Study Finds Home Births Increase By 20 Percent

Blogger Gina Crosley-Corcoran is a pre-law student who chronicled nightmarish pressure from nurses and doctors to abandon a vaginal birth with her second after a C-section with her first. She followed up with a third child born at home in April. (AP)

A recent study from the Centers for Disease Control and Prevention found that home births increased by 20 percent between 2004 and 2008.

White women led the uptick in home births, which still only account for around 1 percent of all births in the U.S.

Some women say they want more control of their bodies and are rejecting the hospital and its technology. Medical anthropologist and home birth advocate Robbie Davis-Floyd told Here & Now‘s Robin Young that cost is also a consideration for many choosing to give birth at home.

“A vaginal birth in the hospital can cost anywhere from $7-10,000, a cesarean section can cost between $20-30,000 whereas a professional midwife who attends you at home for 9 months of prenatal care is $2,500-4,000.”

However, the American College of Obstetricians and Gynecologists, which certifies OB-GYNS, warns against home births, especially if the mother has high risk conditions.

Midwives are legal, licensed and regulated in 27 states, they’re illegal in 9 states, and they’re in a gray area in the remaining states. Becoming a midwife requires on average three years of training, during which a midwife learns how to recognize signs that a woman needs to go to a hospital.

“Midwives have a wide repertoire of skills to deal with the emergencies that do happen at home, but an even wider repertoire of skills to transport to the hospital appropriately so that those emergencies do not happen at home,” Davis-Floyd said.

Guest:

Robbie Davis-Floyd, a medical anthropologist at the University of Texas at Austin, and an advocate for home births, who also gave birth at home herself

We welcome comments from all of our listeners. Post below. Please stay on topic and be civil. Comments may be moderated by us, but you are solely responsible for the content of your comments.

Meagsinbangkok

great interview. i wanted to have a home birth but my husband is a doctor and would not even hear of it. the birth of my son was awful and it ended in a c section. i have no desire to go through that again. my son is healthy and beautiful. i need help finding home birth information that speaks to my husband and to people in the medical field. i will send him information and he will just laugh and say that “these people are crazy” and “this is dangerous.” in conclusion, i want to encourage those who support this to use language and approaches that people in the medical field will understand. THANK YOU!!!
- Jessica Leake
  
  Gentle Birth Choices was a wonderful, convincing and informative book.
- guest
  
  Natural born babies is a video documentary where highly respect professionals (cardiologists, Nurses, Lawyers, etc) describe why they had a home birth. This may speak to your husband as will having him talk with an OB who supports home birth.
- guest
  
  My husband is a pediatrician and he also had reservations about home birth…before he did his homework. The Cochran review and all other data supports home as a very safe choice, for both mom and baby. We were fortunate to have a wonderful midwife who “spoke his language” of medicine, and after building a strong relationship, he had absolutely no reservations about her capabilities or her judgment. The birth was a trans-formative process for both of us, and my husband is now a vocal advocate for home birth. While his medical training was all hospital-based (and fear-based), he now has a much more accurate and holistic view of how babies and moms can be cared for. We are both so grateful for our experience, and are working to improve the sad statistics for birth in our country. Evidence supports the midwifery model of care, along with trained obstetricians as backup. Your husband need only look at the numbers around the world and our own data. Performing surgery on one third of women and intervening so heavily does not truly make us safer.
Anonymous

Cautionary tale: A very dear friend chose home birth with midwife. The baby was large and hypoxic due to the midwife’s inability to deliver him quickly. There was no time at that point to help the situation by going to a hospital. The result was a child with cerebral palsy symptoms, poor learning, untreatable seizures and an early death in pre-adolescence. The cost to the wonderful parents and society far outweighed many $30,ooo caesarian deliveries in the hospital. I don’t understand why some educated women are Luddites when it comes to reproductive science. Many still do not use birth control or plan pregnancies. I am sorry to hear of this new wave of unnecessary risk-taking.
- guest
  
  A better “caution” to women would be to do their research thoroughly and interview an adequately experienced and trained professional no matter where they give birth. Bad things DO happen as can be expressed by the united states being ranked 50th(out of 53) in maternal and newborn death. Every country that loses FEWER women and babies than the US use midwives and have a higher rate of home birth. In fact most “traumatic” situations are discovered quicker by midwives since they are by your side throughout the entire labor. Also if “large and hypoxic” actually meant a case of “shoulder dystocia” well then location wouldn’t have altered the outcome. The hospital would have treated the emergency the same as the midwife.
- Woozlemom
  
  None of my pregancies were planned. My son was conceived after 2 miscarriages and we’d given up on being able to conceive and bring a child to term. As soon as we stopped trying so hard, we succeeded. Our daughter was conceived after my husband’s cancer and diagnosis of secondary sterility. He got better. :-) They are the most wonderful accidents in my life.
Kdtrembl

