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Home births can be 'harmful,' journal says
July 29th, 2010
06:42 PM ET

Home births can be 'harmful,' journal says

Moms have a right to “choose how and where to give birth,” says an editorial from the medical journal Lancet, “but they do not have the right to put their baby at risk.”

A strongly worded editorial in the British publication,  “Home Births –Proceed With Caution” cites other studies that had found that “home birth can, after all, be harmful to newborn babies."

A recent article from the American Journal of Obstetrics & Gynecology showed that planned home births compared with planned hospital births doubled the risk of neonatal deaths, with breathing difficulties and failed attempts at resuscitation playing major factors.

But home births in the United States and European countries are increasing.

Vaginal births after C-section usually OK, docs say

The editorial continues to say that hospital delivery should be the preferred method of delivery for high-risk pregnancies and wrote that the desires of the mother and the health of the children “are competing interests that need to be weighed carefully.”

Do you have a story to share about home births?  Tell us on iReport.  Your story may be used in a CNN.com story.


soundoff (655 Responses)
  1. Sconstance

    The results of the study from it's abstract that CNN quoted above state the following:"Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates." I hate when an article doesn't give the entire picture. In the end, there were positives and negatives. I highly respect this journal and consider the article worthy of consideration and as a prenatal mom right now, I am choosing to have my birth in the hospital with my provider that I trust. However, after reading this article, I wouldn't feel any less or more concerned about someone having a home birth as long as they were within a reasonable distance of a hospital in the event that the newborn was having problems.

    July 30, 2010 at 09:16 | Report abuse | Reply
  2. DP2010

    There are many more studies that says there is no difference or, if there is a difference, HB has improved outcomes for the woman with the infant having identical outcomes. Come on, CNN, do more research than that.

    July 30, 2010 at 09:19 | Report abuse | Reply
  3. Court

    Seriously? Is everyone freaking out about these four tiny paragraphs? Did anyone read the journal article? Yep, I did. They had 9 studies that included 11,158 planned home births and 12,515 hospital deliveries (the article is from MAINE BTW). They found that while home births had a decrease in some things (intrapartum analgesia, episiotomy, c-section, operative vaginal delivery, less likely to experience vaginal lacerations and infections, etc.) There was a highly elevated rate of neonatal mortality overall in home births. They concluded that this is contributing to the increase in infant mortality in this country. Also keep in mind that articles in journals are peer reviewed by people not associated with the case before they are published to ensure validity. With this in mind, I'd rather not risk the life of my unborn child and will be going to a hospital. I am less concerned about my comfort than the health and safety of my child.

    July 30, 2010 at 09:22 | Report abuse | Reply
    • ATL CNM

      Actually, our neonatal mortality rate is so high (relatively, considering how much we spend on maternity care) because of our high rate of prematurity– due to high rates of multiples and due to the need to end complicated pregnancies early, and due also to social inequalities. Our rate of homebirth is not high enough to significantly impact the neonatal mortality statistic.

      My understanding about the deaths of babies in this study is that the babies who died at home died mostly due to problems (anomalies) that were incompatible with life (regardless of where they were born), and due to unplanned home birth– very different from home birth with a prepared, knowledgeable attendant.

      July 30, 2010 at 10:14 | Report abuse |
    • Holly, CNM

      Large numbers in a study, while appearing impressive, does not equal quality. Please see this statement from the American College of Nurse-Midwives on the many flaws of the ACOG study:
      http://www.midwife.org/documents/ACNMstatementonAJOG2010.pdf

      July 30, 2010 at 11:23 | Report abuse |
    • a

      A peer reviewed meta-analysis is the strongest statistical study possible; contrary to the statement put out by ACNM, I do believe in both the power (high number) and quality of this study. Also, it's in the best interest of ACNM to say that this study has less quality than it acutally does. The peer reviewed meta-analysis should have ltitle statistical bias.

      July 31, 2010 at 15:34 | Report abuse |
  4. Andrew

    Has anyone read the article? It clearly states that home births are an acceptable choice for low-risk pregnancies. Further, it pins most of the danger of home births on poorly trained midwives. It also is very clear about the negative effects of hospital births on mothers. "home birth seems to be safe for low-risk mothers and, when compared with hospital delivery,
    is associated with a shorter recovery time and fewer lacerations, post-partum haemorrhages, retained
    placentae and infections," Both my sons were born at Hospitals but with a midwife. Both times the midwives were nurse-practitioners. We chose this combination to give us the birth we wanted and what we saw as the safest route for our children to come into this world. And as for teh perceived safety of hospitals over homebirths..."—a recent study from
    Scotland showed that rates of neonatal death are higher in hospitals when births occur outside normal working hours."

    Also, please recall this is a micro look at the issue of birth. Consider this...the United States spend smore money per child on births in the in world and yet has the highest rate of child mortality in the industrialized world. I highly doubt it is the 1% of home births that make up that startling fact.

    July 30, 2010 at 09:23 | Report abuse | Reply
    • Sconstance

      Amen!!!

      July 30, 2010 at 09:29 | Report abuse |
    • Pirogi

      Interesting, all the controversy over that 1%, isn't it?

      July 30, 2010 at 11:18 | Report abuse |
    • K

      When it comes to the contents of someone else's uterus, there is no percentage tiny enough to convince Americans that it's not their highly significant personal business.

      July 30, 2010 at 17:18 | Report abuse |
  5. Desi

    I'm on my third pregnancy, and there is absolutely no way I would give birth at home. I really could care less about my own "personal enjoyment/fulfillment" or "positive experience". All I care about is making sure that baby gets out okay and has immediate access to monitors, a ventilator, proper medications, and neonatologists. Baby comes first!

    July 30, 2010 at 09:24 | Report abuse | Reply
    • hbmindy

      I absolutely agree with you Desi, that baby comes first. And that is exactly why I would choose a homebirth over a hospital birth. Lower rates of injury. Lower rates of neonatal death. Lower rates of infection, extended hospitalization. Higher rates of successful breastfeeding. Please don't assume that homebirthers are putting their comfort first. Most of us have done a thousands times more research than the typical hospital birther and we know that home birth is safer. That's why we make the choice. Not to be cool or natural or crunchy, but because it's what's best for our babies.

      July 30, 2010 at 09:47 | Report abuse |
    • Desi

      You know Mindy, I completely respect your choice. However, I PERSONALLY, would not give birth at home. Either I'm just too paranoid, or my two previous vaginal births in the hospital weren't so bad. I was out in 24 hrs with both and breastfed both my little ones for 15 months each. I never felt pressured or threatened by my docs or nurses. Obviously, this is purely an issue where women just need to be allowed to make their own choices. Nothing I say will ever change your opinion, and nothing you say will ever change mine.

      July 30, 2010 at 10:30 | Report abuse |
  6. Jennifer

    As a pediatrician, I can't tell you how many births I've been called to attend where there were absolutely no indications that anything was going to be amiss. Things can happen so quickly that even if you have a contingency plan for what to do at home if something does not go well you may not have the equipment (deep suction, intubation equipment, cardiovascular drugs) that can be required within 2 minutes of an infant being born. The NRP, which is the official program taught about neonatal resuscitation requires different interventions depending on an infants' response to therapy every 30 seconds. Do you really want to be making those kind of life or death decisions in your home? That being said, ALL newborn infants should receive a vitamin K injection at birth because neonates are at such a higher risk of hemorrhage for a variety of reasons. Is this being done appropriately at home births? I'm not trying to be the health care police, and I am completely for people making informed choices about their health care and their birthing experience, key word being informed.

