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Subscribe to RSSJessica Wilcox thinks her in-laws still view her ideas about childbirth as kind of out there, but it’s hard to argue with success: In the last five years or so, Wilcox has given birth to two boys and two girls -- each weighing more than 10 pounds -- at her northern Virginia home. And she hopes to do it again one or two more times.
Wilcox is part of a small but growing trend. While home births are still rare in the United States, they've posted a surprising climb in recent years, according to a government report out Thursday.
Courtesy Julia Chemotti
Jessica Wilcox has given birth to her two sons and two daughters at their northern Virginia home.
After declining from 1990 to 2004, the percentage of U.S. births that occurred at home jumped 29 percent from 2004 to 2009, when it hit the highest level since researchers began collecting data 20 years earlier.
Non-Hispanic white women were most likely to give birth at home in 2009, with one in every 90 births, or about 1.1 percent, in that group taking place at home. That represents an increase of 36 percent over 2004.
Still, Wilcox’s children represent only a tiny minority. In 2009, 29,650 U.S. births, or .72 percent of total births, occurred at home. Compare that to, say, 1940, when 40 percent of births took place at home.
Home births today tend to be more common among women 35 and older and among women with several previous children, according to the new report from the Centers for Disease Control and Prevention’s National Center for Health Statistics. They're most common in states with renegade reputations, such as Montana, which had the highest percentage of home births, nearly 2.6 percent, followed by Oregon and Vermont, with nearly 2 percent each.
“It’s women who are consciously rejecting the system,” says coauthor Eugene Declercq, professor of community health sciences at Boston University.
Although she's not older, that would describe Wilcox. Now 30, she delivered a baby in a hospital when she was 17 and gave him up for adoption. “It was a great hospital, but it was not a positive birth experience,” Wilcox says.
She didn’t like getting an epidural or an IV. She didn’t like all the poking and prodding by the nurses. And she didn’t like the fact she never saw the same doctor twice for her prenatal care. “I really wanted that personalized care that a midwife provides,” Wilcox says.
Her husband, Jeremy, 34, needed some convincing that it was safe to give birth at home, she says. “He was raised the same way I was: You get pregnant, you go to the hospital to have the baby.”
But now her husband likes to point out that he’s in good company: The son of Super Bowl-bound Tom Brady, New England Patriots’ quarterback, and his wife Gisele Bunchen, was born at home in 2010.
While the risk of death for a baby in a planned home birth is low, the scientific literature suggests it is two or three times higher than that for a newborn in a planned hospital birth, notes an opinion paper published last year by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice.
Home births actually had a lower risk profile than hospital births in 2009, though, according to Declercq and his coauthors. Hospital births were twice as likely to be low birth weight or preterm babies as home births. And just under 1 percent of home births involved more than one baby, compared with 3.5 percent of hospital births. In addition, women who opt for home births are less likely to be teenagers or unmarried. This all suggests that midwives who attend home births select low-risk women as candidates, the authors write.
“Home birth isn’t for anybody who walks in the door,” says Marsha Jackson, the certified nurse midwife who attended Wilcox’s first home birth. For example, Jackson says, her practice rarely accepts women who want to have a vaginal birth after a C-section, or VBAC, at home because of their elevated risk of a uterine tear.
Jackson cofounded BirthCare, a certified nurse midwife practice, back in 1987. Today, Jackson says, the group’s six midwives attend 25 to 30 births a month. About 60 percent are home births, while the rest are in BirthCare’s freestanding birth center in Alexandria, Va.
“The babies that we caught are now having babies with us,” she says. “That is wonderful. When we opened our practice, we never imagined that.”
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I wish I could have been home schooled. I doubt I would have taken the beatings at home that I suffered in middle and high school. Those ' mean boys ' turned me into the pseudo psychotic I am today. I am totally incapable of backing down from a fight, even if it is the smart thing to do. Oh.... and I have a natural hatred for all men, even ones I like and feel friendly towards. I have no male friends and probably never will. Down deep I fear them and thus hate them.
Oh, and I didn't learn sht in public school and they still passed me. I had to discover in college that I was smart and capable. College was nice too because no one tried to rob, beat, or sexually assualt me.
