I have to admit, the title at first made my skin crawl. But I get it, I get what it’s about, no hate. STM here and my first birth “I wanted” all kinds of idealistic birthing experiences. I even skipped the C-section section of books and articles because I was set on “pushing, medicated.” I didn’t get to choose at all; “natural,” which already triggers me because all births are natural. A robot or unnatural being can’t give birth for us. Welp- the day of, my water broke two weeks early, daughters heart rate kept significantly dropping because her umbilical cord was tightly wrapped around her so I needed an immediate c section. I have scoliosis so needed about 9 attempts at an epidural until it finally worked. Perfectly fine. Breast milk didn’t come in until day 4 when I finally went home from the hospital. DD is totally healthy, breast fed for a year with a mix of formula so she knew how to bottle feed when I went back to work. All worked out great. Scary and completely different than what I imagined, so please try to remain open minded that for your safety and the baby’s, anything can change at any time. A really good friend of mine has had 3 successful home births. That’s great for her. I will be doing an elective C-section due to fears of my scar rupturing and bleeding internally during a VBAC and I’m totally fine with that. I have an extreme irrational fear of dying. The risks are low but I don’t want to risk it if I don’t need to. I Just want to stay alive and with a healthy baby to come home with us!
From the very first link you posted to the ACOG opinion (not a study), the risk of death in a planned, low risk home birth is substantially higher that of a planned, low risk hospital birth:
"In the United States, for example, where selection criteria may not be applied broadly, intrapartum (1.3 in 1,000) and neonatal (0.76 in 1,000) deaths among low-risk women planning home birth are more common than expected when compared with rates for low-risk women planning hospital delivery (0.4 in 1,000 and 0.17 in 1,000, respectively), consistent with the findings of an earlier meta-analysis."
As that article notes, it's tough getting good side by side statistics because it's essentially impossible to have a randomized study on the topic, so instead they are observational studies, which are more prone to confounding factors. Plus, something like 22-37% of planned home births end up transferring to a hospital (so if a bad situation lingers too long at home before transferring, but the baby ultimately dies at the hospital, it gets recorded as a hospital death even though that's not really accurate.
From your second link:
"Nine studies included in the meta-analysis reported data on 8 child health outcomes. Analysis of combined data from all 8 studies showed a three-fold increase in risk of neonatal deaths for homebirth attended by midwives, compared to hospital births." The third link looked at home birth outcomes in British Columbia, Canada. Again, Canada and some European countries have much stricter regulations, which make home birth less risky there. But the US is an unregulated wild west situation, which significantly increases the risks.
The fourth study appears to be based entirely on self- reported data from midwives that chose to submit such data, which seems like a fairly significant methodological flaw (how many midwives are likely to voluntarily self-report a f@&%-up that led to a tragic outcome?).
Plenty of births are low risk, right up until they aren't. If someone doesn't want to labor in a hospital, an accredited birthing center adjacent to a hospital, staffed by CNMs, is a much safer option than home birth.
@tuxielove93 I do think that, while you seem well-intentioned, some of your language can be off-putting. People have already mentioned the “natural” label— and while you may think of that label as neutral, it isn’t, because it implies that birthing any way other than an unmediated vaginal birth is “unnatural”. To me, what is unnatural is any mother who wouldn’t want her baby to arrive safely into the world, whether that is via c-section, epidural, in a tub, etc. Second, you said something like “I believe any mother can have an unmedicated birth if that’s what she wants”, but that simply isn’t true. As many of the women on this thread have said, they needed to have a c-section or another intervention in order to keep their babies safe. They could not have had an unmedicated birth, however hard they had tried, however well they had prepared. And implying otherwise makes them feel badly, like they have failed at something.
I think a lot of the language on this thread is problematic, even from the women who have had epidurals, who say things like “I might cave and get an epidural” or “I wish I had lasted longer before getting the drugs”. This language again implies that there is something noble or triumphant about giving birth without medication. If you don’t want an epidural, you do you, I’m fine with it, but please don’t imply that its somehow a better way of giving birth.
