Phlosphr, you are a fucking idiot (re: home birth)

All I can say is, he’d better post some vid on this experience. I want to see those chemical floaty reactions filmed.

Going to go out on a limb here and say it’s all largely the same: ow, push, ow, slimy ugly thing, OOOH ITS SO BEAUTIFUL and mommy exhaustion.

Oh yeah, the dad with the pale face.

First, as a caveat, I think home-birth is not a bright idea, but I at least support a general right to have one when a pregnancy is low risk, with good, certified nurses as midwives and where the parents aren’t blinded by this beautiful birth experience as I feel Phlospher is.

But, why don’t you get your facts straight? Twins = high risk. Period. ACOG (American College of Obstetrics and Gynecology) cites studies that home-births are riskier. ACOG is against home births, but suggests that if you must do so, at least get the recommended prenatal care. It’s a wishy washy opinion. However, ACOG is completely against at-home birth for twins. Why? High risk–meaning there is likely to be a need for intervention. For that matter ACOG’s position on VBAC home-births is similarly strident. Why? Because that is ABSOLUTLEY STUPID. There are several people here that clearly have experience in the medical realm and still say home-births can be fine. Ask them about a twin birth at home. See http://www.acog.org/from_home/publications/press_releases/nr01-20-11.cfm

ACOG is pretty much the gold standard when it comes to delivery. People do complain that its opinions are developed to make sure that OBGYNs make money. Trust me, it’s generally not. The more guidelines/opinions that are out there, the easier a court case is–Plaintiffs claim that ACOG is the standard of care meaning anything less is negligence if it proximately causes damages. Doctors hate written bright line guidelines, and OBGYNs hate it worse than anyone since “bad baby” cases are about the only economically viable medical malpractice cases where caps exist. Most OBGYNs who regularly deliver babies have been sued or threatened with suit. Of course, this does not mean the doctors did anything wrong.

I googled the subject and the number of midwives and crunchy people out there that say it is OK to have a home-birth with twins or VBAC boggles the damn mind.
People that advertise or even advocate twin-birth or VBAC at home should lose their certification. Parents who choose that are irresponsible.

These days quite a few midwives are “nurse-midwives”, and many who aren’t also nurses are still licensed and regulated by the state.

In other words, a licensed midwife is a “real medical professional”.

As to whether or not there’s an advantage… well, let the argument continue.

A “nurse-midwife” is a nurse who specializes in childbirth.

Seriously, that’s like asking if there’s a difference between two doctors, one internal medicine and one OB/GYN - which would you pick for your pregnant spouse? The generalist or the childbirth specialist?

Apperently most of them are nothing of the sort, according to Erdosain’s link.

That’s what OB nurses are for.

According that Slate article, this “midwife” thing is (as I suspected) largely a pseudo-profession akin to chiropractors or homeopaths, though some have legitimate medical certifications as well.

It’s major abdominal surgery. It’s not evil, but it does carry risks which must be compared to the benefits given.

The benefit is a live baby instead of a dead one.

Plus the natural birthers always talk about vaginal birth like it’s crucial to the baby. The baby doesn’t give a crap.

I guess you just totally missed the part of her post where she said her husband followed after the kid, was not permitted to retrieve his own child from the nursery!, and they spent FOUR HOURS trying to get the kid back, right?

That’s hardly “going along with whatever they say”.

Yes, this sort of shit happens in the USA, even today.

And it’s fine to say “shop around” but if you go into labor unexpectedly you might not wind up at the hospital of your choice. If you’re poor/don’t have insurance/have shit insurance you might not have an option. If you live outside a major urban center you might not have a choice.

I have a friend who went to medical school with one of the arrangements where you trade government service for loan forgiveness. She’s internal medicine. She wound up in rural New Mexico and found herself catching babies and dealing with OB emergencies so often - being one of only two doctors within several hundred miles - she went back for training in delivering kids. Sure, she was horrified when someone died, or their baby died, or both died because they lived in the middle of nowhere and went into labor early and the airlift helicopter just didn’t arrive in time. On the hand, as someone else said, delivery beside the road is arguably worse than a planned home birth, and those happen all the damned time. Sure, they encouraged women to come to their clinic to deliver, but realistically, given the equipment they had, it wasn’t much better as it was just that, a clinic, not a hospital or birthing center.

Not everyone gets the ideal set up, the progressive hospital, or a choice. Of course, there’s a definite difference between someone who could deliver in a hospital or birthing center and chooses not to, and someone who wakes up at 2 am to find herself delivering a kid a month early, or who lives in a remote area.

