Home birth advocate's baby dies during... home birth

[A*O]

As usual there's a middle path here. I can understand why medics don't like these extremists who insist on NO medical intervention during childbirth and I can understand why women resent it being over-medicalised in hospital. My sister was born at home because the pregnancy had been perfectly normal and straightforward BUT there was a family doctor and a midwife in attendance too.

A home birth is not a safe birth
Miranda Devine
April 9, 2009

Reports this week of the death during childbirth of the baby of a leading home birth advocate at her inner-western Sydney home come just as the Government is considering a review of maternity services.

The review, while advocating an increased role for midwives in co-operative settings with doctors, rejected Government funding for home births when it was released in February. This was despite the fact that more than half its submissions came from a minority of home birth advocates, who have besieged the Health Minister, Nicola Roxon, ever since.

The most ardent of lobby groups is Joyous Birth, whose convener, Janet Fraser, 40, tragically lost her baby after several days of labour at her Croydon Park home, which ended on March 27, when an ambulance was called. The NSW Coroner's Office yesterday confirmed it had received a report of the baby's death.

The last thing anyone wants to do is compound the grief of Fraser and her family, so we will spare readers further details. But as one of the most extreme proponents of home births, Joyous Birth has been influential in persuading pregnant women to shun medical intervention in childbirth. It describes as "birth rape" doctor intervention that saves the lives of mothers and babies, and has made Australia one of the safest countries in the world for childbirth.

Its website is popular, boasting 30,000 visitors each month and claiming to have doubled its membership to 1000 last year. So it is important to dispel the myth it promotes: that home birth is safe, medical intervention dangerous and obstetricians evil incarnate.

As a Wodonga obstetrician, Dr Pieter Mourik, says, the natural birth lobby "has been advocating dangerous practices and I believe the media has a responsibility to publish these cases when a totally avoidable baby death occurs … so gullible, pregnant women are not persuaded to follow these risky practices".

Dr Andrew Pesce, Westmead Hospital's clinical director of women's health, says he knows of four home births in the past eight months in western Sydney in which the baby has died, along with a further four home births in which the baby has suffered possible brain damage from oxygen deprivation; preventable tragedies if prompt medical care had been available.

Despite the disasters, Joyous Birth continues to promote 2009 as "Birth Trauma Awareness" year, urging members to write graffiti on hospital walls: "Birth rape on demand, a surgeon's right to choose"; "Did your rapist wear a mask and gown? Mine did"; "Episiotomy is genital mutilation"; "Fingers, forceps, hands, ventouse, baby - which one belongs in a vagina?"; "My body, my birth, my choice".

The website features a fantastic account of an emergency caesarean by a woman calling herself Sungaikecil:

"There is a man at the end of my bed. He is big. He is overbearing. He has soft hands. His eyes are strange … He tells me to lay [sic] back … He tells me to open my legs. I don't want to … He uses his arm to spread them. I fight him. He fights back. I am scared … He enters me. With his hand. With his fist … Where's my mum …

"There are sharp things inside me. There are people's hands inside me … My stomach is cut. One swift cut. The man is cutting me. He is scarring me. He laughs. He does not look at me. He admires his cut. The slit he made. He has wounded me."

Honestly. At the end of this deathless prose, she says she is "handed a baby". Hello? wasn't that the point?

Even if few women (2.5 per cent) are convinced by such propaganda to opt for a home birth, the anti-hospital message is pervasive, making women fear and reject basic medical help, as Ellen discovered, when she gave birth last year to her first child at Orange Base Hospital.

"I'm still traumatised by the experience, and not just because it was horribly painful. Mostly, I'm furious," she wrote to me last month.

"It was virtually impossible to find anything written which was not informed by the ideologies of the powerful, anti-medical intervention natural birth lobby … [They] made my first experience of birth more painful than it needed to be …

"Two good things happened during the 18 ½ hours of trying to give birth to my son. The first was the male anaesthetist giving me an epidural, the second was the male obstetrician delivering my son with a vacuum …

"It did not take me an inordinately long time to recover because I had medical interventions. I just felt great about having a healthy baby. The only thing that was hard to recover from was that nobody had just told me the truth about birth - that it's agonising, that it's not that important in the great scheme of being a mother."

Women seduced by the "empowering" idea that only a woman knows how to deliver her child forget, as Pesce said yesterday, that "100 years ago one in 10 women died from complications of childbirth, and [one in 10] babies".

