Friday

homebirth

A new, mainstream study is out that confirms previous studies demonstrating that home birth is a safe, affordable, satisfying option for women with no complications.

I've written about this HERE and HERE.

If I have another baby, it will be at home.

15 comments:

Dewi said...

It’s very exciting. I’ve been hearing about this study at conferences for a couple of years and finally read it yesterday; it’s fantastic that they analyzed over 5000 home births. Maybe it will put to rest the controversy over homebirth not being safe.

Anonymous said...

eeew. she does it again. another stupid statement. my own father was brain damaged because of a home birth gone wrong. intelligent minds...lets just think about this...if you get equal or slightly lower death rates in a group of women hand picked to be the lowest of low risk births as you do in a group that by default includes all kinds of situations ripe to go awry, that doesnt say much about safety to me. no thank you. I will choose modern medical technology any day. its there for my usage, why do I want to go back???? why do I want to risk a precious babies life just to try and prove an ideological point???

Anonymous said...

but, Katie, you arent looking for a husband..how can you have another baby? I forgot..you will just be oh so modern and oh so hip and find a guy to use as a sperm bank because you know..you dont need men. just thier sperm because thus far feminists havent found a way to reproduce without it.

katie allison granju said...

I am not actively looking for a husband. That doesn't mean I might not accidentally find one one of these days... There are things about being married I miss a lot and things I miss not at all.

And I can't say for sure whether I would necessarily marry again just to have a baby. I wouldn't ever want to have a baby with a man who didn't want to be an active, involved father, but I just don't know about the marrying part.

Jamie said...

Anonymous asks, Why do I want to go back? Because my two amazing home births have been some of the most sacred and empowering hours I will ever experience.

If I can have a sacred and empowering (and far less painful) experience with the same level of safety as an experience that leaves too many women feeling manhandled and ambivalent, I'll pick the home birth every time. It's a shame more women don't have the option.

I've been chewing on a post about this study but am busy writing about bfing lately--

Anonymous said...

I think I will take "safer" over "spiritual and empowering"any day of the week. let cut the spiritual and empowering crap anyway...if you want a spiritual experience go stand on a mountaintop and say "OM". if you want to maximize your chances of a live baby sans birth defects and sans damage to you...go for the hospital. I cannot believe anyone would be so stupid as to sacrifice thier precious baby so they can have a "spiritual" birth experience. probably the same people who risk their baby sleeping in their bed so they can "bond" better. I repeat: if you get near identical death statistics with a group preselected to be the lowest risk women as compared to a group that by default contains all the hairy scary situations, thats no comparison at all.

Jamie said...

Hello, Anonymous. The data on planned attended home birth show that it is no less safe than hospital birth for low-risk women. The rates of iatrogenic complications and nosocomial infection for women choosing hospital birth are troubling.

I wouldn't have a baby at home if the data showed I was putting either of us at risk. And if you can cite studies (not funded by crib manufacturers, please) to demonstrate that sober, non-smoking parents sleeping in firm, appropriately sized beds with their babies are putting them at risk, I'll eat my unused crib mattress.

Cordially yours--

Jamie said...

One more thing: valid research doesn't compare all home births and all hospital births. Only low-risk women are good candidates for home births; unplanned home births are a bad idea. This study is worth reading about because it compares low-risk women having planned home births with low-risk women having planned hospital births. The mortality stats in this study don't include "all the hairy-scary situations": higher-risk women were excluded.

The BMJ abstract, along with some related links, is here if you'd like more information than is included in the article Katie linked to. The research is worth looking at because it is so counterintuitive for many Americans.

Anonymous said...

I think you can manipulate data to say what you want. infections in hospitals not withstanding...if something goes wrong during your birth do you want to be next door to emergency help or a ten minute drive away??? I rest my case.

