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
A lot of readers have pointed out the right for the woman to decide where and how she births, and the calm home environment leads to a better post-birth experience for all involved. Yes, if things are straightforward and go to plan I have no problem with women home birthing and parents do have a right to choose. However the baby also has a right to obtain necessary medical care if and when things go wrong. I had both my daughters in a public hospital. I do not like hospitals however I knew that in the event things went wrong, my babies (and me) had the best chance possible.
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I get it now. The Mamamia readers are for the most part establishment style people who buy the mainstream version of just about every issue and flame anyone for thinking otherwise regardless of the facts.
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That’s a tad unfair Herrin. People in Australia are largely unfamiliar with what homebirth is about. As I said earlier-
This discussion has lacked any definition of what homebirth means. There are some here presuming that it means no medical intervention which is understandable given that the so-called midwife present at these births was not actually professionally accredited and happy to assist high risk cases. NOT ON.
I just got this definition of Homebirth from the Australian College of Midwives:
It is the position of the Australian College of Midwives that home is an appropriate place of birth for women considered to be at low obstetric risk, and that women must be supported in safe, planned homebirth, by midwives and/or other appropriately qualified and regulated health professionals with adequate access to support, advice, and referral and transfer mechanisms.
The Australian College of Midwives supports the use of the National Competency Standards for the Midwife, the Code of Professional Conduct for Midwives in Australia, the Code of Ethics for Midwives in Australia, the Australian College of Midwives National Midwifery Guidelines for Consultation and Referral (“the Guidelines”) and the NHMRC Guidance on Collaborative Maternity Care as the appropriate resources for guiding midwives in their practice.”
The suggestion that anyone choosing a homebirth is after a ‘birth experience’ rather than a healthy baby at the end, or that they are forgoing access to modern medicine for a simulated Ethiopian experience is just ridiculous and very patronizing.
As it is our hospitals are running close to capacity. Hosptial birthers (of which I will be one shortly) are often pushed out the door before feeling ready to return home. We need better integration of accredited homebirthing midwives within our medical system to ensure that hospitals can better manage deliveries requiring more acute care and to better manage the overall load of obstetric care across the system. This would mean better outcomes for everyone and the elimination of rogue practioners in homebirthing.
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Just what I was thinking. Well said. I think I would rather bang my head against a brick wall then bother having an opinion again on this site.
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Leigh it’s fine to have an opinion, and it’s fine to have a differing opinion. But you need to be able to back it up with something that’s substantive.
Out of curiosity, is this Leigh Robshaw, our AVN defending friend?
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I can’t help but feel that alot of people who have had good hospital experiences, are on private health insurance or at least were in good hospitals in metro areas. I’d be interested in learning more about private health insurance – I’m 29 and feel pressured to get it, even though I can’t really afford it nor do I understand how it works.
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I had a good experience with both my births in the public system. I have private health cover however my research before i had my first child highlighted that intervention rates were lower in the public system. I wanted the births to be as natural as possible and I figured in an awful emergency you would end up in a public hospital anyway.
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Thanks Ladybug, I didn’t know that about emergencies being transferred to public hospitals
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It depends which private hospital you are in, what facilities they have.
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I went private for my first child. After paying thousands in non-rebateable medical fees to the obs (they don’t tell you about those when you sign up for health care!), the delivery happened so fast that he all but missed it. So I laboured with midwives I’d never seen before, and there was a shift change halfway through. So no benefit there. But, we did get to go to a very nice city hotel for the duration of my confinement.
This time I’m going public. So far I’ve been completely left alone, no one’s been checking anything. That would worry me if I hadn’t already done it before (before anyone goes nuts, I’ve had all the routine checks, everything as normal. Just less visits than I had with my obs).
In general, I’m getting the feeling that private health care is a bit of scam. I look at what we’ve paid in fees vs what it’s gotten us, and I’m almost hoping one of us has a serious medical issue otherwise it’s money down the drain (but that’s all insurance, and I glad we’re all healthy).
That said, the ageing population will see the cost and availability of health care go up and down (respectively) in the future – getting private care now, and keeping it, is probably a very good investment in your future.
Hope that helps.
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That helps heaps!!
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Sorry Anonymous, I should also add that my experience was one of a super easy, complication free delivery. Had it been otherwise, I probably would have been grateful for the obs (assuming he was there). But there were a few complications during the pregnancy where the support and attention of my obs were incredibly helpful and reassuring. A bit of bleeding? See you in a hour (at 7am on a public holiday). Question? Issue? He’s only a phone call away. No sitting in ED at the womens’, we got taken straight to a nice suite in our private hospital and my husband was offered a sandwich
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Thanks again Anna, that would make a difference to me – I can easily see myself being anxiously pregnant first time around, it’d be good to know support is there “on call”. Still, it saddens me that the best health care is for the few who can afford it, even though I recognise and appreciate that our public health system is one of the best in the world.
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My experience in the public system was terrible (sorry I’ve ranted about it below!) – not so much with the birth but the care afterwards. With all 3 they were just so under staffed there was no help at all with the baby- I may have been unlucky but my sister who had her baby in a large metro public hospital also had a terrible experience. The care during the actual birth was good – but afterwards shocking! No one helped her with BF or even showed her how to bath a baby, once again staff shortages were to blame. I could be wrong but from what I have heard from friends who have gone private the experience after birth was much more positive – more chance to recuperate, wasn’t kicked out of hospital (although I was begging to get out it was so awful!), more help with BF. If I had my time over I would opt private.
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I’ve had one baby in the public system (birthing centre) and 3 in private. Public was absolutely great and the midwives were lovely but the private system is my preference. In the pub hospital I was mostly left alone until I got close to delivery, then a midwife stayed with me. In private, a midwife stayed in the room the entire time and helped coach my husband in how to support me. My dr was called with an update every half hour and also was present for the second half of my labours and for an hour or so afterwards.
I know the stats show that more interventions happen in private but that’s not my experience (I asked for a c-sec and but my ob talked me out of it coz he knew I had other little ones at home and that wld make it hard to chase after them)
The aftercare in private is also much better. My hospital let my husband room in, had settling assistants who wld come and help you settle your bub (and who took my husband and bub to shared lounge to teach him how to do it while I slept)
I also had some dramas post birth and having an ob who knew my history was great.
Our health insurance covered everything in hospital but doesn’t cover the ob fees or your scans. All up we were prob about $4k out of pocket (in qld).
Hope this helps.
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It’s great that you have hadngood experiences with both the public and private systems. I havemonly dealt with thempublic system, but my best experience has to have been at King Edward Memorial in Perth. They are a teaching hospital who specialise in high risk births. Because my first child was stillborn and a very fast delivery, they wanted to induce. While I was there they were actually rebuilding the delivery suites, so I was in a private room in a normal ward.
I loved it. At no time was I left alone for more than two minutes. The midwives, trainee midwives and doctors were all relaxed and pleasant. If I had the choice, I would have had my subsequent children there also! My experience at the following hospital was so bad that it made me seriously look at home birth or a birthing centre. I even started trying to find a place to live in the only areas I could find hospitals that had associated midwives who attend homebirths! Finally I had to take what Inconsidered the risky route of booking into a hospital over half an hour away. With my first three deliveries being fast, half an hour is a LONG time to get to the hospital. In many respects I was lucky that the baby was in a posterior position which tends to make deliveries last longer. Once I reached that hospital, I had a minimum of two people attending the entire time. To be fair, it was a fairly short delivery time once I got there, even if it was longer than any of my previous deliveries.
So, From your post I get the impression that I found a brilliant hospital in KEMH, which may have almost the same care as a private hospital.
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In a public hospital, you will be cared for primarily by midwives while in labour and antenatally actually, as well as postnatally. During the antenatal period you usually see the midwives while seeing the doctors at specified points (36 weeks for example). You’ll only see a doctor more antenatally if you’re high risk.
During labour, again, a doctor is only called in if the midwives are concerned, you need to have an induction, or epidural and in that instance an anaestist is called not an obstetrician.
In the private system, you get referred to an obstetrician by your GP. If you know of one, you can request to see him/her, otherwise you get referred to a local one your GP knows. You see the obstetrician the whole way through. Midwives look after you in hospital and call the obstetrician in when you’re getting close to second stage. If they happen to be in the hospital at the time, they just page them then. If your doctor is “off duty” when you deliver, one of their colleagues will “catch the baby”.
Most hospitals, public or private can cope with emergencies, the baby if sick or early enough may need to be transferred to a tertiary public hospital.
I wish I had the private hospital experience of the other poster’s. I got virtually ignored. My profession may have had something to do with that, as with it was my 3rd, but I went back to the public system after that one.
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I had a good experience with the public system for my first – however I was low risk and birthed in a birthing unit connected to a small regional hospital as opposed to in a large hospital. I had looked at private health insurance but could not see any benefits for me personally
I don’t know anyone who has gone through privately recently so have no knowledge of that side of it.
A relative went public at a large hospital and had a bad experience but she is young and fairly uninformed about her options so I am not sure how much was the hospital/public thing or just circumstances.
Research your options, it really depends on what facilities are near you and if you are in a regional area or a city as to what you would use.
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If you birth in a private hospital chances are that if anything goes seriously wrong you will be transferred to a major public hospital.
Major public maternity hospitals have anaesthetists and obs on site at all times. Private hospitals don’t.
I’m lucky as I live in a capital city – I imagine the situation is quite different in the country.
From the point of view of birth safety it would seem to me you are better off in a major public hospital compared to a private hospital.
Rates of intervention are also lower in public hospitals. When I was researching my options I would ask obstetricians offices what their caesarian and induction rates were – strangely this information couldn’t be given out. Public hospitals have to report on these rates and will provide them if asked. I think getting this information from private hospitals is more difficult. Midwifes are also required to keep statistics on this as part of their professional development – so ask.
I would say going to a private hospital is a lifestyle choice – nicer facilities and the hotel stay.
If you are concerned with such things as giving birth naturally and successfully breastfeeding your baby then having continuity of care with a known midwife is the best way of achieving this.
Options for continuity of care include having an independent midwife (most likely a homebirth but in some cases a hospital birth is possible), a group practice in a maternity hospital or birthing centre.
I believe the ideal is to have a known midwife but to have some visits with an obstetrician in case you need them. Your midwife should normally deliver your baby – if there are complications then the obstetrician is called in.
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I don’t think the home birth debate needs to be discussed in terms of hierarchies of competency – midwives against doctors – home birth midwives against hospital based midwives etc. I personally wouldn’t go a head with a high risk birth at home, nor do I necessarily see the sense in free birthing when the support and guidance of midwives is usually second to none. In fact I probably would even choose to have a home birth. But I don’t think we need to tar the entire notion of ‘home births ‘ because of the irresponsible actions of a small number of mid-wives and the dangerous choices of some parents. I know several women who had beautiful home-birth, facilitated by wonderful, adept mid-wives who knew there stuff. I also know women who attempted home-births and needed to go into hospital – which they did early on – and thus had safe births within a more medicalised environment. I also know some women who were pressured to stay at home in the initial stages of their birth and thus gave birth at home and one in the car on the way to the hospital. Thankfully in both cases, the births were uncomplicated and the babies were born without harm (although the mothers were in severe shock!) – but what if it had been otherwise? These women were intending on giving birth in hospitals but they were told ‘not to come in’. I’m not necessarily criticizing the actions of the mid-wives who told them not to come in. I’m just saying there is no way to know sometimes what is in store – regardlesss of the circumstances, contexts and plans that have been put in place. None of us are gods – not doctors or midwives, nor the parents who try and do the best for their children. Yes, I think we need to be circumspect when considering how to birth our precious children – especially if there are risks or have been risks in the past – but we also need to respect that home-birth can be a very peaceful AND safe way to birth a child when facilitated by an experienced and knowledgeable midwife team – and when hospital facilities are close to home.
