Home birth advocate dies in home birth

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AP

The extra time is spent in the first stage of labour - the longest part of the process, before the "pushing" stage, according to findings published in the American Journal of Obstetrics & Gynecology.

London - A passionate advocate of home births has died after her own home labour.

Australian campaigner Caroline Lovell, 36, went into cardiac arrest while giving birth to her second daughter, Zahra, at her home.

She was taken to hospital but died the next day. Her daughter survived.

The tragedy, in Melbourne on January 23, will re-ignite debate about the safety of home births.

NHS statistics show that between 2000 and 2008, home births in the UK soared by 54 percent.

Lovell had made arrangements for a private midwife to assist with the delivery, but unknown complications during the birth caused her heart to stop. By the time paramedics arrived at her home, she was critically ill.

The photographer, who leaves behind her husband Nick, her first daughter Lulu, three, and newborn Zahra, had lobbied the Australian government for more state support for women who wanted home births.

In 2009 she told a health inquiry that midwives who assisted with home births needed proper funding and legal protection, in line with other countries.

Her written submission warned that “lives will be in threat without proper midwifery assistance” from the state.

She wrote: “On a personal note, I am quite shocked and ashamed that homebirth will no longer be a woman’s free choice in low-risk pregnancies.

“As a homebirthing mother I will have no choice but to have an unassisted birth at home as this is the place I want to birth my children.”

Lovell had spoken of her excitement at her impending arrival.

On October 19, she posted a message on the Facebook site for her massage business that read: “Maternity leave officially started this morning... had a beautiful last night at work and will keep you all posted on my burgeoning growth as a mother to be - second time round.”

The Midwives in Private Practice group said it was the first time they had heard of a mother’s death following a home birth. A spokesman said: “It’s very, very rare.”

A senior midwife told the Mail that a severe haemorrhage was the most likely cause of death, but an inquest has yet to be held.

The Association for Improvements in the Maternity Services in the UK said the tragedy should not put expectant mothers off home births.

Chairman Beverley Lawrence Beech said: “While this is very sad, it is extremely rare - almost unheard of - for women to die during home births.

“Research clearly shows that home births in the UK are no more dangerous than hospital births.

“If anything, it is safer and you are much less likely to have unnecessary medical intervention.”

In the UK, women are provided with NHS midwives if they opt for a home birth.

But in Australia, women are discouraged from giving birth at home and expectant mothers must find a private midwife.

Lawrence Beech said the “medical mafia” in Australia should reconsider their stance and provide “adequate support” for mothers who choose home birth.

Beth Wilson, Health Services Commissioner for the Australian state of Victoria, said she had long held concerns about home births when medical back-up might not be immediately available.

“It’s very sad to hear about this and I know the coroner will conduct a full and thorough investigation,” she said.

Last night, friends paid tribute to Lovell.

One wrote: “This world will miss your beauty, your vibrance and your refreshingly honest and truthful way of living. What a beautiful woman. We will miss you.”

Another said: “Caroline was a beautiful being whose naturalness touched so many. She didn’t know she was special, but we did.

A story from the Daily Mail - 01-02-2012

HOME BIRTHS: THE FACTS

In England, about 1 baby in 50 is born at home and women are usually assisted through labour and birth by a professional such as a midwife.

Many women opt for home births because they prefer a relaxed, familiar environment and would rather avoid a hospital visit.

The safety of home births is a subject of frequent debate and many experts have called for a ban on the birthing technique.

They argue women who give birth outside of a clinical setting put themselves and their newborns at risk.

In many developed countries, home birth declined rapidly over the 20th century, for example in the U.S. home birth declined from 50 per cent in 1938 to fewer than 1 per cent in 1955.

According to the American Pregnancy Association the risks associated with at-home delivery include fetal distress, cord prolapse, hemorrhage and high blood pressure.

New data suggests home births have risen by 29 per cent in the U.S. triggered by the 'Hollywood influence', better safety measures and lower costs. - Daily Mail


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Mwiks, wrote

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10:55am on 10 February 2012
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This is very unfortunate. Even here in Kenya we are advising women on giving birth in hospitals. The risk involved is too high.

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Anonymous, wrote

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09:16am on 9 February 2012
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The difficulty is you are talking about Australia, where the rates of home birth are very different to other parts of the world, and for good reason. Our rates of mortality and morbidity post home birth is higher due to many different reasons, one being the sheer size of the country- there is no way people in an emergency can be retrieved and transported to tertiary level of care quickly enough. Additionally, a 'routine' delivery can turn into a high risk delivery in the blink of an eye. I appreciate that not everyone may have seen it happen, but I have, and it is terrifying. As a doctor, I have no problem with midwives who are trained and patients well screened delivering at home, but the midwives must pay their own insurance, just as the obstetricians do- not beg the government to pay it for them. Which is the situation here.