What doctor can you see who spends 1 hour plus with you for each of your appointments, comes to your home when you call them telling them you are in labor, and stays with you for hours after the child is born? They also come back the following day to check on you... I don't know a single one...
What midwife can you see who can save you and your infant in an emergency?
If this trend continues, it's just a question of time until lobbies like big pharma, or the AMA have their bought and paid for politicians pass a bill outlawing home births.
I agree.
Paranoid much?
IS THIS REALLY A SURPRISE?? With the poor and uneducated breeding out of control, and 47% of Americans on welfare, we are sinking into a third world country. In 50 years we will be as poor as Haiti, if the immigaration of the poor and the unwed mothers are not stopped.
Wow, you sound like Marie Antoinette, and we all know what happened to her.
Let me guess; conservative Republican? The number of Americans on welfare is less than 5%; the only way you get a larger number is to include SSN (which would include retired seniors).
You do realize don't you that the vast majority of home birthers are well educated upper-middle class women right?
You can always tell win you've hit a home run of truth when the liberals attack you on these blogs.
I stand by my statement. As a youth coach I have experienced many of these home schooled children and I can 1st hand tell you they are more polite, social and interact just fine with others. Now the public school pagans, that's another story. rude, spoiled,arrogant,jersey stealing, foul mouthed. The nut doesn't fall far from the tree and these kids are clones of their parents.
You are a total jackass. The only one really brainwashed here is you. Seriously, just looking at your profile and seeing your past comments is just disturbing.
Wow, you must not know many children to make such a statement. Sad for you really! I know plenty of polite children who attend public school. Perhaps you should reallyget out of your pigeonhole where you seem to put everybody?
Anyone interested in learning more please read the article linked here.
Most pregnancies (especially first pregnancies) are low-risk until they aren't anymore and unfortunately you can never know when that moment may come. Why would you ever want to be somewhere that help is not immediately available when yours and your childs life is in danger. Having a qualified CRNM at a home delivery is great, except when they only have 2 hands and you need 4 or 6 or an entire team. This day in age it's ridiculous for any woman to say "my only options are a horrible hospital experience or a home birth". There are plenty of birth centers that cater to women with birth plans and who want minimal interventions and many hospitals who do the same. I wonder if with the increase of home births we will see an increase in litigation for "birth injuries" as well.
Great post. Almost lost my 2nd son and that was in the hospital. Took more than two hands for us and that was not ever anticipated. It just happened as his head was born that the cord was wrapped tightly around his neck twice. There were problems with me internally as well, so it did take 2 teams so we both got the best care at the same time.
I had a friend in high school who later died having her baby and that was in the hospital. They barely saved the baby. I don't know why people forget that by the time you get to the hospital you are already in labor , and have been for some time. The body for many women is never under so much stress as it is during labor and delivery. She had something sudden happen (heart attack or aneurism (sp?)) I can't remember which.
Freestanding birth centers typically have exactly the same equipment that a homebirth midwife (CNM) carries. It just has a perception of being "safer" because it isn't at home. My CNM carried the same equipment available to me at the freestanding birth center. Doppler, oxygen, attendant trained in neonatal rescusitation, etc. My first child was born at a hospital with a CNM, my 2nd at a freestanding birth center (with a CNM), and my third was a homebirth attended by a CNM.
Most homebirth midwives also bring 1-2 assistants so they can have extra hands, or if the baby needs attended while the mom also needs medical attention.
Anecdotes are not particularly useful. Research that teases out *planned* homebirth, the attendant's training and education level, whether the attendant took on low risk vs. higher risk women (which I agree should not consider HB), how rural the woman is (did the midwife take on a case that was extremely rural and with a greater transfer time than 30 mins for example, etc. shows homebirth can be a very viable option for appropriate candidates giving birth with an appropriately trained midwife.
So funny, when it comes to womens choices everyone seems to have an opinion , even the people who are NOT women. This is a womans choice just like birthcontrol and abortion and whether she gets married or not or who she marries.........nobody gets to make these decisions for us anymore.
Hmmm I wonder if there would be more or less infant mortality if all the hospitals disappeared and all babies were born at home?
Midwives often make it sound safe by comparing themselves to hospital births, but they won't tell you is that midwives always accept low risk pregnancies, high risk ones are born in hospitals, AND if there is a complication and the baby is rushed to the hospital after a home birth, its counted as a problem that occurred at the hospital.
