Former midwife Lisa Barrett, implicated in the deaths of three babies
Three babies. All of them died at home having never seen the inside of a hospital.
And they could have been saved.
Today, the South Australian Coroner has found that it was a ‘matter of certainty’ that three newborns would have lived if their mothers had elected to undergo a caesarian … or even if they’d just been born in a hospital.
Neither of these things happened, however, because in each of the three cases the baby’s mother chose to give birth at home with the assistance of a midwife.
There’s another common denominator: all three births were presided over by a former midwife (now homebirth advocate) Lisa Barrett. She was a registered midwife at the time of the births.
“Ms Barrett told the coroner that she had given up her midwifery registration and had elected to act only as a birth advocate because of a new regulatory framework which discouraged midwives from taking on some women, essentially leaving them unsupported.
The coroner said Ms Barrett was also wrong in some of her opinions regarding the likely outcome had a caesarean section been performed in one of the births and had been “completely oblivious” to the deterioration in the condition of one of the unborn babies.”
The Coroner didn’t mince his words. He meant them to be heard and heard clearly: “In other words, it is said that these deaths could and should have been prevented.”
The deaths of babies are not the only dangers of a birth that takes place at home.
Earlier this year home birth campaigner Caroline Lovell died during a home birth. She was 36.
Fact: birth is risky. It’s natural, but it’s risky.
The Coroner, Anthony Schapel, has gone further and recommended widespread reform and changes to prevent more senseless tragedy. The Adelaide Advertiser reported:
“In his findings, Mr Schapel said the practice of midwifery should only be carried out by registered midwives.”It ought to be regarded as an offence, punishable by law, for midwives to practice midwifery without registration with the Nursing and Midwifery Board of Australia,” he said.
He also urged the minister to introduce new legislation imposing a duty on any person providing a health service to report to the Department of Health the intention of any person to undergo a homebirth known to have an increased risk of complication.
The parents of both babies had employed Ms Barrett as a midwife to attend the homebirth after undergoing emergency caesarean sections in the delivery of their first children.”
So let’s break this down.
- Three babies who could have lived, would have lived, had they been born in a hospital.
- Three women who knew their births would be high-risk but insisted on home births anyway.
- A midwife who could not and was unable to provide the same level of medical support as a hospital.
- Three mothers who lost their children because they wanted a ‘lifestyle’ birth.
No criminal charges have been recommended against Ms Barrett.
Still pending are the coronial findings after an investigation into the death of Roisin Fraser – the daughter of free birth and homebirth advocate Janet Fraser. Free birthing is also done at home but even more high risk because it is done without ANY medically trained supervision or support. Not even a midwife is in attendance.
Janet Fraser’s birth (her third) was also known to be high risk due to her second pregnancy ending in an emergency caesarean. She claims her daughter was stillborn at home but there is evidence to suggest the baby died during the birth process due to a lack of medical support.
If you have had or ever considered a homebirth, has the Coroner’s damning findings changed your mind?
Comments
913 Comments so far
Will always wish I had my 3rd Baby at home, like my 2nd
and Will always wish I had reported the midwife, as I know she killed him.
Was years ago now, but what she said as she left the little room I was moved into after giving birth, will stay with me forever, she said ‘You have two children, I can’t have any ‘ and if you ask me, his lungs burst’ the lady in the next bed also heard her, and gasped at what this so called midwife said as I had just told her I was worried, I thought the midwife blew into him rather than sucked just after he was born. she never even gave him to me to hold, but put him into a cot. said she was in a rush.
We got over his death as we had to, but to my dying day, I wish I had had the postmortem offered and spoken up at all that had happened at his birth while alone with this midwife, .. at the time I could not, he was gone, and I just wanted to get home to my other children .. was years ago now, and I have moved on with my life, but I will always regret not bringing that midwife to justice, and always will … That haunts me more now than ever …
If it would have bought him back, I would have done anything, but coud not cope at the time with anything on top of his loss, but now feel doomed to regret it for the rest of my life ….
Sorry if of topic, I just needed to get this out… Bit late though… x
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Janet Fraser’s second was a home birth and she haemoragged so badly she was rushed to hospital.
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Nikki, it is Lisa fault that the babies died, read the coroners report, he has all the facts, if she was a skilled midwife she would have not attempted to deliver those babies at home, at the least she should have had another midwife with her, she would know the risks but has fueled her own ego, and she doesn’t seem to learn from her mistakes, she is very dangerous, she is doing such damage to sensible homebirths and putting the cause back years!!
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All the talk about Janet Frasers child being born alive or stillborn, the coronor was right th assume it was a case to be investigated as there was no trained person who was skilled enough th decide if it was born alive or stillborn, a severely distressed baby may appear to be stillborn to the uniformed.
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I supported my partner in her choice of a home birth, assisted by a qualified midwife with lengthy obstetric hospital experience and subsequent to a normal pregnancy with all indications of a normal birth. I would have been more comfortable in a good hospital with good staff to provide quality advice and perform emergency interventions if necessary, but I understood my partner’s decision and, ultimately, it was hers to make.
We are both familiar with first-hand-horror stories resulting from hospital malpractice and dubious standard practice. Members of our family have died, almost died and/or have been permanently traumatised and injured due to main-stream medical malpractice or inadequate standard practice. Trust is a very real and vital pre-requisite for a healthy birth.
Our experience of medical “service” during a prolonged miscarriage, added to past mis-diagnosis, and belligerent, nonsensical and incompetent advise and inappropriate medical treatment informed the decision.
We do not live in a Tee-Pee or babble about absurd supposed supernatural personifications of complex natural phenomena. We made a considered decision based on research, experience, evidence and instinct. We have a wonderful, healthy and happy daughter.
Yes, I would have preferred to see my partner give birth in a good hospital. As I had no guarantee of this and the pregnancy was monitored and progressing well I accepted my Parter’s argument. As it was her decision to make I would have supported her regardless. Placing faith in the medical industry involves risk. Placing faith in your partner to successfully give birth after a healthy pregnancy involves risk. I place more faith in my partner.
It would be good if more women had faith in our obstetric industry. It is understandable that many don’t. Most western countries incorporate out-patient mid-wife services far more effectively than Australia does. Perhaps, instead of feeding reactionary conservative sentiment our institutions and conservative medical bodies would do better to improve their own performance. Incompetent independent mid-wives are held more accountable than incompetent medical institutions and the recording and reporting of institutional deaths is also disproportionate. The health and well-being of mother’s and children should take precedence over dogma, and witch-hunts.
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I supported my partner in her choice of a home birth, assisted by a qualified midwife with lengthy obstetric hospital experience and subsequent to a normal pregnancy with all indications of a normal birth. I would have been more comfortable in a good hospital with good staff to provide quality advice and perform emergency interventions if necessary, but I understood my partner’s decision and, ultimately, it was hers to make.
We are both familiar with first-hand-horror stories resulting from hospital malpractice and dubious standard practice. Members of our family have died, almost died and/or have been permanently traumatised and injured due to main-stream medical malpractice or inadequate standard practice. Trust is a very real and vital pre-requisite for a healthy birth.
Our experience of medical “service” during a prolonged miscarriage, added to past mis-diagnosis, and belligerent, nonsensical and incompetent advise and inappropriate medical treatment informed the decision.
We do not live in a Tee-Pee or babble about absurd supposed supernatural personifications of complex natural phenomena. We made a considered decision based on research, experience, evidence and instinct. We have a wonderful, healthy and happy daughter.
Yes, I would have preferred to see my partner give birth in a good hospital. As I had no guarantee of this and the pregnancy was monitored and progressing well I accepted my Parter’s argument. As it was her decision to make I would have supported her regardless. Placing faith in the medical industry involves risk. Placing faith in your partner to successfully give birth after a healthy pregnancy involves risk. I place more faith in my partner.
It would be good if more women had faith in our obstetric industry. It is understandable that many don’t. Most western countries incorporate out-patient mid-wife services far more effectively than Australia does. Perhaps, instead of feeding reactionary conservative sentiment our institutions and conservative medical bodies would do better to improve their own performance. Incompetent independent mid-wives are held more accountable than incompetent medical institutions and the recording and reporting of institutional deaths is also disproportionate. The health and well-being of mother’s and children should take precedence over dogma, and witch-hunts.
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I still advocate for a ‘to each their own’ in this debate. I believe parents should have the right to deliver their baby, their way. Informed choice is important, but there is a plethora of info out there already… its up to parents to pursue it and make their own decisions.
I’m sorry for the families who lost their babes – I’m sure regardless of whether a baby died in home-birth or hospital birth, the parents involved would be shattered to lose one of their loves.
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sorry, but now it’s baby number 4 who has died, in a home birth this female has been involved in…she should be brought up on criminal charges for manslaughter at least, if not negligent homicide http://www.adelaidenow.com.au/news/breaking-news/baby-dies-after-sa-home-birth/story-e6frea7l-1226547028116
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You don’t know the whole story of any of the births. It isn’t Lisa’s fault that the deaths occurred or the fact that they were homebirths. Babies die in the hospital, babies die at home, babies die at birth centres. When a birthing woman chooses to stay at home rather than go to the hospital, that is her choice; a good birth advocate will stay with the birthing woman regardless and that is what Lisa did. Lisa has done nothing illegal and should not be convicted of anything. Was she supposed to abandon the birthing women? I think that’s far worse than helping a woman birth at home who does not want to go into the hospital system.
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Hi, this is my first visit to the site and sorry to say am not too impressed with the journalism…almost like a current affairs, choose controversial topics at apply a one sided view.
I don’t think home birth can be broken down so simply and accusingly. I had my 2 children in hospital but would have loved to have the support from society and not to mention other mothers to have a home birth. Perhaps more information in this article/ opinion would be helpful.
Won’t be back.
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I know of a recent case where a baby died at birth because it was born in hospital. Tragically the mother was allergic to the antibiotics routinely given at birth if a mother tests positive to a swab. The mother nearly died and the baby didn’t make it.
There is the mother who is permanently disabled at St George hospital in Sydney who was given an epidural with the wrong substance.
Babies sometimes die in hospital because they are in hospital. Babies sometimes die and would die no matter where they were born.
I had 2 normal healthy pregnancies, with the baby in a normal position, with all scans normal. I consulted an obstetrician, had an independant midwife, was booked into the hospital in case and lived 5 minutes drive from the WCH.
In those circumstances given the high rates of intervention at the Women and Childrens hospital I concluded that it was safer to give birth at home with a qualified midwife than in hospital.
In making my decision to have a homebirth my research showed that the risk of the baby dying at home was the same as the baby dying in hospital. This is for a singleton pregnancy with no complicating factors with the baby in a normal position.
However, my research showed that there were a whole lot of problems that could be caused by having my baby in a hospital. I did a lot of reading – including of scientific journals.
Midwives are trained to recognise problems that occur during birth. The role of my midwife was to assist me with my normal birth but to recognise if that birth was no longer normal and call an ambulance in those circumstances.
I successfully gave birth to 2 babies at home. This was not a lifestyle choice. This was an evidence based decision which I believed was safest for my children and gave them the best chance of a healthy start to life.
Each pregnancy and birth is different. If I had any risk factors I would havev given birth in a hospital. If any problems had arisen during the birth I would have gone straight to hospital.
Women should be able to give birth where they feel most comfortable. Birth is a physiological process – if the women is stressed, feels rushed or does not feel safe this process is likely to stall. Unfortunately in a hospital setting the reality is beds need to be available for the next patient. Drugs are given to speed things up, resulting in higher rates of caesarian and other interventions.
Caesarians are not safe – their are higher rates of death and other complications for caesarians than for normal vaginal birth. The rates are so significant that NSW health has banned elective caesarians in public hospitals. Caesarians are sometimes necessary to save the lives of babies where there are problems during the birth.
Please don’t judge people who have homebirths. Most of us do a lot of research and have our babies at home because we believe it is a safer option.
I believe that some women have suffered post-traumatic stress after very
bad hospital experiences which lead them to have homebirths where they have risk factors that may make this a less than safe choice.
In the case where the twin died it was reported in the media (this is from memory) that the mother had been spoken to by an obstetrician and informed of the risks of homebirth. She had been so traumatised by her previous experience in hospital that she decided to go ahead with the homebirth despite being fully aware of the risks.
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If you are so calm about home birth, why the hell do you run to a hospital the moment there are problems…… Seriously lets be smart about this. Some births dont go to plan, 2 minutes can be the difference between life and death. If you choose to birth in your bedroom , face the consequences that you will come home with an empty crade.
