Homebirth controversy

Akrasia · 01-08-2013 09:28AM #1

http://www.rte.ie/news/2013/0731/465665-homebirth-court-aja-teehan/

Aja Teehan is currently sueing the state for the right to give birth to her second baby at her home despite the current best medical advice that it is safer to deliver in a maternity as her first delivery was via cesearean section.

Do people have 'the right' to deliver their baby in the manner of their choosing?

Obviously, the state can not force people to come into hospital to deliver their baby but there are professional guidelines for Midwifes that they are legally obliged to follow. These guidelines are based on the current best practice and are there purely for the safety of the women and the babies.

Should the state be forced to cater for a woman's birth plan by changing the guidelines against the medical advice of the medical council?

In most of the world, pregnancy is still associated with a very high risk of infant and maternal mortality. Luckily, Ireland is a very safe place to give birth, but does this mean that there is a risk that some people won't take the risks seriously enough?

I tried to research the medical evidence around 'vbac' (vaginal birth after cesearean) and 'hbac' (home birth after cesearan) but the internet is infested with special interest sites promoting 'natural and alternative lifestyles' with all of the top search results linked to advocacy groups who are not necessarily the most unbiased sources on this issue.

One of the biggest problems with the research is that it is very very easy to manipulate in favour of 'natural' forms of birth

Advocates of home birth point to statistics showing reduced complications and shorter recovery times. However, the statistics are very heavily skewed by the different studies methodologies.

If there are complications during a home birth, these women are usually rushed to a maternity hospital where they are recorded as complicated pregnancies in the hospital statistics making hospital delivery look bad, when it was the hospital that most likely saved the mother and child (or had to deal with the more negative outcomes)
http://www.thelancet.com/journals/lancet/article/PIIS0140673610611658/fulltext?rss=yes

One study in the Netherlands shows that 40% of women who start labour at home, end up delivering in a hospital. So the outcomes recorded for home birth may only reflect 60% of home births and not include the 40% where there was already an elevated risk of injury to the mother or baby.

Of all the 'First world problems', respecting a mothers 'birthplan' has to rank amongst the most upsetting. Millions of women and babies die every year during pregnancy and delivery. Even in Ireland, where it is relatively safe, babies are lost and severely injured with depressing regularity despite all the best efforts of the maternity services. Should we really be taking steps that increase the risks associated with childbirth on the basis that some women like the idea of a natural birth?

Frank Black · 01-08-2013 09:33AM

Sorry, stopped reading after 'vaginal'.

Love2love · 01-08-2013 09:35AM

The midwives don't want to be sued and if something does happen they're left open to be sued so if you want a home birth don't expect help.

FatherLen · 01-08-2013 09:36AM

I don't understand what's going on here.

The HSE has told Ms Teehan she has the right to have her baby at home.

What is she complaining about?
The fact that because she chooses to not give birth in a hospital, she wont be given the same support as someone who does?

She can't have it both ways.

Akrasia · 01-08-2013 09:37AM

Frank Black wrote: »

Sorry, stopped reading after 'vaginal'.

Your lucky I didn't post up any pictures

My wife makes me watch 'one born every minute', it's a good form of contraception as it completely puts you off sex for the night

01-08-2013 09:37AM

She has a right to have the baby at home if she wants.

The HSE also has the right to not be held responsible in case something goes wrong in that situation.

F35 · 01-08-2013 09:38AM

Akrasia wrote: »

Your lucky I didn't post up any pictures

My wife makes me watch 'one born every minute', it's a good form of contraception as it completely puts you off sex for the night

hehehh

Akrasia · 01-08-2013 09:40AM

Love2love wrote: »

The midwives don't want to be sued and if something does happen they're left open to be sued so if you want a home birth don't expect help.

There are some independent midwives who are totally in favour of home births (that's how they make their money) but they are prevented from 'HBAC' deliveries because of the medical council guidelines (which are legally binding)

If Aja Teehan wins her case she'll have no problem finding a Midwife

Smiles35 · 01-08-2013 09:41AM

Deleted User wrote: »

She has a right to have the baby at home if she wants.

The HSE also has the right to not be held responsible in case something goes wrong in that situation.

Yeah but I think the thing is that for her to get a registerd midwife you need go-ahead from the HSE.

