Australian home birth advocate collapses, dies after childbirth

The debate over the safety of home birth is sure to be re-invigorated after a home birth advocate died this week after delivering her baby at home.

Caroline Lovell, 36, died January 24 after she was rushed to the hospital when she developed symptoms of heart failure during labor. Lovell was able to hold her newborn daughter, named Zahra, before she passed away. Zahra has a three-year-old sister named Lulu. Lovell advocated for the legalization and funding of midwives in Australia.

Home births have enjoyed a resurgence of popularity, after a steep decline in the 20th century when hospital births became the norm. In fact, home births increased by 29 percent between 2004 and 2009, though they still comprise less than one percent of all births. Women who give birth at home are generally assisted by midwives and doulas, not doctors.

The death, though highly publicized, is unlikely to affect the rising trend towards natural, home birth. The movement has steadily gained momentum and has become a virtual cottage industry of books, DVD’s, and birth-assisting professionals.

“For healthy, low-risk women, we believe birth is a normal process and the body is well designed to do it. Home-birth midwifery care has been proven to be a safe and nurturing alternative to physician-attended hospital births,” said Susan Moray, spokeswoman for Midwives Alliance of North America, which represents certified professional midwives who work outside of hospitals.

Home birth gained popularity as part of a broader movement away from standard Western medical practices, which often treat natural conditions, such as pregnancy, as medical ones. Natural and home birth advocates point out that pregnancy and birth have been going on since the advent of… well, mammalian species, and that our bodies are perfectly equipped to do so without major medical intervention.

Moray, who is herself a midwife, says that deaths as a complication of labor do sometimes occur – in and out of the hospital, but that the hospital deaths inevitably do not garner the media attention that a case like this does.

“I don’t think one death is going to swing the pendulum” away from home-based labor and delivery, she said. “What’s swinging the pendulum to the 29 percent increase in home births is women talking about the satisfaction of their births and the good safety record.”

The American College of Obstetricians and Gynecologists disagrees. Its official position is that the safest place to have a baby is at a hospital or birthing center, where life-saving interventions, if necessary, are virtually at one’s fingertips. The college points out that published medical evidence shows home birth does carry a two- to three-fold increase in the risk of newborn death compared with planned hospital births.

Most pregnant women are generally healthy, but even the healthiest ones can develop emergency complications as a result of pregnancy or labor. And it’s those emergency cases that have doctors worried about home delivery outcomes. The time it takes to identify that there is a problem and the subsequent travel time to the nearest hospital can mean the difference between life and death.

“There are circumstances where medical intervention is necessary,” said Dr. Erin Tracy, an obstetrician and gynecologist at Massachusetts General Hospital in Boston. “We can provide that intervention much more quickly in the hospital.”

The college said that there were 548 documented cases of deaths due to pregnancy related causes in 2007 in the U.S. The annual figure has not gone over 1,000 since 1960. The top causes of maternal deaths are uncontrolled bleeding (hemorrhage), blood clots, high blood pressure, infection, stroke, amniotic fluid in the blood, and heart disease. These conditions used to kill women with much higher frequency in past centuries.

Source

Image Source: Wikimedia Commons

Comment and add to the story without registration, but keep the comments meaningful please. Links are not accepted.