Guest Writers

Birth Safety as a Binary Condition

40 Comments 01 April 2010

Morgan, co-director of North Metro Birth & Breastfeeding Coalition

Guest post by Morgan A. McLaughlin McFarland

“Your baby is healthy and that’s all that really matters.”

How many times have you heard it or some variation of it? How many times have you said it or something like it?

A new mom is struggling to make sense of a traumatic or confusing birth experience, to come to terms with unplanned interventions, perhaps an instrumental vaginal delivery or cesarean section that she’d never imagined she’d have. When she expresses her sorrow over the loss of the birth she had hoped for, the beautiful event she’d imagined, too often the response is, “At least you have a healthy baby.”

Christy Fiscer’s essay, “A Healthy Baby Isn’t All That Matters“, addresses this troubling tendency to trivialize a woman’s birth experience by implying she isn’t grateful enough that her baby is “healthy” (which really equates to “not dead or noticeably damaged”) or that she’s selfish for wanting, let alone expecting, more from birth than to be treated like an insignificant baby-bearing vessel.

Seeking meaning in birth outside of a “healthy” newborn is viewed as frivolous, and women seeking empowering birth experiences are portrayed as solely being out to prove something or expecting to “get a medal for going without drugs.”

There’s no need for me to rehash in great detail something that Christy has already addressed so passionately and eloquently. The “healthy baby is all that matters” attitude is merely one facet of a larger flaw in how our culture views birth outcomes.

The other day, someone left a comment [which was deleted due to the comment's author, not the comment's content] on my essay about “bravery” not really being a factor in choosing a homebirth to the effect that, if maternal and neonatal mortality outcomes of homebirths and hospital are nearly identical, that neither hospital birth nor home birth was more or less dangerous.

I found this to be an interesting interpretation of the Johnson & Daviss study. While it’s true that outcomes in terms of mortality rates were nearly identical, what made the study relevant to my essay was NOT that it showed a difference in the number of deaths, but that the low rate of mortality in the homebirth group was achieved with significantly fewer interventions than that of the hospital birthing group. If safety is measured by number of deaths alone, I suppose this would indicate that neither hospital nor home is more “dangerous” than the other, but is “not a lot of people died” really all that we’re going for?

When did “didn’t die” become our only barometer for success in childbirth?

Baby was born/extracted from womb, both mother and child survived, therefor all is well, regardless of whatever other steps may have been involved in that birth/extraction process, regardless of any long-term harm (or increase in risk) to the mother or child, and regardless of the way anyone feels about the experience. Mom and baby lived; most studies would consider that a positive outcome.

From a purely statistical standpoint, the birth was a success. This is certainly how birth is judged in this country from an obstetrical standpoint, but are we really satisfied as individuals with this binary notion of birth wherein “bad” is defined only as “dead” and “good” is defined only as “not dead”?

If a living mother and child are all that is required for birth success (or if, indeed, a healthy baby is the only thing that matters) then yes, hospital birth is “just as safe” (or “equally dangerous” or “no more dangerous,” choose whichever language you prefer). If you start measuring safety and success by something more than a binary “live or die” condition, however, then you find disparity in outcomes.

Why do many homebirth advocates view hospital birth as dangerous?

It’s not because more women die in hospitals, or because more babies die in hospitals, but because the interventions performed in ever increasing numbers in hospitals can have a devastating effect on long-term physical and mental health.

The increased likelihood of cesarean section for women giving birth in hospitals is a good example of what is perceived by homebirth advocates as a danger of hospital birth. Cesarean section is a major abdominal surgery. While some care providers like to present surgical delivery as “just another way to give birth,” the reality is that the procedure introduces a host of new risks to mother, child, and future pregnancies.

These risks are worthwhile if the cesarean section is necessary, as the World Health Organization says the procedure is for less than 15% of births, but the procedure is grossly over-performed in the United States. Can a woman who did not need a cesarean, but who was manipulated/pressured, legally forced, misled by care providers about the necessity of the procedure, or who experienced iatrogenic health complications (for herself or her baby) due to mismanagement or over-management of her birth, be said to have had a “safe” or “successful” birth experience, even if the immediate outcome of the surgery is that mother and child live?