I am a white middle income highly educated and I chose to have a homebirth with my second child in 2007- so I am one of those who accounted for the uptick in homebirths during the last several years. Besides being one of the most beautiful experiences of our lives- it was also a practical and convenient choice for our family and a healthy one for my newborn (mainly there are only sick people in the hospital!). My husband and I are educated adults, we are both PhD level scientists and we did our research on our homebirth choices and the data supports the safety of homebirths. In this country we have allowed the fear of litigiousness to impact health policy and unfortunately hospital births are highly influenced by this fear rather than common sense. There is no reason why we as a society need to treat healthy pregnant women as if they are patients rather than women going through a normal natural process their bodies are designed to handle. I also agree with the discussion on the radio about ob/gyns being trained in high risk situations- they tend to get a skewed view that most births need intervention. The data suggests that this simply is not true however if you look at the statistics regarding hospital births you see that a significant portion of women who choose a hospital birth receive some type of intervention. I am very happy that there are trained ob/gyns because in a minority of situations they are needed, and a trained midwife in a homebirth situation knows when hospital transfer is needed and do not hesitate to do so. I certainly had our route to the hospital mapped out in case, however most women, myself included, did not need to make that trip.
- http://twitter.com/PorterOnSurg Chris Porter
  
  The body is indeed designed to handle child birth. Why consider pregnant mothers patients, if childbirth is a normal natural process? Because the risk of death to the infant is 1 in 10, and risk of death to the mother is 1 in 100, naturally.
  - guest
    
    Your statistics are blatantly wrong and so ignorantly stated that no one, home birth or hospital birth supporters alike will believe your credibility, Naturally.
    - http://twitter.com/PorterOnSurg Chris Porter
      
      In five weeks I delivered the dead children of three failed home births in Sudan. Home birth without prenatal care, attended by non-medically-trained personal, results in death of the child in one in ten deliveries. These are the cruel statistics of Nature – same as the statistics in American settlers.
      - Cryscobabe87
        
        thats sudan, not america. The stats on American home births have the same death rate of mom and baby as hospital births, without all the added uncessary c-sections and medical interventions
travelinveggiemama

Our second child was a Home Birth After Cesarean (HBAC) baby 1n 1998 in Massachusetts with a midwife (2 actually). We consider birth a natural process and didn’t want to be on the defensive against all of the routine interventions into labor at hospitals. Additionally, after having our first child by cesarean (which was a homebirth transport, non-emergency, and due to the positioning of the baby’s head), I knew that at a hospital I would be considered a risk and would have to perform to a timed schedule. We had health insurance and had to appeal for almost a year to get them to pay for our homebirth that actually saved them over $7000.
KarenAnn

I was born by
emergency c-section, and I am lucky to have lived. My son was also born by emergency c-section,
and I will be forever grateful that intervention was close at hand.

While many of
those who chose home births are self-selected to be healthy candidates, the
gospel is reaching those for whom this should not be an option. I am afraid for the trendy choice my children
are making in choosing home birth.

I find the
arguments presented by the representative advocating home birth to be
absurd. To justify the risk by the how few
the emergency trips to the hospital does not adequate reflect the danger. How many of these women suffered postnatal
trauma or infection and more importantly how many of the children suffer from
damage—including learning problems or even muscular dystrophy that they might
have escaped under the advanced medical care available today? There are no statistics to back up the longitudinal
well-being of the children.

This is not to
say that it is not possible to have poor care in a hospital, and the needless
pain inflicted by insensitive and unnecessary interventions. The medical field has unfortunately
frequently earned its own bad reputation on hospital births. Physicians and hospitals need to change, and
these women, fools that they might be, at least are making that point. Everyone knows the stories of trauma in
hospitals, but who proclaims so noisily the difficulties they foisted on their
babies by a poor decisions on home birth?

Unfortunately,
we all are the poorer for the consequences of the same type of logic that
causes families not to properly inoculate their children against dangerous
communicable diseases.
- Billfightr
  