Better training, better medicine, better births.
No one is advocating all babies should be born at home, and to assume so is a ridiculous argument. A good homebirth midwife only takes on appropriate candidates who are low risk. The rate of of homebirth is still so small and then tease out the number of transfers (most of the time these do not end up being a true emergency but the midwife transfers out of an abundance of caution), that it isn't going to really impact hospital numbers.
Keep in mind the major medical bodies like the World Health Organization continue to criticize the ridiculous c/s rate in this country, acknowledging it is more than double what it should be. Those c-sections, while potentially life saving in certain circumstances, do come with risks. It is well documented that babies born via c/s have increased rates of respiratory issues for example. If it is a true emergency, that risk is outweighed by the need. But a substantial number of c/s are occurring that do not need to occur. Those come with increased risk to the baby and mother, without the "benefit" outweighing the risk. Not only does it impact the health of that baby, but an unneeded c/s impacts the health of *future* pregnancies. INcreased risk of rupture in subsequent pregnancy forces a woman to decide between vbac (if even available to her. In some cases it is nearly impossible for a woman to find someone allowing her to vbac even though it can be a reasonable choice per the NIH conference on this topic) or have a repeat c. That repeat c comes with risks to *that* child of increased rates of respiratory complications, etc. So not just the baby from the first c/s is impacted, but also the subsequent pregnancies are impacted. It is important to consider that, especially in the current environment where vbac may not be an option even for a "good" candidate.
If you look at the literature, "decision to incision" times in many hospitals in this country exceed 30 mins for a woman already in the hospital.
But it does impact the midwives numbers doesn't it. So its not a fair comparison. If two people took a math test and one just had to do the easy problems and could give the really difficult ones to the other person to do for them without them being marked wrong. It would not be fair to say that they are both just as good at math.
I am aware that their are shortcomings in the health care system, I'm just not sure at home births are the answer. There are too many "alternative medicine" quacks who think their methods/medicine is just as good as modern western medicine. If you can't clinically show that the medicine works than you shouldn't be able to sell it. If you cannot meet the high standards that is expected from a licensed doctor than you shouldn't get to practice medicine. We should be wanting higher standards if we want an improvement in our health care system, not selling snake oil as an alternative.
Just a passing thought, how many out of wedlock babies are born at home and never reported? Do these figures include those babies born at home and discarded in the trash?
It wasn't many years ago that having babies born at home was the 'norm', hospitals were for the well to do people. How many of the Greatest Generation were born in hospitals?
Home births are on the rise because of the economy; period! What idiot wouldn't want a doctor around just in case a complication arose? Yeah I'm sure it was just Tom Brady all by himself with his wife at home. What ever.
Most women giving birth at home are not doing it because of the economy. Most homebirthers skew toward highly educated and middle class or above socioeconomically. Some states require insurance cover homebirth. In other states, it is out of pocket and may be more money than a hospital birth if the woman is paying 100 percent out of pocket.
Sure, because Tom and Giselle were on such a tight budget right? No one said they were by themselves. They had a competent midwife, I'm sure. You really don't know what you're talking about. Giselle is a fanatic about taking care of her body and she no doubt chose this route for a good reason.
Fanatic is just about how I would describe some of these "My body is a temple" and "I want to control every aspect of MY birthing experience" types.
It also happens to be your infant's "birthing experience" and "Big Pharma" and the AMA are not out to get you.
I was born in 1943 and most babies were still being born at home. Hospitals were for sick people and no one thought a pregnant woman was sick. Now we think we need a million dollars worth of high tech to get a baby.
US infant mortality rate (per 1000 live births) in 1950 ----29.2
US infant mortality rate (per 1000 live births) in 2010 -----6.5
That's 4.5 times higher back in the "good old days" an that's even including the higher teen pregnancy, drug usage etc. that we have today.
Can you put a price on a human life?
In 1950 women were already having babies in hospitals. To get a comparison you would have to go back to the late 30s early 40s and then you have other issues that skew your data (the depression for example left a lot of women malnourished for a start). Add to that that up to 10% of women are likely to need actual medical help and you have genuinely bad stats. Home birth is NOT for everyone. Home births are for women who are in excellent physical condition. I don't personally even condone them for women who are in less than optimal shape or are unwilling to do what it takes to get their body healthy enough to lower the risks.
