Waterbirth has been touted as an alternative form of pain relief in childbirth. Indeed, it is often recommended as the method of choice for pain relief in "natural" childbirth. It's hardly natural, though. In fact, it is completely unnatural. No primates give birth in water, because primates initiate breathing almost immediately after birth and the entire notion of waterbirth made up only 200 years ago. Not suprisingly, waterbirth appears to increase the risk of neonatal death.
Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey was published in the BMJ in 1999. Out of 4,030 deliveries in water, 35 babies suffered serious problems and 3 subsequently died. It is unclear if any of the deaths can be attributed to delivery in water. However, of the 32 survivors who were admitted to the NICU, 13 had significant respiratory problems including pneumonia, meconium aspiration, water aspiration, and drowning. Other complications attributable to water birth include 5 babies who had significant hemorrhage due to snapped umbilical cord. In all, 18 babies had serious complications directly attributable to waterbirth. The risk of serious complications necessitating prolonged NICU admissions was 4.5/1000.
Hospitals in Ireland recently suspended the practice of waterbirth after a baby died from freshwater drowning after delivery in a waterbirth pool.
The most nonsensical aspect of waterbirth is that it puts the baby at risk for freshwater drowning. The second nonsensical aspect is that the baby is born into what is essentially toilet water, because the water in the pool is fecally contaminated. In Water birth and the risk of infection; Experience after 1500 water births, Thoeni et al. analyzed the water found in waterbirth pools both before and after birth. The water in a birth pool, conveniently heated to body temperature, the optimum temperature for bacterial growth, is a microbial paradise.
The authors were aware that the water system itself can harbor bacteria, given the report of at least two neonatal deaths from Legionella pneumonia, one that occurred in the hospital, and one that occurred at home. Therefore, they tested the water before anyone entered the pool. To their surprise and dismay, analysis of the water itself revealed that 12% of samples contained Legionella pneumophila, 11% Pseudomonas aeruginosa, 19% Enterococcus, 21% coliforms, and 10% Escherichia coli. Most of these organisms can and do cause infections in neonates. After installing a special water filter, and instituting more stringent pool cleaning procedures, contamination of the water by these bacteria was reduced, but not eliminated.
The analysis of the water after birth was shocking. Almost all 200 water samples were heavily (as opposed to slightly) contaminated with various infectious bacteria.
In the samples taken after the birth there was a high rate of contamination with coliforms (82%) and Escherichia coli (64%) with concentrations of up to 105cfu/100 ml; Pseudomonas aeruginosa, Staphylocooccus aureus, and yeasts were found less frequently.The authors claim that the fecally contaminated water did not affect the rate of infection. First of all, the study is underpowered to reliably detect the impact of the contaminated water on the rate of infection. Second, the authors express their claim in a curious way:
Only 1.34% of children (10 of 741) born in water showed infectious signs such as tachypnea and suspect skin color compared with 3.40% (15 of 440) in the [control] group.
The relevant finding is not which babies displayed signs of infection. The relevant finding is which babies actually had infections. The authors neglect to share that information, suggesting that there was a significant difference.
Waterbirth is praised for its ability to ease pain in some women, but is that really worth the risk of delivering a baby into toilet water teeming with harmful bacteria? What's "natural" about that?
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Where I live one hospital offers waterbirth and from what I've learned, they haven't had any of these problems. Perhaps sanitation has something to do with that?
The other hospital offers tub use during labor (but Mom is out once she is past a certain point)
Like everything else regarding Birth, this has risks and benefits. I would like to see a good, solid study that pinpoints the safety of waterbirth (either way) once and for all. I'm weary of hearing the extremes: "Oh its just so perfect and wonderful" or "You do this and your baby WILL die."
Rated.
"In all, 18 babies had serious complications directly attributable to waterbirth."
I'm confused. Which is it? It can't be both.