Anonymous said...

as for the cribs..yeah thats all just a plot of the furniture industry to sell more cribs isnt it? just like studies on head injuries is a plot to sell more helmets (right Katie???) talk toany ER nurse and she will tell you heartbreaking stories about overlaying and suffucation etc. it is impossible to follow the "safe sleep" rules particularly if you do not have an only child. they all say "only sleep with one child at a time">.yeah right if you have them two years apart..either you break your own rule or you are forcing a kid out before they are "ready" (and after two years in the "family bed" that IS a lot meaner than putting them where they belong from day one). and who goes without pillows and warm blankets? not very many. which means even a lot of people who think they are "sleeping safely" still are breaking their rules of safe sleep. further the popularizing of it encourages people who are not going to bother to learn about safe sleep to think they are doing the best thing while putting their babies at great risk.

Anonymous said...

you know what...I read that story. I also read the comments. I read letters to the editor because a lot of time thats so much more telling than the text of an article (journalists, ever the pox, are always trying to manipulate society..objective..bah) anyway...someonepointed out, that death is not the only measure..indeed I have not heard of a baby death from a home birth, but I HAVE heard of neuro damage..that is what happened to my own father...I found out what had happened to him a few days before our local fair and it was all I could do to avoid bludgeoning the local "midwife" who was peddling her misleading materials at a a booth (said woman is also locally known nutjob for other reasons)
I could never live with myself if my child had preventable birth defects that because I was so desperate to have a picture perfect birth I brought upon him/her myself.

Jamie said...

This recent study is just one piece of a large body of data on home birth safety. It is beyond unlikely that all the results are being manipulated. The consensus is clear: planned, attended home birth is a safe option for low-risk women.

Hospitals cause about as many problems as they solve. You're more likely to need emergency intervention if you plan a hospital birth than if you plan to give birth ten minutes away. I'm not saying, by any means, that every low-risk woman ought to have a home birth. I'm only saying I wish it were an option for more women because it is a wonderful way to have a baby.

You're welcome to your opinion -- I can understand why you'd be uncomfortable with home birth personally -- but the research is compelling. I think other women deserve room to make their own choices without being lambasted for evidence-based decisions about their babies' birthplaces.

FWIW, I have four children, eight and under, and I am confident that we co-sleep safely with our baby.

Anonymous said...

I think this new study is one of the first to not just look at overall numbers and insert "low risk"....again...it was pointed out in the comment section that death rate is only ONE measure. I really dont pay a lot of attention to studies because they say one thing and then a few years later its oops, we were wrong. (the current vitamin E business springs to mind...the various factions of "which kind of weight loss diet is best" is another) mostly whats best for you is common sense.
my common sense says that even if some problems or unneccessary interventions occur in hospitals, that there is a trade off if something unexpected happens. I was reading some article somewhere about how there is a backlash to the whole anti cesarian thing of a few years back. why? because a lot of babies were harmed because their doctors had been pressured into giving women this "happy birth". some situations were obviously so grave that a non surgical birth wasnt an option. but a lot of these cases are judgement calls. err to far one way and you have an angry woman who wants to sue you for "depriving her of her birth experience". err too far the other and you have a handicapped child (that seems to be the outcome more when needed interventtions are not done is damage rather than death). actually the reality is that a lot of doctors are not going into obstetrics because of the fear of lawsuits.
I think a lot of people who sing the praises of the good ole days forget how just how bad they were.. maternal infant mortality, babies starving to death because they didnt latch on or someone screwed up (just like happens today, except now we have formula) babies being rolled on etc etc etc.
I find it interesting that you pooh pooh the study on cribs but are pushing this study because it supports decisions you have already made. I really dont, like I said, base much on studies because data can be manipulated or reported in a way that doesnt really reflect whats going on. or they miss some co factor and what appears to be a cause and effect relationship actually isnt. but what I have heard is hospital ERs seeing a lot of babies that have died due to co sleeping. I have read the "guidelines" and they sound darn difficult to implement...I mean who is going to not have some warm blanket on them in the winter? who is not going to have a pillow in thier bed and be careful at all times if they do that it is nowhere near the baby? dont tell me even all these "safe sleepers" just bundle up in warm jammies and a light sheet in the dead of winter. ditto on the "only sleep with one child at a time" that is in conflict with the idea that you are supposedly letting the child self wean from the "family bed". so either you are sleeping unsafely if you have kids closer together than five or six years or you are forcing them out intot heir own bed (which attachment types put up as a trauma on a par with child rape or the like). further these ER nurses are saying that the big push on attachment parenting encourages people who are not safety minded to just go ahead and do it and of course they arent researching safety but because Le Leche League is everywhere blabbing about how you will "bond" better with your kid, they go ahead and do it and tragedy results.
if you do any kind of observation of cultures civilized enough to have furniture; what you will find is that yes, families slept together in a couple of beds...BUT you will almost always find small separate enclosures for newborns: cradles and the like. even if older children are sleeping together for warmth, newborn vulnerable babies have separate little beds. most likely people found out the hard way how dangerous it is to share a bed with a newborn. I know there are reports of people sleepign with newborns in times past but that does not negate that other factions of that culture did not recognize it as unsafe. I know someone will accuse me of being heartless in pointing this out about poor people but usually poor people are not the ones exploring every angle of a situation, even if among educated people it was accepted that babies are safer in a cradle, that is not negated by the fact that you have poor, uneducated poeple in the same culture doing dangerous things anyway because they didnt know better and they saw someone else do it or so and so who helped them told them to do it and it worked for them.