  Your ignorance on this subject is stunning. In fact there are numerous longitudinal studies on how children do after home birth. Having worked 29 years as a Labor and Delivery nurse, hospital midwife and home birth midwife, I can definitively say that the detrimental effects “foisted” on our general population because of such ignorance has significantly added to the bottom line of hospitals. Healthy is not nearly as lucrative as sick. Hospitals are making perfectly healthy women and babies ill in the name of profit. The more proceedures performed the more money made for the hospital and their protocols reflect this. Artificial rupturing of membranes, induction with cytotec (expressly against the drug manufacturers advice), pitocin augmention, episiotomy (the most unnecessary operation in the U.S.), are all unheard of at home. Do you really think you have a better chance getting MRSA, one of the 8 super viruses that killed 100,000 people in hospitals last year, at home? Apparently you missed the report by Amnesty International just over a year ago that condemned how we do birth in hospitals here in the U.S. This is an organization that normally condemns human rights abuses in countries like Libya and Syria. My clients are academics, teachers and tons of hospital nurses and a few doctors that know how bad it is in our hospitals and refuse to expose themselves and their newborns to the uncaring “protocols” created in hospitals to justify their skewed methodology. Home birth clients are significantly better educated about birth and healthier than the general population. Alas, these are all things hospitals have done a magnificent job keeping from the public.
Joy

I’m a proponent of midwife-assisted, low-risk home births. My first labor was attempted at home with a Certified Nurse Midwife, and ended up transported to the hospital: I had lost my strength after pushing for six hours. My midwife knew a doctor who was friendly toward midwives, and he agreed to come in early and pull out my daughter by suction. My baby was never in danger, her heart rate never dropped, and she scored perfectly in the post birth APGAR test. I credit this successful vaginal delivery to my excellent midwife, for I believe that otherwise, I would have had a Cesarean section.

My second daughter was born successfully at home last summer. I had a lay midwife (the former had moved) and felt very confident in her ability, but more than that, I was confident that she knew her limits. My oldest daughter was present for the delivery, and the bond between these two girls has been strong. I’ve never seen two children as close and affectionate, and I credit the home labor and birth, along with the care and preparation by my midwife.

There are certainly incompetent midwives out there, the same way there are incompetent professionals of any field. The important thing, I believe, is for the parents to do their homework, become informed, and choose a midwife who may not have all the slick answers and quote all the stats, but knows what she can do, knows that well, and knows when a situation is beyond her ability.

I am certain that if not for my two wonderful midwives, I would have had two C-section births. My midwives allowed me to carry my babies more than 2 weeks post date, while monitoring the baby closely, believing that when things were ready, they would come. My labors were prone to stopping, and they took this as signs that things needed to rest, and so never rushed me. My second child came 8 days after contractions came strong and regular, with another 6 hours of pushing. These things, and many others I experienced, would not have been tolerated in a hospital setting that is more concerned with convenience for the professionals than my goals of natural, personal, intimate, family-focused childbirth.
Michele

I had three home births in 1988, 1991, and 1994. My first was with a nurse midwife, the second two with lay midwives. All were wonderful, positive experiences. I valued being in control of my decisions with an experienced woman in a setting that I was comfortable in.
MomAgain

We’re choosing a Midwife assisted birth at a hospital. Though technically we’re considered high-risk. We’re being seen by a Perinatologist and the midwife will deliver us at a high-risk pregnancy hospital (Winnie Palmer in Orlando, FL). The best of both worlds.

My last delivery was natural but at a hospital as well. Unmedicated and the nurses did most of the work.
- Caroline Wise
  
  The nurses always do most of the work. Before I had my own homebirths I observed as a doula that the dr showed up the last 30 minutes and the labor was run by the nurses. He gets paid and he is not there most of the time
Anonymous

I had two beautiful home births, one water birth on the back patio of our rural home on a sunny afternoon, the other inside that same home. It is worth noting that there is a culture of fear surrounding the birth process in this country, rather than viewing it as a natural process. Women are not generally taught to listen to their bodies and intuitive selves, thus removing themselves from the entire process. The medical industry in many ways creates a sense that birth is dangerous and risky. Obviously there are some situations and pregnancies that warrant extra care and monitoring, but home birth midwives are highly skilled and intuitive professionals who are trained to transport to hospitals when necessary. I respect that each woman should choose where and how to give birth depending on her own comfort level but it makes me sad when a woman with a perfectly normal, healthy pregnancy displays so much fear of the pain or the “what ifs” that it clouds her openness to fully experience the pregnancy and birth process.
Karenkoltrane88

I started my pregnancy in a way most traditional American’s do, with a Certified Nurse Midwife who worked in a hospital, visits were short and I felt no connection to her whatsoever, once she told me that she has every other weekend off and might not attend my birth I had serious anxiety about someone I had never met delivering my child. I was scolded when I told her two weeks before my due date I was choosing to do a home birth. I found a Midwifery with two of the most amazing women who took me in their care with a loving attitude.
My first son who is now 14 months old was born at home here in Portland, OR. My labor was long and extensive for 50 hours pushing for 2 1/2, not once did my baby’s heart rate drop, it was long and painful but the best experience of my life, I was in the comfort of my own home with the comfort of all of my things and loved ones with amazing midwives and a doula who were non intrusive. It was something that I feel proud about and feel no shame telling other people my story! Usually they are amazed, but I simply tell them it is what women are made to do! Of course there are rare occasions where intervention is needed and for that I am thankful for modern technology, but in my case, I would never choose to admit myself into a hospital unless it were a life or death situation.
Steph, Indiana

