British statistics show that well screened home birth is actually safer. If all you see is the complications or bad outcomes, you're not equipped to make an objective assessment of safety. Sorry. Our hospital statistics regarding maternal and perinatal mortality stink when compared internationally with other first world countries.
I feel like since he doesn’t agree with home birth, he definitely should NOT have a baby at home. Thank you for acknowledging that we suck at maternal care. And that doesn’t just mean that women die. It means that they routinely have traumatic, dehumanizing experiences. He says “become a certified nurse midwife” as if it’s an easy thing to do lol. I love how he talks about the experience of home birth not being that important. Has he ever experienced a birth? Also he acknowledged that home births in Europe (where care is well integrated) are safe and then basically says he’s going to ignore that information. Please don’t ignore that data. I am hearing a lot of “women don’t matter” in this conversation.
I had 3 home births after a bad Hospital birth. I went back to school and became an RN, although I had been entertaining the idea of becoming a CPM. Training was difficult to acquire though, and finding a preceptor was too much of a drive. I think the problem stems more though from a broken hospital system rather than failed expectations and most of the complaints I hear from moms that didn't have the delivery they were hoping for were that they felt pressured, depersonalized, and treated like just another patient in a bed. Moms-to-be want to be heard and treated like a part of the process rather than a victim of the process. I got my RN and work in a hospital because I want to support Health 3.0 (even before i knew what it was) What makes these moms feel like home is safer? What makes them want to be out of the hospital environment and escape the OB system? The idea of Health 3.0 and getting back to patients as people can solve a lot of this to keep more patients safe and delivering in environment in which they feel safe, whether they still choose home or the hospital. Improving the care we give will improve our outcomes.
Anne LeClaire we need more health professionals like you! I am just a phlebotomist (entertaining the idea of going back to nursing school) but I completely agree with heath 3.0! I had 2 home births myself and am pretty crunchy (not as much as some people, though), but I see life-saving interventions performed all the time at the hospital I work at. So I feel like people like you and I understand and appreciate both sides to this, and that helps us connect with patients better. I won’t force or pressure anyone to do anything they don’t want to do, but I also won’t sugarcoat things. Patients ALWAYS have a choice and shouldn’t be pressured into anything or shamed or guilted. I am also considering becoming a CPM, but am leaning more towards nursing school.
All four of our children, three girls and a boy, were born at home. I'm a Family Physician and my wife is an R.N.. She told me there was no way she was going to the hospital. After our eldest daughter had her first child, she was sent home where she bled herself down to 5 g of hemoglobin because her doctor wouldn't believe that she didn't feel right. After she was transfused, she vowed that she would not trust the medical system again. How's that for irony?
What I don’t get is that you can have a crunchy all natural birth right in the hospital! I had a whirlpool tub for labor and no iv or meds but still the OR was right around the corner just in case.
That wasn't the case when I had my two babies at home in the late seventies early eighties. The OB/GYNs I consulted during my first pregnancy didn't inspire confidence, either, one of them telling me that HE would tell me if I needed pain medication. It was also part of my religious beliefs back then that God didn't like western medicine, and I thought/hoped that nothing bad would happen to me or my babies if I had them at home. There was also a counter-cultural push for natural childbirth. When my daughters had their babies in hospitals (which I wholeheartedly supported), it was interesting--and one time scary-- to see the good and bad side of medical interventions, both for mom and baby. I think there's still room for improvement for hospital births, but the lack of training of most home birth midwives needs to be addressed. I think these docs are on the right track.
I agree completely. My aunt had her third in the hospital with a midwife, but the doctor ended up having to intervene and do a forceps delivery. The midwife made the general experience better for her because she was able to be a supportive presence, but we were all pretty damn happy the doctor was there.
Kathleen Kakacek that sounds horrible! I am glad things have gotten better since then, and agree that certainly there are always ways for hospitals to improve.
I'd imagine they'd be 100% ok with that. If you don't have a medical need for a C-section or intervention, it's better that you don't, a C-section IS surgery and it should be avoided, up to the point where it's more medically beneficial to get a C-section.
My hospital didn't allow water births, didn't allow me to wear what I wanted, didn't allow me to go without an IV tube, and didn't allow me to go unmonitored, so I was continually strapped to something, and my labor was interrupted every half hour as they took my vitals and adjusted the baby monitor on my belly. Also, being checked every couple hours was extremely painful and a source of great stress for me. Midwives don't require checking dilation. Not everyone's hospital has the same policies, or can be as accommodating. Also, in my area, midwives are not licensed to practice within the hospital unless they also have recieved a nursing license. So I would have to go with a general obgyn, who doesn't have the expertise I would prefer in a birth, since I want someone who can advocate for me what my labor and delivery desires are, when I am at my most vulnerable. I want to focus on bringing a baby into the world, not being distracted by the terrible reality of being a patient in a hospital.
"Science is a process, not an ideology." YES!!! I really appreciated this interview. It was very informative. I hope we can continue to improve our system and minimize interventions for the birthing process.
In Paramedic school they taught us to recognize all the different OB delivery complications. Then they told us the interventions for all of them: left lateral recumbent position, high flow O2, HATH (haul ass to the hospital), and try to get 2 large bore IV access en route. Because both mom and baby are on the line, and only an OR can save them. Made quite the impression on me. We need to do better for the delivery experience for the uncomplicated births in hospitals and certainly better post partum monitoring of moms, but when something goes wrong you want the OR down the hall, not 30 min away.
The AntiChick I’ve been a paramedic for 20 years. Helped deliver 4 babies prehospital. Two were super easy. One had a cord around the neck, not a big deal because we caught it early. One was Two months premature, not breathing and needed to be resuscitated. SCARIEST GODDAMN CALL I HAVE EVER DONE. There’s so much that can go wrong. It would seem like you’d would want to give mom and baby the best chance possible.
@@Ravenankh Yet we just delivered at home a beautiful perfectly healthy baby girl last night. Ahe is doing just fine. Was actually 1000x easier than a hospital, where we had and lost our first and then had our second. And it was absolutely the fault of the hospital when we lost our first baby. Don't tell me that hospitals are safer, because I have seen evidence of the contrary first hand. Every child we have from now on will be had at home. So much easier and more natural than at a hospital, where a ton of things are forced on the parents that may be unwanted, such as premature cord cutting, dangerous vaccines, forced epidural, etc. We have been doing it for thousands of years. If so many babies died as a result, why then is it that we have had 100 times the population currently walk this earth. And that is just on record. Sounds to me like not too many died in child birth or shortly after if that many people have lived here.
@@mightysobe I'm sorry for the loss of your child. Whatever happened I hope that you made a big impact and the hospital did a giant case study and trained the entire department so that it will never happen again. That being said there are statements that are way off. Dangerous vaccines and forced epidurals? Getting a Hep B vaccine for a newborn is a big deal and a lifesaver. Medical professionals can not force you to get an epidural. You have to consent to any procedure. If you are dying but of sound mind and you say don't touch me. I can not do a thing to you otherwise that is assault and battery. Also your last comment about population growth, maternal and infant mortality is absolutely absurd.
@@justinchapman5876 I asked my docter about when he did epuidurals. He said only when needed. My baby was 5 LB 14oz. He pointed and the intern cut! He didn't ask me if I wanted it!!
So my birth of my daughter is a good sample (I think) of a birth that can go off the rails. I planned (and did) on having her in a hospital, and my whole pregnancy was fantastic. No problems, myself and my daughter were healthy, and I even went into remission with my RA. My water broke at 2 and we were at the hospital and in the room by 3. They gave me pitocin because I still wasn't dilating. They had me moving and then at 5 they told me to lay down and would have me change positions (left & right side). The nurses were checking my vitals and I meanwhile was focusing on my breathing because it felt like the worse menses cramping of my life! At 6 then told me I had to have an emergency c section because everytime I was contracting my daughters heart rate were drop. Turns out she was holding the umbilical cord and squeezing it during contractions. So they got me in the OR, all the while I was freaking out, shaking, my heart rate sky high. I was terrified! I wake up from anesthesia and hold my daughter for the first time at 815pm. The story isn't over yet though! I reach down and feel something dropping by my left hip bone. It was blood. Turns out I now have to go back under anesthesia because I had a subdermal hematoma. The on call doctor had done both procedures, as my OBGYN was in another hospital that was an hour and a half away! So, had I been one to want a home birth... What could of happened? Could I have died? My daughter? Would I have to be rushed to the nearest hospital from our home, which could have been upwards of an hour and a half? I, nor anyone who knows me, could have predicted that type of birthing experience... I certainly didn't. I did beat myself up for months after delivery over not being able to have her vaginally, I felt like a failure. I felt like my body failed me. After a few months though I started thinking 'fuck that'! I successfully carried my daughter for 9 months. My body did an amazing task! I am damn proud of what I accomplished. I had the privelage of having high quality medical care in order to assist with my birth, and that is NOTHING to be ashamed of! So that's my story. Lol
Skeptical Rationality 3 c-sections for me, 3 bottle fed boys, all beautiful 6 foot tall men who bonded with me and their dad, not psychotic ,and we are all as good as any one else
@Mzisa I have read that c-section is more likely when pitocin is administered but I'm not sure if it's just correlation. I do think it's probably better to hold off on induction until absolutely necessary, which I don't think is what's currently being done in most hospitals. At least that's how it seems when I'm speaking to other women about their birthing experience. Most women I know were induced with pitocin and the majority ended up with c-sections.
Yeah I know NCBese and they would totally blame that on the Pit. I think my birth was a better example on why NCB is a load of bull. With my first I wanted a natural birth. While I did chose to birth in the hospital I declined all interventions. I went to almost 42 weeks before I naturally went into labor. I had no epidural, no pit, intermittent fetal monitoring only, and lots and lots of support. I didn't even have a saline IV, nothing. I moved around as I pleased, and even ate a little. But once my water broke my daughter ended up sitting on her cord, and went into distress. I like you, felt csection guilt. But years after the fact I shutter at the thought this scenario playing out at the stand alone birthing center I was considering. Would the CPM even notice something bad was going down? I've read too many homebirth nightmare stories where the CPM didn't even realize things were going south until the woman pushed out a blue baby. I could have been one of those women with a dead or brain damage baby if I had made a different choice. Yikes.
Wow, NO your not a failure, thank goodness for modern care, I bet your an amazing mother, women’s body’s do an amazing job after birth. You know birth is just the beginning of mothering , every mother wants a great birthing experience however the safe arrival of your baby and your safety is the most important outcome!
Thirty years ago I was helping people have babies at home and in the hospital. I remember how difficult it was for midwives to get docs to be backup for when women needed to be risked out of a home birth. There were (and are) countries that have a cohesive system so that midwives and docs can collaborate for the best possible care for families. I had 3 home births in the 1980s and I was never "home birth at ANY cost" with families I worked with. In fact, working with one of those was an incredibly frightening experience when the baby was in distress with pea soup mec and mom didn't want to transport. Then we got to the hospital and they didn't believe us! I was hopping on one foot, but finally they did a C section. The CNM assisting looked over when they opened the uterus and said, "Pea soup mec," like we'd be surprised. It is difficult to assess who knows what they're looking at and who doesn't, I get it. But the history of childbirth in this country holds some clues as to where attitudes came about. When doctors decided to get into the business of birth, they started referring to the "dirty midwives". I guess my comment would be, "Watch out for the broad brush." One direct entry midwife I worked with had been an ICU RN and was also an ARNP and she wasn't the only one I knew with those kinds of credentials.
Make sure the statistics and studies you are referring to are just assisted home birth not a mix of unassisted/unplanned and assisted home birth mixed. I have reviewed all of the studies on referenced on the ACOG site and every single one was mixed with unassisted birth (mom and dad at home alone). We need more research and more structured training for CPMs. Don’t throw home birth out the window. It should be a safe option for women in the US like it is in Canada and the UK. Canada’s and the UK’s government recommend keeping low risk women out of the hospital. Out of hospital birth center for first birth and home birth for pregnancy after.
100% vaccinate your kids but do not say oh perinatal death that is all because of home birth. Perinatal death dropped in South Carolina when they instituted elective c-sections must be done after 39 weeks. Perinatal death in America is an overall birth issue.
As someone who had a horrific hospital birth, ended up in a c section under general, the idea of going through labor agains scared me soo much I haven’t had another. One thing I have a huge problem with is “I just want a healthy baby”. What about healthy Mum? My birth gave me ptsd because all anyone cared about was a healthy baby. I was terrified. No one but my nurse midwife gave a shit about me and talked over me and about me and not to me. And then when. It was over, I was left to the antepartum nurses who had no idea what I went through. In an ideal world I’d love to have an OB who cared for me physically and emotionally throughout my pregnancy and birth. That if it didn’t go well, to support me and just care.
Bingo. Except our experience was a C-section under a spinal anesthetic that did not cover the entire surgical incision. That was five minutes of level 9 pain endured for the health and safety of our one and only child. To make matters worse, because of a complication, our son was whisked off to another hospital specializing in children and not reunited with his mother for four days. He had been bottle-fed and rejected both the natural nipple and is mother. We were given a gloomy prognosis for successful breat feeding. It all turned out well in the end. The bond eventually developed, and mother and baby worked out the breatfeeding thing on their own. But this was in spite of the medical intervention rather than because of it. Sometimes the medical establishment doesn't 'get it'. Emotional health is as important as physical health.
I am so sorry this happened to you. Recently the medical community has gotten better, but for a long time they were focused on getting infant mortality rates down to such an extent that they did forget about what the mother needed. I think however that you need to look at his statement in context. They are talking about homebirths right now and the reasons that he has against them. This discussion is specifically about babies health. Again, I am very sorry that that was your experience. No one in the hospital should ever be made to feel like they are not important enough to have medical professionals’ full attention.
My first c-section ended up being under general also. I did go on to have another (and she was a planned c-section as I wasn't rolling the dice again). It was a fantastic experience the second time around! As for finding the most caring doctor, at the risk of sounding totally sexist here, I'd find a male OB. The female OBs in my practice weren't sympathetic at all, but the 2 men (one in particular) were amazing. It helped that they both had a LOT of kids each, so they'd obviously supported their wives through many pregnancies. It seems counter-intuitive, but that was my experience.
Purely guessing why they mentioned that but. Pure sugar/sucrose is used as an anesthetic for newborns (sugar dipped pacifiers during circumcision). So I wonder what that would have done in baby formula
I found this quite insightful as someone who works for an out of hospital birth center with midwives that are only CNM that do birth center and home births. I hope you do a part 2 with a CNM to gather their experience and opinions about home births 😊
My 13 year-old was born by c-section while I was under general anesthesia. If I'd attempted a homebirth, she wouldn't be here. There was no indication that she was sunny side up and diagonally placed when I had all of my appointments, no indication that "she was never coming out vaginally" to quote my doctor. I went to push and my OB realized that my baby was in no position to come out vaginally. I don't know if she turned during labor or what, but something clearly happened. Thank God I was in the hospital. We live in a first world country. I cannot wrap my mind around attempting a homebirth.
We just did and it was amazing. Labor lasted maybe 2 hours, took maybe 15 minutes of pushing, and my wife said there was very little pain. She hardly tore at all. And baby is perfect. This was just last night with 2 certified nurse midwives present. We weren't a third world country 150 years ago either, yet home birth was an everyday thing. Plus just look how long we have been having babies naturally and at home and how many people have lived here before us. If home birth were really that dangerous, would we have the huge numbers of people recorded to have lived here in the past?? I think not. Yes, things happen, but that doesn't mean that risks should equal completely ruling out the option of a home birth. We personally will be doing it this way from now on.