Maternal mortality rates do not tell us…

If the mother who had a unneeded cesarean section went on to have more children (as cesareans can cause fertility problems).

Maternal mortality rates do not tell us if she had other cesarean deliveries as a result of her primary c-section (as fewer and fewer doctors/midwives will attend VBACs and many insurance providers will not cover them), or what complications or outcomes came from that birth (as each additional cesarean section has increased risks over the previous cesareans).

They do not tell us if she experienced uterine rupture during her VBAC or repeat cesarean as a result of scar tissue from the primary surgery (the risk of rupture for VBAC and repeat cesarean is nearly identical, at slightly less than 1%).

They do not tell us if she experienced placental previa or accreta in later pregnancies as a result of her prior c-section (the risk of both is increased in women who had have c-sections).

They do not tell us if additional surgeries had to be performed after birth to correct iatrogenic health conditions, such as damage to the bowels or bladder (rare, but possible).

They do not tell us if she experienced post-traumatic stress disorder, postpartum depression, or sexual dysfunction (all more common among women who had unplanned c-section than women who had planned vaginal births or planned c-sections) as a result of the unexpected surgery.

Maternal mortality rates don’t tell us if the mother had difficulty breastfeeding (women who have c-section are less likely to breastfeed).

The only thing that maternal mortality rates tell us is whether or not a woman died during or shortly after giving birth as a result of that birth.

These rates say nothing about the dangers to a woman’s long-term health, either physical or mental, that resulted from the cesarean section. These rates say nothing about the feelings of disappointment, guilt, confusion, anger, or fear experienced during or after the birth.

I could list every intervention more common in hospital births than homebirths and tell you exactly why I, as a homebirth advocate, feel the overuse and misuse of these interventions make hospitals a dangerous place for low risk women to give birth, but why beleaguer that point?

The heart of the issue, for me, isn’t to examine the individual interventions, or even the cumulative risks of the whole cascade of interventions, but to bring attention to how little a binary notion of birth location safety actually tells us about the safety of giving birth.

When a child is born, a new mother is made.

The process of her making, the experience of her birthing, is a meaningful one. Statements like “a healthy baby is all that matters” marginalize the mother by implying that the she doesn’t matter, that she is lacking in worth (either by comparison to her child or in general). Though every mother’s primary concern is a healthy baby, the mother’s own experiences are not suddenly made worthless or unimportant if that goal of a healthy child is attained.

Defining birth outcome by whether or not the mother and her child lived is equally marginalizing of the mother, because this narrow definition doesn’t allow for variations in personal experience, physical or mental health, non-mortal birth crises. This definition of birth success says that only life or death, not the process, has meaning, and that even if you were poked, prodded, injected, cut, dehumanized — if you didn’t die, well, you were actually “safe” the whole time. You were in no danger, because the end justified all the means.

I don’t know about you, but I want more than that particular binary view of safety.

Morgan is a freelance writer and co-director of North Metro Birth & Breastfeeding Coalition. Contact Morgan at morgan@mcfamilies.com

Read Morgan’s previous post, “Home Birth: “Brave” Has Nothing To Do With It.”

Your Comments

40 Comments so far

  1. babycatcherKim says:

    THANK YOU, Morgan. I have sincerely appreciated your two posts here and think they need to be widely read and understood.
    And especially by Amy, formerly known as an OB.

  2. SC says:

    Excellent. A heartfelt thank you.