January · 01-08-2013 09:43AM

The problem is that although the HSE are saying she is entitled to the birth she wants she won't find a midwife to attend to her at home because of the MOU guidelines which will prosecute a midwife if they attend to a homebirth outside of the guidelines.

kneemos · 01-08-2013 09:44AM

Is it a hippy thing or something?surly going to a hospital would be the responsible thing to do.

Czarcasm · 01-08-2013 09:46AM

This is it in a nutshell really-

The HSE respected Ms Teehan's right to disagree with it but she could not come to court to compel the HSE to provide, support or finance a practice it did not believe was safe.

3DataModem · 01-08-2013 09:47AM

Your mortality rate is NEVER higher then it is in the moments after birth.

3DataModem · 01-08-2013 09:48AM

[Deleted User] wrote: »

The HSE also has the right to not be held responsible in case something goes wrong in that situation.

Alas, they don't. They have a duty of care to both child and mother that they can't ignore.

Leroy42 · 01-08-2013 09:51AM

I really don't get this either. The HSE is telling her that the C Section last time increases the risks in this pregnancy.

She seems to be suggesting that she knows better and that she should be allowed to make that call (despite the doctors being qualified!).

While she may feel she has a Right, surely the safety of her baby comes first. Even if the increased risks are very small, why even put any additional risks when it can be removed by going to the hospital.

This story reeks of a person more concerned about her rights than the rights of her child.

She evens says herself that she would be the first to cal lthe ambulance if something started to go wrong, so at that stage she accepts that the HSE as best placed to get her out of the situation, just they are qualified enough to make the initial call?

Celly Smunt · 01-08-2013 09:51AM

I really don't see why the HSE should entertain her,she's been warned by profressionals not to go for a home birth but disregards their advice and expects aid for what they advise against.

MurdyWurdy · 01-08-2013 09:54AM

I had a baby recently and just don't get this - the HSE have told her they don't believe it is safe and they're not comfortable providing home birth services to her because of this and she still wants to put herself at risk and demand that they assist her to do so? I'm sure she believes that it is safe for her to have a home birth but I can't undersatnd women who put themselves and their unborn child in danger like this against medical advice. I would have done anything the professionals told me I needed to have a safe delivery - and as a matter of fact, I did. I understand women want to control what happens to their bodies and want to have the birth experience that feels right for them but you have to have a bit of sense as well.

I bet if they had agreed to provide midwifery services to a woman in this situation, against their better judgement and something happened to her that woman's family would be up in arms that they were negligent in their care. They can't win.

josip · 01-08-2013 09:54AM

3DataModem wrote: »

Alas, they don't. They have a duty of care to both child and mother that they can't ignore.

But neither the mother nor child is "in their care" if the mother decides to go ahead and give birth at home against medical advice. It's not the faceless HSE that's makeing this policy/decision. It's one or more doctors with a lot of experience.

The mother has every right to go ahead and give birth at home. Evolution will ultimately determine who is right. Those type of genes will either thrive or die off.

Uriel. · 01-08-2013 09:55AM

FatherLen wrote: »

I don't understand what's going on here.

What is she complaining about?
The fact that because she chooses to not give birth in a hospital, she wont be given the same support as someone who does?

She can't have it both ways.

The HSE provide an indemnity for midwives when operating within the HSE's policies and regulations.

Due to the risks involved in this particular case, the HSE policy does not cover a homebirth and so a midwife assisting the birth will not be indemnified (as such might be mad to go ahead, in the event that something goes wrong).

Risk factor (there is argument between the parties as to the significance of the risk) but as far as the HSE is concerned the risk factor is outside of the limits of their policies and will not provide the indemnity.

I guess that effectively stops the midwife in question from proceeding. I think the woman will lose her case and rightly so. The HSE, despite its controversies has more experience and expertise than this woman has and they have a duty to protect the taxpayer in the event of one of the risks being realised.

Perhaps the woman (not sure of the legality of this) could waive her comeback against the state in the event that something go wrong.

Stavro Mueller · 01-08-2013 09:56AM

And of course if it goes all wrong and the baby's brain damaged as a result, we will all be picking up the tab for its lifelong care.

Celly Smunt · 01-08-2013 09:58AM

cymbaline wrote: »

And of course if it goes all wrong and the baby's brain damaged as a result, we will all be picking up the tab for its lifelong care.

She should be put away for negligence if the baby is disabled due to her stupidity.

