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On one hand you have to respect the rights of the women to her own body, on the other hand we have a newborn with rights for proper healthcare. What is the right policy here? Shall we allow women to give birth at home even if it means there is a higher risk of infant and mother death compared to giving birth in the hospital?

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On one hand you have to respect the rights of the women to her own body, on the other hand we have a newborn with rights for proper healthcare. What is the right policy here? Shall we allow women to give birth at home even if it means there is a higher risk of infant and mother death compared to giving birth in the hospital?

Given that every study done clearly demonstrates either equal or better neonate and maternal outcomes for midwife-assisted homebirth in western countries, your hypothetical seems a bit trivial to contemplate. Much like, "if green were blue, would it be okay to call blue 'green'?"

Please also consider what a "right to healthcare" means. Also consider your idea that 'we' may 'allow' women to give birth at home. Also check your premise that the hospital offers what each individual woman wants and is valuable/life enhancing for herself and child in a birth scenario.

You have a lot of work ahead of you to parse the issues of a woman's rights, her responsibilities to her children, society's place in deciding how she ought to act toward herself and children, what constitutes safety, what the real issues surrounding birth are, and the rights of children.

When you know what the real questions are, you can begin to figure out the answers.

I've studied these issues intensely for seven years. My opinion is that your question is too simplistic, which renders it absurd.

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Given that every study done clearly demonstrates either equal or better neonate and maternal outcomes for midwife-assisted homebirth in western countries

Question: Does this have to do with the fact that in the vast majority of hospital births the mother is drugged up for it? I know I have heard fairly regularly that some women prefer to go "natural" for that because of (sometimes religious) medical reasons, since apparently those drugs can sometimes increase the rate of complications etc.

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Given that every study done clearly demonstrates either equal or better neonate and maternal outcomes for midwife-assisted homebirth in western countries, your hypothetical seems a bit trivial to contemplate. Much like, "if green were blue, would it be okay to call blue 'green'?"

Please also consider what a "right to healthcare" means. Also consider your idea that 'we' may 'allow' women to give birth at home. Also check your premise that the hospital offers what each individual woman wants and is valuable/life enhancing for herself and child in a birth scenario.

You have a lot of work ahead of you to parse the issues of a woman's rights, her responsibilities to her children, society's place in deciding how she ought to act toward herself and children, what constitutes safety, what the real issues surrounding birth are, and the rights of children.

When you know what the real questions are, you can begin to figure out the answers.

I've studied these issues intensely for seven years. My opinion is that your question is too simplistic, which renders it absurd.

You are very hostile and condescending, why is that? You're telling me I have to do a lot of learning? That's exactly why I asked the question. Honestly, I find your answer unhelpful and unreasonable.

In eastern europe you do get better chances of survival in a hospital compared to mid-wife assisted delivery at home. Green is green. And, the very first study I found with google doesn't prove you correct even in the western world. So the question is legitimate green=green.

A recent study by Canadian researchers compared the outcomes of home birth vs. hospital birth in British Columbia. The study consisted of:

2889 home births attended by certified midwives

4752 planned hospital births attended by the same midwives

5331 hospital births attended by doctors

The researchers reported that women who planned a home birth had less maternity-related interventions but also less adverse outcomes. The interventions associated with hospital childbirth are induction of, electronic fetal monitoring, epidural anesthesia, assisted vaginal delivery, and cesarean section. The adverse outcomes reported were infection and hemorrhage. The risk of newborn mortality was similar for both home and hospital births.

So why are there fewer complications in home birth than in hospital birth? The researchers think it might have something to do with self-selection.

You suggest there is no "we" when it comes to allowing certain things to women. Yet, there is a "we". We as a society create laws that we through the state do not allow to be broken, right? There is a we who doesn't allow taking another person's life, right? If the baby dies of negligence that will that be the women's fault? Or does she own the baby and therefore she can do whatever with it? Where do you draw the line? Or do you even have to draw the line? Again, I'm asking, I would appreciate an answer.

Is the question too simplistic? I don't think it's over simplified. It's a question from the real world with real conditions. What's simplistic about it? Maybe it's too simple for you but it's a very real question to me.

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Question: Does this have to do with the fact that in the vast majority of hospital births the mother is drugged up for it? I know I have heard fairly regularly that some women prefer to go "natural" for that because of (sometimes religious) medical reasons, since apparently those drugs can sometimes increase the rate of complications etc.

I don't thin this question has been settled yet. There are several studies pro and contra. And whatever the outcome it only applies to an average, individual cases can deviate significantly. There are some homes and hospitals with very bad and very good conditions.

