Zatera Ul

1. That breastfeeding success rates for hospital births would significantly improve if they simply fed the mothers better. Not being allowed to eat or drink in labor, then having a good chance of not being fed a real meal until hours and hours after, probably does not help the milk to come in. Three meals a day is not a good plan for pregnant or nursing women; little babies eat around the clock, in the womb and out.

2. That the increased risk of death (mainly for the baby) with home birth is more than compensated for by the decreased risk of death afterwards in infancy (assuming the baby survives the birth), because homebirthers have a much higher rate of breastfeeding, and are more likely to breastfeed for the longer term. (Somewhere I read an estimate that the difference in death rate between formula feeding infants and breastfeeding infants was 4 in 1000. The best estimate that I know of difference in death rate between home birth and hospital birth is 1-2 babies per 1000. I tend to categorize activities that have risks in the 1-9 per 1000 range as “mostly safe”.)

3. That the increased risk of death for the mother with home birth (small enough that I’ve never heard of any) is much more than compensated for by the decreased risk of death from breast cancer later, because homebirthers have a much higher rate of breastfeeding, and breastfeeding reduces the risk of breast cancer.

4. That breastfeeding rates for hospital births would greatly improve if a visit from a lactation consultant in the first day or two was standard. Nurses are supposedly trained in breastfeeding stuff, but from what I’ve seen and heard, their helpfulness varies widely. (Though the same also holds true for lactation consultants….)

5. That doing the above would also decrease the rate of serious jaundice. (Most severe ABO incompatibility jaundice cases occur in infants where breastfeeding is slow to take off. With our case, I’m still furious that a breastfed baby that was considered sick enough for immediate readmission to the hospital had to wait nearly three full days to see a lactation consultant.)

6. That the reason ABO incompatibility jaundice is generally less (or at least not more) severe in later babies is that the mother’s antibody levels against the baby’s blood type remain about the same–they don’t get worse with each baby as Rh disease can, and that with later babies, breastfeeding is likely to go better (or have already been abandoned in favor of formula), so the bilirubin gets flushed out faster.

7. That doing caesarean surgeries at the current rate probably prevents more future babies than it saves in present babies. The pain of recovery while trying to care for a newborn, the permanent damage to reproductive organs leading to potential complications in future pregnancies, the difficulty of finding providers that fully support VBAC….. A couple of years ago, the Pioneer Press ran a story on homebirth, and presented a pie chart of number of homebirths in Minnesota for a year vs. parity (which birth it was for the mother). Naturally, most of the births were first or second births, but the number of sixth births was high enough to get its own, significant slice of the pie. It would be interesting to compare it to a similar graph for hospital births, and for caesarean births in particular.