My sister-in-law and my brother wanted to have a natural birth at home with their midwife. When her water broke, everything was going really well, then about 2 or 3 hours into the labor, they realized that the baby was breeched. Since the midwife didn't have experience with turning babies, they rushed to the hospital. She had only been in labor for 4 hours at this point, so they were able to get her in and assess the situation before jumping into a C-section. Luckily, there was a doctor there who had a lot of experience with breeched births, and he was actually able to deliver my nephew breeched, without any complications. His little legs were bruised pretty bad when we came to see him, but he was doing really well considering he was three weeks early. In my opinion, they were really lucky! She didn't get the natural birth they had agreed on, but at least everything was ok and she didn't have to get a C-section. I'm sure what I'll do when we have kids, but because of that experience, I will most likely be having the baby in the hospital or birthing center. Scary!

I have done both - hospital and home delivery (with a certified professional midwife) and if I have a third I will choose to do it at home again.  I would tend to agree with @Abibigail@xanga - that I would be more likely to have another hospital birth if I knew I would be allowed to do it the way I want - not with monitors everywhere, an IV pole attached to me at all times, laying on my back in a hospital bed pushing.  That was NOT a good experience for me.  It was much more relaxing and calming for me to be in my own home with just my husband and my midwife.  And I had a water birth, which was fabulous and even more relaxing.  There aren't any hospitals in my area that have a birthing tub.....

@Punk_Rock_Mommy@xanga - I hope you don't think I was looking down on you or anyone who wants a hospital birth, drugs, c-section, whatever they need/want.  I like to share what worked for me in different situations and the way I preferred giving birth, but I am TOTALLY a "whatever works for you" kind of mom.  Whether it be birthing, breastfeeding, sleeping, etc. I think every mom and family has the right to choose what works best for them.  I would never put down or look down upon a mother for any choice that is right for her or her children. 

I had a wonderful delivery, in the hospital, using a certified nurse midwife.  I was able to do everything I wanted, the way I wanted, with the exact level of "medical intervention" that I wanted.  I was allowed to go into labor on my own, past my due date, was able to attempt vaginal delivery (large baby) and was able to tear rather than have a preemptive episiotomy.  In short, I had everything I wanted, in a safe setting, in case something were to go wrong and require more intervention.  I think with good communication and assertiveness on the mother and father's part, you can have a "perfect" birthing experience using certified midwives, who have the training and experience to deal with the what-ifs.

I'm glad to hear everyone's thoughts this! As a nurse who has worked with plenty of doctors (and midwives) who are all too eager to push a delivery on their timeline, I am very sympathetic and supportive of those who wish to avoid as much intervention as possible.  However, this does not change my position that a hospital or appropriate birthing center is the safest place to have a baby, or that it is indeed a doctor or *certified* nurse midwife who is best able to handle emergencies that arise.

I agree that being educated and approprately assertive about what you want (though being aggressive rarely does anyone any good on either side), usually gets you a lot closer to the type of delivery you desire. (Look for my blog soon on birth plans). For example, a patient I somewhat recently cared for wanted a natural delivery.  She wanted no pain medication, no rupturing of membranes, minimal fetal monitoring and no pitocin.  That is exactly what she got.  And she delivered an over 10 pound baby without even tearing.  She was in labor, in the hospital, for over 24 hours and my suggestion to her would have been to have labored longer at home and she would have been more comfortable there, but nonetheless, she got the delivery she wanted (and I actually delivered the baby since the doctor couldn't even get down the hall fast enough!)  I think she and her husband were happy and her baby was fat and healthy. 

Not all providers insist on labor interventions, but sometimes they are actually necessary and we try our best to explain why.  This is where it is important to trust your doctor or midwife's (and nurse's!) medical judgement and ask more questions if you feel you don't have an adequate explanation.  We spend all day looking a fetal heart rate patterns.  We have a pretty good idea when babies are in distress and we try to get them delivered before they are to the point where they will need intensive interventions when they are born.  A little intervention in labor may save several days in the NICU and ultimately we feel that is better for both moms and babies.  Nobody wants to be separted from their baby. 

Don't forget, when babies come out pink and screaming it is not always because everything was fine all along. Sometimes it is because we intervened in time that NOW everything is fine.  I think that idea gets lost sometimes.

To quickly comment on infant/maternal mortality rates.   It has been shown that babies born at home have over double the mortality rate of babies born in the hospital.  This is from the BMJ comparing full-term babies.  I can get the reference if anyone is interested.  Though the US infant mortal rate in general is sadly high compared to other nations, I'm not sure the same is true for the maternal mortality rate.  I will have to do a little hunting on that.

