Horror Stories

shellybean3788

I'm nearly 19 weeks pregnant with my first child, and have decided (after much research and consideration) to attempt an at-home water birth. I quickly realized that sharing this idea with anyone is a bad idea, and so I only volunteer this information now when EXPRESSLY asked what my plans are for my delivery.

That being said, I have never in my life been subjected to so many gruesome birth stories as I have been in the past few months.

"My second daughter broke my hip on the way out."

"My baby would've died if I hadn't been in the hospital."

Firefighter/Paramedic Friend: "I ran a call on a stillbirth caused by an at-home water birth. It was the midwife's fault. You can't trust those people."

"You know you can bleed to death in under five minutes. There will be no saving you if you hemorrhage at home."

The list goes on and on, and I have no idea how to politely tell people to stop telling me these stories. I have no doubt that what I am doing is safe as long as my pregnancy remains low-risk, but I honest to God can't help letting these thoughts into my head and I'm afraid they'll have a negative effect on my birthing process. (Adrenaline and fear are no good when trying to dilate, so I hear).

Have any of you experienced these types of horror stories? How did you get people to stop?

jennypolkadots

Most people believe their interventions were necessary, even though they very rarely are. You can't try to reason with them because that would only make them feel less satisfied with their own birth experience. I am so thankful for modern medicine and the tragedies it prevents. I love having a care giver (midwives) who if they say "you need a cesarean" I don't have to question it and can calmly accept it and know it is the right choice. 

I think there are answers that give information without giving too much. For example when I am asked if we have figured out our birth plan I say excitedly something like "yes! We are so lucky to be working with the best midwives. I can't wait for our birth!" If they press further, then maybe "yes, she does home births but has emergency medicine for most complications and I trust her to make the call of when to transfer if something arises." Some people are just naysayers. You can always just tell them that you hope they will do more research if they are interested but your birth is not really up for public debate. 

jennypolkadots

Also - I am a FTM and planning a similar birth to yours. It will be a home birth with access to a jetted birthing tub if I decide to use it. I am kind of just keeping options open since I don't know what I will like during labor. We won't be in our home because midwife assisted home birth is illegal in our state. We will be driving 30 minutes to the birth house just past the state line. 

To some family members I have described it as a birthing center since it won't be our own home. I have also found that many people are unaware that midwives carry emergency medicine, give vitamin k shots, and are trained in neonatal resuscitation. I think there is this weird idea that we are just calling some old lady from down the street... our midwife has practiced for 30 years and delivered 1000 babies. No maternal deaths and only lost one baby that would have had the same outcome in a hospital. I trust her and love her for what she does!

runawaylaurel

I'm 14 weeks along and I haven't gotten this question much yet, so I don't have any good responses, but just wanted to say that it must suck to hear those stories. We're planning a homebirth with a midwifery practice that's been in our area for 30 years. When my mother-in-law expressed surprise/irritation at our choice, I said "I have done a lot of research and my husband and I have decided this is the best option for us." At the end of the day, it's your choice and you and your partner are the only ones who have to be comfortable with it. 

catsinawindow

I think the best thing you can do is just avoid talking about the fact that you are having a homebirth/unmedicated birth.  You'll likely still get some horror stories, but hopefully less.  When you get horror stories remind yourself that statistics/research is on your side (ie. out-of-hosptial birth is just as safe as hospital birth, your MW will likely have all the same things to stop a hemorrhage as they use at a hospital).  If you feel like it, you can gently educate people when they say incorrect things, but don't feel like you need to if you don't feel like getting into a debate.

Also, keep in mind that a lot of those "horror stories" are women working through their own stressful birth experiences.  After I had my son, I had to keep reminding myself to not tell pregnant friends about my own birth "horror story."  And as someone who wanted an intervention-free birth, I of all people should have known better!

Finally, during my pregnancy with my daughter, I had a birth horror story playing in my head the entire 9 months - my own experience delivering my son!  I too worried about whether this would affect my daughter's birth, but there's no getting away from it when it's your own experience, YKWIM?  Turned out I had a quick, un-medicated, very positive birth with my daughter.  Even though I was thinking about that bad experience, even during labor, it didn't affect her birth.

