From: anne@dolores.Stanford.EDU (Anne Paulson)
Subject: Re: Homebirth vs. Hospital birth
Organization: Stanford University
	<1992Dec18.011853.11794@intellistor.com>
	<ANNE.92Dec20213836@dolores.Stanford.EDU>
	<1992Dec22.211607.8527@intellistor.com>
Date: 23 Dec 92 00:18:49

In article <1992Dec22.211607.8527@intellistor.com> grun@intellistor.com (Paul Grun) writes:

   In <ANNE.92Dec20213836@dolores.Stanford.EDU> anne@dolores.Stanford.EDU (Anne Paulson) writes:


   >Grun@intellistor writes:

   >   But what if things start to go wrong [in a home birth]?  
   >  I have no statistics, but when
   >   things *do* go wrong, (which they do, sometimes, and without regard
   >   for the health of the mother) there is frequently _very little time_ in which
   >   to intervene.  An ambulance ride would be too long.

   >You certainly don't have any statistics.  If you did, you would know
   >that when things go wrong, there is virtually always plenty of time to
   >intervene, which is why study after study has demonstrated that home
   >birth is as safe or safer than hospital birth, for low-risk women.
		     ^^^^^^^^ ???

Yes.  Safer.  Going to a hospital to give birth also has risks.  For
one thing, hospitals are full of sick people who can infect your baby.
For another, the interventions that are often done in the hospital
(but never at home ) such as epidural anesthesia, have small risks.

   I think that it can be tough to tell beforehand that the cord is
   wrapped around the kid's neck, for example.  This can have potentially
   devastating consequences, and may not leave adequate time for transportation.
   I could VERY WELL be wrong about that; maybe it's very easy to spot early in
   the delivery and handle it.

Ah, the cord wrapped around the baby's neck, that famous "problem".
Actually, about a third of babies are born with the cord one or more
times around their neck;  it's the first thing that midwives check
when the head is born.  Usually all the midwife has to do is unwrap
it.  No problem.  If the cord is quite tight, it has to be cut, and
then the baby needs to be born fairly quickly, but with the head born,
the rest will come easily most times.

Now if the cord is entangled in some way so that the baby can't stand
contractions, this can be detected by fetoscope and a C-section
performed.  A planned home birth would be a benefit in this case, as
the midwife would likely be checking the mother in early labor and
could detect the problem sooner, whereas the mother who planned a
hospital birth would be laboring at home and would only go to the
hospital later in labor.  It was fortunate for my nephew that my
sister's midwife decided to to check my sister while she was in early
labor;  Timmy was in trouble and my sister was whisked off to the
hospital for a C-section.

   The point isn't whether or not I can identify a particular problem that
   either can't be detected or can't be solved.  The point was whether or not
   someone would be willing to take the risk (however small) that such 
   an unforseen circumstance _might_ occur.

The real point is whether the risks are higher for home births or for
hospital births.  And it turns out that for mothers who would be
accepted for home births, home births are safer. There are some rare
cases where a bad outcome at home could have been prevented by a
hospital birth;  there are more rare cases where a bad outcome at the
hospital could have been prevented by a home birth.  Nothing is
perfectly safe, and each couple must examine their choices and figure
out what feels right for them.

-- Anne