Australian 'home birth advocate' dies while delivering her second child at home

[Tx4obama]

Home Births on the Rise: But Are They Safe?

According to a recent study by the Centers for Disease Control (CDC), home births are on the rise, but the tragic January 23, 2012, death of an Australian home birth advocate highlights a debate over safety. Caroline Lovell, a professional photographer who reportedly petitioned the Australian government to provide funding and legal protection for home births, suffered cardiac arrest while delivering her second child at home. She died the next day after being rushed to a hospital. A Yahoo! 7 News reports a private midwife was in attendance.

Between 2004 and 2009, the percentage of American women giving birth at home increased by nearly 30 percent. That number is highest amongst white, non-Hispanic women. For that group, about 1 out of 90 births occur at home.

SNIP

http://shine.yahoo.com/parenting/home-births-rise-safe-205400504.html

[mrbscott19]

1. It's safe enough.

we're here, aren't we?

[Tx4obama]

2. Well, I was born in a hospital :) n/t

[fasttense]

3. My son would have died if I had given birth at home.

He was very severly breeched and could never had survived without a doctor's intervention.

With my 2nd child, I had placenta previa and lost a lot of blood before her birth.

But some women seem able to give birth without any problems and those women are good candidates for home birth.

[pipi_k]

14. Trouble

with all of mine...

Puerperal fever after baby #1

Neonatal jaundice in baby #2

Placenta Previa (and placental infection) with #3, accompanied by a whole lot of bleeding...

[laundry_queen]

20. Both of your cases

would have been noticed by a qualified midwife and she'd have never let you be at home. Homebirth does not mean no care. Midwives are trained professionals and they generally transfer anyone with any complications to hospital care. Your particular complications would have been noticed well before any kind of labour and you'd have been transferred to a doctor's care.

[Chemisse]

4. A cardiac arrest?

That is not directly home-birth related. She could just as easily had that heart attack while out jogging two months later, with the same end result.

[Nay]

5. My first thought as well. Home birth and heart attack prob unrelated, but admittedly, if she had

been in the hospital for the birth and had the heart attack there, she would have been much closer to medical help and might well have been saved. But it would have been by lucky accident.

[d_r]

11. well, actually,

pregnancy puts a lot of demand on a woman's heart because of the increased blood circulation. Sometimes woman develop cardiac issues during pregnancy and during birth, that is directly related to the pregnancy and birth. It's impossible for us to know in this particular case, of course, but it absolutely does happen. There is a condition called peripartum cardiomyopathy, which occurs during the last month of pregnancy or after birth, that results in heart failure - we don't know if that is what happened here, but certainly it is possible, if not likely. If she was in the hospital she would have had access to emergency care. Early diagnosis and treatment might have saved her life, but we can never know.

[Chill Keney]

12. Yes

A women's heart has to increase blood-pumping by 30% during pregnancy. If she has a preexisting cardiac problem, eben if it's only a heart murmur, she's in danger.

[laundry_queen]

21. I agree about how pregnancy puts a lot of pressure

on the heart. However, I think people have an idealized view of a hospital birth, that help is just a step away. With my first, when it was decided I needed a c-section, it took an hour to gather all of the staff and ready the OR. Midwives are generally very well trained in rescussitation (sp?) just like doctors are and they also know how to look for complications. I read a portion of a book not too long ago about a woman who died a day or so after giving birth. She was still in the hospital. Dropped dead at the side of her bed from a blood clot in her lungs. She stood up, then collapsed. All the doctors in the hospital couldn't save her. Unfortunately women still die due to pregnancy and birth complications and the setting you are in won't always save you. Hospitals cause a lot of complications as well. It's really a crapshoot, and midwives and OB's are BOTH trained to reduce complications as much as they possibly can, they often just have different ways of going about it.

[d_r]

27. yes, no one here gets out alive

lots of people die in hospitals every day, its all a crap shoot.

[Zalatix]

33. Indeed, quite true.

Whether you're giving birth in a home or a hospital, you need the right tools, a clean environment, and the right expertise.

I would want my kid born with the help of experienced and capable hands, whether it be in a hospital or at home.

[barbtries]

32. that's what i was thinking.

she also may have suffered cardiac arrest and died in the hospital. we don't know.

[MADem]

6. A lot of the hospitals nowadays have very "home like" settings.

Lots of privacy, comfort, soft furnishings, television, the ability to have nosy family about (or get rid of them). It's not a cold, unfeeling, medical environment in some of these places.

People are going to do what they want to do and they're going to make their own choices on this topic.

If someone asked me to make the choice of home or hospital for them, I'd go for hospital--simply because there's a lot more emergency equipment at the ready, just in case.

I'd hate to see a mother or child die of something preventable because the help was too far away.

[xmas74]

7. I've always thought there should be more

birthing centers. Most are very homey yet have all the emergency equipment needed for life-sustaining measures until the patient can be transported to the nearest hospital. And they usually have nurses, nurse midwives, and even an OB or two working at the center.

