospital from an infection in his bloodstream. Nobody blamed her for going to the hospital where there are antibiotic resistant infections. Maybe her baby would have died either way but the point is that there are bad outcomes in both cases. Occasionally making a different decision might have changed the outcomes, but without a crystal ball who can know for sure? Most of the time the factors involved are complex and oftentimes there is nothing that ANYONE could have done to change the outcome.

I tried to make that point in my first response to this nasty woman. She is naïve for believing that being in a hospital guarantees a good outcome. She is naïve to think that being connected to an electronic fetal monitor, receiving Pitocin, not eating or drinking, getting an epidural in your back or forceps on your baby’s head is without risk. And even if she doesn’t do a single intervention in the hospital (which is bloody unlikely) just walking in the door increases the risk of getting yourself or your baby infected with something life threatening. Just driving the hospital and back home with your newborn could have a bad outcome, but no one would ever blame you for having driven there. Why is your choice protected, but mine is not?

It makes me so mad that I probably sound like I think people are bad for choosing to go the hospital for their births, but the point is that each choice has risk and each choice has benefits, none have guarantees. I understand that people are just doing the best that thing for themselves in light of their own circumstances. I really wish that people like this could be understanding about my choices.

Compromise Passes

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With only minutes to spare the compromise bill passed through the Senate and on to the governor for his signature. There is always the potential for him to veto it, but at this point that is highly unlikely.

Someone on the Utah Friends of Midwives message board pointed out that you know it is a truly good compromise when both sides are angry. Well I guess it was a great compromise! The docs are upset that the midwives will still attend VBAC births. The homebirth community is outraged that anyone gets to tell them what they can and cannot do for their births.

The homebirth community in general does not take their choices lightly, many have not had cesareans but they still fought long and hard to preserve the options of their VBAC sisters. Many will not ever have breech babies or twins, but they fought hard to protect women who will. They are angry that any woman may have lost the birth of her choice due to this bill, but most are aware that we were at risk of losing a lot more if we didn’t accept the compromise.

The midwives and home birth community will continue to try and educate the community at large about home birth, their excellent outcomes and the enhanced experience of families who choose home birth. The licensed midwives will continue to practice carefully and accumulate more excellent statistics. Hopefully in 2011 we can win back some of the ground we lost this year.