Sad story

MCranEY05 writes:

: Show me where it is more safe to deliver a breech baby at home vaginally, vs'
: in the hospital. I want to see the literature. Please post a link.. something.

This is very iffy. There are lots of different kinds of breech; frank
breech, complete breech, and footling breech. They are listed in order
of safety, safest first, riskiest last. That is factor 1.

Second, there is the training of the caregiver. Whereas 50 years ago
most OBs and midwives were trained to deliver breech babies, very few
today have even seen a breech baby delivered vaginally. It is NOT
safer without a competently trained caregiver who has *EXPERIENCE*.
Sadly, this is being taught less and less.

If you look at the statistics for survival of vaginal breeches versus
cesareans from that time period you will find very favorable results.
Today, unfortuantely, you cannot find enough vaginal breech deliveries
to do a study.

Bottom line is that on average it is probably safer to deliver a breech
today by c-section, simply because no one knows how to do it any more,
and it requires different techinques than a head first birth. However,
if it were taught consistently, it *COULD* be safer than c-sections.

Sad,
Larry

Tori M. wrote:

I agree.. while I think it is great that people can have a homebirth I think
it is irresponcable to do so where I live. The closest hospital is 30
minutes away by car so if you figure you need an ambulance right away you
are looking at atleast a 45 minute time frame between when you call and when
you get to the hospital.

Have you asked your hospital what their "decision to
incision" time is for c-sections? Many hospitals can't
guarantee meeting the 15 minute gold standard, or even 30 minutes.
Many people have false assumptions about what can be done
in their hospital...

Best wishes,
Ericka

Vicky Bilaniuk wrote:

This is one thing that I've been thinking... People are probably
thinking that the midwives refused her out of fear of being sued. Well,
lawsuits don't happen as much in Canada as they do in the US (not sure
why - we just don't sue as much for some reason, even though we can), so
I just don't think that this was the reason. I would love to know the
reason, but I'm sure it probably wasn't that. Also, insurance rates
probably wouldn't have been affected as much, due to the huge behemoth
called health care.

Midwives in Canada practice on sufferance, just as they
do in the US. Midwives who practice outside the boundaries
imposed on them risk not being able to practice at all
(individually, or as a group).

Best wishes,
Ericka

ChocolateTruffles wrote:

Vicky Bilaniuk wrote:

The whole thing is very sad. I wish we had more details. Would be
something to learn from.


Apparently the "fake" midwife is being charged in the death of the baby.
Here are 2 stories I found:

http://vancouver.cbc.ca/regional/ser...idwife20040706
or http://tinyurl.com/2zt4a

http://www.canada.com/victoria/times...3-623133802b6d

or http://tinyurl.com/22fgs


So at least one lesson is to be sure of credentials. Pretty scary.

On Fri, 9 Jul 2004 19:49:31 -0400, "Sue"
wrote:
I wouldn't mind a homebirth, as it sounds absolutely lovely and more
comfortable, but I definitely would have it by attended by a legal midwife.
Having an unattended homebirth imo, is more riskier and not the most wisest
decision a woman could make.

I would do it again (except that I won't be having more babies).
Marie the unwise

for 2 of the 3 hemoraging was the problem not labor but after labor.. One
SIL's life was saved by her midwife as the sped to the hospital with the
midwifes finger putting presure on the vein in the ambulance.. My other SIL
was rushed because something was wrong with either my SIL or the baby but
they had to be rushed in an ambulance and then airlifted to someplace else
as it turned out in the middle of her pushing.. I can not remember all the
details as it was told to me but did not sound like fun.. the 3rd person I
know hemorages easily and hemoraged with all 4 of her kids.. after the
secound time she was refused homebirth as an option.

Many people in this area chose homebirth because it is actualy A LOT cheaper
then hospital births and the midwifes are qualified. It just isnt for me.
I admire people that are brave enough to do it.

Tori

--
Bonnie 3/20/02
Xavier due 10/17/04
"Larry McMahan" wrote in message
...
Tori M. writes:

: I agree.. while I think it is great that people can have a homebirth I
think
: it is irresponcable to do so where I live. The closest hospital is 30
: minutes away by car so if you figure you need an ambulance right away
you
: are looking at atleast a 45 minute time frame between when you call and
when
: you get to the hospital. While many women have homebirths everyday and
dont
: need anything I have known women in this area that it has gone wrong. I
: would rather be in the hospital even if not hooked up to anything. On
the
: other hand I am looking forward to my 48 hours in the hospital to