Ah, the good old days.
Some things were good, some things were not.
Mortality and health were not.
My wife tore tremendously "down there" giving a vaginal birth at the hospital. We would have had to have gone there anyway right after the birth if we'd have done it at home, so thankfully we were smart enough to already be at the hospital.
And in that same light, where are the statistics on how much safer/more dangerous it is for the mom to give birth at home than the hospital??
A good midwife and good adherence to the exercises, massage and relaxation techniques that they teach and practice might have prevented or reduced that tearing - wouldn't that have been nice?
Yep a little massage would have prevented a "tremendous tear". I'm sure the midwife would have tried that for quite some time while she was screaming her head off in agony, that is until it became a real serious injury that had to be passed off to some one that was actually qualified. Than it would have been a black mark against the ER doctor and not the midwife. Giving the midwife a clean record so they can brag about how much better they are than an OB.
You don't do perineal massage at the time of the birth, you do it for months in preparation for it as well as doing kegels and stretching exercises with the vagina. At the time of birth, warm water is the preferred method to relax the area, and avoiding giving birth laying on your back helps a lot too . I noticed that in the hospital they rarely use the warm water treatment even though it is so old and well known that old movies have a running line about boiling water for a delivery. It's complicated and I don't wish to get graphic here, but yes midwives do a lot more than doctors do in prevention of tearing and other birth injuries. This is one of the main reasons for choosing a midwife/ home birth experience for a lot of women. That doesn't mean that no one ever tears when they give birth at home, but at least they address the issue and start prevenative measures early in the pregnancy instead of just hoping for the best and reacting to fix it after the fact.
Interesting. Is there a study I can look at that shows that massaging, etc. can prevent tearing from happening? Sorry if I don't take your word on it, but if someone sold me a fake cancer preventative medicine, and when tests later showed that I didn't have cancer they could claim that the medicine was working. If I did by chance get cancer they could claim I would have gotten it anyway. So I'm a little skeptical of preventative medicine and that it can be shown to be effective. Having a baby is a hard and often traumatic experience, it could be possible that little can be done to prepare a person's body for it. I'm also skeptical that in the all the years of education and training that a doctor goes through that they don't know about these "simple, secret methods" that midwives all know about. If doctors through the years stopped doing water baths, perhaps it was because they found better methods, why else would they discard something that works? I'm not looking for a fight, just looking for some answers.
Mr. Jones78: Yes, perineal massage does reduce the risk of tearing and can lower the need for episiotomy in some cases. This is not a "midwife" only knowledge. Physicians are taught about this - and yes, many ob/gyn's will mention to pregnant women that it can be done and why it helps. It is most effective if performed throughout pregnancy; though some benefit is seen even if done only during delivery.
Here is one link that compares use of sterilized vaseline during perineal massage v. perineal massage w/o sterilized vaseline.
http://www.ncbi.nlm.nih.gov/pubmed/21614497
If you go to pubmed.gov and do a search for perineal massage and labor, you'll get a lot more journal articles.
http://www.modernpregnancytips.com/pelvic-health/5-ways-to-avoid-vaginal-tearing-in-childbirth/
http://notjustskin.org/node/12
Here are a couple of good resources to help your wife next time. It's not that it is some "secret" known only to midwives , but that midwives (and they type of women who choose them) put more emphasis on what the mother does to prepare for birth. Doctors will tell you do this or that if you want to, but don't stress the importance. Some issues that may be very important to a woman may be insignificant to a doctor (good example - stretch marks - also related to skin elasticity) when you see a midwife they don't just dismiss these concerns, they address them directly, and quite often with pretty good success.
sunnybunny1269: The only modification I would add to your post is by adding that SOME doctors dismiss these issues and SOME midwives will address them directly. It really depends on the personality of the doctor and the midwife. That's why it's crucial that a woman find a midwife or doctor that is both knowledgeable AND that they are comfortable with.
