Ozzidoc

Wow! Look at the American's approach to homebirths:
http://www.acog.org/from_home/public...02-06-08-2.cfm

augigi

I doubt that is an american position. I'm sure it's not surprising that the college of ob-gyns doesn't support births which don't involve their services!

Ozzidoc

I'm not suggesting that it is a USA midwifery position.

I think that it is surprising that the wording is so strong! I certainly see where they are coming from, especially given that there are many people living in rural America who are an hour or more from their nearest hospital.

However, there is no reference to any evidence for the benefits of home delivery. It appears that clearly there is no evidence in their eyes when weighing up the safety of home vs centre birth.

charlie-k

Interesting reading Ozzidoc. I aggree - wow
Who advocates VBAC at home?
It doesn't mention how unsafe it is to practice in a low risk birth center (as I do) where women very rarely get 1 - 1 care as the unit is so very very busy. Women CAN get that at home. Great obstetric perspective hey?

itsmylife

I love this quote:
"Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre."
like women haven't been giving birth at home for hundreds of years... its just suddenly become fashionable

charlie-k

Yes, great isn't it?!!!!!!!!!!!

RReed

Couldn't resist this one!

I am a midwife with experience of hospital and homebirth. I have just taken the step to move out of the hospital system in Oz and become an Independent Midwife. I can't cope with seeing the limited options and in some cases dangerous care women get in the system (Qld). I am also working at the local Uni in research so have access to the latest evidence.

There is lots of research on homebirth vs hospital birth. For low risk healthy women it is as safe (if not safer) to birth at home with a skilled midwife. The major difference is that women are more satisfied with their birth experience when they birth at home and have less unnecessary interventions (that then lead to problems).

In the Netherlands you cannot birth in a hospital unless you are prepared to pay for it. The government and insurance companies realise that it is a waste of money. The cheapest, safest and most effective way to run the maternity services is with midwives based in the community. They have better outcomes for women and babies too.

In Australia the obstetricians have a lot of power and suppress midwifery and women's choice at every turn. This has led to women being fed through a medicalised system with less than half managing to birth without medical help. Unfortunately this has not improved outcomes for babies or mothers.

While there is money and power involved obstetricians will continue to fight any move towards midwifery led care, birth centres, or homebirth and women and babies will be the losers.

Rachel

Ozzidoc

Rachel - give us some links to your references please

RReed

Hi Ozzidoc

Sorry for the delay - I've been too busy to check this site!

I'm not sure which 'statements' you wanted references for. I have attached the reference list for a presentation I gave for Maternity Coalition below. Maternity Coalition are a consumer group pushing for choice and access to safe maternity care for all Australian women. Their site =

http://www.maternitycoalition.org.au.../content/?id=1

Luckily there is a move towards community based, midwifery care as a cheaper and safer option - but not quick enough. There is a lot of resistance from the medical side because they have seen what happened in New Zealand when women were given direct access to midwives - 74% chose this rather than obstetricians = big loss of cash for the drs.

If you want specific references let me know.