I'm guessing this could be a question of sanitation standards or poor practices on the part of the midwife or doctor (since there are a few places in hospitals that allow some form of waterbirth). But again, are these the fault of water birth primarily or could they be attributed to some other cause? I'm not messing with you here, I swear. You just say both things, and I'd like to know which one is accurate.
I did always wonder about babies breathing in the water--my cousin's baby was delivered by emergency C-section and she had breathing problems because the pressure of delivery usually forces the baby to expell whatever fluid they have in their lungs and begin to breathe air.
"Yikes! Anyone with half a brain knows that babies gasp and swallow in the womb so I don't know why they would not do the same in warm, possibly disgusting water."
That's right, but waterbirth advocates have made up their own "science" to suit themselves.
"I would like to see a good, solid study that pinpoints the safety of waterbirth"
The proponents of waterbirth have never studied it. They just assumed it was safe because it seemed safe to them.
"Which is it? It can't be both."
The babies who had serious complications are separate from the additional babies who died.
"Are there dangers to laboring, but not giving birth, in water?"
No, there don't appear to be any dangers to laboring in water and getting out to give birth.
Just guessing but I bet the water used to fill a birthing pool at a home birth is cleaner than the water in a hospital. Just guessing. And I'm also guessing that the tub at a home birth is also cleaner than the tubs in the hospital, but we'll never really know.
My gut feeling is that it's probably okay to give birth underwater but we became land based mammals millions of years ago. Labor in the water give birth on land but give birth in a position that makes sense for the woman birthing the baby, not the doctor with his/her head in the crotch.
"Babies poop in the water they are bathed in and it doesn't turn instantly into a fetid pool."
That's true, but they are not likely to breathe it in.
Touche' Dr. Amy.
And here's a toast raised (literally, i am eating breakfast) to the energy and steadiness you show here and always following up with comments. You are indefatigable.
Water birth is groovy. Waterbirth is mellow. Waterbirth is I am sure soothing to many mothers. Waterbirth is overhyped, and an unnecessary level of extra risks.
Giving birth (i was there for all three daughters) is not an opportunity to prove things about your hipness.
Thanks for the kind words.
"Give me a break -women who deliver naturally do not do it for bragging rights, that is absurd."
Actually, many of them do. Natural childbirth (the philosophy) is almost exclusively a phenomenon of white, middle to upper-middle class women
But I live near Woodstock NY. I can site chapter and verse going back over 15 years stories of mind-bogglingly dumb birth stories, and one of the unifying themes is self-centered white hipsters being "cool".
I lived on an 80 acre farm in Saugertie, near Wdstk, a decade+ ago. My neighbors, consumate hippies, did this: dead of winter, 2'+ of snow on the ground, went down to our cow pond, her in labor, and had their "shaman" due a "native american immersion" ceremony at 2 am, to encourage the baby to "want to come out". all five of them, including the mother, were on mushrooms.
In the years since I have rub into them and their child. So many things wrong with that kid: flat affect, does poorly in school, very needy with mother. 2 days of home birth labor without attention and lots of drugs just might have something to do with it.
And it is by a wide margin NOT an odd story up here.
Always appreciate your well-informed essays even when I don't 100% agree with you. But I am posting here for the first time because I do agree with you on this one.
I appreciate your article very much. I always suspected that water births were inherently disgusting (just judging by what is likely to come out of the mom before the baby comes through).
I know that western medicine is not infallible, but I would rather put my trust in my highly trained OB/GYN and the phenomenal hospital nurses and midwives they work with to deliver my children in a safe, sterile setting then follow the latest wackadoo trend of the moment.
Sure, childbirth is natural and pregnancy is not an "illness" but plenty of mothers and infants died in childbirth in the "good old days." So much can go wrong on the delivery table, I would rather know that a problem could be detected and addressed immediately without having to make a last-minute run to the hospital after something has started to go wrong. I am risk-averse that way. I am very grateful to the doctors and nurses who helped bring my two children into the world.