Just a quick note to say that it’s not only CPMs who attend home births. Certified nurse-midwives do, also. CNMs are trained first as nurses and then go on to, essentially, earn a master’s degree in nursing specializing in midwifery. Either way, midwifes are highly skilled and trained and are – usually – far better qualified to attend healthy women than OBs are. HOMEBIRTH nut here! Two myself (VBACs, nonetheless) and assist at as many as I can get to. Teach CBE too for OOH birthers.
- Billfightr
  
  Unfortunately, hospitals usually threaten CNM’s with loss of privileges if they perform home births. In my wife’s case, they threatened EVERY doctor in our area with loss of privileges if they had anything to do with a Home Birth Midwife. This despite PA state regulations that plainly allow for it.
  Husband of former CNM
Kathy

I had my second child back in 1968 at home in Cambridge, England. My first birth (a year earlier) had been a normal hospital birth in the US with an epidural anaesthesia and a routine episiotomy. (ugh) I was 20 and I didn’t know any better.

At the time of my second child’s birth the National Health Service in Great Britian would not allow a healthy woman who had already had a normal childbirth to go to a hospital. I had no choice but to have my second at home in our student apartment with the district midwife in attendance.

The preparation was top rate. They made sure the apartment was ambulance accessible and clean. There was fabulous training in natural childbirth and pain management methods. They made sure we had a telephone for the midwife to call the hospital if needed. (We did…a pay phone in the shared Laundry Room.)

The midwife arrived on her bicycle. 2 hours later we had a lovely 2nd son. That night I felt so full of energy that I got up and cooked supper for our little family. I had two more children after this, both in US hospitals (I ask myself why.) None of the other three births came close to having the magic of that second birth in our little bedroom. It was the greatest day of life.
Kristendc

As a health care provider who works closely with midwives both in and out of hospitals, and as a mother who has had both a hospital and a home birth, I am grateful that options are available to women to birth the way they want to in a safe environment both in the hospital and at home.

Unfortunately, hospital birthing has become more and more dangerous as the ability to intervene has become more popular. With Cesarian rates as high as 50-60% in some hospitals and with the U.S. average hovering around 33%, the risks of birthing in the hospital have greatly increased. Women who trust in their body’s ability to birth are afraid of getting into the intervention cascade (epidural, pitocin, c-section) which greatly increases their risks from infection to even death. Yes cesarian sections are sometimes very necessary (in the case of distress, malposition, rupture, infection etc. – all of which a midwife is trained to recognize) but hospital births have lost touch with necessity for convenience sake. Recent studies have even shown possible increases in ADHD and pitocin use. http://www.ncbi.nlm.nih.gov/pubmed/21527574 As a society we are intervening more and more in a natural process with sometimes unseen and dire concequences.

Having experience both hospital and home birth, I was pressured at the hospital to have intervention even though I expressed from the beginning that I did not want any unnecessary intervention. I had to fight my nurses to not have drugs and to move around during my labor. I had to fight to prevent intervention. Unfortunately, so many people are of the mind-set to “do what the doctor/ nurse says” that they do not fight for their rights and end up in with a surgery that could have been prevented. Studies show that the cesarean rate increases for each additional intervention implemented during labor and that induction leads to a 44% higher rate of cesareans.

With my home birth I did assume risks that could occur either at home or in the hospital. I trusted that my midwife was trained and could recognize any risks that would necessitate a transfer to a hospital. I also educated myself more thoroughly to recognize any risks I might incur, which I see with most home birthers. I recently had a client who had a partial placental abruption. Her midwife recognized the problem over the phone and had her to the hospital and in the ER in less than 15 min (less time than it would have taken to actually reach a doctor by phone.) She is doing great, and her midwife probably saved her life. Recent studies also show that home birth for low-risk women is as safe as hospital births.

With any thing we do, there are risks. Each of us has the opportunity to educate ourselves and make our own choice. I’m glad to see more and more women choosing to trust their body without intervention or unnecessary treatments for a natural process.
- Joy
  
  I appreciate your approach here. I, too, am grateful that there are options out there for people who look for them. Many people told me I was brave to have home births, especially with my first (see above stories), but I felt that it would take more courage for me to face professionals and strangers in a medical setting. Giving birth at home seemed to me like the most normal and natural thing in the world, though I realize many would feel much safer and more secure with doctors in a hospital.
  
  I think if everyone shared their birth stories, we’d realize that each
  one is unique and unpredictable, and we can never know what would have
  really happened if we’d chosen different modes.
  
