Deanne,
>The discussion is getting pretty interesting but I am not convinced after 35
>years working in a hospital and married to an obstetrician that hospitals
>are really bad places for mothers to give birth, or babies to start life.
There are pros and cons. It is *not* the right place to give birth if
the mother doesn't want to be there, that's the point. We are not so
different from the animals, and if an animal is frightened and insecure,
they cannot labour effectively. I spent the 27 hours of my first labour
having a panic attack because I am *terrified* of being a patient in a
hospital. I hated every single second of it and it was torture for me.
In total, I was there 3 days, and I was utterly miserable.
Where I live, the *planned* homebirth rate is 14%, but we have huge
numbers of women having unplanned homebirths, basically because they
don't want to go to hospital, they've been talked out of it and then in
labour, they wait too long before heading off. My own sister made it to
the hospital with only 15 minutes to spare.
There are risks to hospital birth too, including the very real and
scarey risk of hospital acquired infections.
>
>Not all doctors and nurses are unfeeling professionals who are incapable of
>functioning as 'doulas'.
Is that the point? Surely the real point is that many women actually
labour more easily in familiar surroundings where they feel in control?
It doesn't matter how friendly they are - they are a friendly *stranger*
and the place is alien to the woman. For my homebirths, I had two
wonderfully professional, NHS midwives from the local hospital, in whom
I had complete confidence. Homebirth is not the same as unassisted birth
- most women have extremely professional and skilled birth attendants.
>Last week I helped a mother gently put her baby to breast for the first and
>last time, as we shared a box of Kleenex. The baby had a problem
>incompatible with life and died peacefully in her mother's arms, at her
>breast, surrounded by those family members invited to come. Would it have
>been better at home?
I don't know that case, but I do know a woman who planned to have her
baby with serious problems at home. She said she could not contemplate
him dying in a hospital, but needed to have him at home, surrounded by
her family. I don't think hospital is the best place for anyone to die -
ask any terminally ill patient.
>However, to use epidurals as an example, I can tell you that all the
>education in the world about the problems associated with epidurals, and
>knowing all the other non-intervention, non-pharmaceutical tools for
>dealing with a normal labor, does not convince the majority of mothers
>experiencing pain not to have the epidural.
I don't think the majority of women want epidurals, not in their heart
of hearts. When asked, I believe most say they would like a natural
birth. But it's hard to cope with labour in an alien place surrounded by
strangers. If women are requesting an epidural in labour, having
previously expressed reservations, I think something else is going on.
Maybe it's the culture? A common reason I hear for women wanting
homebirths is because they are afraid they will "crack" and ask for an
epidural if one is available. And I honestly don't think most women are
informed of the true risks of epidural - when I discuss such things on
the Net or IRL, women usually react horrified that they didn't know
these things. Just MHO.
>Nobody (at least
>in our hospital) stands around with the epidural kit in their hands
>pleading with the mom to have one.
Your hospital is rather different to many, then. Many women have related
to me how hospital staff have been disparaging of their stated wish to
avoid drugs, have pushed drugs on them or even bullied them into
accepting them. I was persuaded, against my better judgement to accept
Pethidine in my first labour and my sister was persuaded to have an
epidural in hers. It has been my observation that often HCPs don't know
how to deal with a woman in pain, and want to be seen to "rescue" her
from it. I also notice a great lack of psychological care of women in
labour. This is in the UK, ofcourse.
> This decision is still up to the couple,
>and those who are advocates of home birth are just as negative about this
>choice as the medical personnel tend to be about the decision to have a home
>birth.
That sounds a little like the "breastfeeding nazis" type argument to me.
Advocates of homebirth might be antagonistic to the idea of epidurals
because there are a host of problems associated with it; there are no
side-effects that I am aware of from *not* having pain relief in labour.
And btw, I don't know a single homebirth advocate in UK who would try
and actively persuade a woman into homebirth who wasn't already
expressing an interest in it - anymore than HCPs really try and "bully"
women into breastfeeding.
>My complaint is when a mother has chosen to breastfeed and either she,
>herself, or the nurses, or her doctor, or a family member sabotage that
>decision with poor advice and information.
Likewise, women get persuaded/tricked into having hospital births, when
they know it isn't the right decision for them.
--
Anna H. (Mummy to Emma, 17-1-95, Alice, 11-9-96, Samuel, 25-4-98)
"You might say that, but I couldn't possibly comment"
mailto: [log in to unmask]
http://www.ratbag.demon.co.uk/anna/
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