Just an example, but one of my friends is currently doing her ob/gyn rotation as a 3rd year medical student. She works with doctors and residents mostly; but also works with certified midwives that deliver at the hospital. One of the midwives is very open to discussing these issues with her patients; the other one, not as much. (Those are the only two midwives there are there). Two of the doctors will directly and freely discuss these issues; the other doctor not so much (there are three doctors there). One of the residents is horrible - he stands in quietly in the corner while the woman is laboring. He doesn't talk to her, doesn't interact with her - and then jumps in and catches the baby and stitches the woman up (poorly also). If I were a laboring woman - I would feel like some guy that I've never met, standing in the corner, not talking to me, while I'm exposed and laboring is a creep and I'd demand he leave the room. The other resident is very good about interacting with the women. To be fair to the resident that just stands there - he's actually a family practice resident on an ob rotation (so this isn't something he is accustomed to).
In the end - women need to be sure that not only is the person providing their care is medically knowledgeable, but has the personality that matches with her personality. What are the things that are important to the woman, is the health care provider willing to address these things? If there is a disagreement about the health care that should be provided, is the provider willing to listen to the woman and give an understandable explanation about why the provider things the care should be managed differently than the woman may want? Etc., Etc.
Summer1597193 - I think you are going to be good at this. Someday women will be lucky to have you as their doctor. I wish you lots of success.
Thank you so much sunnybunny1269. I hope that I can help women have the families they want to have, when they want to have them and in the way they want to have them. I've had two very difficult deliveries myself, and I want to help women who are having a hard time. It's one of those specialties that when things are good, they are great; but when things go wrong, it can be devastating.
How the hell are they ever going to obtain the right to vote????
Unless some authority issues a birth certificate...... in a lot of states....... babies born at home..... don't exist.
I had a homebirth with my third and the midwife was legally allowed to complete the paperwork. No trouble at all. I have never heard of a homebirther unable to get a birth certificate. There are women who deliver on the side of the road on the way to the hospital or accidentally give birth at home. Do you think they can't get a birth certificate?
The health department issues official birth certificates - not the hospital.
In Oklahoma, where I live, all you have to do is go to the health department and apply for a birth certificate.
As someone who had to have an emergency c-section to save my beloved son's life, I will be forever thankful for the wonderful hospital and staff where I "gave birth". If you can give birth at home, more power to you, but I am thankful for doctors who know what they are doing!
I think what is missing here is the right for parents to make informed decisions based on their individual situation. Birth is not a one size fits all event. And making a blanket statement about what people should or shouldn't be allowed to do is just wrong. I have two children. My first was born at home in Arizona with an amazing midwife team. In my situation it doesn't get any better than that. My second was born naturally at the hospital in Georgia with an equally amazing OB/GYN and a doula. I wasn't crazy about the hospital staff and we had to fight a few of the nurses to do it our way but you have to expect that when you are dealing with people you meet on the day of delivery and the horrible state that liability suits have put our hospitals in. We were educated and ready for the fight thankfully. In each case we weighed our options and made the choice that was best for us at the time. My voice in this fight is to allow the information to be readily out there and the parents to make informed decisions about how and where they want there birth. Healthy babies and healthy mommas should be everyone's end goal no matter where the birth occurs. Treat the individual, not the statistic.
Curiously, the report on the rise in homebirths leaves out the rise in homebirth deaths.
The latest CDC data (on the CDC Wonder website) shows planned homebirth with non-nurse midwife has a neonatal mortality rate 7.7 times higher than comparable risk hospital birth.
The Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, has collected a database of 24,000 planned homebirths and refuses to release the death rates.
In the state of Colorado, which has licensed homebirth midwives since 2006, that the homebirth death rate has exceeded the death rate for the state as a whole (including premature babies and pregnancy complications) in every single year since and has risen in every single year since 2006, The death rates are so appalling that the homebirth midwives of Colorado refused to release the death rates for 2010.
The state of Oregon has had at least 19 reported neonatal deaths in the past 10 years for a rate that is more than 4 times higher than the death rate for comparable risk hospital birth.
Homebirth increases the risk of neonatal death. Women cannot make an informed decision about homebirth unless they know the real risks.
Dr Amy-obviously we need to address midwife training (CNM vs. lay midwife), how rural the woman is (time to transfer to a hospital for care), planned vs. unplanned, and whether the midwife was "legal" and integrated into the system vs. "illegal" or "alegal" where in some cases there may be (unfortunately) hesitation to transfer the woman as soon as things start to look like they are headed for trouble.