So says the well-off American who doesn’t have to go back to Nigeria and risk having a uterine rupture - a medical emergency that can be fatal even in the most modern, fully equipped hospitable with doctor standing by in the same room for emergency surgery.

It’s not like Nigeria is known for readily available birth control, or is a rape-free zone, or women there aren’t coerced into bearing children.

If she really has to go back to Nigeria then performing a c-section on her today to save the baby can condemn her to death a few years down the line - leaving her children orphaned. Yeah, great choice. Granted, there isn’t really a good choice there, but given that, why not let her make the decision?

Oh, wait - she made a decision. Then the doctors decided she was wrong and made a different decision that might, after she goes home, kill her. Great going, guys. Yeah, great move if you live in a first world country but it sucks if you’re the woman who has to go back and live in the third world. The woman was actually making a rational decision for her circumstances, but you know, fuck her, she’s just a woman hopped up on hormones and isn’t making the decision YOU would, sitting in your first world country with easy access to modern medicine so she’s crazy, right?

Easy for you to say, when you aren’t the one getting your belly cut open, isn’t it?

Not that I’m opposed to c-sections - they do save lives. However, they ARE major surgery. Like all major surgery there is a risk of life-threatening infections, scarring, adhesions, c-sections make certain types of complications in subsequent pregnancies more likely, and DEFINITELY they make non-hospital births much more risky. While it’s all very well to say, well, just do c-sections for all following deliveries no one can guarantee that. Women who have had c-sections can wind up with unexpectedly delivery times just like any other woman, and it would really suck to be such a woman suffering a VBAC complication because you went into labor early while stuck in traffic on the freeway, right?

Ideally, you not only want to minimize complications NOW, but also in the future. Certainly there are cases where a c-section is a no-brainer, but they should never be treated in a cavalier fashion or dismissed as something less than serious surgery.

I keep seeing people saying that most of the time, for most mothers, home birth is usually safe. I don’t disagree with that. What I’ve been trying to point out is that you cannot know if you’re in that group ahead of time. No number of anecdotes about your friend who did it fine at home don’t change that fact. Again - when my stepson was born, my wife would have been considered a perfect candidate for home birth. She was young, healthy, and had no complications in her pregnancy at all. The baby was healthy by every measure they could make. Yet if she had chosen to give birth at home - even if she had all the medical “backup” prepared and ready to go - her son would have died. No ifs or maybes or probablys about it. He would have died. He nearly did anyway.

No matter how good things look, you cannot know ahead of time if you’re going to need major medical intervention, and if you do, time is critical. Sure, you can play the odds and know that you probably won’t need it and take that risk. I have a hard time with that attitude. I would much rather be surrounded by people ready to handle anything, no matter how rare or bizarre.

And, for the record, when our daughter was born a year and a half ago, we had an amazingly good experience with the doctors in the hospital. They were respectful and helpful. They offered a huge range of options for labor and delivery, and we kept the baby with us from the first instant unless we asked them to take her for a while. They did the weighing and cleaning and testing right there in the birth room. I understand that not all hospitals are able or, perhaps, willing to do this, but ours was. Given that Philosphr is in Boulder, CO, I’d be willing to bet that the majority of the hospitals around him would bend over backwards to accommodate whatever requests they had.

Look here, asshole. You know goddamned well that my wife nearly died from complications to her C-section. You also know goddamned well that your nephew was taken from us and kept in another room for two days. Either you know all these things, but you are still taking the ignorant blowhard route, or you are so goddamned selfish that you don’t even know things you were told involving direct family.

My question is, when you guys were growing up, did Dio ever say, “My fist is my cite!” while punching you in the face? Because that wouldn’t surprise me in the least.

Dio, of course, is trying to ruin his perfectly good argument by overstating his case. C-sections are major, traumatic surgery, and should be avoided if at all possible. If you’ve ever seen a video of one, they basically take all your intestines out of your body and pile them up on your belly so they can get to the uterus. Obviously it’s worth it to save the mother or baby, but it’s nothing to be dismissed.

Another scenario (mine): the choice to have a c-section is sometimes the choice to have no more children. I’m prone to having early labors that I can’t feel. That is, my son was born at 37 weeks (not technically premature, but unexpectedly early, and before the elective c-section date of 38 weeks) and I was in labor for about 12 hours with no labor pains at all - the monitor showed tracings, but the only way I could tell there was a contraction was feeling my abdomen with my hands. I started having contractions at 23 weeks with my daughter - again, I didn’t feel a thing, but the tracings were present on the monitor.