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Thank you for providing such a measured response to this article. I don’t see why the debate needs to be so polarise either.
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‘polarised’
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Urbane – I think the Coroner is essentially saying hte same thing – not that home birth should be banned, but that registered health providers should act according to the standards of their own profession.
The discussion is not just about competencies but, inevitably, about location. Even the most skilled obstetrician could do nothing at home to save a baby that could only be saved by Cesarean.
The best thing about hospital birth is that midwives and obstetricians can work together as teams – each contributing their skills.
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Sue, I think what has irked most people about this article is the implication that ALL homebirths are high risk and will result in death and that ALL homebirths are a bad idea.
Sadly these cases have tarnished all homebirths even though the majority of them are carried out by registerd health providers who do act according to the standards of their own profession. Just because there are bad midwives out there and parents who are prepared to take huge chances in very high risk circumstances against all medical advice doesn’t mean we should demonise the entire thing, which the tone of this article does.
Homebirth can be safe and successful when the right procedures, support and transfer protocols are in place, as has been shown by studies done, and just because you wouldn’t personally do it or agree with it doesn’t change that. And not to be rude or anything but please don’t throw anymore ‘research’ at me, I have read plenty of literature from medical and scientific journals, I know the stats and the fors and againsts and there are circumstances where homebirth can and has been safe in certain circumstances.
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For those of you interested in the worldwide fight for women to reclaim their rights in childbirth, there has just been a Human Rights in Childbirth conference in the Hague this past week. This was partly in response to the jailing of a midwife in Hungary for assisting in homebirths (no deaths were an issue) and one mother’s fight to the European Court of Human Rights. Two filmakers are making a documentary about the issue of the control of childbirth and the fight for midwifery around the globe. You can read about it (and contribute to their campaign) at http://www.indiegogo.com/freedomforbirth?c=home&a=653136. This issue does polarise the community and this article has brought out the worst in many and seen “facts” splashed from one side to the other. This issue is complicated by the fact that these three deaths were associated with one medical practitioner and not just any homebirth. They were high-risk and perhaps not suitable for home, but that doesn’t make all homebirths wrong. As I said in a previous post, let’s look at what is wrong with our system that drove these woman to make the choices they did (and will live with forever). I do not believe for one minute that any of those involved in these tragic deaths deliberately set out to harm their babies or to pick a “lifestyle” choice over safety, or to pick a lovely experience of birth over their child dying. Those of you who have suggested so need to have a good hard look at yourselves. Wouldn’t we all have loved a retrospectascope at some point in our lives. We all can spout stories of our good and bad experiences and how “my sister’s baby would have died if she was at home” etc. The issue of childbirth is not as black and white as hospital vs home, midwife vs obstetrician. Articles written with such a negative slant as this one (under the defence of “but it was the Coroner’s findings not ours” – paraphrase Rick) do not help anyone. I realise that Mamamia espouses to be a place of opinion and for popular news, but that is no excuse for not providing a balanced viewpoint. Please, please, please try to publish a piece on childbirth that is not as polarising as this in the future.
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I agree – we need to look at current system and understand why these women were so desperate not to have their babies in a hospital. The fact is that giving birth, however you do it, is one of the most significant events in a woman’s life. Obviously of most importance is the safety of mother and baby, and while we have made important inroads to ensure this, I don’t see why this has to be to the detriment of the psychological care of the mother. No one would advocate going back in time where mothers and babies did die – however, I do think it’s a shame we can’t combine our medical advances with some of the practices of old ie loved ones nurturing women in their own homes to enable them to recuperate fully from the birth and establish breastfeeding. I don’t equate giving birth with just the usual medical procedure – and while I agree hospitals do deal with the medical side of births well they certainly don’t deal at all well with the psychological side of giving birth.
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Steph – do you think that spending a day or two giving birth in hospital is really working against ” loved ones nurturing women in their own homes to enable them to recuperate fully from the birth and establish breastfeeding.”?
I don’t know of any hospitals that will stand in the way of an early discharge if all is well and the mother wants to recuperate in her own home. Do you?
The issue, perhaps, is that nuclear families and isolated migrants no longer have that circle of support at home. On the contrary, hospitals supply lactation consultants, and screen women for post-natal depression.
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I hate the title of this article. Whether the author was being facetious or not.
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me too. it may be fact, but it does set a tone.
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I just don’t quite get it when we’re all supposed to be supportive of one another, accepting each others choices (yeah, yeah, I get that this article is based on the facts from The Coroner), yet a title like that is just asking for bias.
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http://www.youtube.com/watch?v=puCu8lBWJMs
I urge EVERY woman, whether child-bearing age or not, to watch this film. It is incredible, passionate, intelligent and challenging.
It is the REASON I am a midwife, and the reason I so passionately advocate for what is best for the woman as a whole entity.
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Home births cna actually be better and safer than hospital births. My first was born well (vaginally, no tearing, forceps or drugs) in a private hospital with an OB in attendance. My second was born well also (again vaginally, no tearing, forceps or drugs) in a hospital birth centre with midwives in attendance. I wanted the best for my third child, and given my history a home birth (via a hospital-trial home birth program) offered me the best outcome. Why? Because (given my history) I statistically had more chance of a optimal outcome in a home birth situation than having her in a hospital. I had more chance of having a healthy baby, born with all the benefits that a stress-free vaginal birth can give, more chance of successful breastfeeding and less chance of developing PND than if I had my baby in a hospital. So sometimes, some of the joy of holding your baby for the first time is in how he or she is born. My overwhelming joy at my daughter’s birth was partly due to the fact that I had been through the “good” and the “better” to give her the “best”.
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I don’t understand how the “birth experience” has become such an event in itself. When did the manner of the birth become as or more important than the outcome??
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Because the way a birth goes can often have a very big impact on what happens afterwards too, including your relationship to your baby, your ability to breastfeed, your mental/emotional wellbeing etc.
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Mmm, yes, I supposuntie death of a baby that otherwise cold have been saved would have a very large impact on what happens afterwards.
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Ladybug, that’s really unnecessary. I was responding to the query above. For the record, I do support home births where appropriate. My friend is about to have a home birth through Sunshine Public Hospital in Melbourne. I wish I had that option, but chose to have my children in hospital because I considered myself to be at higher risk due to my age, and the fact that we live in a remote area. I don’t think comments like yours really add to this debate, save to inflame and judge.
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Utter rubbish – the concern for ‘quality’ of our birthing experience indicative of our first world, self obsessed preoccupations. Many parents would attest that all the anxiety and anticipation surrounding the birthing process is replaced by the main event – the business of parenting – almost immediately after the baby is born, in your arms, confronting you with such a profound sense of responsibility and realisation of the insignificance of your own petty whims.
Let’s get our most precious ones into the world as safely as possible and be thankful we live in a society where such an opportunity exists for all.
Birthing away from a hospital in this country simply denies women the choice of timely additional support if required. It limits options. It takes us back to a standard of care that the (majority) of the medical and midwifery profession have worked hard to improve over decades.
Our society, it seems, has a short memory – clouded the propaganda of individuals such as Lisa Barrett.
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Same for you sk
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sk, have you ever had your perenium sliced open while you screamed “no”? Have you ever had virtual strangers repeatedly thrusting their hands inside your vagina despite your protests? Have you ever had your baby ripped from your vagina with tongs? Have you ever been so traumatised by a surgical wound to your abdomen that you were bullied into having that you’d rather die than go on living – despite a ‘healthy’ baby? I would think that perhaps you haven’t, given the flippancy of your post.
Yes, the experience of birth DOES matter.
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I’ll trade you your traumatic birth experience for a live baby any day.
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I have had my vagina “sliced” open and strangers “thrusting” their hands in me but I call that an episiotomy and a vaginal exam and refused to let that impact upon the blessing of having a healthy living baby in my arms.
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Absolutely, I’ve had a vaginal birth involving a vaginal examinations, episiotomy and vacuum extraction. I’ve also had a caesar from which I was up and about the next day with less discomfort overall than the vaginal birth. In each of these experiences I was treated with the utmost respect by medical and midwifery team. But then, I’m a fairly rational individual, I didn’t enter the experience with head full of hang-ups about my ‘rights’ to a ‘empowering’ experience. I knew there would be nothing more empowering than the experience of my healthy newborn in my arms. I wasn’t so arrogant as to assume that I knew more than the professionals who managed the care of myself and my children. We’re just different, it seems.
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I’m so sorry that these experiences have hindered your capacity to feel compassion for another human being. Trauma is subjective – what hurts one, may not hurt another. I’m glad your experiences were not traumatic for you. I wish I could say the same for many other women. All the best. xo
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Sk I couldn’t agree more with both your comments above.
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I have met women who have had episiotomies go wrong. One woman was literally cut from her vagina to past her anus, required multiple stitches, and it permanently affected her ability to have sex, to go to the toilet, and have more children. Since then she has had a large number of infections in the general area. Just because someone has an episiotomy that had no lasting damage doesn’t mean that everyone goes through the same experience.
What is worse, it was found that in her case, an episiotomy was not even required. The doctor in charge of the delivery did them as a matter of course. The doctor was given a verbal warning, and told that from then on confirmation from another doctor would be required before they could do another episiotomy. The woman did not even get an apology.
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So what did you do about it. Have you made a complaint to the hospital, have you had the health professionals charged with assault or did you simply choose to bitch and moan about them???????? How would you be feeling if instead of a healthy baby you had non of the mentioned interventions in your labour and a dead or brain damaged baby? Do you think you would still be traumatized by that????
It is offense to suggest Dr’s and Midwives are like that. Do you really think they enter the profession to cause patients harm????? Why is it ok for them to be critized like this, but when a home birth goes pear shaped they head for the hospital and these professionals help. Bit hypocritical don’t you think.
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because birthing a child is one of the biggest moments in many womens life and the circumstances in which it happens have an enourmous impact on the person experiencing it.
Even in the best of hospital circumstances is disempowering, and there is a us vs them attitude that just doesnt need to exist, there should be room for home birth, birthing centres, and hospital births, and there should be room to move between them as circumstances change. for many women home birth is safe, i have watched it happen. I have also had a appalling experience having an emergency c section and know of many other women whose birth experiences will leave lifelong emotional scars.
I can understand women who react against bad experiences by trying to move away from hospitals.
I think women who believe they “deserve” a certain birth experience are in the minority, most women are wanting to birth safely first of all, but that doesnt nessesarily exclude home births for all.