I think that in the 1950s and 1960s maybe a doctor's bedside manner was a little too clinical, and women didn't have much control over what happened to them, which led to the alternative birthing movement. But this is the 2000's not the 1950's. I think that hospitals have come along way in providing support and care to mothers in labor. I think many women are taught to fear hospitals and embrace methods like water birth based on stereotypes that are 50 years old.
It a choice and if a woman decides that the benefits outweigh the risks (for her situation) than what the hell, go for it.
I chose natural birth because it's safer. I can tell you with absolute certainty there's no staph infection in my house, which was one of the many reasons I chose to stay home for my second birth. People might want to read more about these studies before they agree with you, considering how your interpretation differs from reality.
Could you please explain how you would know this? From what I know of staph (and MRSA), it is not uncommon for ~25% of the population to have staph on their skin or in their nose, without any infection or syptoms to tip you off that it's there. Were you somehow able to test all the surfaces of your home as well as all members of the household?
"People might want to read more about these studies before they agree with you, considering how your interpretation differs from reality."
Is there an Objective Reality that tells you that Dr. Amy is wrong? Or have you read the studies and have critiques of how she has interpreted them? If you have specific critiques, I'm sure we would all be happy to hear some scientific debate on the subject! (Or, at least, I would!) If you haven't read them, or have read them but don't know how to crunch the numbers, could you please explain what makes you believe that Dr. Amy is misrepresenting them from her alternate reality? :-)
"I chose natural birth because it's safer. I can tell you with absolute certainty there's no staph infection in my house, which was one of the many reasons I chose to stay home for my second birth"
Natural birth is NOT safer; natural childbirth advocates simply made that up.
When it comes to staph, you don't seem to realize that it is on your skin, on everyone's skin. Even methicillin resistant staph is very common outside the hospital. In fact, 90% of MRSA infections are acquired in the community.
thank you for your forbearance. I thought I had worded carefully enough in both posts, and do sincerely believe flutegirl.
I am asserting that, anecdotally, I have direct experience with many for whom waterbirthing and much else besides have a hipness, a cache. So a satisfaction with being au courant co-exists with any and all else they admire about, or derive benefit from, such alternatives.
And humans will continue to devise alternatives, about which we must weigh the risks, as you say. But birth involves two human beings, and statistics emerge now that shows elevated risk. So there is at least a sobering dimension to that decision, that makes a blithe "what the hell, go for it" a little jarring. Methinks.
My "what the hell, go for it" was meant in this regard: If a woman and her Dr find that waterlabor/birth is acceptable (not every woman is a canidate for it) than what is the big deal?
Oh and I completely see what you are saying about "hipness" and I agree. My frustration comes from the fact that its the "I have to do X to fit in" crowd (in regards to birth) that makes rational women who just desire more choices in birth, look nutty.
I have a sibling who delivered both her kids via Section just because she didn't want to "mess herself up down there" and really didn't want to go through labor. Said sibling also critized me for refusing pain meds when I delivered my stillbrn son at 25 wks, go figure.
My question is that, if a woman can have an elective section and no one bats an eyelash, why does the woman who wants a natural delivery get scrutinized?
I think Amy's post is not about natural childbirth per se, only the elevated risk emerging in the data for this waterbirthing practice. And that is the difference, but as you point out, selectively: anyone who adds risk to childbirth methods, whether for atmosphere and experience (waterbirth), or for preserving, um, tightness down under, is using questionable judgement. I honestly don't know if your sibling increased risk using sections, tho.
True.
Now, four years after her youngest was born, my sister wants another one, but now she wants a VBAC (vaginal birth after C-section) and I just don't see it happening. She even joked about ME having it for her . . as if! I'm having a bit of a problem concieveing MY OWN right now. :) I laughed and told her to get a puppy, lol
Such is life!
"Give me a break -women who deliver naturally do not do it for bragging rights, that is absurd."