I'm an RN that works L&D and I work for an OB/Gyn in clinic. I also had two kids in a hospital. I didn't even know about midwives until I went to my nursing OB clinicals and just recently learned more about homebirths because a few of my friends are the more "crunchy granola" type people and kept asking me tons of questions. I've done a lot of research lately on this subject and I guess I was expecting a more comprehensive view of this topic from this 45 minute video. I feel like your argument was just do what's safest no matter what. And the simple take away could be taken to the extreme and say, "well, the best thing for your baby and you would be to deliver in a huge hospital with a NICU, perinatologist, and in house surgical team, etc and if you decide to do anything else you're just selfish" but obviously it's not always realistic to do that, so I just wish you would talk more about what kind of situations warrant more risk? In my few years of nursing, I don't think the patients/friends I've talked to are choosing homebirth for the experience so much as for other reasons. Hospitals are under staffed and nurses are sometimes inexperienced, and sometimes I feel could be more dangerous in some situations. Not to mention the different ideologies and reasoning behind the decisions OBs make, such as litigation and what they feel like they would want if they were in the patients shoes. I want to know what he or you think about those that choose a homebirth with a CNM that has a RN birth attendant with NRP. I had a friend who chose this because she knew she would have at least one to one care for her birth and felt safer. The CNM had almost all the same meds and equipment we bring to the delivery room and she was 5-10 minutes from the hospital with a surgical team & NICU. At first I thought she was crazy but she had quite a bit of reasoning for her choice. I also wonder if you could talk about how we could help patients in rural areas with less access to healthcare. Many of our patients live over an hour to two hours away. I've seen a few choose homebirth with lay midwives or just family members or most choose to go to the local small rural hospital because financially, culturally or whatever else they didn't think it was worth it to stay in a hotel for up to 3 weeks just so they could deliver in a bigger hospital. Most end up getting transferred to our hospital either in labor or postpartum and many are train wrecks. I think they are taking a huge risk but I try to be understanding of their situation. I've heard of women choosing homebirth because they were uninsured and felt that they couldn't afford the hospital bill. They said that they would rather take the risk so that they had money to provide for their newborn. I guess I didn't feel like you really covered all the different reasons for choosing homebirth and made it seem like most of the women choosing this are uneducated and narcissistic when statistically speaking most of them that deliver with a midwife at home are college educated and do want what's best for their family. I appreciate you talking about it though and you both did mention some really good points. I really enjoy your shows and I just want something to help me better educate patients and my "granola" friends. Thanks.
Bingo the three Mama's I know that did home births all have there bachelor's degree in the health science ( 2 nurses 1 microbiology). Personally I think people need to be more aware of what to do for home births even if it's just for ER. My last baby was born in 45 minutes from first contraction and if we didn't live 5 minutes to the hospital she would have been born in the car. I also live in a state that most people live 100 miles (if they live on the road system at all) from hospitals.
Thanks for this. I used to be one of those very crunch types when it came to what I wanted for my future deliveries... Until I started working as a L&D nurse in a high risk OB. It's really scary how shit can hit the fan at any instant. Sometimes we get some of these "home births gone wrong" and it makes me think the risks are just too great to have that status of having a home birth. Hospitals nowadays really do try to normalize births. We let our patients decorate their rooms, bring their essential oils, hypnobirth - whatever. But outside that room you got a floor full of nurses, the OB/GYN residents, 2 hospital attendings, anesthesia and the rotating staff midwife at any given time in case shit goes down.
I'm an AEMT. As a minimum standard, it's about 600 hours of classroom and ~200 hours of clinical with only high school as a pre-req. Most of that is *not* in OB related issues. I'm officially trained/certified to deal with uncomplicated and complicated (for certain definitions thereof) childbirths. As a part of my training I needed to witness 1 live birth and do a few hours worth of training with a simulator. How is it that these low-level providers with 60 births are considered inadequate whereas I, with far less training, am considered trained and certified? How/what can I do to be better at this?
Paramedic here and i have delivered several but NOT BY CHOICE. AEMT IS NOT ADEQUATE TRAINING. PARAMEDIC IS NOT EVEN CLOSE TO WHERE IT NEEDS TO BE. i have had mothers start to slmost hemorrhage to death, muconium., babies born high drugs, no prenatal care. As a profession we need to be increasing training not lowering standards
Another paramedic here, I don't think anyone would consider an AEMT or paramedic adequately trained to routinely give birth. Yes, we go over it in school with uncomplicated and complicated deliveries. We have to go through labor and delivery clinicals. But, I would never say that we're the most qualified to deal with these issues. We're better than nothing. We can deliver these babies and we can even intubate them and hopefully resuscitate them if needed. But, I think we can all agree that we would rather these things happen inside a hospital with specialists and not in the back of our ambulance.
@@mac5399 In emergencies where something needs to happen now, I would hope paramedics and AEMTs are adequately, certainly shouldn't be a routine thing but in emergencies you guys need to be adequately trained since you say you're not.
My sister was born at home but we also live around the corner (literally 2 blocks) from a hospital so there would be a safeguard. I can understand not wanting to have your kid in the hospital tbh, I wouldn't want that many people around me while I'm going through that
And medicine is a practice not a science... physicians are practicing medicine. SCI means to know... medicine has way to many variables for anything to really be known without doubt.
There’s so much to say here. I absolutely concur with everything Dr. Duddy has said, and I’m a tree-hugger at heart! Ultimately, there is one powerful reality: that baby and that Mom have one chance. With everything from hypoxia to hemorrhage..., one chance. Hope for the most beautiful best, but if it hits the fan, be ready for providing full support of all hands and resources on deck.
I have PTSD from my son's birth only a bit over 2 years ago. I was having nightmares during my pregnancy about being confined to the bed and being controlled and having cords and wires covering me. That was my reality. I remember being surrounded by strangers and was treated like a thing, not a human that was terrified going through a huge process. I never met the OB that did the surgery, she never even came in during the 3 days I was in the hospital. I was completely knocked out for the surgery, I didn't hear my sons first cry. The first thing I hear was "I don't know why they red lighted her." I'm pregnant again now and trying so hard to get better from the flashbacks and PTSD caused by a hospital birth. The system HERE SUCKS. There are states where not a single hospital allows a vbac. The closest birthing center to me that's admitting privileges to a hospital is 3 hours away. So I have to choose, go back to the hospital where I KNOW I will experience flashbacks and anxiety and be treated like a thing and risk making my ptsd worse; or I can attempt a home birth with a CNM (the RN), while living close to the hospital and also seeing an OB and keeping them in the loop. This is exhausting and expensive, and I have to fight for this choice more often than I would like. So instead of pointing out how dangerous home birth is, how about you work on improving the maternity care available to us?! How about you go talk to hospitals with outdated and/or harmful policies? You want us to come to hospitals because they're safer for baby, then make them safe for mom too.
Your experience is not uncommon and is the reason why people want an alternative to medical driven births. It sounds like you may have required a surgical procedure during birth and you deserve better, more loving care. It's the birth of your child. Yours is the story that needs to be known in order to improve the care of each mother and child. The system needs to be better.
Um, they didn't put you under general anesthesia and give you a stat c-section for nothing. In my experience even getting an epidural was difficult. Maybe you didn't understand the reasoning behind it. Wanting a home birth isn't wrong, but in cases of emergency it can come down to life or death in a very short amount of time. As long as you're prepared for the risk to yourself and your baby, no one will stop you.
We had a pt who was having a home birth, things happened, she was so far from the hospital that after the midwife decided to transfer her to a hospital, they could not save the baby, the baby was normal....but could have been saved if delivered in hospital. As an RN I could never recommend a home birth, its just too risky, I have seen it all as an RN. You guys were great and I totally agree, thank you so much and appreciate the humor
Delivered a perfect baby girl at home just last night. Went too well if I do say so myself, and momma and baby are doing just fine. From labor to birth was only 2 and a half hours. And my wife even said there was little pain. Had a terrible experience after losing a child at the hospital with the hospital being 100% at fault (they failed to mention the UTI she was having no symptoms for for 4 weeks). Tell me, would you tell us we were wrong for making this decision?
@@mightysobe you didn't even watch the video, am I right? If you had, they even say 1% of births outside of the hospital result in death. That means 99% do not. However, the rate is statistically significant compared to a birth where modern medicine is available. In cases of emergency, it can be absolutely crucial to have immediate treatments available. Maybe try listening instead of getting all heated.
Hey Zdogg! I am a CNM and a FNP who works both as a CNM Hospitalist at a MLoC level 4 hospital as well as PRN at a pediatric urgent care. I am currently working on my DNP with the focus of my studies on improving systems for community birth transfer. I am also in the process of developing/opening a Free Standing Birth Center. I listed to your interview with Dr D as well. You make some good points, but I really missed the point of the main problem which is a systems issue rather than a CPM issue. We have a huge problem in this county with how we provide maternity care and in reality birth both inside and outside of the hospital poses more risks then needed. I would love to talk with you more about the subject. Mary Love
Background: Washington State. Midwives here are ARNP-Midwife. I have 2 healthy (vaccinated) sons. I had one premature and complicated birth in a hospital and my second was full term no complications and at home. I think a home birth after proper prenatal care and planning with the assistance of trained and educated professionals is beautiful and wonderful.
Hailey Ney the home-birth of my first son was attended to by a Certified Nurse Midwife (who was a Family Nurse Practitioner with her doctorate in nursing degree before she even went back to CNM school). She cared for me during my whole pregnancy, delivery, postpartum, AND she could even care for me and my child for the rest of our lives if we wanted her to since she is also a Family Nurse Practitioner. We need more advanced practitioners who are willing to do home births! Don’t get me wrong, I had a wonderful CPM for my second birth, but CNMs are perfect for people who want a home birth but are a little hesitant.
It is very hard as a new doctor, to focus on one patient at a time. When you deliver a baby, there is two patients that need very immediate attention. Even if everything goes well, you are always in a position where you are not capable of doing everything you should.
My sister and I were the first in our family to be born in hospital. My Mum was born at home, premature and weighing 3lbs. Her bed was a cotton wool lined dresser draw. She lived to a ripe old age. There have been many infant deaths and damage caused by medical staff and hospitals. I will take home birth any day.
I was home delivered by the head nurse midwife at a top hospital in NYC after my mother's first birth in a hospital was a terrible experience and the Dr only showed up to get paid. The rest of her children were home birthed too. I do think if you live more than 3 miles from a hospital you can't deliver at home.
Ours is getting her screenings tomorrow. Our midwife, who is certified btw, will be here at noon. She helped deliver beautiful Eliza Sue into the world at 11:39 last night with hardly any labor at all and only 10 minutes of pushing. She is perfect. Wanna tell me what I did was wrong? Am I so terrible for wanting our daughter born at home rather than in a hospital, which our local one is responsible for the dwmeath of our first. You honestly think we should go to a hospital anyways?? Haha, you so funny. Our two year old son is doing well too. May have been in a hospital, but we refused the vaccines except for the vitamin k, and only reason we did that one is because it was the preservative free. We were fully prepared to go elsewhere for it if they didn't have the preservative free. Our little Zachariah is 2, vaccine free, and has only been sick once. And it was a common cold. We took him to the doctor for it, and the doctors ran all these other tests because he was unvaccinated and even scolded us. We are lucky he's not dead I this is what they told us. Then were so mad when they found it wasnt anything they tested for and just a cold. Basically gave us a prescription and told us to "just go". Complete waste of our time and total disrespect on the doctors and nurses' part.
@@mightysobe because we have seen unvaccinated kids die. Like in the VIDEO, he has seen kids die from meningitis, etc. So we would be moronic and culpable not to warn you of the potential complications/risks of staying unvaccinated. What if his symptoms HAD been from a vaccine preventable illness like meningitis, pertussis, tetanus, hepatitis? Would you have declined medical treatment and let your kid die or suffer at home? No, you brought him to the doctor for help. Turns out you were lucky. If it had been severe you would have relied on life-saving medicines and help from the medical team. Don't cherry-pick just because you think you're right, and then run back when things go wrong. Pediatricianshave seen what can go horriblywrong and also all the complications that can happen if you get help too late. That is an extreme gamble.
1982 Tyler, Texas, my second was born at home with lay midwife. Local hospital: Fathers weren't allowed, still doing spinal blocks. Most significantly: they admitted to an 85% C-section rate! Note: we were 3 blocks from the hospital. My midwife was President of the State lay association. I delivered my daughter's hand and arm with her head! It could have gone bad fast, but we were blessed. I couldn't assist with home births as a doctor. But took care of them before & after.
I’m not a midwife, but my mother is. She practices in a hospital and would never do home births. Here in Colorado, Certified Nurse Midwives need both a bachelors in nursing and a masters or doctorate in nurse midwifery. Either way, there are very few home birth practitioners here, and the few are highly selective about who they take on as patients and are highly skilled. Birthing centers run by midwives and nurses with OBGYNs on call are much more popular than home births.
It's so strange I didn't realise people died from chickenpox, I had it when I was a toddler and it was very minor, it pretty much just itched a lot of a week or two and then it went away, it was 100% uncomplicated and it was the same thing for my cousin who was a year older than me that actually gave me chickenpox, I thought that's how it was for most people. I thought it was more of a cold type illness where it's really not that harmful at all. And then as I get older I hear people talk about it as if it's as bad is measles or polio and i was shocked because my expiernce of it and what I've heard about it from other people is that it's a pretty benign illness. And apparently they did have the vaccine around when I was a toddler but I never got (one because I actually got chickenpox instead) because it was only being administered to vulnerable children who I guess would be the ones who had a higher likelihood of really bad outcomes from chickenpox, which sort of explains why chickenpox has never been this monster in my expiernce even though I HAVE experienced it.
At the very least, any woman considering a non-hospital birth should find out whether her local hospital has an OB Hospitalist program: board-certified obstetricians on the Labor & Delivery unit 24/7/365. These physicians, by nature of the work they do, are confronted with OB emergencies more frequently and become adept at managing them much better than you average OB in private practice. They will give mom and baby the best chance of avoiding morbidity and mortality if the home birth goes sideways.
This may be my new favorite informational video. It puts into a well organized and research backed form all of the reasons I have always said I would never give birth outside a hospital.
Thank you for sharing this information. I am a type 1 diabetic, my pregnanies are high risk even though I take excellent care of myself. I've felt like a failure for having highly medicalized, high intervention, pregnanies and delivery. This message is important. I played into this whole 'birth experience' being sacred BS. I just want to live and I want my baby to live with as few complications as possible. That's all.
The only thing that damaged me by having my babies in a hospital was being dismissed and getting sent home and then almost giving birth in the hospital lobby and later they dismissed my bleeding concerns and I had to have an emergency d&c. Everything else that happened I couldn't care less about because my kids got out safely.
Melisa Roberson You listen to the medical advice, balance that with what your mom or trusted older mom friends tell you. Then decide for your self. I bottle fed my kids, had c sections, and bonded with my babies AFTER the experts took care of me and my boys.
what if you had appropriate medical care AND respect for the sacred moments of birth and postpartum time? It's not an either-or scenario. Every birth is sacred.