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I have noticed multiple comments about how being at the hospital you get immediate care if there are difficulties. My first delivery was a stilborn. The doctor never made it to the room before the delivery, even though they were called in before I reached the delivery suite. My second delivery (and I LOVED the place because of the great care) I had constant attendence by midwives and trainee midwives, but at one point they grew concerned because they lost track of the heartbeat. Again, the doctor arrived after the delivery because they were busy with someone else who had arrived in an ambulance. People who come into hospitals in an ambilance often get priority care because their exact situation is known, and the people in the hospital already are being attended to by other people already.
Now, while this really is just a basic reality of the system, it means that people can, and do, fall in between the cracks even at the hospital, where they would have received better care if they had arrived via ambulance with a paramedic team.
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What a moronic comment, it makes no sense. Most homebirths end up at home without hospital intervention….what are you talking about???
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@ do we have to choose ….. Your baby’s welfare is more paramount than your organic home birth experience. A baby breathing, alive and kicking is paramount over an experience that could lead to death. Any woman who chooses to risk their life and their babies is just selfish. You cannot save a baby in a bedroom,. but you can surely save a baby in a hospital….If you disagree with me, why the HELL DO WOMEN WITH COMPLICATIONS IN HOME BIRTHS GET RUSHED TO HOSPITAL……. .
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2 out of 3 babies who die at homebirth could have been saved in the hospital.
0 babies who die in the hospital could have been saved at homebirth.
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2 out of 3 babies who die at homebirth could have been saved in the hospital.
0 babies who die in the hospital could have been saved at homebirth.
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well done do we have to choose, pity not everyone can be so objective about this topic,
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This story breaks my heart. I am mum to a beautiful, healthy 18 week old baby girl who was delivered by forceps in hospital. My baby was distressed and needed to be delivered urgently – her first apgar score was 4 – if she hadn’t been delivered in a hospital I hate to think what the outcome would have been. I understand that some women want to avoid intervention, but the point of intervention is to minimise risk and ultimately birth a live, healthy baby.
You can recover from a cesarian or an episiotomy and forceps delivery, but you can’t recover from the loss of your baby.
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For my third child I did shared care with an obstetrician and a private midwife. I saw the ob every trimester and then a couple times towards the end and the private midwife for all the other routine visits. I birthed with the midwife in the end, and there was no need to call the ob to assist. I can’t help but think this was the best of both worlds and certainly made me feel supported. It does only work though if the midwife is able to practice in hospital or if there is good dialogue and quick departure to hospital and ob back up if labouring at home. It is the dialogue and shared care between the midwife who is an expert in normal labour and birth and an ob who is an expert in the complicated variety not the location of the birth that in my experience brings the best outcomes for both mother and baby.
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Do you even fact check? Janet Fraser’s first birth ended in a csection not her second, her second was a honebirth.
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The most important person in a birth is the baby…….’Not the father, not the mother and certainly not the mid-wife……..Home-births have always been risky and just because thousands of births have happened at home it doesn’t mean that it’s not risky. Yes birth is natural, but terrible, unexpected things happen during many births which require medical assistance……increase that danger many times over if the birth is happening too far from immediate medical assistance……….just as some hairdressers will encourage you to keep your hair in a short hairstyle so that you’ll keep coming back – midwives will defend their practices so that they won’t lose their jobs……….I don’t have a problem with midwives in the birthing room of an overcrowded hospital – as long as the doctor & team are able to jump in with literally a moment’s notice…. Forget about a “relaxing, soothing, self-indulgent home-birth experience’..the baby is always the most important person in any birth.
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Remember it is the midwife who rubs your back who encourages you along who knows what normal birth is yes it is the doctor who jumps in with the often with the necessary drip, scissors, baby monitor. Every one has their place in assisting women to birth. The sad fact is the medical profession is out of control. I know of one hospital were there a predominantly healthy group of women have a 60% caesarian rate because they do not have access to a known midwife and it is the public system. There has never been any investigation into this hospital or ridiculous comments made about these health professionals. Any health professional that is out of line needs regulation and accountability. Sensationalising one professional group over another shows a limited view of reality.
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No, guest – IVs and monitors are applied by midwives – who are practising health care – not just providing back rubs.
Also, it seems highly unlikely that any public hospital has a 60% cesarean rate – where did you get this data from?
Be that as it may, however, the optimum cesarean rate is the one that leads the the best neonatal outcomes without compromising maternal safety. It is basically a compromise – cesarean improves neonatal outcomes (look at the confirmatory research if you don’t accept what I say). Cesarean involves a tiny risk to the mother from the anaesthetic, otherwise there are risks associated with the surgical wound – none of which are remotely comparable with the death or oxygen-deprivation of a new baby.
A cesarean is comparable to having your gall-bladder out – except that you get to take home a healthy baby.
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Yes a healthy baby who now has an increased other risks see ACMI comment “Emerging epidemiological and epigenetic evidence is also showing the longer term health ramifications of caesareans for the child, such as Type 1 diabetes, asthma, obesity and some cancers” There are those women and babies that do require their LSCS however Australian rates are way above recommended levels without decrease in the neonatal death rates. Have a look at the SA maternity and mortality stats and maybe you will find your 60% LSCS rate.
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guest – there is no good evidence linking mode of dlivery (independently) to any of the health outcomes you list. There are many confounders – such as Type 2 diabetes may lead to a higher C/S rate due to macrosomia (large baby), and it is also passed on in families. It is not the way the baby was born that passed on diabetes or cancer.
What stands out in teh SA birth statistics is the high mortality from home birth. Here is a direct quote from the SA perinatal outcomes report:
“In 2009 the proportion of women giving birth by
caesarean section was 32%, a proportion which has been relatively stable for four years. Of those who had previously given birth, 30% had previously had a caesarean section.” 30%, not 60%.
As I said earlier, however, there is no number that represents the “ideal” or “recommended” cesarean rate. The rate should be whatever optimises the balance between harm to the newborn and complications for the mother. (Not forgetting that difficult vaginal birth leads to injuries to both mother and child, including severe bleeding plus bruising, nerve damage and fractures to the newborn).
I see many people passing on this story about “epidenetic evidence” but, if you actually read the references, it is much less real than people imply. Have you read the studies, guest? What did you think of the methodology and the results? Were the studies well-controlled?
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Sue, you seem to have an issue with women being able to choose. Do you understand the law in this country is that no one is to be molested into accepting medical treatment. Be it in birthing or dying. It seems you use statistical knowledge as being the final power in say over all medical interventions for human existence. I would have thought with all your knowledge you could understand that a human being is much more complex than that. Statistics alone do no remove choice when it comes to choosing health care. Why are you so against home birth, have you been at one? Maybe to be truly informed you should attend a low risk home birth with two eligible midwives who have a supportive transport system and collaborative arrangements with obstetric and hospital staff and then your comments would become less clinical and more humane
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Anonymous – I can understand the limitations of homebirth safety without having to be there – just like I understand the dangers of driving while drunk without having done so.
You don’t like discussion about the data – but that’s how we understand risk. I have do doubt that there are very skilled midwives but they are limited in what they can do in the home environment – as an obstetrician would be.
I’m not interested in banning anyone from birthing at home, but I am interested in correcting the type of misinformation that led to these women above losing their precious newborns. Aren’t you?
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What about the health risks for the baby when a mother refuses or tries to avoid a c/s. Death, brain injury and cerebal palsy are some that come to mind. You failed to mention those.
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These are rare events usually brought on by other issues. What I find amazing is the level of emotion brought about on this issue. Women by nature are protective of their young. This issue is an issue of who has the power, if women are given power to determine their course of care they will protect their young. What we have seen in the above deaths are women who have experienced situations which have left them traumatised hence they have gone outside of the system designed to protect women and babies. No one is saying much about why did they get to that point. I would think that this should feature more in the topic of this debate.
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This highlights the need for hospitals to have better colaboration with consumers. Women should not be outcast because they want the most natural birth possible – which every women SHOULD want (not fear it, that is) I had a very sick child and I hated everyone saying ‘lucky you didn’t have a homebirth’….why? i say. I would hope my child would have access to good health care regardless of my choices. No women should be led by guilt or fear in their birth choices, only information and reassurance, whatever they choose, home, hospital, vaginal, or ceasar.
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Hayley – where is it that women who “want the most natural birth possible” are allegedly “outcast”?
Of course your child should have good access to health care. If they were born at home, however, they would not have immediate access. That’s the point.
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Totally hear you. There are obviously a lot of people who do NOT like the hospital system, and seemed to be forced to take great risks with themselves and their babies. Look I’m a hospital-all-the-way person for me and my kids, but why has it become so binary – hospital or home? Why aren’t there more hospital-adjacent birth facilities, and better supported home births? Seems like plenty of other developed sophisticated countries (Holland and UK) do this really well, without impacting infant or maternal mortality. Not sure why Australia can’t get its act together.
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Seahorse – the recent studies of Home Birth in both the UK and Netherlands show worse neonatal outcomes for planned home birth.
The best recent study (UK Birthplace Study) used much stricter conditions for HB, and included a tranfer rate of 40%, but still found a higher neonatal mortality for the babies of first-time mothers.
If people fully understand the real risks and benefits of each situation (not just the ideology), then they have the right to choose where they give birth. registered health care providers, however, are ethically obliged to support the safest pathway possible, rec
ognising that losing a baby or having a very disabled baby leads to life-long impact – not comparable with dissatisfaction about the birth process.
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all these post and comments annoy me a bit people have the right to make informed decisions to the options they have giving birth. my mother is a midwife and had 3 out of her 4 childern at home with the aid of several midwifes(she had a risk factor of diebeties to factor in) and she knew her options and what gidelines she was choosing by opting to have home births there for she made a personal decision as to what was right for her. i had my two childen in hospital for the simple fact that i wanted to have the option to have pain releif should i have need it. 100% my choise no one elses and my mum chose to have homebirths. everyone is intitaled to make there own decision based on ther own circumstances. yes babies died and yes they may have survived if the were born in hospitals but it really is no one elses business but the people involved women have been giving birth for 1000 of years and they will for 1000 of years more it is the mothers choise where she elects to do this and she is the ultimate one who has to live with it.so lets stop judging people!!
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That reasoning makes no sense. That’s like saying it’s ok to abuse your child because it’s you that has to live with the consequences, not everyone else..
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learn to spell then we can maybe understand your point!
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Unnecessary dig at someone’s spelling. Poor form.
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looks like you understood her just fine.
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This has really brought out the best in people, hasn’t it?
I’m quite appalled by the number of people indulging in name calling and stereotyping.
It’s a classic way of shutting down rational intelligent discussion.
Calling home-birth supporters selfish, hippies who just want to be better than everyone else etc.
Also some splendid de-railing of arguments by bringing up aspects of birth that are essentially superfluous to the argument at hand is another unappealing tactic.
I’m frankly embarrassed to have recommended Mamamia to my friends. Was it ever a supportive community or has it always been full of judgmental unkind people? I really feel like an idiot thinking that this was a lovely community.
Mia, you must be so happy with your hit rate for this topic.
I would love to see a balanced, researched article on different types of home-birth. Maybe an exploration of modern practice in Europe.
Maybe a plea to stop the name-calling and nastiness in the comments.
I’ll be waiting a looong time though, I think!
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Agree, agree, agree with everything you have to say.
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Exactly – It’s not the topic that has annoyed me. it is the double standards of requesting respect and nice comments in one instance ‘Chrissy Swan article” and then allowing this kind of nastiness and in fact promoting it by saying nothing and bumping the article back up to the top position over the weekend. I think mamamia is definitley becoming about the $$’s. Maybe not a bad thing after all this is a business but please just be consistent or honest.
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Any woman selfish enough to have a home birth and things go tragically wrong and your baby dies, well you have the rest of your life to feel guilty over your decision.
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What a beautiful sentiment.
Bless you.
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I guess then that any woman who chooses to have a hospital birth and things go tragically wrong and her baby dies, she too has the rest of her life to feel guilty over her decision. Have you ever considered that medical interventions often cause things to go tragically wrong? Which is one of the reasons women choose not to birth in a hospital in the first place. There is a risk that it will go wrong in a home birth, seems to me there is a larger risk it will go wrong in a hospital. 3 babies have died in home births, did you look at the 2000 plus babies that died in hospital? Why are the medical practitioners that attended those hospital births being vilified?
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Earlier today- I wrote a comment asking how Mia Freedman could judge another women’s choices and publish another article that condemns homebirth- without having researched home birth enough to be fair. I mentioned it seemed unfeminist to not believe in the choice of a mother at birth, (and her own body), when you believed she had the right to choose WHETHER the baby lived or not (e.g. abortion) etc. This comment was deleted . I wonder how it’s okay to judge women with different choices- such as home birth- because even though this article is about 3 high risk pregnancies- previous articles on home birth on Mama Mia and different birthing styles have been represented similarly- and yet it’s not okay to judge the publisher of these articles and their expressed opinions.
