WOMENS-HEALTH Messages for April, 2000: Re: Homebirth

Re: Homebirth

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 19 Apr 2000 10:20:33 -0500 (CDT)

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At Tue, 18 Apr 2000, Rhianwen wrote: >
>I was just wondering, since I am an Australian, and things are likely to
>be different here than in the USA, what the criteria for a woman having
>a homebirth are in the States.
>
>I am due to have one any day now, and am just curious about the US
>situation with regards to matters such as these.
>
>--
>Rhianwen
>
>--
>No matter how much cats fight, there always seem to be plenty of kittens-Lincoln
>

Rhianwen, I don't find anything wrong with home births, as long as the patient is completely aware of the potentials. The vast majority of deliveries go very smoothly. However, there is always the potential need for a cesarean section. Depending on the numbers you see, this can range from 4% of the time, to as high as 25%. I think that most midwives find that their rate is closer to the lower number. As long as the indication for the cesarean is not urgent, the patient can just be provided transport to a facility that provides operative delivery. If the indication for cesarean is urgent, this can result in a potential problem. Again, this is not the common occurence. Additionally, on occasion, there are problems following the delivery (i.e. bleeding) that can result in the requirement for additional therapy. In summary, I feel that the potential for problems in a home delivery occur primarily in three areas: 1)Fetal distress-the baby develops problems with it's heart rate and requires emergent cesarean section. 2)The second stage of labor-having seen patients that have been allowed to push for many hours at home prior to being brought to a facility for evaluation. 3)Problems such as bleeding that can occur following a delivery. Again, if the patient is aware of these potentials and accepts them for what they can mean, I think that she is within her rights to proceed any way she chooses. Lynn

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.

**Thank you for your understanding ;-)

Next message: Lynn D. Montgomery, MD: "Re: Ovulation pain post hysterectomy"
Previous message: D.N.: "Re: Ovulation pain post hysterectomy"
In reply to: Rhianwen: "Homebirth"
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