@@joannasaad298 "only thing..?" that's embarrassingly bad care. I'm so happy your babies arrived safely. But your labor was misdiagnosed and your bleeding was misdiagnosed and that's unacceptable. Moms deserve quality care, too.
Speaking as a neonatal icu Nurse, please don’t have a home birth. I have seen all the worse outcomes that can happen. Don’t risk your child’s health or even life for what you think will be a good birth experience. Does an experience make up for losing your baby or having a child who suffers hypoxic brain injury...I say it shouldn’t. Things can go wrong in a home birth and help is then too far away to make a difference As an aside, never write out a birth plan it’s end of all normal birth processes....
We lost our first in a hospital. They failed to tell us about her UTI, which she was feeling no symptoms for. He was born alive but had so much infection in his lungs he couldn't breathe and was pronounced deceased an hour later. And yet the hospital claims no wrong doing and basically says they would get the case turned against us if we even tried to sue them. We actually did have a home birth just last night. It went amazingly well, with delivery only taking about 15 minutes, very minor tearing, and the baby and mom are both perfectly fine. After our last one (now 2) taking over 24 hours to be born and the petosin that they administered after hours of laboring with little to no dilation dropped both her and the baby's heartrate down so low it nearly killed them, yeah we are having all ours at home from now on. You can say this and say that. Doea not change a thing. Not to mention we have faith in the Almighty and wholeheartedly believe that our prayers were answered with this one, praying for an easy labor an d no complications. Wanna tell me I'm wrong for doing this? Go ahead.
I was so apprehensive to listen to this (I’m a podcaster), because I have some PTSD symptoms around my second son’s birth and I was worried I’d be triggered. I had true cephalopelvic disproportion with my first son; I labored drug free at home for 37 hours. When we arrived at the birth center I was 10 cm dilated; I pushed for 5 hours and our son never moved past -2 station. I ended up having a no-regrets emergency c-section, that I KNOW saved our lives. The second time around, I opted for a scheduled c-section based on the previous experience and the 3rd trimester ultrasounds that revealed our baby was in transverse presentation and slightly large for gestational age. Long story short, a resident did my spinal block and had to reinsert/adjust the needle 5 times (which caused the most heinous and indescribable pain I’ve ever felt), my son’s shoulders were too large so a larger incision had to be made and my abdominal adhesions made closing the incision difficult. I was basically hanging upside down trying to comfort my frantic starving newborn. It was over an hour before I could breastfeed my baby and his blood glucose was extremely low. I’ve been so traumatized by the experience and felt such profound guilt about his birth. Why didn’t I just try a VBAC? Even if I ended up with another emergency c-section, at least it would have been better than that, right? Dr. Duddy’s remark about that day being just one day out of tens of thousands was profound. Thank you.
Mary Tocco my rider knows that. Rationally, I know I made the correct choice but my emotional brain isn’t concerned with pesky facts like presentation and head circumference. My emotional brain tells me that this failure is just one more that proves that I’m too selfish to be a perfect, glowing, crunchy, size-2-one-day-postpartum mom. I could have done exercises to “flip” my son, I could have had a TOL, but I made a choice that I thought would be best for us and I just happen to deeply regret it.
Things can happen in either scenario. The hospital isn't perfect either. But having life saving treatments available are helpful. Maybe a happy medium would have been to let you attempt a VBAC in hospital if they could have got the baby into a better position. If the baby had been in the wrong position during a home birth, it could have been even more disastrous though, so I think you were in the right place. But it didn't go as you hoped, and I'm sorry for the bad experience that you had. I felt traumatized because the hospital denied me epidural medication and I felt the most excruciating pain of my life giving birth to my daughter's giant head, which felt like a betrayal. Childbirth can definitely be traumatic all around.
I'll preface my story with this. Ms sister is a BSN, MSN, clinical nurse educator. I'm in higher ed and spent my first years working in an RN to BSN program. I'm fairly well educated on medical "stuff". While my 5th but only successful pregnancy required some hormones to get going and stay, otherwise it was an easy and successful pregnancy. Baby was breech for a long while but eventually turned. I was induced because I was dilated for too long which was cool with me. Was planning vaginal birth with epidural. Back spasms limited my ability to breathe while pushing and I'm screaming for a c-section. (Which I was cool with anyway.) Easy c-section. Except for them strapping me down like Christ on the cross to administer anesthesia and I'm screaming in pain. Then all better. I recall my doc saying while stitching me up that "she just gave up but as it turns out the baby's head was too big and wouldn't have come out anyway". So there's that. Baby latched well. All good until 36 hours post csection and I'm spiking very high fevers, blood pressure is rock bottom and i'm throwing up. TLDR: catheter left in too long led to a blood infection. I was in the hospital 8 days. I have no memory of 2 of those days. I had a down the throat check on your heart via camera with only benadryl to "calm me". I was in terror. I had a first, failed, PIC line insertion with only xanax. I went home with 2x a day IV antibiotics for 3 weeks. Even though I won't have another child because 1 non-viable vaginal delivery and 3 miscarriages is enough plus MTHFR mutation and funky shaped uterus, I would never consider having a home birth. Baby was jaundiced as it was. Knowing that his head literally wouldn't have fit out of my body not matter how much tearing might have happened? Heck no. Yes, know your options and be prepared but don't let a preference for a certain type of delivery be more important that you and your child's life.
You don't see kids with hearing aides anymore??? 50% of hearing loss diagnosed prior to age 3 is actually genetic, we aren't to the point of fixing the genes, so I'm wondering where he's looking. Maybe not counting cochlear implants as a hearing device? Plus many choose to go without and just use sign language and don't consider it a handicap.
@@777Ryank ?? Are you replying to my comment? I didnt say anything about any birth that I had. I commented on the causes of congenital hearing loss, 50% of which are genetic.
I really enjoy your videos but I have to take issue with this one. If all heart surgeries were done in physicians offices the outcomes probably wouldn't be good. Trained midwives know which patients aren't good candidates for home birth and it's poor statistics and science to conflate all births to the negative outcomes. If reasonable precautions are taken the stats show that home births are safer for mothers and babies. It's not just about the experience, as you kept repeating.
That’s a good point. Let’s say for a certain birth complication, he is saying that 4000 more babies would die every year if they were all born at home. Well that isn’t taking into consideration the fact that many times, these mothers may not be eligible to have a home birth in the first place due to health concerns. Not to mention, at the first sign of something going wrong, a well-trained midwife is going to transfer you to a hospital before it gets to the point of something tragic happening. So would 4000 more babies a year REALLY die? Maybe, but probably not. I do get what he’s saying, though.
But it can go terribly wrong even with a seemingly healthy mom and baby. I know a young healthy g1p1 mom who had a home birth. Labored at home with the midwife but was failure to progress. Arrived at the hospital and baby was already in distress. Aspirated meconium and severe anoxic brain injury and did not survive. Tragic and exactly what this podcast is addressing. I have a close relationship with a very experienced NP midwife who told me one of the biggest issues with home births is the reluctance of moms to understand- when the midwife says it's time to go to the hospital, it's time to go to the hospital. Often these moms are so stuck on the ideal home birth and their ideal birth plan they will resist hospital admission (sadly to the detriment of the newborn in some cases)
NICU nurse here...12 years experience in the del rooms....I'm my personal opinion and from some of the situations I have seen,. I personally feel it is always safer to deliver in the hospital ... However .... I do feel that many Hospitals could do a better job of offering alternatives during labor such as wireless fetal monitoring so mom's can walk during labor, the use of peanuts)birthing balls, alternative laboring/delivery positioning, use of massage/aromayyherapy.......AND decreasing the use of IV drugs that push the labor process to go quicker....hospitals are already working hard to decrease the c section rates, increase breast feeding rates and many are trying to get away from double patient rooms...have attempted to allow, as you both said...the delivery room to be more comfortable...even getting baby's skin to skin in the OR if there was a C-section or skin to skin with the support person/partner/ father if mom was not stable enough to do so right at delivery.... As an NRP teacher and within neonatal resusc. Practice.... Encouraging that baby stay with his/her mother on their chest during delayed cord clamping and/or crying/with tone etc...keeping these baby's OFF the resuscitation bed UNLESS NRP guidelines are needed to resusc ...has been quite helpful ... I do love attending Del's where midwives are delivering the baby, and see a bit more holistic and alternative practices as far as positioning etc....and I have seen hundreds of Del's with doctors delivering the baby also using different methods.... I have also seen "perfect" pregnancies with birth plans end up in crash c sections and full neonatal resuscitation and/or maternal full anesthesia and/or emergency resuscitation of the mother.... Things happen all the time that are just not what was planned... maternal bleeding, retained placenta, shoulder dystocia, neonatal intolerance to labor etc.....so much that I have even changed my own personal feelings about home birthing ... If we worked on making the environment where women are coming to deliver their baby's less "clinical" feeling, set up training for all nursing staff about using effective/alternative methods during laboring... Etc ... I do believe that we would be doing a major justice to every family coming into the hospital to deliver their baby. And on the birth plan discussion...I think that a family's pre thought out plan is not a bad thing...however some of these birth plans can be a little much, perhaps instead of handing these fill in the blank forms to expectant families...there is a more personalized discussion about the birthing process one that could include the hopes of every families own desire for that perfectly laid out birth plan ..that mostly sets this family up for a reality that is not real and sets up the hospital staff who get the birth plans that are way left field....we need to do better PRE hospital prep... Back in the day everyone did Lamaze class ..these classes rarely exist anymore...there are many new methods of supporting the laboring mother and the family that should be shared pre hospital ....it is heart breaking to see the "perfect" pregnancy with a color coded birth plan go to absolute you know what....and the mommy to ICU and 32 week (or less)baby to the NICU...where are the reality TV shows that show the lives of NICU parents who have babies in the unit for Monnnnttthhhssssss.... The roller coaster of preemie life, breast milk pumping, emotional stress, PTSD of the family, financial hardships of the family, infant maternal/paternal bonding and family separation ? Some of the TV networks with their reality shows are definitely not fully representing the true risks of the laboring woman in 2019.... I get that so many eons ago...many women delivered at home, they didn't have IVs, or fetal monitoring and everything was "fine".... Really? How many of those mother's and/or babys died during the delivery? What was the viability at that time of any baby born less that term? What milks were being fed to those baby's? We cannot compare today's complications to yesterday's ways..... What we CAN do is advocate for the safest, evidenced based, current recommended practices, family centered care to all families who are expecting a new baby soon ...we have to do better, educate ourselves as healthcare providers both pre hospital and at hospital ..... Just my opinion.....❤️🌻
I had two home births, one with a doctor and a nurse and one with 2 nurse-midwives. Check out the work of Ina May Gaskin, who has had excellent outcomes with thousands of home births (with her team of trained midwives). Back when I had the babies (1980), the hospital birth scene was pretty awful. I also volunteered at a birth center in NC as a translator (for Spanish-speaking families) and doula. The environment there was very homelike, staffed by nurse-midwives, and their outcomes were very good. Even though my daughter had her baby in hospital, I am still enthusiastic about home (and birth center) births when they are professionally screened for risk. There has been some good research on it out of Europe.
Ina May and the NCB community set me up for failure and left me feeling like I failed for having a C-section for years. Unfortunately, I still have one of her books in my house. I'm very tempted to throw it in the garbage as I don't want anyone else getting influenced by that garbage.
Just in case of something going wrong it is good to be in a hospital with a nurse midwife for delivery. Good nurse midwives really know how to relax both the mom and dad. 10 minutes after the birth of my first, I started bleeding terribly, like a faucet turned on low. The midwife yelled for the doctor who saved my life. There was no way to foresee that problem would occur, I had an uneventful pregnancy, was healthy, ate well and exercised. To me it is just not worth the small additional risk to have a home birth. Having a good midwife attending in the hospital will make the experience much better as they advocate for you, help with breastfeeding and give great advice overall. With the birth of my 3rd and last child we used a different hospital. It was the first time a midwife had attended a birth there. (The doctor waited outside the room on call.) So it was just me, my husband, the nurse midwife and a hospital nurse. The hospital nurse kept asking me questions for a form even though we were preregistered. My husband told her to wait until later. She looked put off. I delivered 10 minutes later, got to hold my daughter immediately after the midwife jokingly wanted to weigh our baby first, as she was so chubby. Then my husband held our daughter, smiled and talked to her. The hospital nurse got choked up. She said our experience was so different, not clinical at all, that it was beautiful. So yes to hospital delivery WITH a midwife RN.
We just had our newborn baby girl born at home at 11:39 last night with no complications. Maybe 15 minute delivery. Baby is fine. Mom barely scathed. All at home with a certified nurse midwife. Wife even said it was easier at home than the hospital where we had our now 2 year old. You telling us we are wrong and bad parents for doing so???
Just had a perfectly healthy baby girl at home. No death. No complication. Yet we lost our first in a hospital from fault of the hospital (UTI that they failed to tell us about for 4 weeks and she didn't have any symptoms for it). I for one say that home birth is not dangerous if done correctly. And btw, our midwife has delivered over 8000 babies prior to Us so yeah. Don't think that all home births are bad and dangerous. And also, him saying that majority of midwives are underqualified and/or undertrained is a flat out lie according to our midwife. Also, our recent little one took maybe 20 minutes to come out so yeah. I am 100% advocating home birth as long as you know what you are doing. And to those totally against it because of "danger" we are not baby killers and how dare you accuse us of it. (I got my fair shair saying our baby would either die soon after or would be born dead, yet she is perfect so screw everyone who attacked us.)
@@mightysobe i don't think anyone is saying that you are a baby killer or that all homebirths go wrong. If you WATCH THE VIDEO, in fact he said that only 1% of natural births result in death. However it is significantly higher than those that have the opportunity to get emergency treatment if there is an emergency. Your experience is not the only one. I have heard tragic stories of mom and baby dying or suffering severe oxygen deprivation/ blood loss. I myself almost died from an ectopic pregnancy hemorrhage and let me tell you, I would 100% be dead had I not had immediate surgery. 10 mins later and I wouldn't have made it. Sometimes you don't have the luxury of time, which is why if you have the natural birth in the hospital at least there is help available right away, but you don't have to use it if not needed.
@@mightysobe also knowing what you are doing isn't the issue. Sometimes crazy things happen that even the more experienced midwife has never encountered and may not have the tools/training to intervene if it is emergent. A team of specialists are available at the hospital just in case. Even an OB may need to consult cardiology or neurology for things outside their training. It isn't a personal insult, why be so absolute in your opinions? It was bad when medicine thought they had all the answers, and it's also bad to think natural is the only answer. People have died "naturally" for eons.
do we know the rate/risk of infant post-partum hemorrhage, metabolic diseases, thyroid disorders, hearing loss, hyperbili or CCHD misses that can be extrapolated from these home births not getting initial screening/Vit K or followups within first few days after birth. I assume most families are good at making quick pediatrician followups but those families I seem to have trouble with tracking down for followups are also the ones wanting to refuse initial medical interventions. based on my limited colloquial experience
Yeah, in Canada, midwives are registered and regulated. It’s a bachelor’s degree (4 years) and fairly comprehensive, similar to the level of education all of our Registered Nurses have. Midwives usually have hospital privileges and offer clients choice in their birthing location. They have a less medicalized model of care. But they also are limited in their scope of practice, don’t generally treat high risk mothers. I would never personally choose a home birth, but then again I have reproductive health issues that increase my risk of complications. I would only feel safe in a hospital with ob/gyns and a special care nursery with close proximity to a NICU. Might be less comfortable than home, but I would be so worried and never forgive myself if something went wrong.