Lumping *all* of these things together under the umbrella of "homebirth" is not really fair. It is important to tease out how rural one is so that transfer times are taken into account, what the midwife's training is, whether the midwife is integrated into the hospital system (which is difficult for midwives who aren't "legal" based on their type of training, etc.
Also based on legality, access, etc. what type of equipment the midwife carries or can legally carry, and is she trained in neonatal resuscitation?
What type of patients is she taking on in her practice? Low risk or is she taking on higher risk patients? Again, these points are obviously important for anyone to consider and for that reason it is unfair to lump all homebirths together under a single umbrella.
For each it’s on own. I had midwife throughout my pregnancy for check-ups, etc not for birth. When I was ready to give birth I went to the hospital and had a doctor in case there was any complication. It was good that I went to the hospital because my blood pressure went sky high so I had to stay at the hospital for a week. My midwife was wonderful she was there for me throughout my birth. She came to check up on me during the time I was at the hospital. She did a follow up visit at home for the next two weeks (free of charge). What doctor would do that? My person experience the doctor was good in case there are complications during your birth but the midwife gave me that personal touch.
Whysoserious-you do realize that the same equipment employed at birth centers is typically carried by a midwife attending homebirth? Doppler, resuscitation equipment, oxygen, etc. are commonly carried.
To the NICU nurse who advises high risk women to deliver in a hospital-of course! No reputable midwife is going to take on a "high risk" case for a homebirth. Those clients are risked out. When we look at the stats on the safety of homebirth it is important that we are looking at low risk women. I had a CNM attended hospital birth, followed by a birth center birth (freestanding birth center attended by a CNM), and a homebirth with a CNM.
Whenever reading safety data or listening to anecdotal evidence, it is important to tease out *homebirth with a trained attendant* from an "accidental" or unplanned homebirth where the mom was not necessarily attended by a medical professional, or in some cases no one (not even a spouse) was present. There's a difference, obviously, but some studies have lumped these "homebirths" together.
Technology can certainly save, but it also increases the risk of c sections (for example, studies linking routine electronic fetal monitoring to increase in c/s rate without improving outcomes for moms or babies). Unnecessary c-sections (which clearly do happen, if you look at the WHO, CDC, NIH data that says they are definitely overused) have very serious risk factors for the newborn, including increased chance of fluid in the lungs for example. Not to mention once a woman undergoes an unnecessary *primary* c-section, she now has to deal with the dilemma of a possible rupture in subsequent pregnancies. The choice then becomes a vbac or repeat C, each with their own risk factors (see NIH's recent report on vbac). So it isn't just the primary c-section that is an issue, but the trickle down effect that c-s has on subsequent pregnancies, labors and deliveries. That doesn't mean C-s aren't life saving, but it is well established that the rate is too high for a variety of reasons, and obviously there are significant cases where they are being overused.
In terms of transfer to a hospital, remember that many hospitals in this country do not have 24/7 anesthesia available. If a c/s is necessary an anesthesiologist may need to be paged. There is plenty in the literature on decision to incision times exceeding 30 minutes for a woman already in the hospital. Most midwives who transfer women transfer well before a full blown emergency arises. If a true emergency does arise, most want their clients to stay within 30 mins of a hospital so that they can call in and the surgical team can start prepping for the woman's arrival.
There are risks to both hospital births with unnecessary interventions, as well as homebirths.
my daughter gave birth 2 times at home with midwife and she and babies are very healthy and very smart not that has anything to do with at home or hosptial. But she is a very smart women and i am so proud of her and my 3 grand children 2 were home birth . if you can then do what makes you happy .... good luck with home or hosptial births . and if you are more happy to give birth at home than a hosptial do what makes you happy oh and the hosptial was not that far from her home and it has to be a very clen place to do so think about it and do what you feel is for you and your child.
I would amend that to say "do what is healthy for the BABY."
yeah it's all those illegals having babies at home who can't afford the hospitals and worried they will get arrested and deported!!!!
The midwife said they don't accept anyone with high risk issues...so of course their home birth rate is "safer", it's skewed that way. A woman should do what makes her most comfortable and confident. Whatever that may be! If you are far away from a hospital you should probably consider that in case an unexpected emergency occurs. Epidurals are choices, not musts! Women need to understand that even if they are in a hospital they are in control....
