Tragic Irony

[Mattus]

Caroline Lovell was a lobbyist for the rights of mothers to have home births, and for the state to provide funding and indemnity for midwives who assist with home births. Strong language was used in submissions to government and to the press, depicting doctors as men invading this sacred process and seeking to control women.



She died last week after a home birth. A tragic irony that despite her passion and lobbying for home birth legislation, her death will set that cause in Australia back irretrievably.

A tragedy like this in isolation should not sway public policy, which should be based on data rather than high profile tragic anomalies. However, data would suggest that home birth in Australia has and remains associated with a higher risk of this tragic occurrence. Meaning this is not an anomaly, but rather a known risk of home births (*)

Some here might suggest her dying means she didn't believe strongly enough in home births. That strong will, a firm belief and positive thought should overcome the lack of medical treatment afforded to a home birth. An argument that would seem indefensible in light of this tragic event, and the supporting data over the decades. After all, who would have more belief than such a public advocate of the procedure? Don’t you think Caroline was convinced of the safety of what she was doing?
Perhaps she would have died regardless of the level of medical care (awaiting coroner's finding on this), but the decades of clinical evidence suggests outcomes of homebirths are poorer.

Should women who prefer the option, regardless of whether they are aware of the risk of home births, still have the prerogative of taking this approach, and if so, should their risk be indemnified by the state?

Extra bonus points if you can omit from your response terms such as "leftards", "rightwingers" or other such partisan intellectual procaine.


"Robust evidence, rather than political pressure, should inform decisions about maternity care" - Andrew F Pesce, MB BS, FRANZCOG, Obstetrician and Gynaecologist, and Clinical Director, Women’s Health

(*) 1. Med J Aust 1990; 153: 664-671. 2. Br Med J 1998; 317: 384-388. 3. Midwifery 1994; 10: 125-135. 4. Med J Aust 2010; 192: 76-80.

[freediver]

So what are the hospital vs home death rates? Bonus points for the death rates for apparently 'healthy' situations prior to labor to cut out people who planned to have a home birth but died in hospital because they could tell something was up.

I think a fair proportion of gynacologists and midwives are female these days, so the patriarchy argument doesn't cut it. And the 'firm belief' thing - was just making fun of this dead woman?

Death in childbirth is completely natural.

[Mattus]

And the 'firm belief' thing - was just making fun of this dead woman?

Try to keep up

[Super Nova]

I was pro home birth and subscribed to that being pregnant is not an illness view.

That is until my wife was pregnant and I had to get into the middle of the issue.

Now I have the complete opposite view.

When we went to prenatal classes the midwife keep saying "if your baby get in distress we will need to....". This was repeated. I then asked "what do you mean by distress?" an tgher answer was "the baby is being starved of oxygen". No one else asked more questions than me that night after I got started.

There was a lot of pressure to have a natural birth. Home birth was being promoted as well. Heavily promoted.

I know a young lady that was cooked to perfection and suffered brain damage during birth due to "being in distress". Has effected her all her life. Bloody preventable.

So we investigated the risks, the effect on the mothers body, the pain and decided on a planned C-section.

I am pleased we did because when our daugther came out the cord was wrapped around her neck. If we did what was suggestion there is a high risk our daughter would have been damaged.

Here in the UK and I expect the same in Australia there is huge pressure on costs. The NHS (national health service) pushes low costs options promotign them as safe.

Home birth is the cheapest....
Natural birth in hostpitla is next... run by midwifes with no medical training.
Doctors delivered birth for high risk pregnancies.
C-Section... only in emergences
Plan C-Section.

So I think it is the womens choice. I know many women who deliver naturally without problems.

I don't think the government should be promoting one over the other. It should be an informed choice.

The problem is here in the UK, the widwifes have a position of trust and people run with their advice unquestioned. Not everyone has the capability to challenge them. When there is an agenda to push one delivery method over another to reduce cost the advice is not driven by what is best for mother and child, it is driven by cost directives from government and their policies.

I so do not find promoting home irth to have any basis in science. It is not the safest option. Statistics and bloody statistics can be maniplated to support any view for any agenda.

Inform the women. Let her understand the real risks. Let her choose... in an imformed way with being pushed one way or another.

[Outlaw Yogi]

Should women who prefer the option, regardless of whether they are aware of the risk of home births, still have the prerogative of taking this approach,

Yes.

... and if so, should their risk be indemnified by the state?

No.

[Black Orchid]

Some here might suggest her dying means she didn't believe strongly enough in home births. That strong will, a firm belief and positive thought should overcome the lack of medical treatment afforded to a home birth.

Strong will, manifestation and mind over matter type cures would only be applicable to long term illnesses. I don't know how she died but I am assuming haemorrhage. You can't manifest an illness or a cure in 10 minutes and if you are bleeding to death I doubt you would have the concentration, or awareness, to do much at all

Should women who prefer the option, regardless of whether they are aware of the risk of home births, still have the prerogative of taking this approach, and if so, should their risk be indemnified by the state?

Yes to the first and no to the latter. It's a choice and with choice comes consequence

[AiA in Atlanta]

Should women who prefer the option, regardless of whether they are aware of the risk of home births, still have the prerogative of taking this approach, and if so, should their risk be indemnified by the state?

Yes to the first and no to the latter. It's a choice and with choice comes consequence

Well said BO. The option of home birth should always be available with the mother clearly informed of the risks.

[mantra]

Should women who prefer the option, regardless of whether they are aware of the risk of home births, still have the prerogative of taking this approach, and if so, should their risk be indemnified by the state?

They have always got the option, but to my knowledge home births have never been supported much in Australia. Unless midwives are fully indemnified now - their practise is deemed illegal, even though doctors have been fully indemnified by the government for the last decade. Midwives are the only health practitioners not given a support package which should be a deterrant to both parties.

Personally I think it's taking too big a risk. Women have always died in childbirth, but many of these deaths could have been prevented provided they had received the appropriate treatment at the time.

[Super Nova]

Personally I think it's taking too big a risk. Women have always died in childbirth, but many of these deaths could have been prevented provided they had received the appropriate treatment at the time.

I totally agree.

[AiA in Atlanta]

A researcher who spent most of his career looking for a cure for ALS died of the same disease himself:

http://www.washingtonpost.com/local/obi ... story.html