JCWhitey

Unfortunately bad things do happen, but they happen in the hospital just as much (if not more) as they do to those birthing at home.  If you had a midwife you trust that is very important!   I used to attend births with both midwives and doctors and I can tell you that as far as experience with care they are extremely similar.  In fact I'd trust a midwife more with a natural, uncomplicated delivery and with basic emergencies as that is where their expertise is.  I would trust an OB more with an emergency c-section.  And the number of women who TRULY need an emergency c-section is very small.

While it's hard to "block out" those bad stories, I don't think the answer is to stop telling people your plans.  I think it's important for people to learn that home birth is an option and know someone who is planning one/has done one.  It'll create more awareness and education.   YEARS ago if someone told me they were having a home birth I would have thought they were crazy.  Then I attended my first one and realized how amazing they are!  I wish I could have one, but no HB midwife services the area I live in.  Although I really, really LOVED my hospital birth, I'm sad I'll probably never get to experience a home birth.

shellybean3788

Wow! Can I just say that I posted this thread in both "2nd Trimester" and on this board, and the responses were hugely different in some cases. 

Thank you all for being so supportive. Preparing to become a mother for the first time is a daunting experience. It's reassuring just to hear like-minded people tell you to keep your chin up

I guess if you're going to be different, you have to be prepared to be treated like it. I think this is where the being "brave" part comes in. Read read read, research, and if you have doubts, educate yourself some more, I guess. It's the only way to reassure yourself that you're not crazy when the whole world insists on telling you that you are.

jennypolkadots

I read your post and the responses over on the 2nd trimester board. The responses more closely match the general public and what I would expect on this forum. Many women are here for support after very traumatic birth experiences or have just never done research about home birth. Some people use weird blanket statements like "my baby would have died if we weren't in the hospital" but of course no one knows what would happen. Many doctors tell women these things to help them accept the negative birth experience they had, or the snap decision for a cesarean. Of course, these things are necessary in certain cases and I will be so happy they are there if we need them... but for the vast majority of births from healthy women there is no need for medical intervention.

I saw where someone over there quoted the "infant mortality in home birth is 3x greater than hospitals" and that has been proven inaccurate. This statistics are skewed depending on who collects the data. They also include unplanned home births (true emergencies!), high risk births that still were at home, unattended births where no midwife was present, and those attended by lay midwives without medical training or emergency medicine... or births that took place a very long ways from a hospital. There is no way to compare apples to apples. We have hired the most qualified midwife I could possibly imagine and she always attends births with at least one or two assistants by her side. Our birth situation is really identical to a birthing center rather than what is counted as a home birth in studies. 

Take it all with a grain of salt. We all make different decisions and educate ourselves with different biases. I really look forward to my birth and am just turning a deaf ear to naysayers! 

shellybean3788

I saw where someone over there quoted the "infant mortality in home birth is 3x greater than hospitals" and that has been proven inaccurate. This statistics are skewed depending on who collects the data. They also include unplanned home births (true emergencies!), high risk births that still were at home, unattended births where no midwife was present, and those attended by lay midwives without medical training or emergency medicine... or births that took place a very long ways from a hospital.

Thank you for sharing that information. When I read that about babies being 3X more likely to die at home, I was greatly confused and worried. I had always read that a low-risk home birth with a qualified midwife was as safe as a hospital birth, statistically. I understand where the other poster got her information now.

MsMacual

Sigh.  I agree with @lisagde- some moms want to share their birth story from a theraputic perspective and their opinions are riddled with their own feelings about whatever happened during their birthing process.  Like many parenting related decisions, I learned to confidently state our plans and ignored whatever responses were given.  I also try really hard not to discuss the specifics of our son's birth unless I'm asked b/c it isn't important- he arrived safely and that was what mattered in the end.  It is frustrating to hear people express doubt and try to instill fear when it isn't needed, though.  Home births and water births (at home or in a hospital) are perfectly safe for most women.  I'm sure your MW will discuss your options with you should she feel that one or both are not in your best interest health-wise.