Even if you compare low risk women homebirthing to low risk women birthing in a hospital, homebirth still comes out as a very safe option. Of course, it is important to tease out confounding variables like distance from hospital (midwife shouldn't take on cases that are very rural with a long transfer time), how high risk the woman is, the midwife's training, whether the midwife is "legal" or not (for example, some states only permit CNMs to legally attend a homebirth, whereas other states allow "lay midwives" to attend homebirths legally. The training is different, and a midwife attending a birth who is not licensed to do so may be less likely to transfer her patient and endure the scrutiny of hospital staff), whether the birth was a *planned* homebirth (vs. an oops, I didn't make it in time or no one was home to drive me, or I didn't even have a spouse present because things went so rapidly), etc. When you tease out that info, for low risk women HB is a reasonable option if you look at the safety studies.
Even if you compare low risk women homebirthing to low risk women birthing in a hospital, homebirth still comes out as a very safe option. Of course, it is important to tease out confounding variables like distance from hospital (midwife shouldn't take on cases that are very rural with a long transfer time), how high risk the woman is, the midwife's training, whether the midwife is "legal" or not (for example, some states only permit CNMs to legally attend a homebirth, whereas other states allow "lay midwives" to attend homebirths legally. The training is different, and a midwife attending a birth who is not licensed to do so may be less likely to transfer her patient and endure the scrutiny of hospital staff), whether the birth was a *planned* homebirth (vs. an oops, I didn't make it in time or no one was home to drive me, or I didn't even have a spouse present because things went so rapidly), etc. When you tease out that info, for low risk women HB is a reasonable option if you look at the safety studies.
Really? It's surprising? Dur dur dur how much does a hospital charge for the privelige of giving birth there? $20,000? Surprising you say?
Time to price fix the medical industry.
I can agree that home births are not for everybody, and vice versa.
Personally, I wouldn't be able to risk the safety of my unborn child just for the "comfort and relaxing atmosphere" of a home birth.
I agree they aren't for everyone. Women choosing homebirth are not largely choosing it for the "comfort and atmosphere." Many are concerned about the excessively high c-section rate (called out by organizations such as the WHO, CDC, and others) and the use of interventions that in some cases research has shown increase c/s rate without improving outcomes for mom and baby. Keep in mind with the c/s rate what it is, women who undergo an unnecessary primary c section not only have risks associated with that (well documented respiratory issues in newborns associated with c/s, which is one thing when needed and another issue when they are being overused), but those women also are then left with an increased risk of rupture in subsequent pregnancies. They are then forced to choose between vbac (see NIH report on VBAC which considers it to be a viable option for many women, but continues to be an unavailable option for many women because of fear of lawsuits) or a repeat C, even if she's a good vbac candidate. That repeat c comes with its own risk of incresed respiratory issues for the newborn. SO not just the primary pregnancy is impacted from that first unnecessary c/s, but subsequent pregnancies have their own set of risks due to the primary c/s. Obviously some c/s needed and are life saving (and homebirthers and homebirth midwives do usually acknowledge this), WHO says somewhere around 15% or a little lower would be reasonable if I recall correctly. We are at 30-35% or even higher in some areas of the country)
For those espousing the time before doctors being involved in pregnancy and births....just remember what goes on in third world countries where a woman bears children without any medical intervention..... in a lot of those countries the #1 reason a woman dies is...because of pregnancy and child birth. Home births are not for everyone. There are very good reasons to choose a hospital. Even if it is just because a woman feels more comfortable or confident there. People should really stop judging each other just because a different choice is made! Isn't it wonderful that we actually can make a choice? Let's celebrate that fact and stop all this "my way is the only" stuff.
Comparing homebirth in a country where appropriately trained midwives with appropriate equipment, ability to provide appropriate prenatal screening and care, ability to test for anemia and other medical complications, etc. to a woman having a "homebirth" in a developing nation isn't really logical. WHO and other major medical bodies are looking for more midwives to train to help these women. How many of them are malnourished? Have had their blood tested for anemia and other factors? How many of them are giving birth with a trained attendant (not just lay trained but with the appropriate degree, etc)? How many do not have access to birth control and have closely spaced pregnancies that are linked to poorer outcomes for mom and baby?