Infant mortality: 0-27 days, not in a hospital by Midwife, white women only, birth weight 2500 g+, not excluding high risk medical factors for hospital births:
.45 by CNM
.73 by MD
:dubious: That’s just taking into account age of mother (20-40), race (white), and birth weight (above low birth weight, including large babies). That’s not taking into account any other high risk factor, such as diabetes, VBAC, HIV, high blood pressure…etc.
Somehow those stats aren’t convincing me, sorry.
Heh, side topic. When I had my third baby, I arrived at the hospital fully dilated and ready to push. They got me into a delivery room ASAP, and as I was pushing the baby out - pushing along with the contractions, of course - there was this nurse who was just randomly counting loudly to 10 right next to me. The count had absolutely nothing to do with when my contractions were happening, and I just ignored her. Afterward my doula and I had kind of a laugh about it. The nurse was clearly like, “Well, you are supposed to count to 10 in this situation so I don’t care if she’s pushing or not, I’M COUNTING.”
That was a great birth experience, by the way. It’s probably about the least mother/baby friendly hospital I’ve seen, but having my doula and a supportive OB there made all the difference.
Link is broked 
But as you suggested, how big the baby is is a huge infant moratality factor. One of the biggest factors for the US infant mortality rate is premature birth - once you are only talking about full-term infants, the infant mortality rate drops to 2.4/1000. Obviously virtually all of the babies born so early they later died are MD delivered, not midwife delivered.
Some of them are probably reported as “delivered at home” (obviously not planned), though - another confounder of the statistics.
I specifically selected ‘delivered by CNM’. A midwife that is not a nurse has a mortality rate of twice a doc.
Although my guess is that when you have a transport - you end up with “delivered by M.D.” - which means that deliveries that go pear shape are often “credited” to an M.D. rather than a midwife.
A friend of mine had a midwife planned delivery in a hospital that went pear shaped. Obviously the midwife did not do the c-section that saved the babies life. So that’s an M.D. delivered baby.
Speaking of credit, does your midwife get paid the same amount if your wife has to be transported to the hospital part way through her delivery? If your midwife’s compensation is dependent on delivering your baby at home that’s extra incentive to avoid medical intervention and something you should keep in mind if problems develop.
Our midwife has been practicing for 27 years and has delivered over 1,000 babies. What about that is glossing over anything? She has experience, lot’s of it. The Boulder Birthing Center at the Boulder Hospital is fairly new. The 1000th baby was just born there, see, her name is Barrett. Our midwife is not connected to the Boulder Birthing Center, though she has delivered babies there.
You already stated you think home birth is for my wife, and that it is “fucking absurd”. You seem to me to be someone who thinks that since hospitals were invented all babies ought to be born in them. That is simply not true. In 2011, we have options for delivering babies in industrialized nations, ***one ***of them is delivering at a hospital. We are choosing one of the others. I fully understand you do not agree with home birth because it is too risky for the baby, and I understand you think making the decision to do so is fool-hearty, or fucking absurd…that’s ok too.
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Speaking of credit, does your midwife get paid the same amount if your wife has to be transported to the hospital part way through her delivery? If your midwife’s compensation is dependent on delivering your baby at home that’s extra incentive to avoid medical intervention and something you should keep in mind if problems develop.
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Yes, the midwife get’s paid the same amount if we have to transport, and we are fully aware that she has absolutely no problem transporting. Which is a good thing.
On a different note, there are women out there who make decisions about home birthing that are truly absurd - we heard a story of a woman who said to her midwife, you’ll have to hit me over the head with a frying pan to get me to go to a hospital…we are not like that.
Phlosphr,
I don’t have the time or the energy to read the whole thread. I got to the end of the first page and got pissed and just skipped to the quick reply box.
I am a dad who went through a home birth. In said home birth we ended up having to do a hospital transfer because my daughter flipped breech mid labor. She was born vaginally (!) at the hospital. PM me if you want to talk. When we have our next kid we don’t plan to do anything differently, in fact the transfer just cemented in our minds that home birth is the way to go for us.
I did all the research you did (probably watched the same movies even) and have been through it on both sides and am happy to talk you through whatever you want to talk about.
After reading this thread, I can’t really see the advantages for the baby to being born at home. The very fact that you have to negotiate the proper reaction with the midwife as to what to do in an emergency indicates that this isn’t thought out properly. To me, the conversation would go like this:
“If there’s a problem, we need to go to the hospital.”
“OK.”
“How much time from start of problem until mom+baby are in capable medical hands?”
“10 minutes to an hour, depending upon my response time, your time to make the decision to change this plan that you’re emotionally invested in, the time to call and get into an ambulance, distance to hospital, etc”
“And how much time does my baby have to breath again (if there is a lack of oxygen) before brain damage starts to occur?”
“2-5 minutes.”
…
to wife “… Why are we doing this again?”