JCWhitey

 

shellybean3788 said:

I saw where someone over there quoted the "infant mortality in home birth is 3x greater than hospitals" and that has been proven inaccurate. This statistics are skewed depending on who collects the data. They also include unplanned home births (true emergencies!), high risk births that still were at home, unattended births where no midwife was present, and those attended by lay midwives without medical training or emergency medicine... or births that took place a very long ways from a hospital.

Thank you for sharing that information. When I read that about babies being 3X more likely to die at home, I was greatly confused and worried. I had always read that a low-risk home birth with a qualified midwife was as safe as a hospital birth, statistically. I understand where the other poster got her information now.

I was about to come over here and post the same thing after reading the second trimester responses.  Unfortunately the data is not very clear on the actual details of the births and lumps every out of hospital birth into the same category as "home birth".  

I also wanted to add something about the "if we weren't in the hospital my child would have died" comments.  I actually know of one woman who was at a birth center and they quickly realized something was wrong and she needed to transfer.  Within 10 minutes she was in the hospital and both she and the baby are just fine.  She even wonders if the transfer was really needed in the end (she still had a vaginal birth), but everyone decided better safe than sorry.  Most medical emergencies regarding birth are not "OMG we have to do this NOW!", it's more like "OK, there's a problem we're not sure we can handle, let's get you to the hospital just in case".  And a good midwife knows when to do that.

Btw if you want to hear some great birth stories, check out the Pregtastic Pregnancy Podcast.  Go through the list and look for "So-And-Sos Natural Birth Story" or "So-And-Sos Birth Center Birth Story" and listen to those.  Only one has sort of a crazy ending but still was a good experience for her.  They are great stories.  That podcast overall has some great information on home birth, midwifes, birth centers, etc. that you can listen to in order to hear positive stories.

jess9802

OP (and others), one of the best sources for the risks of out of hospital birth may be to look at the data that was collected by the State of Oregon for 2012 births. The state requires that intended place of birth be reported when the birth certificate is submitted to the state. It is a very long and detailed report of where you intended to give birth, number of prenatal visits, type of provider, facility (home, birth center, etc.) maternal risk factors, etc.

Judith Rooks's initial report to the Oregon legislature showed a total mortality rate for planned OOH births at 4.5 per 1000. For planned OOH births with direct-entry midwives, the mortality rate was 4.8 per 1000. Deaths due to congenital abnormalities are excluded from the data. The total term intrapartum plus neonatal death rate for planned hospital births was 0.6 per 1000. I have read other data from the report that indicates a high percentage of the babies who died in planned OOH births should have been risked out due to presentation or maternal health according to ACOG guidelines. I live in Oregon and have followed the homebirth/OOH birth issues for a few years. I considered at one time giving birth in an accredited birth center - changed my mind and would have been risked out anyway. I changed my mind after hearing a horror story on the news and reading about it in the newspaper.

You have an absolute right to make whatever decision you wish regarding the birth of your child and that is a decision that should remain between you, your husband, and your healthcare provider. You don't need to share it with anyone. But it should be an informed decision, and I think there is a sufficient and growing body of evidence that calls into question the safety of OOH births relative to hospital births. The overall risks are still very low, for sure. Only you can decide what to do with that information.

jennypolkadots

 I have combed through all of the research I can find. We want a safe delivery of our child, not just some birth experience. I'm not at all scared of hospitals, we just don't really have any natural birth friendly ones around us. I believe the risk of interventions and quality of care deserve consideration when thinking of where to birth a child. We decided on an out of hospital birth with a midwife that we trust and truly connect with. I hope others are as comfortable with their choice as we are, because it should require a lot of thought and soul searching, not just going with the status quo.  

No matter what study you look at and how the results appear, you have to realize that the absolute risk of a poor outcome is very very low. Of course for families who experience these outcomes, the data is still significant. The relative risk when comparing the birth places (hospital v. home) is what we are taking about here. Relative risk may be high while absolute risk is still low. Make sure you are okay with whatever risks and how you would deal with a poor outcome if it occurs. It can occur no matter where you are but if you are at home you can expect to be blamed by some people who won't understand your choice. We are making a decision based on love and not fear, and I can live with the risks. 

