31/01/2023
In the words one I respect greatly ... For safety, stay home....
If you want to reduce your chances of postpartum haemorrhage (PPH) have a homebirth with a midwife who knows how to provide holistic physiological care
It’s an evidence based strategy to reduce the chances of PPH, like, by a lot! 1.7% at home/birth centre with a known midwife compared to 11.2% with active management in hospital…. And these stats are for women considered at low risk of a postpartum bleed.
So if we are really interested in keeping women safe from PPH we’d be encouraging women to hire a midwife and have their babies outside the hospital. BUT mainstream services are focused on trying to maintain the rhetoric that ‘birth is dangerous and hospital is safest’ that they can’t gather their thoughts to the idea of providing a holistic service that focuses on giving every woman access to continuity of care with a midwife or encouraging women to pursue evidence based birth places like home.
The researchers in this study concluded that ‘active management was associated with a 7-8 fold increase in postpartum haemorrhage rates’ for low risk women. This means that when you attend a hospital as a low risk woman, at low risk of PPH, the standard method of placental birth management will result in 11.2% chance of excessive postpartum bleeding…. Compared to 1.7% chance if you were cared for at home/birth centre by a midwife skilled in physiological placental birth.
You can read it for yourself, it’s open access, it’s called ‘holistic physiological care compared with active management of the third stage of labour for women at low risk of postpartum haemorrhage: a cohort study’.
Note: of course, if you are at high risk of bleeding or have care providers or a birth location that can’t facilitate the physiological birth process, active management of the placenta may be the better option… I’m not saying there isn’t a place for medicine… I’m just saying, when you take women out of a physiological environment and put them in hospitals with midwives unskilled in holistic midwifery care, you increase the risk of PPH by 7-8 times