Rachel


Albers, L. L., Sedler, K. D., Bedrick, E. J., Teaf, D., & Peralta, P. (2006). Factors related to genital tract trauma in normal spontaneous vaginal births. Birth, 33(2), 94-100.
Anderson, T. (2002). Peeling back the layers: A new look at midwifery interventions. MIDIRS Midwifery Digest, 12(2), 207-210.
Anderson, T. (2000). Feeling safe enough to let go: The relationship between a woman and her midwife during the second stage of labour. In M. Kirham (Ed.), The midwife-mother relationship (pp.92-119). Basingstoke: Macmillian.
Andrews, I., Sullivan, G., & Minchiello, V. (2004). The philosophical and theoretical context of qualitative research. In V. Minichiello, G. Sullivan, K. Greenwood, & R. Axford (Eds.), Handbook of research methods for nursing and health science (2nd ed.) (pp. 59-70). Pearson Education Australia.
Aslam, R. (1999) Risk management in midwifery practice. British Journal of Midwifery, 7(1), 41-44.
Australian College of Midwives Incorporated. (2002). Competency standards for midwives. Canberra: ACMI
Australian College of Midwives. (2006). Standards for the accreditation of bachelor of midwifery education programs leading to initial registration as a midwife in Australia.
Australian College of Midwives Incorporated. (2001) Code of ethics. Canberra: ACMI.
Australian College of Midwives. (1999). Reforming Midwifery: A discussion paper on the introduction of Bachelor of Midwifery programs into Victoria. Victoria: ACMI - Victorian Branch.
Australian Nursing and Midwifery Council. (2006). National competency standards for midwives.
Australian Health Workforce Advisory Committee. (2002). The midwifery workforce in Australia. AHWAC Report 2002.2: Sydney.
Axford, R., Minichiello, V., Cruickshank, M., McParlane, J., Irwin, L., & Coulson, I. (2004). The relevance of research for practitioners. In V. Minichiello, G. Sullivan, K. Greenwood, & R. Axford (Eds.), Handbook of research methods for nursing and health science (2nd ed.) (pp. 1-32). Pearson Education Australia.
Ayers, S., & Pickering, A. (2005). Women’s expectations and experience of birth. Psychology and Health, 20, 79-92.
Beech, B., L. (2005) What is a normal midwife? The consumer’s view. In S. Wickham (Ed.), Midwifery Best Practice Volume 3 (pp.23-24). Elsevier Butterworth Heinemann.
Beech, B. L., & Phipps, B. (2004). Normal birth: Women’s stories. In S. Downe (Ed.), Normal childbirth: Evidence and debate (pp. 59-70). London: Churchill Livingstone.
Begley, C. M. (2001). Giving midwifery care: Student midwives’ views of their working role.
Midwifery, 17 (1), 24-34.
Bewley, C. (1995). Clinical teaching in midwifery: An exploration of meanings. Nurse Education Today, 15, 129-135.
Bergstrom, L., Roberts, J., Skillman, L., & Seidel, J. (1992). “You’ll feel me touching you, sweetie”: vaginal examinations during the second stage of labor. Birth, 19(1), 10-18.
Bergstrom L (1997). ‘“I gotta push. Please let me push”: social interactions during the change from
first to second stage labor’. Birth, 24 (3): 173-180
Bloom (2006).Coached pushing offers little immediate benefit Bloom (2006) Source: American Journal of Obstetrics and Gynecology 2006; 194: 10-3 Comparing obstetric outcomes with and without coached pushing during the second stage of labor.