    July 30, 2010 at 09:29 | Report abuse | Reply
    • Max

      Exactly... but most of these folks aren't really looking to be informed... they're just looking for evidence to support their "gut feeling" to be a "natural" woman. They view labor and delivery almost like a tribal rite of passage... and I really think they look down on women who choose "interventions".

      July 30, 2010 at 09:45 | Report abuse |
    • DP2010

      Not all newborns need Vit K injections. My midwife is making sure I eat greens before the birth, but the main thing to prevent neonatal hemorrhage is that preemies get delivered in hospitals if the mother can make it.

      July 30, 2010 at 10:16 | Report abuse |
    • Peter

      Max,
      You have no idea the countless hours my wife and I spent researching statistics on birth, complications with birth, different scenarios for birth, and birth outcomes before deciding to birth in a midwifery instead of a hospital. For you to be insulting toward everyone on this blog who sought a different, SAFE experience is not helping the debate.

      Statistics show no difference in birth outcomes for LOW-RISK pregnancies between hospital, home-birth, and birthing center settings. Every woman I met at the midwifery at which we birthed was INSANELY informed about their birth options, and most were dead-set on having a HEALTHY PREGNANCY (diet and exercise), which drastically reduces the risk of complications.

      July 30, 2010 at 10:38 | Report abuse |
    • midwifinn

      Help us, good doctor, with our risk/benefit analysis. What is the statistical probability (using numbers) of a baby being born after a physiologic birth (no AROM, no pitocin, no drugs, no mom on back causing poor placental blood flow, no immediate cord clamping which reduces blood flow to the lungs for first breath) with good reassuring fetal heart rate before birth who needs resuscitation but does not respond to resuscitation ventilations and even heart compressions, thereby requiring cardio-stimulating drugs in the first 2 minutes of life? That is one side of the risk equation. (Risk of home birth) The same baby born in the hospital also has risks: Risk of cesarean birth if low risk: 20% - times increased risk for wet lungs requiring resuscitation and higher risk of NICU admission. Risk of induced birth if low risk, estimated 20% - times increased risk for fetal distress from AROM, pitocin, maternal supine position when stuck in bed on the monitor. Risk of epidural (80%) times increased risk of maternal hypotension leading to poor placental blood flow caused by epidural... All of these "routine, normal" interventions in hospital care are independent variables for newborn resuscitation. (Risk of normal hospital birth) What number here? I hope that you see that the risk of the baby needing advanced resuscitation at home is exceedingly rare, very unlikely, virtually nonexistant, (supported by the research article, above) yet you base your argument against home birth on this. The likelihood of the baby needing advanced resuscitation in the hospital is not that unlikely. Good thing you have the knowledge, skills and equipment to manage this complication caused by routine hospital care.

      Which brings me to my second point, Informed consent. Does that actually occur in the hospital? Lets use elective cesarean as an example: 4-7 times more maternal mortality, increase hysterectomy, infections, adhesions, newborn resuscitation and NICU admissions, next pregnancy - increase stillbirth, uterine rupture, life threatening placental adhesion (accreta, percreta), additional cesarean births. And we are told that women's choice is driving up the cesarean rate? Informed consent for induction - are women told about risk of prematurity with inductions? The comments on this site are enough evidence that women won't do anything they perceive as dangerous for the baby. So why are "elective" cesareans and inductions increasing? We all know that informed consent in most medical settings consists of giving women information in a manner to manipulate them into the provider's desired course of action. The most agregious, "well, you know your baby could die... Many women are on to this and choose home birth because home birth providers philosphically believe in shared decisionmaking, providing information that empowers women to have choice in their care. So as to Vitamin K, I have found that with good informed consent based on AAP sources, about 15% choose injectible Vit K, 75% choose oral preparation (you probably don't offer that choice), and 10% decline. What is your rate? If it is 100% injectible vitamin K, it is highly unlikely you are giving women/families informed consent. So that is another benefit of home birth - individualization of care.

      July 30, 2010 at 10:57 | Report abuse |
    • Holly, CNM

      Certified Nurse-Midwives are trained and proficient in NRP. At my practice, we carry two oxygen tanks, full intubation equipment for mom and baby, and even a kit for umbilical line placement if necessary. We have two well-trained birth assistants (STABLE and NRP certified) and one midwife at each birth so there are plenty of hands in the uncommon event of an emergency. With the appropriate equipment, as we have, NRP can be carried out anywhere.

      July 30, 2010 at 11:30 | Report abuse |
  7. mary

    I had 3 home births, and 2 of them came with complications. However, I never felt I should have been in a hospital.
    My midwives were skilled and attentive, and they handled those complications very efficiently.
    I would not say home births are both better and safer than hospital births, but I can say is that no matter where you are, it is the competence of those assisting you that will make a difference.

    July 30, 2010 at 09:29 | Report abuse | Reply
  8. midwifinn

    The AJOG article is not available to the public to read and analyse, so you are left to trust the headlines. The article actually states that there is no difference in newborn death rates when comparing low-risk home and hospital births, when those births are attended by certifed or certified nurse midwives (end of results section), and home births have "fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation." This result was the most significant finding for North American women, yet is was not part of the discussion or abstract. The result of increased rates of newborn death that were reported in the abstract come from studies that are "confounded" by including unplanned, unassisted home births, which are inherently risky. An unbaised researcher would have to conclude that the benefits and safety of homebirth are significant. Unfortuately, this study shows the lengths medicine is willing to go to further its political-economic hedgemony - even to the point of compromising science. The article was rushed to online publishing so that it could influence a legislative movement in NY which would allow midwives to work more independently. The Lancet editorial, from Britain, is more balance, though the headline again is misleading. The point is there is enough quality data to conclude that women should be supported in the choice of place of birth - home, birth center, or hospital with qualified birth attendent. Furthermore, there is overwhelming data that practices that support physiologic birth (normal, natural, optimal, or what ever you want to call it) are much healthier for mother and baby. When low-risk women give birth in locations were medical interventions are readily available for higher-risk women, it is more likely these interventions will be used also for lower-risk women without medical benefit and possible medical harm. Said another way, in the risk/benefit analysis, these interventions have the potential for adverse side effects without much potential benefit because low-risk women/babies are at low risk for harm simply from birth. This is why women have their babies at home with midwives. They want to avoid the iatrogenic risks of inappropropriate intervention in birth that frequently occurs in hospitals (such as unnecessary induction or cesarean), besides all the psychosocial benefits. 80% of women are low risk and will benefit from low-intervention care, and screening is the method that identifies the women/babies that will benefit the most from medicalized care at birth. The urgent emergencies in low-risk physiologic birth are rare, and qualified attendants are skilled and have equiptment for managing most complications including identifying fetal stress, controlling hemorrages, and newborn resuscitations. Transport to hospitals are rarely emergencies, and provide the safety net when women are screened as needing medcal care.

    July 30, 2010 at 09:32 | Report abuse | Reply
    • Max

      I see this same argument over and over again... You say homebirths reduce frequency of all these maternal interventions. But Mothers who choose to endure homebirths are also more likely NOT to choose these interventions. It's not because homebirths are healthier... it represents a trend in maternal decision making. You also make mention of low birth rates, prematurity.. etc. These are all factors that would indicate a higher-risk pregnancy... which makes a hospital birth more likely. Again it does not reflect that homebirths are healthier... it indicates a trend in what type of pregnancies usually ALLOW for a homebirth. I really feel like homebirthers have such a holier than thou attitude. Ok you chose homebirth... congratulations... now leave me alone.

