unassisited childbirth-what do you think?

Sexual my sweet patootie!

Birth is sexual and spiritual, magical and miraculous
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Speaking as someone who's done it, it's also painful, exhausting, and frightening, especially the first time through. A woman's own intellect and intuition are indeed no match for the medical establishment: no one of us knows as much as the entire hospital staff, and I for one found it encouraging to know that there were plenty of people around who had more experience than me with the process and knew what to do if anything went wrong. I was far too wrapped up in alternately hurting and gasping for breath to apply any intellect or intuition to anticipating potential trouble, and I didn't know what indicators to monitor even if I had the attention to spare.

Sexual indeed. Sexual is the LAST thing you feel like when the sensation is like trying to clear the largest bout of constipation you've ever had. The magical and miraculous part comes AFTER all that, when the hard part is over (by that time I was trembling uncontrollably and was grateful to be wheeled away to a quiet corner and have other people do the mopping up, cord-cutting, Apgar-measuring, and so forth).
 
Home birthing is needlessly hazardous

I must admit my bias up front. I am a pediatrician and an active member of the medical community in Colorado.

Giving birth outside of a hospital where emergency services are available 24/7 is a needless risk, and a significant one at that. Risks to the mother (and they are significant) aside, lets think about what can and does happen to the child and the timeframes involved using two common complications: placental abruption, and compromise of the umbilical cord. Both occur in otherwise normal pregancies, giving no warning no matter how good the prenatal care may have been. An overwhelming majority occur during labor and result in compromise or complete loss of blood supply to the infant. This is equivalent to the child suddenly not breathing. The infant has a similar tolerance to this insult as anyone else does, and will die within minutes if no intervention is made, just like anyone else.

The intervention I mention is IMMEDIATE delivery of the child, by "crash" C-section if needed, followed by CPR. The only way to know this is happening and the only way to intervene is to have fetal monitoring during labor and the ability to perform a C-section and resuscitate an infant while caring for the mother. Minutes count. Even being "close" to a hospital would realistically take 20-30 minutes for travel and triage, not to mention starting to help the mother and child. If something catastrophic has occured, that is far too long.

I may sound alarmist. I assure you I am not. 1 in 10 normal deliveries require some form of resuscitation beyond stimulation, warming, and oxygen. 1 in 100 normal deliveries require intensive resuscitation with artificial respiration and chest compressions. Luckily, our success rate for recovering the infant is quite high, but these are not numbers to take lightly.

Absolutely, we should make mothers and families comfortable. If you don't want pain medicine as the mother, fine, it's your body. If you want only a midwife in the room to assist you, no problem. We should bend over backwards to make the event occur in the way the family would wish, so long as it is done without incurring additional risk to the mother or child. We risk death or permanent brain damage to the child being born by not giving birth where help is available.

Don't even get me started on water births.
 
The way I see it on a social level : Her body her choice.

The way I see it on a personal level : Compare the ratio of women who died without modern medicine during childbirth, vs. with... and one can see how insane that quote was.
 
I would also point out that at the time of birth it is not only her body, but that of her child. I will NOT make this into a discussion on abortion. However, at the time of a full term delivery (which is the topic of this thread) everyone including the mother attempting to give birth, sees this as a new human being fully entitled to the rights of a human being. We cannot discount the risks being imposed on the child.

True, an adult is free to risk their life in any way they see fit, but it is neglect (in some cases criminally prosecuted) to place a child in harm's way because of a voluntary decision by his or her guardian.
 
So, yes, women have been giving birth for thousands of years. But it is harder for us than most mammals because of our bipedal physique. More dangerous, too, so medical help is a great thing for us. Birth is a natural process, but with our small birth canal and the rather large size of our babies heads (due to our evolved intelligence) who wouldn't want medical intervention while giving birth?
 
I can add little more than what has already been said except that this notion of "doctors being trained to intervene" is hogwash and fear-mongering of the worst kind.

If all I wanted to do is interventions, I would have done something else.

You wouldn't gamble with your child's life once it was born, so why would you while it was being born?
 
Don't even get me started on water births.
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I would like a professional's opinion on water birth, actually, if you would like to give one. It is sweeping Japan like wildfire, but the literature for it sounds like major woo-woo , ie., 'Giving birth in water is natural as all life forms sprang from the sea' etc. I find it rather alarming and a senseless risk, but my concerns are poo-poo'd as 'overreacting'.