AmyTuteurMD:
"Actually, many of them do. Natural childbirth (the philosophy) is almost exclusively a phenomenon of white, middle to upper-middle class women"
Natural childbirth (the philosophy)? Ummm, how about natural childbirth (the way women have been having children since the dawn of time)? Healthy babies are born naturally all around the world every day, and I'm pretty sure it's not all white upper- and middle-class women pushing them out. Birth is not in and of itself a medical emergency, yet our nation is one of the few industrialized nations that seems hellbent on treating it like one. Somehow we still manage to have the second highest infant mortality rates in all of the industrialized world. Funny, that.
I was willing to hear you out on water birth until my girlfriend pointed out this little pearl of wisdom that you wrote in the comments: "Natural birth is NOT safer; natural childbirth advocates simply made that up."
It's one thing to argue about the downsides and the merits of different birthing methods, but to outright dismiss information presented by the other side by saying they just made it up? That's beyond the pale. You're obviously not willing to engage in any real debate or look at any information that might challenge what you already believe, and that, despite your medical credentials, undermines your credibility as a reliable source on this issue.
Circle of life, I guess.
I've always been a bit confused by the idea that somehow natural childbirth is "better" and a medically assisted childbirth is somehow wimping out, or a lesser experience.
When my first turned out to be breech, and I had a scheduled c-section, I wish I had a dollar for every person who said how sorry they were. As if it was some kind of tragedy that I didn't get to experience labor and vaginal delivery.
Who cares? I had a healthy baby. I now have a healthy 11-year-old. I'm a whole lot more worried at the moment about impending middle school than I am about how he came into the world. He's healthy, so am I, life goes on. I can't imagine putting a baby at risk for lifelong complications so that I can say I did it right in the birthing process.
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"delivering a baby into toilet water " -By your definition then is bath water also toilet water?
And now Dr Amy speaks against the evils of natural childbirth? I've defended you before. Now I feel a mite foolish.
You can't 'sanitize' a pool of water that someone has just pooped in. I don't care how clean the water is when you start, as soon as there is poo in it it becomes a potential source for infection. Gah. How people can blame the hospital janitorial staff for this is beyond me.
2) Regarding 'natural childbirth':
What does that even mean? Can't we evaluate each procedure or proposed intervention on its own merits? I feel like people on both sides of this debate tend to slap labels on the various choices and then uphold or decry them on that basis, rather than engaging in an actual analysis of the risks and benefits as they pertain to the case.
Who cares whether waterbirth is 'natural'? The question is, is it beneficial? Sounds like the plus is some pain relief, the minus is a risk of infection and drowning for the baby. On balance, sounds like a bad idea.
How about epidurals? Probably not what you'd call 'natural,' but again, who cares? The plus is pain relief, the minuses I guess are less effective labor positioning for the mom, possibly slightly longer labor and slightly increased risk for instrumental delivery and episiotomy? Seems like the kind of thing each woman should have to evaluate for herself.
Anyways. My point is that 'natural' is a word almost devoid of meaning in most contexts, including this one.
Only if it was contained human waste particles, as the water at a waterbirth normally does. That's the biggest difference...a large majority of women will have a BM while pushing in labor. Even if a midwife/doc "fishes" it out with a net, the bacteria is still present. The baby is then born into that contaminated water, so it's entire body is covered with it. If the baby happens to try and take a breath, it will inhale the contaminated water. Even if it does not try to inhale, if it opens it's mouth, the contaminated water goes in. If after it is brought to the surface, and before it is bathed, it puts it's fingers in it's mouth, the contaminated water is injested. Actually, if the mother's breast(s) were covered in the post-BM water and then breastfed the baby immediately after birth (as is pushed in the natural birth crowds) then the bacteria could get in then too, I suppose. Just seems to risky to me.
It's amazing we're a paper culture...