      July 30, 2010 at 09:39 | Report abuse |
  9. Max

    Everyone wants to be so earthy crunchy natural happy these days... just because something is natural doesn't make it good. Cancer is natural, earthquakes, tornados, and hurricaines are all natural... just the whims of loving mother earth. People need to make educated decisions about what to do, and I quite frankly don't have any understanding of why you would want a homebirth, away from all the medical supplies and personnel you would need if something went wrong. It SHOULD be the parents' decision of what to do... but this is from a British journal, where there is socialized medicine, and the next logical step in a socialized society is to take those types of decisions away from individuals.

    July 30, 2010 at 09:34 | Report abuse | Reply
    • rbnlegend

      If you don't understand why someone would want a homebirth, you don't understand the birthing process and the medical interventions that are common.

      Under socialised medicine, british women have more options than american women. Not fewer. In many states in the US, if you give birth at home, you MUST do so without medical assistance, by law. They can't stop you from giving birth at home, but they can make it illegal to plan to do so in a responsible supported manner. Many birthing options are restricted or prohibited in various states in the US, that are routine options elsewhere.

      July 30, 2010 at 11:19 | Report abuse |
    • midwifinn

      Wow, Max, it seems illogical to you that a discussion thread about the safety of home brith would actually be about the safely of home birth. No one is saying that you should have a home birth or pushing it down your throat. ISo you find it hard to get that quality scientific evidence supports women who would like that choice (for both safety and psychosocial reasons) and that our health system should be organized to support home birth choice. Your analogy about natural disasters and birth thousands of years ago is beside the point and clues me in that you don't really care to think about birth sytems and their problems/solutions in the 21st century.

      July 30, 2010 at 11:27 | Report abuse |
  10. BlackCat930

    I am really struggling to understand the modern world's view on child birth. Where do you think women have been giving birth for THOUSANDS of years?????? Up until the past, say, 60ish years women having been giving birth, gasp, at home!!! Modern medical professionals have scared women into thinking birth is a bad, horrible, thing and that they need to be drugged and cut open for it to be done properly. Like, I get it, there are risks for a newborn baby. But those risks are there no matter where the baby is born. A woman should make an informed decision based on her prenatal care whether a home birth or hospital birth woul dbe best for her and the baby. This stuff just kid of makes me sad.

    July 30, 2010 at 09:37 | Report abuse | Reply
    • Max

      Mothers and babies have also been dying at homebirths for thousands of years. A study that shows hospital births leads to less infant deaths makes you sad? Why? If you want people to make informed decisions... shouldn't they be... GASP... informed?

      July 30, 2010 at 09:41 | Report abuse |
    • Not All Docs Play Golf

      Have you not recently been to a more modern birthing center at you local hospital system? It's not like the old days...very home-like private rooms where babies are delivered with family around just like at home, but with available modern care if something goes wrong. I suggest you go educate yourself by touring one of these newer facilities, and quit romanticizing about the middle ages with its high mortality rate for both mom and baby.

      July 30, 2010 at 09:47 | Report abuse |
    • Tess

      Max, yes women were dying more back then, but women nowadays also take better care of themselves! Problems don't only arise during labour. If you don't take care of yourself during your pregnancy (like they did in the past) then you will have most likely have high risks no matter where you give birth. It's stupid to think that all problems in the past occurred simply because women were at home rather than a hospital. If the solution is as simple as giving birth in the hospital (as oppose to at home) then we have been wasting our time these last few decades in understanding prenatal care. Your simple logic is flawed. The day you give birth, then you can dictate where it should be done

      July 30, 2010 at 13:32 | Report abuse |
  11. Not All Docs Play Golf

    As a physician, I don't know why anyone would not want to take advantage of available higher-level care. Historically, peri-partum mortality was high for both mom and baby before more sophisticated care became available. Then people romanticized home birthing with the advent of "midwives." It seems to appeal most to the alternative medicine crowd. But if something goes wrong ( and it can go wrong quickly and unexpectedly) I'd rather be in a setting where advanced care can be rendered if needed. We live in 2010, not the 1400's. We have evolved. And, besides, most inpatient birthing centers in hospital systems are extremely "home-like" today as the system has responded to this wish. Go check out your hospital's latest facility, it's not like the old days. Babies are delivered now in the same home-like room with family around, no rushing mom off to a separate "delivery room" like in the past, and yet if it becomes necessary, the full complement of technology is readily availabe. So when that best of both worlds is available, why would you not want to take advantage of that?

    July 30, 2010 at 09:43 | Report abuse | Reply
    • Pirogi

      1. There was no "advent" of midwives. Midwives have been around since humans began to birth babies. There WAS an advent of obstetricians, however. The first obstetricians were barbers. Yep, the kind that cut hair and shave faces. Midwives were shunted out of birth as obstetricians became more powerful. "Rediscovery of midwives" would be more accurate.

      2. Yes, obstetricians provide higher-level care. That is the point. Contrary to our current statistics in the US, 1/3 of birthing women today don't require cesarean section. They don't require machines, or doctors. When something does go wrong, THEN your services are required, for higher-level care.

      3. Do you honestly believe that womene "evolved" over the last hundred or so years (since birth began to occur in the hospital) to not be able to give birth without obstetrical services? We evolved over thousands of years TO GIVE BIRTH SAFELY, even if no one is there, the majority of the time. Yes, sometimes things go wrong. But evolution is firmly on the side of the birthing woman NOT needing medical care.

      July 30, 2010 at 11:14 | Report abuse |
    • rbnlegend

      You can put icing on a hamburger, it's still not a birthday cake. Putting up curtains and paintings and bringing in a rocking chair doesn't change the fact that the room is still in a hospital, with a doctor who wants to perform medical proceedures. He has the best of intentions, I understand that, and if things go wrong, you want that doctor there, along with the massive quantity of medical equipment on wheels around the corner. But suggesting that "look, we have curtains and a quilt" will trick an expectant mother into feeling like she is at home shows just how little you think of the women who are in your care. Anything to get her in the right place, under your program, to progress the medical event according to your expectations.

      That being said, some doctors and hospitals are great about respecting the mothers wishes and allowing the birth to proceed until and unless something does actually go wrong. The hospital we went to had a moderately high c-section rate, but the doctor we used had a low rate, and my wife escaped with little intervention. We did have to fire the doctor she was seeing when the pregnancy started, but that was for the best, in the end.

      July 30, 2010 at 11:27 | Report abuse |
    • K

      Doc, I'm a CNM and believe me, I am extremely appreciative of OBs. When you're needed, you are SO needed.

      But the idea that all hospitals are like the one you apparently work in is close-minded in the extreme.

      July 30, 2010 at 17:24 | Report abuse |
    • D'Anne

      So many things wrong/incorrect about what you wrote; and the others answered some. I will address this one:
      "Historically, peri-partum mortality was high for both mom and baby before more sophisticated care became available."
      As a historian, I can tell you you are wrong–historically birth has gone well without "sophisticated care". Complications the result of an unhealthy mom–or the introduction of the meddlesome male practitioner–something that has not changed and we pay for it. Oh, how we pay for it.

      August 6, 2010 at 00:20 | Report abuse |
  12. hbmindy

    This might be true, if hospitals and OBs did CAUSE so many complications. If all things were equal, if hospitals didn't push drugs and interventions, if they let women progress naturally, and if women could feel comfortable and at ease in a hospital, than a hospital might be as safe as home. But it's simply not the case. Laboring women in a hospital are under a great deal more stress than they would be in the comfort of their own home. They are under the pressure of the clock to get that baby out. If things deviate even slightly from the norm, in most hospitals, the cascade of interventions start.

    Home births are safer for healthy moms because labor is allowed to progress on its own. Interventions are kept to a minimum, so complications are far less likely.