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Question: Does this have to do with the fact that in the vast majority of hospital births the mother is drugged up for it? I know I have heard fairly regularly that some women prefer to go "natural" for that because of (sometimes religious) medical reasons, since apparently those drugs can sometimes increase the rate of complications etc.

No. It has to do with the fact that pregnant women who already feel bad, or suspect something is wrong, are more likely to go to the hospital than those who feel great. It doesn't make not going to the hospital a good idea, it just slants the statistic.

If the results are still comparable, despite that, it means not going to the hospital is a terrible idea.

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Women had children in the home for milennia before there were hospitals. Of course, women used to die in childbirth on a regular basis, too. I don't think anyone should be forced to give birth in a hospital (although I'm sure Obama may feel otherwise), but it's probably a wise idea.

Edited by Maximus
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Women had children in the home for milennia before there were hospitals. Of course, women used to die in childbirth on a regular basis, too. I don't think anyone should be forced to give birth in a hospital (although I'm sure Obama may feel otherwise), but it's probably a wise idea.

I agree. What if the child dies because they can't provide emergency care at home. Is the woman responsible for the death as negligence?

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You are very hostile and condescending, why is that? You're telling me I have to do a lot of learning? That's exactly why I asked the question. Honestly, I find your answer unhelpful and unreasonable.In eastern europe you do get better chances of survival in a hospital compared to mid-wife assisted delivery at home. Green is green. And, the very first study I found with google doesn't prove you correct even in the western world. So the question is legitimate green=green.You suggest there is no "we" when it comes to allowing certain things to women. Yet, there is a "we". We as a society create laws that we through the state do not allow to be broken, right? There is a we who doesn't allow taking another person's life, right? If the baby dies of negligence that will that be the women's fault? Or does she own the baby and therefore she can do whatever with it? Where do you draw the line? Or do you even have to draw the line? Again, I'm asking, I would appreciate an answer.Is the question too simplistic? I don't think it's over simplified. It's a question from the real world with real conditions. What's simplistic about it? Maybe it's too simple for you but it's a very real question to me.

The article quoted by you explicitly states that planned homebirth is as safe as hospital births, so I am unsure how you intended it to counter my point, but perhaps I've missed the context of your point, or it wasn't clearly stated. There are many other studies that show the same or that homebirth is safer in western countries, and depending on which eastern European country you would refer to, I am not sure it would be included in my intended definition of 'western' countries; I should have written 'first-world' or 'developed' countries if 'western' no longer connotes these.

Here is an illuminating article about eastern European countries as compared/contrasted with the previously so-called pinnacle of excellent maternal outcomes, California. Here's another, but just about California.

Here is a UK-based site with many references to birth statistics that would be helpful to you if you are interested. These vary in quality, but you should be able to glean most or all of what you need to settle your concerns by reading through them.

I am actually not hostile, though I am properly condescending as far as knowledge of the issues you raised is concerned. I am not suggesting that I am a superior human being, but my understanding of this topic certainly is superior. I have to guess that your assertion that I am hostile, assumedly based on your assessment of my post, has to do more with what your expectations were than what I expressed. I wrote concisely, but not with hostility. If/when you are better equipped with knowledge to discuss this topic, you will more than likely see that my post was not hostile; it was to the point and accurate.

Incidentally, if I am allowed the right to abort/kill the child up to but not including the involuntary expulsion of it from my body, why on earth should I be subject to (clearly contradictory) regulations/laws that enforce my compliance to circumstances under which I may birth the child and allow it to live? Is that immeasurable instance in time an actual line that can be drawn? Either I have sovereignty over my body or I am enslaved, and either I am responsible for my neonates care, or I am enslaved. The slippery slope goes in many directions. Yes, there is a line in this, and I think it is drawn in a circle around the individual, even when that individual contains another one. The deliberate refusal to properly care for a birthed infant is altogether a different question.

People die all the time, and it's not uncommon for them to die in circumstances that were they not entered into, the person would not have died. A football game is a pretty rough event, especially for a child, one during which everyone expects injury. If a mother allows her son to play football should she be required to have on-site emergency medics in case the child needs them? And if he dies, should she be held responsible? The answer is that she should do as she determines is necessary and proper for her child, and she should take responsibility for her choices to act accordingly, whatever the outcome. Should 'we' allow her to allow her son to play a potentially injurious sport such as football?

