Comments on: The Perils of Midwifery! Reality Rounds calls a “Code Bullshit” on the Today Show.

By: Jessica

Jessica — Tue, 01 Dec 2009 12:58:41 +0000

I know this is an older post but just had to comment, this kind of thing really gets my goat.
My first was born at home, almost exactly 24 hours after labor started (but about 16 hours of that was early labor with contractions 10 min apart but with clockwork timing). My midwife monitored him via doppler atleast every 15 min, and, once we got to pushing, at least every other contraction. His heartbeat was “great” throughout. Strong, sure, consistant, with healthy variables during a contraction. But in the last 5 min his heart rate dropped, it became apparent he was stuck, and they manually manipulated him out within 5 min (quite a bit less than the 20-30 min an emergency c-section would have taken, even if it could have been performed that late in the game since he was already crowning). He was born without a pulse or resperation, but they got a positive pressure oxygen mask on him as soon as he was out (literally as soon as they laid him down, they already had the O2 out) and got his heart beat back within 3 rounds of chest compressions. The paramedics were called immediately, but, when they arrived (very fast, we were very thankful how quickly they got there) they had to borrow the infant face mask from the midwife, took him off their positive pressure oxygen and started ‘bagging’ him with room air, didn’t have an infant backboard, didn’t have the correct tube to intubate him etc. Thankfully the hospital was very close (part of our requirement for a homebirth) and, between the time he showed dangerous deceleration of heart rate to being in the ER intubated was less than the standard “30 minutes from decision to insecion” that is recommended for an emergency c-section (5 min from decel to birth, 5-6 min for paramedics to arrive, 1 for them to leave, less than 5 min to the hospital, total time apx 17 minutes). Not only that but midwives have a statistically better outcome with shoulder dystocia than doctor’s do. If it took 2 midwives with years experiance and over 500 births to their record all four hands on and a change in position to get him out (they both said he was the most stuck baby they had ever had), what realistic chance would a doctor have had with me in a backlying postion with my pelvis narrowed by my legs up in sirrups and how much longer would it have taken him? The hospital is the best place to deal with complications in general (specifically if they are known before hand) but that doesn’t mean that home with a midwife can’t be as good or better than a doctor/hospital to deal with those sudden complications that can happen at the last minute, especially if there is a hospital close by. We feel very strongly that our midwives saved our baby’s life, and, had we been in a hospital, the best outcome would have been everything that happened, plus a broken shoulder. More likley, a far more seriously injured/sick baby. While the doctor’s at the NICU (ended up he wasn’t breathing because of a severe MecAsp and the heartbeat/hypoxic brain injury was most likely from cord compression when he got stuck, btw there was NO meconium present in my water, prebirth, on baby, or in afterbirth so there wasn’t a previous reason to imply we might be dealing with a MecAsp) were VERY condecending to us and had the gaul to write in our chart “despite a homebirth parents have a normal interest and concern in their child’s health”, several NICU nurses quitely assured me “thank goodness you had a midwife!” when told our story. Some babies die at/before birth, some babies suffer birthing complications, assuming (obviously after careful consideration sometimes it does) ‘place of birth’ had ANYTHING to do with it is completely disingenious and just shows that the Today show is far more interested in sensationalizing some poor family tragedy than in reporting information.

By: Sunday News Round-Up, 9/13/09 » Post » healthyjoyful

Sunday News Round-Up, 9/13/09 » Post » healthyjoyful — Fri, 25 Sep 2009 15:32:00 +0000

[...] of varying sorts – it was about home birth. I’ve nonetheless to see it. you know Reality Rounds, Science as great as Sensibility, as great as Midwife Connection have responses vicious of the [...]

By: Kathryn

Kathryn — Tue, 15 Sep 2009 17:05:13 +0000

C-sections frequently save lives. I am an enormous supporter of surgical intervention when it is warranted. Hell, one of my daughter’s best friends would not be here without every obstetrical intervention short of surgery; she was induced with Cervidil, then with pitocin, and finally (three days later) had her baby with the help of a vacuum extractor. She was hurtling headlong towards pre-eclampsia, and those interventions saved her life and her son’s both.