We we infertile for almost a decade. When we finally got pregnant with our 1st I was consumed with the ‘perfect’ experience. It was almost ideal in the nutty/crunchy arena but she needed just a little help breathing at the beginning. My husband said that if we had a great birthday second time then we could do a homebirth for the third. Fast forward to years were giving birth to her second child, he is breach there are many complications many interventions and he hast to spend time in the NICU. I was overwhelmed with guilt and anxiety that somehow my breastfeeding would be affected or that I wouldn’t bond with my baby. He is now healthy and we are nursing like a champ. I will be forever grateful for his NICU team and the excellent doctors and medical staff we had caring for us. We will never have a home birth now and I’m good with that. Good Discussion
I appreciate this. I've considered home birth myself, but truly, working in a hospital has shown me how much things have changed for pregnant moms. Hospitals really are making an effort to make it as comfortable and customized to each situation as possible. Last time I checked we do have a higher mortality rate, which is usually attributed to other countries doing home births, but I think as long as unnecessary interventions are avoided we can achieve a better outcome in the hospital. With CERTIFIED NURSE MIDWIVES. Not someone who went to a seminar and took a test.
You have not talked about how medical intervention can cause more problems with the birth than would have been. And hospitols and docters have a LONG way to go before they are as good as a midwife in supporting the woman durning labor.
My mom had her first in a hospital and was nearly killed by the doctor, who decided to yank on the umbilical cord to try to get the placenta out faster (literally because he was late for a golf game), which caused her to hemorrhage. She chose to use a midwife at home for me and my younger brother because she was traumatized by that experience. Because of her bias, I was raised to believe that a home birth with a midwife was the safest and healthiest option unless there's a high-risk pregnancy. Now, I completely understand why a woman like my mom would feel that way, and I agree with her that well-trained midwives are amazing. But in no way would I ever choose to have a baby outside of a hospital. Knowing what I know now about how terribly wrong it can all go, and how quickly, I want someone in the building who is qualified to intervene in any way that might be necessary.
If the doc really pulled on the umbilical cord without a good medical reason to do so, that's negligence and undo harm to a patient. You're mom should have reported that, that is not ok!
Hey Z Dog, I'd love to see you speak with some PAs sometime. A lot of the public still doesn't really understand what a PA is or what they can do, so it would be nice to see you spread a little bit of awareness.
As an L&D nurse, losing my son at 33 weeks of IUFD. I cannot imagine doing any of this at home, if we can get pregnant again I’ll be delivering in the hospital. I’ve seen how things can go wrong and quickly, I will do everything I can to save my child. It frustrates me when I see people putting mothers down for c sections, we have a large population of a culture in our area where it is frowned upon to the extent most cases they will let the baby die instead of a c section. It breaks my heart
I had 3 wonderful pregnancies and births because I didn't go anywhere near a doctor. I lived 2 blocks from the hospital if there were any complications, which of course there were none. The USA has higher infant death rates than some developing countries. Clean up your own backyard before you start giving advice.
Something that I'm curious about... most of the developed world that has a lot of highly qualified midwives have more accessible post secondary education than America. I wonder if CPMs would be so common here if getting a masters degree was more accessible.
Thank you for doing this episode, very informative. I am so glad I had all my babies in a hospital. Better safe than sorry, I didn't even mind being bugged as much as I was- I knew my babies and I were in good hands.
I am completely down with the whole make the hospital labor and delivery feel safer to folks, I had 3 cnm attended births as crunchy as you could want, knowing that the cavalry could come storm in and carry me off to the OR if we got into trouble made me very comfortable. Hospitality OBs make me uncomfortable because they don’t know you or what you are really like. But if they were backing CNMs who had followed the pregnancy and knew moms. I wanted to add a couple of thought points, one, Ina May Gaskin, in the late 1960’s early 1970’s did many out of hospital births, she also wrote a book that is probably on the shelves of many CPMs “Spiritual Midwifery” the birth stories in it didn’t inspire me to try a home birth but they did teach me that I could go through the birth experience without meds and that contractions were nothing to be afraid of. She was kind of goofy in that she called them “rushes” but whatever. Positive stories of low intervention hospital births are a highly positive thing. We need more of them. As my babies grew, I was for a time involved with the Mothering.com forums. They were always very natural and crunchy and I aspired to some of it, between 2003 and 2005 I wasn’t there much, when I went back during my last pregnancy I was horrified. People were trying to outcrunch each other, Like “I’ll see your CPM attended home birth and raise you an unassisted home birth.” Then the next one comes in and says “ well I had an unattended pregnancy and Birth in a puddle in my back yard with both of my older children there. We left the placenta attached for three weeks, until it fell off of it’s own accord!” Gag! It was some kind of a bizarre contest and another board or two arose from it that kind of poked fun at it as well as being horrified by it. Then of course there is the Skeptical OB, Amy Tuetor (sp?) who seems to make you feel stupid if you don’t slavishly allow modern OB to direct your whole pregnancy. She has good stuff at times, but otherwise seems like whiplash from the Mothering.com crowd. There is a happy and safe medium.
Thank you for this interview with Dr. Buddy. I am generally in full agreement. The only thing that I would like to interject is that the process of having a child though the medical based system in the US can be very expensive and stressful for a expectant mother. I know that my wife has gone through a very stressful process of finding an OB. Then being told that she would need to pay for all projected gaps in reimbursement up front. Then being told that she would need to see a specialist for her anatomy scan because her BMI was in the overweight category. Fortunately we have good insurance and she has the knowledge to navigate this mess without feeling like a fat pain in the ass, but this is a real experience that many women have. The general feeling among many women I have talked with is that they feel like they are being sent to specialists for no reason and that, in the end, there is nothing wrong with their pregnancy and they just paid an enormous amount of money. My wife and I are very fortunate financially but the cost of having a child for an average family who does not qualify for medicaid can be daunting. I just wish that we took better care of our future in this country by making the medical model less sour than a kitchen table. Which, by the way, is what I was born on. Keep up the good work Z.
11:08 "it's high school only" ZDogg's face mirroring mine :P:P Seriously though, the "people don't understand statistics" is one very important point. And it's they reason why patients many times don't understand the risk/benefit ratio and would rather rely on emotion for decisions.
LOL... MDs don't understand statistics! Ever wonder why Statins, which should only be prescribed to those with a previous heart attack, are prescribed to "everyone"? Yup, it is because BigPharm knows MDs don't know the difference between absolute and relative risk. I rolled my eyes at the "high school" comment, since many of the smartest, well read people I know have only high school diplomas. Education doesn't make you intelligent, but experience does. Education just gives you legitimacy, and I say this as someone with multiple Ivy degrees, and a doctorate.
Preach! It doesn’t matter at all how children are born. At all. It is narcissistic on the part of any woman who would choose to endanger the life of their child so they have a story to tell. Ridiculous. The only thing that is important is the health of mother and child. Thank you, doctors, for addressing this important issue. Most anti-vaxxers also drank the Koolaid about home births. The ignorance is both sad and frustrating.
Matt Hirschhorn yes, Birth by c section does have some health implications But if the other option is death of baby and or mother because a section couldn’t, wouldn’t, didn’t happen... that also has health implications.
@@tanya5322 Well obviously I agree, I just think as a culture we should push for vaginal birth and breastfeeding as much as possible, instead of "formula is just as good", or whatever excuse we use for convenience, we should be honest and just say the truth. I understand some people are going to have to be born c-section, my issue is that people are getting c-sections when they do not have to, doctors are telling people it's fine when the scientific literature is clear that it is not. All im saying is we should be pushing for what is optimal for the baby, instead of what is "convenient". Ofcourse c-sections and formula should exist and be used when needed, but they should be used as last resorts. I do give sympathy to the public because the medical industry is not educating the public on the dangers, so I understand that, but the health implications are utterly severe, were talking 300-400 % increases in certain diseases just from c-section. Yes, they should be used when needed, just like formula should be also, but I think their needs to be more educating from the medical community to the public.
Er, women who give birth in hospitals also get a story to tell, and often it isn't very flattering to the medical establishment. As the doctor said, a delayed mother/child bond does have an effect on the success of breastfeeding, which in turn has an effect on overall infant health. Like it or not, in a hospital human needs often take a back seat to institutional policy and send mother and baby off to a rockier start than necessary. Isn't the term 'narcisist' a tad mommy-shaming in itself?
@@matthirschhorn5309 👏👏👏👏 agree! 1 -in-3 births here in the US are c- section. Most of which is more convenient than neccessary. I agree with these docs. L&D should be more homey, have true midwives and a OB/GYN Hospitalist or your OB/GYN on standby in case needed. Where I had my baby, your doc delivered your baby. So with this, they are still available if needed so you can be comfortable. Maybe even midwives affiliated with your doc so you are comfortable with them also. I had a bad experience when having my baby on part of my nurses but luckily I love my doc and he knew what I wanted and stayed true to that as much as he could.
I feel like if I was going to have a kid I’d want them to have access to the most advanced medical care and treatment if anything unfortunate happened.
About measles: Just a few days ago, I saw a Facebook post from a doctor who has worked in Africa for many years that he had observed that the aftermath of measles was "like having AIDS for 6 months" and when it was reported a few years ago that measles causes a sort of amnesia of the immune system, he understood why.
My perfect delivery right now currently pregnant with twins is we all live and we are all okay! I’m scared of having a major surgery if I need to have a c section but I’m 100000x more afraid of something going awfully wrong. Baby A has at least one club foot and their monitoring her for borderline small cerebellum (but nothing alarming yet) at this point for gods sake I just want us to live and be healthy.
Off subject but I thought hilarious. In postpartum room after the delivery of my 1st son the lady next to me named her baby daughter Meconium. After asking her why she replied "oh I heard a nurse say Meconium is present. So I thought what a pretty name that make."
This was amazing! I’m a new nurse who loves watching this show! Lately, I’ve had guilt because talking to my partner about pregnancy and home birth has come up a lot due to it being glorified. Being in healthcare, especially working in an ICU; this just never felt right (because as you said you know and think of everything that is going to go wrong). This has absolutely made my decision for when we decide our family planning! Thanks docs!
Women have delivered outside of the hospital for decades, but cemeteries are also full of newborns and mothers. Check it out in any old cemetery or on Ancestry.com.
Didn’t childbirth use to be the leading cause of death in women before c sections and hospitals came around? That’s natural for you. Hey Zdogg, I appreciate this show. I work in a NICU and would never even consider home birth...I’ve seen too much of what can happen. We have a golden minute where swift intervention with the baby can even prevent a NICU stay . Prolapsed cords may be rare, but I have seen many of them over 30 years. Some come out just fine after a stat c section but others can be born mostly dead even though the mom was in the hospital. Add ten or 20 minutes to the response time, I just can’t see a good outcome. We’ve admitted babies that were home birth disasters that could have been prevented. And don’t even get me started on “free birth “! Imagine, you’re the dad,you delivered your baby, it’s not breathing and your wife is hemorrhaging. What do you do? Who do you try to save, if you even can. Scary. The hospital I work at has a very nice women’s center. We will follow your birth plan, you can deliver in the position you want, use whatever tools help you. But in the end, if something goes wrong, we can help you.
" I work in a NICU and would never even consider home birth...I’ve seen too much of what can happen. " So, working in NICU is how you've witnessed enough home births to understand what happens during them? An extreme number of complications are caused by unnecessary hospital interventions, which don't happen in the first place during home births, and it is clear that you are not taking this fact into account.
seeingjay no, I don’t see the ones that go right, I’m sure it’s great. I only see the tragedies . And if you are in that small percentage, it’s pretty devastating
Catherine Hazur They can work if they have full medical support very near by. I would by all means prefer that to a home birth or free birth experience
My oldest uncle was born at home in 1930. I don't know the details, but his birth was extremely difficult, and Grandma would have had a c-section if she had been in a hospital. (IN 1930!) He graduated 2nd in his HS class and is still reasonably active and healthy at age 88. :) My other uncle and mother were born in a hospital, both without complications. That said, I used to live in an area with a large Amish population, and most of their babies are born at home, delivered by lay Amish midwives. (The state of Missouri had a big debate about this a few years ago.) Most of the time, everything's OK, but those midwives knew when they were in over their heads and needed to call an ambulance, which they usually did with solar-charged cell phones. They had no hesitation about using modern medicine when needed, BUT many of them were unvaccinated because they had never been in an environment where they had to. Most of the vaccine-preventable diseases we saw were among the Amish, or people who had direct contact with them.
As it pertains to IL we don’t have CPMs, but CNMs do frequently do home deliveries. But they work with OBs and moms see (or are supposed to) see an ob. CNMs do come with meds, O2, assistants, transfer plans (the threshold to transfer or risk out of home-birth)- in IL As a mom with severe medical issues, I’ve had 5 preemies.... in a hospital with good NICUs
Elizabeth Handler I don’t know about in IL, but in Minnesota CNM is a Masters level of nursing. That’s why they’re able to give medications without a doctor’s purview. That is totally different than the high school level midwives that they are talking about.
My sister was bullied by our dad for not breastfeeding. My niece was born with rubella and when she was finally able to have breast milk, she would latch on. This was an awful added mental and emotional stress she didn't need.
I love midwives. I learned a lot from them. However, when things go wrong in a delivery, which they often do, you want to have a surgical team down the hall.
This is what the Duggars were promoting on their show! A few of their daughters because CPMs although I doubt they are practicing anymore now that most of them are married.
British statistics show that well screened home birth is actually safer. If all you see is the complications or bad outcomes, you're not equipped to make an objective assessment of safety. Sorry. Our hospital statistics regarding maternal and perinatal mortality stink when compared internationally with other first world countries.
I feel like since he doesn’t agree with home birth, he definitely should NOT have a baby at home.
Thank you for acknowledging that we suck at maternal care. And that doesn’t just mean that women die. It means that they routinely have traumatic, dehumanizing experiences.
He says “become a certified nurse midwife” as if it’s an easy thing to do lol.
I love how he talks about the experience of home birth not being that important. Has he ever experienced a birth?
Also he acknowledged that home births in Europe (where care is well integrated) are safe and then basically says he’s going to ignore that information. Please don’t ignore that data.
I am hearing a lot of “women don’t matter” in this conversation.
Yeah let's all take two men sitting around talking about birth seriously, LOL.
I had 3 home births after a bad Hospital birth. I went back to school and became an RN, although I had been entertaining the idea of becoming a CPM. Training was difficult to acquire though, and finding a preceptor was too much of a drive.
I think the problem stems more though from a broken hospital system rather than failed expectations and most of the complaints I hear from moms that didn't have the delivery they were hoping for were that they felt pressured, depersonalized, and treated like just another patient in a bed.
Moms-to-be want to be heard and treated like a part of the process rather than a victim of the process. I got my RN and work in a hospital because I want to support Health 3.0 (even before i knew what it was)
What makes these moms feel like home is safer? What makes them want to be out of the hospital environment and escape the OB system?
The idea of Health 3.0 and getting back to patients as people can solve a lot of this to keep more patients safe and delivering in environment in which they feel safe, whether they still choose home or the hospital. Improving the care we give will improve our outcomes.
