The American Medical Association recently issued a controversial position essentially opposing home birth:"That our AMA support state legislation that helps ensure safe deliveries and healthy babies by acknowledging of the concept that the safest setting for labor, delivery and the immediate post-partum period is in the hospital . . ."
Women's Health News has a good analysis of the statement and on what it might mean for the regulation of birth, which is done on a state-by-state basis.
Madeline Holler has an amazing article up now on Babble.com about her illegal Missouri home birth (of an 11-pound girl!), which her midwife could have been charged with a felony for attending.
She writes about the trade-offs in going off the grid to have her baby. For example, she couldn't have prescriptions, and she was sometimes concerned by her midwife's reliance on prayer. But she got to give birth on her own terms and with no drugs. Not that she didn't grill her midwife about all the things that could go wrong. She asked her:
What about a head that's stuck? (That happens when you're flat on your back. You need to be up to push the baby out.) What if the cord slips out before the baby? (We go straight to the hospital.) Bleeding? (Hospital.) Premature labor? (Hospital.) If can't stand the contractions? (Get in the tub.) If I change my mind at the last minute and want to go to the hospital? (Hospital.)
Read the full story here.
And if you want to read something more overwhelmingly pro the practice, check out home-birth advocate Ricki Lake's response to the AMA on the Huffington Post.
Our hyper-medicalized hospital birth wasn't exactly magical, but we did get a healthy baby, so we're not tempted to play Monday morning quarterback. But for women more crunchy and less anxious about possible complications than we are, it seems like home birth should certainly be an option.
Have you had a home birth, or would you ever consider one?
Reader Comments ( Page 1 of 2)
1. i would never consider one. but i do tell as many ppl as possible that if they want a "natural" birthing experience, they can get one. it's all a matter of talking to your doctor/midwife/dula and choosing a hospital that respects your wishes. of course, it helps to have a spouse and family members who respect your wishes as well. if anything have something written up as to what you want and who you want in the room (or even at the hospital) to make sure that you get what you want. but i also say, that you should consider ALL your possibilities. having an epidural is NOT evil. c-sections ARE life saving. and always remember that, whatever you choose is the best choice for YOU.
Devynn at 5:26PM on Jun 23rd 2008
2. My Daughter went to the hospital for both her babies. She had them so fast there was no time for any drugs and she was in labor a very short time. Kids now are 13 and 8 and just fine. On the other hand, she weighed 2 lbs when she was born back in 1967 when they didn't have all that fancy stuff for preemies. She has done fine also.
Michele at 10:13PM on Jun 23rd 2008
3. My mother gave birth to my herself in the backseat of the car on the way to the hospital, and I turned out just fine. I see nothing wrong with home births, so long as the mother would be able to get to the hospital quickly if something were to go wrong. It's rather obvious that hospitals make money off of births, so of course they'd oppose women cutting out the middle man and doing it all themselves...I'm sure hospitals have concerns about the safety of a mother and her child, but that doesn't mean they can force anyone to give birth in a hospital. Most people can choose to reject medical treatment if they don't want it, and I don't see why choosing to give birth some place other than the hospital should be any different.
Jesi at 11:03PM on Jun 23rd 2008
4. Neonatal Nurse practitioner for 25+ years - I just have to say, if your cord prolapsed (slipped out of the birth canal before the baby did, or even if it just got compressed between the skull and the vaginal wall) or one of a million other possible emergencies, you would NOT have time to get to the hospital before your baby either died or was born severely brain-damaged. I do not advocate home births. Go to a nice hospital that will treat you like a queen but still has all the equipment and personnel needed in case of an obstetric emergency for you and your baby. Babies are stillborn everyday, mothers still die from childbirth and one out of every 10 babies requires medical assistance at birth, even in the best hospitals. If you are afraid of not being in control of the situation, then welcome to the wide world of parenting, where the only control you have is to do the best you can and pray to God about everything else - because this will be your first lesson about (not) having control!
Sarah at 11:08PM on Jun 23rd 2008
5. I would never have a baby at home (my mild autism gives me a mind-bogglingly low tolerance for pain, for one thing), and I would be suspicious that any woman who did do it was a fruitcake.