But she was identified as high-risk weeks before her baby was born, and the necessity for a hospital birth was made extremely plain at her 38 week appointment. I have another friend who was a homebirth conversion for low fluid and IUGR; the piece of technology that caught the problem was a freaking TAPE MEASURE. Even in my case, where I came within minutes of needing a crash section because of a non-reassuring fetal heartbeat pattern — I avoided one only because of luck, a splendidly titred epidural, and an unexpectedly good pushing ability — the problem was detected a few hours before birth, and would have been detected in a homebirth setting as well.

How often do problems in birth present themselves so suddenly and acutely that the 20 minutes it takes to transfer to the hospital is too long? In how many hospitals is the time from C-section decision to actual surgery less than twenty minutes? And how do those incidences compare to the intrapartum injuries to mother and child that result from the HALF of all C-sections performed in this country that are, statistically, unnecessary? For that matter, how do they compare to the danger borne by simply driving to the hospital when the driver is distracted by a laboring passenger?

By: Jill--Unnecesarean

Jill--Unnecesarean — Tue, 15 Sep 2009 00:52:23 +0000

Akiko, you aren’t talking about the U.S., are you?

By: Kathy

Kathy — Mon, 14 Sep 2009 22:18:25 +0000

They discourage them, that is why they often wont pay for them. They want all of us to go home and have our babies.
Insurance companies like this may exist, but from the home-birthing women I’ve talked to who have insurance, it’s not the norm. Most women have to choose between an insurance-paid hospital birth or a self-pay home birth (with perhaps reimbursement). My SIL was told by her insurance company that they would reimburse most or all of the midwife’s fee, and after the birth changed their mind. Many won’t even pretend to pay it. Others will reimburse at an out-of-network (higher) rate. Many women say, “I’d have a home birth, but my insurance won’t pay for it. If I have a hospital birth, they’ll pay almost everything; but they won’t pay for anything with a home birth.”

Not having insurance I don’t have personal experience with this, though!

By: Akiko

Akiko — Mon, 14 Sep 2009 20:59:16 +0000

This whole conspiracy theory attitude about hospitals pushing more c-sections is ludicrous. Insurance companies dont want more c-sections. They cost a lot more money. The discourage them, that is why they often wont pay for them. They want all of us to go home and have our babies. The doctors are terrified of being sued so they opt for a c-section a bit quicker than they would otherwise. Tort reform would take care of that and c-section rates would drop dramatically. However, you also give away your right to sue the crap out of them if they show up overtired and injure you. Insurance companies love Tort reform, it will save them a lot of money.

By: Akiko

Akiko — Mon, 14 Sep 2009 20:55:33 +0000

“Sometimes babies die during birth. It’s horrific, but it happens, regardless of the birth setting”
And mine would have been one of them had it not been for the quick thinking of my OB. An emergency C-section saved her life and mine. Had I worried about my birth experience or my feelings neither of us would be here today. Perhaps if her labor had not been pushed to 4 days her baby might have made it. Sometimes C-sections save lives.

By: Darcie

Darcie — Mon, 14 Sep 2009 20:50:31 +0000

http://acnm-midwives.blogspot.com/2009/09/non-perils-of-midwifery.html

FYI, this is a response from the ACNM blog site

By: Akiko

Akiko — Mon, 14 Sep 2009 20:48:12 +0000

That is weird. My insurance company is encouraging home births because they are cheaper than hospital births. They love to keep their expenses down. In England home births are encouraged for the same reason. If things go well then you can only have a home birth in dire cases of medical emergencies like in Yemen, Afghanistan and Saudi Arabia.

By: Akiko

Akiko — Mon, 14 Sep 2009 20:33:50 +0000

Read this story on Cara. She is an egotisical nut. She carries no malpractice insurance and loves to brag on all of “her” high risk deliveries. Worse than an OB with a God complex.

http://nymag.com/news/features/55500/

What she puts some women through is horrific. Her ego wont let up. She was sued for the death of the newborn and settled. Turns out the baby was too big to deliver vaginally. She was also sued for causing Erbs Palsy to another baby. She has a habit of blaming the mother if the delivery does not go well. Worse than an OB right there.