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Feminism? Oh how I love how this is dragged out obfuscate an issue that really should be beyond ideology.
It does such a disservice to women.
But if feminism is about choice, well let’s talk about choice:
Birthing at home RESTRICTS the choices available to women during childbirth. Women are at home, WITHOUT access to particular forms of pain relief, WITHOUT access to particular interventions and MEDICAL EXPERTISE that may save their lives or the lives of their baby.
Post partum haemorrhage can kill women quickly, in minutes.
Home birthing takes women back decades, DECADES. What a travesty to equate it with feminism.
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yes a pph can kill in minutes… My PPH almost killed me on the operating table, and was caused by the OB GYN leaving me on syntocin for 16 hours then performing a c-section because of failed induction. For all of those women commenting about how it is safer to birth in a hospital… look up cascading interventions, then comment. Hospitals have their risks and blindly trusting that your doctor is doing the right thing by you is a dangerous road indeed. For any Birth home or hospital, informed consent is paramount. we all need to take responsibility for our bodies and health. Doctors are not omnipotent deities, they make mistakes and things can go wrong.
OB GYN’s are not trained to handle a natural birth, they are trained to intervene and speed up the process to an “optimal” time frame. vilifying women who choose to normalise birth is not the answer. We need more support and understanding (especialy from the medical community) to ensure that when a woman chooses a home birth, that she is taken care for the optimal outcome.
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I agree with every word. It gets my nose out of joint that people feel they can make women give birth a certain way.
People should not need permission to do things that involve their own body and their own baby who would not even be here without the mother.
I personally don’t “get ” home birth but I respect people have a right to do things as they see fit.
If things were not so polarized and an choice supported these high risk mother may not have been so militant in their home birth beliefs.
And I really hate how people who chose a different path are called selfish and bad mothers . Two of my friends home birthed- one over 40 both without mid wives and while I had concerns for them I understood their choice. ad they are both exceptional mothers. Much better then most actually.
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Home births are beautiful, wonderful things… if they go to plan. Lots do.
However you should have to qualify for a home birth. It is no longer about your rights but the rights of your child. I had an emergency cesarean with my first child, and was told that I had to give birth at a hospital for all subsequent children due to the risk of my scar tearing. Not what I wanted but ok, it was quite clear to do otherwise was to go against medical advice of the person I was entrusting my childs life.
To be honest it’s a bit of a no-brainer. Midwives should not be allowed to do homebirths if the child/mother is at risk. If they don’t tick all the boxes go to hospital.
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This article certainly has legs, doesn’t it! I agree, with low risk women (and proximity to a hospital) only for home births. I wish, also, that women intending to homebirth, could book in to a hospital with that intention and with the occasional visit to the antenatal clinic during pregnancy, so that they could have some obstetric monitoring and that homebirth midwives could stay with their patients in the event of a transfer. I know there are some govt approved homebirth trials in WA and SA going on at the moment and I’m keen to see the results down the track.
There are also trial caseload/group practice midwifery programs for some women happening now. One of them at our local hospital. The women love it, but the midwives are getting a bit burnt out. They need a better rotation of experienced midwives in our local caseload trial.
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i have had 3 homebirths. the 3rd was with twins and it was a waterbirth. all 3 pregnancies, labours and 4 deliveries were complication free. i was very fortunate not only in that regard but also my midwife was trained and competent and had complete faith that i would be safe with her.
i wanted to put this out there to hopefully lessen the negativity stirred by the tragic deaths of these homebirthed babies.
i have read that 0.23% of homebirthed babies die and 0.78% hospital birthed babies die in australia. can anyone confirm this?
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They are a bit hard to compare as all the complicated premature and dangerous births would end up in hospitals so the stats on’t really mean a lot in this context.
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Mum of 4 – what was your plan to mitigate the risk for the second twin? We know that the second twin is at risk from placental separation as the uterus contracts – plus a range of other complications. Were you just happy to accept that risk?
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the twins had separate placentas.
i was fortunate to have no complications and felt any risk to be extremely minimal.
my twins were born at 40 weeks and 1 day. 3.85 kgs and 3.75kgs. yes. i was big.
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mumof 4 – you “felt” any risk to be “extremely minimal”? ON what basis did you think this?
Not only does the Coroner disagree with you, the COllege of midwives disagrees.
By all means stand by your choices, but don’t pretend that the risk to your second twin wasn’t there.
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Having read the Coroner’s report the thing that stood out for me is that 2 out of the 3 mothers claimed that they were not informed of the real risks involved in their births (enormous baby + untried pelvis and breech birth), they were told that there would be no problem delivering these babies at home. With tragic consequences. The mother of the twins was aware of the risks but as she said afterwards (I’m paraphrasing as I don’t remember the exact quote) “you hear the risks and you think one in however sounds low, but someone has to be the ‘one’ and if it’s you it’s going to stay with you forever”. I feel so sad for those mothers that their babies are dead and that they will know forever that things could have been done to save them. Lisa Barrett’s arrogance and incompetence seems staggering. Unfortunately her efforts set the cause of low-risk homebirth back decades.
I hope Lisa Barrett is prosecuted and that the Coroner’s sensible recommendations are put in place.
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I don’t think the mothers can claim ignorance. it is ovious that these are all complications and they chose to listen to someone with a bias towards home birth over a balanced professional.
One quick google would provide plenty of information. They took a risk when the odds were not good and now live with the consequences. very sad.
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Oh I can totally see it happening that they had a caregiver that they trusted who was telling them from the start that everything was no problem – overweight, vbac ‘trust your body it knows how to birth’, then when other risk factors came into play – big baby, breech ‘it’s just a variation of normal’. i don’t know if we would judge a mother so harshly for not googling if it were a rogue obstetrician giving crap advice? Lisa Barrett was obviously telling them what they wanted to hear, but she passes herself off as an expert and demonises other medical opinion as scaremongering and interfering with the natural beauty of birth.
Hopefully one good thing to come of this is that more women will at least ask for a second opinion.
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A couple of things here. Firstly, no matter which medical professional you speak with, you will get some measure of bias in one way or another. Doctors are human too, and they learn, either with their experiences, or with the way they learn to cut corners, what works for them.
People are taught to always listen to what the medical professional says, because they have had the training and experience, and they “know what they are doing”. Not many people ask for a second opinion if their doctor says they need immediate surgery, even with the inherent risks all surgeries have. I note that this includes emergency c-sections. Many emergency c-sections are done for the convenience of the doctors and because of their fear or being sued should something go wrong in a normal birth. I have come across multiple women who were told they MUST have a c-section, despite it being a second or third child, and the previous births going flawlessly, with no complications in the pregnancy. There are a LOT of c-sections that are needed in order to save mother, child, or both. However, there are many that did not need to happen, where things were going smoothly, but the doctors stated “emergency c-section” and the parents of the baby believed it.
Secondly, I know that this may be inconceivable to many, but not everyone has a computer. Even those who have a computer at home, may not have the internet. Not everyone has the power to tupe in http://www.google.com and get answers to their questions. Even those who DO have google can type in search terms and get bad advice. In the beginning. The internet was mainly giving out information from experts. People who had the knowledge and it was put up for them. Now, Joe Public can write a blog on anything, and even if they know diddly squat about it, they can convince hundred, thousands or millions of people that they are the foremost expert, and they know what they are talking about.
For instance, I have one child with Aspergers, one child with Autism, and a husband with Sarcoidosis. I could write until the cows came home about my experiences with these things, but I am no expert. What works for my children, or even my husband, may not work for someone else. The scary thing is, what works for them may actually make things worse for someone else if they tried the same measures. None of these conditions are “standard”, all of them have a huge variance in what is experienced. I cam, and do, read blogs about the conditions. However, I will take everything with. Hefty container of salt, and try to take out of them what may work in my own situation.
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I would just like to say the whole ‘natural birthing experience for the mother ‘ is crap. The birth should be about getting the baby out safely and alive, not about the mother having some Zen-like birth experience! Once a women has had a caesarean she not only has stitches in her stomach, she has stitches in her womb, which during a second birth, with the stress of the contractions etc, can easily split open. But of course the outside of your stomach does not split open again. Guess what happens to the baby then! It is stuck inside you, half in the womb, half in the womans insides, and it dies! This is incredibly risky and women that choose to do a natural birth at home after a caesar are putting their unborn baby at undue risk for their own selfishness of wanting ‘their perfect birth’. With no regard to the health and safety of their baby. And yes there should be charges laid. Birth should be about the baby not all about the mother.
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Why are you assuming homebirth is anything to do with ‘Zen’?
Don’t make the insulting assumption that women who consider homebirth are all arrogant, misguided hippies.
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thank you anonymous. i had a home birth and it was bloody hard work. if i had wanted a zen experience i would have gone to the hospital and gotten an epidural.
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“gone to the hospital and gotten an epidural”
A bit harsh.
Giving birth is hard for everyone. Epidural or otherwise.
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Oh for pete’s sake.
It epidurals didn’t make it easier no-one would have one!
I went through hours of torturous agony with no drugs, finally the bliss of a spinal tap and an emergency caeser!
If one of the best moment of my life involves being cut open and stitched up again those painkillers must be pretty awesome.
I’d go so far as to say my spinal block was pretty zen!
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Thanks for making me laugh!
One happy note in a sea of nastiness!
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Well, I’m interested in what you think should be “done” to women who want to birth at home…?? Should we have maternity birthing jails? Shackled to the wall?
Birth Rights is a real issue here. Many women feel akin to have been raped after their hospital births and therefore look for another way in which to birth. In their own home they can control the space & the people allowed into the birthing space… and with a good fully trained homebirth midwife the signs are recognised early when a woman needs to go to hospital. But the current Legislation makes it difficult for a woman to find any homebirth midwife and many hospitals are less than supportive of homebirth transfers.
And yes, Birth Rights for babies too – and this doesn’t imply they should be in a hospital. This implies they are cared for fully by a fully trained Homebirth Midwife who has all the equipment needed (yes they do carry a fair amount of equipment) – and the baby is treated gently and with respect at all times.
Question: How many babies die in hospital? What are the figures compared with homebirth babies?
I was once told that if my baby died in hospital even the people in the next room wouldn’t know, but if my baby died at home it would be on the front page of Australian Newspapers.
This is a personal choice and, frankly, the reasons a woman chooses to have a homebirth are many and varied. Be sure of this though: these mothers love their babies too!
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A couple of points:
Firstly, to take your point re women feeling as though they have been raped. I can’t imagine what it is like to have a traumatic birth but I do feel as though this remark is insensitive, perhaps even offensive. Can women not do enough justice in the description of their experiences that they must resort to a term which is sensationalist? Rape is, in most cases, about control for controls sake, about power, in dominating someone and creating fear. Or, at the very least, controlling someone for their own self-gratification. Birthing interventions *may* be about control (of the situation) in some instances but always with the application of years of study and experience in order to bring about the safest outcomes for the mother and child. The intent is not about causing harm to someone but to minimise harm to two people – the mother and baby. For me, the two just don’t compare and I’d have much more sympathy for these women if they could steer away from dropping in the ‘r’ word to describe their experience.
Secondly, with regard to the number of babies who die in hospital vs. the number of babies who die in birth at home, these figures will always be skewed by the fact that:
a) most high risk births occur, planned, in the hospital setting
b) most cases of difficult births (that are occurring at home) are then transferred to hospital anyway with the ability of the obs to secure the most positive outcome hindered by the late intervention.
I’d suggest that a far more effective and safer response to a traumatic birth is to seek treatment for that trauma before choosing to have another child rather than steadfastly avoiding medical intervention no matter the potential cost to the child.
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Although the current media debate would suggest otherwise, the percentage of homebirth in Australia is so small that it is unlikely to affect the data on hospital deaths.
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Anon, I wish I could like your comment 100 times!
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Well I note that on this forum the word rape has upset a few people – but I have heard several women use the “rape” word in describing how they felt after having had their baby in very traumatic circumstances in the hospital. I’m lucky enough to have have 4 beautiful water births myself, but “rape” is the word not a few other women have used when describing their baby’s birth…
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I find the association made here between a hospital birth and rape so utterly offensive.
It’s simply deeming and disrespectful to those women who have been victim of rape. Actual rape, not off-with-the-fairies rape.
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er…re: midwives carry a lot of equipment with them…
Midwives can’t do surgery! Midwives. Can’t. Do. Surgery.
