About Home Birth
January 2012~The Associated Press reports homebirth increased 29% from 2004-2009
The idea of being comfortable during childbirth may strike many mothers who have delivered in the hospital as impossible. They (may) remember being confined to a hospital bed, denied food and water, separated from their other children and supportive family members and friends, enduring frequent internal examinations and vital sign checks, being transfered from one room to another on a stretcher at the peak of labor's intensity and having their legs strapped into stirrups.
Birthing rooms and their homey furnishings are an effort to eliminate some of the stress and discomfort that comes from being in the strange surroundings of the hospital.
Studies show that labor can be compromised by an unfamiliar environment. Discomfort and fear can actually increase the pain experienced in childbirth, while relaxation can diminish maternal stress, improve oxygen flow to the baby and facilitate labor.
In her own home a laboring woman has "the home court advantage." She can move about freely, wear what clothing she chooses, sip on energizing juices, continue caring for other children as she is able, relax in a warm tub of water, have her feet rubbed by loving friends and try different birthing positions. Normal labor is a healthy stress for the baby, clearing the lungs of fluid and preparing it to take its first breaths.
After the birth, the baby is never taken from its mother's side. The entire family can climb into a clean bed for a much needed cuddle and nap. The emotional bonding that takes place in the moments after birth between mother and child and between the baby and the entire family promotes well being, encourages breastfeeding and speeds recovery of the mother.
... In the hospital, obstetricians do not routinely sit at the bedsides of their laboring patients but rely on machinery and others for information — then appear at the last minute in the delivery room. Most physicians do not build a relationship of supportive rapport with each patient or offer much encouragement to give birth naturally.
Labor and delivery room nurses by and large enjoy giving support to women during childbirth. Hospital life, however, involves a great deal of paperwork, personnel changes by the clock and wild fluctuations in how many women each nurse must be responsible for. And nurses have no authority to stop an impatient doctor from trying to "speed up" a slow-but-steady, normal labor.
Midwifery is basically a system of wellness care given by professional midwives to women and infants during the childbearing year, and in many other countries midwives are the primary care givers in maternity systems with better neonatal mortality rates than ours. Midwives are trained to watch for deviations from health throughout the pregnancy and labor and refer their clients to a physician if necessary.
The number of direct-entry midwives has increased in the last twenty years due to more demand for their services. Most non-nurse midwives have completed a course of study and then furthered their education by apprenticing with a more experienced midwife. ~Quotes from GentleBirth.org
Randi Payton LM, CPM
(and 4 of her 6 children)
So why are families having homebirths? Though each couple may have individual reasons, most plan homebirths because they believe that most of the time pregnancy and childbirth are normal functions of a healthy body — not a potential life-and-death crisis that requires the supervision of a surgeon.
There are risks involved in childbearing. In a small percentage of cases the skills of an obstetrician/gynecologist and high-tech equipment like ultrasound and fetal monitors are necessary in order for the mother or the baby to survive childbirth without long-term ill effects.
The neonatal mortality rate for the U.S. in 1989 was slightly more than 10 per 1,000 live births. We have the most highly sophisticated and expensive system of maternity care in the world, yet in the same year twenty other countries — countries with less technology than we have in our hospitals and laboratories — had more babies survive their first months of life than our babies in the United States.
What do they do in those 20 countries to have better outcomes?
With fewer high-tech hospitals and obstetricians available, many of those countries — like Holland, Sweden and Denmark — use midwives as the primary care-givers for healthy women during their pregnancies and births.
1.National Committee to Prevent Infant Mortality, HOMEBIRTH No. 8, Sept/Oct 1990, p. 5.
2.The Five Standards of Safe Childbearing, 1981, Stewart, p. 114.
Overall neonatal death rates have also improved since the 30s, but homebirths appeared to be safer even then. In 1939, Baylor Hospital Charity Service in Dallas, Texas, published a study that revealed a perinatal mortality rate of 26.6 per 1,000 live births in homes compared to a hospital birth mortality rate of 50.4 per 1,000.
Since the 1970s, research done in northern California, Arizona, England and Tennessee all point to the relative safety of homebirth. The only matched population study, comparing 1,046 homebirths with 1,046 hospital births, was published in 1977 by Dr. Lewis Mehl, a family physician and medical statistician. While neonatal and perinatal death rates were statistically the same in Mehl's report, morbidity was higher in the hospital group: 3.7 times as many babies born in the hospital required resuscitation. Infection rates of newborns were four times higher in the hospital, and the incidence of respiratory distress among newborns was 17 times higher in the hospital than in the home.
A six-year study done by the Texas Department of Health for the years 1983-1989 revealed that the infant mortality rate for non-nurse midwives attending homebirths was 1.9 per 1,000 compared with the doctors' rate of 5.7 per 1,000.
A study of 3,257 out-of-hospital births attended by Arizona licensed midwives between 1978-85 shows a perinatal mortality rate of 2.2 per 1,000 and a neonatal mortality rate of 1.1 per 1,000 live births.
In testimony before the U.S. Commission to Prevent Infant Mortality, Marsden Wagner MD, European Director of the World Health Organization, suggested the need in the U.S. for a "strong independent midwifery profession as a counterbalance to the obstetrical profession in preventing excessive interventions in the normal birth process." Wagner states that in Europe midwives far outnumber physicians: "In no European country do obstetricians provide the primary health care for most women with normal pregnancy and birth." He states that the U.S. has the highest obstetrical intervention rates as well as a serious problem with malpractice suits and concludes that a strong, independent midwifery service in the U.S. would be a most important counterbalance to the present situation.
1.The Five Standards of Safe Childbearing, 1981, Stewart, p. 241.
2.Ibid, p. 115-116, 127, 243-246.
3.Ibid, p. 247-253.
4.Texas Lay Midwifery Program, Six Year Report, 1983-1989, Bernstein & Bryant, Appendix VIIIf, Texas Department of Health, 1100 West 49th St., Austin, TX 78756-3199.
5.Mothering, Jan/Feb, 1990.
Home birth may be significantly easier on your bank account. An average uncomplicated vaginal birth costs about 60% less in a home than in a hospital. ~AmericanPregnancy.org