Bluff, R. (2006). Grounded Theory. In E. R. Cluett, & R. Bluff (Eds.), Principles and practice of research in midwifery (2nd ed.) (pp. 154170). Elsevier Ltd.
Bluff, R. (2003). Learning and teaching in the context of clinical practice: The midwife as a role model. MIDIRS Midwifery Digest, 13(4), 453-454.
Boon, J. (1997). Teaching midwives’ skills. Midwives, 110 (13), 147.
Bosanquet, A. (2002). Stones can make people docile: Reflections of a student midwife on how the hospital environment makes ‘good girls’. MIDIRS Midwifery Digest, 12(3), 301-305.
Bosomworth, A., & Bettany-Saltikov, J. (2006). Just take a deep breath: A review to compare the effects of spontaneous versus directed Valsalva pushing in the second stage of labour on maternal and fetal well-being. MIDIRS Midwifery Digest, 16(2), 157-165.
Brody, P., & Barclay, R. (2001). Contemporary issues in the regulation of Australian Midwifery. Australian Health Review Oct/Nov.
Brown, K. (1999). Push! Or is that shove? Nursing Times, 95 (15), 58-60.
Bruce L and Flamm M D (1999). ‘Tight nuchal cord and shoulder dystocia: a potentially catastrophic combination’. The American College of Obstetricians and Gynecologists, 94 (5): 853.
Callister, L., C., Vehvilainen-Julkunen, K., Sirkka, L. (2001). Giving birth: Perceptions of Finnish childbearing women. The American Journal of Maternal/Child Nursing, 26(1), 28-32.
Callister, L., C. (2006). Making meaning: women’s birth narratives. JOGNN, 33(4), 508-515.
Chamberlain, M. (1997). Challenges of clinical learning for student midwives. Midwifery, 13, 85-91.
Chamberlain, M. (1996). The clinical education of student midwives. In: S. Robinson, & A. M. Thomson (Eds.), Midwives, Research and Childbirth: volume 4. Chapman and Hall.
Chan, D. (2001). Development of an innovative tool to assess hospital learning environments. Nurse Education Today, 21, 624-631.
Cheung, N. F. (2002). Choice and control as experienced by Chinese and Scottish childbearing women. Midwifery, 18, 200-213.
Clement, S., Wilson, J., & Sikorski, J. (1999). The development of an intrapartum intervention score based on women’s experiences. Journal of Reproductive Infant Psychology, 17, 53-61.
Cluett, E., R., & Bluff, R. (2006). From practice to research. In E. R. Cluett, & R. Bluff (Eds.), Principles and practice of research in midwifery (2nd ed.) (pp. 14-31). Elsevier Ltd.
Cluett, E., R. (2006). Evidence-based practice. In E. R. Cluett, & R. Bluff (Eds.), Principles and practice of research in midwifery (2nd ed.) (pp. 34-56). Elsevier Ltd.
Coad J and Dunstall D (2001). Anatomy and Physiology for Midwives. Mosby
Cope, P., Cuthbertson, P., & Stoddart, B. (2000). Situated learning in the practice placement. Journal of Advanced Learning, 31(4), 850-856.
Carolan, M. (2006). Women’s stories of birth: A suitable form of research evidence? Women and Birth, 19, 65-71.
Crabtree, S. (2004). Midwives constructing ‘normal birth’. In S. Downe (Ed.), Normal childbirth: Evidence and debate (pp.85-99). London: Churchill Livingstone.
Cunningham, F. G., Leveuo, J., Bloom, S. L., Hauth, J. C., Gilstrapp III, L. C., & Wenstrom, K. D. (2005). Williams obstetrics (22nd ed.). United States: McCraw-Hill Medical Publishing Division.
Dahlberg, K., Berg, M., & Lundgren, I. (1999). Commentary: studying maternal experiences of childbirth. Birth, 26(4), 215-217.