Anne LeClaire we need more health professionals like you! I am just a phlebotomist (entertaining the idea of going back to nursing school) but I completely agree with heath 3.0!
I had 2 home births myself and am pretty crunchy (not as much as some people, though), but I see life-saving interventions performed all the time at the hospital I work at. So I feel like people like you and I understand and appreciate both sides to this, and that helps us connect with patients better. I won’t force or pressure anyone to do anything they don’t want to do, but I also won’t sugarcoat things. Patients ALWAYS have a choice and shouldn’t be pressured into anything or shamed or guilted.
I am also considering becoming a CPM, but am leaning more towards nursing school.
Anne LeClaire - Have you never heard of birth control and over-population?
@@peachesandcream.2612 wth does that have to do with her comment?
@@chelseatomkowiak7712 I started as a phlebotomist. (Became a family Dr.) Go for it!
All four of our children, three girls and a boy, were born at home. I'm a Family Physician and my wife is an R.N.. She told me there was no way she was going to the hospital. After our eldest daughter had her first child, she was sent home where she bled herself down to 5 g of hemoglobin because her doctor wouldn't believe that she didn't feel right. After she was transfused, she vowed that she would not trust the medical system again. How's that for irony?
What I don’t get is that you can have a crunchy all natural birth right in the hospital! I had a whirlpool tub for labor and no iv or meds but still the OR was right around the corner just in case.
That wasn't the case when I had my two babies at home in the late seventies early eighties. The OB/GYNs I consulted during my first pregnancy didn't inspire confidence, either, one of them telling me that HE would tell me if I needed pain medication. It was also part of my religious beliefs back then that God didn't like western medicine, and I thought/hoped that nothing bad would happen to me or my babies if I had them at home. There was also a counter-cultural push for natural childbirth. When my daughters had their babies in hospitals (which I wholeheartedly supported), it was interesting--and one time scary-- to see the good and bad side of medical interventions, both for mom and baby. I think there's still room for improvement for hospital births, but the lack of training of most home birth midwives needs to be addressed. I think these docs are on the right track.
I agree completely. My aunt had her third in the hospital with a midwife, but the doctor ended up having to intervene and do a forceps delivery. The midwife made the general experience better for her because she was able to be a supportive presence, but we were all pretty damn happy the doctor was there.
Kathleen Kakacek that sounds horrible! I am glad things have gotten better since then, and agree that certainly there are always ways for hospitals to improve.
I'd imagine they'd be 100% ok with that. If you don't have a medical need for a C-section or intervention, it's better that you don't, a C-section IS surgery and it should be avoided, up to the point where it's more medically beneficial to get a C-section.
My hospital didn't allow water births, didn't allow me to wear what I wanted, didn't allow me to go without an IV tube, and didn't allow me to go unmonitored, so I was continually strapped to something, and my labor was interrupted every half hour as they took my vitals and adjusted the baby monitor on my belly. Also, being checked every couple hours was extremely painful and a source of great stress for me. Midwives don't require checking dilation.
Not everyone's hospital has the same policies, or can be as accommodating.
Also, in my area, midwives are not licensed to practice within the hospital unless they also have recieved a nursing license. So I would have to go with a general obgyn, who doesn't have the expertise I would prefer in a birth, since I want someone who can advocate for me what my labor and delivery desires are, when I am at my most vulnerable. I want to focus on bringing a baby into the world, not being distracted by the terrible reality of being a patient in a hospital.
"Science is a process, not an ideology." YES!!! I really appreciated this interview. It was very informative. I hope we can continue to improve our system and minimize interventions for the birthing process.
In Paramedic school they taught us to recognize all the different OB delivery complications. Then they told us the interventions for all of them: left lateral recumbent position, high flow O2, HATH (haul ass to the hospital), and try to get 2 large bore IV access en route. Because both mom and baby are on the line, and only an OR can save them. Made quite the impression on me. We need to do better for the delivery experience for the uncomplicated births in hospitals and certainly better post partum monitoring of moms, but when something goes wrong you want the OR down the hall, not 30 min away.
The AntiChick I’ve been a paramedic for 20 years. Helped deliver 4 babies prehospital. Two were super easy. One had a cord around the neck, not a big deal because we caught it early. One was Two months premature, not breathing and needed to be resuscitated. SCARIEST GODDAMN CALL I HAVE EVER DONE. There’s so much that can go wrong. It would seem like you’d would want to give mom and baby the best chance possible.
@@Ravenankh Yet we just delivered at home a beautiful perfectly healthy baby girl last night. Ahe is doing just fine. Was actually 1000x easier than a hospital, where we had and lost our first and then had our second. And it was absolutely the fault of the hospital when we lost our first baby. Don't tell me that hospitals are safer, because I have seen evidence of the contrary first hand. Every child we have from now on will be had at home. So much easier and more natural than at a hospital, where a ton of things are forced on the parents that may be unwanted, such as premature cord cutting, dangerous vaccines, forced epidural, etc. We have been doing it for thousands of years. If so many babies died as a result, why then is it that we have had 100 times the population currently walk this earth. And that is just on record. Sounds to me like not too many died in child birth or shortly after if that many people have lived here.
@@mightysobe I'm sorry for the loss of your child. Whatever happened I hope that you made a big impact and the hospital did a giant case study and trained the entire department so that it will never happen again. That being said there are statements that are way off. Dangerous vaccines and forced epidurals? Getting a Hep B vaccine for a newborn is a big deal and a lifesaver. Medical professionals can not force you to get an epidural. You have to consent to any procedure. If you are dying but of sound mind and you say don't touch me. I can not do a thing to you otherwise that is assault and battery. Also your last comment about population growth, maternal and infant mortality is absolutely absurd.
@@justinchapman5876 I asked my docter about when he did epuidurals. He said only when needed. My baby was 5 LB 14oz. He pointed and the intern cut! He didn't ask me if I wanted it!!
So my birth of my daughter is a good sample (I think) of a birth that can go off the rails. I planned (and did) on having her in a hospital, and my whole pregnancy was fantastic. No problems, myself and my daughter were healthy, and I even went into remission with my RA. My water broke at 2 and we were at the hospital and in the room by 3. They gave me pitocin because I still wasn't dilating. They had me moving and then at 5 they told me to lay down and would have me change positions (left & right side). The nurses were checking my vitals and I meanwhile was focusing on my breathing because it felt like the worse menses cramping of my life! At 6 then told me I had to have an emergency c section because everytime I was contracting my daughters heart rate were drop. Turns out she was holding the umbilical cord and squeezing it during contractions. So they got me in the OR, all the while I was freaking out, shaking, my heart rate sky high. I was terrified! I wake up from anesthesia and hold my daughter for the first time at 815pm. The story isn't over yet though! I reach down and feel something dropping by my left hip bone. It was blood. Turns out I now have to go back under anesthesia because I had a subdermal hematoma. The on call doctor had done both procedures, as my OBGYN was in another hospital that was an hour and a half away!
So, had I been one to want a home birth... What could of happened? Could I have died? My daughter? Would I have to be rushed to the nearest hospital from our home, which could have been upwards of an hour and a half? I, nor anyone who knows me, could have predicted that type of birthing experience... I certainly didn't. I did beat myself up for months after delivery over not being able to have her vaginally, I felt like a failure. I felt like my body failed me. After a few months though I started thinking 'fuck that'! I successfully carried my daughter for 9 months. My body did an amazing task! I am damn proud of what I accomplished. I had the privelage of having high quality medical care in order to assist with my birth, and that is NOTHING to be ashamed of!
So that's my story. Lol
Skeptical Rationality 3 c-sections for me, 3 bottle fed boys, all beautiful 6 foot tall men who bonded with me and their dad, not psychotic ,and we are all as good as any one else
@Mzisa I have read that c-section is more likely when pitocin is administered but I'm not sure if it's just correlation. I do think it's probably better to hold off on induction until absolutely necessary, which I don't think is what's currently being done in most hospitals. At least that's how it seems when I'm speaking to other women about their birthing experience. Most women I know were induced with pitocin and the majority ended up with c-sections.
"Pit to Distress" google it. This is a classic example.
Yeah I know NCBese and they would totally blame that on the Pit. I think my birth was a better example on why NCB is a load of bull. With my first I wanted a natural birth. While I did chose to birth in the hospital I declined all interventions. I went to almost 42 weeks before I naturally went into labor. I had no epidural, no pit, intermittent fetal monitoring only, and lots and lots of support. I didn't even have a saline IV, nothing. I moved around as I pleased, and even ate a little. But once my water broke my daughter ended up sitting on her cord, and went into distress.
I like you, felt csection guilt. But years after the fact I shutter at the thought this scenario playing out at the stand alone birthing center I was considering. Would the CPM even notice something bad was going down? I've read too many homebirth nightmare stories where the CPM didn't even realize things were going south until the woman pushed out a blue baby. I could have been one of those women with a dead or brain damage baby if I had made a different choice. Yikes.
Wow, NO your not a failure, thank goodness for modern care, I bet your an amazing mother, women’s body’s do an amazing job after birth. You know birth is just the beginning of mothering , every mother wants a great birthing experience however the safe arrival of your baby and your safety is the most important outcome!
Two men talking about giving birth... okkkk planning my 3rd home birth thanks. Body autonomy, heard of it?
Thirty years ago I was helping people have babies at home and in the hospital. I remember how difficult it was for midwives to get docs to be backup for when women needed to be risked out of a home birth. There were (and are) countries that have a cohesive system so that midwives and docs can collaborate for the best possible care for families. I had 3 home births in the 1980s and I was never "home birth at ANY cost" with families I worked with. In fact, working with one of those was an incredibly frightening experience when the baby was in distress with pea soup mec and mom didn't want to transport. Then we got to the hospital and they didn't believe us! I was hopping on one foot, but finally they did a C section. The CNM assisting looked over when they opened the uterus and said, "Pea soup mec," like we'd be surprised. It is difficult to assess who knows what they're looking at and who doesn't, I get it. But the history of childbirth in this country holds some clues as to where attitudes came about. When doctors decided to get into the business of birth, they started referring to the "dirty midwives". I guess my comment would be, "Watch out for the broad brush." One direct entry midwife I worked with had been an ICU RN and was also an ARNP and she wasn't the only one I knew with those kinds of credentials.
Make sure the statistics and studies you are referring to are just assisted home birth not a mix of unassisted/unplanned and assisted home birth mixed. I have reviewed all of the studies on referenced on the ACOG site and every single one was mixed with unassisted birth (mom and dad at home alone). We need more research and more structured training for CPMs. Don’t throw home birth out the window. It should be a safe option for women in the US like it is in Canada and the UK. Canada’s and the UK’s government recommend keeping low risk women out of the hospital. Out of hospital birth center for first birth and home birth for pregnancy after.
100% vaccinate your kids but do not say oh perinatal death that is all because of home birth. Perinatal death dropped in South Carolina when they instituted elective c-sections must be done after 39 weeks. Perinatal death in America is an overall birth issue.
As someone who had a horrific hospital birth, ended up in a c section under general, the idea of going through labor agains scared me soo much I haven’t had another.
One thing I have a huge problem with is “I just want a healthy baby”. What about healthy Mum? My birth gave me ptsd because all anyone cared about was a healthy baby. I was terrified. No one but my nurse midwife gave a shit about me and talked over me and about me and not to me. And then when. It was over, I was left to the antepartum nurses who had no idea what I went through.
In an ideal world I’d love to have an OB who cared for me physically and emotionally throughout my pregnancy and birth. That if it didn’t go well, to support me and just care.
Bingo. Except our experience was a C-section under a spinal anesthetic that did not cover the entire surgical incision. That was five minutes of level 9 pain endured for the health and safety of our one and only child. To make matters worse, because of a complication, our son was whisked off to another hospital specializing in children and not reunited with his mother for four days. He had been bottle-fed and rejected both the natural nipple and is mother. We were given a gloomy prognosis for successful breat feeding. It all turned out well in the end. The bond eventually developed, and mother and baby worked out the breatfeeding thing on their own. But this was in spite of the medical intervention rather than because of it.
Sometimes the medical establishment doesn't 'get it'. Emotional health is as important as physical health.
I am so sorry this happened to you. Recently the medical community has gotten better, but for a long time they were focused on getting infant mortality rates down to such an extent that they did forget about what the mother needed. I think however that you need to look at his statement in context. They are talking about homebirths right now and the reasons that he has against them. This discussion is specifically about babies health. Again, I am very sorry that that was your experience. No one in the hospital should ever be made to feel like they are not important enough to have medical professionals’ full attention.
My first c-section ended up being under general also. I did go on to have another (and she was a planned c-section as I wasn't rolling the dice again). It was a fantastic experience the second time around! As for finding the most caring doctor, at the risk of sounding totally sexist here, I'd find a male OB. The female OBs in my practice weren't sympathetic at all, but the 2 men (one in particular) were amazing. It helped that they both had a LOT of kids each, so they'd obviously supported their wives through many pregnancies. It seems counter-intuitive, but that was my experience.
7:00 What the heck does "Organic" (not using synthetic fertilizers, etc.) have to do with sugar in baby formula...?
Purely guessing why they mentioned that but.
Pure sugar/sucrose is used as an anesthetic for newborns (sugar dipped pacifiers during circumcision).
So I wonder what that would have done in baby formula
I found this quite insightful as someone who works for an out of hospital birth center with midwives that are only CNM that do birth center and home births. I hope you do a part 2 with a CNM to gather their experience and opinions about home births 😊
My 13 year-old was born by c-section while I was under general anesthesia. If I'd attempted a homebirth, she wouldn't be here. There was no indication that she was sunny side up and diagonally placed when I had all of my appointments, no indication that "she was never coming out vaginally" to quote my doctor. I went to push and my OB realized that my baby was in no position to come out vaginally. I don't know if she turned during labor or what, but something clearly happened. Thank God I was in the hospital. We live in a first world country. I cannot wrap my mind around attempting a homebirth.
We just did and it was amazing. Labor lasted maybe 2 hours, took maybe 15 minutes of pushing, and my wife said there was very little pain. She hardly tore at all. And baby is perfect. This was just last night with 2 certified nurse midwives present. We weren't a third world country 150 years ago either, yet home birth was an everyday thing. Plus just look how long we have been having babies naturally and at home and how many people have lived here before us. If home birth were really that dangerous, would we have the huge numbers of people recorded to have lived here in the past?? I think not. Yes, things happen, but that doesn't mean that risks should equal completely ruling out the option of a home birth. We personally will be doing it this way from now on.
I'm an RN that works L&D and I work for an OB/Gyn in clinic. I also had two kids in a hospital. I didn't even know about midwives until I went to my nursing OB clinicals and just recently learned more about homebirths because a few of my friends are the more "crunchy granola" type people and kept asking me tons of questions.
I've done a lot of research lately on this subject and I guess I was expecting a more comprehensive view of this topic from this 45 minute video. I feel like your argument was just do what's safest no matter what. And the simple take away could be taken to the extreme and say, "well, the best thing for your baby and you would be to deliver in a huge hospital with a NICU, perinatologist, and in house surgical team, etc and if you decide to do anything else you're just selfish" but obviously it's not always realistic to do that, so I just wish you would talk more about what kind of situations warrant more risk? In my few years of nursing, I don't think the patients/friends I've talked to are choosing homebirth for the experience so much as for other reasons. Hospitals are under staffed and nurses are sometimes inexperienced, and sometimes I feel could be more dangerous in some situations. Not to mention the different ideologies and reasoning behind the decisions OBs make, such as litigation and what they feel like they would want if they were in the patients shoes.