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While I don’t have any evidence for this I do wonder if there is a link between PND as well as problems with establishing breastfeeding as a result of our current hospital system (in public hospitals anyway I’m not familiar with private hospitals). My mother’s generation talk blissfully of their 2 week hospital stay which enabled them to get some rest, establish feeding and even read books! Babies were usually kept in the nursery to enable this. I’m sure it wasn;t as idyllic as it sounded and I know this policy was linked to poor establishment of breastfeeding. However is it any better these days? Desperate for sleep more than anyting else I had no choice but to look after my babies immediately after having a caesarean. Luckily for me BF wasn’t too much of a drama, even so with my first baby I needed a midwife, who was usually busy, to help me attach everytime. I can’t imagine what it would be like if I had significant feeding problems. After each birth I was begging to be let out of hospital just so I could get some rest and some help from hubby and mum with the baby! Unfortunately. while specific details might vary I think that there are a lot of exhausted, sleep deprived, hormonal, vulnerable mothers out there in our public hospitals. Hospitals great place for the actual birth – emergencies in particular but bloody awful awfterwards! A question obviously policy of early release for vaginal deliveries would negate a lot of these problems – but what do women do when there are still problems feeding (often is particulary with first). A daily visit from midwife wouldn’t be enough as often women need help with every feed to begin with.
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As a mum who has had four kids – three at home with very experienced midwives – the choice is the parents. The first question I asked my midwives at interview was “what would you do if there was a problem and I refused to go to hospital?” I’d never given birth before, I didn’t know if I would behave like a stubborn insistent cow if there was an issue – but my midwives made me confident that the safety of the baby and my health comes before ‘preferences’.
My fourth was an emergency csection – which probably would have been avoided if I had similar care to the first three. I only saw my midwife in hospital when I was induced – then on delivery – which I knew there was a problem before she’d admit to it.
Midwives in hospitals are placed under extreme pressure – and I’m sorry – but babies in hospital die too.
Those who are insistence on putting their preferences first – before babies – are literally playing with lives. There are usually warning signs.
This does not mean Home Birth is unsafe or wrong.
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Very well said.
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Why is it that I can’t ‘like’ comments like this, has that functionality been disabled for comments the writer of the article doesn’t agree with?
Marina, well said indeed.
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Marina – you say “and I’m sorry – but babies in hospital die too.”
All the cases investigated by the Coroner were thriving prior to the delivery, and could have been saved in hospital. (This comes over clearly in the report)
Do you know of any, ANY, condition that a baby could die from in hospital where they would have been better off at home?
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What about Golden Staph, or transfer of disease bacteria etc that is not present at home, but in the hospital – colds, viruses from other patients, staff etc…
here is an interesting article on a woman who went to hospital to give birth and got staph – http://www.scientificamerican.com/article.cfm?id=hospitals-and-superbugs
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Anonymous – transfer of infections is very rarely an issue on the maternity ward, where almost all women are healthy and young. The vast majority of infection transfer is in intensive care and surgical wards.
Newborns who battle infections get them from the maternal birth canal, or from prolonged rupture of membranes prior to delivery. I have never heard of any baby dying in hospital from catching a hospital infection. Have you?
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I cannot believe you said that. the hospital infection rate is approx 1 %.
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And how many died or are injured every year IN hospitals- deaths and injuries that are preventable by not intervening? Smh…
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and how many babies have died or are injured from lack of intervention?
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I think that is far more common that we realise. My ob is attached to a large public hospital and works there in the maternity ward as well as caring for his private patients at a private hospital. He told me he is often called to the public clinic to try and save baby and/or mother who have been left for too long without appropriate internvention. Sometimes the outcomes arent very good and it could have been avoided if an Obstetrician was called earlier.
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“deaths and injuries that are preventable by not intervening”
NONE.
What causes of death do you think are preventable by doing nothing?
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I had a low risk pregnancy, followed by an uneventful labour and delivery in hospital. No medical intervention was needed nor were drugs administered. I could have had a home birth, if the option was made available.
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Shame you didn’t know how well it would all go beforehand.
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Wow. a few days ago this place was full of love and calls for people not to judge others parenting choices and now we’re full of venom.
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I agree! It’s a bit pot-kettle-black hey? Sad.
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If you choose to have a home birth rather than go to a hospital then you need to own the outcome and the death or injury of your child is your fault. The joy of birth is seeing and holding your baby for the first time and not in how it was delivered! How can any mother put her need for a home birth ahead of the well-being of her baby?
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It isn’t about being hooked on the experience of child birth. It is about making an informed decision about what is safest for your child. Study after study keep coming out that (especially in the States) birthing outside of a hospital if you are low-risk is SAFER than birthing inside of one. Ina May’s Farm has a c-section rate of less than 3%. Compare that to the 33% hospitals in the States. We hook low-risk women to IV’s and pitocin and constant fetal monitors and epidurals and have them birth on their back and are shocked when baby is distress- “Thank goodness they were in a hospital so the doctor could SAVE them!”. I counter with, “What was that poor woman, low-risk woman doing in such a dangerous, intervention heavy place that just ended in a preventable surgery for her and her child?”
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Perahps not so smart, momma.
No, there is no data showing HB to be safer than hospital (for comparable risk deliveries) because it is not true.
Do you know the Ina May’s death rate? Do you think we should sacrifice a few newborns just to keep the cesarean rate down?
Are you really comparing the need for surgery with the potential death of a child?
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So if your baby is one of the 2339 (or more) babies who die in hospital EVERY YEAR – do you need to ‘own’ that too??
Latest national data from 2009 from the Australian Institute of Health & welfare shows 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.
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With the numbers you posted, fetal deaths in hospitals and other centres = 0.008%. Fetal deaths at homebirths = 0.002%.
Considering those hospital figures would include everyone ie women who had little or no prenatal care, those giving birth to multiples often at early gestation, premature and high risk births, those who partake in harmful activities ie addicts, one would think the % would be much higher than for those 863 women who planned their homebirths. The fact that it’s not says a lot.
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Why are so many people hooked on “experience”? You know what? Lots of things suck. Seriously. But very, very few of those end up in something as beautiful as your children. Put on your big girl panties and do what’s safest for your baby and not what meshes best with your wanted experience.
And for those talking about education…really? Because the only people who seem to be uneducated are the ones spouting off about how others need to become educated.
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But education is hard and might ruin someones life experience because she would have to study or read boring information instead of doing more fun things.
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As a midwife and a mother with two of my children born at home overseas, where my choice was not interfered with. I had plans in place where I could move across the interface of the maternity care system if a medical emergency occurred in childbirth. Overseas my choice was supported, when my third child was born here in Australia, these are the uninvited comments I came across from health professionals in the community I lived in, if she is going to birth at home don’t think she can come here (the local hospital) if it goes wrong. Don’t have anything to do with her, home birth is illegal, GP to my antenatal midwife. GP then manage to get my antenatal care ceased with my health care provider, of which I needed to use words like duty of care to get it reinstated. It was an extremely difficult time in navigating my way through a very tense and opinionated maternity care system. Phone calls were made to secure assurances from the hospital that I would be treated, in the unlikely event of an emergency, a curtsey visit were made to the GP service to give my history. I am still amazed that it is such a hot topic where our system and community lacks understanding on the role of the midwife in protecting normal birth, recognising risk factors and complications, referring to tertiary care. I understand why the system lets women down at hospital and at home. It is about collaboration, timely referral from home to hospital when required, and respecting women choices at home and in hospital. What amazes me is that as a midwife of 24 years I have met one obstetrician and one GP who would patiently sit through a normal labour. Medical students do approximately five catches without sitting through normal labour. I would argue whilst our medical practitioners are experts in dealing with complications in childbirth their experiential knowledge of normal labour and birth can be limited. As a midwife I greatly respect their ability to assist woman when complications arise, as a woman, mother and midwife I felt safer to birth at home until such situation occurred which required the expert emergency care that the medical profession can provide, with an adequate transport system and a hospital system which was willing to assist me if I needed it. Come on Australia we can stop arguing and produce a workable system that does not alienate women who choose to birth at home and provide a hospital system that does not push high risk women into birthing at home because the hospital system refuses to respect their choices.
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Hiya, could I make a friendly suggestion to separate your post into paragraphs? I’d love to read it but it’s much easier in paragraphs!
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” I would argue whilst our medical practitioners are experts in dealing with complications in childbirth their experiential knowledge of normal labour and birth can be limited. ”
Absolutely! That is exactly the problem of the system!
I heard of so many women being rushed through the labour and disappointed with how it all happened but could never pinpoint the issue. THIS IS IT!
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” I would argue whilst our medical practitioners are experts in dealing with complications in childbirth their experiential knowledge of normal labour and birth can be limited. ”
You might argue that, but it’s not true.
Obstetricians have seen and been involved with literally thousands of births – mostly vaginal, mostly “normal”. What do you think they do during their training?
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Sorry Sue – but obstetricians are medical specialists and their training revolves around surgical interventions. They are secondary or tertiary carers. Primary care for women with normal low-risk pregnancies is appropriately provided by midwives and or GPs and if secondary or tertiary care is required then obstetricians should be involved (please see the Commonwealth DoHA document on Primary Maternity Services Framework). One of the problems with our maternity system is that obstetricians have been brought in as primary carers and have medicalised normal birth. They have lost their skills to deliver breech births and twins vaginally because they are so quick to jump for their scalpels. I am not saying there is no place for Obs or caesareans but we need to remember they are specialists and many of them have in fact forgotten what “normal” labour and birth are. In fact, many trainee obstetricians don’t get to participate in normal labours and deliveries because these are appropriately managed by midwives. Walking in during the final stages of labour and “catching” the baby is not the same thing as experiencing “thousands of births – mostly vaginal, mostly normal”. If you have a sore foot do you go straight to an orthopaedic specialist – no, you go to see your GP, your primary carer. So why if you have a normal pregnancy and birth do you go straight to an obstetrician instead of a midwife? If you have risk factors that need secondary or tertiary management then you will be referred as appropriate. Unfortunately, obstetricians participating in primary maternity care is inappropriate and has led to the increased medicalisation of pregnancy and birth with an associated rise in caesarean sections and instrumental births with associated morbidity for women and babies. The latest epigenic research is suggesting that there may be long-term population effects of the increase in caesarean births with changes to our genetics causing increases in various cancers, obesity, asthma and the like. The attitude that a caesarean is minor surgery and “normal” is wrong and is having long term effects on our community. This debate should be about the ensuring the right care for the right women in the right place and how our system is not allowing that to happen.
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Anon – on the one hand you say “but obstetricians are medical specialists and their training revolves around surgical interventions. They are secondary or tertiary carers. ”
and on the other hand
“One of the problems with our maternity system is that obstetricians have been brought in as primary carers and have medicalised normal birth. ”
Which one is it?
In private hospitals, obstetricians are primary providers. The vast majority of deliveries, even in private hospitals, are uncomplicated vaginal deliveries. The obstetrician might not be there for the entire labour, but across all their patients, they are there for many, many labours.
WHere is the evidence of cesearean section “changing our genetics” and causing cancer? How is that feasible? Or are you saying that babies who would die without intervention should just be sacrificed? That sounds extremely callous.
