Reply to Mixed feelings about not being more outspoken about brother’s homebirth plan

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[quote=Anonymous]OP as you can tell from this thread, they wouldn't have listened to you. I am so sorry about your niece. Of course being in a hospital doesn't mean scary things don't still happen, both my son's had trouble breathing at birth and it had nothing to do with the hospital or the birthing situation.

I will say I was tempted by a home birth and very much fell into the reading of all the natural birth stuff (and I had an unmedicated birth, so like I get it I do) but now my cousin is an OBGYN and the stories she tells of home birth transfers are truly terrifying. She would tell you it's not because home birth is inherently unsafe, of course not. It is wonderful for someone to be able to birth at home and in most cases it can be beautiful and result in a healthy baby and mom. But the issue is that our system in this country is not well set up to ensure the safety of everyone in a home birth situation like some other countries. The training of midwives is incredibly all over the place and not at all equal. Some midwives are amazing and have great training, others not so much but it's hard to differentiate in our system that doesn't have many standards. And there isn't a good system for transfer, and often when she receives transfers they are wayyy beyond when they should have come in. Way beyond. Total crisis and the midwives waited WAY too long. This may be because of lack of training or because there is such insistence on the birth experience being the primary goal. This is my biggest worry based on talking to her about home birth, I used to think well if there is an issue the midwife will call it and transfer in. But you have to truly trust that your midwife will make the call at the right time and it sounds like that is often not the case.

There is a reality that OBGYNs take a different risk assessment than some other birthing providers. This is true. Because to put it frankly, they are the ones that deal with the catastrophes. The babies that do not survive. Midwives step out when things really go awry (not necessarily because anyone did anything wrong, but because it happens), the OB is the one that steps in and is trained to handle that. So understandably their risk tolerance is different. i have found it fascinating to learn from my cousin living this every day. She explained it to me one time - when I assess risk, a live baby and mother is the number one goal, always. If five more women have to get xyz intervention so that ONE baby or one mother lives instead of dies, for me that is worth it. Because that one baby is someone's child (or mother) and their life is the MOST important. And it is worth some small interventions for a few that MAYBE we could have gotten through without, but in one of the instances the baby would have died. No, that's one baby one child - too many. That really struck me. And she is not very interventionist, has a very low c-section rate. We are all looking at ourselves individually and so focused on what is the perfect birthing experience for us, but at the end of the day every mom and baby walking out of that hospital or home has to be the goal. And we have to mitigate risk and make calls to do that. [/quote]

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