And no one can do surgery at home. Not even Lisa Barrett.
Who wants to be stuck at home if it becomes evident that surgical intervention is required??? And yes, this can happen all too quickly, even in ‘normal’ pregnancies.
Wheel me down the corridor to theatre vs call the ambulance / waddle bleeding down to the car for the drive to the hospital …..hmmmm not a difficult decision, really.
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I really wish people would not compare giving birth in a hospital to rape. They are NOT the same thing. They are not even close to being the same thing. It just makes me really upset to compare the two. I can guarantee you that the person who made that statement had never been raped.
“I don’t like the first class medical care I get in my clean, sanitary first-world hospital” = FIRST WORLD PROBLEMS!!!! Gah!
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Like x100000
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The world health organization defines rape as “physically forced or otherwise coerced penetration – even if slight – of the vulva or anus, using a penis, other body parts or an object”.
Could you explain to me please how a doctor inserting something into a woman’s vagina when she has refused consent does not fall under this definition?
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The difference is so clear I’m surprised you can’t see it.
Intent.
When someone actually rapes you, the intention behind that act is totally different to someone trying to save your or your baby’s life.
Would you rather a doctor let you or your child die? Or at the very least run the risk of that happening because they haven’t obtained your consent to something at a time when, realistically, you’re probably not thinking straight and not in a position to understand the very immediate risk you are facing and make an informed decision anyway?
That’s like saying someone kicking you in the chest in a vicious attack and breaking your ribsis the same as someone breaking your ribs while performing CPR on you.
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Actually “intent” has nothing to do with it.
You can’t prove intent. Only physical action.
So maybe don’t be so rude?
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You’re either trolling or totally irrational; in either case, it’s a total waste of my time to argue with you.
You’re obviously far more emotionally invested in this topic than I am, but nonetheless I do apologize if my comment came across as rude; the tone was intended to convey how perplexed I was that someone could actually think medical intervention during labour is in any way akin to rape.
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There is such a thing as diagnostic rape… it is very real, and a lot of women have experienced it. Diagnostic rape occurs when procedures are carried out without informed consent leading to the patient experiencing trauma(emotional or physical). It occurs most often when a women is in labour. has anyone on this sight read articles on the OB GYN in Lismore who carved his initals into a womans abdomen… the woman described feeling violated.
My own partner relayed to me how upsetting it was for him to witness me undergo an internal exam during labour. I had refused but the doctor did it anyway. These situations are catergorised as diagnostic rape.
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Laura S, you truly seem NQR . What a ridiculous post. Seriously.
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I don’t know what NQR means. But I do know that I don’t trust doctors, and no one sticks anything in my vagina without asking me first. I don’t care who you are.
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Not Quite Right.. Secondly doctors always tell you what they doing, thirdly if its an emergency why the hell do you care. Isnt getting your baby out alive a priority over complaining about someone doing an internal. Most babies come out of a vagina for god sake. If you dont trust a doctor, dont have a baby .,Plus get over yourself, doctors are not interested in fondling your vagina, they only want to get your baby out alive. Another NQR comment,.
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Natasha – doctors don’t always tell you what they are doing in my experience, that was my point. I have come across some doctors who seem to have a God complex, and think they can do whatever they like to you without your consent, because they are the expert. Of course I would allow a doctor to do whatever they felt was required to save myself or my baby, but have enough respect for my mental health to explain what you are doing, and give me some warning before you shove stuff in my vagina (especially as this can be quite painful).
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Natasha, doctors don’t ‘always tell you what they are doing. I was given an episiotomy with a pair of scissors and no painkillers and I was not told that it was going to happen let alone asked. That was in 2004 at the Mater in Brisbane.
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Natasha.
A doctor was very much interested in fondling my vagina and breasts. I was sexually assaulted by a locum GP years ago when I was too young and inexperienced to tell him to stay the hell away from me.
Also doctors certainly do not always inform patients as to their course of action.
You may have had some good experiences, that is nice for you but we don’t all have the same experiences!
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your poor husband !
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@Laura S ,, your poor hubby
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Anonymous – a doctor may have done that to you, and I’m sorry if it did, but that doesn’t mean you forego all doctors. You find someone else and you get the offending doctor charged.
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@ Anonymous – sorry i dont believe you
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Well f*ck you too, Anonymous.
I don’t need you to believe me or be supportive, but that is just rude.
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Thanks Kris for the supportive words.
All the rape talk triggered some bad feelings in me and I let it out.
I have a fabulous GP. I still get pap smears. etc
Generally it’s all fine.
But sometimes feelings just bubble up.
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Anonymous, that sounds like a truly horrific experience and that doctor’s predatory behaviour is totally inexcusable. There can be bad seeds in all groups of society, but it’s particularly abhorrent when that person engages their prey in a relationship of trust.
My firm opinion is that that doctor was in the very slim minority; I’m glad you’ve been able to seek medical elsewhere.
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Anonymous – I dont believe you either. He was examining you. That involves internals, breast examinations.
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Notat all – if the doctor explained what hey were doing and why they were doing it, I would never think it was rape. Uncomfortable yes, but in my best interests.
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Um last time I checked rape was a criminal offence. Medical intervention during birth, whether wanted or not, is about getting the baby out safely. Your comparison is questionable. And here I was thinking that birth is about the safe delivery of a baby.
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Exactly. There is a huge difference. When you get pregnant, you presumably acknowledge that at some stage the baby has to come out. The doctor is attempting to help you with this. You are on the same side. The fact that you might have to have something inserted in you to get the baby out is part and parcel of choosing to have a child.
However, when you are raped or assaulted, your attacker is not there at your behest, or to help you. They are there to attack you. Their motive is completely different. The trauma is lasting.
Obviously, I am not talking about a rogue doctor who IS actually sexually assaulting you and not just doing their job as a medical professional, because they would fall into the second category and not the first.
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So on one hand – Do not judge a mother who has not educated herself on portion control and good eating habits for her children …… but it’s a free for all to judge and negatively comment towards home birthers??
What is going on mamamia? and also noted that you bumped this article back up to the top of your home page today as ‘news’…. days after it was originally posted? Stats are working for you on this one aren’t they.
I am confused, 8 – 10 months ago the reporting and perception of bias on this site was irritating me but I returned to the site, and in recent months I have really enjoyed the reports and the style the blog has taken.
But these last 2 weeks have lost me again. I mean Mia tweeted Chrissy Swan a message to look at the site and all the love for her but at the bottom of the original post was written “Any harsh, rude or offensive comments about Chrissie or her children will be deleted” so of course there was only going to be a positive response….. you can hardly manipulate the responses and comments and the go crying that all your readers are wonderful and supportive….. and then you let the vitriol being written by commenters on this here blog stay!
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You never know what life is going to throw at you. For this reason I chose to have my babies in hospital with an obstetrician. I did like to know that the crash cart, NICU and theatre were right there if baby or I needed them. In the end both were smooth, uncomplicated deliveries. This is the pnly issue I have with home births. If something goes wrong you just dont have the degree of back up near enough, and it’s just not worth the risk. In my opinion.
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Shame on all the “mother bashers” who have commented here and passed judgement on the 3 mothers who lost their babies- lighten up sisters!!! http://thehoopla.com.au/35958/ Have a read of what Corinne Grant has to say about ‘mother bashing’ Ask yourself since when did it become ok to publicly attack other mothers for making a choice different to yours?
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Hey Adele, they ‘lost’ their babies because they made the choice to give birth at home despite being high risk.
Lighten up?
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@ Adele, lighten up sisters??? 3x dead babies due to selfish mothers putting their own needs first. Yes mother bashing is alive and well. Pity their babies are not.
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The mothers have admitted that they didn’t understand the risks they were taking. They are probably hurting right now more than you could possible imagine – go easy.
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What a ridiculous comment by you LauraS. What do you mean,? Common sense would tell any woman that delivering a baby in your bedroom is risky. These women choose to risk their babies lives for their little organic experience and paid the highest price.
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Natasha, can you stop being so Nasty and Patronising.
‘little organic experience’? really?
You clearly enjoy it, but it is not nice.
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I cant cope with your ridiculous posts LauraS.
Calling an internal, a possible rape. Lord a baby comes out of your vagina. Doctors need to do internals for gods sake. Secondly babies born in bedrooms are risky. So why risk your baby or your life when things can go wrong in 2 minutes. You make absolutely no valid points.
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Yeah. I’m not LauraS.
You don’t make valid points either Natasha.
You just say nasty, patronising things.
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I had the best delivery, epidural and by god I loved it yes. safe and well knowing I was in good hands in a hospital.
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Too many women are having Caesars, too high a rate- quick stop the Caesar rate being so high! national headline!(from last year some time) Now- too many home births! Dangerous! Stop the home births! For f’s sake everyone calm down. The fact of the matter is 100 years ago most of us would be dead from trying to give birth..I know I would no longer be here, and at least four of my friends. Women died all the time giving birth hence the number of 19 year old second wives in your family if you have a look in Ancestry.com …it is a thousands times better than 100 years ago and this is just another judgey mcjudgerson story that I can see no use for.
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What an odd comment. Calm down, you say. 3 babies died unnecessarily. You don’t think that’s a shame at all? Oh wait, more people died 1000 years ago.
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Three years of TTC. Over 25k spent on IVF and natural therapies. I’m finally, fingers crossed, getting pregnant through the use of my sister in laws eggs. The stakes are too high for me to even consider a home birth.
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good luck, good luck, good luck, good luck!!!
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Thank you!!
)
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Just clearing up a few things that were said in the original article: firstly, Ms Barrett was unregistered by the time she attended the third birth (the birth of the twins) and secondly, one of the babies did indeed see the inside of a hospital. The twin who died spent two days in NICU before being sent home to die of catastrophic hypoxic brain injury. The parents of the twins knew that Ms Barrett was unregistered at the time they retained her services.
All that aside, this is a very grey area when it comes to where to lay blame. Yes, Ms Barrett was grossly negligent but the parents were also determined to opt for homebirth regardless of any risks they knew about. I suppose one could argue that Ms Barrett had no business aiding and enabling them. Each of these women would have gone to hospital if they’d been unable to find a midwife who’d attend a homebirth in their circumstances. None of the women are saying so, but I’ll bet they all wish they could go back and do things differently. I think we ought to leave them alone and let them grieve.
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Yes, all true, however after the first baby was born and concerns for the second baby were raised, the family and Lisa Barrett travelled in a private car to the hospital and the second baby was delivered before in the car before arriving at the hospital. If concerned enough to travel to the hospital, why not at least call an ambulance. Whether this would have made a great deal of difference in the end, no one will know, but at least trained medical staff and equipment would have been on hand.
Secondly, the mother chose to have a home birth will all the knowledge (like you have said) that this was a high risk pregnancy however still chose to risk it. Her reason was one of her previous pregnancies she had had hemorrhaged and the dr present at the time had done all they could at the time to save her and minimise the bleeding by putting his or her hand up there to attempt to stop the bleeding which she believed was ‘birth rape”, not ‘trying to save your bloody life right now!’
It is absolutely gut-renching & devastating for any family to loose a child, but people need to remember as fantastic as it is to have an ideal birth plan, but the rest result needs to be mum and baby/ies both healthy and alive at the end of the day!
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… Depending on the distance between hospital and home, it can often be faster to get in a car and transport yourself to a hospital than to call an ambulance, wait until the ambulance can be dispatched (hope that there are no major emergencies where all the ambulances are busy on other calls), wait from then until the ambulance arrives. Once in the ambulance, there is some equipment, but not a full amount of equipment in case of complictions while travelling… So in reality, you still have to wait until the ambulance gets to the hospital before getting full treatment. In a private car, the midwife can call the hospital in advance to give them warning about what is happening and to get doctors prepared for their arrival. The partner can drive the car directly to the hospital, and they can go straight into A&E. With the nurses at the front desk being prewarned, there shouldn’t even be a massive wait to be attented to there, either.
Some births are faster than expected. I’m living proof that some women just don’t have to wait hours before delivery. My first birth was a whole 12 minutes in length, from first contraction to delivery.
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How can we be absolutely positive that these little ones would have survived in a hospital?
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Because THE CORONER – an expert with many years experience in investigating the circumstances surrounding death heard all the facts of the case, all the arguments from both sides, and, incorporating the most up to date statistics regarding childbirth and its complications – has come to this conclusion.
Sure, we cant be 100% positive – hey, a meteor may have hit the hospital should they have chosen to birth there – it’s possible – but statistically, unlikely.
When the risks were weighed up in these cases, the findings were that these little bubs would most likely have been alive today if born in hospital.