Also, if doctors are involved in the birthing process, is the woman less responsible if her baby and/or she die? Who is ultimately responsible for the outcome of the birth? Is the woman who hires an obstetrician less ultimately responsible for her birth experience given her choice to involve the OB? What if that OB has a record of having caused several deaths? Is the woman not responsible for making sure that those to whom she delegates specific actions/roles as pertain to aspects of the her welfare are equipped to adequately carry out her wishes? If no OB is willing to divulge such stats of his own work, would it be rational to demand of her that she just pick the one she thinks/feels is the least ill-equipped/most capable?

I don't thin this question has been settled yet. There are several studies pro and contra. And whatever the outcome it only applies to an average, individual cases can deviate significantly. There are some homes and hospitals with very bad and very good conditions.

Here is where you are somewhat correct, and why your concern about whether or not 'we' should 'allow' women to give birth at home is an empirically unfounded concern. What's more is that, given your above recognition, not only are there a variety of circumstances to consider, but 'women' don't give birth to 'a' baby. An individual woman gives birth to her baby. And this leads to your next question about responsibility.

(I'd be interested in the studies that show a statistical significance of unfavourable outcomes to mothers and neonates in first world/developed countries who homebirth.)

What if the child dies because they can't provide emergency care at home. Is the woman responsible for the death as negligence?

Yes, absolutely the woman is responsible, and a major reason for birthing at home- to ensure and highlight the reality that she alone is the one ultimately responsible for the situation. If the child dies, the woman should be responsible to submit to justice, but which should not be meted out in any more serious or severe a way than it is for other people who involve themselves in birthing situations, such as doctors (who by the way, are routinely NOT held responsible for the injuries and deaths they cause to mothers and babies by negligence/incompetence, but should be unless they have been forthright in presenting the condemning evidence of their quality of care). So she should be subject to the the just laws that anyone else taking responsibility for the birth of a child should, but no more.

No. It has to do with the fact that pregnant women who already feel bad, or suspect something is wrong, are more likely to go to the hospital than those who feel great. It doesn't make not going to the hospital a good idea, it just slants the statistic.If the results are still comparable, despite that, it means not going to the hospital is a terrible idea.

Women had children in the home for milennia before there were hospitals. Of course, women used to die in childbirth on a regular basis, too. I don't think anyone should be forced to give birth in a hospital (although I'm sure Obama may feel otherwise), but it's probably a wise idea.

This highlights another issue. The insidious lore that intimates that women used to drop off like flies from childbirth impressively leaves out the pertinent context of the assertion. What were the living conditions of those women? Women who were bound by fashionably tight corsets during their formative years had obviously deformed pelvises and rib cages. Pregnancy was excruciating and this is the time period that also gave us the notion that pregnancy itself commonly induces fainting spells. It only makes sense that women with woefully deformed pelvises would not properly birth and the outcome would more than likely cause serious morbidity if not death of both the mum and/or her baby.

Then, in circumstances where women were malnourished from a young age, deformities occur from scurvy, rickets, and other deficiency-caused maladies. These women also have a significant morbidity/mortality rate currently. Women who are malnourished during pregnancy face similar outcomes. Is there any wonder? What does any of this have to do with the safety of home or hospital birth? This has more to do with the living standards that individuals choose or are forced to accept, or are fighting to take charge of.

Regardless of who is employed in the process, the woman is always ultimately responsible for herself and the child she carries and births. She is responsible to seek competent, deliberately chosen through thorough investigation, assistance if she knows she needs it; she is responsible to the condition of her body before, during and following pregnancy; she is responsible for the circumstances under which she chooses to birth and for the outcome. Thinking she can delegate full responsibility to someone else and not be implicated in the outcome is to deliberately evade reality.

I have had both excellent and nearly fatal birth experiences and all of them were and are completely my responsibility. In two cases, I ignorantly, and hastily employed incompetent practitioners who nearly killed me and two of my babies. They played golf and went to a tropical island, respectively, afterward while I took full responsibility for the infants they nearly killed and myself as well. Those mistakes (mine) were costly and it took many years to resolve the damage that was done. The practitioners were responsible for the lies they told in order to convince me to hire them, but ultimately, as I figured out afterward, it was my choice to hire them, and had I researched their history properly and learned what I needed to know about human health and disease, childbirth, and the medical model for obstetrics, I wouldn't have hired those people to begin with, and their lies would have been transparent.

I am sure I missed much. Please do not mistake my passion and forthrightness for hostility; it would be better for those concerned with pregnancy and childbirth to have a proper understanding, and I don't want to be in the way of such progress.

