Comments on: Tragedies Highlight Risks of Homebirth http://www.amotherinisrael.com/home-birth-hesitations/ A community surrounding parenting, Judaism, and Israeli living. Wed, 16 May 2012 19:32:25 +0000 hourly 1 http://wordpress.org/?v=3.3.2 By: Healthcare News Roundup | Shira Pransky Project http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22977 Healthcare News Roundup | Shira Pransky Project Wed, 15 Feb 2012 11:51:39 +0000 http://www.amotherinisrael.com/?p=7366#comment-22977 [...] @mominisrael Risks of Homebirth ow.ly/1haEey [...] [...] @mominisrael Risks of Homebirth ow.ly/1haEey [...]

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]]> By: Nurse Yachne http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22922 Nurse Yachne Thu, 09 Feb 2012 17:24:37 +0000 http://www.amotherinisrael.com/?p=7366#comment-22922 "However, in over-riding the first two, the stage is all too often set for DECREASING the the third, not the reverse." If that's what you think, I would venture to say that you haven't been in many medical emergency situations. “However, in over-riding the first two, the stage is all too often set for DECREASING the the third, not the reverse.”

If that’s what you think, I would venture to say that you haven’t been in many medical emergency situations.

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]]> By: keren http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22921 keren Thu, 09 Feb 2012 14:14:48 +0000 http://www.amotherinisrael.com/?p=7366#comment-22921 and this was all in hospital and this was all in hospital

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]]> By: Observer http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22915 Observer Thu, 09 Feb 2012 03:10:26 +0000 http://www.amotherinisrael.com/?p=7366#comment-22915 You say "Dignity and phyiscal integrity are good things, but they are secondary to physical safety. Hospital birth (and hospitals in general) frequently override the first two in single-minded pursuit of the third." However, in over-riding the first two, the stage is all too often set for DECREASING the the third, not the reverse. You say “Dignity and phyiscal integrity are good things, but they are secondary to physical safety. Hospital birth (and hospitals in general) frequently override the first two in single-minded pursuit of the third.”

However, in over-riding the first two, the stage is all too often set for DECREASING the the third, not the reverse.

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]]> By: Nurse Yachne http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22910 Nurse Yachne Wed, 08 Feb 2012 08:14:54 +0000 http://www.amotherinisrael.com/?p=7366#comment-22910 Dignity and phyiscal integrity are good things, but they are secondary to physical safety. Hospital birth (and hospitals in general) frequently override the first two in single-minded pursuit of the third. To work in a clinical setting for any period of time is to realize that, yes, the unexpected "horror story" WILL occur given a large enough statistical sample. It is NOT, however, caused by reading about it or by being "morbid". Dignity and phyiscal integrity are good things, but they are secondary to physical safety. Hospital birth (and hospitals in general) frequently override the first two in single-minded pursuit of the third.

To work in a clinical setting for any period of time is to realize that, yes, the unexpected “horror story” WILL occur given a large enough statistical sample. It is NOT, however, caused by reading about it or by being “morbid”.

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]]> By: Ms. Krieger http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22909 Ms. Krieger Wed, 08 Feb 2012 01:20:19 +0000 http://www.amotherinisrael.com/?p=7366#comment-22909 @NurseYachne Home birth is not about convenience. It is about the safety, dignity, and physical integrity of women and their children. I am glad that some hospitals in Israel allow women to keep their dignity and physical integrity, and keep them safe. That is not the case everywhere. And even if it were, women still have the right to give birth where, how, and with the attendants they see fit to have with them. I agree that birth is risky, and that death is always a possibility. This is true whether you are in a hospital or in your own bed. @NurseYachne

Home birth is not about convenience. It is about the safety, dignity, and physical integrity of women and their children. I am glad that some hospitals in Israel allow women to keep their dignity and physical integrity, and keep them safe. That is not the case everywhere. And even if it were, women still have the right to give birth where, how, and with the attendants they see fit to have with them. I agree that birth is risky, and that death is always a possibility. This is true whether you are in a hospital or in your own bed.

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]]> By: Ms. Krieger http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22908 Ms. Krieger Wed, 08 Feb 2012 01:11:38 +0000 http://www.amotherinisrael.com/?p=7366#comment-22908 @amotherinisrael, regarding "putting incompetent midwives out of business" Much of the problem in the US is political. Quite a few states in the US refuse to license midwives to practice medicine. If they don't license them, they can't regulate them, except to put them in jail if they are caught practicing medicine without a license. Other states (for example, Virginia) will put onerous restrictions on midwives who are licensed. Not allowing them to carry potentially life-saving drugs such as oxygen or pitocin, for example. So if a midwife in Virginia agrees to be licensed, she is then morally obligated to obey restrictions under the license that could put her clients' health at risk. So many midwives refuse to be licensed in Virginia and practice outside the law. So being licensed is no guarantee of quality, as they say. It's a bad situation here. (Note that midwives are trained and certified by their own organizations, just as OBGYNs are trained and certified by their own organizations. States then license doctors and midwives with credentials the state decides to accept. I don't know how this process works in Israel, or Australia.) If all states in the US licensed midwives with appropriate credentials, it would be easier to regulate their practice, the way doctors are regulated. @amotherinisrael, regarding “putting incompetent midwives out of business”

Much of the problem in the US is political. Quite a few states in the US refuse to license midwives to practice medicine. If they don’t license them, they can’t regulate them, except to put them in jail if they are caught practicing medicine without a license. Other states (for example, Virginia) will put onerous restrictions on midwives who are licensed. Not allowing them to carry potentially life-saving drugs such as oxygen or pitocin, for example. So if a midwife in Virginia agrees to be licensed, she is then morally obligated to obey restrictions under the license that could put her clients’ health at risk. So many midwives refuse to be licensed in Virginia and practice outside the law.