  3. Michelle says:

    Great article! This is exactly what I have been trying to tell my c-section friends about how I feel. I feel that they either truly don’t understand because they are so brainwashed to believe that a c-section “saved their lives and the lives of their baby.” I did everything “right” – no drugs, no interventions, nothing, and my son got stuck at -1 for 9 hours of pushing and I STILL felt like a failure for needing a c-section. It really did not bother me that much afterward, but I am convinced a mild form of PTSD is what has made this pregnancy (37 wks today), so emotionally difficult for me. I have a palpable fear and anxiety about going to the hospital for this birth, but homebirth is not an option for me. Thanks for putting it so well…..of course we love/appreciate our healthy babies, but the feelings of failure and inferiority are so hard to deal with in the aftermath – it shakes your confidence in yourself as a woman, a mother, and a wife.

  4. Heather says:

    Thank you for articulating a lot of the things that most of us intuitively know, but just don’t have on the tip of our tongue when confronted with others’ stereotypes about c-sections, home births, or midwife-assisted births.

    There’s such an ingrained perception in our society that hospitals are the safest place to be, always. Unfortunately, that’s often not true. A JAMA article published in 2000, titled “Is US Health Really the Best in the World?” cites the following stats on various types of iatrogenic damage:

    # 12,000 deaths/year from unnecessary surgery
    # 7000 deaths/year from medication errors in hospitals
    # 20,000 deaths/year from other errors in hospitals
    # 80,000 deaths/year from nosocomial infections in hospitals
    # 106,000 deaths/year from nonerror, adverse effects of medications

    Unfortunately, there’s a deeply held view among both patients and professionals that interventions are always more harmful than helpful. I’m not anti-modern medicine, but I do question why, when there are so many risks, everyone wants to reach for a pill rather than change their lifestyle or pursue a less interventionist option.

  5. Morgan McFarland says:

    Michelle,

    Do you have a doula or a trusted, birth-positive friend who can provide support for you through your birth? I hope you are able to have a wonderful experience this time.

  6. Wow! I am honored that my article and story touched you in some way. It’s such a tragedy that women are made to feel that they are behaving ungratefully when they express sadness over their birth experience. I don’t understand why this doesn’t or shouldn’t matter.

    Feel free to post a link to the original article, if anyone wants to read it:

    http://midwiferyramblings.blogspot.com/2008/07/healthy-baby-isnt-all-that-matters.html

  7. Hillary says:

    While I respect the views of this article I truly think that a home birth is irresponsible and naive. The onus for a birth plan is on the parents and their ability to insist upon the birth they want with their doctor/midwife/facility etc. Many women choose cesareans – out of vanity and convenience. This is unacceptable – but the answer is NOT a home birth. For the safety of the mother and the child and the quick reaction to any unforseen circumstances, an appropriate birthing facility and personnel is crucial. I would like to see comments from someone condoning a home birth who has had a child with multiple, life threatening, prenatally undetected birth defects. Someone who had appropriate care during their pregnancy and yet was still surprised by the birth of a child who would not have survived without an immediately nearby nicu facility. There is a way to have balance – a healthy and happy birth plan AND a safe and prepared medical birth.

  8. Nicky says:

    Thank you. I can’t say much else other than that. Such a great essay.

  9. Morgan McFarland says:

    Hilary,

    I’m really not sure where you’re getting your information, but maternal choice cesareans are exceptionally rare. Perhaps you’re thinking of “elective” cesareans, which are often not cesareans by choice, but cesareans of circumstance. “Elective” cesareans are any non-emergent cesarean sections, including repeat cesareans that happen under duress or due to lack of VBAC-friendly providers or facilities.

    Are you really saying it’s as easy as “insisting on the birth you want?” How dare you! How dare you blame the tragic failings of our obstetrical system on mothers not fighting hard enough! How dare you blame the abuses at the hands of doctors and nurses (and, sadly, hospital-based miwives) on women not having a good enough birth plan! Women are lied to, manipulated, even forced, physically or legally, into procedures they do not want, and you’re blaming them for not insisting it be different? If they’d just “insist” on it, they wouldn’t have had the horrible experiences that so many women have shared?