    So many of the stories I'm reading here of moms who think having their baby in the hospital saved their life are just not accurate. In most of these cases, the reason their babies were at perceived risk is because of the interventions started in the hospital. Pitocin, induction, epidurals, infections, etc. The cord around the neck is a perfect example. This happens ALL THE TIME. Approximately 1/3 of babies have the cord around their neck. It's not a big deal. It's not going to kill the baby. It's natural and normal. Two of my three kids had the cord around their neck. The only one that had issues was the one with pitocin and an epidural. An already stressed mom and baby meant fear and panic for a slowing heart rate. My home birth baby with the cord around her neck was just part of the natural progression. Head out, slip the cord over, out she came. No biggie. But doctors and nurses practice in fear every day, so are constantly bombarding moms with "your baby would have died". Home births are safer.

    July 30, 2010 at 09:43 | Report abuse | Reply
    • Anne

      Not true. I know of no doc who has ever pushed a drug or procedure to me or anyone I know. I find the oposite occuring in the health field, all the way down to family practice docs who now want to wait before prescribing anti-biotics or invasive tests. You are using scare tactics and most horror stores are glorified by those trying to scare!

      My first child, I was scared and the moment I arrived at the hospital after my water broke, I asked for an epidural. I would have taken one in the 7th month onward if it was allowed! My doctor said to me, "I can give you one if you want, but they take affect immediately so maybe let's wait and see how your contractions feel first and if they get bad enough, we'll get you the pain releif you need." Turned out I was tougher than I thought and delivered naturally. With my second child, drugs were never even brought up by me or my doctor.

      July 30, 2010 at 10:08 | Report abuse |
    • rbnlegend

      Must have been nice, anne. The administrative nurse at the front desk was pushing epidural when my wife walked through the hospital door.

      July 30, 2010 at 11:30 | Report abuse |
    • BeachMama

      Sorry, HB Mindy, but your generalizations are just not accurate. Many moms feel more relaxed in the hospital because they know that a team of experienced doctors and nurses are in the room if something goes wrong. Once my husband and I arrived at the hospital for the delivery, I felt a rush of relief that we'd made it in time.

      Unless you were present to observe the births described in these comments, you have no basis to dispute their accuracy.

      July 30, 2010 at 14:22 | Report abuse |
  13. Caring Father

    Providing a waterbirth at home to my daughter is one of the greatest gifts she has been given. Her very first impression of the world was one of soft lighting, warm water, quiet and nurturing sounds. It was very gentle and peaceful, and was done foremost for her benefit. Contrast that with the noise, light, cold, and stress of most births. This vital first impression of what it is to be alive in the world has a lot of power to shape the psychic composition of a child. I would do it again in a heartbeat unless the birth were deemed high risk for some reason.

    July 30, 2010 at 09:44 | Report abuse | Reply
    • Max

      Do you have any evidence to support this assertion? Or are you just pulling it from thin air? Yep thats what I thought.

      July 30, 2010 at 09:48 | Report abuse |
    • Not All Docs Play Golf

      Water birthing is a romanticized crock. We are not seals. Adverse outcomes with water birthing are well-documented. Don't put your child at risk over your misinformed romanticizing of this technique.

      July 30, 2010 at 09:51 | Report abuse |
    • Anne

      I think it's really cool that you guys had such a great birthing experience. Baby can sense tension in the mother, and that often affects bonding and nursing. So, by keeping everyone relaxed, you brought baby into a relaxed and comfortable world. I disagree that coming into a cold, bright, loud world is harmful for a child though, or affects their phychic composition. I personally don't remember a thing about my own birth. Many children are born into pretty chaotic worlds (back of a taxi, low apgars, etc.) and I would find it hard to beleive they grow up differently than those born into warm water. It's 0 – 18+ years after the birth that counts the most when raising a child!

      July 30, 2010 at 10:00 | Report abuse |
  14. Diane Smith

    Hospitals are the safest place, but their birthing policies should be revised across the board. With one sick baby, I was glad to have been in a hospital but my experiences having both my children were extremely disappointing. I rather outwitten them, refusing all drugs that usually lead to a C-section and did it as naturally as I could. Nonetheless, the nurses especially made my experience simply miserable. None were my friends, none were helpful. I think nurses in general are around so much hurt and pain in their lives they become indifferent to it. If I had had a doula in a hospital and demanded to be left alone until the baby was actually born, that might have been a better experience.

    July 30, 2010 at 09:45 | Report abuse | Reply
  15. Anne

    According to the CDC, in 1900 six to nine women died for every 1,000 delivering babies. The infant mortality rate was 100 per 1000 births (10%). From 1900 to 1997 the infant mortality rate dropped 99% to .1 deaths for every 1000 births. According to the CDC, "Maternal mortality rates were highest in this century during 1900-1930 (2). Poor obstetric education and delivery practices were mainly responsible for the high numbers of maternal deaths, most of which were preventable."

    I think everyone should be able to choose home birth vs hospital, but it doesn't mean that hospitals are icky or dirty. Those are also scare tactics meant to promote an agenda. If hospitals were so terrible, we would not see such a huge improvement in live births and healthy mothers.

    I do think it would benefit hospitals to build a separate building or wing for maternity only, and design the rooms to be more comfy, with showers, hot tubs, recliners, etc to give birthing mothers more options for delivering and more of a relaxed "at home" feeling. I gave birth at a women's hospital, which was 90% used for maternity. My birthing room was the same room I stayed in for two nights, and it was a huge, comfortable room, with a roll-out bed for dad and plenty of room for visitors.

    July 30, 2010 at 09:55 | Report abuse | Reply
    • Pirogi

      I agree with you that women should have the option to choose where to give birth. But to deny that hospitals are germ-infested is simply closing your eyes to the facts.

      July 30, 2010 at 11:03 | Report abuse |
  16. cc

    My grandma had all kids at home but one died. she did nto like it. she died at 88. my ex mother in law had all but the last two babies at home. during a war. i have had both in a hospital one in a nice setting in the room for this but one was c sectin not pressured. it saves my son's life. the one after was a vbac. not chaotic as someone mentioned. my son cord was around his neck and this was before they did ultrasounds rorating babies used to kill many of them in utero to avoid c sectoin.

    July 30, 2010 at 09:56 | Report abuse | Reply
    • K

      My grandmother had ten kids in the hospital and one died. She didn't like it. She's 82. What's your point?

      July 30, 2010 at 17:28 | Report abuse |
  17. mae

    Having a home birth seems cozy and wonderful, but when something goes wrong you need a team of medical professionals who can leap to action to save lives. If I had elected on a home birth, I and my baby would have died. If my daughter had elected for a home birth, she too would not have survived. The same for my sister in-law. You do need to check out the hospital and choose the right one to ensure a happy experience, but I know from experiences in my family that the safest route to go is a hospital and babies should NOT be put at risk for the sake of a woman's warm and fuzzy ideal of a home birth.

    July 30, 2010 at 09:57 | Report abuse | Reply
  18. MCH2011

    I am SERIOUSLY disappointed with CNN's reporting on this editorial. If anyone actually took the time to read the letter in the Lancet, they would learn that the author says, "The main attributable factors for the increase in mortality were the occurrence of breathing difficulties and failed attempts at resuscitation—two factors associated with poor midwife training and a lack of access to hospital equipment. In the USA, for example, only a third of home births are accompanied
    by a certified midwife." The letter goes on to conclude that HOME BIRTHS ARE SAFE for low risk pregnancies, so long as they are attended by a certified midwife with resuscitation skills and occur within a reasonable distance from a hospital. Even the title of the letter to the Lancet says to PROCEED with caution.