Find me anything that is 100% positively guaranteed in life.
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I hate reading theses articles. I had my third baby at home unplanned, it was traumatic – thank god he was breathing, thank god nothing went wrong!!
How can someone put their own wants before their babies is beyond me, when clearly when the mothers have been informed not have a home birth and know it’s not safe. Then DON’T do it! You do what’s best for the baby, no excuse!!
sometimes there is too much choice and this is one of one them.
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I just don’t get the whole plan thing anyway.
From the start I wanted a healthy baby, I did not care how the baby arrived as long as it was alive and breathing. (years of IVF probably influenced my thinking)
I have had two live babies and two still births.
Believe me how the baby get’s here is irrelevant. You should not have to go through that experience to realise this surely??
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I think the plan thing is more to get the mother to concentrate on the final “goal” – that being the delivery of a living, breathing baby. All of the birthing plan things I have seen have been inconsequential during the delivery itself, but it can help to focus the mother on what needs to be done, open their eyes to potential complications and what they want to do should any of those complications arise.
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MEDIA RELEASE 6 June 2012
Serious health system issues to be addressed following the release of South Australian Deputy State Coroner’s report into baby deaths during birth at home
The Australian College of Midwives (ACM) calls for a calm, considered way forward following the release of South Australian Deputy State Coroner’s report
The release of the South Australian Coronial report into the deaths of three babies in SA who died during births at home has pointed to some serious system problems that need addressing, but a calm and considered approach is now needed. The ACM respects the important role coroners have in making recommendations to prevent adverse events in the future.
The ACM recognises that homebirth for low risk women networked into responsive health services are safe when attended by registered midwives and that when women have significant risk factors in their pregnancy or during the birth that consultation and referral to other health providers/hospitals is ideal. The midwife chosen by a woman to be her primary care provider must be allowed to continue to support and care for her when transfer to hospital is required and this is not currently a reality, providing a significant disincentive to safety.
The ACM supports the Deputy State Coroner’s recommendation that the practice of midwifery should be permissible only in the case of midwives registered under National Law as this ensures accountability and the meeting of standards that protect the safety of the public, but it needs to extend across the full scope of practice of a midwife. The ACM also commends the Deputy State Coroner on his recognition of the importance and usefulness of the ACM Consultation and Referral Guidelines for enabling safe and appropriate consultation and referral.
However, the ACM is disappointed that there has not been a greater emphasis on strategies to prevent such tragedies as seen in these three cases. All these women had suffered traumatic previous births in the hospital system and some sought care in birth centres but this was not made available to them. Providing recommendations about more access to continuity of care in hospitals, counselling of women following traumatic births and a recognition of the impact of birth trauma on women’s psychological wellbeing would have been welcomed, but were dismissed as irrelevant. With post traumatic stress disorders now affecting a significant number of women who give birth and suicide as one of the leading causes of maternal death we cannot ignore the ramifications of birth trauma.
The recommendation to report women who are seeking to have a baby at home with risk factors is of grave concern as it may push some women further underground and lead to them not seeking any engagement with health services. The ACM finds the statement that all these babies would have certainly survived if a caesarean section was performed concerning as such certainty is not possible with childbirth. It is also a concerning message to send to women in this country with one of the highest caesarean section rates in the world. Once a woman has had caesarean, complications in subsequent pregnancies are significantly increased. Emerging epidemiological and epigenetic evidence is also showing the longer term health ramifications of caesareans for the child, such as Type 1 diabetes, asthma, obesity and some cancers.
The ACM also recognises that until private midwives are allowed clinical privileges to be able to practice in hospitals that reluctance on the part of the woman and midwife will continue to compromise safety and seamless transfer. The ACM calls on all governments to take a calm and considered approach to improving birth outcomes through system change and make sure that we provide safe, appropriate and individualised care that maximises continuity, collaboration and a seamless integrated service.
Contacts:
Australian College of Midwives Media Spokesperson Hannah Dahlen 0407 643 943; President Sue Kruske 0418882337; Executive Officer Ann Kinnear 0438 855 529
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This statement contains a few issues of concern:
“when women have significant risk factors in their pregnancy or during the birth that consultation and referral to other health providers/hospitals is ideal.”
“Ideal”? Not mandatory? IF the ACM is the standards-setting body for the practice of midwifery, then standards should be set – not just suggestions.
“The midwife chosen by a woman to be her primary care provider must be allowed to continue to support and care for her when transfer to hospital is required..” It is not clear how this could be mandatory, as the midwife would have to be credentialed by that hospital, just like any other clinician. No other doctor or nurse can enter and practice in an institution in which they are not credentialed to practice. The onus is on the midwife to seek this hospital credentialing, just like any other contracted clinician.
“The ACM finds the statement that all these babies would have certainly survived if a caesarean section was performed concerning as such certainty is not possible with childbirth.” While this is strictly true, it is very rare for previously thriving babies to die intra-partum in hospital. The post-mortem results for all were reported, and there were no unsurvivable congenital abnormalities. “Almost certainly would have survived” is accurate.
“The ACM calls on all governments to take a calm and considered approach to improving birth outcomes ” This is exactly what the SA Coroner is calling for.
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Just as an aside here, the reason I could not organise a homebirth for my last child was because of the lack of a hospital which had registered midwives associated with the hospital, so ongoing care could be organised should complications be found – even before going into labour. There were three hospitals that I found in all of NSW that had midwives registered with them that also attended to homebirths. Three. If midwives and hospitals could actually work together perhaps woman would be more open to communication with the hospital and the midwife if they were worried about something. Even more concerning to me at the tome was the lack of a birth centre. I was open to going to a birthing centre rather than a home birth, but there were very few of those, and the ones I found needed to be booked in, as they could handle a MAXIMUM of four deliveries at their best times. Generally, they couldn’t easily handle more than one delivery at a time.
There is definitely room for improvement
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By interfering with constitutional law which states that no one is to be enforced, bullied or molested into accepting medical treatment. Something that those in the medical profession are good at. Be realistic this is an issue of power.
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Have your baby at a hospital otherwise consider yourself a selfish human being.
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So many “opinions”, imagine if those 3 mothers of those 3 lost babies had the opportunity to post a comment on here…..do you think they would be touting their “opinions” and saying they wouldnt change a thing about their decisions? Of course they wouldnt, they would be teaching from their own lessons learned (like everyone else here is doing) and I can only say that if one person said they had a “wonderful fulfilling homebirth” and one person said that their baby died because they chose to have a homebirth id like to think that my pig headedness wouldnt be put in front of the health and life of my child.
Many rules have changed over time, ususally because more information was gathered and learned and people made a decision to change because it benefited someone. In this case doesnt it benefit the child to change?
ive had a couple of kids, and their birth is but a blip on my radar along with breastfeeding, sleeping, playdates, nappy rash, disposables vs cloth. Being pregnant is a distant memory and i dont hug myself to sleep every night in the bliss knowledge that i made sure to get enough excercise and drink enough water and participated in yoga. Birthing memory’s for me is the divine jelly with fruit in it that they served one lunch which i still crave to this day 12 years on, not wether i had a fulfilling experience surrounded by whale music or felt pushed around by the birthing staff.
Dont get me started on the circumcision debate, that was a heated couple of weeks for me about ummmmmm 13 years ago, guess what….i got over it!
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I’ve read the Coroner’s Report, all 106 pages of it. What the Coroner has highlighted is NOT the issue of wether women should have access to home birth.
His findings were that the women involved were not provided with all the information about the risks of their particular situation in a home birth situation. Therefore they were not able to make a truly informed choice.
The Coroner wants women to have access to this information, when they are considering a home birth.
If this article helps to provide a balanced view to women considering a home birth isn’t that a great thing?
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A little off the topic, but I have to say I don’t like how giving birth has become such a competition… it’s really like people have something to prove, that they are ‘strong’ enough to give birth naturally without drugs, and there’s almost a shame to admit you had pain relief.
It really is such a different experience for everyone, and we all feel pain so differently.
I went into labour after some sudden complications and was in agony. I was dead set against having an epidural (although looking back I’m not even exactly sure why) but after 6 hours I had only dilated 4cm and was a wreck, I begged for an epidural.
It was amazing and I even fell asleep for 2 hours! When I woke up, I kept saying I was feeling pressure and the midwife was surprised to see I was fully dilated 3 hours after having an epidural, after constant warnings it would slow my labour down.
I know epidurals can slow labour of course, but I think having the epidural and making me relax was the best thing for my body, and I delivered a healthy baby naturally. I honestly don’t think I could have done that without an epidural.
I’m not advocating epidurals, but I think it’s ok for women to hear positive stories about having them too. A drug free birth would be amazing I’m sure, but I did not feel my body was capable of that and I’m fine with my decision.
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I did have a drug free birth. Two in fact. And both were amazing. But during both pregnancies I was able to get to know my midwives, who were there with me when I birthed my beautfiul babies. We knew, trusted and respected each other and that made the whole experience even more amazing.
My babies were both born alert, drug-free, had the benefit of receiving all the cord blood, skin-to-skin contact and baby-led attachment for breastfeeding. How could the outcomes be any better for them? Which is actually what it was all about.
My choices – made with the intention of giving my babies the best start in life – were understood and respected by my midwives and those births were empowered and incredible.
And for me? No stiches, no trauma and I went home within 22 hours of the first birth and 8 hours for the second. I prepared mentally and physically for those births. My first labour was less than five hours, with just 20 minutes at the hospital before bub arrived, and the second was only three hours, with 40 minutes spent in labour at hospital.
Oh, yes, I birthed in a birth centre. I was lucky to be able to access a birth centre, and i fully understand why women choose to homebirth. But I doubt the same outcomes would have been achieved in many hospitals with care providers that don’t respect mums. And don’t say they aren’t out there, because I came across enough during my second pregnancy (mainly OBs) who seem more focused on managing their potential risk of being sued that enabling positive and empowered births.
Frankly, some of the comments in response to this story absolutely disgust me. Stop pointing the finger at everyone else and look at yourselves. Being in a hospital does not automatically result in a better birth or better outcomes in every case. Medicalised birth is not superior to natural birth.
Every woman deserves an appropriate level of care and our health system is fundamentally flawed at enabling this.
Let’s stop fighting each other and instead put our energy into fighting for better pregnancy and birth care (like continuity of care with a known midwife which is proven by research to be the blue-ribbon standard of care in terms of outcomes for mums and bubs – see the Cochrane Review if you want the source of that).
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I don’t really know much about this issue, I never considered a homebirth, is there actually any benefits to the baby for being born at home?? Or is it mostly to give the mother a better experience and help her bond?
To be honest, as shocking as this was to many, I had no real birth plan. I just wanted a healthy baby, if that meant delivering naturally without drugs- fantastic, if it meant an emergency c-section, so be it. I’m a nurse so witness how quickly things can go wrong regularly, and while many criticise me for it, personally it wasn’t about me at all, all I was focused on was my baby.
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I had no birth plan either and was happy to do whatever the doctor recommended! They are the experts, aren’t they?
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On the whole the medical profession as students sit through approximately five births and rarely through normal labour. Where they develop expertise is in the area of complications and high risk pregnancy labour and birth. The Public need to be aware their education is in the area of complications not normal pregnancy labour and birth. Thus for many medical officers they view human reproduction as a dangerous process which needs extensive testing close scrutinisation and immediate action before anything goes awry. Unfortunately this often creates the complications which are being avoided. Midwives are trained in normal birth they sit through 30 or so labours and assist 30 – 40 women to birth. They guard against practices which deviate birth from its normal process, the are recognised by the WHO as the most appropriate practitioner in normal pregnancy and normal birth with the ability to recognise risk factors and access timely and appropriate referral as required. The issue in Australia is collaboration, the NHMRC has a very good document called National Collaboration in Maternity Care which is a very informative document on the standards that the Public should expect from all Health Professionals involved in their pregnancy and birth. Unfortunately we have a long way to go before Doctors Hospitals and Midwives have a system in place which meets these guidelines this document can be accessed at http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/CP124.pdf the shorter client version is at http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp124_maternity_brochure_update081110.pdf The reason this was written is because though midwives are very willing to work in collaboration is is rarely a reciprocal arrangement the other way around. As the public of Australia it is up to families to demand the standard of care that is best for them and their families
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Exactly.
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“On the whole the medical profession as students sit through approximately five births and rarely through normal labour.”
Guest – “on the whole” medical practitioners don’t deliver babies. Obstetricians, on the other hand, are involved in hundreds, if not thousands of births – of all kinds.
Even if a private hospital with a high Cesearean rate – say even 30% – then 70% of the deliveries are vaginal. Obstetricians are experts in all types of birth – vaginal, unmedicated, medicated, instrumental, surgical.