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I haven’t contradicted myself at all Sue – Obs are known as secondary or tertiary care providers (as stated in my first point you requoted) but they have been gradually shifting over to provide primary maternity care which is not appropriate. As suggested before, read the Commonwealth’s own guideline about primary maternity care. That is exactly why birth has been medicalised because otherwise normal pregnancies are now being managed in a medical acute-care model rather than within a wellness-paradigm. At no point did I say that babies should die instead of receiving appropriate interventions – in fact I clearly maintained that there is a very important role for obstetricians as specialists when things are not going according to the “normal”.
In terms of the epigenetics studies – perhaps you should spend a few hours researching the medical literature before dismissing it us unfeasible (flat-earth society springs to mind, but that would be just facetious of me
. To start you off, here are some links for you to read. Epigenetics is a relatively new branch of scientific research that is examining why there is a surge across the developed world in many conditions such as asthma, allergies and some cancers. The rise in unnecessary caesarean sections may be contributing to the rise in these conditions due to the altered birth response changing DNA methylation. Caesarean Sections can be life-saving when done appropriately, but with some private hospitals having >50% CS rate, I think we need to be asking why. Could have alot to do with it being an obstetric-medical model of care with no continuity provided by midwives but lots of money to be made by surgeons… I’m sure the daughter of an Ob will have plenty to say back…
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Sorry, I forgot to put in the link on epigenetics in my post below:
http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2009.01371.x/full
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Anon today – having already spent years studing the clinical sciences and research methods, I have no need to spend hours to see that both your logic and reference are dodgy.
Firstly, we already know that the prevalence of asthma in AUstralia has started to fall over the last decade, despite a rising cesarean rate.
If you spend a few hours your might learn that increasing cancer incidence is a result of population ageing.
There is no evidence that the way a child emerges from the womg affects its genetics – even looking at your citation. You linked to a tiny study of a handful of babies that measured a white blood cell change that disappeared after a few days.
All this suggests you have very little understanding of scientific research in general, let alone genetics.
Finally, the daughter of an OB might tell you how little reward there is for taking on this high risk practice, in comparison to other high-risk professions.
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They manage complications I work in a large maternity unit where our obstetric trainees or registrars do not sit through normal labour and birth, they deal with complications. There training is in complications, try and be honest.
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I have just finished reading the Coroners report on this case.
It is quite disturbing.
I absolutely support the right for homebirth, I think it has it’s place.
Lisa Barrett, the midwife involved has been the midwife where 4 babies have died as a result of difficulty in labour, 3 in SA and 1 in WA.
All completely preventable.
It may seem cruel to point out but how on earth could you choose to have a home birth when in every single one of these cases, there was a known risk involved.
As I said before, home births have their place, but in this day and age, when we in the Western World have all the resources in the world to access information, get advice, have ourselves and the babies we carry checked out, how people would still choose a path that puts themselves and their baby in danger, just to avoid ‘medical intervention’.
It really annoys me when people insinuate that Drs and medical staff intervene just for the hell of it. Utterly ridiculous.
I have lost a baby in hospital. It was horrific. But if I’d done it at home, I’d be dead too.
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exactly!!!
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I know these situations were homebirths, not freebirths – but Lisa Barrett does actually support freebirth (or UC Unassisted Childbirth). In her words:
”I would always do what the woman wanted which means sitting in the car outside if she’d prefer, but I understand midwives who feel compromised by this.I feel that a woman’s choice is just that and as long as she is willing to own her decision then the responsibility is with her. I am also happy to be a point of contact for women who UC. I don’t consider this to undermine my professional status but enhance it.”
other charming comments on her blog include:
”I’m glad for you to chose the hospital, get an induction, get your baby ripped out of your body, plyed with oxygen put in a plastic box if that is what makes you feel great”
(in reply to a woman who had been turned down by 16 midwives for a homebirth due to her risk factors, incl the fact that she had had a massive heomerage and a c-section with her first birth: ”you have 2 choices, find an unregistered practitioner to help you or fly to South Australia and we will help you here.”
She also supports homebirths after multiple caesareans, breech birth home births, using methods other than oxygen for resuscitation, using unregistered practitioners and twin homebirths. Yes, even twin freebirths after caesarean. Basically, anything the woman wants. Not something generally considered a good thing in a health professional. Her comments in response to some of her blog posts are quite breathtaking in their arrogance and fanaticism.
Seriously – I am actually not anti safe and supported home birthing, it’s pretty common here in the UK – but anyone who supports freebirthing and the kind of fanatical, all hospitals are evil, all doctors are out to get you, ANY homebirths at ANY cost kind of attitude? Dangerous.
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You raise some excellent points Kate.
This discussion has lacked any definition of what a homebirth means. There are some here presuming that it means no medical intervention which is understandable given that the so-called midwife present at these births was not actually professionally accredited and happy to assist high risk cases. NOT ON.
I just got this definition of Homebirth from the Australian College of Midwives:
It is the position of the Australian College of Midwives that home is an appropriate place of birth for women considered to be at low obstetric risk, and that women must be supported in safe, planned homebirth, by midwives and/or other appropriately qualified and regulated health professionals with adequate access to support, advice, and referral and transfer mechanisms.
The Australian College of Midwives supports the use of the National Competency Standards for the Midwife, the Code of Professional Conduct for Midwives in Australia, the Code of Ethics for Midwives in Australia, the Australian College of Midwives National Midwifery Guidelines for Consultation and Referral (“the Guidelines”) and the NHMRC Guidance on Collaborative Maternity Care as the appropriate resources for guiding midwives in their practice.”
The suggestion that anyone choosing a homebirth is after a ‘birth experience’ rather than a healthy baby at the end, or that they are forgoing access to modern medicine for a simulated Ethiopian experience is just ridiculous and very patronizing.
As it is our hospitals are running close to capacity. Hosptial birthers (of which I will be one shortly) are often pushed out the door before feeling ready to return home. We need better integration of accredited homebirthing midwives within our medical system to ensure that hospitals can better manage deliveries requiring more acute care and to better manage the overall load of obstetric care across the system. This would mean better outcomes for everyone and the elimination of rogue practioners in homebirthing.
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I would not choose to have a home-birth, particularly after a complicated first birth. But I support parents’ rights to make informed choices. My observation is that it is difficult to make an informed choice about such a divisive issue, as opinions are so one-sided and attacking of the other side. In addition, for many, there seems to be an underlying fear of hospital. Wouldn’t it be more productive to explore what it is about the hospital system that makes people fearful of giving birth there. And what needs to change?
Also, why is it only the mothers who are judged? In many cases, there is also a father who is just as involved in making the decision.
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Well said, guest!! Spot on!
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I think your comment is exactly right – my research into this issue has found that the dangerous and risky home births are often following a previous negative hospital experience, which was often associated with a high risk birth, or birth complication, such as use of instuments, emergency csection etc.
I work in a womens hospital as a registered nurse in a high level NICU ward and I see many babies after complicated births and the births themselves. Often these births occur after a low risk pregnancy.
I also see a need within the hospital for a patient advocate – a person whose role it is to discuss the options for birth with women who may need more medical intervention than they would have ideally expected. Doctors and midwives often don’t have enough time to sit down and listen to the needs of their patients.
I agree – we need to look at our hospital system.
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I sat through every day of this coronial inquest.
There was at least 2 full days exploring the failings of the hospitals in relation to these families’ previous births. And we are not talking little things, we are talking invasive, abusive procedures with NO CONSENT. In at least one case one mother ended up with severe post traumatic stress disorder (diagnosed by more then one psychiatrist) yet there was literally nothing about this in the findings. In fact, in court many times it was referred to as a ‘perceived traumatic experience’ and shouldn’t be ‘pandered to’. We are talking about severe PTSD. The lack of care on behalf of the hospital and then the coroner is astounding.
Maybe the question that should be considered is not ‘why are these women homebirthing?’ but ‘what is happening in maternity care that would make women with higher risk opt for homebirth?’.
There is so much more to this case then the media and the coroner are telling you all (surprise, surprise!). Please remember that in future when laying judgement and blame. Also remember that three families’ lost beloved babies. You may not agree with their choices but have some compassion!
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I also wish people knew that they could educate themselves about birth and pregnancy from sources other then just the hospitals leaflets. If you really love and want to protect your baby from death or harm, then you would look into and consider more then just what the hospital doctor tells you.
If anyone is interested a couple of sources that come to mind are: ‘midwifethinking.com’ and a brilliant facebook page with many sources called ‘Leaving a baby’s umbilical cord to stop pulsating (delayed cord clamping)’. There are cases with some doctors and some midwives in hospitals (and this doesn’t go for everyone of them) where they do not respect your decision to do things they way you believe to be right (after educating yourself and careful decision making), and it has threatened your babies life or health. To parents who are thoroughly educated, birthing at a hospital can feel like a huge risk for their babies.
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I don’t think reading a few facebook pages / websites gives you an ‘education’ which rivals that of doctors and midwives. Reading piecemeal bits of medical information does not give you a holistic understanding about how the human body works. When something goes wrong during birth, this is what you need. Where the bleeding is coming from, how to make it stop, why the baby isn’t breathing, how to make it start, and so on.
Wise people know when there are things they don’t know – when there are things others are better equipped to handle. In our modern age, birth is one of those things.
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I agree that reading a few piecemeal bits of information doesn’t give you a holistic understanding of how the human body works. That is my point exactly. As for the modern age, … information can come from technology.
Best not presume I would only get my info from a few webpages and not from the medical profession, and that is definitely not what I said in my post. Speaking with a midwife this year, she was surprised about the amount of information I knew about birthing and what to do in emergency situations. Anyone has the means to educate themselves. She also mentioned that many widwives are loosing the ‘midwife’ skills that have been sucessfully practiced for a long time, and are coming more regimented in following only a few chosen procedures that are not always in the best interest for the given situation.
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Anyone has the means to educate themselves, but that doesn’t make them well educated. It just means they think they know stuff about something.
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So true Kris. We don’t know everything about everything do we?
Luckily for us, someone chose to educate us about ‘stuff’ like reading and writing, so that we could make a reply.
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If you really love and want to protect your baby I hope you will talk to a medical professional like a doctor or Certified Nurse Midwife and not look at a blog or facebook page.
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I have to comment again… “To parents who are thoroughly educated, birthing at a hospital can feel like a huge risk to their babies.”
By “thoroughly educated”, do you mean reading websites, blogs and facebook pages? Do you really think that this will provide you with better information than an OB received in medical school? Your ignorance astounds me.
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I was actually very sincere in what I wrote. I take it you didn’t look into the sites I mentioned. The sites are written by trained medical profession. No need to get nasty honey. Websites are another platform that “gasp” even professionals use to give and receive information.
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I think you’re missing their point, Leigh. Reading something written by a doctor doesn’t MAKE you a doctor.
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Did you know that when a baby is born, and it is blue in the face, that the best thing to do is not clamp/cut the umbilical cord? The baby is still ‘breathing’ by it. This is it’s best chance of survival. I have read of many cases where the baby was pronounced still born, and once the midwife massaged the placenta (leaving the cord intact) the babies where revived. I have also read of many cases where a baby is born stillborn, and the doctors or midwives have cut the cord immediately, ending its chance of being able to breathe again.