Cecilia at 11:15PM on Jun 23rd 2008
6. Just about EVERYTHING is a felony in the US these days. Home to the most prisoners of any nation on the planet. More than BOTH China and Russia COMBINED, but with only 1/6th of their total population. "Land of the free" ? In slogan only.
Titanium Chef at 10:06AM on Jun 24th 2008
7. I had a home birth with my 4th child, was not planned but I knew it would happen when I was 3 months along, everyone laughed, hosp. was only 6 miles away, well a bunch of things happpened that was not suppose to. He was 9lb 9oz and 55 mins old when husband came home to check on me, Husband cut the cord, you have upto one hour to do so. Having a child at home alone is not the way to go, but if one finds themselves having the child you just do what nature tells you to do and push
Debbie at 12:13AM on Jun 24th 2008
8. It's frustrating to see responses making it sound like you can get the same treatment in a hospital as you can with a midwife working independently. I've heard enough from my firends who chose hospital deliveries to know it's not commonly true.
It's also sad to see C-sections referred to as "life saving". They can be in an emergency, but the vast majority taking place now are no more an emergency than is a hangnail.
The AMA's position on homebirth is not evidence-based, as is sadly true for a lot of the practices they advocate. A great number of other countries make heavier use of midwives and homebirth than we do, and their maternal and fetal outcome statistics beat ours to a pulp.
For the record, I have two daughters, both born out-of-hospital with midwives attending. My prenatal care was exemplary - well beyond what my pregnant friends got from most of their OB's. My deliveries were unmedicated and uncomplicated, and resulted in no tearing.
My second daughter was born with the cord around her neck, and was initially limp and blue. The midwives handled it like the pros they are, and gave her oxygen and got her breathing correctly. A friend told me I was "lucky" that my daughter was o.k. after this. I told her luck had little to do with it. It was skill and grace under pressure that got her through.
Alice at 1:26AM on Jun 24th 2008
9. I've had a hospital C-section with a wonderful OB and a home birth with a wonderful midwife.
The c-section was necessary and I used the expertise of my OB and the appropriate facilities at the hospital.
My home birth was expertly attended by my skilled midwife and it was not necessary to use the hospital facilities or my OB's surgeon skills for that birth.
There is more than one way to have a baby, folks. Anyone who says otherwise has got money involved (as in... their paycheck) or is not well informed on the issue. All evidence based studies have shown home birth to be equal to or safer than hospital birth for low-risk pregnancies. Just take a look at any of the many other countries who use midwives and home birth for low risk pregnancies. The US has one of the worst infant AND maternal morbidity rates among developed nations.
Having a baby at home does not mean "pushing out a kid in the back woods of some cabin"!!!! My midwife is well trained, very skilled and has MORE experience than my first OB when it comes to helping a laboring mom and catching babies from a natural labor.
Check out "Born in the USA" by Dr. Marsden Wagner for more info that is well cited. Personally, I don't agree with his politics and his idea that socialized health care will "cure" the problem. (since when has ANY government agency proven to be more effective at running things?????!!!! The last thing we need is MORE government involvement/control!) However, he does use the beginning of his book to provide a good background on the current state of our birth situation in the USA, and again, it is well cited.
Amy at 5:21AM on Jun 24th 2008
10. I'm all for home birthing. As a nurse, I love my job, but am sometimes ashamed to shout out that I work for a profession that has become so corrupt, and greedy. It's no longer about helping the individual first. It's more about what kind of money is our company going to make if patients don't have the top-notch insurance?
Home birth? You betcha, as long as there are no complications during the pregnancy that would raise red flags for the health and saftey of the unborn child.
motherof5 at 9:17AM on Jun 24th 2008
11. Sarah -
Sadly, you see the result every day of the overuse of interventions that result in premature births and distressed babies. You're in the thick of the system and I'm sure what you see seems to be the result of how dangerous childbirth is, but most of your patients are the result of how dangerous medically managed labor is.
Midwives are trained to safely transfer when it is necessary. If a cor prolapses, they have protcol to get mom and baby safely to the hospital. There is an excellent article in 'Midwifery Today' about it right now. Multiple studies (and I'm not talking retrospective collection of inaccurate birth certificate date) conclude that homebirth is a safe option for low risk women provided she has a highly skilled, trained midwife assisting her.
