Why Choose Home Birth?
Why Choose Homebirth?
- Better outcomes with no unnecessary intervention
- Education is provided to help prevent avoidable complications
- Pregnancy is treated as a normal healthy part of life
- Women have the freedom to make choices about what is happening to them and their babies
- A more personal relationship with the midwife helps ensure that your midwife has a sound knowledge of your history and needs (continuity of care)
- Freedom to experience the spiritual and emotional aspects of your birth with people you know instead of strangers
- Greater rate of satisfaction for everyone involved
- Family is allowed to actively participate
- Babies are not separated from their mothers
- About 3-5% C-Section rate compared to the national average of 30%
- Relaxed, peaceful environment
- Economical
Midwives are trained to recognize and handle complications should they occur. Should a problem arise the midwife consults with a physician who is on call. If necessary, the woman and/or baby can be transported to a local hospital. However, only about five percent (5%) of first time low risk mothers will need hospital attention, while the other ninety-five percent (95%) will birth successfully at home. Ninety-nine percent (99%) of low risk mothers who have birthed vaginally before will birth successfully at home.
What is a Midwife?
Some beliefs that midwives commonly share are:
- Birth is a fundamentally healthy process with many normal variations.
- Birth is a normal part of life, not an illness.
- The birth process is best accomplished without interference.
- The birth experience belongs to the family, not the birth attendant.
- Knowledge is to be freely shared. Educating women is an important part of the midwife's role.
Home Birth Studies & Statistics
In Australia 3,400 home births were analyzed by the National Perinatal Statistics Unit. Some of the women studied were considered high risk because they were primigravidas (this was their first birth), were carrying twins, the baby was breech, they were over 35, or they had previous cesarean sections. The perinatal mortality rate was 5.9 per 1,000. The percentage of mothers who were transported to the hospital was 8.6. The cesarean section rate was 2.2 percent, 3.1 percent had forceps.
In Britain perinatal mortality rates per 1,000 births were 27.8 for hospital deliveries and 4.3 for home deliveries. Perinatal mortality rates in the Netherlands in 1986 reveal that out of 119,037 births in hospitals there were 1,653 deaths (13.9 per 1,000). Out of 66,536 home births there were 149 deaths (2.2 per 1,000). Further analysis in the same study showed that the perinatal mortality rate per 1,000 births when attended by a obstetrician in the hospital was 18.9, when attended by a midwife in the hospital was 2.1, and when attended by a midwife at home was 1.0.
In the Netherlands the infant mortality rate has been significantly lower than in the United States for over 20 years. 70 % of all births in the Netherlands are attended by midwives, and 40% of all births occur at home. (GBCp.52)
One of the largest studies done comparing home birth and hospital birth was done by the United States Center for Disease Control. It studied 242,000 hospital births and 2,200 out-of-hospital births in North Carolina between 1974 and 1976. The infant mortality rate in hospitals was 12 per 1,000 live births compared to 4 per 1,000 for planned, attended home births.
Another study was also conducted in 1976 at Stanford University by Dr. Lewis Mehl and a group of researchers. They studied 2,092 births, half of which were planned home births and the other half were planned hospital births. Of all these births there was only one infant death which occurred at the hospital. The researchers also studied the differences between interventions and complications in these births. They found that 75% of all the hospitalized mothers received some form of medications, where as only 5% of the home birth mothers were medicated. In the hospital births there were three times as many cesarean sections, the infants had more birth injuries, infections, and fetal distress. There were also ten times more episiotomies, and twice as many severe perineal lacerations.
The Farm in Summertown, Tennessee is an independent home birth practice. Between 1970 -1979 they recorded statistics on 1,000 births. There were 15 cesarean sections (1.5%), 3 forceps deliveries (.3%), 7 induced deliveries (.7%). Of the babies delivered on the Farm there were 8 perinatal deaths (3 of which were lethal congenital defects). The statistics for perinatal mortality faired better than the State of Tennessee's whose infant mortality in 1977 was 26 per 1000. There were 37 deliveries that the midwives considered high risk and were delivered at the hospital. The perinatal mortality rate including these deliveries was 15 per 1000. Only 1.6% of the women had anesthesia, and only 0.1% had continuous fetal monitoring. In 1994 an update showed similar statistics on the 1,917 births that were managed there.
9. Netherlands 7.7 21. USA 9.9
10. Hong Kong 7.7 22. New Zealand 10.0
11. Norway 7.8 23. Italy 10.1
12. Canada 7.9 24. Israel 10.7
Countries with the highest rate of births attended by midwives have the best maternal and perinatal mortality statistics. In Japan for every 250 midwives there is 1 obstetrician. There are 34,000 trained midwives in the Japanese Midwives Association. The Netherlands and Scandinavian countries also routinely use midwives.