I would love to see a study comparing low risk hospital births to planned home births attended by certified midwives that carry emergency medicine and have good hospital relations. Of course, you can't do a study like this because it is too hard to find the specific midwife data. What I do know is my particular midwife keep detailed reports of all births she has attended and blows hospital statistics out of the water. We will pay $3K more out of pocket than we would have for a hospital birth, but there is nothing I'd rather spend money on. I am so excited for our birth!! 

sschwege

It was really disheartening to read the misinformation over on the second tri board, sadly that is typical of the general population.  Truthfully up until four years ago I had similar ideas, this board really changed the way I view HBs.   @jennypolkadots addressed the issues so well, I'm not going to go into that.   

I just wanted to say that there is something about being a parent that will open you up to massive amounts of unsolicited opinions and as hard as it is you just have to find a way to let it roll off of you.  As pp said try your best not to discuss it.   But perhaps when you start to hear the horror stories maybe you need to rephrase them in your mind, like, yes, perhaps your baby would have died had they not been in the hands of a TRAINED PROFESSIONAL.  I think so often people hear homebirth and think unassisted birth.  You have hired a trained professional and are making the best decision for you and your baby! 

Oh and for what it's worth even delivering in a hospital is not without judgement from others.  My MIL hated the fact that I was being seen by a CNM, to the point where DH had to tell her if she wasn't going to be supportive she wouldn't be welcome in the room.  She shaped up and now thinks they are awesome and said if she had it to do all over she would do what I did.  A lot of people like my MIL are just misinformed.  My mother tried to gently tell me that I should pick a hospital with a Level III nursery, the hospital we were at 'only' had a Level II and that was concerning to her.  

iris427

Well, some of those horror stories are true.  There are sudden emergencies that can't be handled at home (or a birth center) the same way they can be in a hospital with 24/7 OR access and other emergency resources.  Instead of just dismissing every story you hear as a "horror story" or people who were too dumb to know they were pushed into interventions they "didn't need," maybe you should consider listening to what they are saying for a minute.

I had a home birth with my second child.  It was great.  But there was no OR in my living room.  There was no blood bank, or pediatrics staff or neonatal resuscitation team. If we had needed them, we might have been OK transferring in time, but we might not have.  If you truly honestly think that everything can be handled at home just as safely as it can in a hospital, you're not getting all the information.  I think women have every right to have a home birth.  But they should do it knowing full well that there is a small, but real, risk that something will go wrong with no warning, that could be life-threatening.  I had a low-risk pregnancy that turned suddenly life-threatening for my baby with no warning during my third birth.  If it happened to me, an ardent believer in natural childbirth who had NO medical interventions in labor and a completely supportive doctor, it can happen to anyone.  And I honestly find it offensive that stories like mine are dismissed here as "horror stories" as if they are somehow less legit than the birth stories you want to hear, as if they are just campfire legend used to scare poor pregnant women, or that the obstetrical care that saved my baby's life was probably unnecessary according to people with zero medical training.

If you're not OK with that small but real risk, don't have a home birth.  If you want a home birth, do it but be informed. And that includes considering the risks, not just the benefits.

iris427

jennypolkadots said:

I read your post and the responses over on the 2nd trimester board. The responses more closely match the general public and what I would expect on this forum. Many women are here for support after very traumatic birth experiences or have just never done research about home birth. Some people use weird blanket statements like "my baby would have died if we weren't in the hospital" but of course no one knows what would happen. Many doctors tell women these things to help them accept the negative birth experience they had, or the snap decision for a cesarean. Of course, these things are necessary in certain cases and I will be so happy they are there if we need them... but for the vast majority of births from healthy women there is no need for medical intervention.

