Sunday, November 27, 2011

My Doctor Says He Sees Only Bad Home Births That End In Transport

This is one of my pet peeves. 

Somebody is mentioning home birth to a health care professional (EMT, paramedic, firefighter, doctor or nurse, etc.) and their first response is,
"All the home birth transfers I see are because something went wrong.... You are really lucky that your home birth was safe."
This is stated in a very serious tone.

First, there are a few things I should point out that I recognize.

I recognize that home birth has some risks that may not be present in a hospital.  I also recognize that hospital birth has some risks that may not be present in a home birth.

I believe that care providers vary a lot in their skill, intelligence, ability and ethics.  This applies not just to obstetric doctors but also to home birth midwives.  I try to choose mine carefully.

I recognize that sometimes, for the safety of mom and/or baby, a home birth must be moved and become a hospital birth.  This can be for very minor things to very serious, life threatening things.  When done at the right time, it is not a failure, just a change of plans.

I also have a deep appreciation for the fact that all of my children's births have been safe, from my hospital birth to my accidental unassisted home birth.  I am blessed, and I am deeply grateful.  

Now that I have that out of the way, I just need to point out the obvious.


If you work in a hospital or in emergency transport, the only home births that you will ever see are the ones in which something went wrong.  

The other ones, where nothing goes wrong, STAY AT HOME.


OK, now I am done.  Carry on. 

(Robbie Davis-Floyd mentions that the home birth transport rate averages around 12%.  You may want to find your own midwife's transport rate and lots of other info about her.  I highly recommend researching your midwife and have some tips here.)

3 comments:

Diana J. said...

Also, the transport rate of homebirths is nothing compared to the "transport" rate of hospitals - when you consider that any hospital birth ending in instrumental delivery, cesarean, medicated birth, etc., or a birth in which the mother ends up needing some sort of hospital-based medical care - is the equivalent of a transport. If you look at it that ways, hospitals have a 75%+ "transport" rate!!!

Rosie said...

Not only is a home birth transfer NOT a FAILURE, it is a success in that the home birth team recognized a situation that required an increase in intervention/acuity. It always astounded me that people weren't cognizant that the transfer happens because someone (mom or midwife) decides that the mom/baby needs something that cannot be provided in the home environment. This is how it is supposed to work. As a L&D RN, I always wanted to take the home birth tranfers because the last thing they need is negative judgment about their choices (which so many nurses pile on). They need compassion and good care, just like all birthing families.

Ashley said...

And even when they go wrong, it's often not very wrong. I transferred to the hospital at 8cms when it became clear that something was wrong with my baby's position (turns out she had a brow presentation). I was fine, if tired, and she was fine. We annoyed some of the staff, I know, and one nurse treated us quite badly, but at no point were either of us in any danger. In the 6 hours between my arrival at the hospital and my signing the c-section papers, all they did was hook me to a monitor, run an IV, and occasionally say something mean. I was begging for the epidural, but they refused (brow presentations hurt in ways that are really NOT normal) to give me one. Eventually the doctor came in and recommended a c-section, a conclusion I came to hours before. And it took them 90 minutes to prep for the surgery! They were taking their sweet time, which was annoying, but hey, definitely not an emergency.

Surgery went well, she was healthy, I was healthy, and we were home in our own bed 32 hours post-partum.

Not every homebirth transfer is an emergency. Mine sure wasn't.

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