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I was honored to be invited to speak as an expert on this important topic on today's show.  I do have a degree of expertise stemming from my 17+ years as an obstetrician, and having delivered thousands of babies.  But each woman is the expert about her own experience.

I want to respond to lasonador, who says that I believe "a MOTHER is incapable of making an educated decision about her own care and her pregnancy."  Not at all!  My comment on the show related to the fact that some women may see an unlicensed, unregulated direct entry midwife (DEM) as the same thing as a licensed, certified DEM or nurse midwife, and without specific knowledge regarding the difference, may find herself in a situation not of her choosing.

Bottom line, the question is: what degree of risk do you find acceptable?  Everyone will answer that question differently.  In the hospital there is indeed the red button on the wall, and the csection room down the hall.  An emergency csection in a well-staffed hospital with immediate anesthesia availability should happen in much less than 30 minutes, or even 15.  We can have that baby out in minutes.  Although those kind of "drop and run" emergencies happen very rarely, immediate surgery can be the difference between life and death.

As I said on the show today, home birth can be safe (meaning, can carry with it an acceptably low level of risk) in carefully chosen women with a competent provider who has good judgment and a backup plan for hospital transport.  But some situations are simply not appropriate for home birth: vaginal breech (risk of head entrapment), vaginal birth after csection (risk of uterine rupture), twins (risk of cord prolapse), etc.

This isn't a "god complex," as ani calls it, but the best recommendations we can come up with based on medical science.  If the science changes, then the recommendations will change.  Those sorts of guidelines are why you seek medical advice for in the first place, and why your doctor's opinion should carry some weight.

Such an important discussion--thanks for the opportunity to weigh in.

posted 3 years ago
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