I saw where someone over there quoted the "infant mortality in home birth is 3x greater than hospitals" and that has been proven inaccurate. This statistics are skewed depending on who collects the data. They also include unplanned home births (true emergencies!), high risk births that still were at home, unattended births where no midwife was present, and those attended by lay midwives without medical training or emergency medicine... or births that took place a very long ways from a hospital. There is no way to compare apples to apples. We have hired the most qualified midwife I could possibly imagine and she always attends births with at least one or two assistants by her side. Our birth situation is really identical to a birthing center rather than what is counted as a home birth in studies. 

Take it all with a grain of salt. We all make different decisions and educate ourselves with different biases. I really look forward to my birth and am just turning a deaf ear to naysayers! 

No, it has not been "proven inaccurate." A previous poster gave you the data from Oregon's planned home births compared to hospital births.  That data was collected by a midwife, Judith Rooks, and it shows a significantly increased risk of intrapartum death in births at home--actually greater than 3x.  She found OOH birth increased death by 6-8x when compared to hospital birth.  Here's her data and statement to the Oregon legislature:

https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeMeetingDocument/8585

There was also another study that came out recently looking at birth certificate data where the birth attendant was listed (so again, these were planned home births) and found that home birth had a 4x higher death rate than hospital births attended by midwives.  Birth centers had a death rate twice as high as hospital births attended by midwives.

https://www.ajog.org/article/S0002-9378(13)01155-1/fulltext

  

Here's a study from Missouri also showing planned home birth is significantly more likely to have poor outcomes/intrapartum death.

https://www.ncbi.nlm.nih.gov/pubmed/21380991

Here's a meta-analysis showing a 3x increased risk of death with home birth:

https://www.azdhs.gov/als/midwife/documents/committee/U-of-A-literature-review.pdf

There are also studies showing increased risk of low 5 minute Apgar scores, and brain damage to the baby:

https://www.ajog.org/article/S0002-9378(13)00630-3/abstract

https://www.ajog.org/article/S0002-9378(13)00641-8/abstract

So yeah, when multiple studies show that home birth increases death rates/poor perinatal outcomes, it might just be accurate.  At best we would have to say that the data on home birth is mixed.  

Is the absolute risk of home birth low?  Yes, at least if you are low-risk, near a hospital, and have a good, responsible midwife.  And by low-risk I mean actually low-risk, not past 42 weeks, not carrying a breech baby, not a VBAC mom, etc.  Is there evidence suggesting that home birth does significantly increase risk of brain damage and death to the baby?  Yes.  If you're comfortable with the increased relative risk because the absolute risk is low, go for it.  Make an informed choice.

jennypolkadots

@iris427 - thanks for sharing all of the links!

I made an assumption that the statistic sited on the comment on the other board was the ACOG study that was later retracted and they published a new study showing much lower numbers. Midwifery care is just not black and white. There are many factors to take into consideration. OP never actually said rather she is being attended during her birth or what her specific scenario is, but I hope she is making smart choices that she is comfortable with. 

I have skimmed the Oregon data. As with other studies, they can't isolate a lot of individual factors. These include midwives who are using herbs or are an hour from a hospital. There is no way to know. The best you can do is get the actual figures from your midwife practice and decide if you are comfortable with those statistics. If the relative risk is high but the absolute risk is very low, you have to decide how you would feel/handle if you were one of the unlucky few that have a very bad birth outcome. It is equally as important that your partner is 100% on board with your plan because this is his baby too and his risk to help assess. 

jennypolkadots

Also I agree that the data on home birth is mixed and it is very possible that outcomes are poorer than those expected in a hospital. It is just impossible to account for all of the various types of birth scenarios and put them into a readable study. Home birth is not all the same, but neither is hospital birth. My personal preference would be a hospital birth center with a CNM but that doesn't exist within 2 1/2 hours of me. Once again, assess your personal risk with your partner and choose a competent provider that you trust. Don't choose home birth just because you are scared of hospitals, and research research research. 

JCWhitey

Even @jess9802 commented that "I have read other data from the report that indicates a high percentage of the babies who died in planned OOH births should have been risked out due to presentation or maternal health according to ACOG guidelines." (clipped as to not quote the whole thing)...