No studies have ever shown that hospitalization or any particular medical treatment given in the hospital improves the statistical outcome for normal pregnant women. Many people ask "Is home birth safe?" The question should instead be "Is hospital birth safe?" We should remember that hospital birth is only a small spot on the long time line of the history of childbearing.
A study published in the British Medical Journal in November 2011 suggests that there’s little difference in complications among the babies of women with low-risk pregnancies who delivered in hospitals vs. those who gave birth at home with a midwife.
Here are some additional studies regarding homebirth:
British Medical Jounal Study of North American Women
Dutch Home Birth Study
Safety of Homebirth Literature (multiple sources)
University of Copenhagen (Denmark)
Canadian Study
University of British Columbia
Journal of Nurse Midwifery
Mothering.com Resources
Safety of Homebirth
One of the most frequently asked questions about home birth is "Is it safe?" Current medical tradition tells us that birth is a medical emergency that must be handled by physicians at a medically equipped facility (usually a hospital) and that anything outside of these parameters is considered dangerous.
Some people react very strongly when they hear a friend or loved on is planning a home birth. They consider home birth negligent, crazy, and some will go so far to say abusive. For the most part the people who say these things are sincere in their concern for the welfare of the mother and the child. They are simply uniformed about the high risks of hospital birth. They usually have no malice intended, but often their feelings about our choice deeply affect us.
We often hear horror stories about the birth where the baby "would have died" if it had not been born in the hospital. What we don't know is if the complication was actually caused by the hospital environment or procedures. It is extremely rare for a complication to arise in a home birth that is so unforeseen the mother or the baby can't be transported in time to receive appropriate care. One of my clients had a good answer for the people who would gasp when she explained that she was having a home birth. They would ask "Aren't you afraid?" Her reply was "Aren't you afraid to go to the hospital? Do you know what they do to people there?"
We must realize that obstetrics is a huge money making business in the United States. Home birth is a direct threat to the medical community. Much of the difficulty we have in America with the opposition to home birth is directly related to the campaigning and advertising of the medical community. They stand to lose a major amount of income if we choose to alter the way women give birth in America. Most physicians, nurses, and other professionals in the medical community are taught that birth is inherently dangerous. This wrong perception of labor is woven into our communities.
In fact the major issue is money. Hospitals and obstetricians stand to lose a great deal of money. Almost one in three women are delivered by cesarean section at the current time. 90% of women have an epidural during labor. The loss of this income would deeply impact the medical community.
We struggle with whether or not we should conform to the normal way birth is conducted in our culture, (even though is not the norm for how women have birthed for the 6000 years before our time.) If we educate ourselves about the safety of home birth we can feel confident in our decision and we will be better able to explain our choice to loved ones.
Studies have shown that homebirth is safer than hospital birth. Statistically births with midwives fair better than those with physicians. There are many reasons for this.
Research has shown that the more relaxed a woman is during labor, the more efficiently her body will function. If she is stressed or frightened her body will release hormones (catecholamines) that will interfere with labor. It is logical that a normal physical response if a woman is in danger would be to stop or delay labor until a safer time. This response is out of the woman's control. Because the hospital environment is foreign to her, her senses react even though she may not want them to. The inconvenience of moving to the hospital often of itself will disturb the rhythms of contractions and slow labor. Once admitted to the hospital, she is regulated by hospital procedures and people she does not know. Many of these procedures directly effect her labor. She must ask permission before she does anything. The temperature is cold, the environment sterile. Even the birthing rooms with their more home like decor is unfamiliar. If she is in her own home she has the freedom to do whatever she wants and to maintain her sense of privacy. She can choose what position she wants to birth in, who she wants to be at her birth. She can relax in the comfort and security of a familiar atmosphere, with loved ones around her. These factors will greatly influence the normal rhythm of labor.
In America the rate of cesarean sections is 32%. One third of all babies born in America will be delivered either by forceps or cesarean. There is no possible way to justify these outrageous statistics. God in His infinite wisdom did not make our bodies so that one third of all women could not give birth without major intervention. These numbers should anger us and make us realize that women are being abused in our country. Women who are not willing to take a 1 in 3 chance of major surgery must do something to increase their chances of having a normal vaginal delivery.
There are some common criteria for home delivery. Some of the reasons a home birth may be ruled out include the following:
- Chronic disease
- Breech
- Twins
- Premature labor
- Fetal distress
- Excessive maternal bleeding
- Active herpes or other sexually transmitted disease at the time of delivery
- Pre-eclampsia
- Hypertension
- Diabetes
- Find a skilled midwife that you feel comfortable with. (Planned home birth with a skilled midwife is very important. The statistics for unattended home birth are very poor.)
- Educate yourself. Get all the information you can that will help you with your delivery. Approach your birth without fear and with a positive attitude.
- Have a telephone available in case of emergency. Have an alternate plan in case of emergency of which hospital you will go to.
- Make sure you have hot and cold water, air conditioning or heating depending on the season, and that your home is reasonably clean and comfortable.