I want to know what he or you think about those that choose a homebirth with a CNM that has a RN birth attendant with NRP. I had a friend who chose this because she knew she would have at least one to one care for her birth and felt safer. The CNM had almost all the same meds and equipment we bring to the delivery room and she was 5-10 minutes from the hospital with a surgical team & NICU. At first I thought she was crazy but she had quite a bit of reasoning for her choice.
I also wonder if you could talk about how we could help patients in rural areas with less access to healthcare. Many of our patients live over an hour to two hours away. I've seen a few choose homebirth with lay midwives or just family members or most choose to go to the local small rural hospital because financially, culturally or whatever else they didn't think it was worth it to stay in a hotel for up to 3 weeks just so they could deliver in a bigger hospital. Most end up getting transferred to our hospital either in labor or postpartum and many are train wrecks. I think they are taking a huge risk but I try to be understanding of their situation.
I've heard of women choosing homebirth because they were uninsured and felt that they couldn't afford the hospital bill. They said that they would rather take the risk so that they had money to provide for their newborn.
I guess I didn't feel like you really covered all the different reasons for choosing homebirth and made it seem like most of the women choosing this are uneducated and narcissistic when statistically speaking most of them that deliver with a midwife at home are college educated and do want what's best for their family.
I appreciate you talking about it though and you both did mention some really good points. I really enjoy your shows and I just want something to help me better educate patients and my "granola" friends. Thanks.
Bingo the three Mama's I know that did home births all have there bachelor's degree in the health science ( 2 nurses 1 microbiology). Personally I think people need to be more aware of what to do for home births even if it's just for ER. My last baby was born in 45 minutes from first contraction and if we didn't live 5 minutes to the hospital she would have been born in the car. I also live in a state that most people live 100 miles (if they live on the road system at all) from hospitals.
Thanks for this. I used to be one of those very crunch types when it came to what I wanted for my future deliveries... Until I started working as a L&D nurse in a high risk OB. It's really scary how shit can hit the fan at any instant. Sometimes we get some of these "home births gone wrong" and it makes me think the risks are just too great to have that status of having a home birth. Hospitals nowadays really do try to normalize births. We let our patients decorate their rooms, bring their essential oils, hypnobirth - whatever. But outside that room you got a floor full of nurses, the OB/GYN residents, 2 hospital attendings, anesthesia and the rotating staff midwife at any given time in case shit goes down.
I'm an AEMT. As a minimum standard, it's about 600 hours of classroom and ~200 hours of clinical with only high school as a pre-req. Most of that is *not* in OB related issues. I'm officially trained/certified to deal with uncomplicated and complicated (for certain definitions thereof) childbirths. As a part of my training I needed to witness 1 live birth and do a few hours worth of training with a simulator.
How is it that these low-level providers with 60 births are considered inadequate whereas I, with far less training, am considered trained and certified? How/what can I do to be better at this?
Paramedic here and i have delivered several but NOT BY CHOICE. AEMT IS NOT ADEQUATE TRAINING. PARAMEDIC IS NOT EVEN CLOSE TO WHERE IT NEEDS TO BE. i have had mothers start to slmost hemorrhage to death, muconium., babies born high drugs, no prenatal care. As a profession we need to be increasing training not lowering standards
Another paramedic here, I don't think anyone would consider an AEMT or paramedic adequately trained to routinely give birth. Yes, we go over it in school with uncomplicated and complicated deliveries. We have to go through labor and delivery clinicals. But, I would never say that we're the most qualified to deal with these issues. We're better than nothing. We can deliver these babies and we can even intubate them and hopefully resuscitate them if needed. But, I think we can all agree that we would rather these things happen inside a hospital with specialists and not in the back of our ambulance.
@@mac5399 In emergencies where something needs to happen now, I would hope paramedics and AEMTs are adequately, certainly shouldn't be a routine thing but in emergencies you guys need to be adequately trained since you say you're not.
Melissa Cruz I completely agree
My sister was born at home but we also live around the corner (literally 2 blocks) from a hospital so there would be a safeguard. I can understand not wanting to have your kid in the hospital tbh, I wouldn't want that many people around me while I'm going through that
I had my baby at home , the hospital was 5 minutes away. I didn't have to go there. It worked out.
"Science is a process, not an ideology."
Bumper stickers, tattoos, billboards, etc. Shout it from the mountains.
And medicine is a practice not a science... physicians are practicing medicine. SCI means to know... medicine has way to many variables for anything to really be known without doubt.
There’s so much to say here. I absolutely concur with everything Dr. Duddy has said, and I’m a tree-hugger at heart! Ultimately, there is one powerful reality: that baby and that Mom have one chance. With everything from hypoxia to hemorrhage..., one chance. Hope for the most beautiful best, but if it hits the fan, be ready for providing full support of all hands and resources on deck.
I have PTSD from my son's birth only a bit over 2 years ago. I was having nightmares during my pregnancy about being confined to the bed and being controlled and having cords and wires covering me. That was my reality. I remember being surrounded by strangers and was treated like a thing, not a human that was terrified going through a huge process. I never met the OB that did the surgery, she never even came in during the 3 days I was in the hospital. I was completely knocked out for the surgery, I didn't hear my sons first cry. The first thing I hear was "I don't know why they red lighted her."
I'm pregnant again now and trying so hard to get better from the flashbacks and PTSD caused by a hospital birth. The system HERE SUCKS. There are states where not a single hospital allows a vbac. The closest birthing center to me that's admitting privileges to a hospital is 3 hours away. So I have to choose, go back to the hospital where I KNOW I will experience flashbacks and anxiety and be treated like a thing and risk making my ptsd worse; or I can attempt a home birth with a CNM (the RN), while living close to the hospital and also seeing an OB and keeping them in the loop. This is exhausting and expensive, and I have to fight for this choice more often than I would like.
So instead of pointing out how dangerous home birth is, how about you work on improving the maternity care available to us?! How about you go talk to hospitals with outdated and/or harmful policies? You want us to come to hospitals because they're safer for baby, then make them safe for mom too.
Your experience is not uncommon and is the reason why people want an alternative to medical driven births. It sounds like you may have required a surgical procedure during birth and you deserve better, more loving care. It's the birth of your child. Yours is the story that needs to be known in order to improve the care of each mother and child. The system needs to be better.
THIS. x the 99% of women who all birth in hospital in the U.S. Thank you for sharing - this is all too typical for too many women.
Um, they didn't put you under general anesthesia and give you a stat c-section for nothing. In my experience even getting an epidural was difficult. Maybe you didn't understand the reasoning behind it. Wanting a home birth isn't wrong, but in cases of emergency it can come down to life or death in a very short amount of time. As long as you're prepared for the risk to yourself and your baby, no one will stop you.
We had a pt who was having a home birth, things happened, she was so far from the hospital that after the midwife decided to transfer her to a hospital, they could not save the baby, the baby was normal....but could have been saved if delivered in hospital. As an RN I could never recommend a home birth, its just too risky, I have seen it all as an RN. You guys were great and I totally agree, thank you so much and appreciate the humor
Delivered a perfect baby girl at home just last night. Went too well if I do say so myself, and momma and baby are doing just fine. From labor to birth was only 2 and a half hours. And my wife even said there was little pain. Had a terrible experience after losing a child at the hospital with the hospital being 100% at fault (they failed to mention the UTI she was having no symptoms for for 4 weeks). Tell me, would you tell us we were wrong for making this decision?
@@mightysobe you didn't even watch the video, am I right? If you had, they even say 1% of births outside of the hospital result in death. That means 99% do not. However, the rate is statistically significant compared to a birth where modern medicine is available. In cases of emergency, it can be absolutely crucial to have immediate treatments available. Maybe try listening instead of getting all heated.
Hey Zdogg! I am a CNM and a FNP who works both as a CNM Hospitalist at a MLoC level 4 hospital as well as PRN at a pediatric urgent care. I am currently working on my DNP with the focus of my studies on improving systems for community birth transfer. I am also in the process of developing/opening a Free Standing Birth Center. I listed to your interview with Dr D as well. You make some good points, but I really missed the point of the main problem which is a systems issue rather than a CPM issue. We have a huge problem in this county with how we provide maternity care and in reality birth both inside and outside of the hospital poses more risks then needed. I would love to talk with you more about the subject.
Mary Love
Background: Washington State. Midwives here are ARNP-Midwife. I have 2 healthy (vaccinated) sons. I had one premature and complicated birth in a hospital and my second was full term no complications and at home. I think a home birth after proper prenatal care and planning with the assistance of trained and educated professionals is beautiful and wonderful.
Hailey Ney the home-birth of my first son was attended to by a Certified Nurse Midwife (who was a Family Nurse Practitioner with her doctorate in nursing degree before she even went back to CNM school). She cared for me during my whole pregnancy, delivery, postpartum, AND she could even care for me and my child for the rest of our lives if we wanted her to since she is also a Family Nurse Practitioner.
We need more advanced practitioners who are willing to do home births! Don’t get me wrong, I had a wonderful CPM for my second birth, but CNMs are perfect for people who want a home birth but are a little hesitant.
It is very hard as a new doctor, to focus on one patient at a time. When you deliver a baby, there is two patients that need very immediate attention. Even if everything goes well, you are always in a position where you are not capable of doing everything you should.
My sister and I were the first in our family to be born in hospital.
My Mum was born at home, premature and weighing 3lbs.
Her bed was a cotton wool lined dresser draw.
She lived to a ripe old age.
There have been many infant deaths and damage caused by medical staff and hospitals.
I will take home birth any day.
I was home delivered by the head nurse midwife at a top hospital in NYC after my mother's first birth in a hospital was a terrible experience and the Dr only showed up to get paid. The rest of her children were home birthed too.
I do think if you live more than 3 miles from a hospital you can't deliver at home.
If newborn screenings aren’t done with home births, that could be tragic too.
Robin Hensley they are done at home births with licensed CPMs, unless the mother declines it.
Ours is getting her screenings tomorrow. Our midwife, who is certified btw, will be here at noon. She helped deliver beautiful Eliza Sue into the world at 11:39 last night with hardly any labor at all and only 10 minutes of pushing. She is perfect. Wanna tell me what I did was wrong? Am I so terrible for wanting our daughter born at home rather than in a hospital, which our local one is responsible for the dwmeath of our first. You honestly think we should go to a hospital anyways?? Haha, you so funny. Our two year old son is doing well too. May have been in a hospital, but we refused the vaccines except for the vitamin k, and only reason we did that one is because it was the preservative free. We were fully prepared to go elsewhere for it if they didn't have the preservative free. Our little Zachariah is 2, vaccine free, and has only been sick once. And it was a common cold. We took him to the doctor for it, and the doctors ran all these other tests because he was unvaccinated and even scolded us. We are lucky he's not dead I this is what they told us. Then were so mad when they found it wasnt anything they tested for and just a cold. Basically gave us a prescription and told us to "just go". Complete waste of our time and total disrespect on the doctors and nurses' part.
@@mightysobe because we have seen unvaccinated kids die. Like in the VIDEO, he has seen kids die from meningitis, etc. So we would be moronic and culpable not to warn you of the potential complications/risks of staying unvaccinated. What if his symptoms HAD been from a vaccine preventable illness like meningitis, pertussis, tetanus, hepatitis? Would you have declined medical treatment and let your kid die or suffer at home? No, you brought him to the doctor for help. Turns out you were lucky. If it had been severe you would have relied on life-saving medicines and help from the medical team. Don't cherry-pick just because you think you're right, and then run back when things go wrong. Pediatricianshave seen what can go horriblywrong and also all the complications that can happen if you get help too late. That is an extreme gamble.
@@mightysobe also, vitamin K is not a vaccine. But there are plenty of preservative free vaccines available if you ask for them.
1982 Tyler, Texas, my second was born at home with lay midwife. Local hospital: Fathers weren't allowed, still doing spinal blocks. Most significantly: they admitted to an 85% C-section rate!
Note: we were 3 blocks from the hospital. My midwife was President of the State lay association. I delivered my daughter's hand and arm with her head! It could have gone bad fast, but we were blessed.
I couldn't assist with home births as a doctor. But took care of them before & after.
I’m not a midwife, but my mother is. She practices in a hospital and would never do home births. Here in Colorado, Certified Nurse Midwives need both a bachelors in nursing and a masters or doctorate in nurse midwifery. Either way, there are very few home birth practitioners here, and the few are highly selective about who they take on as patients and are highly skilled. Birthing centers run by midwives and nurses with OBGYNs on call are much more popular than home births.
It's so strange I didn't realise people died from chickenpox, I had it when I was a toddler and it was very minor, it pretty much just itched a lot of a week or two and then it went away, it was 100% uncomplicated and it was the same thing for my cousin who was a year older than me that actually gave me chickenpox, I thought that's how it was for most people. I thought it was more of a cold type illness where it's really not that harmful at all. And then as I get older I hear people talk about it as if it's as bad is measles or polio and i was shocked because my expiernce of it and what I've heard about it from other people is that it's a pretty benign illness. And apparently they did have the vaccine around when I was a toddler but I never got (one because I actually got chickenpox instead) because it was only being administered to vulnerable children who I guess would be the ones who had a higher likelihood of really bad outcomes from chickenpox, which sort of explains why chickenpox has never been this monster in my expiernce even though I HAVE experienced it.
At the very least, any woman considering a non-hospital birth should find out whether her local hospital has an OB Hospitalist program: board-certified obstetricians on the Labor & Delivery unit 24/7/365. These physicians, by nature of the work they do, are confronted with OB emergencies more frequently and become adept at managing them much better than you average OB in private practice. They will give mom and baby the best chance of avoiding morbidity and mortality if the home birth goes sideways.
This may be my new favorite informational video. It puts into a well organized and research backed form all of the reasons I have always said I would never give birth outside a hospital.
Thank you for sharing this information. I am a type 1 diabetic, my pregnanies are high risk even though I take excellent care of myself. I've felt like a failure for having highly medicalized, high intervention, pregnanies and delivery. This message is important. I played into this whole 'birth experience' being sacred BS. I just want to live and I want my baby to live with as few complications as possible. That's all.
The only thing that damaged me by having my babies in a hospital was being dismissed and getting sent home and then almost giving birth in the hospital lobby and later they dismissed my bleeding concerns and I had to have an emergency d&c. Everything else that happened I couldn't care less about because my kids got out safely.
Melisa Roberson You listen to the medical advice, balance that with what your mom or trusted older mom friends tell you. Then decide for your self. I bottle fed my kids, had c sections, and bonded with my babies AFTER the experts took care of me and my boys.
You got through two pregnancies with type 1 diabetes! You aren’t a failure you are a freaking superhero! 👏
what if you had appropriate medical care AND respect for the sacred moments of birth and postpartum time? It's not an either-or scenario. Every birth is sacred.
@@joannasaad298 "only thing..?" that's embarrassingly bad care. I'm so happy your babies arrived safely. But your labor was misdiagnosed and your bleeding was misdiagnosed and that's unacceptable. Moms deserve quality care, too.