    July 30, 2010 at 09:58 | Report abuse | Reply
  19. Linda

    I feel terrible for those of you who felt pressured to induce, C-section, take drugs, etc. I happen to live in NYC where there are many medical options. If you meet an OB who pushes a philosophy you don't believe in, you move on to another one. Why wouldn't you? If your pediatrician or oncologist pushed something you didn't believe in, you would find a new pediatrician or oncologist, right? The trouble lies in smaller locales with fewer options and I can understand that would be tougher and frustrating. Also, around here, you can have a midwife in your delivery room in the hospital if you want, plus there are options for water births nearby (within or attached to hospital). Finally, I know several women who had VBAC and I myself had a vaginal birth less than one year after an abdominal myomectomy (essentially a c-section to remove fibroids and deal with endometriosis), so there are doctors out there who are perfectly willing to work with you. I'm sorry for those without such options. Some of these posts are truly depressing – it doesn't have to be one way or the other. you can have a good experience birthing in a hospital and you can have a good experience birthing at home (barring any complicatiing factors). I love my OB and Lenox Hill was fantastic. In fact, when I was giving birth to my second, a celebrity couple wanted to be induced at the hospital and record it for a reality show. The hospital said ok in your room, but no recording in the halls and no getting any other patients, families, visitors, etc. on camera. The celebrity couple went elsewhere. I was thrilled they left and also thrilled that Lenox Hill stood up for the rest of us.

    July 30, 2010 at 09:58 | Report abuse | Reply
  20. Not All Docs Play Golf

    If anyone is doing the "scaring", it's not doctors, it's those telling stories from their hospital experiences years ago. I suggest everyone go tour the latest inpatient birthing centers at their major local hospitals. I think many would be impressed by the changes...private home-like settings, where what appears to be a pretty picture hanging on the wall can be removed to expose what it was covering...a modern anesthesia set-up if needed. It's really amazingly cool. The birthing takes place right there in the home-like room with family. Some people here are telling stories of hospital births that are horror stories from the past. Don't listen to them, go tour your local facility to see how vastly things have changed.

    July 30, 2010 at 09:59 | Report abuse | Reply
    • MCH2011

      It takes a lot more than a pretty room to make a woman feel at home during labor. The pictures on the wall might have changed, but the unnecessary medical interventions and impersonal care remain largely the same. I'm sure that most Ob/Gyns have good intentions, but the fact of the matter is that they do not have the time to accompany a woman throughout her labor (nor is that what they're trained to do) the way a well trained home birth midwife can. Over the course of a 12 or 14 hour labor, how much time do you actually spend with a laboring woman in that lovely room you describe?

      July 30, 2010 at 10:05 | Report abuse |
    • Anne

      MHC, my nurse was with me the entire time. She was assigned to me and never left. In fact, when her shift was up I was just getting ready to push. Her replacement came in, but my nurse and I had spent 6 hours bonding and she said, "I've got it, I'm staying to the end." LOVED my nurse, with both my children.

      I see a lot of people on here who are pro hospital saying, "let the woman make the choice" but it looks like the pro home-birthers are pusing some agenda and looking down on someone who dares to step into a hospital as though it's some form a child abuse. I hate closed minded people!

      July 30, 2010 at 10:13 | Report abuse |
    • MCH2011

      Anne, I'm glad to hear that you had such a positive experience in the hospital and kudos to your nurse for being so wonderful. I'm certainly not pushing a pro-hospital or pro-home birth agenda. What I am pushing is a pro-woman agenda. As a doula, I want the women I work with to feel like they have all the information they need to make important decisions about how and where they birth their babies and I want their care providers to be as wonderful as the nurse that looked after you. Lots of times in hospitals, though, women really have to fight for that level of care.

      July 30, 2010 at 10:27 | Report abuse |
    • Anne

      MHC, that's great that you want to educate women so they can make an informed decision on what is best for them. However, you are lying when you say that they won't receive the same level of care in a hospital. You ARE pushing your agenda with those lies. Rather, you should educate a women on the benefits of a home birth (rather than pitfalls of a hospital) and then let the woman tour the hospital to experience the benefits (or lack of) there. It's like the politician that says "vote for me, because the other guy is terrible." A lot of hospitals have come a long way in the past 10 years – they are not horrible places to give birth. Home births have benefits too, obviously. I just don't think it's right to scew information to push one agenda or another.

      July 30, 2010 at 10:41 | Report abuse |
    • MCH2011

      Anne, when I give women information about home birth vs. hospital birth I have a long conversation with them about the pros and cons of each. I am not pushing any kind of agenda and there's no one size fits all approach. The conversation centers around what a woman wants during her labor. If a client tells me she wants an epidural, for instance, I am going to support that decision and, therefore, her preference for a hospital birth. Similarly, if a woman tells me she wants a natural birth at her home, I will support that decision as well. One thing that's extremely important when working with pregnant women is to be able to separate your own personal preferences from what the woman wants and I try to do that the best I can every single day. I did not say that women will never receive one on one care in a hospital, but I've worked in a lot of hospitals and seen a lot of births and I can tell you that the experience you had was rare. It's not always a negative thing, but it's something a woman needs to know when making the decision about where to have her children.

      July 30, 2010 at 10:55 | Report abuse |
    • Pirogi

      One change that is irrefutable is that our national c-section rate is continuing to rise. 31% of women in the US have their abdomen cut open, their uterus removed and cut open, and the baby pulled out from the sliced hole. No amount of "home-like" curtains or wallpaper or lighting changes that fact.

      July 30, 2010 at 11:00 | Report abuse |
    • Ituri

      Funny how my best friend is still healing from her birth a month ago, which she contends as "the most horrific experience in" her life, in an entirely modern and up-to-date hospital here in California. She was treated so badly she's refused to go in for check-ups.

      But thats "all in the past," right? It doesn't happen anymore! That was a whole month ago, hospitals have changed!

      Hospitals are good for emergencies. They treat labor like an emergency. Any wonder things don't go well for many women?

      July 30, 2010 at 14:32 | Report abuse |
  21. Ellie

    As I tell the young mothers in my line of work, "Everyone's birth experience is different." So, personal anecdotes often are immaterial, however, I must give mine.

    No decision was ever forced with my birth experiences. My OBGYN and the nurses that attended during the births of my children always asked questions about how I was feeling, what my desires were, etc. I'm glad I had my children in the hospital, though there were no serious complications, there could have been. We had a problem that could not be predicted and had the potential to cause complications. I would not have been "more relaxed" at home. There is a great deal of security in having qualified staff and equipment on hand.

    I do admire those who give birth at home. If all risks are considered, it appears to be a good option. But I must say the decision should not be made because it is "cooler" or "because the hospital is out to get your money" or other sensationalized rhetoric. A few comments are not based upon research but seem to be people's whims.

    We should educate ourselves from multiple reliable sources and weigh the risk of all the options. It is silly to rule out a choice because of anecdotes we have heard from friends, a movie, or one article that we found on the internet. I am so glad I had the freedom to make the best choice for my family, and I will not criticize those who do not do things they way I think they should....unless they do it without educating themselves.

    July 30, 2010 at 10:02 | Report abuse | Reply
    • Anne

      Well said, Elle!

      July 30, 2010 at 10:15 | Report abuse |
  22. oneStarman

    NO PLACE DIRTIER THAN A HOSPITAL – That's where MRSA and other infections are come from.