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helen, wrote

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04:46pm on 3 February 2012
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to all those who think she would have gone into cardiac arrest even in the hospital are probably quite wrong... as an RN , im sure she arrested from blood loss which than caused her heart to stop.duh. anyone who delivers a baby at home is doing it for their own personal ego and are not concerning themselves with the child. I think its very selfish and very stupid...to all those so called empowered women...A truly empowered women would know the risk outweigh any advantage. I am so appalled.

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Lacri, wrote

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03:22pm on 3 February 2012
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Proud Husband, low risk people do not just "fall into" cardiac arrest. It is likely that the cardiac arrest resulted from uncontrolled haemorrhage or, perhaps, from an amniotic fluid embolism. Perhaps something else - stroke, undiagnosed pre-eclampsia, there are many possibilities. These conditions (especially haemorrhage) are very treatable in hospital. She was already in cardiac arrest by the time emergency services arrived - even cardiac arrest is survivable if you are ALREADY in hospital. One can always find individual studies to support one's pre-existing opinions, but a systematic review of ALL the studies of home birth is very clear perinatal mortality rates 2-3 times higher than comparable hospital births, although the absolute risk in both settings is low (this assuming that home birth takes place in ideal conditions). Maternal mortality is much rarer in both scenarios, and it is probably not possible to compare them definitively. I also hope that Caroline is not forgotten, but for different reasons.

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Proud Husband, wrote

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02:17pm on 3 February 2012
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Lacri, you are most likely right that she was low risk and had done her research etc. and not knowing details of her situation I will not question this. However, from what I understand she fell into cardiac arrest which could well have happened in hospital also. The recovery rate of a cardiac arrest is still only around 30% regardless of location as I understand. Also, the difference between home birth and hospital perinatal mortality rates, according to numerous studies, is too small to be considered significant. The research I talked about is only a small part internet based. There are many books out there (with scientific studies) and some fantastic midwives and other women who have gone through both hospital and home births who can give advice first hand. Knowing what to expect is most important. I believe this significantly reduces the chance of complications and gives a birthing mother control of her birth. A drunk driver doesn't have full control of themselves but a driver who knows the road and has a clear mind of what to expect can safely navigate in the harshest of conditions. Caroline, while being known as a home birth advocate was, I'm sure, more focused on promoting the education and quality of birth and giving women a choice. I personally hope that her death doesn't taint home birth but draw attention to the need for better support (and safety?) in this preferred method (for many women) of birthing. I'm sure Caroline and her cause will not be forgotten.

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Lacri, wrote

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09:50am on 3 February 2012
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no name, Proud Husband and Sarah. This woman was, apparently, a low risk patient having her second child. She had certainly "done her research" (by which I take it you mean reading stuff on the internet, not conducting scientific studies). She was apparently attended by two midwives who were presumably trained in the "art of birthing". And yet she died. Low risk can turn to high risk in a heartbeat. What the research does show, time and time again, is that homebirth in a first world country with well trained midwives and a good backup and support system has low perinatal rates. As low as they are, the rate of perinatal mortality is still 2-3 times higher the rate of similarly low risk women giving birth in hospital. The vast majority of mothers and babies will survive. But so will the vast majority of drunk drivers, and nobody would be so stupid as to believe that drunk driving is therefore "safe".

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Sarah, wrote

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07:04pm on 2 February 2012
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It's very sad to see people blaming the fact that this was a homebirth as the cause of her death. Time after time studies have shown that homebirth is safe when attended by a skilled midwife and where back up care is readily available. Women are also carefully screen for being good candidates for home births. This research is readily available online. There is no guarantee that having her baby in hospital would have had any different outcome. The fact that the US has one of the highest maternal mortality rates in the world, and also one of highest rates of hospital births and a highly medicalised approach is even further proof of this.

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Proud Husband, wrote

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04:46pm on 2 February 2012
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Cobus and others, I am the husband of a wonderful and empowered wife who had a homebirth. One problem we as a society face is the lack of knowledge in the art of birthing. I recommend researching for yourself as my wife did. The advantage of a homebirth (in a low risk pregnancy) is that a familiar and comfortable environment that is dimly lit is the ideal atmosphere to release the love hormone "oxytosin" (among others) which is (put simply) also the hormone that allows a smooth, low complication and (dare I say) pleasurable and empowering birth. A hospital environment can be quite the opposite to many women even when trying to be comfortable etc. It can easily turn off this 'shy' hormone which can cause such complications as fetal distress. This introduces the potential for such incidents as the "cascade of interventions". Look that one up. Every woman has the freedom (currently) to choose what she feels most comfortable doing. Comfortable being the operative word. Do your research and learn how to have a great birthing experience wherever you decide to birth.