Australian hospitals already practice the best collaborative model, where midwives and obsteticians collaborate, each providing their particular expertise.
If childbirth were not a hazardous life event, there would be no need for birth attendants at all. Trouble-free deliveries need no experts – they essentially deliver themselves. The whole point of having trained clinicians assisting is that catastrophic things can, and do, happen.
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30 percent is not high. One of our private hospitals has a rate of 60. Australa wide the rate is almost 35 percent I think. Much higher than the WHO recommended 10.
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Anonymous – the previous WHO recommendation was made up – not based on any actual evidence – and has been withdrawn.
The “ideal” rate is based on the outcomes, not the number of operations done.
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At the time I gave birth to my first child the caesarian rate for first time mothers in the midwifery group practice (midwife led birth in a public hospital) was 36%. One of the reasons I decided to give birth at home.
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The voice of reason, Sue. Thank you for taking the time to make such well informed comments. I hope they are read and understood.
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Sue try and tell the truth and get a little balance
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That’s exactly the “birth plan” I gave to my OB (verbally) – Healthy Mother/Healthy Child…the rest was up to him to plan!
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What a ridiculous headline – Hospital Births killed 2339 babies – it’s official
In 2009, 294,540 women gave birth to 299,220 babies in Australia. There were 285,460 women who gave birth in hospitals, 6,396 women gave birth in birth centres and 863 planned homebirths. There were 2,339 fetal deaths in hospital and other facilities. There were 2 fetal deaths at homebirths. Of babies born at home in 2009, 99.8% were liveborn. (from the Australian Institute of Health and Welfare)
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There is so much more behind those statistics… a large percentage of those born in hospital would have died in utero, and many women with high-risk pregnanices who may have been seeing a private midwife would have been referred to hospital as a birth centre or private midwife would not be equipped to handle those complications. Therefore, these babies most likely still would have passed away if they were born at home with a private midwife. It’s all very well to come out with statistics such as these but to be really informed, there are so many factors behind them.
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EXACTLY Anya!! The statistics would actually mean something if the hospital deaths listed here were ‘term, low risk pregnancies’, which is what 99% of home births are!!!
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Shut those killer hospitals down! Quick! It’s official!
Lock up all those doctor-killers! Flay the Doctor Most Evil: the obstetrician!
To all patients: Go home! Put on your PJs, turn up the whale music and brew the herbal tea! Death, illness, pain – it’s all natural after all!
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This does not prove that home births are safe. It proves that even with medical help some babies will not live and they certainly would not have lived if they had been born in a home. What about the poor women who have had to go through the heart breaking scenario of delivering a known still birth. They would be included in those stats but they would not have survived a home birth. I think implying from stats that hospitals are bad and home births are safe is a very unsafe argument.
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Exactly, people die in hospital from heart attacks all the time, so it must be better to stay home!
(no, really please call the ambulance early if you get chest pain, better to be safe than sorry. Check out the heart foundation website!)
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What Anon fails to mention is that many fetal deaths in hospital are due to prematurity, placental abruption, termination of pregnancy and fetal death inutero to name a few. Hence the reason there are 2339 fetal deaths in hospital.
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Ask the paramedics who attend home births when things go wrong! The midwife stands back while the paramedics attempt to save two people! Mmm very safe! I doubt it, have your babies in hospital!
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Interesting fact, when the ambulance arrived at our planned homebirth when it was requested to be on stand-by by our midwife I was surprised when I realised that our midwife knew one of the paramedics. How did she know the paramedic you may ask? Why she’d delivered his wifes 3 children, at home. Something we tend not to hear too much about is the amount of medical professionals that choose hombirth as a preferred option. Our midwife has a fairly impressive clientelle and most of us arent tree-huggers.
Just in case you might be wondering, our baby was born safely at home with no intervention necessary from the paramedics other than observation.
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I had a smooth complication free homebirth for my third child after a very traumatic experience with my previous hospital birth. It is very sad that these mothers have lost the chance to bring up the babies that they have grown for 9 months, and whose entrance into the world they have carefully researched and planned for almost as long. They did however make a choice about their body and how they wanted to give birth. I am alarmed at the prospect of legislation restricting homebirth and womens rights to make choices about their bodies. Lisa Barrett is a very good midwife who gave support to 3 families who made a choice to have a homebirth, and made that choice because medical professionals didn’t support their choices in a hospital setting. There is a lot of grey area here and the medical profession must bear some responsibility for alienating and traumatising women to the extent that they are unable to give birth in a hospital setting. Speaking only from my own experience, I would probably not have another homebirth. Although it was an immensely satisfying experience, I don’t wish to invite the level of scrutiny or judgement that the coroners case has aroused to be an unwitting but toxic influence on what is one of life most precious moments- the birth of a new life and new family member.
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If it’s so safe and straightforward, why would you be worried about legislation?
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There can be personal responsibility in the decisions we make about our bodies, to me that is much better than legislation.
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It isn’t only your body though, it’s the body and life of a child that you’re not doing your best to look after as well.
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Her body, Her Choice.
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What about the baby? You choose to have a baby, you are signing on to do your utmost to make sure that baby is safe and healthy when you decide to have it.
You can make all the choices you want in hospital. The birth of your baby isn’t the time to get all petulant and complain about your “rights”.
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But there are TWO bodies involved.
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That’s the crux of it isn’t it: whose rights should take precedence. Personally I think women should be free to give birth any way they please (everything from elective caesars to free birthing).
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And dismiss the rights of the baby? Why is this okay?
I’m not dismissing the rights of the mother, I’m just saying that birth should occur where safety is the top and equal priority for mother and baby (which clearly isn’t the case in free-birthing or high risk home births).
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Re-read my comment. You sign on to bring a baby into the world, you do your best to make sure that baby is OK.
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Doctors choose to risk babies all the time… I had to refuse surgery on my leg that a doctor told me was medically necessary for me but could cause me to go into labour at 28 wks o,r even cause the baby to be damaged or die. why is it ok for a doctor to put a unborn baby at risk, but not ok for a mother to choose what she thinks is best for her and her baby… double standard.
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Did you actually read the report? She may have been a good midwife once, but the insanity of offering the choice to homebirth to high-risk women aside, it sounds like she really cracked under pressure in at least one case. Then did her best to dissemble after the fact.
As for legislation and the scrutiny of a coroner, I think after the death of a baby that would be the least of your worries! The issue is not so much legislation per se, but that midwives (like all medical professionals) are required to have indemnity insurance. As it stands, no insurer is willing to underwrite homebirths because they deem the liability too great, and the Commonwealth, which could also underwrite if it chose, is of the same view.
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Double r co, have you read the Coroners Report. It includes evidence that the mothers stated they were not informed of the risks of their particular situation in a home birth situation. Lisa Barrett did not discuss these risks with these women. Therefore they were unable to truly make an informed decision to home birth, and very sadly loss their babies. And this is a midwife that claims she is all about women’s choices.
I would strongly recommend you read the report yourself before you blindly make claims that Lisa Barrett is a good midwife.
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If you think “Lisa Barrett is a very good midwife”, perhaps you should read the Coroner’s report.
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if a good midwife is a highly trained professional, with many years of experience and someone who advises and then supports a woman and her choices during the pregnancy, birth and post natal period then yes I think that by that measure Lisa Barrett appears to be a good midwife. The real point is that the women who gave birth with her in attendance CHOSE to do so.
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She didn’t fully inform these women of the risks in their situation, denying them the ability to make a fully informed choice. She also lacked the skills to resolve shoulder dystocia. A student midwife who was there in the capacity of a friend was the one who actually got the bub out.
I could go on and on. Maybe you should read the Coroner’s Report to fully inform yourself.
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Well I don’t think that she appears from the report, which I suggest you read, to be a good midwife at all. And in all their careful research did they ever think to seek a second opinion from a doctor as to the high risk nature of their deliveries. I think having your baby die in your home with no medical help at hand would be far more traumatising than anything that may have happened to you in hospital where you may have ended up with a healthy baby.
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Not to diminish the findings of the coroner, but i dont think it possible for reasonable adults to meet regularly with a midwife over a nine month period and not discuss potential risks and what if something goes wrong scenarios. These are women who would have read, researched extensively, and consciously chosen a homebirth. Perhaps they chose poorly. Perhaps things may have been different if they had not chosen a home birth. Not necessarily. We don’t hear about the mothers and babies who don’t survive hospital deliveries. I would be surprised if the this coronal inquiry has provided any help or closure for the families involved in these births in Adelaide. Also it why haven’t we heard how many babies were delivered safely by Lisa Barrett – I believe it is many- both home and at a number of well regarded maternity hospitals.
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The Coroners Report is based upon sworn evidence presented by witnesses and those involved. To suggest that these women, who have already lost a baby, are not telling the truth re discussions of risk is pretty insensitive.
Researching home birth via the Internet does not constitute research. You are reading opinions by others, not studies, evidence based practice etc. Employing a health professional involves a duty of care by that professional to ensure that their client is fully aware of risk/benefit.
In regards to your comment re hospital deaths- you need to compare apples with apples. These four babies were healthy bubs up until the point of their delivery. The number of healthy, term babies that die during delivery in hospital would be extremely low. Four deaths to one midwife is extremely high. Yes babies die in hospital, normally premature bubs, or bubs with congenital abnormalities. Not healthy, term babies.
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am not suggesting that anyone is not telling the truth I have nothing but sympathy for the tragic loss of babies. My position is merely that it is a reasonable expectation that adults should have some responsibilty to research thouroughly a service that they intend to use. Particularly one that is obviously a little outside the mainstream. while the service provider obviously has a responsibility to disclose relevant information including risks, would you just take opinions in regards to your body or baby at face value even if they were the ones that you wanted to hear?
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I am all for increased regulations and support for home births, so sad for these babies though.
I do find it very interesting that Mammamia is so pro choice on abortion for whatever reason, including lifestyle choices, but is quite anti home birthing, which to me is also about a women’s right to choose, to birth where she thinks is best for her and her baby. I am not anti abortion and wouldn’t home birth if you paid me (I mean for one, the MESS!!) but it does make me uncomfortable to see legitimate choices being subtley sledged. Anyhoo, just my two cents!!
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Each to their own, if you want a holistic home birth good for you, if you baby dies because he or she is not close enough to proper medical intervention at a hospital well sorry you have to live with that for the REST OF YOUR LIFE..
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That’s totally a non-biased ‘each to their own’ opinion.
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The anti-homebirth sentiment in these comments, is astonishing. And the cries of ‘irresponsible!’ and ‘avoidable’ are surely a joke? It shocks me that NO-ONE has given a moment of sensible thought to question why, if homebirth is SOOOOO dangerous, the neonatal mortality rates of the UK, New Zealand and The Netherlands- where homebirth rates are encroaching on hospital births- are not at all increased from countries who shun homebirth like Australia? Seriously. Someone just answer that question. If every single one of you who believes your baby ‘would have died if they were born at home’ birthed your baby at home in The Netherlands, as regularly practiced, the truth HAS to be that they would not have all died (or even had reason to die). Otherwise there can only be two possibilities- The Netherlands would have an appalling number of dead babies being hidden in a massive conspiracy or the uteruses and vaginas and ability to birth babies of Australian women are biologically different to that of Dutch women. Both of those options are blatantly ridiculous leaving a third option- the excessive number of Australian women who have dangerous births have them BECAUSE of medical interventions. Because we induce otherwise comfortable and safe babies. Because we deem inconveniently ‘long’ labours as ‘failure to progress’. Because we give epidurals like panadol. Because epiduralised women are forced to labour on their backs. Because the normal ebbs and flows of babies heartrates are caught on monitors and deemed ‘distress’. I get that no-one wants to believe that they’ve been duped in their birth experiences but everyone simply cannot have been at the level of risk that they believe themselves to have been (or at least have gotten to that level without intervention) and still explain why The Netherlands isn’t one giant baby grave.
I never get why common sense doesn’t prevail in these instances and why everyone has to believe themselves to be the marginal statistic when it just doesn’t add up. It’s like the belief of women in their ‘inability’ to breastfeed. How is it even possible that the majority of the 54% of Australian women who aren’t exclusively breastfeeding past 4 months seem to all believe that they are physically unable to breastfeed while 94% of Rwandan women are still breastfeeding? Again I ask, are they biologically different to us? Do their breasts work more efficiently? Would 50% of Australian babies die if we didn’t have formula? Did 50% of Australian babies die before the relatively recent introduction of formula? No. It’s not about blame or us and them or any of that. It’s about common sense and research and not listening to propaganda bullshit or taking advice from websites that have their hands in the pants of formula companies.