I am a practicing RN/EM in Australia, (I think the equivalent in the US is CNM), with a graduate diploma in Intensive Care Nursing as well. Your comments sounded very scientific but in reality were rather uninformed. I know my very good friend, who is a Doctor, (and does home births) would agree with me. I was shocked at your brazen misrepresentation of the facts. When I read your comments about the babies that died and those that had “serious problems” my first thought was that you didn’t give the statistics for ‘out of water births’. “How odd” I thought. So I went the study, and found that babies died when born out of water also. Some of them also had pneumonias and other infections. In fact, this is what the author’s concluded –
“Perinatal mortality is not substantially higher among babies delivered in water than among those born to low risk women who delivered conventionally.”
In what other ways have you conveniently misrepresented the whole picture to give weight to your personal opinion? Quoting that study in the way that you did was unscientific, unmedical and almost fraudulent. No responsible person would ever make the claim that birthing in water makes all risk in childbirth dissolve. Risk in birth, the same as risk in life, is a basic fact – in or out of water (and in and out of hospital for that matter). Your emotional and unscientific comment in a later post “Natural birth is NOT safer; natural childbirth advocates simply made that up” Is just as big a misrepresentation of the facts – some truth but not the whole story. The major studies comparing safety of home birth to hospital birth show that the rate of maternal and neonatal death and permanent injury are about the same, (so you were right in saying that natural birth is not safer) but home birth has greatly reduced harm – less haemorrhages, less tears, less episiotomies, less caesars and other instrumental forms of delivery, less post natal depression etc. In fact why don’t you talk about the studies that show the risk of maternal death is 4 times higher with elective caesarean than low risk vaginal birth? (http://www.medscape.com/viewprogram/4546 ) Also, the studies that show the risks to the baby are higher for elective caesarean birth vs. low risk vaginal birth (nearly 3 times higher) http://members.iinet.net.au/~freotbd/MacDorman%20et%20al%202006%20neo%20mort%20and%20primary%20CS.pdf
Infection - Another aspect that sounds very scientific is naming all the various bacteria present in water. If I came to your home, and swabbed for bacteria, I would find alarming results, as I would anywhere, in anyone’s home. A television show here in Australia a couple of years ago swabbed people’s tooth brushes and grew ecoli!! The point is that the presence of bacteria does not necessarily cause harm, it is allowing that bacteria to grow out of balance with the surrounding flora that causes infection. Hospitals (and therefore hospital baths) are perfect places for that balance to be – well, out of balance. The sterile conditions and the use of antibiotics have created bacteria capable of rapid growth (unhindered because all other bacteria have been killed) as well as being resistant to treatment. As regards to your difficulties with the author’s conclusions that “The authors claim that the fecally contaminated water did not affect the rate of infection” - I understand your difficulties with studies not examining the entire facts (I have similar problems with most studies) but I would like to ask a question. What babies get infections without “signs” of infection? Surely if there is no sign, no sickness, basically a well neonate, there is no infection? Surely as doctor you agree that colonisation is not necessarily the same as infection? If I swabbed your nose at present do you think you might have MRSA (as most of us do)? Are you infected? Are you sick? Or is your nose colonised? What are the rates of non-water birth infections in neonates? Why didn’t you quote them? Could it be that they are higher than home water births?? Perhaps the issue is not water birth but hospital births? All studies that I have seen (as well as over 13 years of experience of birth in a hospital) indicate that women should flee hospital as a place for birth because of the infection rates.
Drowning - A comment on your site referred to watching the birth of a baby where they witnessed the asphyxiation of the baby under water. I think I have seen a similar (or the same) video to this and also squirmed – it is irresponsible (and criminal in my opinion) to keep an obviously oxygen deprived baby under water. Typical water birth is not like this at all, as most babies are lifted straight to the surface. Since I have been practicing independently and helping women with home births, I have only ever had to do one “full on” neonatal resuscitation, and it was a birth out of water. How many water births have you witnessed in practice? I have witnessed well over 100 and been the primary (and only) care giver in about 50. Small numbers I know, but surely if it were so dangerous I would have seen at least one baby try and breathe under water? In fact, when I add the water births I have attended to those of the colleagues in my area, the amount of water births that we have assisted in a 25 year period (in and out of hospital) is over 3000. None of us has ever witnessed a baby trying to breathe under water, let alone drowned. I do remember more than one baby born in hospital though – out of water – born via caesarean that needed to be flown to a tertiary hospital because of their inability to move the fluid out of their lungs. Hmmm. We can get highly emotive can’t we when we give only one side of the story?
