For those of you who plan to have home births...

[Anonymous]

Of every 1,000 babies born at home with a midwife attending, 1.6 lacked a pulse and weren’t breathing five minutes after birth. For hospital births with a doctor, the rate was 0.16 per 1,000 infants.

Full article: http://www.ajog.org/article/S0002-9378%2813%2900641-8/abstract

[Anonymous]

Let's not do this.

And I say this as someone who would never, ever intentionally have a home birth.

[Anonymous]

Thanks!

[Anonymous]

Did you wake up this morning deciding to pick a fight, or did the decision come to you later?

[Anonymous]

Not OP, but how is this picking a fight? If I were planning a home birth (which I'm not), I would be interested in knowing this.

[Anonymous]

If I were planning a home birth, I'd want as much information as possible.

[Anonymous]

Thanks sockpuppet!

[Anonymous]

Dear OP and people who agree with OP,

Thanks for assuming that everyone planning to have a homebirth needs to be educated by you. I didn't have a homebirth, but no one I know who has had one made that decision without someone feeling the need to enlighten them "about the facts", as if things like health and safety never occurred to them.

[Anonymous]

Both my home births has (highly unusual) APGARs of 10 at both 1 minute and 5 minutes. that's about as useful information to you as this study.

[Anonymous]

I always find it ironic when people assume that those choosing homebirth are uneducated. I've found the opposite to be true - they very carefully evaluate the relative (and more importantly, the absolute risks) of giving birth in a hospital setting vs. a home or birth center setting. I find that there are a handful of friends (and I'd include me, since I do my birthing in hospital settings) who chose hospital settings who have given it equal thought, but most have not. They choose out of blind fear, and aren't participants in their medical care; rather, they are simply passive recipients who don't question anything at all, despite the major lack of evidence-based care one receives in hospitals.

This study is an oversimplification (by the way, it's not news - this study was published in march - why rouse the rabble now?) with little detail available in the abstract, but it only looks at one set of risk factors, which is an apgra and neurological assessment. The relative risk is high but the absolute risk is low and I wasn't able to see any details about controls, confounding factors, limitations, or study size, which I use to judge a study for how much it means to me.

In the meantime, the well-respected cochrane group reviewed the available literature this year, and updated its former conclusion, confirming that planned homebirth with qualified midwife attendance can be just as safe as a hospital birth. And, the cochrane review did not leave out extremely important evidence that was not considered by OP's linked to study, such as the fact that interference with normal labor processes in a hospital setting, and hospital protocols themselves often lead to birth complications, ranging from relatively small (increased maternal pain and discomfort during delivery) to large (unnecessary surgery, hemorrhage, premature induction, fetal or maternal death). These things do happen.

http://summaries.cochrane.org/CD000352/benefits-and-harms-of-planned-hospital-birth-compared-with-planned-home-birth-for-low-risk-pregnant-women

So, OP, keep trying to push your views; that's fine. There is no legitimate need to educate here, though. Your assumptions are off. People who choose midwife attended home births have given the birth setting, including their relative and absolute risks vis a vis delivery in a hospital, the proper consideration already. But you don't care about that, because you're just slinging sh*t, aren't you?

[Anonymous]

Anonymous wrote:Both my home births has (highly unusual) APGARs of 10 at both 1 minute and 5 minutes. that's about as useful information to you as this study.

The plural of anecdote is not data.

[Anonymous]

This is useful:

http://www.mana.org/blog/0/understanding-outliers-in-home-birth-research

This argues that the source of the data is flawed (that is for example, that it includes unintended and unattended out of hospital births which are inherently unsafe and lumps them in with CNM attended home births with full prenatal care).

" In recent well-designed studies that captured planned place of birth and used better sources of data, there were no differences in 5-minute Apgar scores between home and hospital settings (Hutton et al, 2009; Janssen et al, 2009; van der Kooy et al, 2011)."

[Anonymous]

Anonymous wrote:

Anonymous wrote:Both my home births has (highly unusual) APGARs of 10 at both 1 minute and 5 minutes. that's about as useful information to you as this study.

The plural of anecdote is not data.

Blah, blah, blah. I will repeat, my anecdote is about as useful as the information in this study. Do you get the point now?

[Anonymous]

Anonymous wrote:Not OP, but how is this picking a fight? If I were planning a home birth (which I'm not), I would be interested in knowing this.

Do you really think anyone deliberately making a decision to not deliver at a hospital won't have already conducted some risk analysis? Personally, I think they're deluded, but OP's post is a bit like telling a smoker that cigarettes can kill them. The smoker knows this alread, and the woman who's decided to have a home birth already knows it's exponentially more risky.

[Anonymous]

Anonymous wrote:I always find it ironic when people assume that those choosing homebirth are uneducated. I've found the opposite to be true - they very carefully evaluate the relative (and more importantly, the absolute risks) of giving birth in a hospital setting vs. a home or birth center setting. I find that there are a handful of friends (and I'd include me, since I do my birthing in hospital settings) who chose hospital settings who have given it equal thought, but most have not. They choose out of blind fear, and aren't participants in their medical care; rather, they are simply passive recipients who don't question anything at all, despite the major lack of evidence-based care one receives in hospitals.

This study is an oversimplification (by the way, it's not news - this study was published in march - why rouse the rabble now?) with little detail available in the abstract, but it only looks at one set of risk factors, which is an apgra and neurological assessment. The relative risk is high but the absolute risk is low and I wasn't able to see any details about controls, confounding factors, limitations, or study size, which I use to judge a study for how much it means to me.

In the meantime, the well-respected cochrane group reviewed the available literature this year, and updated its former conclusion, confirming that planned homebirth with qualified midwife attendance can be just as safe as a hospital birth. And, the cochrane review did not leave out extremely important evidence that was not considered by OP's linked to study, such as the fact that interference with normal labor processes in a hospital setting, and hospital protocols themselves often lead to birth complications, ranging from relatively small (increased maternal pain and discomfort during delivery) to large (unnecessary surgery, hemorrhage, premature induction, fetal or maternal death). These things do happen.

http://summaries.cochrane.org/CD000352/benefits-and-harms-of-planned-hospital-birth-compared-with-planned-home-birth-for-low-risk-pregnant-women

So, OP, keep trying to push your views; that's fine. There is no legitimate need to educate here, though. Your assumptions are off. People who choose midwife attended home births have given the birth setting, including their relative and absolute risks vis a vis delivery in a hospital, the proper consideration already. But you don't care about that, because you're just slinging sh*t, aren't you?

Well said!