Back in May, I made a post on Mothers in Medicine about home vs. hospital birth. I have a few things to add to this, which may be controversial, so I will post here instead.
For starters, the reason I made the post in the first place was that a woman in an online pregnancy community that I'm part of posted some pro-homebirth propaganda. I didn't know how true the stats she gave were, but I hate obvious propaganda and it was hard for me to keep my mouth shut.
The thing is, I'm not an ob/gyn or a pediatrician. When I read this propaganda, I didn't know much about homebirth. All I knew was that when I rotated through L&D as a med student, I saw a few seemingly normal deliveries go south and it was a good thing the women were at a hospital. But I can't say I had a particularly strong opinion about homebirth aside from the fact that it was something I'd never do. It seemed like it was something that was probably okay for low risk women. But at the same time, I thought it was kind of insensitive to post propaganda scaring women into thinking that they were going to have a worse outcome with their hospital births, especially since many of them needed hospital births for medical reasons.
Like I said, I'm not an ob/gyn, pediatrician, midwife, doula, whatever. But I am a physician. I also did a research fellowship and have had multiple publications in peer-reviewed journals, so I've like to think I have some idea of how to interpret research. So when I get in a discussion with someone about homebirth, I can call bullshit on the following statement:
The fact that homebirth is safer is not even "controversial," as it is based on solid medical research.
That was said to me almost verbatim by more than one person. Let me tell you why this bothered me, in case it's not obvious:
1) No studies could be provided to me that in any way supported this. Every study I found myself showed the opposite.
2) Practically everything in medicine is controversial on some level. "Beta blockers should never be used in heart failure." "Oh wait, beta blockers are a good treatment for heart failure." To say that something that has never (and will never) be tested with a randomized trial isn't even controversial is just ridiculous. Especially when there are so many blogs arguing vehemently on both sides of the topic. Clearly it's a very controversial and emotional topic.
3) This statement was meant to imply that I could not argue further because the point I was arguing against was simply a fact, like the Earth being flat.
Before this argument, I had never heard of something called "birth trauma." I don't want to undermine the seriousness of birth trauma. But when every argument I made is shut down because it is triggering to people with birth trauma, that makes it hard to have a discussion. Especially if the other person refuses to stop making statements akin to "you will be butchered and raped in the hospital" around women about to give birth.
After participating in the most frustrating argument ever, in which I started even doubting my own name, I talked to a couple of the lovely women on MiM, who assured me that I wasn't crazy and that the official position of ACOG, based on what research is available, is that hospital birth is safer for both mom and baby.
I also discovered Dr. Amy's blog. I love this blog with all my heart. I wish I knew Dr. Amy so I could shake her hand. Every time I get irritated that a crunchy mom says that hospital birth will kill you, epidurals are the root of all evil, or vaccines/formula are poison, I read Dr. Amy's blog and her no-nonsense logic makes me smile. Pretty much any entry will do.
So that's the story of how I went from being pretty much neutral on the homebirth issue to being staunchly against it.
But the moral of the story isn't so much that I think homebirthing is a huge risk (although I do, sorry). Or that I'm going to go around telling random pregnant women not to have their babies at home (I won't). The moral of the story is something that has absolutely nothing to do with homebirth:
When you try to argue a point with someone, the goal is not to push them way to the opposite side.
Maybe this woman could have even convinced me that homebirth was a good option if she had:
1) Refrained from calling me names
2) Addressed my arguments instead of calling them all "triggers" or saying that the articles I cited had been refuted (and not saying where or how)
3) Provided me with actual links to articles instead of telling me they all got swallowed in some other comment she tried to write
Ultimately though, it was good because I learned a lot and discovered an awesome blog. (And had a non-traumatic hospital birth.)