As you seem to make factual statements and ridicule other opinions without “backup” I would like to please have your research for the following statements, so I to can read and evaluate the studies –
“entire notion of waterbirth made up only 200 years ago.”
“Natural childbirth (the philosophy) is almost exclusively a phenomenon of white, middle to upper-middle class women”
hmm, maybe in America, (but I doubt it) and definitely not in my back yard. Natural childbirth is the philosophy of people smart enough to question the assumptions and errors of modern medicine. My clients are from all “classes” and financial backgrounds, a good portion less well off than “middle to upper-middle class”, who struggle and save to have enough money to afford a midwife attended home birth and reject the free medically controlled hospital birth. (All basic medical care in Australia is practically free). Don’t get me wrong, medicine has lots of good, and I am not anti medicine, but I have been involved in the medical world for 22 years now and I see lots of errors and lots of assumptions and lots of misrepresentations of the facts. Both of your comments are entirely your opinion. Women, since the beginning of time, have sought what was available in their environment to help them during labour and birth. The aboriginals in my local area tell of the time “before white man” that the women used to go to the creek (small flowing water course) to birth their babies. The aborigines in central Australia had no access to such water courses, and not surprisingly have no traditions of using water for birth. These aboriginal women lived what would be scientifically described as ‘stone-age type civilisation’. – hardly a description of your white middle class braggers. Philosophically, women use water because of their belief that it helps them cope and it is a gentle way to birth – not to “brag”. The notion is laughable and insulting. There may be an exception or two, but that applies to every group of women, regardless of their method of birth.
Other emotive comments on your site (not from you but from your supporters) of drug induced hippies etc deserve no reply. Individual people’s abusive practices have nothing to do with responsible natural birth or water birth.
Water birth is definitely not for everyone, and definitely not safe in all circumstances. I personally don’t care if a woman chooses to birth in or out of water. In most cases where the birth is unhindered (that is not subject to medical interference) the mother has a very strong instinct one way or the other and she should be encouraged to follow that instinct. But the suggestion of birthing into “toilet water” and “drowning” your baby is un-scientific fear mongering.
"The major studies comparing safety of home birth to hospital birth show that the rate of maternal and neonatal death and permanent injury are about the same,"
That's false. ALL the existing scientific studies of homebirth show that homebirth increases the risk of neonatal death. Even the studies that claim to show that that homebirth is as safe as hospital birth actually show the opposite. The famous Johnson and Daviss study actually shows that homebirth has almost triple the neonatal death rate of low risk hospital birth.
"If I came to your home, and swabbed for bacteria, I would find alarming results, as I would anywhere, in anyone’s home."
Sure, if you swabbed the toilet bowl, you'd find lots of bacteria, too. The point is that you wouldn't drop your newborn in it and hope he didn't suck in a lung full. The water birth at waterbirth is the equivalent of a toilet.
The whole concept of waterbirth is inane, as is a great deal of what passes for "natural" childbirth. Waterbirth is made up, unnatural, and ignores the basics of newborn physiology. It kills babies, and the only people who seem unaware of that fact are midwives who promote it.