Again, studies like these cannot absolutely determine the safety of home birth versus hospital birth for the sole factor that not all statistically relevant data is available.  The reason I always tell people that you need to get a midwife that is experienced, educated, and that you trust is because they have to be able to say "you are not a candidate for home birth" and you need to trust that they aren't just saying that, they really mean it.  I heard of one mother who was dropped by her home birth midwife when she was diagnosed with GD, and then turned around and tried hiring another one with the intentions of lying about that.  It didn't work since the midwife community is rather small, but it makes you wonder how often someone does that OR how often a midwife without enough experience doesn't recognize warning signs early enough.

With that, it's also not fair to compare all hospital births to one another.   The hospital I'm birthing at is really not much different than a home birth.  They don't have a team of trained professionals on hand in case something goes wrong.  No NICU, the closest one is 45 minutes away by Life Flight.  The entire hospital has just nine nurses on staff, three at any given time.  The only doctors who are there are the ones performing surgery or doing the delivery, and even my doctor is a family practitioner, not an OB.  There is an OB on staff, but they are not in the hospital sitting around but rather on call in case they are needed.  So my access to emergency care has about the same timeline as a home birth transfer to a major hospital.  Because of this the c-section rate is super low.  But also because of this if you are considered high risk you are transferred out and not allowed to birth at that hospital.  So even comparing hospital births doesn't give you the full picture of what is really happening and why things happen the way they do.  

jess9802

JCWhitey said:

Even @jess9802 commented that "I have read other data from the report that indicates a high percentage of the babies who died in planned OOH births should have been risked out due to presentation or maternal health according to ACOG guidelines." (clipped as to not quote the whole thing)...

Again, studies like these cannot absolutely determine the safety of home birth versus hospital birth for the sole factor that not all statistically relevant data is available.  The reason I always tell people that you need to get a midwife that is experienced, educated, and that you trust is because they have to be able to say "you are not a candidate for home birth" and you need to trust that they aren't just saying that, they really mean it.  I heard of one mother who was dropped by her home birth midwife when she was diagnosed with GD, and then turned around and tried hiring another one with the intentions of lying about that.  It didn't work since the midwife community is rather small, but it makes you wonder how often someone does that OR how often a midwife without enough experience doesn't recognize warning signs early enough.

With that, it's also not fair to compare all hospital births to one another.   The hospital I'm birthing at is really not much different than a home birth.  They don't have a team of trained professionals on hand in case something goes wrong.  No NICU, the closest one is 45 minutes away by Life Flight.  The entire hospital has just nine nurses on staff, three at any given time.  The only doctors who are there are the ones performing surgery or doing the delivery, and even my doctor is a family practitioner, not an OB.  There is an OB on staff, but they are not in the hospital sitting around but rather on call in case they are needed.  So my access to emergency care has about the same timeline as a home birth transfer to a major hospital.  Because of this the c-section rate is super low.  But also because of this if you are considered high risk you are transferred out and not allowed to birth at that hospital.  So even comparing hospital births doesn't give you the full picture of what is really happening and why things happen the way they do.  

I'm looking at the Oregon report now. Six of the eight perinatal deaths for planned OOH births did not meet published low-risk criteria for OOH birth: Four were past 41 weeks gestation; two were twin pregnancies; one involved morbid obesity. The planned attendants at these six deaths were one CNM, three licensed direct-entry midwives, one unlicensed midwife, and one naturopathic physician.

You're absolutely right that what complicates the picture is that some midwives/birth attendants will not strictly follow the guidelines for homebirth. Part of the reason for that is that homebirth and those midwives are not well integrated into the health care system. Unfortunately, what I have seen of the homebirth community is that these identified risk factors are believed to not be issues at all. One of the homebirth deaths in my community involved a midwife who agreed to deliver a breech baby. In a state like Oregon, you can have midwives with ZERO medical training or knowledge, and a mere high school diploma, having to evaluate these conditions and risks, and doing so in a culture that denies that these conditions are risks at all. But the homebirth/natural birth community tends to oppose strict licensing and insurance requirements that might actually protect women.