As for unassisted childbirth, there is too much that can go wrong...some babies are born with the cord wrapped around the neck and/or pinched in the birth canal. Incidents like this are going to be impossible for the birthing mother to detect and correct on her own.
 
OPECOILER said:
I already posted it yet somehow the edit tab isn't there on my first post.
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OPECOILER-
Don't worry about this. Edits are restricted to 2 hours after posting. Stops people going back to substantially alter an argument after the rebuttals come in.
There's a tendency for a certain type of poster (often a newcomer) to start a thread - often quoting unattributed sources- then fail to reappear. Drive-by trolling in effect. Clearly not the case here.

Looks like the views on this forum are pretty uniform whether from medics , non-medics, men or women. The source is silly and your "alarm bells" are justified. The right to choose is important, but consent must be informed and the risks known. It would be good to get a signed consent from the other involved party too - but babies can't write.
 
Katana said:
I can add little more than what has already been said except that this notion of "doctors being trained to intervene" is hogwash and fear-mongering of the worst kind.

If all I wanted to do is interventions, I would have done something else.

You wouldn't gamble with your child's life once it was born, so why would you while it was being born?
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I agree, but "they" don't look at it like that. Statistically, a child is no less likely to die being born at home compared to being born in a hospital. (this is the deal for midwife attended births, not the "unassisted childbirth" thing. I doubt there's any data on that.) Now, it seems to me that most midwives do screen for things like placenta privia, and send those women to OBs. So that right there skews the numbers in favor of homebirths. And then there are premature labors and things of that sort, which obviously result in child mortality in a hospital. And the home-to-hospital transfers where the babies die at the hospital. So the statistics are deceptive.

But people who do this are assuming that there are things like hospital acquired bacterial infections, unnecessary "just in case" C-sections, and things like that which are behind the apparent complication equality.

So, yeah. I think their math is off, but they don't think they're taking an excessive risk.
 
crella said:
I would like a professional's opinion on water birth, actually, if you would like to give one. It is sweeping Japan like wildfire, but the literature for it sounds like major woo-woo , ie., 'Giving birth in water is natural as all life forms sprang from the sea' etc. I find it rather alarming and a senseless risk, but my concerns are poo-poo'd as 'overreacting'.

As for unassisted childbirth, there is too much that can go wrong...some babies are born with the cord wrapped around the neck and/or pinched in the birth canal. Incidents like this are going to be impossible for the birthing mother to detect and correct on her own.
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I'll give you my opinion since I've done a few. When they go fine, it's all well and dandy...well, except for Dad (or the partner) who gets the net with which to scoop out the, shall we say, poop and the OB who gets covered in dirty water, blood, and amniotic fluid. Oh, it's heart-warming.

Having said that, try getting a woman, contracting, slippery from water, off-balance and heavy from pregnancy, and with a partially-delivered baby between her legs back to bed from the pool because the kiddo gets stuck on the way out. As you can imagine, everyone involved is at risk for bodily injury. I've known more than one nurse who threw out her back trying to help a woman out of the tub. Not good.

If you detect a bit of cynicism on this topic, you're justified. There is a reason why we are conditioned to take a breath when we exit the uterus. The aqueous environment is supposed to end with birth. We're wonderfully adapted to make that transition.
 
kellyb said:
I agree, but "they" don't look at it like that. Statistically, a child is no less likely to die being born at home compared to being born in a hospital. (this is the deal for midwife attended births, not the "unassisted childbirth" thing. I doubt there's any data on that.) Now, it seems to me that most midwives do screen for things like placenta privia, and send those women to OBs. So that right there skews the numbers in favor of homebirths. And then there are premature labors and things of that sort, which obviously result in child mortality in a hospital. And the home-to-hospital transfers where the babies die at the hospital. So the statistics are deceptive.

But people who do this are assuming that there are things like hospital acquired bacterial infections, unnecessary "just in case" C-sections, and things like that which are behind the apparent complication equality.

So, yeah. I think their math is off, but they don't think they're taking an excessive risk.
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You're absolutely right in that lay midwife patient populations are skewed in favor of young, healthy women with uncomplicated pregnancies (as could be argued is appropriate). So, yes, those are the patients least likely to require higher-level care that you would find in a hospital. Thing is, even under the best of circumstances, issues can arise that need addressing immediately - either for Mom or the baby. Why take a chance? Yes, the odds are in your favor, but, again, at what other time would you gamble with your child's life (or your own)?
 