@NurseJenna - i'm glad that you posted that link to the article.
i had heard about the mortality rates and was appalled. but i consider myself a "thinker" (haha) so i was still a little suspicios. that article makes perfect sense. we're a fat nation. . . it's not surprising we're sacrificing our babies and ourselves for our stomachs.
but i still stand by home births. i'm glad there are steps being taken to make birth center deliveries safer, etc. but i think we walk a fine line.
the thing that troubles me about modern obstetrics. . . is that we really don't know yet of the long term side effects of some of the drugs we used. i mean, there was an entire decade where doctors used a drug that caused babies to be born with malformed arms and legs. now, obviously we aren't dealing with anything that drastic, but it's true that pitocin is a relatively new drug. . . and doctors do not use it as it is specified by the pharmicologcial (sp?) recommendations (i've read them). pitocin is used so liberally when it's not needed and it disrupts a hormonal system that (most of the time) works perfectly on it's own.
so, anyway. i think women should do whatever brings them peace. . . because if you aren't comfortable, you aren't gonna have a good birth experience. i think women need to be informed. and far too many doctors are not so accomidating with information.

As a mama with first hand experience of 2 hospital births with an OB, 1 hospital birth with a midwife, and one home birth with a lay midwife........my opinion is totally unbiased. :)

I have nearly died twice during childbirth as a result of over management and intervention.  I believed what my OB said whole heartedly and did not question it at all.  It nearlt cost me my life...twice. :(

Had it not been for a wonderful midwife helping me question my risk factors, I would never have known any better.

Now...I believe an educated choice on the mother's part, is the safest place/way for her to birth.  Whether that be with an OB or unassisted at home, I will FULLY support her right to do so.

Knowledge is empowerment.  If you know better you are able to do better.

Angela

Feel free to email me if you have further questions regarding my birth stories.

thenextstepdanceacad@msn.com

Thank you for posting this.  I think it is important to remember that things can go wrong.  Most deliveries progress with none or few problems.  Other deliveries are completely the opposite. 

I, unfortunately, learned the hard way with my niece that not everyone gets to go home with their baby.  Things do happen.  But without medical intercession, these instances would be far greater. 

Although women have been having babies for as long as there has been life, I think people fail to realize how often babies used to die.  Looking back over my own personal family tree, it is evident many, many times.  Thankfully, we have to deal with this far less often thanks to modern medicine.

@amyunicorn@xanga -  There is a very specific difference between a "lay-midwife" (CPM) and a Certified Nurse Midwife (CNM).  Yes, that one initial makes a huge difference. The latter means you are not only a Registered Nurse, but also have a Master's degree and are licensed by the state you are practicing in.  The former, the "lay-midwife" does not need to be a nurse, nor have any formal education.  There are serveral programs for one to become a CPM, you do not however, have a degree or a license.  The amount of training and experience is not even remotely comparable.  This is exactly what the AMA resolution was referring to.  It does not condone the legality of lay-midwives, nor does the American College of Obstetricians and Gynecologists (ACOG), nor does the American College of Nurse Midwives (ACNM).  This has nothing to do with midwives "where I am," I have actually worked all over the country.  These are nationally recognized asssociations.

@mommy_2130 - 

I am personally not a fan of interventions, but I love that you had the medicine you felt you needed and walked away happy with the birth. It's important, I think, to show and discuss happy, healthy births that take place everywhere. I don't think there is any one right way or place; that's my big problem with the resolution anyway.

That was rambly and incoherent, but I think you get my point. :)

@NurseJenna - I'm sorry, I should have been more specific. I live in Canada, in Ontario more specifically. We do not have lay-midwives or nurse-midwives. We have certified, fully educated, highly regarded midwives. You either see a midwife, or an ob-gyn. No other choices. I like our system. Either one is highly specific in the field of prenatal care and labour/delivery, except midwives are more involved in the mother's choices, options and rights whereas the ob-gyns are usually over-scheduled, overworked and completely removed from the process (they pop in a couple of times throughout your labour IF they're on call, and maybe they might make it when they're paged as you're pushing). So, technically? Your labour and delivery is either monitored by a midwife, or nurses. Not nurse-midwives, nurses (and more than one due to breaks and shift changes). I still advocate midwives with every beat of my heart. I had two uncomplicated, happy and healthy deliveries. The first was ob-gyn directed and medicated, and my second was midwife supported and completely natural. If I were to have another baby (I cannot as my tubes are tied), I would have a midwife again, and birth at home.

@mamaturtle - Women who are overweight are definately more at risk for diabetes, including gestational diabetes.  This does often cause uncontrolled blood sugars and a propensity for babies that are large for gestational age.  This I'm sure does lead to more interventions (ie inducing because the baby is large, NICU admissions due to the baby's inability to regulate its blood sugar etc).  However, it is definately the preference that obese women are NOT c-sectioned.  It is extrememly difficult to section women over a certain BMI (body mass index).  From logistical things like fitting on the O.R table, to the amount of tissue there is to cut through.  Anesthsia has its own set of additonal complications.  It is difficult to place a spinal in obese people, yet general anesthsia is rarely preferred.   I would suggest that it would a rare situation that all other things being equal that an obese woman would be as healthy as similarly situated appropriately-weighted woman.  Slender people can have complications too, no doubt.  The "fat-bias" it that they overall have greater risks.  Though the maternal mortality-rate article does not specifically reference obesity, like so many of our nations health problems, I would not at all be surprised if this contributes to pregnancy and delivery complications.