http://press.thelancet.com/editorials3107.pdf
Its interesting that this editorial came out so soon after the meta-analysis that "determined" that home births are more dangerous than hospital births. The entire meta analysis was flawed - the studies that they used were outdated, did not specify between midwife assisted and spontaneous home births ("I didn't know I was pregnant!"), nor did they separate out healthy, low risk pregnancies versus high risk. And unfortunately so many people - doctors - see this study and use it as the word of God when it comes to advising against home births. The lancet editorial does a little bit of a better job - it mentions the meta analysis but also mentions the flaws. I'll be interested to see the data when the new study they mention comes out.
And maybe all this attention to home birthing has me on home birth alert, but lately a fellow home birther and i have been discussing the benefits of home birth versus hospital versus midwife assisted hospital births. My baby, born at home, had no jaundice, scored a 10 out of 10 on her apgar, and was basically as good as you get. The question of jaundice came up b/c all of the home birthers we've talked to never had jaundiced babies. Almost every hospital birther i've asked has. So this leads to the question - what is the reason for this discrepancy (and more importantly, why have OBs not been aware of this)? Is it the fact that the home birth baby is immediately allowed to breastfeed, on demand, no interruptions from the moment they're born until...they stop breastfeeding? Is it the immediate skin to skin contact? Is it the unmediated, vaginal birth? Its probably all of these things. But the evidence (based on our own flawed, nonscientific study) is pretty clear: these babies born without any interventions end up looking and acting much healthier than the "safe at the hospital" babies. But this polling led to this follow up: almost all home birthing moms had no problems breastfeeding. sure, there were initial " i have no f'n clue what we're doing" latch problems, but there were no milk supply issues in any of these moms (myself included). But almost all of the hospital birth moms I know have had supply issues, and definite issues with latching that have lasted well past the first week. So what is this about? My theory - again, the baby is allowed to be with the mom from the minute they're born, no one is whisking them away to bathe them, test them, stick them in the nursery. Mom and baby are basically forced to figure it out and keep trying until they get it right at home. And i think that the constant trying, latching, absolutely no introduction of bottle, helps. Could it signal to the hormones to make milk and keep on making it whereas if there is a lag time between trying - either b/c the baby isn't in the room, or there was a bottle feed so the mom could get some sleep - that messes with the hormonal signals?* its very possible. again - its my own theory. its extremely interesting that i've heard the same two sides from the two groups of moms.
of course, i'm completely biased. i had an awesome experience and i want everyone to have the same experience. what me and my friend both find so frustrating is this: you work so hard on doing the right things during the pregnancy - eating right, exercising, not drinking, smoking... and you work so hard to get everything perfect for the new baby - the best and safest. but when it comes to the actual birth and labor - everything goes out the window and moms just want to get through it with out realizing how incredibly important the actual act of birthing is and how much it affects both the mom and the baby. i wish the birthing classes spent more time on this point than anything else. maybe one day, i'll start my own birthing class.
*"Scheduling feedings for a baby or spacing feedings out more and more during the day (or night) will lead to the same decrease in milk production. Emptying the breasts frequently leads to an overall increase in milk production." http://lactinv.com/breastfeeding_qna.php?article=maintaining_your_milk_supply
-could this happen so early on it affects milk supply for the rest of post-partum?
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