Of course I’m not a doctor because I can read, but I can educate myself and intervene if necessary.
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Well said Leigh!! As the parent of a child with disabilities, caused by the medical profession, let me tell you, they are as fallible, and human as the rest of us!! We need to educate ourselves as much as possible! The stuff I read about brain training and neurology 30 years ago, then considered “way out” is NOW being accepted as “normal” procedure for coma arousal and brain training. Unfortunately, the medical establishment is often caught up in vested interests, and is not always flexible in it’s approach. Also, all of life is now medicalised, birth , menopause, death, Bah!!
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Leigh, they’re all pretty blue in the face when they’re born, that’s why their apgars at 1 minute aren’t 10. Yes delayed cord clamping can be beneficial to the baby, but can also contribute to jaundice and I don’t know how useful it would be given that Syntocinon is usually given to the mum by the support midwife/birth attendant when the shoulders come out.,
Doctors have to update their knowledge every year, just like other professionals to maintain their registration, so even if they learned something 30 years ago, they’ll still know the more modern procedures etc.
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Leigh – the benefits of delayed cord clamping relate only to the passage of further red blood cells to the baby. This is important because exclusively breast fed babies so not recieve enough iRon in their diet, so that iron early on is needed. However the problem with this is that more red blood cells increases the risk of jaundice.
However, a pulsing umbilical cord cannot bring oxygen to the baby once foetal circulation has ceased, I.e once the child is BORN. The infant requires air. It needs to breathe to open up it’s lungs. I’m sure you can tell me lots of anecdotes, but that isn’t the same as data, science and many years of practice resuscitating infants.
We do practice delayed cord clamping, as much as possible in hospital. However if the baby is nor breathing, then the best thing to do is cut the cord and resuscitate.
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Hey Leigh, all those doctors read books by other doctors when they were med students and it made them doctors.
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really? people commenting on the websites are doctors, considering I work for 5 OBGYNs who laugh at those websites, I find it hard to believe.
still don’t know why anyone would take advice from an anon person on a website over someone who has studied the said area of medicine for 20+ years is astounding. Unless you’re reading medical journals, with year and years of experience and millions of dollars worth of study behind it, your reading an ad. deal with it.
friggin doctor google needs a smack
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Yeah…because when I’m teaching my students about looking for credible sources of information I say “Forget pubmed, medscape, the CDC database or the library, look at this facebook page and remember if it doesn’t agree with your own preconceived ideals it’s probably wrong.” Sorry was that too snarky?
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Yes I think it probably was. Even doctors use google you know. I consulted a doctor once who openly and unashamedly googled my complaint because he couldn’t answer the questions I’d asked him.
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I hope you ran away as fast as your little legs could carry you!! GOOGLE!!?!?!? WTF???
I think for me the main point was continuity of care. I had a good 9 months to work out whether my OB knew what she was talking about or whether she sprouted BS. I ‘educated myself’ and read widely both before my pregnancy and after.
My doctor was very respectful of my wishes while acknowledging that the main outcome that I wanted was a healthy baby. I had the perfect birth plan, we were going to delay clamping the cord, she was going to stay on my chest for at least an hour after birth.
My OB knew and respected my wishes. That’s why I paid her the big bucks and stayed with her throughout the pregnancy.
When push came to shove and my baby’s heartrate dropped I deferred to her superior knowledge with complete trust that we were doing the right thing. I had an emergency C section. It broke my heart. I suffered postnatal depression from which I am only just recovering (2 years later) but, there is not a day that I am not grateful to my doctor and the care she provided.
It didn’t go my way or the way I wanted but, I have my baby. I am only now considering a second child and while we are in a much different financial position I know that we will find the money because the only way to guarantee continuity of care is the pay for it.
AND THAT SUCKS!!!! Where is the support from the government (through medicare) to support women so they don’t have to be afraid of the hospital. The thing that scared/scares me most is strangers who don’t know me poking about making decisions that affect my life.
Anyway, huge tangent but, my point is that ‘educating yourself’ doesn’t change what will happen in the moment it just helps you work out what you would like in a perfect world.
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Medicare funding does not apply to public hospitals. The Commonwealth provides funding to the States (through the National Health Reform Agreement), which then fund hospitals (secondary care) at that level. Medicare rebates apply outside of hospitals (primary care and specialist services). There are, however, a range of measures now in place for midwives to access Medicare rebates, however the difficulty is in finding obstetricians to provide joint care with those midwives. Lots of bugs to be ironed out, but the Commonwealth is working to make alternate midwifery care options available. And a few States are working to provide safe homebirth programs which are run out of major tertiary hospitals.
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For all who are trying to burn me at the stake … My point is actually that people who home birth aren’t necessarily going into it blindly and stupidly. All I was saying, is whether you want to deliver in a hospital, or a home, is to get yourself educated as best as you can about birth.
Why the backlash? Have you something against education? Would you rather not make informed decisions?
Just because I mentioned a facebook page and a website doesn’t mean I don’t think you should read books in libraries. I did. And if you had bothered to look at the sites, you would have had a great discovery on all the sources of info from many doctors and midwives, as well as videos of evidence. You’ll discover they aren’t dodgy sites that other docs laugh at. I’m surprised you don’t know to use technology to research. You could do yourself a favour and take advantage of the piece of technology sitting in front of you.
Faybian – If you read a little more about DCC than you will find out how useful it is.
Doc – thanks for the info, but it does run deeper then that. Info I received from many other docs with ‘data, science and years of practice’.
So, back to wanting to sincerely share some great info, if anyone is interested, there is some great into here on the topics brought up (only one of many, many topics to do with birth). http://www.youtube.com/watch?v=SwvRUrn0p90 Yep … Youtube!
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Yeah, Leigh, I’m sure doctors send people to a facebook page created by the chick from Bellybelly, who happily touts AVN and other nonsense. Uber-credible.
It’s educational, but only in a “this is not fair dinkum and actually quite dodgy” way.
How is giving birth in a hospital a great risk to a baby?
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I acknowledge the value in freedom of choice. I am a vehement supporter of women’s abortion rights. But passing up on modern medical care in the name of what I can only recognize to be some level of illogical superstition strikes me as pure lunacy. I value my children’s lives above and beyond any other belief or creed I posses. Period. No amount of love of all things ‘natural’ could even compare.
Home birth is fraught with danger. So is hospital birth, but incommensurably less so. Why would anyone opt to increase the risks faced by them and their unborn child? Why would anyone gamble with something so precious? I would part heaven and earth to minimize the risks my children encounter every day – already my husband and I buy safety plugs to put over the power outlets in our house, get flu vaccines for the whole family, install smoke detectors, belong to Neighbourhood Watch, own a car with curtain airbags, avoid traveling on long journeys together in case one of us dies and the kids are left on their own, and the list goes on.
Some of these measures protect against dangers which probably have an even lower probability of materializing than home-birth complications. But I still do them. To prevent the unthinkable happening any way I possibly can. Why anyone would take the risk of a home birth is completely beyond me.
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I don’t know why but this article really ticks me off and I would never have a home birth.
Maybe it’s because my first baby son died in a hospital due to neglience but the doctor didn’t have to answer to that, it wasn’t splashed over the news.
I am writing this because doctors are not god and they make mistakes and yet because my son was stilborn at 40 weeks and didn’t take a breath outside the womb, the law doesn’t consider him a life and so the doctor was not held accountable for his neglience in causing my son’s death.
Yet a common person can punch a pregnant woman and the baby dies and they can be charged with murder…how can there be such an condriction in law?
Maybe Mamamia could shine a light on this issue and how this law needs to be changed and doctors should be held accountable by law if their neglience causes an unborn babies death.
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as a medical person I am at a loss to see how a doctor could be responsible for a stillbirth, that just doesn’t make sense
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I couldn’t get enough obstetricians in the room when I had my children. I had one – I would have had a hundred more. My children and my life as their mother was just too important to risk. The simple fact is that no one but an obstetrician or a trained GP can perform surgery and sometimes surgery is what is required – and quickly – to save lives.
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I’m not a medical professional, I can think of a couple.
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There are way too many ways that a medical professional can be responsible for a stillbirth for me to even begin (but I will anyway!)! Most of them however relate to delays in recognising or responding to fetal distress or failing to diagnose conditions such as vasa praevia (which can be detected prenatally), or providing unnecessary interventions such as epidurals or inductions. This is applicable for both midwives and doctors, so I’m not doctor-bashing here BTW.
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Because I had pre-eclampsia and the doctor didn’t diagnose it even though I had all the symptoms and so my baby died during labour. The hospital later admitted if he had diagnosed the preeclampsia and he had delievered my son that day, he would have lived. (I had all the symptoms for the last two weeks of my pregnancy but nothing was done, I didn’t know this till after everything happened). I also nearly died. I could have sued for his neligence towards me but I didn’t. I did go through a concilliation process with the health rights comission and hospital, mainly because I wanted answers and for them to admit what was done wrong. That was a long and painful process and really all I want now is that what happened to me, doesn’t happen again to any other person if it can be prevented like it was in my case.
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Hi Anon, I don’t know when this happened – and I’m so so sorry that it did – but as a medical negligence lawyer I can tell you that doctors can be legally held accountable for the of a foetus or baby through negligence. It becomes a “nervous shock” claim, and the parents recieve compensated for psychiatric injuries resulting from the loss of their child.
In terms of criminal law, if a doctor isn’t charged for the death of a baby (or adult) it is probably as a policy issue. If every doctor was exposed to serious criminal charges every time they made a mistake, why on earth would anyone ever run the risk of being a doctor?
What happened to you is truly, truly awful. But there is a policy reason for why criminal charges are limited. Medical negligence claims are available though.
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I think there’s far too little information here to say whether it would change my mind about homebirth.
I haven’t had a homebirth but am fully supportive of those that want to try.
My understanding is that homebirths are just as safe as hospital births provided that you are within easy transfer distance. In other words, if your birth becomes troubled in hospital there is still a time delay in prepping the operating theatre and you/your ob for a caesarean. If you’re at home, your midwife can call the hospital and get you transferred in a similar amount of time. [That's my understanding]
In this case, it seems like there was a ‘rogue’ operator. Not sure she’s indicative of the whole homebirth midwifery thang.
Caesareans are going through the roof in hospitals. I think the World Health Organisation recommends it should be around 15-20%. In some private hospitals it’s around 50%. In most public hospitals, it’s a lot lower. Why? It’s hard to avoid the conclusion that in public hospitals, if you’re unhappy you sue the hospital. In private hospitals, you sue the obstetrician. Not many people sue their obstetrician for a caesarean.
In summary, as worrying as the coroner’s report is, I don’t think it’s damning to homebirth.
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The WHO recommendation was pulled out of thin air. They’ve admitted this and withdrawn the recommendation. The right number of c-sections is the number needed to minimize mortality.
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Really, that’s interesting re WHO. Still doesn’t explain the wide disparity in caesarean rates between public and private hospitals though.
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I think the issue here is, who is the expert at the homebirth that recognises early enough that there is a problem and then gets you to hospital? In hospital a team of professionals spot the trouble early. At home you are relying on one midwife to know whats going on inside without the use of modern day medical equipment that shows them what’s happening.
