Which came first, the narcissism or the homebirth?

Does homebirth encourage narcissism or do narcissists choose homebirth?

There's no question that homebirth encourages narcissism by creating a false equivalence between a mother's experience and a baby's health, brain function and life. I will admit that it is unfathomable to me that any woman would think that her experience is anywhere near as important as whether her baby lives or dies, but not only does homebirth encourage that view, it promotes that view by dramatically minimizing the risks of homebirth and dramatically overstating the benefits.

But I know of no professional homebirth advocate who claims that a birth experience is MORE important than a baby's health, brain function or life. That's intrinsic narcissism on the part of the mother.

Consider the mother who gives birth to a baby with significant brain damage as a result of homebirth, but chooses to have another homebirth. The mind boggling narcissism of this mother shines through almost everything she writes.

In announcing the birth of her daughter (Homebirth after HIE), Karissa writes:

Unlike most HIE parents, I can honestly say that I worried very little about a re-occurance. I recognised the situation with Joshua for what it was, a rare and random event that was bad luck, and I had no doubt that it would not happen again. When I imagined Amelie's birth in my head while I was pregnant, I imagined everything going well. The main point of difference for me, was that when I was pregnant with Joshua I was 100% confident that everything would be fine, I knew sometimes people could have bad outcomes but I never imagined that could happen to me. After having Joshua, I knew that it could...

What happened to Joshua?

You can read the full story on the blog, but the basic story is that intermittent auscultation revealed fetal distress, the mother transferred to the hospital, the baby was delivered immediately, and began having seizures within an hour of his birth. Joshua now has secondary microcephaly (small brain) and cerebral palsy.

Karissa is quite clear that it is the labor that led to Joshua's brain damage. She sent his records to someone she describes as a specialist in hypoxic ischemic encephalopathy and received the following assessment:

We spent TWO HOURS on the phone this morning discussing it all. Firstly, he talked me through the results of the neuro-imaging reports.

Firstly, an Ultrasound of his head was done on the day he was born. The results of this were normal. Dr Hill said the main purpose of this ultrasound is to identify bleeds in the brain that would require immediate action. None were found, and that is about the scope of ultrasound imaging... it is not as detailed as other scans like CT and MRI. MRI is the best form of imaging.

Joshua suffered widespread brain damage:

Joshua's MRI was done at 5 days old, which, from a clinical point of view, allows enough time to see what damage has occurred... They made reference in the report to the Peripheral brain, which he said that his interpretation of that would be the outer layers of the brain were where these signal abnormalities were at their worse, but although affected, the temporal/parietal regions showed less of a problem than the other areas. Overall though, the damage was all encompassing, which he believes is consistent with a generalised decrease in blood flow. Brain damage can also be focal, affecting only a specific area, but in Joshua's case, it was the whole lot.

A follow up CT scan revealed the extent of the damage:

A CT scan which was done at 5 months of age showed Encephalomalacia in the right parietal region and atrophy/hypoplasia of the frontoparietal regions of both cerebral hemispheres. Encephalomalcia basically looks like cysts in the brain... it occurs because brain tissue has died, and the pockets of dead cells are surrounded by healthy tissue.... the pockets fill with cerebral spinal fluid and appear like a cyst.

Why did this extensive brain damage occur?

As far as timing of the injury goes, he believes it happened during the labour and delivery period. The biggest indicator of that, is the fact that Joshua was born with a normal head circumference on the 50th percentile. If for example, the problem occurred a month before he was born, we would not expect to see a normal head circumference at birth. Joshua had a normal head circumference which then failed to grow normally in the neonatal period. Indicating that the problem occurred very close to the time of birth...

Dr Hill believes that the most likely cause is intermittent, transient umbilical cord compression...

There is one other possible explanation for this kind of episodic problems with blood flow, and that is utero-placental insufficiency. Where basically, the blood vessels connecting the uterus and the placenta are not as healthy as they should be and cause problems with blood flow...

In other words, Joshua was deprived of oxygen during labor. Even though Karissa transferred to the hospital once her midwife figured out the danger, it was too late. What does Karissa take away from this?