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With regard to the original question it is ultimately the woman's choice where she gives birth. We as reasonable and rational people would hope that she makes an informed decision and one with the best interests and the safety of the child in mind. The rest is up to her.

Yes she would be responsible if the child dies due to complications though I fail to see how that is any different from a hospital being responsible for any of a number of complications that happen in a regular hospital birth.

The point about responsibility is an important one. We want to live in a society where the individual is responsible for his choices. We don't want government or anyone else assuming that they can take choices away from us in the name of protecting us from the responsibility brought about by making choices.

The question couldn't be clearer. Do you believe we have the right to live our own lives or do you believe we can only live by and with permission?

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Ivan,

I know that this very much off-topic, but I've read my initial response over and over and I am not sure why you took it to be hostile. One of the reasons I have enjoyed this board is that for the most part, there is little to no molly-coddling through unnecessary prefacing, an overarching assumption of the benevolence of posters (unless they demonstrate otherwise), and thereby a lot of ground covered in discussion. I wrote in the manner that I did because that is how I express myself with words. You do not have the benefit of my body language and vocal intonation to let you know that I am not a jerk, but like anyone else, I would prefer to be assumed kind unless I exhibit clear evidence that I am not.

If I asked a question that was so simplistic as to be absurd (and I have, many times), being informed of this wouldn't translate into an assumption of hostility, but rather, I would (and have) take it to indicate that I jumped into the deep end before I could tread water; then I'd purpose to learn enough to know what questions to ask. It only makes sense to learn the vocabulary and at least cursory content of a topic before opening a discussion with a can of worms.

So, there wasn't and still isn't any hostility from me to you; I hope that you will take my word on that. Incidentally, discussing this particular topic in depth requires thick skin, or growing some if you don't yet have it.

Edited by Imogen
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...we have a newborn with rights for proper healthcare.

.. Shall we allow women to give birth at home ...?

First, who (exactly) is we?

There is no such thing as a right to healthcare. Such a right would impose an obligation on those who are capable of providing health care, thereby negating their individual rights.

A woman has the right to give birth wherever she believes best and where ever objective laws protecting individual's rights don't prohibit. IF she makes a decision that can be proved legally negligent, then she should suffer the legal penalty. Luckily (not really), women typically want what is best for their baby, so this shouldn't be an issue.

Are you thinking that there should be an law that outlaws home births? If so, why is this a focus of yours, and on what premise would you base the objective reasoning for the law?

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Ivan,

I know that this very much off-topic, but I've read my initial response over and over and I am not sure why you took it to be hostile. One of the reasons I have enjoyed this board is that for the most part, there is little to no molly-coddling through unnecessary prefacing, an overarching assumption of the benevolence of posters (unless they demonstrate otherwise), and thereby a lot of ground covered in discussion. I wrote in the manner that I did because that is how I express myself with words. You do not have the benefit of my body language and vocal intonation to let you know that I am not a jerk, but like anyone else, I would prefer to be assumed kind unless I exhibit clear evidence that I am not.

If I asked a question that was so simplistic as to be absurd (and I have, many times), being informed of this wouldn't translate into an assumption of hostility, but rather, I would (and have) take it to indicate that I jumped into the deep end before I could tread water; then I'd purpose to learn enough to know what questions to ask. It only makes sense to learn the vocabulary and at least cursory content of a topic before opening a discussion with a can of worms.

So, there wasn't and still isn't any hostility from me to you; I hope that you will take my word on that. Incidentally, discussing this particular topic in depth requires thick skin, or growing some if you don't yet have it.

Thanks for your full answer. I fully agree with you and the other members. And I now have a clearer understanding of how such an issue should be broken down.

I thought you're hostile because you didn't specifically answer the question, but prompted me to think my own question over. I now realize that this wasn't meant to be a rude, retrospectively it makes sense. At the time however it didn't answer any questions I had, it posed even more. Sorry for saying that.

Thanks for your help guys.

Edited by Ivan Raszl
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Thanks for your full answer. I fully agree with you and the other members. And I now have a clearer understanding of how such an issue should be broken down.

I thought you're hostile because you didn't specifically answer the question, but prompted me to think my own question over. I now realize that this wasn't meant to be a rude, retrospectively it makes sense. At the time however it didn't answer any questions I had, it posed even more. Sorry for saying that.

Thanks for your help guys.

Hey, no problem. :D And thanks for the additional prompting. Sometimes it's hard to know just how deep I've gone (and how little use my responses sometimes become as a result). I'm glad you found it helpful in the end. So did I.

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