Re: List
From: Anna Meenan, MD (annam@uic.edu)
Fri Oct 27 13:34:44 2000
Okay, can we get one thing straight here? Multiple folks have accused
the home birth proponents of saying that home birth is SAFER than
hospital birth. I for one have never said that and I don't recall
anyone else on the list making that claim either (but you can correct me
if I'm wrong because my computer is too slow to go back and read ALL
those posts again). What has been said is that there is no evidence
that home birth is LESS safe than hospital birth, and that is true.
There isn't. I don't think there is evidence for either option being
safer OR more dangerous, and that is why I think women should be free to
choose what they think works best for them. One of the reasons, I
think, that many industrialized countries with large percentages of
midwife-attended births, either at home or in hospital, have better
perinatal mortality stats than the US, is that by using midwives for
normal births, they can AFFORD to give more generous maternity care
options to a greater percentage of the population. In the US we have
large numbers of women getting little or no prenatal care due to
problems of access and ability to pay and that can't be a good thing.
Perhaps if we were less hostile to midwives in this country, we too
could afford to offer universal free maternity care that extends even
beyond delivery to having a trained provider come to the home to check
mom and baby for several days after birth. I would imagine that would
do a lot to lower infant mortality rates even further in this country.
Just my wishful thinking and rambling. Gotta get back to work.
Anna Meean, MD, FAAFP
At Fri, 27 Oct 2000, Rupak Ranjan Roy wrote:
>
>This debate has been going on this list for quite sometime now. Personally,
>I can never figure out how a home delivery could be SAFER than a hospital
>birth. I always argued that if doing things naturally was always the best
>thing to do, then our country would have had one of the best maternal and
>perinatal outcomes. Our figures are getting better BECAUSE of obstetric
>care. I know, people would argue that it is probably not the obstetrics, but
>the improvement in socio-economic factor etc. etc. etc. that is bringing on
>the change, but if you find that you are actually seeing a lot less number
>of hand prolapses, less V V Fs, less sepsis, less anaemias, fewer mothers
>dying from PPHs, less eclampsias, you can`t help but appreciate the effects
>of modern medicine.
>The problem with your society is that you have reached a point where the
>outcomes for the mother and the baby have reached a pinnacle and that is why
>things are being taken for granted and you are trying to look back. It will
>only take a few disasters at home to make you re-think.
>In our country, home birth is very common, but we are trying to make this
>safe by having trained personnel attend the deliveries with clear
>instructions to send the women to HOSPITAL at the slightest hint of a
>problem. We would have loved to have all our women deliver in hospital if
>the finances permitted.
>I agree with a comment on the list that we must accept a few small
>disadvantages of hospital delivery for the much greater long term gain.
>Delivering low risk women at home is probably NOT UNSAFE in your country,
>but I fail to see how it could be SAFER than a hospital birth. Regarding the
>horror stories of babies being cut open, surely these are exceptional
>things. More women suffer from NATURAL obstetric disasters than the MAN-MADE
>ones.
>
>--
>Rupak Ranjan Roy
>MRCOG
>
>>----- Original Message -----
>From: Luis Sanchez-Ramos, MD <luis.sanchez@jax.ufl.edu>
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
>Sent: 26 October 2000 19:36
>Subject: Re: List
>
>> At Thu, 26 Oct 2000, Sue Turner wrote:
>>
>> >>Although your ancestors and everyone else on this list's ancestors gave
>> >birth at home and everyone seems to have turned out Ok. Funny.<<
>>
>> And what was the maternal mortality rate then? What about maternal
>> morbidity and perinatal mortality. Hospital births and attendance by
>> obstetricians certainly have contributed immensely towards reducing
>> these adverse outcomes. Deliverinf at home is playin russian roulette!
>>
>> >>Also in my L&D experience working at a hospital with a NICU I viewed a
>physician cut open a baby's head when doing an episiotomy, about 1 1/2
>inches long and 1/2 deep, a baby die due to unforseen lung malformation
>directly after birth before anyone could figure out what was going on, a
>> moms kidney cut during a section, a baby's forehead cut open during a
>> section, a woman die due to a severed artery and lots more<<
>>
>> All anecdotes and probably greatly exagerated: have you not heard of
>> catastrophes which have been due to home deliveries? I have!
>>
>> LSR
>>
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