HW 42 Pregnancy and Birth Project

 For a couple of weeks my class has been on the very relevant topic of birth. The outcome, there was a lot that not known about the topic of birth. When I wrote the list of things we should know like OB/GYN, mid wives, epidurals, and Natural birth I realized I was about to enter a unit in which I knew little to nothing! I still remember when birth was done by a bird(The Stork) that sneaked into one's house after a couple either kissed or held hands too long and left a "bundle of joy" on the unsuspecting new parents. So upon hearing all these technical terms for birth, my initial reaction was one of a blind deaf man trying to comprehend what a television is.  

What I am going to focus on in this project is a deeper comparison between home births and hospital births and see which one is the optimal choice to take during birth. And to shed light on the pros and also cons so that one can look at both sides of the argument. The reason I said that the topic of birth is a relevant topic is because about 10,657 babies are born in the U.S a day, so knowing the process in which that many new lives came to be in the world sounds important. Also one in four babies is delivered by C-section – almost double the World Health Organisation’s recommended rate. That figure rises to more than one in two at some private hospitals, so if the C-Sections are bad this is a big problem.
 During the time we were in the birthing unit we saw two films, one was pro home birth and the other was anti home birth. Of the movies I saw, I first saw the film was called "The Business of  being Born", which was correctly named since it showed how the birthing process at a hospital is more of a business than a place that really focuses on the miracle of birth and becoming an industrial nightmare'Why does it matter, if the baby comes out ok". This was a quote by a OB/GYN showing the industrial nightmare in todays birth. We are rapidly removing the sacredness out of birth. 
  The way that hospitals are like a business is seen in the way they do the "Pit" and "Snowball Effect". What Pit is is when nurses take over during the birth. This happens when a birth goes over the set amount of time given for the birth to take place. (I found that extremely interesting that people are given a set time to go through the birth process, even though "they are paying" for it.) Once they exceed the time limit the are put on "Pit" and then the "Snowball Effect" happens. The "Snowball Effect" is when epidural is given to the mother in labor which numbs her but slows the labor process down. Platocin is a chemical that is then given to speed up the labor again but then epidural is injected once more to numb and calm the mother. This slows down the labor again which causes the need for more platocin.  By now the babies heart rate is increasing rapidly due to the strong contractions from all that platocin in the mothers body, which puts the baby in distress and ultimately leads to the now necessary C-section. The weird part about this is after the "necessary" C-section is done the doctor is viewed as the hero for saving the child, when in actuality the doctor is the one responsible for this in the beginning.

 After seeing the first video one might think , just as I did, that there are no flaws with home birth, but as the second video implies, there is. It told of a story of a woman and her husband who had a horrible midwife experience in which their baby died. The mother was in labor for four days and when the baby came out it pronounced dead from being strangled by the umbilical. The video showed that the midwife should have noticed that something was wrong and should have taken some sort of course of action( I'm no doctor but I think that a woman in labor for four days needs to go to a hospital).
 I wanted to research the comparisons between home births and hospital births and see which had more pros and which had more cons since both the movies made me really consider which was better.

Advantages of home birth...

• Statistics show that home birth is as safe or safer than hospital birth for low-risk women with adequate prenatal care and a qualified attendant.
• At home a woman can labor and birth in the privacy and comfort of the familiar surroundings of her own home, surrounded by loved-ones. in whatever positions and attire she finds most comfortable.
• The laboring woman maintains control over everything impacting her labor and birth. Meeting her needs is the only focus of all those present. Nothing is done to her without her consent.
• Labor is allowed to progress normally, without interference and unnecessary interventions.
• Studies show that the risk of infection is reduced for both the mother and the baby.
• During labor the woman is encouraged to eat, drink, walk, change positions, make noise, shower, bathe, etc.
• Care-givers are invited guests in the birthing woman's home. She can have anyone she desires present: family, friends, children, etc. Her medical team (midwife and birth assisiant) do not go home because their shift has ended or because it was supposed to be their day off or because it is a holiday or because they planned something else.
• She doesn't have to worry about when to go to the hospital since her care-providers come to her.
• Continuous one-on-one care is given by the midwife, providing ongoing assessment of the baby's and mother's condition throughout the birth process and postpartum period. Her care provider knows her well and she knows her care provider. They have established a trust relationship.
• Women are supported through the hard work of labor, and encouraged to realize the insights, and experience the personal growth as a human being to be derived from such a powerful, life-changing event.
• Bonding is enhanced and includes everyone who has contact with the baby including neighbors and relatives. Breast feeding is facilitated by the baby remaining with the mother.
• Cesarean Section and forceps deliveries are unavailable - transportation to the hospital is necessary if these interventions are required. However, rates of both, as well as episiotomy, are very low.
• The cost of a home birth may be less than a hospital birth, and is often covered by insurance if a CNM is utilized.
• Pregnancy and birth are viewed as normal, natural body functions and not as an illness or disease.