    July 30, 2010 at 10:04 | Report abuse | Reply
  23. femfilly

    I don't know if I agree with this article. It sounds like it is talking about high risk cases. I think a lot of women are choosing home births these days because they are not okay with the types of intervention that are becoming the norm in hospitals. 1 in 3 births in America happen by C-section, some of them are completely necessary, like in high-risk situations, but if you look at the stats from nordic countries, a large portion of their babies are born at home. These countries all have lower maternal and neonatal mortality rates. Women in America and the UK are recognizing that something in the system needs to be changed. Women are not comfortable giving birth in hospitals. The system needs fixing. A good film to watch on home birthing is "The Business of Being Born" by Ricki Lake.

    July 30, 2010 at 10:05 | Report abuse | Reply
    • Anne

      You state a lot stats. What is your source, please provide.

      July 30, 2010 at 10:17 | Report abuse |
  24. A Mom

    Pick your OB doctor wisely and most of the fears expressed by other posters (being pressured into a C-section, mistakes, etc.) will be significantly reduced. Home birth/birth outside of a hospital may be a personal choice, but its an extremely risky one for the benefit of the mother alone.

    July 30, 2010 at 10:07 | Report abuse | Reply
    • Pirogi

      Your point is equally applicable to midwives or obstetricians. Pick your care provider carefully, and many of the risks go away. Your statement that homebirths are unsafe is incorrect. This study was poorly done and the data was misconstrued. Home birth for many women IS as safe as birth in a hospital, FOR BOTH MOTHER AND BABY but with fewer risks for the mom.

      July 30, 2010 at 10:57 | Report abuse |
  25. Eldorado Sunlight

    My wife and I had a homebirth of my wife's second child and it was the most amazing experience of my life. With MRSA and staf infections on the rise in hospitals, who wants to bring a baby in that way? C sections are at an all time high, mostly because OB's are to lazy to wait or have a golf tournament to go to. I have a friend who tried a home birth and at the 24 hours of labor mark went for the transport and her daughter is beautifula nd healthy and smart as a whip.

    July 30, 2010 at 10:08 | Report abuse | Reply
  26. cc

    btw have any of you been to a new birthring center in a hospita latelyi? if not do not say it is all chaos

    July 30, 2010 at 10:11 | Report abuse | Reply
  27. Tinkets

    What amazes me is the fact before hospitals babies were born at home for thousands+ years. I'm an RN and have seen women who get a spinal have more issues and are run into emergency surgery than a natural birth. All because it has put so much stress on the baby, it's either a c-section or lose the baby. I've seen more complications arise from "technology" than from natural births. However, there are those mothers who Need to be in medical surroundings. Those with risky pregnancies do need the medical facilities and licensed professionals.
    There is always risk with any birth but I think the mother needs to give birth where she feels comfortable, because its her that will endure the hours and pain so it should be her decision as long as its not a risky pregnancy.
    I've known several families locally who chose home birthing and they were fortunate enough to have things go well. One lady has done it 12+ times and all of the children are just fine, another woman who was in her late 30s chose to give birth at home for their last child. All went well.
    For those healthy mothers with no issues, it is their right to give birth how they see fit. It is not any board or laws job to tell a mother what to do with her body.
    Things going well are not always the case but its a natural thing and with nature there is no guarantees of survival, be it man, animal , or setting.
    It boils down to the almighty dollar most of the time.

    July 30, 2010 at 10:13 | Report abuse | Reply
  28. Kitmao

    Having done a very in depth article about home births v.s. hospital births a few months back, I can assure those reading this how completely lacking this article is in information. There have been numerous studies, but there was one in particular done in the U.S. and Canada that was very extensive and showed that the death rate in newborns was practically the same in home births and in hospital. I'd give a citation if I were near my work computer and could look it up, unfortunately I'm not...
    What this article fails to mention, as I'm sure there was no interest to even go into it, is the ridiculously high C-section rate in U.S. hospitals. Not to mention the high rates for other common medical interventions. If you wonder why women chose to give birth at home, this is the reason. A mother is treated like a patient and the birth is treated like a procedure. Women have to fight to have the normal, intervention-free birth that many of them are capable of having.
    And, yes, babies do die in the hospital too despite all that glorious medical advancement.

    July 30, 2010 at 10:14 | Report abuse | Reply
  29. opheliaout5

    I'd like to see more information on the study they're referencing. Did they look at home births in general or did they focus on those attended by medical professionals like nurse midwives? I've had several friends who had successful home births; however, all of them had a history of very fast labors (one friend delivered hers in under an hour, so it actually made more sense to have a home birth than go to a hospital), had their first births in a hospital and were attended by an experienced midwife. I, on the other hand, had a very long, painful first labor and an awful hospital experience, yet chose to have another hospital birth due to the complications experienced the first time around. I chose a different hospital and loved the staff, and had a wonderful, wonderful experience.

    In the first hospital, I absolutely did get the impression that they had a deadline to meet for my birth. If I didn't do things their way or if I even questioned why they were doing something, they were completely unsupportive and almost belligerent. In the second, I had the impression that the nursing staff were truly there to support me and ensure I had the safest, most supportive care possible and was encouraged to ask questions. I felt absolutely no pressure to meet their deadlines and even the lactation staff put no pressure on me, encouraged me to call even after I was discharged and helped me through the often-difficult first week of nursing. I think that's part of the problem – many hospitals are baby factories and want you to toe the line, spitting out the kid by the end of the shift so they can check the box and label you done and get you out as quickly as possible. While I would hardly encourage added, unnecessary hospitalization, I also don't want to feel sub-human if I need it. I think that's why many women are thinking about home births.

    July 30, 2010 at 10:18 | Report abuse | Reply
  30. CJ

    After having a nightmare experience 2 times, giving birth in a hospital, I am giving all women this advice. Do NOT deliver your baby in a hospital unless you are a high risk patient. The staff will pressure you to have drugs and/or an epidural followed by a C-section. There is a high risk for infection for both the mother and baby (especially staph). You will not get any rest while there and the cost is enormous. Giving birth should be a natural, inspiring experience not in a hospital with strangers barking orders at you and bright lights and if you are unlucky enough to be at a teaching hospital, a long trail of young resident doctors staring at your private parts. For hospitals, it's ALL about the money!

    July 30, 2010 at 10:19 | Report abuse | Reply
    • Anne

      Oh yeah, thanks for the generalization there! So because YOU had a bad experience that means EVERYONE will? If you were our congresswoman, you'd probably pass a law banning hospital births because of YOUR experience. I personally had a lovely birthing experience at a hospital twice. I LOVE LOVE LOVE my nurse both times, and LOVED the entire staff. I had so much help and education. But, let's go with your narrow minded method here, shall we? Based on your logic, a black man cut me off in traffic this morning...black people can't drive! They shouldn't be allowed to! Oh, and a black woman just went home from work today because she felt ill. Black people are sick! I don't think we should share water fountains with them. Hmmmm....maybe YOU need to step back into the 1950's and learn how to open your mind a little before you tell everyone that ALL hopsitals are evil just because your's was! sheesh, I thought we had evolved past this by now, people!

      July 30, 2010 at 10:26 | Report abuse |
  31. jeff

    Wait a second. One can kill a baby prior to birth; but, one shouldn't have a home birth because it's harmful to the baby? Huh?

    July 30, 2010 at 10:19 | Report abuse | Reply
  32. Historical point of view

    A "natural" birth 100 yrs ago, without hospitals, technology or drugs resulted in alarming rates of infant/mother mortality. If you want to go "natural" be prepared to to bury some of your babies and risk your own life for "the way nature intended".

    July 30, 2010 at 10:20 | Report abuse | Reply
    • Tigresse

      In essence, let nature take its course. But the medical establishment and technology have effectively taken that away and that's something that should also be put into proper perspective historically. Infant mortality rates are highest when women don't have access to proper sanitation and mothers suffer from poor or malnutrition.