    If you have legitimately made an effort to educate yourself on homebirth, have read the studies and remain unconvinced of its safety, even if you disagree with it because you won’t be bothered to educate yourself, that is your opinion. Whether or not it’s evidence-based, it’s your opinion and you are entitled to it. What I absolutely will not tolerate is someone saying that women are responsible for their own traumatic experiences for failing to exercise choices they did not truly have under circumstances when it is nearly impossible to fight a battle and win.

    Shame on you.

  10. Heather says:

    @ Hillary
    I’m sorry for whatever happened to you, but it is NOT a reason to claim that homebirth is irresponsible, or to imply that homebirthing parents are doing anything but what they are certain is best for their families. The simple facts are: 1. Homebirth for a low-risk pregnancy is as safe or SAFER than hospital birth. This has been the outcome of multiple studies now, and only ACOG & the AMA (who have a HUGE financial conflict of interest, of course) still are trying to officially deny this, and 2. such a situation as you describe, in which a midwife’s emergency equipment could not support the baby at least long enough to get the baby to hospital or the ambulance to the baby, as appropriate, is vanishingly rare.
    Very often, people who are unfamiliar with home birth are unaware that midwives do, indeed, carry such things as oxygen & infant resuscitation equipment. Also, merely having a baby in the hospital does NOT assure the availability of a fully-equipped NICU. My firstborn was born at 35 weeks because I was in a car accident. She needed intubation & spent a week in NICU. HOWEVER, at the hospital where she was born, there was no NICU–the nearest was 35 miles away. The hospital was able to support her till the ambulance team from the NICU (FAR more skilled & professional than the doctor at the birth hospital) arrived. However, they did not have the equipment, quite honestly, to do anything a midwife would not have been equipped to do in my home. It was the NICU ambulance team that did the intubation–the other hospital merely gave her oxygen, which midwives are equipped to do.
    My next baby was born safely at home, after a labor so short that, had I not been planning a homebirth, he probably would have come in the car, on a dangerous, curvy, mountain switchback road, on the way to the hospital.

  11. Swan says:

    Hillary,

    I had a home birth and my son didn’t have severe defects, but he was born with a serious condition that required for him to be immediately transported to the NICU, where he stayed for the next 9 days (he was in the hospital for a total of 21 days). I do not regret the home birth. In our case, a hospital would not have provided extra safety. My baby still would have had to wait the same amount of time to be transported to the nearest NICU. My health might have been compromised by various interventions. In fact, I probably would have had a C-section (due to a long labor), my son probably would have immediately been whisked away (when at home, I was able to hold him, look him in the eyes, and administer oxygen while we were being transported), and as a hospital “inmate” I wouldn’t have been able to immediately travel to the NICU in a nearby town. As traumatic as this time was, the memory of our gentle home birth is something I remember with fondness, and it’s something I will be able to tell my son about with pride.

    I am now pregnant again, and once more, I have done an immense amount of research on the safety of all types of birth. The more I read & discuss, the more I am convinced that our decision to birth at home again is the safest. This is not something most of us take lightly. The main reason I am hoping to birth at home is for health/safety: for me, my baby, and the rest of my family.

  12. Morgan McFarland says:

    Heather,

    Thank you for addressing the other aspects of Hilary’s comment so calmly and rationally. I was too busy spitting nails over the “insist on the birth you want” thing.

  13. Pip says:

    Hillary having experienced the Private hospital C/section, Public hospital VBAC and then two glorious home births, I can say Home birth was the answer for me, might I add a very well educated choice. Having been witness to some 60 odd other births in a variety of settings with women who are educated and informed and vastly more assertive than many of the women I meet I am still sure that barring medical necessity Home is the best place to have a baby. I would ask Hillary home many natural (completely uninterpreted) births you have seen in the system? How many Home births have you attended? Do you really have any substantial experience to base your words on. It may not be the answer for you but it sure was for me and I am a very asservite woman and yet birth is a place for being soft and open and I did not want to spend my birth guarding myself from harm, so given that the single greates impact on a womans birth experience is the beliefs of her care provider I choose to have care the wanted for me what I wanted and it was magic!