  All this to say, the debate seems endless to me. Everyone will have their preferences, and who can say one is better than another?
  
  I noted one listener who commented about people choosing home birth because it is a popular thing to do, and are poor candidates for it, for whatever reason. This is unfortunate. I think the responsibility belongs to the parents, but also to the midwife to be more concerned with making sure her clients are responsible and prepared than improving statistics or making money.
RRow

I had two wonderful homebirths. Once at home and the other in an apartment. Once with a lay midwife and once with a homebirth doctor. Both of my babies were “overdue” and wonderfully healthy after my 12 hour labors without any interventions at all. The midwives and nurses knew exactly what to do and were very knowledgable! I am sure, just like with doctors, there are some out there that do not know what they are doing, so I guess the trick is finding the ones that do. I wouldn’t plan giving birth any other way unless advised by my midwife to do so. They were wonderful!
Anonymous

Back in 1998 one of my housemates chose a homebirth. The midwifery team was very involved in the process and the head midwife was also a Registered Nurse. My housemate went to regular appointments and checkups. Came the time of birth, everything was in place. Everyone save for mom, dad and auntie was banished to the downstairs during the process. So, any news of the birth was filtered down from auntie. I went to sleep and had troubled dreams of soggy floors, caved-in piping and flooding (our downstairs was a basement which frequently flooded). I woke up to one of my housemates — a tough guy who had done some jail time –declaring that he had a bad feeling about what was going on upstairs, and began to cry. Turns out the baby’s heart stopped beating. It took almost 2 hours for my housemate to give vaginal birth to what turned out to be her stillborn son. The paramedics and the police visited our home, presumably to verify the stillbirth. To this day, I’m still not sure what caused the heart to stop so late in the gestational process.

This tragedy gave me some pause towards my fervent support at the time for homebirthing. I have no doubt that mom’s hospitalization would have had a better chance at saving the baby’s life. Alas, some things are just meant to be (or in this case, not be). As long as everyone involved knows the inherent risks and are prepared for the worst-case scenario, I’d still but cautiously recommend homebirthing.
Drkmu

Number one reason not to have your baby at home: traffic!
- travelinveggiemama
  
  Not if you plan…my partner picked out and drove multiple ways and various times of day to 2 different hospitals in case we needed to transport *at any time*. This was before Google maps and online traffic reports.
  - Drkmu
    
    Pretty difficult to “plan” not to have your baby during rush hour.
    - FollowingafterJesus
      
      What about a planned hospital birth and being caught in rush hour traffic? I think it would be much safer to have a home birth planned in this situation, since transfer is highly unlikely- however, in this unlikely event, you can call for a police escort or ambulance if worse came to worse!
BabyRN

I am a NICU nurse and chose to have a home birth. I knew all the risk factors having seen first hand the “home birth disasters”. Having had a doctor deliver my first child and a midwife at the hospital with my second, I knew I wanted a different experience with my last child. My husband, a police officer and medic, was completely against me giving birth at home. Luckily, he loved our midwife, who happened to be our neighbor and learned to trust her. The day of the birth was the most beautiful day in our lives. We were surrounded by my friends (all NICU nurses too) and family. When my son was born, he did need some oxygen briefly to help him perk up. Other than that, the birth was amazing. My husband loved the whole experience and brags to all his friends how fantastic the whole thing was. When I meet other nurses and doctors who gawk at me for having a home birth, I simply explain to them that women had been giving birth at home with midwives for centuries and giving birth is natural process and not a medical condition. I consider myself lucky to have experienced a home birth.
Mickey

My husband and I chose the home birth option. I enjoyed listening to your interview today, and then reflected for a while on our four births, in 1978, 80, 82 and 1985. While I knew lay midwives and couples who went to them, we decided to work with a family practice group run by Dr. Mayer Eisenstein.

My husband had a bit of mistrust of the medical world in general and I felt my feminine potential for natural birth was just as strong as millions of women before me. Our doctors’ philosophy was to educate and empower us to take responsibility for ourselves and our childbirth. Of course, I was screened for possible problems and would have accepted their advice if I wasn’t a good candidate.

Each of the four births was unique and perfect for us. Sometimes there were quite a lot of people with me, but then, one daughter arrived so quickly only my husband, the two older sibs and my mother-in-law were with me. With each birth, I felt more powerful as a woman and more confident in my ability to birth my baby. I always listened to my doctor and midwife, but I never failed to listen to my body and my inner wisdom.

