There are many misconceptions about home birth.
People usually try to picture the typical hospital birth done
at home. Obviously that is not the case other wise birth at home
would not be safe. I usually ask people how they view pregnancy
and birth. Do they see it as a disaster waiting to happen or something
that the woman’s body knows how to do?
There are two views of birth; one being the Medical Pathway and
the other being the Physiologic Pathway. The Medical pathway has
time tables that need to be met and hospital policies that must
be followed. The Physiologic pathway recognizes that each woman
is unique and should be treated as such and that the woman should
be encouraged in her process of birth. This may take hours or
days but that her labor and birth process is unique to herself
and should not be compared to another’s experience. Women
were created so that when we labor and birth we bring with us
our hurts, joys, memories, and baggage as well. How we decide
to walk through labor can be very different for each woman and
even from one pregnancy to the next.
Research shows that planned home birth with a qualified
attendant is safe for most mothers and babies. Home birth reduces:
risk of infection, risk from unnecessary interventions, maternal
morbidity rates from complications and interventions, risks from
errors in hospitals, interference in bonding and breastfeeding
from hospital polices, risks from poor staffing levels in hospitals,
risks of tampering with baby.*
Home birth provides: safe, familiar and private surroundings for
labor and birth, woman-centered care during pregnancy, labor,
and birth, family-oriented birth with no strangers present, an
opportunity for immediate bonding and breastfeeding, less disruption
and stress for the whole family, affirmation that birth is a normal
profound life event.* (*Citizens for Midwifery, 2004)
The Lewis Mehl Study took 1046 births in two
different groups, hospital births and home births. The couples
were matched for age, parity, education, race and risk. What he
found was that the fetal death rate was the same in both groups
and there were no maternal deaths in either group. But what he
did find was that the hospital group had:
• 9x’s more episiotomies, with more tearing
• 3x’s more c-sections
• 2x’s more oxytocin used
• 20x’s more forceps delivery
• 9x’s more analgesia and anesthesia used
• 6x’s more fetal distress
• 5x’s more maternal high blood pressure
• 3x’s more maternal hemorrhage
• 4x’s more infections
• 3x’s more aid for infant breathing
• 30x’s more birth injuries, including skull fracture
and
nerve damage
Hospital births carry a perinatal mortality rate of 9-10 per 1,000
births (Jones, Carl. Alternative Birth. Los Angeles: Jeremy P.
Tarcher, 1990; p. 96, 98). A British childbirth educator, Sheila
Kitzinger, states that planned home birth with an experienced
lay midwife has a perinatal death rate of 3-4 babies per 1,000
births (Kitzinger, Sheila. Home Birth. London: Dorling Kindersley,
1991; p.51).
A study in Australia found a perinatal mortality rate of 5.9/1,000
out of 3400 planned home births (Kitzinger, Sheila. Home Birth
London: Dorling Kindersley, 1991; p. 41). In the book Evolutions
End, Joseph C. Pearce states that home birthed babies have a six
to one better chance of survival than a hospital-birthed child
(Pearce, Joseph Chilton. Evolution’s End: Claiming the Potential
of our Intelligence. San Francisco: Harper, 1992; p.117).
Marsden Wagner, formerly of the World Health Organization, states
that every country in the European Region that has infant mortality
rates better than the US uses midwives as the principal and only
attendant for at least 70% of the births (Jones, Carl. Alternative
Birth. Los Angeles: Jeremy P. Tarcher, 1990; p. 2). He also states
that the countries with the lowest perinatal mortality rates in
the world have cesarean section rates below 10% (Jones, Carl.
Alternative Birth. Los Angeles: Jeremy P. Tarcher, 1990; p.13).
In 2005 the US has a cesarean rate of 30.2% (Center for Disease
Control, 2005 Statistics). The US infant mortality ranks higher
than 28 other countries that spend less money on birth than we
do, including Cuba. Our maternal mortality rate is rising as well,
(World Health Organization) due largely to our 30.2% rate of cesarean
surgery for birth and dangerous drugs to induce labor. According
to a 2005 article in Vol. 95 of the American Journal of Health,
38-50% of US maternal deaths go un-reported (World Health Organization
and the Center for Disease Control, 2005). The World Health Organization
concluded that … There was no justification for any region
to have a cesarean rate more than 10-15 percent. Understanding
the potential danger in the overuse of childbirth technology,
the World Health Organization has repeatedly implored the US medical
authorities to return to a midwife-based system of maternity care
as one way to help reduce our scandalously high mortality rates
(The Five Standards of Safe Childbearing, 1981, Stewart, p. 114).
Carl Jones in his book, Alternative Birth, says, “No one
can tell a mother she is perfectly safe giving birth at home.
Whether she is safer at home than in a hospital, however, is another
question” (Jones, Carl. Alternative Birth. Los Angeles:
Jeremy P. Tarcher, 1990. p. 113). There is always going to be
some risk when giving birth, as in all of life, and women should
be carefully screened for any health problems that could be dangerous
during labor and delivery.
For certain women in rare instances, obstetric care is essential.
However, for most women, better, healthier results are seen when
mothers chose birth centers or home birth. “The danger of
home as a place of birth does not lie in its threat to the healthy
survival of mothers and babies, but in its threat to the healthy
survival of obstetricians and obstetric practice (Korte, Diana
and Roberta Scaer. A Good Birth, A Safe Birth. Boston: Harvard
Common Press, 1992, p. 50).