So you had a medical emergency that required you to go to the hospital and you won’t change a thing? I’m confused…
We were prepared for said emergency, emergency was handled in the hospital. This is something we knew might happen and we were ready. Things went according to plan for what would happen if things went wrong.
The experience in the hospital was terrible from our perspective as parents and patients after the baby was born (and a little during the delivery. My wife punched a doctor and he had it coming.) Cedars Sinai is a great hospital, and generally considered very baby/mother friendly, and even so it was terrible. They lied to us to force us to stay at the hospital longer than we needed to*, the bottle fed our child when we explicitly told them not to, etc etc. They assumed that they knew what we wanted and that ignoring what we told them was ok because we didn’t know better. And it wasn’t ok.
This was at one of the best hospitals in the country, I can only imagine how it is at less than stellar hospitals.
*After both my wife and child had been cleared by the doctors to go home, the nurses lied for an entire shift that our kid hadn’t been checked out by the doctor and that we had to stay. It was only after the shift change that we found out she had been cleared to go home almost 12 hours before.
Missed the edit:
I should also add that I do not advocate home birth for everyone. It is *not *for everyone. It was the right choice for us and our family at that time, and will probably be again in the future. My wife was very low risk and has a very large fear of hospitals. Some people find hospitals comforting, they stress her out.
With everything that happened I wouldn’t change any of it, except for the jerk EMTs and the chief of staff who got punched, they can go jump in a lake. Oh, and the nurses who lied to us sucked too. And the one who showed my wife how to breastfeed improperly isn’t all that high on my list of favorite people either. I can’t imagine having a cracked nipple after nursing for 10 hours is any fun. The lactation consultant, on the other hand, was awesome. As was our midwife, who was there for the delivery, and our doula, and the actual doctor who delivered the baby, and our backup OB.
Can you be a little more specific? What do you mean negotiate the proper reaction to transporting? In this thread I’ve stated the following about transfer:
*Our midwife has Zero problem with transporting
*Our Midwife works in a team, the back-up is a very accomplished midwife and an EMT.
*Our local volunteer ambulance corps associated with the firehouse volunteers to be on standby for the entire labor until baby is out and both mom and baby are ok.
*We love the birthing center we are associated with via our insurance, if we end up there for labor [in case my wife becomes high risk over next two months] we are perfectly ok with that.
NAF1138 - thank you. You sound like a lot of dads in my “home birth dad class” 
The thing about your experience, though, NAF, is that being breech isn’t a life-threatening emergency unless there’s something unusual like the cord being prolapsed. I agree that realizing the baby’s breech and having a nice, safe transfer and delivery is a great example of a situation that was able to be handled appropriately and have a good outcome. But what if it was life-threatening? What if it was an emergency that compromises the baby’s oxygen, such as a prolapsed cord? Then even a 10-minute transfer will be too late.
Fair point, but those sorts of emergencies are rare and you weigh the risks in any birth situation. Had my wife been in a hospital she would have had a c section, the risks of a botched surgery or infection are about as high as a birth complication that can’t be fixed in time for a transfer. I know they happen all the time, but c-sections are *major *surgery and not something that should be taken nearly as lightly as they are.
Home birth isn’t for everyone, and it isn’t without it’s risks, but don’t kid yourself by thinking that just because you are in a hospital you don’t have a huge section of risks as well. They are just different risks.
The US has one of the highest labor related infant mortality rates in the world (don’t make me dig for stats please, I no longer have them at hand. Look for WHO stats on the subject.) The US is also one of the few countries that has the majority of its births performed in hospitals with medical interventions and with the babies delivered by surgeons. More isn’t always better, sometimes it’s just more.
Wow. I’m pretty sure my hospital is not one of the best ones in the country, but I had no problems like this at all. In fact, the only problem I did have was the opposite: I was over-encouraged to breastfeed when it turned out she was crying in hunger because my colostrum wasn’t enough for her. On the recommendation of the pediatrician on duty at the hospital (as well as our personal one), we got her on supplemental formula and she was happy as a clam until my milk came in.
I feel like I should point out that the quality of the nursing staff varied greatly depending on the shift. I don’t want to make Cedars out to have been terrible, it wasn’t, but it wasn’t great either. I feel a little bad about how hard I was on them now that I posted. The bottle feeding thing pissed me off a lot because it only happened after they talked us into sending her to the nursery so we could get some sleep. We said fine, but no bottles…and she came back with a bottle.
Mix ups like that happen at hospitals, it’s understandable, but had we been at home it wouldn’t have been an issue.
It seems like you have a dislike of hospitals more than you have an affection for home birth.
But still - 1,000 babies is not a lot. At all. And not one death or problems? Why, because you have access to people THAT CAN HANDLE IT?! My young ob had delivered 13k by the time my son was born.
But you couldn’t be at home, because the midwife wasn’t available to assist you, and the assistant/doula thought your baby was dead.
Do I have that right?
And you’d do it again?