Home Birth Among Catholic Women?

[KellyPalmer]

No, I don’t want to imply at all that women “cheated” on their preventative care. I meant to imply that more of them can’t afford it, so thank you for clarifying that (as it could be inferred from my mention of diabetics who take their pills but don’t change their diets!)

When you have a system where everyone gets care, you automatically lower the intervention mentality, too–for better and for worse, because the system has an incentive to avoid interventions. When you have a system that anyone might sue even if the doctor (or midwife) is not at fault, you almost enforce an intervention mentality, because nobody can afford to go into court and face the accusation that they “did nothing” when there is some intervention that could have been tried.

It could be that an “intervention” mentality increases good outcomes in preemies, but actually works against the highest number of good outcomes in full term babies. For instance, it was found that avoiding surgery was a good strategy for a lot of carpal tunnel cases because the health care system in some countries enforced a wait-and-see “treatment plan” because of the waiting list for OKd surgeries was so long! They could compare the outcomes of those who got treatment promptly and those who had to wait around, and the ones forced to wait around did better. Getting better by doing nothing and only getting surgery when doing nothing failed to work was the best strategy. When there is the money to do something, though, people want that, especially when waiting around is painful and the condition is debilitating. When the system says, “sorry, it is the best we can do”, though, then it isn’t malpractice to do nothing.

You make some excellent points. Generally, intervention in pregnancy is only beneficial when there is a medical problem going on. Intervention as standard may help those who need it but may harm those who don’t. Most people don’t. Also, it is true that unless a c-section is done, it can’t be said that a provider “did all they could”. This is a motivational factor in unnecessary c-sections but I think it’s important to note that there are many other factors as well. One study explored when inductions and c-sections are most likely to occur and it corresponded with the convenience of a dr. For example, so-called medically indicated c-sections are significantly more likely to happen just before dinner each night and especially so on Fridays, just before the weekend.

We have Tricare Prime where everyone’s care is covered 100% and the intervention rates are not lower. In fact, in many cases, intervention rate is higher even though active duty members are prohibited from suing. And I don’t think diabetic rates are lower among those with Tricare. Medicaid doesn’t appear to have lower intervention rates either. I would also note that low income women are eligible for free or low cost maternity coverage.

Parents do demand that drs do but this is because drs throughout history have created such a culture. With obestetrics, they did not have good evidence to start with and still to this day there is a major lacking, only 1/3 of recommendations put out by the governing body of Obstetricians (ACOG) is based on good evidence. Parents themselves, taking the time to read up on the science, are the ones who have formed a small but vocal and growing minority to impact change in this arena. I hope to see that continue.

 

[KellyPalmer]

Here’s one more practical issue–very few homebirth midwives carry malpractice insurance. If, due to negligence, the mother dies or is seriously injured or if the baby dies or is born with serious birth injuries, there will be little possibility of seeking compensation from an uninsured homebirth midwife. Bear in mind that the care of a child with brain damage due to oxygen deprivation is very difficult and expensive, so that even a non-litigious family would need the money, if only to provide adequately for the care of their injured child.

Whatever the practitioner’s qualifications, it is always wiser to go with one who carries appropriate insurance.

Not always. It is a practical issue to consider. However I actually think a provider without insurance has more incentive to ‘do no harm’ vs one who has that back-up. I don’t want to put myself and my child at greater risk simply because I may receive a bigger payout for damages. Also, my insurance covers all healthcare and services for my children 100%. One of the biggest factors for me was being in a place with a provider where I was able to follow God, my body and my baby instead of relying on a person on the outside who may or may not have insurance. I can only begin to describe how much safer it was for me to birth at home. My body knew exactly what to do when everyone/everything else was not in the way. My hands knew exactly where to go to support exactly the right spot. My body literally changed positions without my control. All of this to get out my 9.5lb baby with a gigantic 15" head and a nuchal arm without even a tear and with perfect apgars! God’s design is good!

 

[kozlosap]

Do all midwives have hospital privledges? I know that a few of the Duggar daughters are completing a distance learning midwife program to become CPM’s. Obviously there is a huge difference between a CNM (RN with equivalent to a MA in midwifery) and someone with no degree taking part in a distance learning program. I would have no problem using a true medical professional with hospital privledges, but I’m not sure I would be comfortable with any others.

 

[Em_in_FL]

Do all midwives have hospital privledges? I know that a few of the Duggar daughters are completing a distance learning midwife program to become CPM’s. Obviously there is a huge difference between a CNM (RN with equivalent to a MA in midwifery) and someone with no degree taking part in a distance learning program. I would have no problem using a true medical professional with hospital privledges, but I’m not sure I would be comfortable with any others.

I think it depends on the law of the state.

I have had CNM (exactly - RN with Masters in midwifery) deliver all 4 of my children in the hospital… I felt it was the most ideal situation!!!