So being licensed is no guarantee of quality, as they say. It’s a bad situation here.

(Note that midwives are trained and certified by their own organizations, just as OBGYNs are trained and certified by their own organizations. States then license doctors and midwives with credentials the state decides to accept. I don’t know how this process works in Israel, or Australia.)

If all states in the US licensed midwives with appropriate credentials, it would be easier to regulate their practice, the way doctors are regulated.

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]]> By: Alexis http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22907 Alexis Wed, 08 Feb 2012 00:35:52 +0000 http://www.amotherinisrael.com/?p=7366#comment-22907 American hospitals don't use separate labor and delivery rooms now--the model is the LDR (labor-delivery-recovery) or sometimes LDRP (labor-delivery-recovery-postpartum, a model that takes more space because you can't move from a big LDR to a small PP room). I didn't labor with either of mine, but I believe you're triaged if you come in in labor, and are admitted and sent to an LDR(P) when judged to be in active labor. If you're not, they send you home. If they're very busy, you might wait in triage, just like in Israel. You deliver in the LDR, and if it's not an LDRP you're shifted to a postpartum room a few hours after birth, when judged to be stable. (With #2, a scheduled CS, I did my prep and recovery in an LDR; I spent 3 or 4 hours in after surgery, being monitored.) American hospitals don’t use separate labor and delivery rooms now–the model is the LDR (labor-delivery-recovery) or sometimes LDRP (labor-delivery-recovery-postpartum, a model that takes more space because you can’t move from a big LDR to a small PP room).

I didn’t labor with either of mine, but I believe you’re triaged if you come in in labor, and are admitted and sent to an LDR(P) when judged to be in active labor. If you’re not, they send you home. If they’re very busy, you might wait in triage, just like in Israel. You deliver in the LDR, and if it’s not an LDRP you’re shifted to a postpartum room a few hours after birth, when judged to be stable. (With #2, a scheduled CS, I did my prep and recovery in an LDR; I spent 3 or 4 hours in after surgery, being monitored.)

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]]> By: LeahGG http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22904 LeahGG Tue, 07 Feb 2012 12:24:19 +0000 http://www.amotherinisrael.com/?p=7366#comment-22904 Right - the woman is in the triage room until she's in the later stages of labor or until a bed opens up, but unlike the American system where women are in a labor area until almost the very end, it's quite common to spend 5 hours or more in the delivery room laboring before the birth. Not that I had that luxury. For my first, I got a room 2 hours before delivery and never got an epidural despite having been in the hospital for 6 hours before delivery. And with my second, I got a room almost as soon as I got there along with the promise of an epidural very soon. My urge to push arrived before the anesthesiologist - to be fair, I gave birth 40 minutes after arriving in the hospital. This is why I tell mothers that they need to be aware of their options, but realize that their body is in control, not them. I've also heard from several mothers that they don't want an IV when they're in labor. Really? Like the tiny little needle prick is what bothers you when you feel like your whole middle is about to explode? Personally, I thought it was nice to end my delivery not dehydrated... and in the last hour or so each time, I couldn't eat or drink anything. (Though I had a double burger and fries while I was in labor with my first - but that was like 10 hours before the birth) YMMV Right – the woman is in the triage room until she’s in the later stages of labor or until a bed opens up, but unlike the American system where women are in a labor area until almost the very end, it’s quite common to spend 5 hours or more in the delivery room laboring before the birth. Not that I had that luxury. For my first, I got a room 2 hours before delivery and never got an epidural despite having been in the hospital for 6 hours before delivery. And with my second, I got a room almost as soon as I got there along with the promise of an epidural very soon. My urge to push arrived before the anesthesiologist – to be fair, I gave birth 40 minutes after arriving in the hospital. This is why I tell mothers that they need to be aware of their options, but realize that their body is in control, not them.

I’ve also heard from several mothers that they don’t want an IV when they’re in labor. Really? Like the tiny little needle prick is what bothers you when you feel like your whole middle is about to explode? Personally, I thought it was nice to end my delivery not dehydrated… and in the last hour or so each time, I couldn’t eat or drink anything. (Though I had a double burger and fries while I was in labor with my first – but that was like 10 hours before the birth) YMMV
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]]> By: LeahGG http://www.amotherinisrael.com/home-birth-hesitations/comment-page-1/#comment-22903 LeahGG Tue, 07 Feb 2012 12:14:13 +0000 http://www.amotherinisrael.com/?p=7366#comment-22903 Maybe because they are transferred to the hospital in time for the death to be in the hospital? Or maybe in Australia the midwives know what they're doing, and don't wait for things to get dangerous before they transfer. A midwife attending a home birth should be on a hair-trigger to transfer as soon as anything is even slightly amiss. In every case listed on the blog, the midwives waited too long - knew things were wrong and kept going, etc. I have a friend who was committed to having a home birth - she went to a special home birth 'tzimmer' and everything. The birth didn't go correctly, and she ended up delivering in a hospital. Both she and the baby were fine. Her midwife was apparently more worried about the lives involved than the politics involved... Thank G-d, and thank that midwife. Maybe because they are transferred to the hospital in time for the death to be in the hospital?
Or maybe in Australia the midwives know what they’re doing, and don’t wait for things to get dangerous before they transfer. A midwife attending a home birth should be on a hair-trigger to transfer as soon as anything is even slightly amiss. In every case listed on the blog, the midwives waited too long – knew things were wrong and kept going, etc.
I have a friend who was committed to having a home birth – she went to a special home birth ‘tzimmer’ and everything. The birth didn’t go correctly, and she ended up delivering in a hospital. Both she and the baby were fine. Her midwife was apparently more worried about the lives involved than the politics involved… Thank G-d, and thank that midwife.

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