Speaking as a neonatal icu Nurse, please don’t have a home birth. I have seen all the worse outcomes that can happen. Don’t risk your child’s health or even life for what you think will be a good birth experience. Does an experience make up for losing your baby or having a child who suffers hypoxic brain injury...I say it shouldn’t. Things can go wrong in a home birth and help is then too far away to make a difference
As an aside, never write out a birth plan it’s end of all normal birth processes....
We lost our first in a hospital. They failed to tell us about her UTI, which she was feeling no symptoms for. He was born alive but had so much infection in his lungs he couldn't breathe and was pronounced deceased an hour later. And yet the hospital claims no wrong doing and basically says they would get the case turned against us if we even tried to sue them. We actually did have a home birth just last night. It went amazingly well, with delivery only taking about 15 minutes, very minor tearing, and the baby and mom are both perfectly fine. After our last one (now 2) taking over 24 hours to be born and the petosin that they administered after hours of laboring with little to no dilation dropped both her and the baby's heartrate down so low it nearly killed them, yeah we are having all ours at home from now on. You can say this and say that. Doea not change a thing. Not to mention we have faith in the Almighty and wholeheartedly believe that our prayers were answered with this one, praying for an easy labor an d no complications. Wanna tell me I'm wrong for doing this? Go ahead.
I was so apprehensive to listen to this (I’m a podcaster), because I have some PTSD symptoms around my second son’s birth and I was worried I’d be triggered. I had true cephalopelvic disproportion with my first son; I labored drug free at home for 37 hours. When we arrived at the birth center I was 10 cm dilated; I pushed for 5 hours and our son never moved past -2 station. I ended up having a no-regrets emergency c-section, that I KNOW saved our lives. The second time around, I opted for a scheduled c-section based on the previous experience and the 3rd trimester ultrasounds that revealed our baby was in transverse presentation and slightly large for gestational age. Long story short, a resident did my spinal block and had to reinsert/adjust the needle 5 times (which caused the most heinous and indescribable pain I’ve ever felt), my son’s shoulders were too large so a larger incision had to be made and my abdominal adhesions made closing the incision difficult. I was basically hanging upside down trying to comfort my frantic starving newborn. It was over an hour before I could breastfeed my baby and his blood glucose was extremely low. I’ve been so traumatized by the experience and felt such profound guilt about his birth. Why didn’t I just try a VBAC? Even if I ended up with another emergency c-section, at least it would have been better than that, right? Dr. Duddy’s remark about that day being just one day out of tens of thousands was profound. Thank you.
You can't vbac with transverse lie.
Mary Tocco my rider knows that. Rationally, I know I made the correct choice but my emotional brain isn’t concerned with pesky facts like presentation and head circumference. My emotional brain tells me that this failure is just one more that proves that I’m too selfish to be a perfect, glowing, crunchy, size-2-one-day-postpartum mom. I could have done exercises to “flip” my son, I could have had a TOL, but I made a choice that I thought would be best for us and I just happen to deeply regret it.
Things can happen in either scenario. The hospital isn't perfect either. But having life saving treatments available are helpful. Maybe a happy medium would have been to let you attempt a VBAC in hospital if they could have got the baby into a better position. If the baby had been in the wrong position during a home birth, it could have been even more disastrous though, so I think you were in the right place. But it didn't go as you hoped, and I'm sorry for the bad experience that you had. I felt traumatized because the hospital denied me epidural medication and I felt the most excruciating pain of my life giving birth to my daughter's giant head, which felt like a betrayal. Childbirth can definitely be traumatic all around.
6:00 "Neonatology was in its infancy" *badoom kshhh*
I'll preface my story with this. Ms sister is a BSN, MSN, clinical nurse educator. I'm in higher ed and spent my first years working in an RN to BSN program. I'm fairly well educated on medical "stuff". While my 5th but only successful pregnancy required some hormones to get going and stay, otherwise it was an easy and successful pregnancy. Baby was breech for a long while but eventually turned. I was induced because I was dilated for too long which was cool with me. Was planning vaginal birth with epidural. Back spasms limited my ability to breathe while pushing and I'm screaming for a c-section. (Which I was cool with anyway.) Easy c-section. Except for them strapping me down like Christ on the cross to administer anesthesia and I'm screaming in pain. Then all better. I recall my doc saying while stitching me up that "she just gave up but as it turns out the baby's head was too big and wouldn't have come out anyway". So there's that. Baby latched well. All good until 36 hours post csection and I'm spiking very high fevers, blood pressure is rock bottom and i'm throwing up. TLDR: catheter left in too long led to a blood infection. I was in the hospital 8 days. I have no memory of 2 of those days. I had a down the throat check on your heart via camera with only benadryl to "calm me". I was in terror. I had a first, failed, PIC line insertion with only xanax. I went home with 2x a day IV antibiotics for 3 weeks. Even though I won't have another child because 1 non-viable vaginal delivery and 3 miscarriages is enough plus MTHFR mutation and funky shaped uterus, I would never consider having a home birth. Baby was jaundiced as it was. Knowing that his head literally wouldn't have fit out of my body not matter how much tearing might have happened? Heck no. Yes, know your options and be prepared but don't let a preference for a certain type of delivery be more important that you and your child's life.
Foxes gaurding the chicken coop lol
You don't see kids with hearing aides anymore??? 50% of hearing loss diagnosed prior to age 3 is actually genetic, we aren't to the point of fixing the genes, so I'm wondering where he's looking. Maybe not counting cochlear implants as a hearing device? Plus many choose to go without and just use sign language and don't consider it a handicap.
Part-Time Permies... That's great you had a successful birth! How long ago was that? Did they force vaccines or anything unnatural at the time?
@@777Ryank ?? Are you replying to my comment? I didnt say anything about any birth that I had. I commented on the causes of congenital hearing loss, 50% of which are genetic.
I really enjoy your videos but I have to take issue with this one. If all heart surgeries were done in physicians offices the outcomes probably wouldn't be good. Trained midwives know which patients aren't good candidates for home birth and it's poor statistics and science to conflate all births to the negative outcomes. If reasonable precautions are taken the stats show that home births are safer for mothers and babies. It's not just about the experience, as you kept repeating.
That’s a good point. Let’s say for a certain birth complication, he is saying that 4000 more babies would die every year if they were all born at home. Well that isn’t taking into consideration the fact that many times, these mothers may not be eligible to have a home birth in the first place due to health concerns. Not to mention, at the first sign of something going wrong, a well-trained midwife is going to transfer you to a hospital before it gets to the point of something tragic happening. So would 4000 more babies a year REALLY die? Maybe, but probably not. I do get what he’s saying, though.
But it can go terribly wrong even with a seemingly healthy mom and baby. I know a young healthy g1p1 mom who had a home birth. Labored at home with the midwife but was failure to progress. Arrived at the hospital and baby was already in distress. Aspirated meconium and severe anoxic brain injury and did not survive. Tragic and exactly what this podcast is addressing.
I have a close relationship with a very experienced NP midwife who told me one of the biggest issues with home births is the reluctance of moms to understand- when the midwife says it's time to go to the hospital, it's time to go to the hospital. Often these moms are so stuck on the ideal home birth and their ideal birth plan they will resist hospital admission (sadly to the detriment of the newborn in some cases)
NICU nurse here...12 years experience in the del rooms....I'm my personal opinion and from some of the situations I have seen,. I personally feel it is always safer to deliver in the hospital ... However .... I do feel that many Hospitals could do a better job of offering alternatives during labor such as wireless fetal monitoring so mom's can walk during labor, the use of peanuts)birthing balls, alternative laboring/delivery positioning, use of massage/aromayyherapy.......AND decreasing the use of IV drugs that push the labor process to go quicker....hospitals are already working hard to decrease the c section rates, increase breast feeding rates and many are trying to get away from double patient rooms...have attempted to allow, as you both said...the delivery room to be more comfortable...even getting baby's skin to skin in the OR if there was a C-section or skin to skin with the support person/partner/ father if mom was not stable enough to do so right at delivery.... As an NRP teacher and within neonatal resusc. Practice.... Encouraging that baby stay with his/her mother on their chest during delayed cord clamping and/or crying/with tone etc...keeping these baby's OFF the resuscitation bed UNLESS NRP guidelines are needed to resusc ...has been quite helpful ... I do love attending Del's where midwives are delivering the baby, and see a bit more holistic and alternative practices as far as positioning etc....and I have seen hundreds of Del's with doctors delivering the baby also using different methods.... I have also seen "perfect" pregnancies with birth plans end up in crash c sections and full neonatal resuscitation and/or maternal full anesthesia and/or emergency resuscitation of the mother.... Things happen all the time that are just not what was planned... maternal bleeding, retained placenta, shoulder dystocia, neonatal intolerance to labor etc.....so much that I have even changed my own personal feelings about home birthing ... If we worked on making the environment where women are coming to deliver their baby's less "clinical" feeling, set up training for all nursing staff about using effective/alternative methods during laboring... Etc ... I do believe that we would be doing a major justice to every family coming into the hospital to deliver their baby. And on the birth plan discussion...I think that a family's pre thought out plan is not a bad thing...however some of these birth plans can be a little much, perhaps instead of handing these fill in the blank forms to expectant families...there is a more personalized discussion about the birthing process one that could include the hopes of every families own desire for that perfectly laid out birth plan ..that mostly sets this family up for a reality that is not real and sets up the hospital staff who get the birth plans that are way left field....we need to do better PRE hospital prep... Back in the day everyone did Lamaze class ..these classes rarely exist anymore...there are many new methods of supporting the laboring mother and the family that should be shared pre hospital ....it is heart breaking to see the "perfect" pregnancy with a color coded birth plan go to absolute you know what....and the mommy to ICU and 32 week (or less)baby to the NICU...where are the reality TV shows that show the lives of NICU parents who have babies in the unit for Monnnnttthhhssssss.... The roller coaster of preemie life, breast milk pumping, emotional stress, PTSD of the family, financial hardships of the family, infant maternal/paternal bonding and family separation ? Some of the TV networks with their reality shows are definitely not fully representing the true risks of the laboring woman in 2019.... I get that so many eons ago...many women delivered at home, they didn't have IVs, or fetal monitoring and everything was "fine".... Really? How many of those mother's and/or babys died during the delivery? What was the viability at that time of any baby born less that term? What milks were being fed to those baby's? We cannot compare today's complications to yesterday's ways..... What we CAN do is advocate for the safest, evidenced based, current recommended practices, family centered care to all families who are expecting a new baby soon ...we have to do better, educate ourselves as healthcare providers both pre hospital and at hospital ..... Just my opinion.....❤️🌻
I had two home births, one with a doctor and a nurse and one with 2 nurse-midwives. Check out the work of Ina May Gaskin, who has had excellent outcomes with thousands of home births (with her team of trained midwives). Back when I had the babies (1980), the hospital birth scene was pretty awful. I also volunteered at a birth center in NC as a translator (for Spanish-speaking families) and doula. The environment there was very homelike, staffed by nurse-midwives, and their outcomes were very good. Even though my daughter had her baby in hospital, I am still enthusiastic about home (and birth center) births when they are professionally screened for risk. There has been some good research on it out of Europe.
Ina May and the NCB community set me up for failure and left me feeling like I failed for having a C-section for years. Unfortunately, I still have one of her books in my house. I'm very tempted to throw it in the garbage as I don't want anyone else getting influenced by that garbage.
Just in case of something going wrong it is good to be in a hospital with a nurse midwife for delivery. Good nurse midwives really know how to relax both the mom and dad. 10 minutes after the birth of my first, I started bleeding terribly, like a faucet turned on low. The midwife yelled for the doctor who saved my life. There was no way to foresee that problem would occur, I had an uneventful pregnancy, was healthy, ate well and exercised.
To me it is just not worth the small additional risk to have a home birth. Having a good midwife attending in the hospital will make the experience much better as they advocate for you, help with breastfeeding and give great advice overall.
With the birth of my 3rd and last child we used a different hospital. It was the first time a midwife had attended a birth there. (The doctor waited outside the room on call.) So it was just me, my husband, the nurse midwife and a hospital nurse. The hospital nurse kept asking me questions for a form even though we were preregistered. My husband told her to wait until later. She looked put off. I delivered 10 minutes later, got to hold my daughter immediately after the midwife jokingly wanted to weigh our baby first, as she was so chubby. Then my husband held our daughter, smiled and talked to her. The hospital nurse got choked up. She said our experience was so different, not clinical at all, that it was beautiful.
So yes to hospital delivery WITH a midwife RN.
We just had our newborn baby girl born at home at 11:39 last night with no complications. Maybe 15 minute delivery. Baby is fine. Mom barely scathed. All at home with a certified nurse midwife. Wife even said it was easier at home than the hospital where we had our now 2 year old. You telling us we are wrong and bad parents for doing so???
“People have been delivering for millennia outside hospitals” and mothers and babies died, a lot.
Just had a perfectly healthy baby girl at home. No death. No complication. Yet we lost our first in a hospital from fault of the hospital (UTI that they failed to tell us about for 4 weeks and she didn't have any symptoms for it). I for one say that home birth is not dangerous if done correctly. And btw, our midwife has delivered over 8000 babies prior to Us so yeah. Don't think that all home births are bad and dangerous. And also, him saying that majority of midwives are underqualified and/or undertrained is a flat out lie according to our midwife. Also, our recent little one took maybe 20 minutes to come out so yeah. I am 100% advocating home birth as long as you know what you are doing. And to those totally against it because of "danger" we are not baby killers and how dare you accuse us of it. (I got my fair shair saying our baby would either die soon after or would be born dead, yet she is perfect so screw everyone who attacked us.)
@@mightysobe i don't think anyone is saying that you are a baby killer or that all homebirths go wrong. If you WATCH THE VIDEO, in fact he said that only 1% of natural births result in death. However it is significantly higher than those that have the opportunity to get emergency treatment if there is an emergency. Your experience is not the only one. I have heard tragic stories of mom and baby dying or suffering severe oxygen deprivation/ blood loss. I myself almost died from an ectopic pregnancy hemorrhage and let me tell you, I would 100% be dead had I not had immediate surgery. 10 mins later and I wouldn't have made it. Sometimes you don't have the luxury of time, which is why if you have the natural birth in the hospital at least there is help available right away, but you don't have to use it if not needed.
@@mightysobe also knowing what you are doing isn't the issue. Sometimes crazy things happen that even the more experienced midwife has never encountered and may not have the tools/training to intervene if it is emergent. A team of specialists are available at the hospital just in case. Even an OB may need to consult cardiology or neurology for things outside their training. It isn't a personal insult, why be so absolute in your opinions? It was bad when medicine thought they had all the answers, and it's also bad to think natural is the only answer. People have died "naturally" for eons.
do we know the rate/risk of infant post-partum hemorrhage, metabolic diseases, thyroid disorders, hearing loss, hyperbili or CCHD misses that can be extrapolated from these home births not getting initial screening/Vit K or followups within first few days after birth. I assume most families are good at making quick pediatrician followups but those families I seem to have trouble with tracking down for followups are also the ones wanting to refuse initial medical interventions. based on my limited colloquial experience
Yeah, in Canada, midwives are registered and regulated. It’s a bachelor’s degree (4 years) and fairly comprehensive, similar to the level of education all of our Registered Nurses have. Midwives usually have hospital privileges and offer clients choice in their birthing location. They have a less medicalized model of care. But they also are limited in their scope of practice, don’t generally treat high risk mothers. I would never personally choose a home birth, but then again I have reproductive health issues that increase my risk of complications. I would only feel safe in a hospital with ob/gyns and a special care nursery with close proximity to a NICU. Might be less comfortable than home, but I would be so worried and never forgive myself if something went wrong.