Thank you. I imagine warm water could be beneficial in relaxing tense muscles, and promoting overall relaxation, but I've often thought that the timing of getting the baby up and out of the water before it tries to draw a breath would be difficult.
 
crella said:
Thank you. I imagine warm water could be beneficial in relaxing tense muscles, and promoting overall relaxation, but I've often thought that the timing of getting the baby up and out of the water before it tries to draw a breath would be difficult.
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To be honest, warm water is quite helpful early on in labor. The value it has for women later on in the more active stages of labor seems to vary widely.
 
Here's a waterbirth woo video.

http://www.youtube.com/watch?v=nZtYCHASqNM

Apparently water births make kids grow up to not have acne.

To be completely honest, the woman having a waterbirth in the middle of the video is perplexing. She's either psychotic, or the video was just really edited well.

ETA:
Wow. I just watched it again. You have to admit...that's some high quality woo. :D Complete with video of dolphins and everything.
 
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Jalbietz said:
I must admit my bias up front. I am a pediatrician and an active member of the medical community in Colorado.

Giving birth outside of a hospital where emergency services are available 24/7 is a needless risk, and a significant one at that. Risks to the mother (and they are significant) aside, lets think about what can and does happen to the child and the timeframes involved using two common complications: placental abruption, and compromise of the umbilical cord. Both occur in otherwise normal pregancies, giving no warning no matter how good the prenatal care may have been. An overwhelming majority occur during labor and result in compromise or complete loss of blood supply to the infant. This is equivalent to the child suddenly not breathing. The infant has a similar tolerance to this insult as anyone else does, and will die within minutes if no intervention is made, just like anyone else.

The intervention I mention is IMMEDIATE delivery of the child, by "crash" C-section if needed, followed by CPR. The only way to know this is happening and the only way to intervene is to have fetal monitoring during labor and the ability to perform a C-section and resuscitate an infant while caring for the mother. Minutes count. Even being "close" to a hospital would realistically take 20-30 minutes for travel and triage, not to mention starting to help the mother and child. If something catastrophic has occured, that is far too long.

I may sound alarmist. I assure you I am not. 1 in 10 normal deliveries require some form of resuscitation beyond stimulation, warming, and oxygen. 1 in 100 normal deliveries require intensive resuscitation with artificial respiration and chest compressions. Luckily, our success rate for recovering the infant is quite high, but these are not numbers to take lightly.
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Yes, but the vast, VAST majority of those births involve labours that were augmented with pitocin, epidurals, and other interventions. Those interventions might be what leads to the problems you see; if the woman had laboured naturally, perhaps the baby wouldn't have needed breathing help or resuscitation. When you look at the statistics comparing healthy women giving birth at home with midwives (where there are no epidurals, pitocin drips, or early labour inductions) to healthy women giving birth in hospitals, the outcomes are the same, and some studies (the most recent BMJ study comes to mind) even show an advantage for homebirth. Midwives are trained to recognize the signs of impending problems and take action - here, where midwives are fully funded by our health care system, a midwife carries with her the exact same or equivilent equipment to that found at our (small) local hospital, and at least 2 attend every birth (usually two plus at least one student).

While I think the unassisted childbirth people are off their rockers, I also was rather shocked that when I did a lot of research during my pregnancy, I found that much of modern obstetrics practice is backed up by almost no good data. Heck, my first OB (who I left in favour of a different, more natural childbirth friendly practice) swore up and down that if the umbilical cord isn't clamped immediately, there would be dire consequences - and now the latest metastudy indicates that cord clamping should in fact be delayed. An awful lot of obstetrics is practiced because that's how it's always been done, not because there's good evidence in favour.

I agree, but "they" don't look at it like that. Statistically, a child is no less likely to die being born at home compared to being born in a hospital. (this is the deal for midwife attended births, not the "unassisted childbirth" thing. I doubt there's any data on that.) Now, it seems to me that most midwives do screen for things like placenta privia, and send those women to OBs. So that right there skews the numbers in favor of homebirths. And then there are premature labors and things of that sort, which obviously result in child mortality in a hospital. And the home-to-hospital transfers where the babies die at the hospital. So the statistics are deceptive.
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In most studies, they only compare like groups - healthy pregnancies at home vs. healthy pregnancies in the hospital. Anyone with complications is removed from the sample.
 
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Don't even get me started on water births.
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I would be very interested in any opinion or information you have on this subject, as my wife planning a "natural birth" and she is now 35 weeks....
 
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