      July 30, 2010 at 10:27 | Report abuse |
    • MCH2011

      The fall in infant mortality rates was due to improved sanitation and cleaner birthing conditions, not the shift in births from home to hospital.

      July 30, 2010 at 10:58 | Report abuse |
  33. jo

    My first delivery was fairly easy and uneventful. If I'd had a home birth for my second child, though, he'd have died. Everything was going fantastically ... well until his cord prolapsed. If it wasn't for the lightning-fast c-section (less than 4 minutes and almost without anesthesia), he'd have died. There would've been no "reasonable distance to a hospital" that could've saved him. No 911 call that could've gotten someone there in time.

    July 30, 2010 at 10:21 | Report abuse | Reply
    • K

      Jo, it's completely true that there really are complications that can happen to anyone and that if they happen at home, there is much less that can be done for them. Cord prolapse is one. However, there ARE risk factors for that and many other complications. One risk factor is having a breach presentation. Another big one is rupture of the membranes while the baby has not fully engaged into the pelvis... something that can especially occur with artificial rupture of membranes.

      But it's true that sometimes it does happen by itself, and if that's the case, all that can be done is to put the mom in a position tilting the baby up towards the uterus, the midwife to keep her hand in the vagina pushing the presenting part off of the cord, and get transported to the hospital as fast as possible for a c/s. And the baby's chances for survival would be less.

      There's way too much of "the ONLY complications in birth are caused by the BAD hospital and EVIL obstetricians" in this thread. The coffee cups are right: Sh*t happens.

      July 30, 2010 at 17:41 | Report abuse |
  34. Tigresse

    When all is said and done, we forget some very important facts: women have been having babies and giving birth for THOUSANDS UPON THOUSANDS of years, without the help of doctors or medical intervention. The advent of hospitals is very, very recent; less than 100 years in most cases and doctors and the medical establishment have succeeded in instilling enough fear into women to disregard what is fundamentally a NATURAL, not medical phenomenon. If women choose to have a home birth, with a skilled midwife, and they know the attendant risks, that is their choice. End of story.

    July 30, 2010 at 10:24 | Report abuse | Reply
  35. Tinkets

    Kudos Jeff! Humans sometimes just make no sense lol

    July 30, 2010 at 10:25 | Report abuse | Reply
  36. Mom-to-be

    Both of my sisters had their babies in hospitals and they're all fine. But that means nothing, because it looks like plenty of others have had home births and they're all fine too. What I find ridiculous is that all of a sudden they're trying to decide for the mother what to do with her baby. Doesn't the majority of American society believe abortion should be legally and socially acceptable? Well, just wait until we see the full effects of socialized healthcare, doctors and government workers will be telling everyone what to do, what to eat, how to live, no choices. And they would have the right to, because they will be the ones managing all of the consequences of what we do, what we eat, how we live, etc. If we don't have the right, it's because we gave it away for the sake of our own comfort and security.

    July 30, 2010 at 10:26 | Report abuse | Reply
  37. Sarah

    ' Moms have a right to “choose how and where to give birth,” says an editorial from the medical journal Lancet, “but they do not have the right to put their baby at risk.” '

    Now there's an opening line that'll trigger an abortion debate if there ever was one.

    July 30, 2010 at 10:28 | Report abuse | Reply
  38. Anne

    Gosh, I hope none of you narrow minded "natural" people never have a heart attack because I assume you'll deny the defribulator too. Damn those human advancements that are killing us all. All these wheels, fire, sliced bread and education; it's bringing us all down!!!!!

    July 30, 2010 at 10:29 | Report abuse | Reply
  39. Tinkets

    Mom-to-be I think you're right about the healthcare. I just got a phone call last week, a poll of sorts. One of the questions I was asked was, "Do you think the government should have the right to control what we put into our bodies since they will be footing the biggest part of the healthcare bill?" This question came immediately after the questions about foods.
    I think we need to be worried.
    A mother has a natural right to do with her body as she sees fit, not how a government sees fit.

    July 30, 2010 at 10:32 | Report abuse | Reply
  40. Bobby

    Funny how humans and other animals managed to have babies without hospitals for millions of years. Obviously you want doctors around for high-risk births, but nature generally takes care of things.

    July 30, 2010 at 10:38 | Report abuse | Reply
  41. suzanne

    I think a well planned home birth with an emergency plan is perfectly fine and safe, with proper pre natal care, you can have a safe delivery at home, i've had a few friends have very successful home births. However, I can't say i've ever experienced the health care in the States as I live in Canada, but I will say, I had my deliveries in the hospital here in Canada, and they were Pro – no drugs, vaginal birth and breastfeeding.

    July 30, 2010 at 10:38 | Report abuse | Reply
  42. Not All Docs Play Golf

    It's amazing how many unqualifed people are here essentially giving advice to women to stay away from the hospitals. If you have an axe to grind against modern medicine, then have scientologist Tom Cruise deliver your baby underwater in an aroma-therapy environment with new-age music is being played by tie-dyed street minstrels. But don't, in your ignorance, espouse that women should opt for your medieval birth experience and give misinformation through embellished anecdotes. For your child's sake, seek approriate, modern care and don't listen to the backward, ethereal science-haters.

    July 30, 2010 at 10:38 | Report abuse | Reply
    • Peter

      OK Doc,
      Publish a link to a study showing that home birthing is more dangerous for low-risk, healthy pregnancies than a hospital birth, and end the debate.

      And, I find it funny that the most educated person on the blog is the one using ad-hominem attacks to try to make his point. You attack the person (unfairly), not the argument, which is a basic logical fallacy.

      July 30, 2010 at 10:43 | Report abuse |
    • MCH2011

      Your ignorant and insulting posts are certainly not convincing me of anything. When a laboring woman dares to challenge your medical advice, will you tell her she has medieval thinking? Having MD behind your name doesn't make you enlightened.

      July 30, 2010 at 11:03 | Report abuse |
    • ECM

      Peter – this study DID demonstrate that low risk pregnancies have a higher mortality for the infant in the home birth setting. I'm sure whatever study comes out showing higher mortality with home births you will disregard in some way. The study did demonstrate better outcomes for the mother, which is something that all practitioners should look at.
      I know that no one likes to be told what to do, but the above MD makes a great point that we should be getting advice from people who have experience with lots and lots of deliveries – not someone on the internet who has a theoretical idea.

      July 30, 2010 at 11:04 | Report abuse |
    • Peter

      ECM,
      Actually, the abstract/results page linked in the above article did not show that low-risk pregnancies were at a higher risk. It showed that when viewed as a whole, there is a higher neonatal death rate among home births. However, since other studies show no difference in outcomes for SPECIFICALLY low-risk home births, I'd have to assume that the higher mortality rate has to do with the high-risk home birthers.

      Even the CNN article above states that hospital birth should be the preferred method for high-risk mothers; the implication is that it need not be the preferred method for low-risk pregnancies.

      Seems like you were trying to be insulting be suggesting I would disregard any study contrary to my viewpoint; however, having recently had a child, I based my opinion on reviewing numerous scientific studies on the topic. It seems as if people are not actually regarding what the above study revealed, and are confusing high-risk and low-risk pregnancy outcomes.

      Here is a quote from the results of the study. It would have been beneficial if the methodology of the study had been more specific in tracking the health/risk of the pregnancy, not just the outcomes of the birth.

      Results

      Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates.