Unfortunately, I think that even in countries with an integrated health care system, strict educational and licensing requirements, and stringent risk management, home birth still has poorer outcomes than hospital birth. Yes, even in The Netherlands.

sschwege

JCWhitey said:

Even @jess9802 commented that "I have read other data from the report that indicates a high percentage of the babies who died in planned OOH births should have been risked out due to presentation or maternal health according to ACOG guidelines." (clipped as to not quote the whole thing)...

Again, studies like these cannot absolutely determine the safety of home birth versus hospital birth for the sole factor that not all statistically relevant data is available.  The reason I always tell people that you need to get a midwife that is experienced, educated, and that you trust is because they have to be able to say "you are not a candidate for home birth" and you need to trust that they aren't just saying that, they really mean it.  I heard of one mother who was dropped by her home birth midwife when she was diagnosed with GD, and then turned around and tried hiring another one with the intentions of lying about that.  It didn't work since the midwife community is rather small, but it makes you wonder how often someone does that OR how often a midwife without enough experience doesn't recognize warning signs early enough.

With that, it's also not fair to compare all hospital births to one another.   The hospital I'm birthing at is really not much different than a home birth.  They don't have a team of trained professionals on hand in case something goes wrong.  No NICU, the closest one is 45 minutes away by Life Flight.  The entire hospital has just nine nurses on staff, three at any given time.  The only doctors who are there are the ones performing surgery or doing the delivery, and even my doctor is a family practitioner, not an OB.  There is an OB on staff, but they are not in the hospital sitting around but rather on call in case they are needed.  So my access to emergency care has about the same timeline as a home birth transfer to a major hospital.  Because of this the c-section rate is super low.  But also because of this if you are considered high risk you are transferred out and not allowed to birth at that hospital.  So even comparing hospital births doesn't give you the full picture of what is really happening and why things happen the way they do.  

Well said!

In addition to your middle paragraph I wanted to add in a personal story.  My Aunt had all three of her babies at home.  With her third, she was 'advanced maternal age' and as the pregnancy progressed her blood pressure kept getting higher and higher.  Her MW told her it was too risky to try to deliver at home and instead she should birth at the hospital and the MW would go as a member of her support team.  My Aunt refused and her MW dropped her from care.  My Aunt went into labor, her husband called the MW and she refused to come, told him to take her to the hospital.  Her husband kept calling saying she was refusing to go and eventually the MW did come and catch the baby.  By the grace of God everything turned out fine.  But that is a prime example of why it's so hard to compare these numbers.  

shellybean3788

I saw it mentioned that I was not very specific with what my plans actually were. Sorry about that. It was more of a rant and I left out some details.

I'm working with a professional midwife who has attended hundreds of water births and so far (knock on wood) has not lost anyone, although she says she did have to resuscitate a baby once. It turned out fine, but of course I'm sure it was extremely scary at the time. 

Before hiring her, I went on Brevard Birth Circle (Florida) and asked other home-birthers which midwife they used, and what their experience was like. Mine did not get any negative reviews, and that's one of the reasons I chose her.

I will also have a doula at my birth, along with my sister and her husband, who are both experienced paramedics and are also trained in neonatal resuscitation. We are approximately fifteen minutes from the nearest hospital (which does have a NICU), and I am confident that no one attending my birth would hesitate in the least to call 911 if they believed something was awry. 

Do I feel pretty safe about what I'm doing? Yes, as much as I can for a first-time mom-to-be who's never done anything like this. Do the stories people tell me about this/that gruesome event still get to me? I won't lie, they do. 

soulcupcake

I actually addressed the common scare tactics in D14, which can be read here. A few posts from the top of the second page.

I first became aware of horror stories when I joined a mainstream fertility/pregnancy forum about 10 years ago when TTC #1. And then of course it continued on for years and years. I'm not phased by them now because I know better, and I can better use objective and critical examination of anecdotal data and evidence-based research.

