I was watching Access Hollywood at lunch today (I know, but the office doesn't have cable) and they had an interview with Ricki Lake. Some of you may not know that Ricki Lake has recently made a movie called "The Business of Being Born" which talks about how home birth is no longer really a part of American culture. I have not personally seen the movie yet, but I am very interested in seeing what it has to offer. As a medical professional who has worked in the Labor and Delivery setting, I am interested to see what criticisms Ricki has to offer about western medicine.
The American Medical Association and The American College of Obstetrics and Gyneocology have both rebuked the movie saying that it encourages all women to have birth at home, when in actuality "the safest place to deliver a baby is in the hospital, birth center or other appropriate medical facility". Ricki Lake backfired with comments that she does not know why AMA and ACOG are singling her out for her film and that her film was meant to inspire women to have choices in their delivery and not just conform to what society tells them.
I find this to be a very interesting argument and do plan to see the movie now and see if she is really biased or if she presents both homebirth and hospital birth in an equal light. My guess is she doesn't. This is not to say that I totally believe that homebirth is wrong and that all women should give birth in the hospital. I think that if this is your 10th or even 2nd baby and you have had a healthy pregnancy and a history of successful labor without medication or epidural, then go for it! I would advise you to have a certified midwife and not just a doula or lay midwife. I think that homebirth can be really great for some women. My goal as a nurse is to always be a patient advocate and I take that role very seriously, therefore, I would encourage a women to do what she feels comfortable with for delivery, as long as it is safe for her and the baby.
However, I will say that although there has been a rise in c-section rates and inductions the last few years, there has also been a rise in the number of high-risk pregnancies. It is true that sometimes doctors are impatient and want to deliver without giving the woman a lot of time to progress on her own, however, patients are also impatient and want to be induced and delivered by c-section more often than before.
My concern for an increased number of home births stems from two sources. First, the doctor I work for has been sued by a patient who had a homebirth and had some very serious complications. The patient's baby had serious brain damage as a result of the condition in which he was delivered. My doctor wasn't even seeing this patient for her pregnancy and the patient and her family had no quoms about suing the midwife who did the homebirth, the ER and my doctor. This concerns me because if patients choose to give birth at home, they need to fully understand that they are also taking on more risk. If your baby's heart rate stops in the hospital, they will have you in the OR in less than 5 minutes. If you are at home it could take much, much longer and every minute that your baby is deprived of oxygen is critical.
Secondly, we recently had a patient who left the country at 27 weeks pregnant and went to see family in rural Mexico. This is an extreme example, but she went into labor even though she had no signs of preterm labor and no complications in her pregnancy. She did not inform us of her trip so we were unable to object and advise her to stay home. The patient delivered her very premature baby in a clinic in rural Mexico. Her baby died 3 days later. Obviously, having a homebirth is not the same as delivering in a clinic in Mexico. However, if you do not live close to a major medical facility and your baby needs advanced care, you will not get it at home. Midwifes are trained in neonatal rescusitation and they can help your baby if it is in trouble, however, if major surgery is needed or advanced care, you would have to transport the baby to the hospital.
I did not intend this blog entry to sound anti-homebirth, but I do think that there are some serious risks associated with homebirth that people should be aware of. I will watch the movie and get back with you on whether or not these risks were addressed. If you want more info on the movie or the press associated with it then check out my links.
http://www.thebusinessofbeingborn.com/index.htm
http://movies.nytimes.com/2008/01/09/movies/09born.html
http://www.nydailynews.com/entertainment/2008/06/17/2008-06-17_ricki_lakes_homebirth_film_upsets_ama.html
http://www.usatoday.com/life/people/2008-06-17-ricki-lake_N.htm?csp=34
Subscribe to:
Post Comments (Atom)
2 comments:
Why would anyone want to have a baby in their own home? That is just weird to me. Give me the medical professionals and the drugs and I'll be happy. It will be great to see you at the wedding! I can't wait to get to Texas, I miss it.
Just the things that are on my mind! I am fast approaching my due date and I just soak in all the L&D stories and perspectives. :) Personally, I don't ever want to have a home birth b/c I think it's weird to experience that in your own home...but mainly, like you pointed out, I want to be in a place where all resources are available to me and my baby if something DOES go wrong or needs further assessment. That's just common sense to me! Anyway, I personally hope I don't have to have a c-section, but I may have to b/c of a very low lying placenta. :( So we'll see!!
Post a Comment