I went to one once and thought it was wonderful. It was just too far from my home for it to be practical for my personal use.

[MADem]

8. THAT's what they call those units! Birthing centers!

It was in the back of my head, there. Some of them are in hospitals, in a wing off to the side, sometimes.

Hell, a lot of them are way nicer than home--with more conveniences AND maid service!

I agree, it would be nice to have more of them available.

Completely unrelated, I also would like to see more "urgent care" clinics available, even ones that are co-located on hospital grounds, to cut down on the amount of ER visits.

I hope we start getting smarter about medical care in this country. There's just way too much waste and inefficiency.

[xmas74]

30. Some are in hospitals

but quite a few are separate stand-alone buildings that are very cozy and home-like. More people are allowed in, compared to hospitals, more attention is paid to the woman and family, etc. If I had money to invest I'd gladly invest in one-I think they're a great idea.

We have an acute care center in my town and I use it for my regular doctor. The doctor is younger and still trying to set up a practice so he takes acute care cases, along with his practice of regulars. I really like it-the hours are later and it's easy to get an appointment, especially after work.

[Maine-ah]

9. "She died the next day after being rushed to a hospital"

um, I guess she didn't die at home while giving birth.

[Chemisse]

36. Good catch!

I didn't notice that detail. That suggests to me that where she was located when the heart attack happened didn't have much or any impact on her death.

[antigone382]

10. One data point doesn't make a statistic.

Statistically, for healthy women, home births are no more dangerous than hospital births, and are much less likely to result in surgical procedures such as C-sections or episiotomies. This does not mean that a home birth is appropriate for every woman. Those with major health issues such as diabetes, who are older, who have experienced major complications in previous births are definitely better off going to the hospital, and no responsible home birth advocate would say otherwise. Furthermore, a home birth is not something that should be engaged in lightly, and it is critical to ensure adequate preparation and sanitation of the place where the home birth will occur.

However, at this point, hospitals are still frequently providing an inadequate environment for normal, healthy deliveries. C-section rates are approaching 40%, and the complicating effects of common hospital practices, such as refusing to let women eat during labor, making them lie on their backs in a way that constricts blood flow to the pelvis, and administering inducement drugs that cause severe contractions right away, rather than allowing them to gradually build as would normally occur, all create an environment where labor is more stressful, and the need for invasive and expensive surgeries is more likely.

However, this is an admittedly tragic situation. I am very sad to hear that Ms. Lovell lost her life, and hope that if anything could have been done to prevent her death, we can learn from it to better protect the health of future new mothers.

[mrs_p]

13. How sad for her and her family

[HopeHoops]

15. All three of my daughters were born at home, in the same room, and with the same midwife.

It's a wonderful experience. Everything was cleaned up and my wife and newborn were in bed sleeping within an hour. If there's a known risk, that's a problem, but otherwise you take your chances whether you're at home or in a hospital. My wife was anemic so I had to build up her iron (almost exclusively through diet) to get her back into a safe range each time. The midwife insisted on it.

We were also fortunate to have a pediatrician who did home visits. She came over on the second or third day after each was born and did a full evaluation. Midwifery is under attack, but it is an ancient profession and an excellent service.

As for the question, yes they are safe. Infant and/or mother deaths happen at home and in hospitals. If there are no advanced warning signs, neither location offers an advantage. If there ARE advanced warning signs, any respectable midwife will send you to the hospital for the birth. With my eldest, the midwife recommended a transfer because of the pre-labor time (three days). She finally suggested a ride down "Purgatory Road" - no shit, that's what the road was called. I had a 1980 Dodge Aspen with leaf springs and vinyl seats. Purgatory Road fit its name - potholes everywhere. I hit every one at about 50mph and when we got home she was in full labor. They used to do that with horse and buggy. It worked.

[barbtries]

35. lol

i remember doing situps when i was 12 days past due with my oldest son. i'd already passed the mucous plug days before but labor just wouldn't start. three days later finally i started having contractions, but still had to be induced. the pattern of ineffective labor continued with the next 3 children and i was induced each time. but at least i was able to give birth vaginally.

[HopeHoops]

39. That's good news! We also had a very effective way of announcing the sex of the child.

I bought a bright pink towel and a bright blue towel. The pink one got hung out of a front window three times. That saved us from a LOT of phone calls. Oh, and my wife gave birth to and nursed the first two (at meetings) while serving on the school board.


On Edit: She didn't give birth at the meetings. That would be really awkward.

[TwilightGardener]

16. Well, that's sad. But I don't think anyone would expect a healthy

woman in an uncomplicated pregnancy (assuming that was the case here) and labor to suddenly go into cardiac arrest. I think this case says little about the safety of home births--sounds like a fluke.

[Zalatix]

34. You can catch staph and a few other nasties in the hospital, too.

And the antibiotics-resistant version could kill you and the baby.