It is clear from your comments that you would never have a home birth, or water birth, or ‘natural’ birth, and from the amount of emotion your words contain, I wonder why. But regardless of your reasons, you have the right to make up your own mind. I applaud the right you have to make your choice, and believe every woman needs to follow her own heart. But to write such vicious misrepresentations of the truth in order to bully other women who would make a different choice is not playing fair. It is as if the presence of an opposing opinion is some sort of threat to you. Your reference to dropping a baby into your toilet is very clever, but once again more emotion than science because it ignores the facts of colonisation/infection. The presence of “nasty” bacteria is just a fact of life. You have also failed to acknowledge that infections do occur in hospital – even out of water. Here is a study for you -
Water birth and the risk of infection Experience after 1500 water births
A. Thoeni, N. Zech, L. Moroder; Pol J Gyn Invest 2004; 7(1/4):21-26
Conclusions:Our results show that water birth has a major advantages over traditional delivery methods. It is associated with a significantly shorter first stage of labor, lower episiotomy rate, and reduced analgesic requirements than other delivery positions. Provided the women are selected appropriately and the rules of hygiene are respected, water birth is safe for the mother and neonate.
Once again, in your post you have made unsubstantiated claims, and have not addressed the fact that you totally misrepresented the facts in your original post. Your referral to the “famous Johnson and Daviss study” is not correct. You are no doubt referring to the fact that they excluded deaths due to fatal congenital abnormality, babies who died in the womb before labour but the mothers chose to still give birth at home, twins and breeches. These exclusions are also made in the data of intrapartum and neonatal deaths from hospital. Fair is Fair. You cannot include these in this study and say “the rate of babies dying is 3 times higher” without also adding them to the hospital statistics. The truth of that study is as follows –
“The study included prospectively reported data from more than 5000 women planning home births with Certified Professional Midwives in the year 2000 in the U.S. and Can, and found that outcomes for mothers and babies were the same as for low-risk mothers giving birth in hospitals, but with a fraction of the interventions.” Here is the study and link for those readers who wish to make up their own minds -
“Outcomes of planned home births with certified professional midwives: large prospective study in North America”; Kenneth C Johnson, senior epidemiologist1, Betty-Anne Daviss, project manager2 ; BMJ 2005;330:1416 (18 June), doi:10.1136/bmj.330.7505.1416
http://www.bmj.com/cgi/content/full/330/7505/1416
It is very clear that you have no interest in scientific debate, or the whole story, or in presenting the truth, nor in encouraging your readers to check things out for themselves. I will not reply to you again, because it is a complete waste of energy. From your previous misrepresentations of what these studies say, I know you will not present what any study says with honesty, but I have included the studies above and below mainly for your readers. Please, anyone who reads anything Dr Amy posts, don’t just take her word for it, but read the study yourself. Paste the title and authors into a search engine and find the study. Dr Amy will probably not give the whole study title and where it is published because she doesn’t want you to read it yourself. In fact, I don’t really think she wants you to think for yourself, otherwise she wouldn’t be so dishonest. Even searching for the authors will help you find the study, especially since you know the subject matter of the study. Here are some other studies for readers to look up -
Northern Region Perinatal Mortality Survey Coordinating Group; “Collaborative survey of perinatal loss in planned and unplanned home births”; BMJ 1996;313:1306-1309 (23 November) http://www.bmj.com/cgi/content/abstract/313/7068/1306 - “The perinatal hazard associated with planned home birth in the few women who exercised this option (
Northern Region Perinatal Mortality Survey Coordinating Group; “Collaborative survey of perinatal loss in planned and unplanned home births”; BMJ 1996;313:1306-1309 (23 November) http://www.bmj.com/cgi/content/abstract/313/7068/1306 - “The perinatal hazard associated with planned home birth in the few women who exercised this option (
Macfarlane A, McCandlish R, Campbell R. Choosing between home and hospital delivery. There is no evidence that hospital is the safest place to give birth. British Medical Journal. 2000 Mar 18;320(7237):798.