If you want homebirth advice ask it of someone who has had a homebirth. If you want breastfeeding advice ask it of someone who has breastfed successfully.
And look at countries who do these things routinely and ask yourself why we are any different.
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The percentage of home births in New Zealand is around 2.5% – hardly encroaching on hospital births.
In the Netherlands home births are in decline down to around 30%. Regarding home birth in the Netherlands “It must be noted that maternity services in the Netherlands are set up to meet the demand for home births, transport is good, and distances short if emergency transfer to hospital is needed. The same advantages are not available in all places in the UK”
I have no issue with homebirth for low risk women, but when you are high risk then you are playing Russian Roulette with your unborn child by birthing at home. Lisa Barrett is a highly experienced midwife and is well known as an expert in difficult births by her peers, but just look what the outcomes were in these high risk cases. If hospitals with all the life saving technology cannot save unborn children in high risk deliveries how is birthing at home supposed to save them?
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Miranda, have you actually seen the evidence about Dutch home birth outcomes? It does not appear to be as good as you suggest.
Here is a recent study from Obstetrics & Gynecology:
November 2011 – Volume 118 – Issue 5 – p 1037–1046
doi: 10.1097/AOG.0b013e3182319737
Planned Home Compared With Planned Hospital Births in The Netherlands: Intrapartum and Early Neonatal Death in Low-Risk Pregnancies. van der Kooy et al.
That study found that: “In certain subgroups, additional mortality may arise at home if risk conditions emerge at birth (up to 20% increase).”
In other words, home birth is safe when it is safe, but, when unforeseen things go wrong, there is a significant excess neonatal mortality – even in a country where home birth is relatively common.
In Australia, the vast majority of families prioritise the safety of their baby over the mode of birth, and our health system supports this by providing unlimited access to free public hospital birth under the care of a midwife as a minimum for every Australian family.
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Amen, sister!!!
(that’s for you, Mirandarine)
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You miss the point. And in fairness to you, I do think a lot of commentators have roundly dismissed ALL homebirth, not the inarguably high risk births which were investigated. But this is not about all homebirths, and it is not about the across-the-board stats pertaining to homebirths. It is about these 3 particular deaths which, the coroner has ruled, were most definitely avoidable beyond all reasonable doubt.
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http://www.ranzcog.edu.au/publications/oandg-magazine/doc_view/762-16-trouble-in-paradise.html
So much for the Netherlands…
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Wow!!! Definitely sounds like the home vs hospital, midwife vs obstetrician debate is exactly the same in The Netherlands as here (and even fiercer).
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Thank you Mirandarine. Brilliant.
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You can still have an intervention free birth in a hospital. I did. It’s important to be informed and have a doctor/ hospital that understands and respects your wishes. The whole point of pregnancy is the birth of your healthy baby. I don’t understand why women protect and cherish their unborn children for nine months (by healthy eating, avoidance of alcohol & smoking etc) yet risk it all at what is arguably the most dangerous part of the process.
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Me too! My intervention free birth was bloody hard (compared to my epidural the first time round!) but my midwife was with me the whole way through and no doctor was needed (I even said at one point, “shouldn’t a doctor be here for the end bit?” and was told, “why would you need a doctor? There’s not a blessed thing wrong with either of you!”).
When my placenta delivered though it was very ‘ragged’ and I had a fair bit of bleeding and clots over the next few days. Perfect delivery, perfect baby, post-birth complications that could have gone horribly wrong. I’m SO glad I was in a hospital for monitoring.
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how lucky for you two, to have well managed births in hospital. Not all hospitals treat all women in all circumstances equally well. which is why some women are willing to take on the POSSIBLE added risk of a homebirth, instead of the certain risk of being forced into procedures that are not evidence based, and that carry a CERTAIN risk of harm.
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And not all hospitals are full of crazy butchers who “force” women to give birth in ways they don’t want to. Those of us who are anti-homebirth don’t write off all midwives after hearing about Lisa Barrett. Why is it OK for you lot to write off hospitals when the VAST majority of people don’t have any dramas at all with how their babies births went in hospital??
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Come on – certain risk of being forced into procedures that are not evidence based and carry a certain risk of harm by birthing in hospital. Please state what the “certain” risks are?
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I had the same thing. Jagged placenta after a great birth. My midwives picked up what was going on and gave me the injection to slow the bleeding. Only difference was that I was at home and the monitoring was done by two midwives with over 30 years experience between them. They calmly called the hospital (who had our backup booking and all the prenatal info about me and my baby including scans and bloodwork) and we were there 15 min later. They met us at the door. The outcome and procedure was no different to what it would have been had we been had we been in hospital. Home birth can be a careful and risk adverse process.
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I would urge anyone who has commented here, and anyone who has an interest in thos (no matter where you sit on the homebirth/hospital birth spectrum – and I do believe it is a spectrum) to read the full Deputy Coroner’s report. It’s an absolutely fascinating read, and I think it goes a long way to answering questions/correcting myths or misunderstandings that have been repeated here. Some of the findings in this report just made my jaw drop.
While I don’t doubt that mamamia have sensationalised this to a certain extent, in this instance it’s completely warranted. All cases before this coroner involved pregnancies with high risks that were known to all parties. In some instances, the parents deliberately chose not to seek consultations with medical practitioners to whom they had been referred, arguably *refusing* education that may have been available to them. I could go on, but instead really urge people to read the report. I understand it is publicly available.
The main point I wanted to get across is that reading this report and all the comments below has actually shifted me from being someone opposed to homebirth no matter what, to someone who accepts that while not for me persoannly, I can appreciate that there are some circumstances where, with the right safeguards in place, it may be an appropriate option (but not *the only* appropriate option). Mostly because the cases investigated by the coroner have such extreme features, both in the high risks that were brushed aside, and the complicity, even deviousness, of those involved to dismiss those risks. This has highlighted, for me, the numerous ways in which homebirth can go *well*…it’s like a “what not to do” guide to homebirth. As I said though, not for me, not with my history and my natural aversion to risk of harm to myself or my children.
I also want to make a suggestion to the mamamia team. The posting of this article has certainly been divisive, and has lead to some very interesting comments. But I think it has also highlighted the lack of options available to women (both within and without the hospital setting), and well as lack of knowledge about how to access those options that do exist. In a previous comment I alluded to various initiatives being explored by State and Cwlth governments (with varying levels of success) to increase options for birthing women. I think there is a real opportunity here for mamamia to do some serious reportage on what is happening in this space, and get women involved in being heard. Please?
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You are so right Crackerpants. I think the bigger issue is how the health system is in some cases letting women down, and how we can improve that system to make women feel safer and to support the choices that women want to make and so all babies are delivered in an environment that is both safe and comfortable for women and babies.
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I agree. I have read through the report. Very interesting. Each of the 3 situations were not considered low risk. To me, reading through, Lisa Barrett should be charged for malpractice, although in the last birth, she was already deregistered.
I note that the findings do not recommend the banning of home birth, but things such as policy changes to include larger babies as a risk factor, midwife registration, consideration of opening more birthing centrers and public education.
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Agreed – a lot of good could arise from these tragedies. For South Australia at least!
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Sadly a lot of the people commenting here seem to think that any mother who chooses to homebirth has just decided to do so on a whim and has no idea what they are getting themselves in for. I think many of you have probably never met someone that has had or considered a homebirth before.
A woman that chooses to have a homebirth does so after a LOT of research and soul-searching. They do not go in to it blindly. And they spend hours upon hours upon hours researching birth of all kinds, reading birth stories, both good and bad, and learn about the mechanics of the body during pregnancy, labour and delivery. I would argue that women who do ultimately choose to homebirth are often times much more educated about the birth process than many other women who choose to birth in a hospital environment. They know the risks and they prepare for them. They don’t assume that there is no chance that something won’t go wrong and they DO make the necessary arrangements to ensure they will receive fast and efficient emergency care if needed.
I myself had a hospital birth, and I will again when we have our next baby. However a close friend of mine recently had a successful homebirth and she was in no way ignorant to the risks and in no way callous about the safety of her baby. Her research actually benefited me and I believe is what helped me to have a successful natural hospital birth (as well as a little bit of luck and genetics!) because I read all the information she was reading about how the body works during labour and delivery and really prepared myself mentally for the labour and delivery process. Having said that there is no accounting for things that can go wrong and even the most well prepared woman can have problems and complications in the birth process, whether at home or in the hospital. I do think to some extent that this largely contributes to the horrible experiences that some women have as they don’t prepare themselves mentally for every possible outcome and accept that things might not go the way they plan or want.
Please don’t assume though that women who homebirth are stupid, ignorant or uneducated about birth and the associated risks. In a lot of cases they have read the literature and statistics and made an informed choice based on all the information available to them from various sources that are both for AND against homebirth.
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I would have died during childbirth had I had a home birth K, so what would you had to say if I decided to have a have a home birth and died afterwards….. Oh poor woman. Luckily I was not stupid enough to make that decision and I am alive and well to tell the story.
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I respect your decision to deliver in a hospital and don’t think you’re stupid at all for making that decision, just as I respect the decision a woman makes to birth at home when there are no or low risk factors. My point is about showing respect towards all women and their choices. There are lots of successful homebirths, it’s only the ones that go wrong that we hear about, and by the same token we never hear about the successful natural hospital births that happen, we only ever hear about the horror stories and the people that die or almost die and we scare women more than we need to. Fair enough if you think that all women should have a hospital birth but I think we can at least be respectful of others in the language that we use and the way we discuss the issue. Calling people stupid or ignorant is not respectful and doesn’t further the discussion, just shuts it down because someone doesn’t agree with your opinion.
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Hear, hear. Well said.
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The issue is not that every woman choosing homebirth is somehow uncaring or stupid, but that they are not accessing appropriate information about risk. At the same time, a lot of idoeological oppopsition against cesearean section is everywhere over the net – even though the outcomes of cesarean birth are overall better for babies.
As the poster above says, it really is worth reading the coroner’s report. Anyone contemplating a home birth should definitely read it. You can read the full Coroner’s report at
http://www.courts.sa.gov.au/courts/coroner/findings/findings_2012/Spencer-Koch_Hobbs_Kavanagh.pdf
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There may be some that don’t access the appropriate information about risk but I reckon that the majority of them do, most of them don’t make the decision lightly without reading as much as they can for and against.
In the case of one woman that I personally know, she spoke to many, many OB’s and midwives at various hospitals about her pregnancy and whether or not a vaginal birth was something she could attempt with relatively low risk. Just about every one of them explained the for and against. One OB registrar with many years experience attached to a hospital with many OB’s and high level NICU facilities did a thourough examination and consultation with her and told her that there was absolutely no reason why she couldn’t have a successful vaginal birth, that her risk was no higher than any other woman with a ‘low-risk’ pregnancy but due to the hospitals policy (and fear of litigation) she would have a hard time being allowed to labour naturally if he wasn’t the OB on duty when she went in to labour, because of a previous c-section. This OB registrar that she met with also informed her that the risks of repeat c-section were just as high, and in some cases higher, than the risks associated with a trial of labour and VBAC.
She was lucky enough to have a sccessful VBAC homebirth with no complications aside from some tearing. I say lucky becasue when we talk about risk its an acknowledgment that it is the luck of the draw, some women are lucky to have no problems and some women aren’t, despite their level of risk. This woman would have hapily birthed in hospital if given the oppportunity to, but because of the prevailing mindset of a lot of OB’s that ‘once a c-section always a c-section’ would have seen her choice to at least try to VBAC taken away from her, she chose the risks of a VBAC over the risks of a repeated c-section, but had to do it at home. Mind you, with 2 qualified midwives with a combined 20 years experience, who both also worked in hospitals, as well as independantly, while living about a 3 minute drive from the hospital.
I think if there were more OB’s like the one she saw then we would see many woman who choose homebirth actually birthing in hospitals. Like I said in another comment, I think that the bigger issue is that the health system needs to be looked at and changes made to allow women to birth safely in an environment that promotes the best possible outcome for mother child with the minimum of intervention unless absolutely necessary.
I agree that the outcomes for c-section babies are better when the c-section is needed because of ‘high-risk’ and other problems like placenta previa, breach birth, previous complications etc, such as the high risks of the mothers involved in these cases. But you also can’t deny the fact that there is an increased c-section rate where there are not those high risks and many hospitals are trying to take steps to reduce the number of c-sections and interventions as a c-sec in itself carries a lot of risk and that is what many homebirthers (who are low-risk) are trying to avoid.