This is my third time planning a homebirth. I was pretty set on the idea back in '06 when I was pregnant with my second, but there weren't any homebirth-practicing midwives in my area at the time. Most of the flack I've come across was from back in '05-07 when out-of-hospital birth was beginning to grow within the birth community, and it was seen as "out there" and fringe. And now I only come across misconceptions and negative attitudes on mainstream parenting forums heavily populated by first time moms or forums with members completely removed from birth culture (often because they're not parents or even considering it any time soon, so their actual knowledge and understanding is limited).

I haven't received any judgment from friends or relatives, but most of my good friends are educated, progressive, "crunchy," and favor evidence-based practice over routine practices (science!). My mom is super supportive, and my dad has an "Okay. Sounds good."/ attitude. Extended relatives... I'm not sure because it's not really a topic that comes up, and I don't live near any extended relatives.

I'm very much aware of poor outcomes of both home and hospital birth. Sadly, when you spend time on pregnancy and parenting forums you get exposed to, well, tragedies and devastating losses. I lost my first son at the end of my pregnancy, and joined a few stillbirth and neonatal loss support groups. 

There, one becomes familiar with late term and birth loss of all sorts of causes. Some have been due to physician or midwife negligence. In one of the support groups a mama joined the group a few months after I joined, and shared her story. She lost her daughter during a homebirth, and the midwife was negligent. I don't recall all of the details, but I remember mom sensing something was off and might have had a slight fever and baby's heart rate was tachycardic during parts of her labor. Well, she didn't make it, and the midwife was definitely at fault.

I'm friends with a mama who was laboring at a birth center, but was getting exhausted during the second stage. She had been pushing for two hours and needed to rest. She was fine and her daughter's heart rate was fine during the transfer to the hospital nearby. She checked in to L&D and was hooked up to the monitors and eventually started pushing, but at birth there were not heart tones. She was not crying. She died in the hospital, and the cause might have been cord compression. Perhaps during her descent the cord got pinched between her shoulder and the birth canal.

Another mama lost her son in a homebirth during her breech delivery due to head entrapment. A very dear friend of mine, who joined the same support group a month before, was planning a homebirth. She was in very early labor. Just started contracting. She was maybe 2-3 cm. She felt lightheaded, so her midwife came over to check her out. She was in the shower and started spotting. She didn't feel right and practically fainted, to which they responded by rushing her to the nearest ER. She bled out on the ER floor and was taken for a stat c-section (this is a true "Oh shit -- emergency c-section NOW!). She had a complete placental abruption and almost died. Her daughter didn't make it. 

One mama shared her story involving a complicated case of shoulder dystocia. She was in the hospital. Baby presented with shoulder dystocia during the second stage and the doctor freaked out, panicked and resorted to the Zavanelli maneuver and taken for a stat c-section. He was stillborn.

Another mama lost her son after labor due to undiagnosed maternal-fetal hemorrhage. One of the mamas in my D09 groups lost her son during a hospital birth. 

I don't mean to be a debbie downer, but babies can and do die in and out of hospitals. Knowing the research, understanding the data in support of evidence-based practice, researching providers, trusting their philosophy/knowledge/skills, is important when making any birth related decision. I certainly don't knock all doctors or all midwives (or those ill-trained lay midwives, as some claim). Obstetrics, a surgical specialty, has its place, as does midwifery model of care. I advocate for choice and options, whatever those may be. It's up to each individual woman to decide what she's comfortable with. I make birth choices based on my own history and the model of care I support and advocate, a model of care supported by the available evidence. I also live 1.3 miles away from the nearest hospital, and if transfer becomes necessary, the staff can responsd quickly (average decision to delivery time for an "emergency c-section" is 30-40 minutes). I trust my midwife's skills and judgment. She carries oxygen, supplies to start an IV, pitocin, resuscitation equipment, etc.

I'm also prepared to birth unattended since I have to plan and prepare for that anyway because I have extremely precipitous births.

jenn43

Pregnancy seems to give people the idea they an ask really personal questions, and share information that otherwise wouldn't be appropriate conversation.  I did a hospital birth, and I still had a bunch of skeptics because I planned to go med-free.  No matter what you tell people, they will have something to say.  You could try using their negative comments as motivation- when I had my med-free birth as planned, it was really satisfying telling all those same skeptics how awesome my labor was.