      July 30, 2010 at 12:43 | Report abuse |
    • Ituri

      Claiming that people pushing for a normal, natural birth in a non-hospital environment are somehow "anti science" is absurd. There is nothing wrong with wanting a non-hospital birth, and the numbers maintain that it IS safe with a trained midwife. Every other civilized country in the world has far higher rates of home births with midwife, and they have lower rates of complications and infant mortality. Japan, France, Europe, over 70% of births are attended by a midwife, many of which are at home. Your fear mongering does not change those facts, or the fact that women are appalled by the treatment they receive OFTEN in US hospitals. Not to mention the absurd costs, with a normal, uncomplicated labor costing upwards of 10 GRAND. Thats without pre-natal or post-natal care! So you can take your fear and shove it, because people are not idiots about such natural processes. Women are rejecting hospitals for a reason, and you would do well to investigate WHY rather than just condemn and threaten.

      July 30, 2010 at 14:26 | Report abuse |
  43. Christopher

    Home births are no more or less dangerous than births at a hospital, excepting when extremely UNCOMMON things happen. This seems to be another step towards monitoring people from 'birth to grave'.

    July 30, 2010 at 10:38 | Report abuse | Reply
  44. PBD

    MC, nearly every pregnant woman in the US can get free or nearly free prenatal care. Medicaid has special provisions for pregnancy, and will cover the expenses retroactively. Also, since delivery is a predictable event, a mother can find prenatal care at charity clinics all over the US. I think the only way that she can't is if she lives in isolated rural areas.

    Home births are increasing because women think it's better. But it isn't- not for the baby, and also not for the mother. This study just proves what every obstetrician knows already. I live near a population that routinely does home births (they're Hutterite). And despite the fact that they're very healthy and avoid all the nastiness like drugs, alcohol and smoking that cause so many problems in pregnancy, if they do have problems, they are life-threatening ones. Immediate ones. Half of all pregnancies that are high-risk become that way IN LABOR and thus are not predictable. So now I have several that sneak away to the city to "accidentally" go into labor (it's not an accident, they fake labor pains and come in to be induced) just so they can have their babies in a hospital. ANd pay cash for the privilege since they are self-insured. They've been through traumatic home-births, and want no part of it.

    July 30, 2010 at 10:39 | Report abuse | Reply
    • Pirogi

      Wow, you threw out quite a lot of unfounded numbers and statements there. Care to show any data to back up your claims?

      July 30, 2010 at 10:47 | Report abuse |
  45. nancy

    Has anyone read the studies done on hospital vs. home birth done in the applachaian region of the US? It shows that a planned home birth has far better outcomes then a hospital birth even among the poorest regions of the US. The report we are now considering was written by Dr.s out to make BIG $$$ doing what women have done for centuries WITHOUT them!! Sorry doc's...women giving birth is not a medical condition requiring your intervention, at leaset not for a whoping 98% of the time!!!!!! The human race went until the 1940's without hospital births...we need to consider that fact as well. Hospital and Dr intervention has sought to control women and their births for far too long. Lets get women back in control of their own bodies and health. Then we will see improvements.

    July 30, 2010 at 10:39 | Report abuse | Reply
  46. kmcg

    THIS IS TERRIBLE.

    CNN – DO NOT post EDITORIALS as fact! It is in fact at LEAST as safe for non-high-risk moms to give birth at home. They even say, "The editorial continues to say that hospital delivery should be the preferred method of delivery for high-risk pregnancies" .... no midwife, nurse midwife or doctor who works with home births and are respectable and trained would ever deliver a high-risk mom.

    What is a mess here is the referral system. Midwives and home birth docs are so discriminated against in the culture of medicine and insurance that OBs are preventing them from bringing patients in, and still attending their births from a hospital setting.

    CNN many readers are very intelligent, but headlines like this, when they are from an EDITORIAL that obviously is siting very biased and actually poorly documented articles (as opposed to the majority of articles that discuss the safety and benefits of low-risk moms birthing at home) is a journalistic lie, and it's very misleading. Shame on you.

    July 30, 2010 at 10:44 | Report abuse | Reply
  47. TC

    As the husband of a 20+ year OB nurse/certified nurse midwife/nursing professor/PhD student, I can tell you that the things they sometimes do in the hospital would curl your hair. This comes from both personal and anecdotal experience. The fact that the C-section rate for midwives is 1/3 that of OB's should tell you something. Follow the money; doctors make far less on an uncomplicated birth than they do on a C-section or even on a "natural" birth with an epidural. Study after study worldwide has confirmed that midwifery care is far safer for both mother and baby than physician care in a normal pregnancy. Doctors are trained to "fix" things, while midwives are trained in a holistic manner to prevent problems from occurring in the first place. Certainly there are times when a surgical or intervention-type delivery is required, but the vast majority of the time it is not.

    I have mixed feelings about home birth, though. Our daughter was born naturally after a very complicated pregnancy that turned out far better than we could have believed possible considering the trajectory we were on. Fibroid tumors, preterm labor, hormone issues, multi-week bed rest, "brain damage" indicated on an ultrasound, etc. Had any of these issues figured into the labor and birth, rather than not turning out to be the problems we feared, a home birth would have been a disaster. As it wound up, she was miraculously born after a short labor, not a stitch to mother or child, and she's the top student in her class.

    July 30, 2010 at 10:45 | Report abuse | Reply
  48. Pirogi

    For a thoughtful look at this study and the problems surrounding it, check out Gail Hart's article at midwiferytoday.com.

    I suspected when the VBAC guidelines came out last week that this study was politically motivated, and I was right.

    Step 1: Discredit the outstanding safety of homebirth, villainize women who choose this route as baby-killers, and use the old tried-and-true cultural tactic of scaring birthing women into submission.
    Step 2: Change the official obstetric position on the safety of vaginal birth after cesarean, AGAIN, to try and lure the ever-increasing percentage of VBAC women (who would have only had homebirth as an option), into the hospital for birth.
    Step 3: Outlaw midwives or anyone else who has the knowledge and skills to facilitate safe birth outside of the hospital.
    Step 4: World domination.

    July 30, 2010 at 10:46 | Report abuse | Reply
    • MCH2011

      Thank you for posting a link to that thoughtful criticism. Everyone should read the Midwifery Today response.

      July 30, 2010 at 16:20 | Report abuse |
  49. Anna

    A responsible midwife will always recommend birth at a medical center for high-risk pregnancy. Two friends have been sent by their midwives to doctors/hospitals in high-risk situations, well in advance of the birth. Most of my friends opt for home birth, before and during which they are closely monitored by professional & experienced midwives. I have been present at both types of births, and home birth allows women to birth in more natural & comfortable positions; women in hospitals are forced to be on their backs, which for many women actually makes labor more difficult and extremely uncomfortable. It is more natural for a woman to squat or get down on all fours. Women also have more neonatal authority and oversight at home; in a hospital everything is pretty standardized and parental requests for things like waiting until the placenta stops pumping to pinch/cut the cord and breast feeding only can easily be overlooked. Statistically speaking, waiting to pinch/cut the cord is more medically beneficial for babies (except those with known a known genetic predisposition to certain diseases) than freezing cord blood! Home birth is not the danger; irresponsible, ill-advised, and unattended home birth is.

    July 30, 2010 at 10:46 | Report abuse | Reply
  50. FCL

    We're expecting our 8th baby in October. This will be our 5th planned homebirth. My 4 homebirths have been MUCH healthier than the previous 3 hospital births – for me and for the babies. I had no medications to cause complications for the babies. Two of my three hospital births resulted in infections in the babies, one hospital birth resulted in severe bleeding for me. I have had none of those happen at home.

    I think this study was poorly done, poorly researched, and sloppily reported upon.

    July 30, 2010 at 10:47 | Report abuse | Reply
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