  14. Ahmie says:

    Hillary, births of babies such as you describe are less than .001% of babies. We should ALL subject ourselves to entering what can amount to feeling like a battlefield while in labor, to FIGHT to give birth the way nature intended, for something that is about as likely to be a problem NATURALLY (instead of caused by the interventions at the hospital, infections from the hospital environment, forced pushing in gravity-and-tailbone-unfriendly positions, etc) as we are likely to win the lottery on any given day? Seriously? That’s your logic?

    As for someone still condoning homebirth after having a child with such challenges, I suggest you go talk to some Dutch women. Not only do more than 30% of them STILL birth at home in the Netherlands, they also generally get MUCH less (if any) prenatal testing because they view it as “spoiling the pregnancy” – they are just happy to be pregnant and *expectant* and consider THAT a gift, regardless of the “product” (aka baby) produced at the end. Helps that they also have excellent governmental and societal support for children who have disabilities, and that they don’t jump to blame the location of birth for anything that would have existed regardless of where the birth happened as you’re so ready to do. I strongly recommend reading “A Pleasing Birth” by Medical Sociologist Raymond De Vries (preface and first chapter appear to be available online as a free excerpt here: http://www.temple.edu/tempress/chapters_1400/1735_ch1.pdf ). Also Barbara Katz Rothman, another sociologist, has extensively studied how birth is done in the Netherlands as well as the United States and other countries and could provide some enlightening reading for you.

    Funny enough, the demographic most likely to homebirth is white, highly educated (at least a bachelor’s degree, though a master’s or more is more common), and financially pretty secure (upper-middle class). Not the demographic one usually thinks of when throwing about labels like “irresponsible and naive”.

  15. Shelli says:

    Thanks so much for this, Morgan. I’ve been trying to put this into words for years now, and as usual, you have a way with them and succeed. I’ve passed the link on to my doula clients so they can verbalize it too.

  16. Chrissy says:

    Wonderfully written….. Thank you for covering a topic that not many choose to tackle.

  17. The average U.S. hospital maternity ward is a much more dangerous place to give birth than the shoulder of a six-lane L.A. freeway.

  18. Jenn says:

    The majority of women in my area cannot VBAC or birth naturally in a hospital, period. We don’t have a climate of natural friendly providers. I can assure you, Hillary, it’s not because we haven’t tried hard enough. We’ve had women thrown out of their OB practices a mere 2 or 3 weeks before delivery for trying to exercise their right of “choice” and refusing to schedule a repeat cesarean. Women have been lied to about their health or their infants health in order to get them to sign that consent form so their OB can finally end their shift and go home. Women who choose to fight harder and harder for what they think is right are eventually forced into repeat cesareans by court orders and local law enforcement. Women are left with homebirth as the only REAL choice they have available to them when it comes to an alternative to being sliced open with little to no medical indication whatsoever. The only irresponsibility I see here is on behalf of the broken and abusive medical establishment that forces us to choose between their rigid system, or birthing at home. How dare you tell us we’re not trying hard enough to fight for what we NEED, and then judge us for making the only choice we actually have available to us.

  19. Lex says:

    A minor point, but I take issue with the premise that “When a child is born, a new mother is made.” Once I had my first child, I was a mother. Women with more children aren’t “more motherly” or whatever. While I grant it is a side note to the larger, much more critical matters here, it is not trivial. Just as “a healthy baby is all that matters” is a fallacy that serves to trivialize families’ birth experiences, there is a very real tendency to trivialize second and later births. Yes, every baby is special, but it seems that the mother and father are pressured even more for later births to except being “treated like an insignificant baby-bearing vessel.” The indulgence some may grant for first time parents is worn very thin from there on out.

    No, not every birth creates a new mother. And creating a mother is not what matters here. This isn’t necessarily a once in a lifetime event, and I fear any implication of it as such plays into the notion that these legitimate medical concerns are indeed frivolous sentimental issues.