[Nye Bevan]

17. Giving birth at home will probably have a good outcome.

And if you drive from New York to Florida on I-95 without wearing a seat belt, you will probably be fine.

But that does not mean that either is a good idea.

[laundry_queen]

23. Statistically

You have less of a chance of dying giving birth at home than in the hospital. Plenty of studies support this. I support freedom of choice for women in this regard.

[Nye Bevan]

26. The American Medical Association and the American College of Obstetricians and Gynecologists oppose

home birth on the basis that a seemingly uncomplicated birth can still potentially become a medical emergency without warning.

http://en.wikipedia.org/wiki/Home_birth

[laundry_queen]

29. Of course they do.

Even though statistics prove it is safe, when high risk women are screened out. They are trained to see nothing but complications in birth and often cause a good many. A 40% c-section rate is only one indication. There is no 'choice' for women when it comes to giving birth, even if statistics show that homebirth is safe. These OB's are trained to see every birth as a medical emergency, often to the detriment of the woman and her baby. Do I need to point out the number of women that die due to medical negligence, hospital infections and medical errors? Those women may have lived had they stayed at home....

A seemingly uncomplicated birth that becomes an emergency happens in the hospital too, and as I said in another post in the thread - help isn't always right there in the hospital either. Midwives also generally don't take chances, they are better at recognizing complications early on and transferring. Look, a co-worker of mine nearly died giving birth in the hospital. Had she been at home, with the same unanticipated complication, the midwife would have transferred and the result likely would have been the same. By the time they (the nurses) figured out my co-worker was bleeding a bit too much after an uneventful birth and that after a long time the placenta wasn't coming out, they panicked. There was not enough available blood at the hospital (it was a smaller hospital), so they had to call live donors in from their lists. My co-worker was in and out of consciousness, and was literally left alone in a room (I was there having just given birth to MY first, and saw her), covered in heating blankets while they awaited an airlift. A midwife would've probably not waited so long for the placenta and probably would have been paying close attention to the amount of blood lost. She'd have called ahead, "I'm transfering my client, she is bleeding and placenta won't come out, ready your blood services." And the result would have been the same. As it was, my co-worker had to get flown out to a larger center - a process that took 6 hours. She ended up with a full hysterectomy because of placenta accreta. She required 12 units of blood total.

An aside - when I had my 4th by c-section (planned, because I had previous c/sections) I wavered in and out of consciousness for the whole day. The nurses just looked at my BP and said, "well, it looks okay" even though it was pretty low for me, and I asked if I was losing too much blood or something. "I dont' know" was the answer "we usually can't tell because the liners get thrown out". So many doctors in a hospital setting are extremely cavalier because they rely on donated blood if a woman starts bleeding extensively. With a homebirth, generally midwives keep a very close eye on blood loss and transfer at the first indication of too much blood. They also have medications to stop or slow the bleeding. And I don't have time to go to your wiki link, but I've researched this EXTENSIVELY - and at one point after a discussion about a particular study my doctor threw up his hands and said he gave up, I knew as much as he did. He let me have complete control of my births because he was no match for me, LOL. I don't think there will be anything at that link I don't already know.

[antigone382]

25. Except that the statistics are much different for these two choices.

Statistically, there is a different outcome for those who do or do not wear seat belts in the case of a car accident.

Statistically, there is no difference in delivery complications or fatalities among healthy women, between those who deliver at home with a trained midwife, and those who deliver in a hospital.

[Snake Alchemist]

18. I prefer the Beyonce method. nt

[laundry_queen]

22. Empathy much? How disgusting. nt

[antigone382]

24. Statistically inaccurate assertion.

Childbirth is risky and women sometimes die from it. This is a tragic truth at equivalent rates in a hospital setting and in a properly set up home birth setting. The only major statistical difference is that home births are much less likely to result in C-sections or episiotomies.

An informed and physically healthy woman with a trained midwife in attendance is at no greater risk at home than she is in a hospital.

[renate]

28. I gave birth in the hospital with my midwife there

She's based in the hospital, so for me it was a perfect combination of top-notch medical care nearby but my own birth plan, etc. I'd seen her all along in the clinic for my prenatal care, too. I wonder how common it is for hospitals to have midwives on staff; I'd think the combination would appeal to a lot of people.

[xmas74]

31. I had a nurse-midwife.

When it was decided that I needed to have a c-section an OB from her practice came to the hospital in the middle of the night and did it.

I requested the midwife and would again, if ever needed. (There are no plans to ever need one again.)

[ecstatic]

37. There seems to be increasing pressure for women to give birth naturally

I think it's ridiculous, but good luck to those who try it.

[JNelson6563]

38. 7 out of 8 kids in my dad's family born at home.

My dad's family were poor Irish immigrants. There were 8 kids, my dad was in the middle somewhere. He told me that as little boy he thought babies came from the doctor's bag. Every time the doctor came to the house with his bag, when he left there was a new baby.

The last child was born in hospital, maybe they had more money by then, I don't know.

Julie