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The expert is the trained, experienced midwife, (often more than one) who has attended the whole birth, who have medical equipment with them, such as oxygen, feotal heart monitors etc.
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I have 2 very experienced hospital registered midwives and a student midwife coming to my home birth with all the oxygen, monitors etc that they would have at the birthing unit.
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Hospital births have killed millions of babies. It’s official. Look into it.
There is a lot that doctors and midwives do wrong in hospitals. Some times having a home birth could save your baby.
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Every one of you spouting this millions of babies die in hospital line need a frippen course in high school statistics. It is the RATE of deaths per number of births that is important, not just the NUMBER of deaths.
And for everyone’s information,
Serious adverse outcomes in first time births:
Maternity hospital = 3.5 per 1000 deliveries
Home birth = 9.5 per 1000 deliveries -THREE TIMES the rate in first time mothers deemed low risk.
Source: The Birthplace in England study, published in the British Medical Journal, compared data for 65,000 women deemed at low risk of complications who planned to give birth either in a hospital maternity department, at home or in a midwife-led birthing unit.
http://www.bmj.com/content/343/bmj.d7400
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The conclusion of the report states:
The results support a policy of offering healthy women with low risk pregnancies a choice of birth setting.
Women planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes. For nulliparous women, planned home births also have fewer interventions but have poorer perinatal outcomes.
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This is such an annoying thing to say, Leigh. You are taking a fact completely out of its context.
Millions of people have died in car accidents while wearing seat belts. But that evidence does not support the conclusion that we should stop wearing seat belts.
I bet a huge proportion of the babies/mothers who die in hospital would have also died during a home birth. I bet the slimmest proportion of those deaths would have been prevented had home birth been elected.
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maybe someone has already made this point but I’m assuming that there are partners in play when it comes to decision making about home births and for those laying blame at the woman’s door, consider the male counterpart too.
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I loved my midwives, OB and lovely private hospital room. But most of all, I loved my epidural needle. Modern medicine rocks.
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Love it! Lets use this new fangled modern medecine and then come home in our cars, put on our TVS, wash our clothes in our machines, cook dinner on our gas stoves and put that baby in a safe, plastic capsule!
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I’ve attended four births, three of my own, one of my sister’s.
My first birth was routine, my second was at a hospital’s birth centre and was fabulous, beautiful even. The next cab off the rank was my sister’s low risk birth at a birth centre at a major hospital.
Her baby nearly died. If she was at home (this was a low risk birth), I am 99% sure she would have died. I saw her baby – she could not breathe, she had meconium inhalation and was extremely ill (it took me a long time to get over seeing how close to death this little girl was). She was in ICU for two weeks, eventually went home and is now, thankfully, a beautiful healthy girl.
I would now never go to a birth centre again let alone consider a home birth. That is of course my opinion and due to my experience, however when it comes to life and death decisions (which is what birth is) I believe you should go for the best care possible. There’s a reason we have doctors and modern medicine. They save lives.
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Janeox, I’m genuinely confused. If the birth centre was at a major hospital, presumably with a NICU, isn’t there no real difference between birthing in the birth centre and the ‘normal’ labour wards? Or are you saying that there was a different level of care in the birth centre that delayed treatment?
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Hi Emma, in this situation yes I believe there was a different level of care. The midwife was out of her depth and didn’t have the backup which she would have had across the hall and down the corridor. Bear in mind that I am not an expert here, this is my opinion and the advice I would give to a friend.
I did however speak a few years ago about this with an obstetrician – he told me that he used to support birth centres (was in fact involved with the set up of a birth centre) but has seen similar situations to the one I was involved in happen too often and now believes labour ward has the best care.
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I think the title of this article is inflammatory and not accurate. But I guess that’s what generates traffic.
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Ok then, how about “Babies would be alive today if their mothers weren’t irresponsible and had instead had them in hospital instead of ignoring sound medical advice”?
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I think these 3 women all had husbands too, so don’t go totally blaming the females just because it’s easy for you to so.
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With all due respect, I don’t think the fathers involved would have gotten much of a say in their babies birth.
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Lol, so true. My DH would PREFER a home birth after our experiences at the hospital. There is NO WAY I’d do it at home! I’m just no that person. I just tell him that when he has to pop out a watermelon he’s welcome to make the decision
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It is unsurprising that a story like this has caused mixed emotions and somewhat heated discussions. I don’t understand the criticism about the article, it’s relaying the findings of the coroner – not their words people!
I have never given birth, so I have no experience in that area. However, as a student nurse and future RN (and hopefully eventually a registered midwife if all goes as planned) I am only interested in what is best for the patient. In a birth, that includes the mother and the baby. The wants of the mother should not outweigh the health of the baby. That doesn’t mean the wants of the mother should be ignored – giving birth is a very personal experience.
On a personal note, I know myself. I have a fairly low pain threshold. I’ll be the woman in a hospital bed grabbing the father by the collar and screaming at him to get me an epidural. I’m all for the drugs – that’s why they’re there. They would not use them if they weren’t safe.
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That’s a really uninformed thing to say, especially as a purported “student nurse” – “they would not use them if they weren’t safe”. Last I checked, epidurals pose huge risks. It is not as simple as “that’s why they are there”. I hope that when the time comes, you will critically consider all options and will choose what’s best for you and your baby, not just use drugs because “they are there”.
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Mamamel, that was mean and unnecessary. Huge risks, you say? All medication and pain relief has risk. If you want to talk about huge risks, how about home births. This isn’t about Lauren’s choice as to whether she wants an epidural. Calm down and go have a cuppa.
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Actually, as I understand from my textbook (Berman et al, 2010), the risks are mainly associated with the technique of the professional inserting the catheter. Of course there are risks with all treatments, infection being one of the most common. Patients with epidurals have to be monitored for pain, neurological and respiratory status as any other patient would.
And sure, maybe I’ll change my mind, but at this point, that is my opinion.
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After watching my friend receive an epidural during labor I would not be asking for one myself. That she had to remain still during contractions and then it failed anyway. Not worth it IMO.
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Haha Kat, you obviously haven’t had children. I was against having an epidural, until I was induced a month early. I didn’t even feel the needle compared to the pain of contractions! Epidurals are sooo worth it in my opinion!
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Another report of how stupid and reckless some people are. If it was only themselves they were putting at risk i wouldn’t care, but there is a baby also involved. Great to see the article has brought all the whackos out of the word work – some fun reading!
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I’m all for complete choice in this matter. It’s about Darwin – survival of the fittest. Have your kid at home. You make that choice, that choice reflects on you as a parent. And if it goes pear shaped, well clearly we’re better off without you contributing to the next generation of society.
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Suzie you are spot on. Ive had three births (one for premature twins) all in a hospital (mix of private and public). My hospital experiences were fine, I have no complaints at all – I was fed, showered, attended to by specialists and my babies given the utmost level of care and attention. You’re only in hospital for a week anyway. I just don’t understand what all the fuss is about. We are privileged to be able to GO to hospital to have our babies in a safe environment. People in some countries don’t. Even if you have a trouble free pregnancy, that doesn’t mean something won’t go wrong during birth so it seems ludicrous not to give your baby the best chance of survival possible. For the sake of being able to stay in your own bed in your pyjamas?? Is that more important than the life/well being of your baby? Please, common sense just has to prevail here.
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Romy, you would be a very welcome guest at ours for dinner! I so completely agree – we live in a first world country, why not take advantage of all that has to offer! We embrace all the other trappings of our society, from a huge choice and variety of food to driving the latest car and connecting to the fast internet from the privacy of our air-conditioned home.
I wonder what home-birthers would say if diagnosed with a terminal disease – I’ll take the “natural’ option and stay home on the couch? Doubt it!
I’ve seen too many people have the world’s easiest pregnancies and nearly die in childbirth to even consider it. That said, I also don’t know of anyone who has successfully given birth at home – they always get rushed to hospital. Fortunately the midwives seem smarter than the parents.
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Your post said that you had a positive experience in hospital so you would say that they are fine. I didn’t. My time there after the birth of my healthy baby daughter (via emergency c section – for which I am grateful for) was quite traumatic. That ‘only a week’ that you describe felt like a whole lot longer and left me devastated.
I can understand how a woman who was traumatised by her previous experiences would want to avoid that trauma again. I feel very sorry for the women involved in the story.
If you don’t ‘understand all the fuss’ , you probably don’t understand the reason they made the choices they did. I do. I personally wouldn’t make their choice but, I can understand the place from where that choice was made.
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Romy and Suzie, I completely agree with both your comments. You know, my mother had an extremely traumatic hospital birth with me, I could have died. Would she have chosen a home birth, no way, I would have died. She then went on to have my brother in the hospital. As traumatic as the experience with me was, she dealt with it and got on with life and was happy she got a living baby.
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I find the responses to this article really fascinating. I’m due in 3 weeks (first bub, low risk easy pregnancy). At 20 weeks, I switched from obstetric care in a private hospital to midwife care in a public hospital birth centre. I had two reasons: I didn’t want to ‘medicalise’ my pregnancy (this private hospital has much higher rates of intervention than its public neighbour) and the birth centre’s low intervention model was more aligned with my attitude; secondly (and most importantly) if anything went wrong during labour, the birth centre is in a major teaching hospital, with NICU through one door, and theatre through another. I completely respect a woman’s right to choose a birth model that’s right for them, but the idea of birthing at home without a qualified, registered midwife scares the bejesus out of me. I think a few others have raised this, but perhaps more (and varied) birth centres could be an answer.
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You’re very lucky to live close enough to a birthing centre for this choice to be an option. Lots of people don’t.
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OMG … yet another story telling us how we should live our lives.
As your statement says ‘Fact: birth is risky. It’s natural, but it’s risky.’
Women have been giving birth at home for thousands of years. Some die, some live. Some children die, some live. That is life.
Speaking from personal experience, I was born 44 years ago, during the middle of a very snowy and cold European winter, by the side of a country road and 3 months premature.
Never saw the inside of a hospital. My first trip to the hospital was about a year later for a vaccination which made me so ill that my father was convinced I was going to die.
I managed to survive. I have no medical or health problems and am eternally grateful to my mother for taking care of me and not taking me to the Dr’s.
I am convinved that had she taken me to see a Dr, I would either not be here today or have some sort of health problem.
Death is sad, however it happens and it must happen for the world to survive. If everyone lived, there is no way that we would be able to sustain ourselves.
We need to accept that every life ends, some early, some late, but it ends. We need to stop being afriad of death.
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Death is sad. But in some cases, it is avoidable.
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Have you ever buried your newborn Marly?
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Have you?
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Yes
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So Marly you’re saying preventable death is just a fact of life? That we shouldn’t be ‘afraid’ of it – even take solace in the fact that preventable deaths serve the ‘common good’?
Don’t be ridiculous. Death is the one thing you should be most afraid of – even animals have instinct to tell them that. Each death is literally the end of someone’s universe – sometimes more than one person’s, for that matter.
You speak about death with a cavalier attitude that I can only hope denotes your naivete, rather than your insensitivity.