Dineen, M. (1996). Clinical risk: a pragmatic approach. British Journal of Midwifery, 4(11), 586-589.
Donnison, J. (1998). Midwives and medical men: a history of the struggle for the control of childbirth. Historical Publications.
Downe, S. (18 August 2006). Nuchal cord research. [email R. Reed], [Online]. Available email: [email protected].
Downe, S. (2003). Transition and the second stage of labour. In D. M. Fraser, & M. A. Cooper (Eds.) Myles textbook for midwives (14th edition). London: Churchill Livingstone.
Downe, S., & McCourt, C. (2004). From being to becoming: reconstructing childbirth knowledges. In S. Downe (Ed.), Normal childbirth: evidence and debate (pp. 3-24).
Duffin, C. (2001). Midwife strife. Nursing Standard, 15(32), 16-17.
Earnshaw, G. J. (1995). Mentorship: the students’ views. Nurse Education Today, 15, 274-279.
Enkin, M., Keirse, M. J. N.C., Neilson, J., Crowther, C., Duley, L., Hodnett, E., & Hofmeyr, J. (2000). A guide to effective care in pregnancy and childbirth (3rd ed.). Oxford: Oxford University Press.
Essay, R., & Hughes, C. (2005). What is a ‘normal’ midwife?: The educationalist’s view. In S. Wickham (Ed.), Midwifery: best practice volume 3. Elsevier Butterworth Heinemann
Fahy, K. M., & Parratt, J. A. (2006). Birth territory: A theory for midwifery practice. Women and Birth, 19, 45-50.
Fahy, K. (2006). An Australian history of the subordination of midwifery. Women and Birth, 20, 25-29.
Forrester, K., & Griffiths, D. (2005). Essentials of Law for Health Professionals. Elsevier Mosby.
Fraser, D., Murphy, R., & Worth-Butler, M. (1997). An outcome evaluation of the effectiveness of pre-registration midwifery programmes of education. English National Board for Nursing, Midwifery and Health Visiting.
Fraser, D. M. (2002). An exploration of the learning environment for students on the labour ward. MIDIRS Midwifery Digest, 12(4), 553-556.
Fullerton, J., Holmes, G., Roe, V., & Campau, N. (1998). Direct entry midwifery education. Journal of Nurse Midwifery, 43(2), 102-104.
Gibbins, J., & Thomson, A. M. (2001). Women’s expectations and experiences of childbirth. Midwifery, 17, 302-313.
Goodman, P., Mackey, M., C., & Tavakoli, A., S. (2004). Factors related to childbirth satisfaction. Journal of Advanced Nursing, 46, 212-219.
Gray, M. A., & Smith, L. N. (2000). the qualities of an effective mentor from the student nurse’s perspective: Findings from a longitudinal qualitative study. Journal of Advanced Nursing, 32 (6), 1542-1549.
Grbich, C. (2004). Qualitative research design. In V. Minichiello, G. Sullivan, K. Greenwood, & R. Axford (Eds.), Handbook of research methods for nursing and health science (2nd ed.) (pp. 151-175). Pearson Education Australia.
Green, J., M., & Baston, H., A. (2003). Feeling in control during labor: concepts, correlates and consequences. Birth, 30, 235-247.
Hall, S., M., & Holloway, I., M. (1998). Staying in control: women’s experiences of labour in water. Midwifery, 14, 30-36.
Hart, R. (2005). It’s 04.27am and I’m about to become Rebecca Hart RM. Midwifery News, Spring, 39.
Hastie, C. (2006) Midwifery: women, history and politics. Birth Issues, 15(1), 11-17.
Hauck, Y., Fenwick, J., Downie, J., & Butt, J. (2006). The influence of childbirth expectations on Western Australian women’s perceptions of their birth experience. Midwifery, doi: 10.10.16/j.midw.2006.02.002.