Pesce, also the president of the National Association of Specialist Obstetricians and Gynaecologists, was at pains yesterday to point out he knew about Fraser's tragedy two weeks ago but did not mention it. It was only when the story became public that he revealed seven other home birth disasters he has encountered since July.

The cases are mainly from the Blue Mountains area, and two stillbirths occurred at the hands of "doulas" - women paid to help women give birth, often former midwives. In one case last September, Pesce says the woman had been warned of the risk of a previous caesarean scar rupturing but had been offered a trial labour at Nepean Hospital. She delivered a stillborn boy at home three days later.

"The trouble is we take safety for granted now and are arguing about quality issues, like maternal satisfaction, which is important. But I'm sorry, as a clinician, survival is the most important thing." Amen to that.

[McJag]

This is just so heartbreaking! We have friends who used a doula-but at the hospital,just to keep them calm. She was also helpful at home to help with breastfeeding,etc. Agreed,most births are uneventful-but if you are the baby need help,you need it quick.

[scooter]

It was not 1 in 10 that died in childbirth in the old days it was 3 in 5 women lost their lives giving birth. I dont get these women who give birth at home without a doctor. When I had my daughter, some one asked me if I had a 'Birth Plan'. I said yes. I'm going to the hospital, getting the epidural the second I get there and then the Doctor will deliver the baby, that's my plan. And that's exactly how we did it. 3 pushes, hello baby.

[gardenofeve]

Here, midwives attend home births and they get the mom in the hospital when they see trouble. That is if the mom is a candidate for a home birth. I'm sure there are people who do it unassisted, not my ideal. I have considered home birth with a midwife, since I've had two with no big issues. We'll see how brave I am when the time comes.

I'm looking through the website for Joyous birth, wow, some of it is really crunchy. There is a section where people keep the placentas attached to the babies and just let them dry off. I can tell you with the 1cm of cord left attached to the baby that that thing reeks as it's drying, I can't even imagine the whole kit and caboodle!

[LynnieD]

Wow, sad. I know several women who have given birth at home, and luckily never had any issues.

I'm sure the debate will rage on for many many more years.

[dolem]

I know of two women who have attempted home births. In both cases they had to be rushed to the emergency room and had to have c-sections because there were unforeseen complications with the birth.

While I understand the desire to do it naturally, I do not grasp putting yourself or your baby at risk. If you want to do it naturally there are plenty of hospitals that will allow you to use a mid-wife, etc. If there is a problem then you can be moved - but the key is instant medical attention.

I would not consider it, personally. But, if that's what you want to do it, go for it. You just never know what is going to happen. I'm much more comfortable with the dr. being there immediately than having to be moved mid-birth.

[southernbelle]

I would not be comfortable with this, and I don't know of anyone who has ever done it. I would prefer to be in a hospital so that any complications could be addressed immediately by medical professionals.

[sputnik]

i'm sorry but the woman was an idiot. seriously, it was only after 3 whole days of labour that she decided to call an ambulance?
and comparing childbirth at the hospital to rape? are they fucking serious?

[MrsMarsters]

She is a damn idiot, shouldn't you have a backup plan if things go wrong at home?

[BoogsBun]

I know this is lame, but I don't care. One of the biggest deterrents to having a homebirth...the clean-up. I didn't want amniotic fluid and various other cooter goo all over my bed.

[ManxMouse]

Originally Posted by BoogsBun

I know this is lame, but I don't care. One of the biggest deterrents to having a homebirth...the clean-up. I didn't want amniotic fluid and various other cooter goo all over my bed.

Well you could do a water birth instead and literally stew in your own juices. Nom nom!

[darksithbunny]

My grandmother gave birth to 2 babies at home not by choice but because it was the only thing she could do. She had her last 2 in hospital and can't see why anyone would want to have babies anywhere but there.

[czb]

the idea of a home birth never appealed to me, and it's not like i'm a big fan of hospitals. as for doulas, my ob/gyn practice does not allow them in the delivery room, they had a bad experience and after that they banned them. not sure why anyone would want a doula there, anyway.

[eeyore0101]

"The trouble is we take safety for granted now and are arguing about quality issues, like maternal satisfaction, which is important. But I'm sorry, as a clinician, survival is the most important thing." Amen to that.

That last sentence sums it all up to me!

[maryk]

DAYS of labor? That might be a sign of trouble. There's natural or homebirth than there's THIS birth rape? How disrespectful.

LOL I never thought of the cleanup after birth.