My c-section had to be a vertical incision. Vertical incisions are even more risky in later labors than horizontal incisions; more prone to rupture. There’s no such thing as a VBAC with a vertical scar, it HAS to be a scheduled c-section. Were I to ever get pregnant again, I’d very likely have no way of knowing when my contractions were starting without a monitor. And given my history, they’d probably come before the date of a scheduled c-section. So my first warning that things were going pear-shaped (new phrase I’ve learned from these threads!) would be a massive tear and hemorrhage.

So when I made the decision to have an emergency c-section instead of letting my premature labor continue and killing my daughter with a vaginal delivery, I was choosing not only to accept the risks of her very premature birth, and the loss of my pregnancy and delivery dreams for her…I was also choosing to *never *have another baby because of the life threatening medical risks. And yes, I had to go through a period of mourning and grieving THAT loss, too.

The docs weren’t going to force me into a c-section, because technically my daughter was pre-viable. They would have let her die. Heck, they would have aborted her, if I wanted it and my body wasn’t already doing it, and been entirely within the abortion laws of my state to do so. They gave ME the choice, and I’m very grateful for that. Had she been full term, the scenario might have played out very differently.

I certainly would not judge someone for making the other choice, though. I couldn’t look someone in the eye, someone who wanted a healthy baby, and tell her that her best option was to have this micropreemie by c-section and never have another child. Had I more than 10 minutes to make the decision, and realized that I’d never have another child, I might not have made the same decision; losing this fetus and preserving my ability to have another full term baby might have been the more logical choice.

All they told me at the time, and only after I asked point-blank, was that “future pregnancies would have to be c-sections”. My doctors and I didn’t put it together until later that the history of early labors which I can’t feel made that option too dangerous to contemplate. Right here, in the first world, with major urban research hospitals all around me, a c-section has rendered future pregnancy a life-threatening condition.

In my experience (kindly note that unlike Diogenes my experience doesn’t apply to anyone outside of my experience) the women who went through the effort to give birth in am unusual way to “improve the bonding experience” forgot all about any of that within the first few years, and by the time the kid was 5 years old they were the same cranky, regretful, resentful, absent-while-in-the-same-room moms who when their kids say “MOM! Aasheleigh-Siouxanne’s drinking bleach again!” mutter “that’s nice, let mommy watch The View.”

The biggest benefit for medicine in general is cost. Nurse practitioners are more cost effective - they make less money. And nowadays I’m on a high deductible health care plan - and most years I’m not going to hit the deductible. Money I don’t use in the HCA is money that I can use for health care costs in retirement. The cost difference in a NP is passed to me.

MOST things a doctor does can be done with someone with far less schooling. There is no need for a gyn to do my pap smear, my mammogram results are reviewed by a radiologist, my blood work is comparing numbers against a norm.

From a patient standpoint - I like my pediatric nurse practitioner a lot. She gives good patient care and hasn’t steered me wrong. My own nurse practitioner I’m sort of wishy washy on - but she is easier to get an appointment with than the Dr. she works under, who I do like better. And she gives fine care - she just has a sort of abrupt bedside manner.

Now, I absolutely expect my NP to pass me along to a MD when she’s over her head. My own has never had to. My kids have been referred to the MD. Often when I make the appointment, intake knows when I describe symptoms that I need to be talking to a doctor.

I agree with that; my regular Dr. is actually a P.A., very experienced and very good. If there’s something that really requires an MD, though, they have them in the practice.

Yes, Physician’s Assistants and Nurse Practitioners are very useful. However, this doesn’t address the concern that most midwives who do home births are NOT Nurse Practitoners and don’t have the same level of medical education as the people who see you for your sniffles in the doctor’s office.

That’s true. I have to state that I don’t believe that a midwife is a substitute for an OB. I also want to make clear again that we were a mile from a hospital and had a backup plan. We informed my wife’s PCP (an OB/GYN) and the hospital that this was going to happen. Despite our successful home birth, I won’t stand here and say that it’s the way to go or is without risks. I’m only saying that it’s an option given proper care and preparation. Period. I’m no hippie, my dad was a Dr., I don’t think hospitals are bad, and we didn’t go into this with blinders on. I wouldn’t recommend going with a hospital birth without proper care and preparation, either. I would recommend, however, that hysterics and hyper-criticism be avoided regarding this issue. It’s not the bugaboo some folks are making it out to be.