With proper pre-natal screening and joyous, thorough preparation, home births could and should become the norm in America. Here in Chicago, we’re lucky to have the pioneering Dr. Eisenstein and his Family Practice, Unlimited leading the way.
Amber

I am a college-educated mother of two living in Bozeman, MT. I had both my children with a CPM. My son was born at home and my daughter in a birth center. I can not say enough how wonderful and amazing both my experiences were. My husband and I absolutely loved our midwife. Her knowledge of childbirth and the nine months before and eight weeks after (I’ve even called her in the past year) is deep. She did an awesome job reassuring us and informing us every step of the way. I would absolutely not trade my home birth and birth center births with hospital births. Most of my friends who had hospital births have unpleasant if not downright scary stories of their childrens’ births. Midwifes and home births are, in my opinion, the best way to bring kids into this world.
http://www.facebook.com/profile.php?id=100000196699684 Eva Mergen

Thank you beyond measure to Robbie Davis-Floyd for saying all of the things that I wish were said every time I hear reports on home birth!!�
My mother was born at home in the 1950′s. I was born at home in Atlanta in the 1970′s when my mom thinks that it was still illegal. And, I went on to birth both of my children at home. With my first, I had an incredibly competent and well educated midwife who came prepared for everything with four hockey-size bags full of equipment that she kept wonderfully hidden. With my second, the same incredibly competent midwife arrived at my home moments after my son was born because the end of my labor progressed so much faster than anyone, including me, expected. But everything was fine and it was so great to have my midwife completely unphased by the fact that the baby came before she did. She just swept in and immediately took care of everything and praised me and my husband for how we handled it.
Jessica Leake

I birthed my first at home. It was hard and I even scared my midwife a bit but we birthed a healthy and happy baby. My midwife and my mom (a nurse) said if I had birthed like that at a hospital they would have definitely intervened…and probably not in a way I would have wanted. My second I planned on a home birth but I allowed fear and pain get in my way. We made it to the hospital and I delivered my baby boy in the exact amount of time my midwife said I would and without any drugs or other medical interventions. However all my hospital fears were realized as they wisked my son away from me and started a long nightmare. Praise the Lord he is fine now! (births were 2006 and 2009) I plan to continue to birth at home! It’s a wonderful experience and much better for mom and baby.
http://twitter.com/PorterOnSurg Chris Porter

To me, home birth seems a spiritual choice which increases the risk of death or anoxic injury to the infant. The risk may be small, but some emergencies occur at the moment of delivery and aren’t predicted during labor. Having delivered children vaginally and by C-section, alive and dead, in developing countries and in the USA, I have great trouble giving the green light to home births to my friends seeking advice.

However, like religions which prohibit blood products during surgery, I respect spiritual choices.
- Joy
  
  My two home births had nothing to do with spirituality.
  - http://twitter.com/PorterOnSurg Chris Porter
    
    I’m curious, what drove your decision?
Kathy

I wrote in earlier today about my wonderful home birth experience back in 1968 in Great Britain, where hospital births were not allowed by the National Health Service for healthy women who already had a child

For brevity, I decided to keep my comments brief and positive. However, after reading some of the pro-hospital comments, some by doctors, I feel the need to weigh in with more of the story.

I mentioned that I had 4 children total, one at home in the UK and three in hospitals in the US. Let me tell you about the birth of my fourth child in 1985 at one of the pre-eminent Boston teaching hospitals on a hot summer weekend night.

My doctor (from a Managed Care Health Group named Harvard…) was on vacation. So were his colleagues. We arrived at the hospital well into labor (4th children come fast). The chief resident looked at me and said : “Oh it looks like you know the ropes here” and turned me over to an intern and some nurses. While checking for dilation, the intern inserted a fetal monitor when my husband had left the room for a moment. I had asked for no intervention.

Suddenly, she said that she had to go to the Emergency Caeasarian that was occupying the Chief Resident. While she was gone, our baby was born fast in a rush of blood which I later realized amounted to a hemorrage. She was fine, beautiful. I guess someone was there to look after the afterbirth but in retrospect they were not looking too closely.

My husband stayed in my room until midnight and left for a few hours at home to look after our other children. The baby was in a bassinet beside my bed. Someone handed her to me at some point during the night and then left me alone with her. I started to feel faint and nauseous. It took all my strength for me to hold on to her and place her back into the bassinet…all alone. Then I got up to go to the bathroom. Blood started to pour out of me and I collapsed onto the bathroom floor. In a little while a nurse or orderly came along and found me and said that all this was normal. The next morning I asked my husband to take me home and they discharged me and the baby.