  20. Morgan McFarland says:

    Lex,

    I can only write from my experiences and the experiences that others choose to share with me, but I do think every birth make a new mother. Perhaps your subsequent births didn’t change you to a great extent, but mine did. Each of my three births did create a new mother — my new experiences, my new child, worked together to alter the woman I was before that child was born. Each birth gave me a different understanding of my self and the births of my second and third child both gave me a deeper appreciation for my relationship with the children who came before them.

    In fact, I think you’ll find that most women who give birth at home do so with their second or later babies, so I’m surprised you think that I (or other homebirth advocates) are discounting the importance of subsequent births. Later births are often a remarkable opportunity to heal and grow after the negative experiences from prior births. Each birth is significant, each is important, and I don’t believe I’ve minimized the value and weight of those here or elsewhere.

    Please know I am not saying second, third, or later births are less important or that their outcomes matter less. I’m actually saying the opposite of that. Every birth experience matters and none of them should be discounted.

  21. Erin says:

    Great blog entry! And let me tell you, it doesn’t stop with birth. I can formula feed instead of breastfeed because we were all breastfed and we are “fine” (meaning alive). I can give cereal in a bottle at 2 months because most of us had the same as babies and we are “fine”. It goes on and on…but I look around this country and see astronomical rates of asthma, obesity, and disease. Everything does not look “fine” to me. Sometimes I feel like I’m the only one who is aiming higher than “not dead” when it comes to raising my child. And those same people who told me I was endangering my child’s life by birthing him at home are the ones that have no problem giving their 2 month olds’s reese’s peanut butter cups. Where is the oh so important concern for infant safety there? Oy!

  22. Nirvana "Harley" says:

    Being a woman who did “insist” during the labour of my first baby, I can tell you firsthand, it was HELL!! I had a long labour and I had to fight the entire time for them to leave me and baby alone. I had to fight to avoid needless interventions to the point I was actually arguing with a nurse DURING LABOUR! I cried and screamed and had major bonding issues because of the “insisting” for over a year. I had horrible dreams for over a year as well.

    During the pushing phase, non of my expectations were respected and that isn’t a time to “insist”. A woman simply can’t fight during then.

    My point, they were trying to force me to do things that I did not want to do that were not safe. I was violated! I did not see that coming. I figured if I just said no that wouldn’t be an issue. But I had to FIGHT! during the labour and I thought my hospital based midwife woul be more supportive. I was wrong.

    It enrages me to think that women have to go through this. I will never birth at a hospital again unless absolutely medically neccessary. To this day, 6 years later, my first and I have healed a lot but to send a baby and mother into a battlefiend, not worth the “insisting”. Avoid the whole fight to begin with and get the birth that I want.

    Women HAVE BEEN INSISTING on getting the birth they want but the medical field isn’t listening. So, Hilary, why walk into a mine field again and risk a life? Not worth it my opinion.

    And before you post an opinion like that, I advise you to have your ducks in a row research wise because obviously you haven’t done it.

    Nirana “Harley”
    A Mamas Nirvana Birth Services
    “A woman meets herself in childbirth.” Callaigh

  23. Nirvana "Harley" says:

    And the birth of my other babies, NOT in hospitals, and even my 2nd trimester miscarriage, helped me heal from the first. It showed me just how bad the bond with my first was damaged and how I was violated. However, it helped me heal the bond as much as I could with my first. The birth and first hours just after helps set the precedence for the relationship. There have been studies showing this. It isn’t just the physical part after for a birth, it is the psychological as well that happens that is so important.

