The increasing popularity of homebirth is the quickest road to ending the increasing popularity of homebirth. Why? Because more homebirths means more homebirth deaths. It is difficult to argue for the safety of homebirth when the dead babies pile up all around.
Even homebirth celebrities are not immune. In fact, they appear to have experienced a mini-epidemic of homebirth deaths. Ina May Gaskin, the doyenne of homebirth midwifery, lost a child at homebirth, Laura Shanley, the American exponent of freebirth (homebirth without a midwife) lost a baby at homebirth, and Janet Fraser, the Australian exponent of freebirth, lost a baby at homebirth, too. Don’t worry about her, though. She thought the entirely preventable death of her baby at home wasn’t particularly traumatic, not nearly as traumatic as the “birth rape” with her first (living) child.
Two months ago Canadian homebirth celebrity Annie Bourgault had a twin homebirth. One of them lived and one of them died.
Bourgault describes herself as:
… a reporter who finds evidence based information about birthing. She interviews health professionals, leading experts in childbirth and parents whose work help women feel empowered and fulfilled during pregnancy, birth and motherhood. Sign up for her free report: 7 Steps To The Perfect Birth Experience.
Bourgault was expecting twins, and her “perfect birth experience” did not involve being “fearful of the birth process.”
She was irritated with her obstetrician when he told her:
The babies were not very well positioned. Very unlikely they will move. I will need an epidural for the second twin. Start thinking of a c-section!
Wow! I understand why we are so fearful of the birth process and why we just hand them our lives and the life of our babies. He got me! He induced fear in me very easily…
Later I talked to my Doula & midwife who repeated what I already know: He just wants to paint the worst scenario for you. Don’t take that on board. You will be fine…
I love this man for doing his job the best he could. I understand where he comes from. But I would like to suggest to him that fear is not the way to help a woman achieve a happy outcome at birth. Comfort is. Knowledge and fear inducing are two different things.
Knowledge and “comfort” are also different things.
Pushing Max who was breech was amazing. I could even say it was easy-ish. Even if it wasn’t that easy. It felt like it. When I held him in my arms I kept thinking: “What was the big deal? Why did the hospital refused to let me birth you the way I wanted? Without drugs? Without a c-section? I knew we could do it.”
Then Sam… came out 45 minutes after his little brother. He was in a perfect position: head down. We heard his little heart beating 10 minutes before he came out…everything was fine…seemed fine. While I was pushing him out I heard my midwife say: Oh no! It’s the placenta!” She came in front of me and said: “push your baby out right now!”
… I pushed a baby and a double placenta at the same time. They came out at the same time!! I felt like I was opening a bottle of Champagne through my vagina. I scooped my baby out of the water. He was limp. We started CPR and gave him oxygen.
I had my little boy in my arms and I named him. Sam! Sam! I kept saying his name over and over..like a song. I thought if he had a name he couldn’t die. ” Sam my boy, my beautiful boy. I love you so much…stay with us Sam. We love you. You are not going anywhere. Are you? Stay with me. Stay with us!” I kissed him, massaged him, loved him with all I had. I believed he was going to be OK.
He wasn’t. He never took a breath.
Bourgault offer the usual homebirth disbelief:
So what were the chances of me suffering a placenta abruption? I was healthy, had energy, did yoga, ate more broccoli and kale in one day than my whole family in a year and my twins were 39 weeks +. So what happened? Fuck! What the fuck happened????
What the fuck happened happened? An utterly predictable complication of twin birth, placental abruption. In fact the high risk of placental abruption is THE reason that twin birth is considered high risk.
Before birth the entire surface area of the placenta adheres to the wall of the uterus. Once the baby is born, the uterus contracts around the empty space. The fact that the placenta is incapable of contracting. The illustration demonstrates that as the uterus contracts the placenta is forced off the uterine wall. The space between the contracted uterine wall and the peeled off placenta fills with blood. The pressure of the blood in the enclosed space forces more placental surface off until the entire placenta comes away accompanied by a gush of blood, the blood that filled the space between the uterus and placenta.
In a twin birth, the first baby is born and the uterus contracts down around the empty space. The placenta is incapable of contracting, both the placenta of the baby that has born and the placenta of the baby still in the uterus, still depending on the placenta for all of its oxygen. That’s the main reason why twins are considered high risk. The second baby may lose its supply of oxygen long before it can be born vaginally. That’s why the second twin needs to be monitored very carefully, typically in an operating room with a team standing nearby to start an immediate C-section if the placenta begins to detach.
What happened to Annie Bourgault’s son Sam? First, the midwife utterly failed to recognize what was happening. During the 45 minutes between the birth of the first and second twin, she was almost certainly listening to the heartbeat of the mother, not the baby. The fact that a completely detached double placenta came out before the second baby indicates that the baby had been dead for some time, but the midwife never even noticed. Second, Bourgault was at home, too far away from the personnel and equipment that would have easily saved her baby’s life.
Bourgault, of course, is busily pretending that Sam’s was unpreventable.
I never thought he wouldn’t make it. I never thought he wouldn’t survive. Babies often come out flat at birth but they come back…Mine didn’t. He never took a breath.
It’s not suppose to be like that. Babies come first and the placenta comes out after because if it doesn’t the baby is deprived of it’s vital oxygen and can die.
Birthing at home is as safe as birthing at the hospital. Isn’t? True. But death doesn’t spare home birth. It doesn’t spare anyone.
Not exactly. Death is ALWAYS a risk at birth. The risk of death does not spare anyone (even those who write books insisting that homebirth is safe). But death itself CAN be prevented. That’s what hospitals are for; that’s what obstetricians are for; that’s what C-sections are for.
Bourgault insists:
When we went to the hospital later that day. I learned that in the case of a placental abruption like this…there is no so called “safer place”. Because when it happens the baby has only a few minutes to live. Had I been at the hospital I was told I would have had an emergency c-section…but I would also have a dead baby or a very brain damaged one. A c-section AND a dead baby. Thank you very much. I’d rather be at home.
Not exactly. The obstetrician who had advised Bourgault to have a C-section was not nearly as sanguine as she about the baby’s death.
The Ob/gyn who wanted me to have an elective c-section before she went on holidays two weeks prior to the birth came to our room to offer her sympathy and announced that she had called the coroner’s office for an investigation in the death of our baby…
Bourgault still doesn’t get it:
I came to the conclusion that women are allowed to give birth at home but not allowed to loose (sic) a child at home.
She didn’t “lose” a child at home. She let him die. It was more important to her to have the “Perfect Birth Experience” than to take the simple precaution of ensuring that her baby had access to life saving technology. Had Bourgault followed her obstetrician’s recommendation for an elective C-section, she’d have two babies at home today, instead of one at home and one in a grave.