Lastly, as I have said before, in my circle of friends (and it seems similarly on this thread), the most important predictors of whether a woman gets interventions are (a) whether her birth is uncomplicated, and (b) whether her labor is short. That’s part of the reason that you see women having epidurals on their first births, and sometimes not getting them on baby #3 or 4– its because higher parity labors are way, way shorter. Uncomplicated first births typically labor for 24 hours or more. It is very, very common for women to labor for 10 or 12 or 14 hours, and then get an epidural so that they can rest. Again, I’m not saying that this is the right thing to do, I just want the first time moms here to understand that births can go all sorts of ways, and that getting really set on a birth plan can make you unprepared for the many ways that labor can go.
I do agree with @tuxielove93 though that learning about a variety of pain relief techniques can be useful— if you have a short, uncomplicated labor they may get you all the way through, and if you have a more typical long labor, they can help you get through the early part before you go to the hospital. Maybe that should be the focus of its own thread, and then if people are interested in home birth, etc, maybe start a thread on that. But I also think that people should be open to dissenting opinions on any thread— it's especially important for first time moms to hear a variety of birth stories, and if lots of people have had positive experiences with epidurals, that is probably useful information for FTMs who are considering whether or not to get one.
My NP midwife is awesome and we kind of have a plan, she was an OB nurse for years before becoming a midwife and knows how to keep mom's comfortable. We'll probably induce because my babies are too big full term, yay. I'll get the epidural ASAP too, because last time I was induced the contractions escalated so quickly and it was out of control. Waiting for the epidural at 2AM was absolutely brutal, they had to call the on call anesthesiologist and he had to come in and it felt like an eternity. I'm happy that there's a NICU at the hospital too, so we can monitor the baby for ABO incompatibility right away and hopefully get her on a bili blanket as needed and for the first time avoid a NICU stay. We covered all the basis at my first appointment and I'm so confident that this will be the easiest labor and that baby has a good chance of actually coming home with us right away. I could write a book about how horrific labor and delivery was with my first two. 😅
@twentythree19 yes! I had the “postural headache” and had to receive not only a blood patch but my spinal fluid was leaking so bad, they had to stitch me up.
*trigger warming**
I had the epidural when I was pregnant with identical twins last year and at 18 weeks was diagnosed with TTTS. I ended up losing them. I do have moderate scoliosis but with the way my body reacted, the doctors at Columbia hospital insisted on scanning my back and came to the conclusion that I might not ever be able to receive another epidural without the same results. It was honestly AWFUL. I couldn’t move my head for about a week. I cannot imagine having a newborn to take care of during that time.
I’ve never planned on getting an epidural so this isn’t devastating to me. I’ve already talked to my midwives about it for my July birth and discussed my (ideal) scenario in which I’m able to move freely with my music playing. The hospital I’ll be delivering at is well equipped with birthing bars, balls and baths and they have a partnership with the midwives. It also makes my husband comfortable to be at the hospital, and after our last experience it’s important that we both feel that we are in an environment that is capable of handling any situation. Though I know I must be flexible with whatever comes my way, I intend on approaching this birth with confidence. I’m a yoga teacher and my midwives say I have a very “doula-like personality” we shall see…
Re: December Natural Birth Thread
From the very first link you posted to the ACOG opinion (not a study), the risk of death in a planned, low risk home birth is substantially higher that of a planned, low risk hospital birth:
"In the United States, for example, where selection criteria may not be applied broadly, intrapartum (1.3 in 1,000) and neonatal (0.76 in 1,000) deaths among low-risk women planning home birth are more common than expected when compared with rates for low-risk women planning hospital delivery (0.4 in 1,000 and 0.17 in 1,000, respectively), consistent with the findings of an earlier meta-analysis."
As that article notes, it's tough getting good side by side statistics because it's essentially impossible to have a randomized study on the topic, so instead they are observational studies, which are more prone to confounding factors. Plus, something like 22-37% of planned home births end up transferring to a hospital (so if a bad situation lingers too long at home before transferring, but the baby ultimately dies at the hospital, it gets recorded as a hospital death even though that's not really accurate.