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K – the data clearly shows that cesarean births are safer for babies, even in the absense of high risk. This is traded for a small increase in risk for the mother. (This is all easily found in the literature).
You report that your friend was told “This OB registrar that she met with also informed her that the risks of repeat c-section were just as high, and in some cases higher, than the risks associated with a trial of labour and VBAC.” This is simply not true. The only adverse affect of cesarean birth on babies is a short-lived increase in breathing rate – known as transient tachypneoa of the newborn. There are no long-term consequences. Again, as the Coroner says, the community needs accurate information.
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You sound pretty stupid to me!
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K i think a lot of first time mums do research. I did a huge amount of research before I had my first child. I wanted as natural a birth as possible but ultimately chose to give birth in hospital (public) so if something went horrendously wrong me being there gave the baby and me the best chance. I had a great experience in hospital, and both my babies were delivered by midwives. Naturally and with no pain relief. Could I have given birth at home? Probably and it would have been lovely. But the risks? I didn’t think they were worth it. Very happy with my decision and now have two healthy daughters. The best possible outcome as far as I am concerned.
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Ladybug, I am exactly the same, I had a lovely hospital birth and could I probably have birthed at home with no problems? Yes. Would I personally choose to? No. My point is more about the way this issue is discussed and the way a lot of people just assume that anyone who makes a choice for themselves to homebirth must be an ignorant fool who has no idea what they are getting in to. I just think it’s rude and not helpful.
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You know K upon reflection you are probably right.there are a lot of people who have obstetricians and just have blind faith in them. I consciously chose not to have one and go through the public system under shared care between my gp and midwives, and just the midwives for my second birth. My point is though a home birth is great if there are no complications, but all the research in the world though can’t predict 100% what will happen during the birth and it is just my view it is not worth the risk, and the baby is entitle to receive the best medical care in the event of an emergency which I don’t believe a home birth can provide.
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And I totally respect that view, and have to say, for myself, I have to agree, that while I would love a homebirth, in the end I wouldn’t mentally be able to accept that risk factor and go ahead with it. What is refreshing about your comments is that while you wouldn’t have a homebirth yourself, and don’t believe its the best choice for women, you also don’t imply or say that anyone who has a different view to you is stupid or ignorant and I like that.
I wish there could be more done to support the hospital system and maternity wards so that the majority of women can have positive hospital experiences like we have so that its the norm and not the perceived exception to the rule.
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K – I think you will find that by far the most common way of giving birth in public hospitals in Australia today is with midwives and little medical intervention.
People need to understand that times have changed in maternity care. Of course the service isn;t perfect, but labour wards have gone a long way in considering women’s needs, and midwives are the main care providers, with medical back-up as needed.
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I had a wonderful experience – as far as labour goes! – in the public hospital system too. We are so lucky to have the high quality medical care we do here in Australia, and I felt like I was in the safest hands. My pregnancy was fairly low risk but even so, my son turned blue after birth and was whisked away to the little crib in the room for some oxygen – boy was I glad I had a hospital birth!
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Oh my. Is this not the most ignorant comment I’ve ever heard ‘TheSheEO’??? – if you claim to represent women, please stop right now.
My sister had a wonderful birth at home (actually she’s had three now) and with one of them her baby son was also blue. Her (incredibly well trained, highly qualified, professional, experienced) midwife was completely prepared with all the neo-natal resuscitation equipment and oxygen and went to work straight away. He’s a beautiful, healthy boy (now four years old.)
Are you so ignorant to think that midwives who serve women at home don’t know how to deal with instances such as these? Dear me. Ignorance reigns.
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It is important to understand that home births do not cause medical emergencies and in low risk birth at home are less likely to occur. However a well thought out transfer system and collaborative care system where home birth midwives can follow their women and continue there care in a tertiary system without the midwife and women being punished, treated poorly etc is what we need in Australia. This is happening for a select few women in the Publicly funded home birth system of which Australia has approximately 12 sites. These are highly competitive to gain access to, chronically underfunded and the burn out rates of midwives are high.
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It is important to understand that home births do not cause medical emergencies and in low risk birth at home are less likely to occur. This is available for a select few women in the Publicly funded home birth system of which Australia has approximately 12 sites. These are highly competitive to gain access to, chronically underfunded and the burn out rates of midwives are high.
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Why is there such a focus on maternal/baby (mostly baby) wellbeing during birth, and not such a focus on baby wellbeing while the baby is in utero and certainly not as much focus on baby wellbeing after the baby is born?
While pregnant, a mother has the right to choose how she cares for herself (and therefore her unborn child). Why isn’t there as much media hype on, say, the issue of smoking during pregnancy? And given that the idea of “risk” is subjective, how much risk (eg smoking) is acceptable? Is one cigarette a day allowable? One every other day? Or should any and all smoking when pregnant be criminalised? After birth, is it acceptable for the mother to smoke? Smoke outside the house only? What about the father – is he allowed to smoke outside, even though evidence suggests particles retained on clothing are sufficient to cause damage?
The concept of “risk” is different for everyone, and everyone has a different level of “risk” that is acceptable for them. And yet we don’t seem to get hyped up as much over other issues – the smoking example is just one, but what about drinking? Car seat safety? The babyproofed-ness of a mother’s house? Society doesn’t micro-regulate these issues, yet there is risk to the wellbeing of the baby. If a mother wants – for whatever reason – to birth outside a hospital setting, she is simply making one of MANY choices that have an impact on her baby. We may never know if that any one decision to homebirth is “safer” than a car-trip to the hospital. Not that I imagine that would be a woman’s reason, but all the same society isn’t demanding that only professional drivers who have completed an advanced driving course chauffeur all pregnant women (at any gestation) so as to ensure maximum safety of their baby.
Many may view my comments as ridiculous, arguing that some risks in life (like the quality of other drivers on the road) can’t be managed, but that childbirth in a hospital setting can. Well, it is a sad fact that even in the hospital system, babies do pass away. “Yes, but even if that happens in hospital we could say that we had done everything we could” I hear the cries. Well, why stop there? Have we only “done all we can” when birth occurs in the “top” hospital with lowest neonatal mortality rates? Only when the “top” obstetrician with the lowest neonatal mortality rates is involved?
It will never end.
*Side note: If a woman was to sadly pass away shortly after birth (in a home setting) as a result of cardiac failure/arrest, that is seen as a tragedy. A terrible, unforeseeable tragedy – unforeseeable in the sense that the likelihood of cardiac failure are minimal for healthy women. Surely, the risk of cardiac failure in overweight/obese individuals while exercising would be higher – and no one is advocating they exercise in a hospital environment “just in case”…
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I personally feel you make an interesting point about risk and everyone making the decision about what level of risk they are willing to undertake.
One thing that people often don’t consider when it comes to risk, is that the risk of a uterine rupture in a woman undergoing VBAC is infinitely smaller than the risks associated with having an epidural for any labouring woman, yet uterine rupture is one risk that people always throw up when discussing VBAC (whether at home or hospital) and the higher risks of epidural and repeat c-sections never seem to be mentioned.
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K – I’m not sure where you get your risk data from – but the “risks” you mention are not comparable.
The risk of uterine rupture may be small, but it’s catastrophic – both mother dand baby can die outside hospital.
The “risks” associated with eipdurals are almost all short-lived. Severe or permanent complications from epidurals are vanishingly rare.
And finally the “risk” of repeat c-section is hardly a risk at all. Outcomes are better for the baby, and only marginally different to the risk of vaginal birth for the mother. maternal deaths from cesarean section are almost unheard of. SOme women take longer to recover from a difficult vaginal birth than from a section.
The data for all these complications is easily available. Your comments re-inforce the Coroner’s advice that the community needs much better education about relative risk.
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Most of the information I speak of comes from what I’ve read in my own personal research into birth when I was pregnant and from talking to my own OB and also my number of friends who are midwives and their experiences in their work (none are independant midwives, they are all attached to major hospitals and most wouldn’t reccommend or have a homebirth themselves however they all feel that major changes need to be made within maternity and labour & delivery wards, particularly in relation to after birth care). Granted, the things I hear from my midwife friends are obviously anecdotal, but when a midwife that works in a major hospital maternity ward is worried about the system it worrie me. And these aren’t the type of midwives who are in to all the flowery, crunchy-mama natural birth philosophy stuff.
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Nonoetheless, K, it is preferable not to make pronouncements about relative risk, as you have done above, without actually knowing the real data. That is the Coroner’s point. People might think they have done their own research, but did they access the real data? What are the actual risks of epidurals – as shown by large trials, rather than by anecdote? what are the actual neonatal and maternal effects of cesarean?
As I said, all this data is readily available.
What is it that your midwife friend is worried about? Does their hospital have bad outcomes? A high rate of complaints? Hospitals are governed systems that collect data on adverse events and complaints. Your friends should access that data and work to improve the shortcomings.
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I apologise for making pronouncements of relative risk due to my interpretation of the data I have read. To be fair, most of the data about obstetric health and outcomes is not entirely conclusive either way and most researchers acknowledge this. Which makes it hard for people to make educated desicions when even the people conducting and interpreting the research note that more study and research is required on a much larger and broader scale.
I can only go by what I have learnt for myself, from my research through google scholar and talking to those in the profession.
As I can’t reply to some of your replies to my comments in other threads for some reason, I will clarify that the information the OB this woman was in relation to risks to the mother and not risks to the child. I can’t state where he got his information from and what studies or research he has interpreted to be giving that information to patients and prehaps he is wrong. But if that is the case and even the OB is ‘wrong’ then what is a woman to do? I guess at some point you have to make a decision about what risks you’re prepared to accept or not.
Personally I am not prepared to accept that risk and that’s my decision. And I respect the choice of other women to decide on what risks they will or won’t accept and won’t ridicule or judge them for the choices they ultimately make or assume that they all have done so without knowing what they are getting in to. And that was my original point.
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K – I think you make some excellent points – particularly in your last comment (which for some reason I couldn’t reply to). I think there is huge confusion among women about the different risks as well as a general lack of communication among practitioners about the different risks – possibly because they aren’t conclusive as you alluded to. I am particulary confused about caesareans vs VBACS. Our high C rate and the risks of multiple C’s is often splashed around in the media (for some reason it is a hot topic) and yet when told I had to have a C for my 3rd pregnancy I was made to feel like an absolute idiot for questioning this. At the same time I was treated as a high risk candidate for a Caesarean becasue of previous placental abruption, high BP, age (37) and third Caesar. I had to attend high risk clinic, get assessments from anathetist, approval from senior ob to give birth in that particular hospital and not a larger one, regular ultrasounds to ensure placenta hadn’t grown into the uterine wall. I was terrified and confused – and yet the risks were never explained to me – what was so risky about a caesar for me?? As ultraounds had shown that placenta hadn’t grown into the unterine wall (main risk of repeat caesars?) – to this day I still don’t know why I was considered so high risk. On the one hand I was treated as if the caesar was going to be the most life threatening operation on the planet (when obviously it isn’t) but if I questioned why I had to have it and suggested a VBAC I was laughed at and scorned. The fact is that there is statitistical evidence out there which suggests VBAC is safer than repeat caesars -I agree that perhaps these statistics don’t paint the whole picture but my whole point is that women deserve to be told (and shouldn’t have to rely on google) why particular decisions have been made, what the different risks are and if caesars are so safe and a better option than VBACS then practitioners need to communicate this to women and perhaps the media to counter all the anti-caesarean hype. You can’t be expected to hear all about the risks of caesars and then treated like an idiot for not wanting one. The latest research says that caesarean babies are more likely to be obese??? While I question this – you can’t blame women for not wanting them! Maybe these poor women were scared about caesars – maybe they believed the doom and gloom about caesar babies having greater health problems down the track. perhaps they believed the statistics about safety of Vbacs and didn’t properly understand the relative risks? I don’t know but it isn’t black and white and I don’t think it is all the fault of the mothers.
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Just read through some of the comments. What a shame, and so predictable.
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I have to say, I am a little dissapointed (although, not surprised) with this. First, I feel that the headline and tone of the article is a little aggressive. Second, I can’t help but feel we are attacking each other unfairly.
When the last article ran – as an opinion piece, there was plenty of people who wanted more information along with less bias. I contacted MM at the time and their response was something along the lines of: as you can imagine, we have been inundated with articles/contributions and look forward to investigating this further. Correct me if I am wrong, but there hasn’t been anything since, until this finding.
I would like to refer back to the piece run a few weeks ago by Andrew Clifton. In it, he closes the article with these wise words: Let’s move forward with logic, reason and love on our side, not maliciousness, anger and hate because they won’t get us anywhere.
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Hear hear. I’m so sick of it.
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