Heath. P, (2002). National Review of Nursing Education: Our duty of care. Commonwealth of Australia.
Hindley, C. (1999). An assessment of clinical competency on an undergraduate midwifery
programme: midwives’ and students’ experiences. Journal of Clinical Excellence, 1(3), 157-162.
Hirst, A. (2005). Rebirthing: Report of the Review of Maternity Services in Queensland. Retrieved December 2, 2005, from http://www.health.qld.gov/rhac/default.asp.
Hodnett, J. (2002). Home-like versus conventional institutional settings for birth (Cochrane Review). In The Cochrane Library Issue 1. Update software, Oxford.
Iffy L, Varadi V, Papp E (2001). ‘Untoward neonatal sequelae deriving from cutting of the umbilical cord before delivery’. Med Law, 20 (4): 627-624.
Impey, L. (1999). Maternal attitudes to amniotomy and labor duration: a survey in early pregnancy. Birth, 26(4), 211-214.
James, H., & Willis, E. (2001). The professionalisation of midwifery through education or politics? ACMI Journal, 14(4), 27-30.
Jefford, E. (18 August 2006). Nuchal cord. [email R. Reed], [Online]. Available email: [email protected].
Jenkins, R. (1995). The Law and the Midwife. Blackwell Science.
Johnson, R., & Taylor, W. (2000). Skills for midwifery practice. Churchill Livingstone.
Johnston, J. (2005). Midwifery: a profession that cannot survive. Birth Matters, 9 (1), 10-12.
Jones, D. (2004). An evaluation of midwifery mentors and their perception of mentoring. MIDIRS Midwifery Digest, 14(2), 157-162.
Kitzinger, S. (2005). The politics of birth. Elsevier Butterworth Heinemann.
Kitzinger, S. (1992b). Ourselves as mothers. Bantam Books
Leap, N., & Barclay, L., with Brodie, P., Nagy, E., Sheehan, A., & Tracy, S. (2002). Midwifery education: Literature review and additional material. Commissioned Research Project, National Review of Nursing Education, Retrieved on December 2, 2005, from http://www.dest.gov.au/highered/programmes/nursing.
Leap, N. (2000). ACMI Bachelor of Midwifery Education Taskforce Report. ACMI Journal, 13, 22-23.
Lessing-Turner, G. H. S. (1997), Supporting midwives who in turn support students. Midwives, 110 (13), 310.
Liamputtong, P., & Ezzy, D. (2005). Qualitative research methods (2nd edition). Oxford University Press.
Lobo, A. (2002). Direct entry midwifery: Traditional midwives’ perceptions. RCM Midwives Journal, 5(2), 60-62.
Löfmark, A., Wikblad, K. (2001). Facilitating and obstructing factors for development of learning in clinical practice: A student perspective. Journal of Advanced Nursing, 34(1), 43-50.
Lukes, S. (1974). Power: a radical view. Macmillian.
Macquarie Dictionary (2005) The Macquarie Library Pty (????REF)
Maternity Coalition Inc. (2004). Our voices, our babies, women’s wisdom: Maternity Coalition Inc (Qld) submission to the Queensland Review of Maternity Services. Maternity Coalition Inc, Qld.
McDonnell, R. (1997) Risk management in midwifery. MIDIRS Midwifery Digest, 7(3), 291-294.
McCandlish, 1998 (HOOP)
McKay, S., Barrows, T., & Roberts, J. (1990). Women’s view of second-stage labor as assessed by interviews and videotapes. Birth, 17(4), 192-198.
Mercer, J., & Skovgaard, R. (2004) Fetal to neonatal transition: first, do no harm. In S. Downe (Ed.). Normal Childbirth: evidence and debate (p141-160). Churchill Livingstone.
Miser W F (1992). ‘Outcomes of infants born with nuchal cords’. Journal of Family Practice, 34 (4):
441-445
Mottram, L. (2000). The diary of a pre-registration midwifery student: Part 2 September - October 2000. MIDIRS Midwifery Digest, 10(4), 425-426.
Myrick, F., & Yonge, O. J. (2001). Creating a climate for critical thinking in the preceptorship
experience. Nurse Education Today, 21, 461-467.
Nolan, C. A. (2002) The consumer view. In J. Wilson, & A. Symon (Eds.). Clinical risk management in midwifery: the right to the perfect baby (pp.???). Oxford: Books for Midwives Press.
Nolan, C. A. (1998). Learning on clinical placement: the experience of six Australian student nurses. Nurse Education Today, 18, 622-629.
Nurses Act 1992 (Qld). Queensland Government, Retrieved on December 2, 2005, from http://www.qnc.qld.gov.au/upload/pdf/Nursing_Act_1992.pdf.
Parsons, M., & Griffiths, R. (2007). The effect of professional socialisation on midwives’ practice. Women and Birth, 20, 31-34.
Phillips, A. (1993). The trouble with boys: parenting the men of the future. Pandora.
Phillips S (2004). ‘To cut or not to cut?’. The Practising Midwife, 7 (7):26-27
QNMC, & ACMI. (2004). Code of practice for midwives incorporating guidelines for midwifery practice. QNMC, & ACMI.
Queensland Nursing Council. (date). Code of practice for midwives incorporating guidelines for midwifery practice.
Queensland Health. (2004). Preceptor resource manual. Queensland Health.
Queensland Nurse. (2005). Re-birthing: Part 2. The Queensland Nurse, 24(5), 16-17.