Peter S. Bernstein, MD, MPH; Complications of Cesarean Deliveries; CME/CE
http://www.medscape.com/viewprogram/4546
Marian F. MacDorman, PhD, Eugene Declercq, PhD, Fay Menacker, DrPH, CPNP, and
Michael H. Malloy, MD, MS; Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with ‘‘No Indicated Risk,’’ United States, 1998–2001 Birth Cohorts; http://members.iinet.net.au/~freotbd/MacDorman%20et%20al%202006%20neo%20mort%20and%20primary%20CS.pdf
Northern Region Perinatal Mortality Survey Coordinating Group; “Collaborative survey of perinatal loss in planned and unplanned home births”; BMJ 1996;313:1306-1309 (23 November) http://www.bmj.com/cgi/content/abstract/313/7068/1306 - “The perinatal hazard associated with planned home birth in the few women who exercised this option (
"Sorry – the studies did not come through somehow. Here they are (and there are more if you look for them)"
I've read all the studies and more. The problem is that you haven't read them. You have no idea what they show; you only know what the abstracts claim.
None of them, not a single one, shows homebirth to be as safe as hospital birth. Sure some of them claim to shows that, but that is because they compare low risk homebirth to hospital births including high risk.
I know this comes as a newsflash to you and other homebirth advocates, but ALL the existing scientific data, and national data from the US and Australia shows that homebirth increases the risk of neonatal death to approximately TRIPLE the rate of comparable risk hospital birth.
Babies die all the time at homebirth. Check out the MotheringdotCommune website. There is more than 1 homebirth death each and every month, and virtually all of them were preventable.
The Midwives Alliance of North America (the trade union for homebirth midwives) has collected statistic on the safety of homebirth from 2001-2008. They have made those statistics publicly available to people who can PROVE that they are "friends" of midwifery. Even then, you must sign a legal non-disclosure agreement to make sure no one else finds out the statistics.
The MANA data almost certainly shows that homebirth increases the risk of neonatal death. The fact that they are withholding it is unconscionable. The fact that homebirth midwives and homebirth advocates are completely oblivious to the truth is indefensible.
The bottom line for waterbirth, though, is this. The water in waterbirth is indistinguishable from toilet water, because IT IS toilet water. That's what happens when feces contaminate warm water. The idea that being born into toilet water is somehow "natural" or beneficial to babies is completely inane, but then homebirth midwifery is completely inane.
Have you thought about the fact that the baby is breathing in it's own waste in the amniotic sac during pregnancy? It lives in "toilet" water for 9 months before it comes out. Of course, most of the baby's waste is filtered through the mother's circulatory system, but there is still some waste in the amniotic fluid that it swallows every day (source: http://www.drspock.com/article/0,1510,5113,00.html).
I'm 11 weeks pregnant with my first child. The doctor's office I go to was recommended to me. They are very advanced and well respected. However, I've been thinking about waterbirth (not an option at their affiliated hospital) because it allows freedom of movement. What if I don't want to lay on my back during delivery? What if that's not the most productive position for me? There is no part of me that wants a hip delivery. I want to have the best, cleanest, healthiest delivery with the most advanced medical assistance available IF NECCESSARY. But, I'm concerned about being confined to a bed. Water birth truly does sound like the easiest way to achieve the freedom of movement that I think is neccessary. Why do I think it's neccessary? Instinct, I guess. Maybe I'm wrong. I just don't want to be left without options on game day. And this whole "infection" conversation seems really extreme. Why wouldn't we assume that the air is contaminated with fecal matter if we have a BM on the table during an out-of-water delivery? Please understand that I'm not a hard line advocate for anything alternative. I just want the best for my child and for me. I'm trying to get the facts. And the "facts" that you're presenting don't seem to make sense to me given that I know that there is waste in the fluid that the baby is living in and swallowing every day during gestation.
"Natural birth" from Australia is right. You're way emotional about this. That doesn't seem to be the way to convince anyone of anything.
I'd appreciate it if you would commend on my post regarding amniotic fluid. Thanks.
But wait... Women in Guyana do it... I read that argument somewhere. That almost boiled my blood. Are we still of that mindset where we can say savage women in a developed country go to the river to birth. All of them? Savages? WTF... Pseudoscience appealing to prejudice as a reason to back up your birth plan?
Short Sale
I wasn't aware of how risky it can really be but I will be sure to make everyone I meet aware of it now.
Astral Projection