From your second link:
"Nine studies included in the meta-analysis reported data on 8 child health outcomes. Analysis of combined data from all 8 studies showed a three-fold increase in risk of neonatal deaths for homebirth attended by midwives, compared to hospital births."
The third link looked at home birth outcomes in British Columbia, Canada. Again, Canada and some European countries have much stricter regulations, which make home birth less risky there. But the US is an unregulated wild west situation, which significantly increases the risks.
The fourth study appears to be based entirely on self- reported data from midwives that chose to submit such data, which seems like a fairly significant methodological flaw (how many midwives are likely to voluntarily self-report a f@&%-up that led to a tragic outcome?).
Plenty of births are low risk, right up until they aren't. If someone doesn't want to labor in a hospital, an accredited birthing center adjacent to a hospital, staffed by CNMs, is a much safer option than home birth.
I think a lot of the language on this thread is problematic, even from the women who have had epidurals, who say things like “I might cave and get an epidural” or “I wish I had lasted longer before getting the drugs”. This language again implies that there is something noble or triumphant about giving birth without medication. If you don’t want an epidural, you do you, I’m fine with it, but please don’t imply that its somehow a better way of giving birth.
Lastly, as I have said before, in my circle of friends (and it seems similarly on this thread), the most important predictors of whether a woman gets interventions are (a) whether her birth is uncomplicated, and (b) whether her labor is short. That’s part of the reason that you see women having epidurals on their first births, and sometimes not getting them on baby #3 or 4– its because higher parity labors are way, way shorter. Uncomplicated first births typically labor for 24 hours or more. It is very, very common for women to labor for 10 or 12 or 14 hours, and then get an epidural so that they can rest. Again, I’m not saying that this is the right thing to do, I just want the first time moms here to understand that births can go all sorts of ways, and that getting really set on a birth plan can make you unprepared for the many ways that labor can go.
I do agree with @tuxielove93 though that learning about a variety of pain relief techniques can be useful— if you have a short, uncomplicated labor they may get you all the way through, and if you have a more typical long labor, they can help you get through the early part before you go to the hospital. Maybe that should be the focus of its own thread, and then if people are interested in home birth, etc, maybe start a thread on that. But I also think that people should be open to dissenting opinions on any thread— it's especially important for first time moms to hear a variety of birth stories, and if lots of people have had positive experiences with epidurals, that is probably useful information for FTMs who are considering whether or not to get one.
BFP 11/30/2017 | MMC 12/31/2017
BFP 6/22/2018 | CP 6/27/2018
BFP 10/5/2018 | EDD 6/14/2019
Baby girl born 6/19/19
TTC #2 May 2020-November 2021
BFP 7/18/2020 | MonoDi Twins | MMC 9/10/2020
BFP 11/7/2020 | CP 11/9/2020
RE Consult January 2021 | Dx "borderline DOR"/RPL
IVF with PGT:
Standard Antagonist:
ER #1 3/27/2021 7R | 5M | 3F | 2B | 1 PGT-A Normal, 1 low-level mosaic
ER #2 4/22/2021 10R | 7M | 3F | 2B | 0 normal, 2 aneuploid
ER #3 5/19/2021 2R | 1M | 0F
Estrogen Priming Antagonist:
ER #4 7/10/2021 5R | 4M | 3F | 1B | 1 PGT-A Normal
Duostim (Standard Antagonist):
ER #5 9/22/2021 13R | 11M | 8F | 5B | 2 PGT-A Normal, 1 low-level mosaic, 2 aneuploid
ER #6 10/9/2021 9R | 6M | 4 F | 1B | 1 aneuploid
FET #1 11/5/2021 | EDD 7/24/2022
Baby boy born 7/19/22
TTC #3 since May 2023 (ntnp)
IVF Started Fall 2023 (Standard Antagonist)
ER #7 10/6/2023 | 9R | 6M | 5F | 3B | 2 aneuploid, 1 high-level mosaic
ER #8 10/31/2023 | 5R | 4M | 3F | 1B | 1 PGT-A Normal
FET #2 11/27/23 | CP (bHCG = 8)
FET #3 planned Jan 2024