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Cobus, wrote

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03:15pm on 2 February 2012
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@no name - please tell me how home birthing is "in most cases is safer then being in hospital"? So being at home away from medical care is safer?

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no name, wrote

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01:17pm on 2 February 2012
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After reading so many of the comments here I feel sick. I had a home birth and am part of the same home birthing community as the lady you are all referring to. She was not mad, nor am I and the many freinds I have who have all birthed at home. Giving birth is not an illness and in most cases is safer then being in hospital. Woman die in hospital giving birth just as newborns do, but because this was at home, everyone has an opinion. My pregnancy was hard and my nearly 30 hour labour was harder. If I had been in a hospital I would have had medical inteventions thrown upon me as the whole process would have been going to slow for them. This is were complications can happen. This is were newborns catch illness. Everyone has a right to their own body and the way in which they see fit to birth, giving birth is a tight of passage that western medicine has completely taken away from woman and the sad thing is that most woman couldn't care less as they know no different.

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Anonymous, wrote

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01:02pm on 2 February 2012
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I don't believe a stupid adult should be made to wear a seatbelt- if they want to take that risk -fine, but I don't believe they can chose to let their children be in a car without a seatbelt on- home birth is the same, you want to let a midwife do a hysterectomy on your kitchen table- fine, but you have no right to chose risking an innocent baby. I also doubt a midwife can handle an emergency, sometimes in emergencies you need skills that a midwife does not possess, no matter how well trained she can't clamp a uterine artery, do a caesarian, give a neonate surfactant, give mum a blood transfusion. When I have been called to torrential post partum haemorrhages it is always an absolute life-threatening problem, and a midwife has little in her toolkit apart from giving drugs and applying direct pressure- and even then not at the same time!

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Husband and father, wrote

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10:41am on 2 February 2012
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There is a reason so many women died in child birth in the past. There is so much that can go wrong, don't be foolish - go to a hospital. My wife and I did, and it is the only reason we are a family of four, not two today. Complications are usually unforseen. Don't gamble with the life of your family.

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Khalsa Singh, wrote

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10:29am on 2 February 2012
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For breeders, home births should be their choice. However, why should the state (read tax-payer) support such insanity when hospitals and clinics have already been built with great expense.

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Anonymous, wrote

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10:28am on 2 February 2012
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My best friend had a home birth and I was there to witness it. She had a healthy pregnancy and the doctor okayed it. Her labour was long and painful (drug-free) and by the time she was ready for drugs, it was too late to take her to the hospital. When her baby was born, there was a complication and the baby had to be rushed to hospital. Care wasn't instant we had to wait for paramedics who treated her like she was scum. Her baby could not be admitted to hospital until she paid a large cash deposit upfront and then she spent 2 weeks in ICU It really wasn't worth it for all the agony that my friend went through in the end.

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Andre, wrote

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10:20am on 2 February 2012
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Rest in peace,but why would a women want to have a home birth?Do women who do this have measures in place incase labour does not go as normal,are they equipt?I think if they do it just because they feel comfortable,then it means they are very selfish,because clearly they are not taking their health and that of the unborn baby seriously

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Never!!, wrote

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10:14am on 2 February 2012
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I cannot believe that a responsible mother would EVER put her life at risk! There is a reason why mother and child deaths during labour has gone down recently! It's the 21st centruy damnit, make use of all the gifts we have - including safe delivery in hospitals!

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Neo, wrote

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10:13am on 2 February 2012
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She wrote: “On a personal note, I am quite shocked and ashamed that homebirth will no longer be a woman’s free choice in low-risk pregnancies. I dont know but i personaly believe had she had the necessary equiptment close-by when she had the attack,she would still be alive

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Anonymous, wrote

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09:22am on 2 February 2012
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You reap what you sow.

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What if.., wrote

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09:21am on 2 February 2012
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I think the question is - would she have survived if she was at a hospital? It is a personal decision and the risk are clear. I feel for the husband... he may now have preferred for her to have been in a hospital.

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Jay, wrote

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09:20am on 2 February 2012
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I quite liked the idea of having a home birth with my second child because my first labour had been so easy. Unfortunately, there were complications with the second pregancy that ruled it out. This is a very sad story.

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