Zedd, what's the image you flashed between 7:33-7:34?? I wanted to catch a great meme (what i'm assuming it is) but cannot :(
It's not worth the risk, birth house do exist too and they are more well equiped and got a communication with the hospital if needed.
I wanted natural birth in hospital. Thank God I was at the hospital because both my daughter and I would have died. The nurse saved my life.
We we infertile for almost a decade. When we finally got pregnant with our 1st I was consumed with the ‘perfect’ experience. It was almost ideal in the nutty/crunchy arena but she needed just a little help breathing at the beginning. My husband said that if we had a great birthday second time then we could do a homebirth for the third. Fast forward to years were giving birth to her second child, he is breach there are many complications many interventions and he hast to spend time in the NICU. I was overwhelmed with guilt and anxiety that somehow my breastfeeding would be affected or that I wouldn’t bond with my baby. He is now healthy and we are nursing like a champ. I will be forever grateful for his NICU team and the excellent doctors and medical staff we had caring for us. We will never have a home birth now and I’m good with that. Good Discussion
"...So what I DIDN'T tell you about..." heard immediately after, "We out!" WHAT didn't he tell you about, Dr. D?
I appreciate this. I've considered home birth myself, but truly, working in a hospital has shown me how much things have changed for pregnant moms. Hospitals really are making an effort to make it as comfortable and customized to each situation as possible. Last time I checked we do have a higher mortality rate, which is usually attributed to other countries doing home births, but I think as long as unnecessary interventions are avoided we can achieve a better outcome in the hospital. With CERTIFIED NURSE MIDWIVES. Not someone who went to a seminar and took a test.
I never realized why the midwives stats were better. THANK YOU for explaining that.
You have not talked about how medical intervention can cause more problems with the birth than would have been. And hospitols and docters have a LONG way to go before they are as good as a midwife in supporting the woman durning labor.
My mom had her first in a hospital and was nearly killed by the doctor, who decided to yank on the umbilical cord to try to get the placenta out faster (literally because he was late for a golf game), which caused her to hemorrhage. She chose to use a midwife at home for me and my younger brother because she was traumatized by that experience. Because of her bias, I was raised to believe that a home birth with a midwife was the safest and healthiest option unless there's a high-risk pregnancy. Now, I completely understand why a woman like my mom would feel that way, and I agree with her that well-trained midwives are amazing. But in no way would I ever choose to have a baby outside of a hospital. Knowing what I know now about how terribly wrong it can all go, and how quickly, I want someone in the building who is qualified to intervene in any way that might be necessary.
I should clarify that this happened in the 1980s.
If the doc really pulled on the umbilical cord without a good medical reason to do so, that's negligence and undo harm to a patient. You're mom should have reported that, that is not ok!
Hey Z Dog, I'd love to see you speak with some PAs sometime. A lot of the public still doesn't really understand what a PA is or what they can do, so it would be nice to see you spread a little bit of awareness.
As an L&D nurse, losing my son at 33 weeks of IUFD. I cannot imagine doing any of this at home, if we can get pregnant again I’ll be delivering in the hospital. I’ve seen how things can go wrong and quickly, I will do everything I can to save my child. It frustrates me when I see people putting mothers down for c sections, we have a large population of a culture in our area where it is frowned upon to the extent most cases they will let the baby die instead of a c section. It breaks my heart
I had 3 wonderful pregnancies and births because I didn't go anywhere near a doctor.
I lived 2 blocks from the hospital if there were any complications, which of course there were none.
The USA has higher infant death rates than some developing countries.
Clean up your own backyard before you start giving advice.
Wow, all I wanna know right now is what came after “What I didn’t tell you....” as you guys faded out!!
Cord prolapse happens when the doctor breaks the woman's water. The baby's head is not low enough and therefore the cord can slip past.
This can happen when the amniotic sac ruptures on its own as well. I have seen this.
Something that I'm curious about... most of the developed world that has a lot of highly qualified midwives have more accessible post secondary education than America. I wonder if CPMs would be so common here if getting a masters degree was more accessible.
Thank you for doing this episode, very informative. I am so glad I had all my babies in a hospital. Better safe than sorry, I didn't even mind being bugged as much as I was- I knew my babies and I were in good hands.
I am completely down with the whole make the hospital labor and delivery feel safer to folks, I had 3 cnm attended births as crunchy as you could want, knowing that the cavalry could come storm in and carry me off to the OR if we got into trouble made me very comfortable. Hospitality OBs make me uncomfortable because they don’t know you or what you are really like. But if they were backing CNMs who had followed the pregnancy and knew moms.
I wanted to add a couple of thought points, one, Ina May Gaskin, in the late 1960’s early 1970’s did many out of hospital births, she also wrote a book that is probably on the shelves of many CPMs “Spiritual Midwifery” the birth stories in it didn’t inspire me to try a home birth but they did teach me that I could go through the birth experience without meds and that contractions were nothing to be afraid of. She was kind of goofy in that she called them “rushes” but whatever. Positive stories of low intervention hospital births are a highly positive thing. We need more of them.
As my babies grew, I was for a time involved with the Mothering.com forums. They were always very natural and crunchy and I aspired to some of it, between 2003 and 2005 I wasn’t there much, when I went back during my last pregnancy I was horrified. People were trying to outcrunch each other, Like “I’ll see your CPM attended home birth and raise you an unassisted home birth.” Then the next one comes in and says “ well I had an unattended pregnancy and Birth in a puddle in my back yard with both of my older children there. We left the placenta attached for three weeks, until it fell off of it’s own accord!” Gag! It was some kind of a bizarre contest and another board or two arose from it that kind of poked fun at it as well as being horrified by it.
Then of course there is the Skeptical OB, Amy Tuetor (sp?) who seems to make you feel stupid if you don’t slavishly allow modern OB to direct your whole pregnancy. She has good stuff at times, but otherwise seems like whiplash from the Mothering.com crowd. There is a happy and safe medium.
Omg we have been begging for this for months!! So pumped!
Thank you for this interview with Dr. Buddy. I am generally in full agreement. The only thing that I would like to interject is that the process of having a child though the medical based system in the US can be very expensive and stressful for a expectant mother. I know that my wife has gone through a very stressful process of finding an OB. Then being told that she would need to pay for all projected gaps in reimbursement up front. Then being told that she would need to see a specialist for her anatomy scan because her BMI was in the overweight category. Fortunately we have good insurance and she has the knowledge to navigate this mess without feeling like a fat pain in the ass, but this is a real experience that many women have. The general feeling among many women I have talked with is that they feel like they are being sent to specialists for no reason and that, in the end, there is nothing wrong with their pregnancy and they just paid an enormous amount of money. My wife and I are very fortunate financially but the cost of having a child for an average family who does not qualify for medicaid can be daunting. I just wish that we took better care of our future in this country by making the medical model less sour than a kitchen table. Which, by the way, is what I was born on. Keep up the good work Z.
11:08 "it's high school only" ZDogg's face mirroring mine :P:P Seriously though, the "people don't understand statistics" is one very important point. And it's they reason why patients many times don't understand the risk/benefit ratio and would rather rely on emotion for decisions.
LOL... MDs don't understand statistics! Ever wonder why Statins, which should only be prescribed to those with a previous heart attack, are prescribed to "everyone"? Yup, it is because BigPharm knows MDs don't know the difference between absolute and relative risk.
I rolled my eyes at the "high school" comment, since many of the smartest, well read people I know have only high school diplomas. Education doesn't make you intelligent, but experience does. Education just gives you legitimacy, and I say this as someone with multiple Ivy degrees, and a doctorate.
Also, The Kissing Hand tho!
Preach! It doesn’t matter at all how children are born. At all. It is narcissistic on the part of any woman who would choose to endanger the life of their child so they have a story to tell. Ridiculous. The only thing that is important is the health of mother and child. Thank you, doctors, for addressing this important issue. Most anti-vaxxers also drank the Koolaid about home births. The ignorance is both sad and frustrating.
Being born c-section does have health implications.
Matt Hirschhorn yes, Birth by c section does have some health implications
But if the other option is death of baby and or mother because a section couldn’t, wouldn’t, didn’t happen... that also has health implications.
@@tanya5322 Well obviously I agree, I just think as a culture we should push for vaginal birth and breastfeeding as much as possible, instead of "formula is just as good", or whatever excuse we use for convenience, we should be honest and just say the truth. I understand some people are going to have to be born c-section, my issue is that people are getting c-sections when they do not have to, doctors are telling people it's fine when the scientific literature is clear that it is not. All im saying is we should be pushing for what is optimal for the baby, instead of what is "convenient". Ofcourse c-sections and formula should exist and be used when needed, but they should be used as last resorts. I do give sympathy to the public because the medical industry is not educating the public on the dangers, so I understand that, but the health implications are utterly severe, were talking 300-400 % increases in certain diseases just from c-section. Yes, they should be used when needed, just like formula should be also, but I think their needs to be more educating from the medical community to the public.
Er, women who give birth in hospitals also get a story to tell, and often it isn't very flattering to the medical establishment. As the doctor said, a delayed mother/child bond does have an effect on the success of breastfeeding, which in turn has an effect on overall infant health. Like it or not, in a hospital human needs often take a back seat to institutional policy and send mother and baby off to a rockier start than necessary. Isn't the term 'narcisist' a tad mommy-shaming in itself?
@@matthirschhorn5309 👏👏👏👏 agree! 1 -in-3 births here in the US are c- section. Most of which is more convenient than neccessary. I agree with these docs. L&D should be more homey, have true midwives and a OB/GYN Hospitalist or your OB/GYN on standby in case needed. Where I had my baby, your doc delivered your baby. So with this, they are still available if needed so you can be comfortable. Maybe even midwives affiliated with your doc so you are comfortable with them also. I had a bad experience when having my baby on part of my nurses but luckily I love my doc and he knew what I wanted and stayed true to that as much as he could.
I feel like if I was going to have a kid I’d want them to have access to the most advanced medical care and treatment if anything unfortunate happened.
Your other half too she could bleed to death if things go wrong
About measles: Just a few days ago, I saw a Facebook post from a doctor who has worked in Africa for many years that he had observed that the aftermath of measles was "like having AIDS for 6 months" and when it was reported a few years ago that measles causes a sort of amnesia of the immune system, he understood why.
My perfect delivery right now currently pregnant with twins is we all live and we are all okay! I’m scared of having a major surgery if I need to have a c section but I’m 100000x more afraid of something going awfully wrong. Baby A has at least one club foot and their monitoring her for borderline small cerebellum (but nothing alarming yet) at this point for gods sake I just want us to live and be healthy.
Do lotus births next!
"Welcome back, son!"
"....Th....thank you so much."
Off subject but I thought hilarious. In postpartum room after the delivery of my 1st son the lady next to me named her baby daughter Meconium. After asking her why she replied "oh I heard a nurse say Meconium is present. So I thought what a pretty name that make."
"you get hemiplegic when you get angry?" that's the best superpower! :P
This was amazing! I’m a new nurse who loves watching this show! Lately, I’ve had guilt because talking to my partner about pregnancy and home birth has come up a lot due to it being glorified. Being in healthcare, especially working in an ICU; this just never felt right (because as you said you know and think of everything that is going to go wrong). This has absolutely made my decision for when we decide our family planning! Thanks docs!
Thanks for an informative upload. 👍🏻
Duddy is my buddy
Women have delivered outside of the hospital for decades, but cemeteries are also full of newborns and mothers. Check it out in any old cemetery or on Ancestry.com.
Didn’t childbirth use to be the leading cause of death in women before c sections and hospitals came around? That’s natural for you. Hey Zdogg, I appreciate this show. I work in a NICU and would never even consider home birth...I’ve seen too much of what can happen. We have a golden minute where swift intervention with the baby can even prevent a NICU stay . Prolapsed cords may be rare, but I have seen many of them over 30 years. Some come out just fine after a stat c section but others can be born mostly dead even though the mom was in the hospital. Add ten or 20 minutes to the response time, I just can’t see a good outcome. We’ve admitted babies that were home birth disasters that could have been prevented. And don’t even get me started on “free birth “! Imagine, you’re the dad,you delivered your baby, it’s not breathing and your wife is hemorrhaging. What do you do? Who do you try to save, if you even can. Scary.
The hospital I work at has a very nice women’s center. We will follow your birth plan, you can deliver in the position you want, use whatever tools help you. But in the end, if something goes wrong, we can help you.
" I work in a NICU and would never even consider home birth...I’ve seen too much of what can happen. "
So, working in NICU is how you've witnessed enough home births to understand what happens during them?
An extreme number of complications are caused by unnecessary hospital interventions, which don't happen in the first place during home births, and it is clear that you are not taking this fact into account.
seeingjay no, I don’t see the ones that go right, I’m sure it’s great. I only see the tragedies . And if you are in that small percentage, it’s pretty devastating
Catherine Hazur
They can work if they have full medical support very near by. I would by all means prefer that to a home birth or free birth experience
My oldest uncle was born at home in 1930. I don't know the details, but his birth was extremely difficult, and Grandma would have had a c-section if she had been in a hospital. (IN 1930!) He graduated 2nd in his HS class and is still reasonably active and healthy at age 88. :) My other uncle and mother were born in a hospital, both without complications.
That said, I used to live in an area with a large Amish population, and most of their babies are born at home, delivered by lay Amish midwives. (The state of Missouri had a big debate about this a few years ago.) Most of the time, everything's OK, but those midwives knew when they were in over their heads and needed to call an ambulance, which they usually did with solar-charged cell phones. They had no hesitation about using modern medicine when needed, BUT many of them were unvaccinated because they had never been in an environment where they had to. Most of the vaccine-preventable diseases we saw were among the Amish, or people who had direct contact with them.
No way. No one can get help at home like you can in hospital. It’s almost an issue for highly educated ethics committee people.
As it pertains to IL we don’t have CPMs, but CNMs do frequently do home deliveries. But they work with OBs and moms see (or are supposed to) see an ob.
CNMs do come with meds, O2, assistants, transfer plans (the threshold to transfer or risk out of home-birth)- in IL
As a mom with severe medical issues, I’ve had 5 preemies.... in a hospital with good NICUs
Elizabeth Handler I don’t know about in IL, but in Minnesota CNM is a Masters level of nursing. That’s why they’re able to give medications without a doctor’s purview. That is totally different than the high school level midwives that they are talking about.
pixiegirl131415 yes, I was stating the education level as it pertains to my state
My sister was bullied by our dad for not breastfeeding. My niece was born with rubella and when she was finally able to have breast milk, she would latch on. This was an awful added mental and emotional stress she didn't need.
I love midwives. I learned a lot from them. However, when things go wrong in a delivery, which they often do, you want to have a surgical team down the hall.
This is what the Duggars were promoting on their show! A few of their daughters because CPMs although I doubt they are practicing anymore now that most of them are married.
Ashley Delmar - Those people are disgusting and repulsive!
The Ricky Lake documentary is cringey but Pregnant in America is far worse
1991 my third child was born at home, unplanned. Luckily everyone was ok.