I was so happy to be out of that hospital but it was not over. Two days later, I had to take the baby back to the offices of the Managed Health Plan because of a blood test she had missed on account of the weekend discharge. While at the Health Plan, I used the Ladies Room and a huge piece of what turned out to be retained placenta came out. I did not know what it was so I wrapped in some toilet tissue and had to take it to the Pediatrics reception desk. They called someone from Obstetrics, one of the doctors who was unavailable several days earlier, when I had given birth. He took my temperature, proclaimed that I had a serious uterine infection (hospital, fetal monitor…hello?) and told me he needed to call an ambulance and that I would need to call my husband who needed to take my three day old baby because she could not re-enter the hospital with me. I asked about my breast feeding and they said that was secondary at this point.

Well, maybe it was a risk but I refused to go and my husband arrived to back me up as did my teeenage son who had driven me to the doctors office. The doctor left for a while to consider his options (call the police?) and they said they would give me drip intravenous antibiotics if I would sign a release statement.

What followed was about 24 harrowing hours. At home wondering if the fever would build or subside, at least holding my baby, I was aware that this was the classic “childbed fever” which, before antibiotics, was the major cause of death at childbirth.

I recovered but not without a tremendous loss of energy which took months to recover. And not without a profound loss of faith in the supposed best-in-the-world Boston medical establishment.

Uterine infections are nasty (formerly fatal) childbirth complications. The clear culprit here was a combination of the fetal monitor (unnecessary in this case), the retained placenta (which any good midwife would have recognized), and the fact that I was an older woman (40) with a little high pressure giving birth (which went so unnoticed that the birth was delegated on a hot busy summer night to an intern).

Give me a good home birth with an omni-present midwife any day. By the way, when I wrote the hospital to tell them of this experience, they asked if I wished to submit a claim. If I would sign a release they would agree to hear my version of what happened.

My goal in life is stay out of hospitals as result of this experience.
Woozlemom

My first child was born in a hospital and because the labor didn’t fit their idea of how fast labor should progress, I was given pitocin which caused a placental abruption. I hemorrhaged and my son and I were close to death. Due to that, I was warned that my second pregnancy was high risk. I spent the pregnancy frightened. The labor started and this time my body was in a hurry. We did go to the hospital, but things progressed so quickly that there was no time to interfere with the labor and my son was born easily and with no complications. When I became pregnant the 3rd time, my OB/GYN immediately preached doom and gloom because I was a geriatric mother (all of 35!). I became disgusted with a natural process being made a disease, so found a nurse/midwife who actually listend to me. My daughter was born at home in 1999. It was the fastest and least difficult birth, despite her being a full face presentation and my largest child as well. We were out visiting the neighbors less than 24 hours later.
http://www.facebook.com/nicolle.littrell Nicolle Littrell

I am so glad that this report is getting covered in so many outlets–because it means more women will know more about the choice to have a homebirth, which has tremendous benefits for moms and babies. And it is always great to hear Robbie speak–who has contributed so much to body of knowledge about homebirth and midwifery care.

I had a homebirth with my son in 2004 in Montville, Maine. My experience was so transformative, so empowering that I now make documentary films about it. My current project is “At Home in Maine” and features 11 authentic, artistic portraits of the homebirth experience. All of the films are accessible online: http://www.mainehomebirth.wordpress.com

Not just for Mainers–and not just about homebirth. “At Home in Maine” provides a picture of normal, natural, woman-centered birth–something that every woman deserves access to.
Homebirth Midwife

I am a homebirth midwife in the state of California, licensed by the Medical Board of California. I also am a CPM, Certified Professional Midwife through NARM.

I feel the medical community and the general pubic focuses on midwives regarding the issue of homebirth instead of accepting the fact that its a natural born right for a woman to give birth where and with whom she chooses. She along with her family have made this choice. Do we still believe women are not capable of making a proper, logical, safe decision for themselves and unborn children??

Why is this? Why should I, the midwife, be scrutinized for supporting women in achieving a healthy pregnancy through routine prenatal care, a safe and supported labor and birth at home while monitor mother and baby. As well as returning to the home for multiple postpartum visits to monitor that health continues for mother and child, if this is what SHE has chosen. Some women choose the midwifery model of care and do not see childbirth as a medical event. Women created midwives, why are we (midwives) not allowed to be apart of the fabric of modern health care??

As a midwife I do not shun doctors. As another human being I would not ignore a doctor, due to that fact while in a room of maybe 4-5 people, doctor included. Again I ask why is this? When I seek to transfer or transport care seeking medical assistance I am treated with such disrespect and disdain its alarming. Doctors and midwives could work together for the benefit of the mother and child if our current health care system allowed for it. As well as the educational system that OB/GYNs go through. I do not understand why this barrier exist.