    Nirvana “Harley”
    A Mamas Nirvana Birth Services
    “A woman meets herself in childbirth.” Callaigh

  24. Erin Warren Murdock says:

    It goes both ways. My first birth experience was vaginal, induced because of severe pre-eclampsia. He got stuck (he was diagonal in the birth canal from the position that is the ‘right’ one.) I was given an episitomy but tore as he was delivered. It was traumatic even after because the chaos of the delivery allowed a contaminated blood sample to be taken, after two days I had to leave the hospital but he remained for two more. He was poked so much that the nurse said she couldn’t find a clear spot to stick him. It felt horrible later and still remains with me. (three women pushing on my belly, the doctor tugging on him to get him out, my mother leaving the room distressed, me screaming despite four shots in the catheter because I could feel him against my bones) I had two planned Cesarean’s after and the birth experience was a thousand times better. I know it’s not for me..but I certainly do not feel a failure for having them. I didn’t get to hold my son for 24 hours after he was born, both my girls I got to hold, and breastfeed, within 30 minutes of birth. Home birth wasn’t an option for me for any of these, which was too bad, a water birth would have been my choice if I could have had one. However, the Cesarean saved my sanity with the second and third experiences.

  25. Nicole says:

    Let me share some New Zealand insight..

    A midwife is highly trained to identify factors which may impact on the wellbeing or the mother and baby, and the progression and the outcome of the birth. Of course there are exceptions to this but this is rare. If the labour is not progressing as it should then this is of significance and the woman may require transfer. Furthermore there are many ways of determining potential difficulties with labour/birth antenatally. The midwife is educated to identify these factors and advise against homebirth if medically indicated, or transfer early if required.

    I am honoured to have attended a number of home births as well as many complicated hospital births.

    My conclusion..

    Natural birth.. Safe birth.. Homebirth x

  26. Jenn says:

    Lovely Nicole!

  27. mamapoekie says:

    Wonderful article, I’ll be sharing it on my bloghop on sunday.
    Imagine if we transposed ‘safe outcome is all that matters’ to other situations: “oh, you were raped, well it’s not all that bad, you are alive, aren’t you”
    If all there was to life is wether or not you are alive, what a sad existance this wold be indeed.

  28. forex robot says:

    What a great resource!

  29. Paul says:

    Lex,

    I can only write from my experiences and the experiences that others choose to share with me, but I do think every birth make a new mother. Perhaps your subsequent births didn’t change you to a great extent, but mine did. Each of my three births did create a new mother — my new experiences, my new child, worked together to alter the woman I was before that child was born. Each birth gave me a different understanding of my self and the births of my second and third child both gave me a deeper appreciation for my relationship with the children who came before them.

    In fact, I think you’ll find that most women who give birth at home do so with their second or later babies, so I’m surprised you think that I (or other homebirth advocates) are discounting the importance of subsequent births. Later births are often a remarkable opportunity to heal and grow after the negative experiences from prior births. Each birth is significant, each is important, and I don’t believe I’ve minimized the value and weight of those here or elsewhere.

    Please know I am not saying second, third, or later births are less important or that their outcomes matter less. I’m actually saying the opposite of that. Every birth experience matters and none of them should be discounted.

  30. Karen says:

    Wonderful article, I’ll be sharing it on my bloghop on sunday.
    Imagine if we transposed ‘safe outcome is all that matters’ to other situations: “oh, you were raped, well it’s not all that bad, you are alive, aren’t you”
    If all there was to life is wether or not you are alive, what a sad existance this wold be indeed.

  31. Nick says:

    Being a woman who did “insist” during the labour of my first baby, I can tell you firsthand, it was HELL!! I had a long labour and I had to fight the entire time for them to leave me and baby alone. I had to fight to avoid needless interventions to the point I was actually arguing with a nurse DURING LABOUR! I cried and screamed and had major bonding issues because of the “insisting” for over a year. I had horrible dreams for over a year as well.

    During the pushing phase, non of my expectations were respected and that isn’t a time to “insist”. A woman simply can’t fight during then.

    My point, they were trying to force me to do things that I did not want to do that were not safe. I was violated! I did not see that coming. I figured if I just said no that wouldn’t be an issue. But I had to FIGHT! during the labour and I thought my hospital based midwife woul be more supportive. I was wrong.

    It enrages me to think that women have to go through this. I will never birth at a hospital again unless absolutely medically neccessary. To this day, 6 years later, my first and I have healed a lot but to send a baby and mother into a battlefiend, not worth the “insisting”. Avoid the whole fight to begin with and get the birth that I want.

