Be Excellent To Each Other

I am v. interested in said stats. This is the first counter-argument that doesn't boil down to "I'm a hippy".

Would I be right in thinking that while there might be less problems at a home birth, the problems you're avoiding are likely to be much less serious?

Then those risks must be offset by other ones present from giving birth at home. As far as I can tell the evidence seems to suggest that where no risk factors to do with the mother have been identified home births are less safe that hospital births, though certainly not by a very significant amount. It's certainly not considered unsafe or else the advice would be different.

I'd be concerned over the carpets.

*extremely suspicious face*

I need peer reviewed meta-studies stat, else I'm filing you with the homeopaths.

The Dutch one I posted earleir showed a very small difference, but when it was filtered for extreme cases it came out as a parity. The NHS says they're basically the same risk overall too. There is an increase if it's your first child, but it's a very marginal absolute difference.

We had our 2nd child at home, I know it's anecdotal, but it was by far the easiest of the 4!

However, there were issues with Raven at birth, although I think that was more to do with the hospital equipment not picking up a heart rate.

Malc

Study into increased risk of death at weekends. This one was widely reported not long ago.

I'm looking for the general point about hospitals being statistically unsafe places to be, but may have to ask Mrs K about it. Poor thing used to be an NHS manager.

A US study, but this shows that hospitals are the third biggest killer after heart disease and cancer.

I'd imagine that quite a few people die in hospitals

Heh. smartarse.

I can't help but think the statistics are slightly imbalanced there.

?

Well, you said "hospital".
So, for starters it is a US study which states outright the US is worse than some other countries-

The US healthcare system is (at the time of the report, at least) insurance based, and there are a large number of people in the US who can not afford even low/mediocre level care, but would still fall into the statistics as healthcare users.

Secondly, the major "killer" was "106000 deaths/year from nonerror, adverse effects
of medications"
We know nothing about these cases other than this, but they are described as "non-error" so I assume that they were prescribed the correct drug for the illness and the correct dosage (see the differentiation between erroneous medication deaths). As such we can take 2 points
1) They were ill and were being prescribed a medication to cure said illness.
2) The adverse effects were not the fault of the proscriber (the correct prescription was administered).

Furthermore, it does not distinguish between hospital prescriptions and GP/dentist/podiatrist prescription in this number.
The sum of other deaths/year is 119k so this 106k being in doubt significantly decreases the total.

Disclaimer: I haven't read the whole report yet.

Plus a huge number of old people die in hospitals purely because they are long term there and have nowhere else to go.

In summary hospitals have to try some complex and risky things in order to unfuck people who find themselves fucked up. Sometimes people die as a result, but in general the alternative was not looking so rosy either.

"hospitals try to kill you" or "hospitals are the third biggest killer" is just a bizarre spin to try to put on it.

The NHS is a liberal conspiracy.

My last visit to an NHS hospital: I was told, absolutely earnestly and in all seriousness, that I was "very lucky" to have someone attending to my broken jaw who was "nearly qualified". (Shortly after being handed a plate of mashed potatoes and boiled fish - with my jaw wired tight shut following (botched) surgery, and not having eaten for 3 days).

Some big time drugs dealer/'gangsta' type was in the bed next to me, complete with armed police escort. This did not seem to affect the "quality of his care" from the nurses, though, far from it shall we say. Some raving lunatic in a backroom somewhere howled at the moon for a good few hours, before the nurses decided to "shut him up" with a dose of morphine (he yelped like a puppy momentarily, before blessed (relative) silence pervaded the night time (mixed) ward).

At about this time, I decided that comprehensive private healthcare insurance was a really good idea.

No, that is unfair, the report clearly gives data for "hospital based" errors, eg wrong medicine, unneeded surgery, it just doesn't define what those are, eg unnecessary could be "chopped off wrong leg" or it could be "the doctor genuinely thought this person had X and the only option to solve it is surgery". There is quite a difference.

Oh, you actually want us to look at the report? Not gonna happen dude

I got a birthday card from people at work.

How many were missdiagnosed as lupus?

I have to confess I don’t follow this point. The report says the numbers are from hospitalised patients.



It does, yes, but then the list of biggest killers in the US (http://www.cdc.gov/nchs/fastats/deaths.htm) is as follows (ignoring hospitals):


Heart disease: 599,413
Cancer: 567,628
Chronic lower respiratory diseases: 137,353
Stroke (cerebrovascular diseases): 128,842
Accidents (unintentional injuries): 118,021
Alzheimer's disease: 79,003
Diabetes: 68,705
Influenza and Pneumonia: 53,692
Nephritis, nephrotic syndrome, and nephrosis: 48,935
Intentional self-harm (suicide): 36,909

So it’s still well, well up there.

And I think you need to still add back on the 98k p.a. errors referred to in the first paragraph (the report’s a little unclear on this point, as the list is preceded with “iatrogenic damage not associated with recognizable error include…”).

I honestly don't know what you are trying to say here. The report says that in the US 225,000 people die as a result of medical care each year. It makes no comment on how many are still alive because of it. Which is kind of crucial when it comes to defending a statement like "hospitals try to kill you".

http://www.guardian.co.uk/global/2012/o ... work-canal

Swim to work? Hilariously ludicrous.

No, it really doesn't. What's important here is the number of people who are killed by hospitals getting it wrong, as the conversation arose in the context of home vs hospital birth.

And having come close to being killed by medical negligence three times in the space of a week myself, and my son twice, I'm rather concerned about this sort of thing.

Yes, obviously, if you've got terminal cancer and you don't go to hospital you'll die anyway, but when people get treated for a tumour or something and then die from hospital-aquired infections it's just tragic and needless.

So you have to weigh up whether they do more harm than good, obviously.