Quilliam, S. (1999). Clinical risk management in midwifery: what are midwives for? MIDIRS Midwifery Digest, 9(3), 280-284.
Reibel, T. (2004). The language of birth: how words colour women’s experiences. Birth Issues, 13(1), 18-23.
Reid, B. (2002). The Albany midwifery practice. MIDIRS Midwifery Digest. 12(1), 118-121.
Robotham, M. (1997). Nurse or midwife? Nursing Times, 93(38), 36-37.
Rosser, J. (2001). Birth centres: The key to modernising the maternity services. MIDIRS Midwifery Digest, 11(3), Supplement 2, S22-S26.
Ryan, M., & Roberts, C. (2005). A retrospective cohort study comparing the clinical outcomes of a birth centre and labour ward in the same hospital. Australian Midwifery Journal, 18 (2), 17-21.
Sanders, J., Peters, J., & Campbell, R. (2005). Techniques to reduce perineal pain during spontaneous vaginal delivery and perineal suturing: A UK survey of midwifery practice. Midwifery, 21, 154-160.
Saunton, P., & Chiarella, M. (2003). Nursing and the law (5th ed.). Elsevier.
Schaffer, J. I., Bloom, S. L., Casey, B. M., McIntire, D. D., Nihira, M. A., & Leveno, K. J. (2005). A randomized trial of the effects of coached vs uncoached maternal pushing during the second stage of labour on postpartum pelvic floor structure and function. Americal Journal of Obstetrics and Gynecology, 192, 1692-6.
Schorn M N and Blanco J D (1991). ‘Management of the nuchal cord’. Journal of Nurse-Midwifery,
36 (2): 131-132
Seibold, C. (2005). The experiences of a first cohort of Bachelor of Midwifery students, Victoria, Australia. Australian Midwifery Journal, 18(3), 9-16.
Shanley, L. (2002). What some women don’t want. Midwifery Today, Autumn, 15-18.
Shorten, A., Donsante, J., & Shorten, B. (2002). Birth position, accoucheur, and perineal outcome: informing women about choices for vaginal birth. Birth, 29(1), 18-27.
Singh, D, & Newburn, M. (2006). Feathering the nest: What women want from the birth environment. Midwives, 9(7), 266-269.
Soet, J. E., Brack, G. A., & Dilorio, C. (2003). Prevalence and predictors of women’s experiences of psychological trauma during childbirth. Birth, 30(1), 36-46.
Spouse, J. (1996). The effective mentor: a model for student-centred learning in clinical practice. NT Research, 1(2), 120-133.
Standards ACoHC. (2000). EquIP: Standards and guidelines for the ACHS. Sydney, Australian Council of Healthcare Standards.
Stanhope, N., & O’Connor, A. (1997). Applying human factor methods to clinical risk management in obstetrics. British Journal of Obstetrics and Gynaecology, 104, 1225-1232.
Stewart, M. (2001) Whose evidence counts? An exploration of health professionals’ perceptions of evidence-based practice, focusing on the maternity services. Midwifery, 17, 279-288.
Stewart, D. (2000). Schools and the law: a preventative risk management perspective. International Journal of Educational Reform, 9(4), 342-348.
Swann, B. (2002). An effective placement: Creating a learning environment. In I. Welsh &
C. Swann (Eds.), Partners in Learning: A guide to support and assessment in nurse education. Radcliffe Medical Press.
Teakle, B. (2005). Queensland branch report. Birth Matters, 9(4), 10-11.
Tew, M. (1998). Safer Childbirth? A critical history of maternity care. Free Association Books.
Tracy, S., Barclay, L., & Brodie, P. (2000). Contemporary issues in the workforce and education of Australian midwives. Australian Health Review, 23, 78-88.
Waldenström, U. (1999). Experience of labor and birth in 1111 women. Journal of Psychosomatic Research, 47(5), 471-482.
Waldenström, U., Borg, I., Olsson, B., Sköld, M., &, Wall, S. (1996). The childbirth experience: A study of 295 new mothers. Birth, 23(3), 144-153.
Walker, J. M., Hall, S., & Thomas, M. (2001). The experience of labour: A perspective from those receiving care in a midwife-led unit. Midwifery, 11, 120-129.
Walsh, D., El-Nemer, A., & Downe, S. (2004). Risk, safety and the study of physiological birth. In S. Downe (Ed.), Normal childbirth: evidence and debate (pp. 103-119). Churchill Livingstone.
Walsh, D. (2002). Evidence and audit: a marriage made in heaven? Birth Issues, 11(1), 5-11.
Walsh, D. (2000a). Evidence-based care series 2: Free standing birth centres. British Journal of Midwifery, 8(6), 18-19.
Walsh, D. (2000b). Small really is beautiful. British Journal of Midwifery, 10(5), 272.
Webster, J., Lloyd, W. C., Pritchard, M. A., Burridge, C. A., Plucknett, L. E., & Byrne, A. J. (1999). Development of evidence-based guidelines in midwifery and gynaecology nursing. Midwifery, 15, 2-5.
Wickham, S. (2003). ‘To feel or not to feel?: checking the nuchal cord’. The Practising Midwife, 6 (2): 27
Wilson, A. (1995). The making of man-midwifery: childbirth in England 1660-1770. UCL Press.
World Health Organization (2003). Managing Complications in Pregnancy and Childbirth: a guide for midwives and doctors. WHO
Wrightson, J. (2001). Multidisciplinary mentorship in practice. The Practising Midwife, 4(9), 19-21.