    Women HAVE BEEN INSISTING on getting the birth they want but the medical field isn’t listening. So, Hilary, why walk into a mine field again and risk a life? Not worth it my opinion.

    And before you post an opinion like that, I advise you to have your ducks in a row research wise because obviously you haven’t done it.

    Nirana “Harley”
    A Mamas Nirvana Birth Services
    “A woman meets herself in childbirth.” Callaigh

  32. Joseph says:

    Wonderful article, I’ll be sharing it on my bloghop on sunday.
    Imagine if we transposed ‘safe outcome is all that matters’ to other situations: “oh, you were raped, well it’s not all that bad, you are alive, aren’t you”
    If all there was to life is wether or not you are alive, what a sad existance this wold be indeed.

  33. Matt says:

    Lovely Nicole!

  34. Ian says:

    Let me share some New Zealand insight..

    A midwife is highly trained to identify factors which may impact on the wellbeing or the mother and baby, and the progression and the outcome of the birth. Of course there are exceptions to this but this is rare. If the labour is not progressing as it should then this is of significance and the woman may require transfer. Furthermore there are many ways of determining potential difficulties with labour/birth antenatally. The midwife is educated to identify these factors and advise against homebirth if medically indicated, or transfer early if required.

    I am honoured to have attended a number of home births as well as many complicated hospital births.

    My conclusion..

    Natural birth.. Safe birth.. Homebirth x

  35. Sheva says:

    Excellent article, may I share it with my midwifery study group?
    I think the word you’re looking for is ‘morbidity’. They use that to describe any outcome that is bad, but not dead.
    So infections, hemorrhage, breathing problems, etc, would all be included.
    So, while the mortality rate is the same or similar for hospital and home births for low-risk women, the morbidity rate is vastly different, with the hospital scoring way worse.
    And Hillary, I wrote an extensive birth plan and fought for what I wanted in the hospital, and it simply got me branded as ‘unfit to make her own decisions’ and they let my husband (who didn’t read one book) make them. I resent the implication that the abuse I endured was my fault. It was the fault the doctors and nurses who didn’t have the decency to tell me the truth about the effects of certain interventions, or the patience to tell me what was happening, to ask my permission before doing an intervention, and to wait for a natural process to unfold.
    Shame on you for your nasty attitude to women. I hope you’re not a doctor or midwife.

  36. Entzückend from Budget impact, there are other reasons as well. prices had gone up as the recent increase rein the eintrag costs had to beryllium passed on to the buyer. But I think, the current price could beryllium stabilised for some time, Mr Srinivasa Longchamp taschenRao, Chief Finance Officer, Rain Commodities Ltd, told Business Line. Longchamp taschen http://www.apsi.com.mx/longchamptaschen.php


Trackbacks/Pingbacks

  1. Home Birth: “Brave” Has Nothing To Do With It | Bring Birth Home - April 1, 2010

    [...] Read Morgan’s follow up article, “Birth Safety as a Binary Condition.” [...]

  2. uberVU - social comments - April 1, 2010

    Social comments and analytics for this post…

    This post was mentioned on Twitter by BringBirthHome: Guest blogger Morgan’s article just posted on BBH: http://bringbirthhome.com/birth-experience/birth-safety-as-a-binary-condition/

  3. Tweets that mention Birth Safety as a Binary Condition | Bring Birth Home -- Topsy.com - April 1, 2010

    [...] This post was mentioned on Twitter by noelove and soozenw, Bring Birth Home. Bring Birth Home said: And her follow-up article is just as good. http://bringbirthhome.com/birth-experience/birth-safety-as-a-binary-condition/ [...]

  4. Glorious Guide To Homebirth. | 7Wins.eu - April 16, 2010

    [...] Birth Safety as a Binary Condition | Bring Birth Home [...]

Share your view

Post a comment

Categories

Post Archives