Tuesday, November 27, 2007

Details of the homebirth deaths

The number of homebirth deaths on MDC is appalling, but it is the details of those deaths that are truly mind boggling. Almost all are deaths that could have easily been prevented basic interventions like C-sections or inductions. This is a roll call that should be read by any woman contemplating homebirth.

#1 breech, nuchal arms (arms trapped behind head), brain dead, ventilator disconnected

#2 shoulder dystocia, profound brain damage

#3 unanticipated anoxic brain damage sustained during labor

#4 normal labor, baby dead at birth

#5 decelerations during attempted home VBAC, transfer to hospital, uterine rupture, baby dead, massive hemorrhage, hysterectomy

#6 postdates, severe meconium aspiration

#7 normal labor, baby dead at birth

#8 post dates, baby dead at birth

#9 unanticipated severe birth asphyxia

#10 prolonged ruptured membranes, overwhelming infection

This list tells us several important things about homebirth. First, homebirth mothers have the exact same unanticipated complications as other pregnant women. Second, the amount of fetal monitoring done at homebirths is inadequate. There is simply no excuse for a midwife attended homebirth to result in the unanticipated birth of a dead baby. Third, in serious complications, the baby is dead or profoundly brain damaged long before arriving at the hospital in transfer.

These are not rare complications that could not have been anticipated. All are known, common causes of neonatal death that used to occur with great frequency and now are rarely seen, except in the absence of qualified obstetric care.

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