Disadvantages of home birth...

• Client's must assume a greater level of responsibility for their own health: physical, mental and spiritual. This requires active ongoing participation in decision making in all aspects of their care, and a willingness to accept the consequences of those choices and decisions.
• Since the hospital is the currently socially acceptable location for birth, choosing otherwise may result in negative judgments and lack of support.
• Cesarean Sections, forceps deliveries and a nconaialogist arc not available at home, transport is necessary for these and other medical interventions.
• Personal arrangements must be made for postpartum care, such as meals, housekeeping, child care etc.
• The cost of a home birth may not be covered by the client's insurance.
• Analgesics are not readily available with a home birth.

Advantages of a birth center birth...

• The facility is usually only provided for pregnancy and birth events.
• In a birth center, pregnancy and birth is considered a natural and healthy process.
• During pregnancy and birth, women arc encouraged to take charge of their own health care.
• It provides an alternative to parents not comfortable with home birth, yet do not want to give birth in a hospital.
• It has many of the same advantages as home birth, such as greater parental control, non-interventive obstetrical care, freedom to eat and move during labor, and to give birth in any position, and to have any number of family and friends attend the birth.
• The parents are usually encouraged to bring family members to their prenatal visits.
• It offers personalized care at much lower costs than traditional hospitals.
• In most centers, parents can meet the entire staff prior to the birth.
• The rate ofCesarcan and forceps deliveries is less than hospital.
• The discharge time after birth is normally measured in hours, not days.

Disadvantages of a birth center birth...

• Rigid screening criteria often eliminates healthy mothers, i.e.; VBAC, mother over 35.
• The mother is still moved to birth center during labor, and still labors away from the home environment.
• Many centers have rigid rules concerning transporting of the mother to the hospital i.e.; prolonged labor, ruptured membranes. Mother may have to be moved during labor.
• There are usually no pediatricians on staff if the baby has special needs after the birth.
• The mother cannot remain at the birth center for a two or three day rest; discharge is usually within four to 24 hours.

Advantages of a hospital birth...

• Many mothers feel safest laboring a hospital.
• It is the safest environment for the mother at risk for medical complications during labor.
• Emergency personnel and equipment is available if the mother develops complications or needs medical attention.
• It avoids the rush of a last-minute transfer to the hospital (from home or a birth center) if medical problems arise.
• It is the only option available in the event a cesarean section is necessary.
• Immediate pediatric attention is available should the newborn need medical care. Baby does not need to be taken off site to be routinely examined by a pediatrician.
• It has round-the-clock help for the mother and baby (food, diaper changes, medical assistance and information.)

Disadvantages of a hospital birth...

• The parents are not on "home ground" and do not have the same control they would at home.
• Hospitals are primarily associated with illness.
• Hospitals can seem impersonal and intimidating.
• As a large institution, the hospital has rules, policies and red tape; they are rarely altered to accommodate an individual.
• Less privacy is available.
• The father is often less actively involved in a hospital setting, and may fell like an "outsider".
• The mother's birth is usually managed by experts trained in pathology, not normal births.
• The risk of iatrogenic complications and infection to the mother and baby is greater among mothers who deliver in hospitals, than among those who give birth at home or in a birthing center.
• The mother is at a significantly higher risk of having an unnecessary cesarean section.
• Some routine separation of the mother and baby is almost unavoidable.
• Most hospitals do not allow the mother much rest.

I don't believe that C-sections are evil in it of themselves , surgery, for in life sometimes surgeries are necessary. In my own experience, without a C-section my sister would not have been born. She was a breech baby and had that option not have been available my mom would have no daughter and I would have no annoying sister. Although I think C-Sections are good as long as they are used in emergencies, I agree with The World Health Organization (WHO) which states that no region in the world is justified in having a cesarean rate greater than 10 to 15 percent. The C-Section rate in the United States reached 32 percent in 2007, the country’s highest rate ever, health officials are reporting. Facts even seem to show that more women are miserable getting a C-section than not. "The fact that it's primarily women who had kids before and had birth in hospitals before, certainly suggests it's a reaction to their prior birth," said Eugene Declercq, a professor of community health sciences at the Boston University School of Public Health, and a author of the study. "It certainly suggests it's an experience they don't want to repeat."

SOURCES:
http://abcnews.go.com/Health/Wellness/cdc-home-births-rise-us/story?id=9998349

 http://www.dailymail.co.uk/health/article-1285105/Babies-born-week-early-risk-health-problems.html#ixzz1InxIJj1n


http://www.nytimes.com/2010/03/24/health/24birth.html


http://www.houstonnaturalbirth.com/adv_homebirth.shtml