If only there were statistics for infant mortality and life expectancy in countries without our kind of hospitals. Like in the third world, or prehistoric times. I bet hardly anybody died at all back then!

Glib, of course, but I find the idea that hospitals are a crazy, risky death trap where perfectly healthy people are butchered on a daily basis to be absolutely insane.

Well, if anyone had actually said that then yes, it would be insane.

My original point was that you shouldn't go into a hospital unless you actually have to. There is a real risk of you either getting ill or dying as a result of a hospital stay, which I for one would weigh up against whatever it is I'd be there for. Compare the risks of home birth vs risk of hospital fuck ups and I'd plump for home births every time.

And we've only been looking at figures for deaths here, and those have been huge enough.

Why else would I go?

Are you not reading two pages?

Except the figures you quoted weren't for fuckups, they were for medication correctly prescribed. If you're given medication that has a fair chance of killing you, then the alternative (not taking the medication) is pretty much guaranteed to be worse. So those people do need to be in hospital. So those figures have absolutely no bearing at all on whether you're better off being in hospital or not to give birth.

Because you're Frank Abagnale and have seen enough hospital dramas to know how to operate.

READ THE ARTICLE*. 100k or so out of 250k were for that. The remainder were for hospital errors and hopsital acquired infections. And then there were another 44k-98k "recognisable error" deaths as well, potentially.


*Or failing that, at least the posts on this page. Sheesh.

The figures comparing outcomes of home vs hospital births are not concerned only with mortality. Without cherry picking studies to support my argument it seems to me that most evidence points to a slight difference in risk such that home births are more dangerous. But it really is a pretty slight difference so people are advised that they have a free choice and provision made for both.

Yes, that is definitely going to happen.

How do things like this get done? Who pays for them? Did the Department for Counting the Moon have a budget surplus and need to spend it quick, or do design agencies do them as a sort of speculative, practice exercise?

Ahh, it's a competition entry. The other entries look equally as sane. See http://www.landscapeinstitute.org/events/competitions/highline.php

I started. Then there was a thing at the end about high-risk sex that looked more interesting. But wasn't.



OK, but look at the base of treatment. Out of the population of hospital patients, some significant number of them will be at risk of acquiring a nosocosmial infection because of their situation. Either a naturally lowered immune system as a result of age or treatment, or because they've had significant surgeries. Other than in the event of a caesarian, surely none of those situations would apply to maternity patients? Same for surgical errors. And let's face it - if you need a caesarian or any other kind of surgical involvement, your home birth person is going to be rushed to hospital anyway

Basically the report's pretty useless without specific numbers covering maternity.

Disclaimer - what the shit do I know about babies?

Peoples lives are at stake and I don't think any of you are giving the situation the gravitas it deserves.

And that's good, right?

I was going to say exactly the same thing.

For all we know, he was a key witness in a murder trial to put a kingpin behind bars and the armed police were because threats had been made against his life. Probably a good thing the nurses were attentive.

The chance of something dramatically fucked up happening in a hospital during birth that would not have happened at home that leads to the death or similar of mother and/or child are teeny tiny.

The chance of something happening at home during birth is also teeny tiny (though I'm surprised at how many on this board have needed operating theatres). Though the stats need to reflect that at-risk people will be at hospitals anyway.

The difference in care if something does go wrong is VAST.

The argument still seems to be that you're more likely to die with lots of care and equipment as opposed to minimal care and equipment. I think this is (obviously) bollocks, or we'd just close the fuckers down and all give birth in a ditch somewhere.

So, Mrs Grim... went to the Grimlet's first "proper school" parent's evening today.

He's very bright with numbers and letters and phonics, and he's popular with the other children and all the teachers like him. He also calls out a lot, doesn't listen, and talks all the time.

It's me, thirty years ago.

Oh fuck.

Good work, sir.

Feex.

Alt+S submits your post!

Alt and other keys does stuff too - alt+P adds the image tags, for instance. B, U and I do bold, underlined and italic.

(This is all on the default branding).

Well, yes.

Shit me, so they do!

Or you need any sort of stitching as a result of vaginal tears etc. There are other reasons your blood system will be open to the elements during birth other than a caesarian.

Well, no. It's a report that shows that being in hospital means you are exposed to a number of additional risks which may result in death (and we're not counting illness/disability here either, which is another component)

Yes, there are situations where not being in hospital is far greater than the risk of being in hospital e.g. terminal cancer etc.

The other reports I've posted show that home births are, on the whole, about at the same level of risk as births in hospital for the baby - they don't cover deaths of the parents as a result of home birth vs hospital birth.) The fact that they’re at roughly the same level may well be because not being in hospital when something goes horrendously wrong makes up a fair whack of the home birth risk, and being in hospital results in a death of the child that otherwise wouldn’t have occurred if you hadn’t been in hospital (i.e. hospital error or infection).

It seems logical that if you have two births where there are no complications in and of itself in the birth, you’re at higher risk in hospital.

No, you're arguing about two different things. On the one hand, yes, if something does go wrong with a birth and you need surgery (and how common's that?!), the baby's more likely to survive if you're in hospital as you've got the kit and doctors there. I've not disputed that.

However, if you're in a situation where all is going smoothly, you're at higher risk in the hospital due to hospital error or infection.

if you've got home births and hospital births both coming out at the same level of risk, that means that all of the deaths in hospital are due to things other than "not having doctors and machines there". The majority of those hospital based deaths are going to be hospital error or infection. So if you're not in any sort of "at risk" category, you're better off at home.

The report doesn't say that at all. It says that there are an amount of deaths caused by those risks in hospitals. At no point does it give any indication whatsoever that a maternity patient would be at the same risk of death for those reasons than X other type of patient. For all you can tell in that report, the deaths could be entirely patients who undergo cardiothorassic surgery.