The state of California is under such economic strain that if the state reimbursed LMs, CPMs through Medi-Cal benefits the state would save at least $20,000 per family that was low risk and wanting a homebirth. In my area $17,000 for normal vaginal delivery (one hospital out of two), and I am uncertain what the doctors charge their Medi-Cal clients. I would assume 3-5 thousand dollars at least. Yes I understand Medi-Cal does not reimburse that much and its difficult to even get that reimbursement. That’s my point. My fee is $3,400 that includes antepartum, intrapartum and postpartum care. Thats a huge saving for the tax payers of this state. That’s affordable for the family that does not have medical insurance as well. Small business owners fall into this category, educated people fall into this category. Those numbers are increasing. Families are seeking out homebirth because they see it as a affordable health care option. They do not qualify for Medi-Cal or AIM due to their income level and their assets i.e. home and cars. Yet still can not afford health care insurance for the whole family. Can not afford to spend up to $20,000 + to have one child in the hospital under a doctors care when the mother is considered low risk and is aware of this fact. Its to expensive. I’m not suggesting we cut corners with our health care options, I am suggesting that midwives are a safe and cost effective option that SHOULD be accepted by our health care system.

I’m suggesting midwives be accepted because women seek us out. I’m suggesting that when we discuss this issue we remember its a woman choice. This is not a” midwifery issue”, this is not a “homebirth issue” this is a woman right to choose for herself and her family issue.
Anne Arthurs

I have had two children in a hospital, one by an OB/GYN and the second delivered by a midwife who worked for that same OB/GYN. If I’d had my first baby at home, I would have bled to death. I am not a risk-taker, and for me, having a baby at home seemed like a risk if something went wrong, which it did. I probably would have been fine having my daughter at home, but after the expernience with my son, I wouldn’t have dared. If women are having a bad experience at the hospital, the problem is the hospital or the doctor. I went to a hosptial where women are given as much freedom of movement as they wish, and can have as natural an experinece as they wish. Because of the OB/GYN/Midwife doctor’s office I chose, and the hospital I went to, I did not feel rushed, I did not feel I was on a time-table, I did not feel I had no control over what was happening. Everything was calm and explained to me. My son’s birth was horrible only because he was crooked and I tore when he was delivered, which was no one’s fault. I think if women want a more natural experinece but also want the safety of a hospital in case anything goes wrong, they should look into a midwife who is associated with a hospital. The midwife who delivered my daughter worked under a doctor who could have been called in if anything went wrong. Another alternative is a birthing center, which is not a hospital, but has professionals available and can tranfer a women quickly to a hospital in anything goes wrong. There are more of these springing up all over to accomodate women who don’t want to give birth in hospitals but want medical professionals around just in case. I believe many insurance plans will cover these. Every woman must make her own decision. For me, I know birth can be a risky business which is why woman in poor countries still have a very good chance of dying from it. I think it says something about how far we’ve come that women feel safe again giving birth at home.
Sandra

My partner told me about this article, and he compelled me to log in and write about our experience. Both our babies were born at home. I changed my mind about having our first in the hospital when I was 7 months pregnant. Best decision I’ve ever made! Birthing in my home my own way, has been the most beautiful, safe and empowering experience of my life.

The first, and most immediate difference was (and still is 3 yrs later) the availability of our midwife. If I have a question about my toddlers, or my female anatomy I still call my midwife first. She listens carefully to MY concerns without preconceived notions or prepared responses – she ACTUALLY listens, help me find underlying issues, and guides me to make an appointment with a doctor when necessary.

The second most important difference for us happened after the first birth at our first pediatrician visit. Doctor said baby did not need a hepatitis vaccine since she was born at home. I was a little shocked about that since I had read of its importance. For clarification he explained to us that yes, it is compulsory for newborns to have an immediate hepatitis vaccine in hospitals, but that is because hospitals are rampaged with hepatitis, and other infectious deceases.

Pregnancy & Birth are a normal part of life, not illnesses. It is unfortunate that the medical industry (aided by Hollywood), uses fear to cash in on birthing. Hospitals have a very important place to help us heal and manage illness. When a pregnancy is abnormal for whatever reason, that mother and child need to be treated in a hospital. Normal pregnancies on the other hand, are most safely birthed and (contrary to the televised myth), EVEN ENJOYED in the familiarity of home.
Liquid59047

I did not want to be “robbed” of the powerful experience of giving birth to another human being which is what I believe many hospitals & doctors do. I wanted to be a participant in the process for the reward of a rich and mind blowing experience which is why I educated myself in the birth process. But many women are afraid & not open to the idea because of the fear so, “take me to the hospital & take the baby out.” It is true an expectant mother needs an attendant who is knowlegdable in the process. I had a nurse practictioner/midwife who was prepared in all the techniques of “turning the baby” if in breech, prepared for everything except a c-section. the birthing process has become too mechanized even down to the scheduling of the birth when it is not an emergency but a convenience.

﻿Study Finds Home Births Increase By 20 Percent

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Study Finds Home Births Increase By 20 Percent