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Forget that. You can be perfectly happy with your child dying and call it a fact of life or whatever. I, on the other hand, will move heaven and earth to make sure that MY children are alive and healthy. There is no acceptance when it’s your child’s life. And if there is such easy acceptance, you don’t deserve to be a parent.
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So just because you’re convinced makes it true? That’s an interesting leap in logic you make there about your Mum raising you and going to the doctor.
No-one denies people live and die (babies and adults) but we do our best to, you know, not die. In the main.
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Marly, you got it in one!!
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Well said, Marly. I find this discussion astounding. What I find even more astounding is the attitudes of many here. Twenty or so years ago women were bemoaning the medicalisation of childbirth and demanding the introduction of birthing centres as a mid-way between home births and the over medicalised hospital births. Now it’s all oh-my-god I need to be where I and my baby can get the best medical care.
Up until about the 1940s most babies were born at home.
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And up until the 1940s, women and babies routinely died in childbirth. But never let facts get in the way, hey?
Marly, I’m interested. How often do you get booked for not using your seatbelt? You often dry your hair in the shower? Cross the road without checking for trucks? All ways to die, but I’m guessing you take those basic precautions.
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Mammia mia has been biased towards this issue from the start. All your posts have been against it. It comes down to this – it’s a womans CHOICE.
You know what would be more useful than SLAMMING women who chose not to be a victim of the drugs and doctors fear of beign sued so they get a ceasean?
EDUCATION. TRAINING of more nurses, midwives, Doulas so the level is higher. Make these services available to people nad help them develop an “but what if” plan to indicate when its time to go to the hospital.
these are useful things, not slamming them like you have the whole TIME,
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And in three cases the woman’s choice was wrong ..the innocent babies did not have a choice and did not have a chance
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Who are you to say they are wrong!!
What if they gave birth in a hospital and still died. Would their choice still be wrong or would it be OK as they died in a hospital.
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This happens often. Unnecesasry cesearans because the doctor is too afraid for natural birth, more for insurance purposes that moral.
I know an obstetrician, who told me this is what they are doing now. Cesearan at first doubt – because their insurance goes up too much.
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Suzie – you say “who are you to say it’s wrong?” but this has nothing to do with us. This is not a matter of opinion.
These were the findings of the coroner who concluded that three babies would have been alive today had they been born in hospitals.
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Mia- the coroner DID NOT say ‘would’ he said COULD- HUGE difference.
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Oh shut up kel, 3 dead babies… would , could, no difference, they ARE GONE…
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No. It’s not your choice to not give your unborn child the very best chance at survival. It’s just not. It’s not just about you, it’s about your baby. Focussing too much on the supposed natural beauty of the birth instead of the cold hard reality of how much is at stake and all in the blink of an eye… Somebody’s LIFE …..is selfish and narrow. Choice regarding your own health is one thing. Choices made for somebody else should be made with the best available evidence for a good outcome. Think about it.
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Parents always have to make a choice regarding their babies/child well being.
From what food they eat (natural or processed and full of chemicals), what school to go to, how to speak, etc
These people who give a home birth often believe its the best for their childrne because they dont want to be swamped with drugs and procedures that aren’t always necessary (HEB B short for a newborn? are you serious?!)
Having a cesarean increasing your childs chances of asthma and allergies later in life, because the lungs aren’t compressed and expanded suddently as theya re via the birth canal. Same with the immune system.
So there are health concerns addressed to these hospital related procedures too!
Try to keep an open mind and view the situation as it really is. In the end we should find ways to support mothers in a safe way.
Births in hospital can be dangerous too and carry risks. Lets not forget to keep an even balance on the arguement.
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I agree – look at all these parents that feed their children crap food. processed, fatty and horrible. They haev fat and obese kids which SEVERELY risks their lives.
If we want to maek home births illegal then I think that we should make having fat and obese kids too. Because its the parents fault right?
BEFORE everyone jumps in – I don’t think of obesity as point and blame to the parents, but the underlying message is the SAME for homebirths. Parents making decisions that affect their children’s health AND life.
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YAY, JESS!!! Good point!!
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You make some great points there Anonymous. Far better to kill the child than have them face a life with asthma or allergies.
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Or teh ebil vacksunashuns!!!111!!!
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Yes Hep B for a newborn. It gives them the greatest chance at developing immunity. But hey, you read AVN, so clearly you’re far more educated than doctors.
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I’d like to see your proof about the asthma stats. I was born naturally as were my sisters and cousins yet many of us have asthma and allergies. I think you’ll find it’s more hereditary than anything.
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An open mind? You seem to assume that going to hospital to give birth means that a caesarian is a forgone conclusion. The stats just don’t bear that out, not even for private hospitals. My obstetrician is as internventionist as the next, but he told me he always hopes for a straightforward birth – he’d much rather catch a baby than start slicing and dicing. Just common sense really.
Too bad the babies in this case weren’t given the chance to be saved by c-section. Or heart monitoring, forceps, vacuum, resus team, whatever may have been required…
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That’s right! It’s a WOMAN’S CHOICE to let her baby die! If she wants to take that risk and selfishly put her child behind her experience, she should be allowed to do it. Who cares if the baby dies as long as mom is happy!
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I had both my boys in hospital. First birth no probs. Second went so fast when he came out he was heaving, struggling to breath. The nurses immediately grabbedim and applied oxygen. Not wanting to alarm me, they quickly took him away and I could see his chest heaving up and down as they moved him out of the room.
Shortly after they returned to the room, reassuring me that everything was ok.
The next day a nurse came by his cradle and said to me “oh this is the little guy who gave us a real scare yesterday”
Had I had a home birth who knows how this may have played out. All I know is, when my little boy arrived, struggling to breathe, I had 4 people at his rescue.
Would I have loved the comfort of birthing at home?sure. The luxury of being in my home withmy family when all was said and done? You bet! Would it have been the best thing for my boy? I’m not so sure…
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a midwife also carries oxygen with her…just saying..
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Oxygen is useless if you’re not breathing….just saying..
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Midwives carry resuscitation equipment, not just a cylinder of oxygen. The same rescus equipment a hospital uses with a baby who is not immediately breathing….. just saying..
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Hospitals do regular and frequent neonatal resussciation drills and do, in fact, have equipment that the typical homebirth midwife does not.
In my area there is no requirement that a midwife even be certified in the appropriate neonatal protocols, much less drill them on a weekly basis.
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Do you really think hospital staff are drilled weekly on neonatal resus???
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Midwives can’t do surgery.
Midwives. Can’t. Do. Surgery.
Did everyone hear that????
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I think low-risk pregnancies should have the ability to give birth at home ONLY with the approval of a doctor, registered professionals on hand and within a few minutes access to hospital (as someone else pointed out – about the same time as to prepare ER).
But high risk pregnancies or free birth or no professional approval? No way. The health concerns and rights of the baby need to take priority over lifestyle choices. Yes it sucks if you really wanted the birth at home, but surely the health of your child comes first.
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I had a text book pregnancy and ended up having an undiagnosed breech baby, just because you have a uneventful pregnancy does not mean that you will have an uneventful birth
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My ex wife and I have 3 great kids. They were all born in a hospital, but there were serious risks presented that allowed our decision as a couple to be easier. My Ex has Lieden Factor V blood clotting disorder. The risk of haemorrhage is far greater with people who have this condition, so she wanted the security of plasma on hand if needed. Both pregnancies were trouble free, but there was a large amount of clotting during the birth of our daughter, (now 7) and it was worse for our sons – she had a twin pregnancy,
the boys (now 5) came in to the world and she went blue from loss of blood.
She received 4 units to stabilise, but the doctor was worried that there was too much damage.
Imagine how it was for me – my wife had delivered two beautiful boys, hugged them, passed out and I was sitting there, holding her hand and not knowing if I was going to be raising these children on my own. She came back to me, but it was touch and go for a while there. If this had been a home birth, as we discussed later, she would have certainly died.
I agree that it is the decision of the mother where and when they give birth – sometimes home births are the result of the baby being in a hurry and aren’t intentional, but I also believe that in the instances where there are serious health risks to either the baby or the mother, there needs to be discussion as to whether the risk is worth taking. The discussions that we had were long before any of our children came into the world. We had our birth plan and stuck to it.
it is the mother’s responsibility to the little voice not yet heard to decide for them both. If the decision is revealed to be wrong, in hindsight, it is something that the mother needs to live with. That is a big decision.
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It seems that a lot of people are lumping Home Birth in with “free birthing”. BIG difference. I am booked in with a hospital birthing program to have a home birth in 2 months. This involves massive amounts of planning, checks and lists as long as my arm of equipment/supplies that are required to be ready including oxygen and syntocin. My pregnancy must remain low risk or no go (this is my second baby and I had NO complications or intervention whatsoever with the first) so far so good. They do NOT allow breech,VBAC or twin births on their home birth program. To be accepted into the program I also had to be living within 30 minutes of a large hospital and be packed ready to go if any complications arise. There will be 2 very experienced midwives and a student midwife in attendance with the usual monitoring equipment etc (yes- medical equipment people!) and it has been made very clear to me that they have no hesitation in transferring to the hospital at the slightest problem. Pregnancy and birth are normal healthy events in a womans life – obviously sometimes things do go wrong but if there is no reason for intervention then why not be where you are comfortable and can be surrounded by loved ones – my daughter is very excited to have the option of seeing her sibling being born at home, she even first suggested it (and yes we will have a support person for her-my sister who will take her away if she decides it’s not her cup of tea when it gets down to it). My issue with the story presented is that it seems to be an unprepared midwife not assessing risks and putting mothers and babies in danger – obviously with tragic consequences. Well managed home births are so different from what lots of people seem to think that they are. It’s not about ego or whatever other suggestions have been made, its about having the choice, being informed and making the most of an experience that you don’t get to do many times in your life – some people not at all. I am fortunate to be able to make this choice – I know many can’t and there is still the chance that if something happens I won’t be able to continue with it and I will be going with what is best for my baby. “Home birth” is NOT “Free birthing”, please inform yourselves before shouting down an idea that you haven’t even investigated.
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Very best of luck Laura with your little one- hope all goes well and thank you for highlighting that homebirth IS and always should be a medical approach to birth.
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I couldn’t agree more Suki!!!!!!
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thanks for clarifying this issue! This is exactly my point – you can have well planned and prepared homebirths with health care professionals.
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Laura, these babies died at a homebirth, not at an unassisted birth.
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Most of the negative comments about homebirth have been using freebirth/unassisted birth as their examples or unregistered/unprepared midwives without backup in high risk situations like the one reported. They seem to assume that all homebirths carry the same risks as the ones in the story.
“Mr [Anthony] Schapel said he rejected those assertions and found she gave up her registration because, in order to be covered by insurance, she would need to follow the safety guidelines and that would hinder her from taking on high-risk home births.”
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I am all for freedom of choice, within reason. And that statement presents some problems in itself. It is sometimes difficult where to draw the line. I would like to see trained midwives at all home births and an assessment of risk for the mother and baby done prior to the birth where possible. Then if there are no serious problems, home birth should be fine. Of course there is always risk in any birth and modern medicine can do a lot for most of those risks, but not all. I personally would not have a home birth and have had three children who are now grown. All their births were very different and because you never know what can happen, I prefer a hospital. I do respect the right of choice though and I would just like to see well trained assistance.