charlie-k

Oooh Errr! Just a few to be going on with then...

Ozzidoc

Thanks for the references Rachel. I was actually after the data on "safest way to run maternity services".

I'll check out the link sometime soon...however, by its name, I am suspicious that it is pro home birth rather than "here is the evidence for all options"

Disclaimer - my grandfather's first wife died in childbirth, as did his sister in law. As did a friend's mum 32 yrs ago. I KNOW that this is very rare in the western world. but it is always in the back of my mind

Babycatcher

I am sorry that you have these experiences. Maternal death in childbirth is really rare these days...with some much antenatal screening etc... Do you know the circumstances that your grandfather'a first wife died as this may help your understanding of it i.e. was it PPH? Or were there pre-existing medical conditions in either/both sisters?

I trained with Community midwife attending a lot of homebirths and although I was nervous of the 'what if' - only one transfered in. I personally delivered two and found that women laboured in a more relaxed atmosphere, they were calmer and more resiliant to their pain. Anyway I could get carried away.

I am pro choice - it should be about what women want and in the safest possible way to meet their needs.
I have heard of women having VBAC at home with independent midwives - not something I would be happy to faciliate - I have also heard of VBAC waterbirth with telemitry - in the NHS.
My hospital supports Homebirth and although there is a number of transfers in - they are usually for need for pain relief with first time Labourers...
Anyway it would be good..if homebirthing policy was evidence based rather than scare mungered! So that it is available for all those who can safey have it...

Ozzidoc

Great post!

Thanks for your comments. I do suspect the relatives' deaths were from a PPH, as my grandfather adament it was at the time of giving birth rather than a few hours or days later. I'm not sure about my friends mum. (It's the cardiomyopathy deaths that I feel really bad about. We had one at my hospital about a year ago - terribly sad.)

By the way, my Dad is very proud of the fact that he still has the dining chairs from the dining table on which he was born! Sounds painful to me LOL.

Sally Redux

I had one in hospital, one at home (in the UK) and that was definitely my experience. I highly recommend home birth if possible.

RReed

Hi All
Sorry to hear about your relatives Ozzidoc. Maternity Coalition is pro-choice - whether that is home, birth centre or hospital. Home birth is only the best option for some women. However, at present a woman can choose to have a hospital birth with an obstetrician but cannot choose to have a home birth with a midwife. Even though the latter is as safe, cheaper and has better outcomes (for healthy women with normal a pregnancy). MC just want access to all options for all women. In Denmark you cannot have a hospital birth funded by the health system unless you are considered 'at risk'. Denmark has better neonatal and maternal outcomes than here. However, I have heard Danish women complaining that they did not get the choice re. hospital birth. I guess the important thing is that each woman is able to choose the birth experience she wants and feels supported in her choice. In order to make a choice she needs access to unbiased information about all options. In Aus a woman who chooses an unnecessary elective c-section is supported and subsidised by the tax payer. Whereas a woman who chooses a homebirth must pay for it all herself and cannot get a midwife with insurance. We just want fairness.
Rachel