A few days ago we told you the news of the death of Carolina Lovell, a fervent defender of childbirth at home, due to complications during the birth of her second daughter at home. After this news, the debate about home birth safety was activated again, echoing the words of Santiago Dexeus, a well-known and renowned gynecologist who said that home birth is a dangerous fad because women are not fit to give birth in that way (words that Dexeus himself has commented on have been taken out of context).
Since Babies and more We thought it might be interesting to know the opposite opinion, that of the professionals who are in favor of home delivery and that, despite what happened, they still think that giving birth at home is still a safe and satisfactory option for women and the baby.
For this we have Inma Marcos, midwife with 16 years of experience who has been attending home delivery for eleven years. With more than three hundred home deliveries attended It is one of the best known voices when it comes to home birth and ensures that Home birth is very safe for mothers. She is also IBCLC (international lactation consultant) and mother of four children.
Inma, how about Cristina Lovell's story?
A very sad tragedy of which we cannot say much because we lack information for it. We do not know what happened and if it could be avoidable or not. Some very rare circumstances can cause death to a woman who has just given birth even if she is in a hospital. Maternal mortality in the first world is very rare, about 3 out of every 100,000 women. Occasionally it happens in hospital births but it is not usually news. I consider it unfair that this woman who struggled so much in life for the right of women to give birth where they feel safe causes her death to reverse her cause. Throughout the world, the media are misrepresenting what happened and pointing out that home birth is a temerity. They support this gynecological information that ignores the current reality of home birth in the first world.
If the death of a woman in a home birth in Australia has gone around the world and has reached us here it is because it is extremely rare. If not the journalists would not have given him so much dissemination, he would not have much interest. This confirms that home birth is very safe for mothers.
Do you mean that many gynecologists think about home birth without knowing how it is being carried out?
Exactly, they compare home birth here, which is attended by well-trained midwives who carry adequate equipment and only healthy women, well fed and in normal hygienic conditions, with delivery in an African cabin where humans share space with animals, where midwives have no training or equipment and where women suffer from malnutrition, severe anemia, malaria, pregnancy at puberty, reduced pelvis due to childhood malnutrition, etc., etc.
And obviously it has nothing to do ...
Of course, anyone with common sense can tell. They also say that hospital birth reduced maternal and perinatal mortality 50 years ago, but experts know that it was not hospital delivery that caused that decrease but the many improvements in the quality of life such as hygiene: Having water Drinking and hot water and heating in homes increased hygiene and decreased puerperal infections. The improvement in the nutrition of the population also improved the physical conditions of pregnant women and decreased the rate of anemias. And the appearance of antibiotics decreased mortality in the entire population. Also the creation of pregnancy monitoring programs. Before women saw the doctor or midwife for the first time the day they went into labor, there was no control in pregnancy.
Why do you think many women prefer to give birth at home?
Because they do not feel sick or want the birth of their children to become a surgical act. To take control of the situation and prevent anyone from doing anything they do not want to be done. In order to give your baby the best birth and no one separates them. To avoid having to fight with anyone on the day of their delivery: Don't make me an episiotomy, let me move, let me push vertically, don't cut the cord yet ...
But hospital protocols have changed a lot and all this should already be done in hospitals, right?
It has come a long way in improving the emotional aspect of deliveries in hospitals, but still today when you go to a hospital to have your baby, by default the delivery care is medicalized. That is to say that if the woman wants natural childbirth she has to ask for it, and according to the team on duty she has more or less chance of getting it.
Also in countries such as the Netherlands, the United Kingdom, Germany or Canada, where it is normal for births to be attended by natural or physiological default, women can choose to give birth at home and the government takes care of the expenses, as it considers that the current scientific evidence is sufficient to demonstrate that home deliveries to low-risk women are as safe as in hospitals and also cheaper and more satisfying for families.
You get a couple. The girl says she wants to give birth at home but her partner says she does not dare, that much better in a hospital for what may happen, how does this story continue?
We offer a free informative appointment to hear the fears and concerns of both. We inform you of our way of working, what we do if things are not going well, we tell you that the risk at home is not "0", nor is it in hospital, and then they process that information and in a reasonable time they communicate their decision. It is important that the pregnant woman who wants to give birth at home has the support of her partner.
Is there any criteria by which a woman cannot give birth at home other than a doctor? By this I mean that there is not enough space at home, live far away from a hospital, ...
If your home has a roof, hot water, a minimum of two square meters and a maximum of 45 minutes from a hospital (ideal less than 30), your home is suitable for calving.
When you go to a home to attend a delivery, is the nearest hospital informed that a woman is giving birth at home and that, in case of complications, you will go?
Less than 10% of women who attend childbirth at home need to go to the hospital, so we notify the situation by telephone just before leaving home. We do not notify the hospital when everything is fine and the baby is born at home.
In the more than three hundred deliveries you have attended at home, have you ever encountered an emergency similar to the one suffered by Cristina Lovell?
I never, nor do I know of any roommate at home that something similar happened to her. It is really an extremely rare case.
Before finishing, Inma, I am one of the romantics who believe that there is still hope and that one can continue fighting to be able to give birth in a hospital as if it were given birth at home. Do you think someday it will be possible?
Of course it is possible, 25 years ago in the United Kingdom things were like here and little by little the change was made. Now there normal deliveries occur in rooms with flower curtains, where the machines are hidden behind wooden cabinet doors and only removed if needed, they can give birth in the position that suits them best, they are not placed intravenously and He asks them permission to perform anything, such as a vaginal touch. But the most respected hospital birth naturally does not resemble a home birth. It's another story home birth. For example, if Inma Marcos myself, I am attending a physiological delivery in hospital, I already wear a uniform that gives me a status of power over the woman I attend. They have signed a consent upon entering where they say that I can do what they see fit. At home the woman sends, I am only a guest at the event. On the other hand, the quiet, warm and dimly lit atmosphere of your own home is difficult to copy in a hospital where the doors open without asking for permission, people come and go, it's very cold and the lights are intense.
We thank Inma Marcos that has attended us to have the vision of one of the reference professionals when talking about home births. If you want to know more about her work and her words you can go to her personal blog Home delivery and breastfeeding advice or to Neixer home (Born at home), a portal, still under construction, in which she and three midwife partners They will offer their services to continue attending home deliveries.