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Home birth is surely a sign we’ve evolved too far. Willingly and voluntarily turning your back on the advances in medical science which have seen the survival rates of both babies and mothers increase radically over the last century. Charles Darwin would be dumbfounded.
And the illogical arguments of the pro-home birthers below are further evidence of the twisted self-serving logic which led them to make the selfish, irrationally decision to give birth to their children in these circumstances in the first place.
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Home birth need not equate to turning back any clocks.
Educate yourselves on the various home-birth options available and you might have your eyes and hopefully brain opened up.
Then perhaps you won’t resort to calling people you’ve never met, selfish or irrational.
And unless you are Charles Darwin don’t tell us what he’s up to, I’m pretty sure homebirth was not really his thing.
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I say the decision to have a home birth (outside of a hospital supported program) is selfish and illogical because a) the mother is prioritising her desire for a particular type of birth experience ahead of the option with the lowest risk factors for her baby (hard to argue that’s not selfish) and b) the statistics for the health outcomes for both mother and child are lowest in a hospital, so surely any other choice defies logic.
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Which stats are those?
From which countries. Arte they the stats form medically supported home-births or wacky free-birthers?
Do you even know?
I can wait for you do do some actual research and self-education before you get back to me.
But by all means stay in the dark ages and keep being rude if that is your preference…
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You seem to be conveniently ignoring the facts of the case above. Perhaps you need to reread what the coroner said. Ooohh, but of course you won’t do that! You are ignoring the facts of this debate because they challenge your own personal views! Pesky facts!
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You have made your choice then.
Would you like a torch?
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Just think of all the highly trained and dedicated medical researchers and the amazing and astounding advances we all benefit from…being virtually brushed aside by some mothers , who without any medical education , thinking that they do not need these incredible benefits of 21st century medicine and that they know better .. I think God must be scratching his head …
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Jesus. First Darwin, now God. You people are amazing mindreaders!
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I’ve been reading the comments all afternoon and one thing’s for sure – this subject is dividing people right down the middle between pro-homebirthers and those who say birth MUST take place in a hospital.
I think the reason why people get so heated up about this kind of topic is because we’re talking about two people (mother and child) going through one experience at the same time – and death is a potential outcome of that experience.
When does life (and thus a child’s rights) start? At fertilization? At 12 weeks gestation? 22 weeks? Full term? Or the moment a baby takes its first breath?
If a child’s rights don’t start until AFTER it has been born, then does that mean a woman can choose where to give birth regardless of risks? Or does a child’s rights start well before birth? And if so, then whose rights come first? The woman, who has a right to choose where to give birth and how her body is treated, or the unborn child who has a right to life?
I think when discussing homebirth and whether it should be allowed/encouraged/whatever, there are more questions than answers. The only thing I’m sure of is that babies have died and that’s just tragic.
[ http://perthwife.wordpress.com/ ]
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While I don’t condone home births in high risk situations, I do understand why so many women desire homebirths. I have had 3 children in a regional public hospital and unfortunately my experience and a lot of the women in my mother’s group was pretty awful. While I aknowledge that of course the care was a lot better than in a developing country, it still left a lot to be desired. It seemed that all of the problems were a result of chronic short staffing. Individual midwives were great but there’s not a lot they can do when they’re literally rushed off their feet. In particular:
* After my caesars I had approx 5 minutes with the babies then they
were taken away. No skin to skin, no breastfeeding, no having baby in recovery and with the last baby it was 5 hours before I saw him again (woman who had her caesar before me had to wait 8 hours). This was due to the wardsman being unavailable to take us back to maternity ward.
* I had to immediately look after babies after caesar – my daughter screamed most of the night and I was unable to get out of bed to look after her. Midwives were literally running around the ward and couldn’t help me.
* After my last caesar I had to wait 12 hours before my pad and bloody sheets were changed
* There were no facilities for my husband to stay over night (wanted him to stay to look after babies at night!)
* Seemed to be minimal handover information (midwives no doubt didn’t have time) – pain relief, BP medication etc haphazard, lucky if I got my obs done (important as my BP was a problem)
* No help at all with BFeeding, bathing baby etc – luckily with my 2nd and 3rd baby I didn’t need help
* At times the labour ward was so busy – women were labouring in the ward
* Common theme in mothers group was women being denied epidurals because anesthetist busy / unavailable. Many of the women were traumatised by lack of pain relief.
* No consultation / discussion about any of the decisions eg my third baby apparently had low glucose levels and while I was in recovery paediatricians decided he needed formula – duration of our stay he was given formula top ups. I was never told what his levels were, why formula would help, what may have caused it etc
Anyway my point after that rant is – the public hospital was great when it was life saving situation as it was with my first baby – but for the rest it was a pretty uninspiring experience. I actually spent most of my 3rd pregnancy dreading the hospital stay and unfortunately it lived up to expectation. If I was a low risk candidate I would definitely have considered a home birth (I probably woudn’t have gone through with it!).
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There is a chronic midwife shortage. Something that will only get worse as the rest of the baby boomers retire.
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Holy shit!
That is truly awful.
That skin to skin thing particularly breaks my heart.
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Sounds like my experience- you leave realising you would get more care at home
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I think that the women who made the choice to have their births as they ‘required’ was inconsiderate and wrong.
Yes, babies die in hospital. It’s true! Sometimes because they are born too early, in my case, due to genetics not known until afterbirth.
I had a parallel pregnancy with a friend. She was absolutely pro-natural, and even back then I was pro-c-section. (Judge me as you wish).
She was offered c-section as her child was in distress. She chose the natural route and was presented with a CP child. Oxygen deprived, needed glasses, hearing aids, specialised teaching in school.. add the etc… Where as my child, planned c-section due to my medical conditions (condemned by my friend!) provided me with a beautiful, successful child. It seems harsh to write the differences in our opinions, yet I believe that my friends’ ‘natural’ stance to basically everything in her life, and my ‘I will do what I think is best for me and my child’ stance is the difference between her marriage downfall and, I know it sounds wrong, and it is wrong to say so, but I do have a successful relationship with my husband and our two successive children.
Her choice to have a ‘natural’ delivery with a negative outcome affected her whole family. I believe that her choice was wrong.
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Gosh…so glad your child is ‘successful’ whereas your friend’s child is clearly labelled ‘CP’…so one presumes ‘unsuccessful’. Could your terminology be any colder and more offensive? Aside from the problems in putting a disability before the PERSON, I find your attitude abhorrent and for me,it obscures anything else you might have to say.
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Yep. It’s grossly offensive. And so cold.
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I agree. Cold and an awful way to refer to another human being
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OMG, can you touch the sky from that pedestal you are on.
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What’s CP??
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cerebral palsy
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Cerebral Palsy.
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Thanks for the clarification…
I am disgusted more so now.
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that type of comment is really unsupportive ‘Alert the Moderator’ – come on!
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Your ‘friend’? Define friend for me.
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…and about 20 women died in Australian hospitals in childbirth in 2011 — we just don’t hear about those because there was no sensational media stories and coronial inquests.
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Untrue. I work in insurance, and I can assure you, there are ongoing and regular coronial inquests into babies dying in childbirth in hopsitals. Medical negligence claims, too. They are very common – they are probably reported in the papers, too, just not on the front page.
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20 women…not babies.
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And those women would be alive today had they homebirthed?
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But isn’t that the point? Birthing has risks so you should do so in a safe environment.
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I think that is the point even in hospitals things can go wrong where they have all the facilities what hope do you have at home?
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People die all the time, from seemingly minor things. Why is it shocking to you that through something as serious and dangerous as childbirth, people die too?
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well we are not seeing Mia writing articles condemning the families of the 2000 babies who dies in hospital in childbirth last year.
rather tedious this website – have fun!
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I have read all the comments again since I posted this afternoon. “i did….”, “my friend did….” etc You know who I would love to hear from? The three babes this article refers too. Guess what? You can’t. They’re dead. They’re dead because of home birthing. That is a FACT. And it could’ve been prevented by giving birth in a hospital. That is a FACT too. The end.
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Another fact is all the babies who died in a hospital didn’t get a choice. Neither did those who were aborted. If you aren’t pro life KTT (I am not FTR) then your argument is invalid.
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This just doesn’t make any sense? Are you implying that the hospitals killed the babies?
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Of course I’m not. I’m saying babies die in hospital births too. That makes about as much sense as saying the the midwives involved killed the babies who died in those home births.
I hope you’re not implying that?
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Killed them? Deliberately? I don’t think Snap is saying that. Was the midwife reckless, negligent or willfully disregarded the health and safety of those three babies. Well I’m not her judge and jury, but she should face charges to determine her culpability in their deaths.
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But surely you can see that the risks are far greater to home birth? It’s just common sense.
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What is the deal with people equating home births to abortion? The argument is absurd. The established facts are that these children would not have have died if they had the chance to be born in a hospital. I am not making this up. This has nothing to do with abortion.
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Uhh, we know the babies would almost certainly not have died in hospital, AS PER THE CORONER’S FINDINGS QUOTED IN THE ARTICLE. Do none of you home birth advocates know how to read?
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Gak- people need to read some research. Many ‘advanced western nations ‘allow’ homebirths in recognition of its relative safety. Its somehow become this weird/scary/female blaming/dont care for your baby witch hunt thing in Oz that the Docs have also bought into. Obstetrics is very limited in its capacity to match current practice with evidence based research. if you read the Royal College of Obs guidelines its much more ‘liberal’ than what the docs/hospitals and current practice utilise.
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Each to their own of course, but I personally can’t fathom why anyone would want to have a home birth. Anything can go wrong at a moment’s notice and I for one would not want to risk losing my child. My pregnancy ended in an emergency c-section and I know that had I been at home, my son would be dead. Give me a hospital over the risk of that outcome any day!
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I must be dealing with a differnt public hospital system!!!
My grand daughter who is now 13 was born in a pleasant room, my son and his partner had friends in the room next door, there was a bean bag, there was massagers, there was laughter. All was pleasant
6 months ago my grand daughter (also a nurse) had her child in a private hospital: they were provided with a double bed so her partner could stay over night with her, she tells me she was given all sorts of help.
If there is no problems then maybe a homebirth with an educated midwife is a pleasant idea, but that is the crux of the problem. NO PROBLEMS. it would be different if the problem was unexpected, but in this case the problems were known. How is that differnt to abuse!!!!
Surely the needs of a helpless child is more important than the “wants ” of an adult who has control of their life.
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So women should be given the right to decide to terminate a pregnancy but they should NOT be given the right to give birth at home? Have I got that right?
I’m not anti-abortion, but this is confusing me!
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It is a very emotional issue when a baby dies. In this instance there were serious mistakes made but I dont think that all homebirths should be condemned because of this. When a baby dies in a hospital due to a mistake made by a doctor or midwife people dont condemn hospital births.
I had my 3rd child as a planned home birth 23 years ago and had a midwife there and a doctor on call.
I respect a woman’s right to choose where to give birth as long as it doesn’t affect the health of the baby. I made an informed choice and my baby was never at risk.
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