Research, people!

Someone once compared giving birth to running a marathon. That analogy works on many different levels, but especially when it comes to preparation. Too many women sit on their couches for nine months then jump up one morning and try to run 50 miles in a pair of new shoes.

When it comes to mental preparation, most women seem to be even lazier. Instead of doing research, reading books, even just searching the Internet, they seem content to passively receive information from whoever is standing closest to them at any given moment and base life-changing decisions on that scant anecdotal evidence.

This morning I was reading a post on one of my baby boards (I really need to start avoiding these things) from a woman who decided that homebirth was unsafe after the experiences of her two friends. The first friend hemorrhaged due to placenta accreta and the second's baby was oxygen-deprived due to shoulder dystocia.

Now, I have three problems with her conclusion. The first problem is that it's based on a sampling of TWO. But let's ignore that for the moment. The more important issues are that first, both of the problems described are linked to hospital births and, second, can be treated just as effectively by a midwife at a homebirth. In other words, they would have been less likely to have problems at home and even if they did, would have not been in any greater danger!

Placenta Accreta is a condition where the placenta grows too deeply into the uterine wall to release easily. Since OB's in the hospital have a bad habit of yanking on the umbilical cord to dislodge the placenta, this can cause hemorrhaging. Midwives generally frown on this practice for exactly this reason. This yanking (or providing "traction") can also cause the placenta to break apart. Regardless, the treatment for hemorrhaging after birth for any reason is a shot of pitocin, which midwives carry with them.

Shoulder Dystocia, according to a study by the American College of Obstetricians and Gynecologists in 2002, is most often caused by the OB's two favorite tools, the vacuum extractor and forceps, making it much less likely to occur during a homebirth. Even if it does, midwives have oxygen and resuscitation equipment on hand--the same equipment that would be used in the hospital. In fact, my midwife gave me an oxygen tank to keep at my house when I turned 36 weeks. In addition, the procedures that midwives use to treat shoulder dystocia are actually less invasive. An OB will try an internal maneuver before simply letting the mother change position--which can be just as effective.

Since deciding to give birth to my child at home, I've gone through a series of reactions to people's questions. In the beginning I felt that I had to defend my decision and would bombard nay-sayers with the tons of research I'd done. Finally, I got tired of being questioned repeatedly--even after giving my reasons--and became angry and frustrated with what I perceived as a lack of respect for my right to make my own decisions. But now, I'm just saddened by what I see as a real lack of education on such an important topic. We make fun of politicians who don't know the difference between a Suni and a Shiite, but what do you do with women who don't bother to find out what's happening (or being done) to their own bodies?