Jamie said...

I'm always interested when a new study comes out on home birth -- one got some publicity in Aug '02, three months after my first home birth, in which the home birth outcomes weren't as good as hospital outcomes. Turns out there were some important methodological issues in that study. (If memory serves, there were 34-weekers being delivered at home -- not a standard of care I'd be comfortable with.) I'll keep reading, and if something changes to make hospital birth safer than home birth and not merely a different set of risks, of course I'll re-evaluate my future birth choices.

Likewise with cribs: as far as I know, there aren't any really solid studies out there comparing mortality rates for co-sleeping and crib-sleeping babies. If someone comes up with a strong piece of research showing that co-sleeping babies are at higher risk than babies in cribs, of course I'll be reconsidering our approach. If a study doesn't control for parental smoking or other SIDS risk factors, it's pretty meaningless, ER nurse anecdotes notwithstanding.

Anonymous said...

yes and what if they manage to miss some factor? common sense says that one is safer in a hospital with emergency services right there than a twenty minute drive away. yes there are also risks in a hospital so to a degree its a tradeoff. perhaps, as they build new hospitals isolating maternity care from the rest of the hospital environment might be a good idea. a separate building perhaps or at least accessible through totally separate entrances. knowing that people who do studies usually are desiring to produce a certain outcome, and knowing what I do as a former psychology/biology major of researcher bias, I cant really rely on studies unless the numbers involved are enormous. although if the numbers are that large (example being smoking) anecdotal observance has long since decided the matter and the research simply confirms what everyone already knows. we didnt need government studies to tell us that smoking is bad for our health...anyone with eyeballs can see it. but when the numbers are much smaller, a lot of how the study goes depends on what the researcher is hoping the results will be.
as for the cosleeping...again..its common sense..a newborn baby in bed with adults is at risk in way a baby in separate sleeping quarters is not. I find it most interesting that since most AP types are very interested in "the old ways" of doing things that they have chosen to ignore that most civilized societies, even those where cosleeping among siblings and older babies/toddlers is commonplace (usually because of housing constraints) still tend to have cradles and the like for very young babies. I think its a very good educated guess that its for safety reasons. I still stand by that most co sleepers break their own rules. Dr Sears himself says to sleep with no more than one child at a time. well which is it? since most people (including the very fertile Dr Sears) have kids two or three years apart either they are sleeping with more than one or they are forcing a child into their own bed before they are "ready" (which in my eyes is much meaner to push a two year old that has never known any different and is too young to get a rational explanation of why..into their own bed...than to have never let them sleep with you in the first place). the "rules" also are in depth about bedding and I really find it hard to believe that all these people are sacrificing pillows and warm bedding and are instead sleeping pillowless and only covered by a light sheet, despite what the guidelines say. I think it makes them feel better until something happens to someone else and then it is always about just about everything else but the fact that sleepign with the baby was a risk factor in the first place. and one thing I heard from an ER nurse did say that popularizing this custom encourages people for whom "safety" isnt something they think about first to sleep with thier children in highly dangerous situations such as on a couch. (sort of the same way you folks bash all formula feeding because women in third world countries cant follow or unable to follow package directions thereby killing their babies)