He basically said that the only real guarantee to prevent brain damage from a cord compression was if every woman was on continuous fetal monitoring for her entire labour and delivery and it was able to be detected immediately. This is not standard practice.

It's not standard practice when the fetal heart rate is completely normal, but it IS standard practice once an abnormal heart rate is detected. Had Karissa been in a hospital during her labor with Joshua, she would have had continuous monitoring at the first sign that anything was wrong. She almost certainly would have had a C-section once continuous monitoring revealed recurrent heart rate abnormalities. Although there is no guarantee that Joshua would have escaped without any brain damage, the amount, and therefore his deficits, would have been smaller. Short version: this could have been diagnosed and treated in a hospital.

But what's more important, Karissa's experience or a baby's brain function? Karissa explains her "reasoning" in choosing homebirth again.

She's learned nothing from her first experience:

... Despite what happened with Joshua, I still believe all of the things that I believed about birth before having him. I still want a natural birth, I still want to avoid common and unnecessary interventions, and I still think I will be happier in an environment that I am comfortable in. I have seen several of the rooms in the Delivery Suite at the hospital... Joshua was ultimately born in one, and I still cannot imagine how a woman spends hours in one of those rooms. I literally turned up and got the baby out.... But having to labour there?

Her experience is more important than anything else.

That might sound selfish, and I guess it is a bit, because primarily I am thinking about what is going to make a painful experience LESS painful to me. And to me the answer to that is being at home. Some people want access to pain relief so a hospital is the clear choice for them... For me, I don't want it... I am WAY more scared of having a needle in my spine than I am of the actual pain.... so its important to me that I can be in an environment where I can deal with things the way I feel like it and not be bothered or subjected to hospital policies.

She is mind bogglingly narcissistic.

There was never any doubt in my mind after having Joshua, that I wanted my next baby to be born at home. That I wanted the chance to have the birth that I wanted, but missed out on with Joshua...

She recognizes that other women would not take the risk of subjecting another baby to major brain damage and life long deficits, but that's not how she feels.

Understandably, having had a child [with HIE} many women feel worried about going on to have another baby. That small risk feels very, very scary the second time around and the majority of women feel safest in making choices very different to mine. They WANT to be in a hospital. They WANT extra monitoring. They WANT an elective C-section. (Many HIE cases, including Joshua's, are caused by an injury during labour... so many women wish to avoid labour completely) I don't judge anybody for feeling that way. When you have been through a traumatic birth experience, you really need to do whatever feels safest to you, whatever option is going to be the best one for your mental health is the right option. I just happen to be the opposite to most women in my situation... and feel that the right choice for me is going on to have a "normal" birth.

Narcissism and denial go hand in glove

I was quite amused recently, looking at the blog of a Obstetrician who is very ANTI home birth and was tipped off to the birth story of a woman who frequents one of the same forums as I do. She put her birth story out on a public forum, and this Dr took it and pulled it apart on her blog. It was titled "You risked your Baby's brain function for this?". Sadly, this woman's midwife made some very questionable decisions, but eventually a hospital transfer was made and Baby was born in the hospital. Very traumatic experience for the Mother, but thankfully the baby is ok.

I got to browsing this blog after being made aware of it due to this unfortunate incident, and this is where the amusement comes in. This very Doctor, who wants to bash women who plan home births (She has another separate blog just for home birth horror stories by the way) has many entries on her blog about the kinds of negligence that takes place in hospitals... It seemed very unusual to me for someone who is so pro-Hospital, to also be highlighting the sometimes very serious mistakes that take place in a hospital. Her blog certainly did nothing for me in terms of making the hospital sound like a safer choice!

So after playing Russian roulette with her first baby's brain ... and losing ... she figures it's okay to play Russian roulette with her second baby's brain. What are the chances that there will be two bullets in the cylinder?

Fortunately, this baby appears to have survived her mother's extreme self-absorption. But, nonetheless, there was another bullet, albeit considerably smaller. Karissa had to transfer to the hospital for suturing of a perineal laceration and mild obstetric hemorrhage.

Oh, well, maybe third time's the charm.