Uriel. · 01-08-2013 09:58AM

Akrasia wrote: »

There are some independent midwives who are totally in favour of home births (that's how they make their money) but they are prevented from 'HBAC' deliveries because of the medical council guidelines (which are legally binding)

If Aja Teehan wins her case she'll have no problem finding a Midwife

She might have a problem finding one that is suitably indemnified. If she wins her case and God forbid something goes wrong with the birth, I just she doesn't come looking for compensation from the state.

Grumpypants · 01-08-2013 09:59AM

Leroy42 wrote: »

This story reeks of a person more concerned about her rights than the rights of her child.

She evens says herself that she would be the first to cal lthe ambulance if something started to go wrong, so at that stage she accepts that the HSE as best placed to get her out of the situation, just they are qualified enough to make the initial call?

Yip wants to ignore the best medical advice put herself and child at risk and on top of that has no problem calling on the hse to send an ambulance to collect her wasting a valuable resource.

kunst nugget · 01-08-2013 10:00AM

3DataModem wrote: »

Your mortality rate is NEVER higher then it is in the moments after birth.

I would have thought being shot in the chest or when you're just about to be hit by a truck might pip that one.

Smiles35 · 01-08-2013 10:00AM

I think hospitals are pox ridden places. If I was told I 'd have to attend due to a technicality I'd be annoyed aswell.

bringupthebook · 01-08-2013 10:02AM

Is there any information on why she is so adament to give birth at home? Has she had a bad experience in hospital on her first birth? Having had a section myself I don’t think I would be going against doctors/HSE advice. Surely she needs to put the safety of her baby and herself first. If she wins who pays costs? If she loses having a home birth will be the least of her worries

Beruthiel · 01-08-2013 10:03AM

Akrasia wrote: »

Do people have 'the right' to deliver their baby in the manner of their choosing?

Women have decided where to have their baby since the dawn of humanity.
Only in the last 5 seconds of humanities lifetime have we had them in hospitals.
Like all women through the millennia, this woman has the right to decide.

Immaculata · 01-08-2013 10:04AM

Akrasia wrote: »

http://www.rte.ie/news/2013/0731/465665-homebirth-court-aja-teehan/
Do people have 'the right' to deliver their baby in the manner of their choosing?

Yes!

And I think you might want to look at your pronoun use there.

Celly Smunt · 01-08-2013 10:05AM

Beruthiel wrote: »

Women have decided where to have their baby since the dawn of humanity.
Only in the last 5 seconds of humanities lifetime have we had them in hospitals.
Like all women through the millennia, this woman has the right to decide.

The right to decide,yes.The right for aid for what is advised against,no.

joebloggs32 · 01-08-2013 10:06AM

Uriel. wrote: »

The HSE provide an indemnity for midwives when operating within the HSE's policies and regulations.

Due to the risks involved in this particular case, the HSE policy does not cover a homebirth and so a midwife assisting the birth will not be indemnified (as such might be mad to go ahead, in the event that something goes wrong).

Risk factor (there is argument between the parties as to the significance of the risk) but as far as the HSE is concerned the risk factor is outside of the limits of their policies and will not provide the indemnity.

I guess that effectively stops the midwife in question from proceeding. I think the woman will lose her case and rightly so. The HSE, despite its controversies has more experience and expertise than this woman has and they have a duty to protect the taxpayer in the event of one of the risks being realised.

Perhaps the woman (not sure of the legality of this) could waive her comeback against the state in the event that something go wrong.

She could waive her comeback, but not that of the unborn child.

Think about it, every time you hear a case reported about medical neglect during birth, it is the child who sues the hospital/HSE.

Also if the child were to suffer a brain injury from a lack of oxygen etc at the end of the day it is the HSE whom will end up providing the expensive services for a lifetime of care, and the parents will get a carers allowance too.

This woman needs yo get out of cloud cuckoo land.

Ms2011 · 01-08-2013 10:06AM

Not completely the same thing but I had a section on my first & because of this I won't be able avail of the midwife led scheme if I have a second pregnancy(although I would choose to give birth in hospital) which really upsets me as I had it on my first & felt really comfortable & reassured through out my pregnancy. I found consultant led care to be more pushy & listened to less.
Someone else dictating such a personal choice can be frustrating, a mother being comfortable with her choice of birth can play a major part on how the labour goes I feel. The more happy & content the mother the better the outcome imo.

Homebirth controversy

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