Our medical associations need either give some factual data to back their point, or to issue a new statement in support of homebirth.
If homebirth with a midwife is so dangerous, why do the World Health Organization and the Royal College of Ob's and Gyns state that it is a safe alternative for low risk women. Both organizations even go so far as to state that women fare BETTER at home than in the hospital. If you need to see their statements for yourself, feel free to look at my blog for sources.
As for me, I was a homebirth transfer after 38 hours of labor post natural rupture of membranes. I gave birth vaginally to a beautiful 8 lb 12 oz daughter. Had I started with OB care I would have ended up with a c-section (without a doubt) either for failure to progress, or from an infection that would have been introduced by the dozens of internal exams they routinely do. As it was I had more internal exams in the 5 hours at the hospital than I did while laboring at home, supported by my midwife and assistant for 38 hours. The interventions were used AS NEEDED because I had great care from an excellent midwife.
Melody at 9:36AM on Jun 24th 2008
12. Until recently, most women gave birth at home. Doctors were more likely to infect their patients during birth before routine hygienic practices were implemented in hospitals. Today, in the US that is not the case, but a home delivery should be an option. I know a woman that gave birth at home. Big healthy baby girl; things were fine. Hospitals are concerned about money. If the care of mothers was really their priority they would reinstate the practice of keeping mothers and babies in the facility for at least 72 hours. They get women out of the hospitals as quickly as a fast food restaurant.
janesophie1 at 10:50AM on Jun 24th 2008
13. i think you should have to give birth in a hospital, too because like the one lady said before, how do you know that something WONT happen? you and your baby could be dead before you even make it to your car. and midwives are depending on PRAYER for medical miracles?? now thats where i gotta draw the line. get yourself a good O.B. im sure an O.B. can help you out more than a silly prayer. what do you think???
Labonna at 12:28PM on Jun 24th 2008
14. I'd like to say that homebirth is NOT illegal in this country. Some states have very restrictive statutes regarding the licensure of midwives--making most that will attend homebirth illegal. Any woman can legally have her baby wherever she may legally be. It is the midwife who may be acting illegally. I have had 3 babies in a hospital setting, 2 at home. With the first I had an epidural, the whole nine yards of how "your supposed to do it" per modern doctors. Nothing happened due to these interventions, thank the Lord. The standard protocols for the only hospital in my area that will deliver babies is to immediately start an IV--just in case, do vaginal checks frequently, and keep you as still as possible with nothing to eat or drink. Birthing a baby is akin to running a marathon. Your body will need fluids and nourishment for energy,etc. It seems that when I was able to move around during labor, the pain wasn't as intense and the baby had an easier time during the contractions. My skilled experienced midwife was listening to the baby's heart rate and my own reactions to the contractions to know how things were going. If most women have uncomplicated births, birth attendants should be trained to provide the lower level of assistance required in these circumstances. They should also be trained to recognize when things are indicating a higher level of assistance--worst case scenario would be c-section. The doctors' skills and training are best used in those cases needing a higher level of care. The doctors and midwives should work together to provide the appropriate care wanted/needed where the customer/patient wants/needs it. Women have been deliver babies since the beginning of time. Most of the time our bodies do the work they were designed to do. On rare occasions, something will happen requiring medical intervention. Medical intervention shouldn't be used "just in case". Even if you would never have a baby at home, don't fight my need to have a skilled, experienced LEGAL midwife assist me with delivering my baby where I am most comfortable.
HillaryinIndiana at 12:31PM on Jun 24th 2008
15. The hospital closest to me has a 50% C-section rate. Most are because modern obstetrics has no patience for length of labor and time that disturbs dinner or office hours. A majority of women in labor at that hospital are induced. Obstetric intervention might very well save lives of babies but they also cause unnecessary surgery, complications and other interventions. Despite our wonderful modern medicine, the U.S. still has a high infant rate. You should be able to choose where your baby is born and there is not a homebirth midwife in practice who does not explain risks and plans for emergencies with every patient they care for.
Sharon at 1:09PM on Jun 24th 2008