While your arguments sound plausable, they are not borne out by the
statistics.
In the first place, some studies were done on emergency homebirth
transports
versus emergencies that required an OR in a hospital. The finding was
that
if the transport took less than 30 minutes, homebirth transports were
actually
in the OR being attended to quicker than hospital emergencies. The
transport
had to be longer than 40 minutes before hospital, on the average were
faster.
Why?...
1. Homebirthers are continually monitored by the midwife, hospital
birthers
are often set to labor with machines monitoring them. Even with
severe
problems it took on average 10 minutes for a nurse to notice and
assess
the problem and call for help. This is most of the time that gave
homebirthers the advantage.
2. Even after the wheels are set in motion, it takes time to schedule,
set up and sterilize an OR, get a surgeon, anesthesiologist, and OR
nurses. The anesthesiologist is often the long link in this chain.
If he is available immediately, the procedure can be done in 30
minutes, if not, and he has to be called from home, the wait can be
longer. The point favoring homebirthers is that the midwife can
call
and set this in motion when she *STARTS* the transport, so that
everything can be ready to go when the mother arrives.
The point of this little exercise is don't expect faster emergency service
just because you are already in the hospital.

Next consider the statistics comparing the *REASON* for transpoert. Bhy
far, the majority of transports is for long labor and exhaustion. Only
a tiny fraction are for emergencies requiring quick action.

However, there are also a fairly substantial number of problems created
merely by virtue of being in a hospital (hospital borne infections,
inappropriate interventions leading to substandard results, etc).
Fortunately, while most of these are "fixable" there are a small number
of infants who suffer because of the problems. This number is AT LEAST
as large at the number of transported infants who suffer because of the
time.

Finally, you don't have to wait for an ambulance. You can tansport in
your own car.

The bottom line is that objectively, even with a transport time of 30
minutes homebirth is still safer/better than hospital birth with a
competently trained midwife. You may still personally not want to
homebirth, but saying that the transport time makes it unsafe is
simply not true.


Larry

Have you asked your hospital what their "decision to
incision" time is for c-sections?

I now know I should ask that.. I never thought to ask before actualy. I
have an OB appointment on the 21st with the Ob not my midwife I need to make
a list of questions. With Bonnie I had lesss stress then I do with this one
I lived 5 minutes from the hospital on a busy trafic day and it was the
"best" hospital in the city for NICU. This time I am delivering at a
smaller hospital that we only chose because we like the Drs at the office
and they have been good with treating DH out of control blood sugar the few
times we had to go there and leave DH there.

Tori

--
Bonnie 3/20/02
Xavier due 10/17/04

Iuil wrote:
"Carol Ann" wrote

I confess to being one of those women. I would NEVER consider
homebirth.


Can I ask why?

I'm not Carol Ann but...

I think I would love a homebirth. I know, in my head, that they are safe
and all that. I *might* be convinced if I spoke more with a midwife or had
a super supportive husband or something.

The thing that holds me back is sort of unreasonable. It is a matter of
what choices you feel like you can live with. If something bad happened at
a home birth I wouldn't deal with that very well at all. I'm talking about
coming to terms with the consequences of my choice. If something happened
at the hospital I think I could blame some one else, or feel like I did all
I could, or bear less responsibility or something. Now that isn't
reasonable but there it is. I know the chances of something awful happening
that would *not* have happened in a hospital setting are very very remote
but it just paralyzes me.

--
Nikki

"Nikki" wrote in message
The thing that holds me back is sort of unreasonable. It is a matter of
what choices you feel like you can live with. If something bad happened
at
a home birth I wouldn't deal with that very well at all. I'm talking
about
coming to terms with the consequences of my choice. If something happened
at the hospital I think I could blame some one else, or feel like I did
all
I could, or bear less responsibility or something. Now that isn't
reasonable but there it is. I know the chances of something awful
happening
that would *not* have happened in a hospital setting are very very remote
but it just paralyzes me.


I felt just that when I was in the hospital to deliver my baby. I had gone
in to be induced 2 weeks early.... I don't know why I went for induction, I
hadn't planned on it originally, but near the end I just felt the time had
to be *now*. Call it a premonition. Only when I arrived at the hospital and
all hooked up and pitocin underway, did the staff notice my baby's heartbeat
was irratically going from high to low to be normal. Nobody said a word to
me, I almost didn't want to know anything except to breath, push, breath,
push.

It turned out my baby had twisted through the umbilical cord and had formed
a "textbook" knot. He was already 2 weeks from full term and was already
pressing on the cord somehow during the contractions so he wasn't getting
enough oxygen/blood. I delivered him within 20 minutes of active labor and
sucking oxygen into my body like this was the end of the world. The doctor
cut the cord and all this blood from the knot just blew out all over him. I
shudder to think if I had waited the full two weeks my baby might have been
delivered stillborn, or worse if I had him at home and took hours instead of
minutes to get my baby out in time.... I don't think I would have ever
recovered if the worse had happened.

Larry wrote:

Bottom line is that on average it is probably safer to deliver a breech
today by c-section, simply because no one knows how to do it any more,
and it requires different techinques than a head first birth. However,
if it were taught consistently, it *COULD* be safer than c-sections.

I was thinking the same thing--if it was done more... etc.

Good point, Larry