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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. midwifinn

    Laura said above: You wouldn't allow your kids to attend a city pool without a lifeguard on duty just because they've never needed rescuing before and the rational that "someone could just call 911 if they started to drown," would you?

    We intuitively "know" public pools without life guards or private pools without fenses are dangerous, and have lots of evidence. But none of us would conclude that we should close our pools that have fences and trained lifeguards. Still, drownings can occur in these pools too. We conclude that small risk is acceptable, and take our families out to enjoy the water and benefits of exercise.

    That is the problem with the study used in this CNN article about home birth. This is the swimming analogy applied to the homebirth study: It is as if they said swimming may have some benefits, but it is just too dangerous. Why is it dangerous? The studies we looked at show swimming causes more deaths. The studies cited had some pools with life guards with training with CPR, some with folks watching kids and no telephones, and some pools without any life guards and where people who didn't know to swim could accidentially fall in the water. These studies found more deaths. But if we only look at the pools that have trained life guards, fences and telephones, the swimming in those pools did not cause extra deaths. This last poinit was not included in the discussion, abstract or title. The article should have reported only on the studeis of pools with life guards, training, telphones and fenses to determine if swimming is safe.

    Likewise, the studies about home birth that only included midwives who have training and certification, are licensed to carry safety equiptment, used fences for screening out the higher risk cases, and have a system for accessing the medical support system, makes home birth very safe with many health benefits.

    The homebirth study published and reported on above is bad science.

    Then they said, the studies that only havec pools with lifeguards do not show increase risk for drowning

    July 30, 2010 at 12:33 | Report abuse | Reply
  2. Amanda

    Obviously the research in the article is paid for by the OBGYN industry. America actually has a higher infant death mortality rate than any other country. If we would educate our women on how to birth babies instead of convincing them they are too stupid to do it themselves and that their body isn't made for natural birth we could solve this. Home births aren't for everyone but hospital births generally cause fear for an expectant mom giving birth, they are one of many in a system designed to make money. The more i research the more i find that doctors don't have much more to offer than drugs drugs and more drugs instead of real answers on how to cure disease!

    July 30, 2010 at 12:33 | Report abuse | Reply
  3. Heath

    I wish thie middle ground was more of an opption in this country. Too bad insurance companies and hospitals a putting birthing centers out of business.

    July 30, 2010 at 12:35 | Report abuse | Reply
  4. dina

    It comes down to individual choice. As long as a woman's birth decision is an educated and informed one and she has a medically trained and qualified attendant that she trusts monitoring the birth, it doesn't matter whether the birth takes place at home or at a hospital. I had 3 children born at a birthing center attached to a hospital so I feel like I got the best of both worlds, a more relaxing, comforting setting, but with an OR just down the hall in case of emergency.

    That's where I felt most comfortable. Women who choose to home birth do so because this is the most comfortable setting for them. Contrary to what some posters have said, it's not a matter of choosing a "birth experience" over the life and safety of their baby. These goals are not mutually exclusive, in most cases. If the mom has the best birth experience she can have, her baby will benefit from that and have a safe and smooth delivery into this world.

    The important thing is that women educate themselves about their options and about what's best for them and their babies. I have cousins who chose to induce their labor because they didn't want to wait for the baby to come on its own. That was too inconvenient. And they choose c sections because they can avoid the pain of labor and the damage to their private parts. These same cousins refused to breastfeed their babies because they thought it was "disgusting."

    Those kinds of decisions are selfish. As long as women are making informed decisions based on the best information available at the time as to health and safety of themselves and their babies, they should be able to have a home birth or a hospital birth or a birthing center birth.

    I

    July 30, 2010 at 12:36 | Report abuse | Reply
  5. Ame

    The midwife needs to be in the hospital delivering those "easy" babies, and then handing the reins to the doctor when that's what is needed. Medical Establishment: stop insisting that women lie down and submit to your belly strap and wire up to the baby's scalp when it's not needed and makes the woman extremely uncomfortable and unable to do her job, which is walk around and bear the pain until it's time to lie down and push. If the hospital can be cool with women saying, "leave us alone until we need you" then you'll see women coming back to hospitals and fewer midwife tragedies.

    July 30, 2010 at 12:36 | Report abuse | Reply
    • Ituri

      Many states have made midwifery illegal, and hospitals will often not allow other medical professionals in the room, or even in the hospital, because they see them "getting in the way." The industry around birth makes it almost impossible to come to a compromise that benefits the woman and baby best. "Our way or the highway" is typically the response you get.

      An interesting documentary is "The Business of Birth." I think thats its name.

      July 30, 2010 at 14:16 | Report abuse |
  6. FCD

    Okay...so this is the stupidity I don't understand. They are saying that women have a right to chose where to give birth, so long as that birth is in a hospital–for the "safety of babies." So women can chose to kill their unborn children via abortion (where doctors make money), but they can't chose to give birth to their children and have them accidentally die because that is putting another life at risk? Hmm...again, when does this baby matter? Only when the doctors are making money from it!

    Anyway, if there was any true research done, for this study, it would be noted the other way around. Europe has many home births attended by midwives. Actually, home births with midwives are the norm. Their ranking for mother-baby deaths, top ten. The United States has medicalized labor to be in hospitals. Their ranking for mother-baby deaths, 32! This article is very biased for the pockets of doctors and I advise everyone to not listen to this pure BS.

    July 30, 2010 at 12:37 | Report abuse | Reply
  7. fd

    Of course they find a way to blame it on women. Maybe if hospitals would stop rushing labors with Pitocin, forcing epidurals and C-sections and episiotomies on people, then giving birth at the hospital would seem a little more attractive. I gave birth at the hospital but had to fight not to have drugs injected in me, not to be rushed, not to be told I "needed" a C-section.

    July 30, 2010 at 12:38 | Report abuse | Reply
  8. GladToBeAlive

    I had a completely risk-free, uncomplicated pregnancy, and delivered without complications in a hospital. Immediately following my daughter's birth I began to hemmorhage uncontrollably. The entire medical staff worked frantically on me for 30 minutes before taking me to emergency surgery. If I had delivered my daughter at home I WOULD NOT HAVE LIVED. For those of you who feel strongly about having a midwife, I support you but PLEASE consider having your baby in a hospital just in case something happens. If hospitals could allow midwives to be present and participate actively in delivery, I think this would be a good compromise.

    July 30, 2010 at 12:40 | Report abuse | Reply
    • FCD

      Did you let them pull your placenta out?

      July 30, 2010 at 12:52 | Report abuse |
    • Pirogi

      Yes, managed third stage can and does often lead to bleeding problems. Because obstetricians largely exclusively practice managed third stage, all they see are dangerous and scary situations, thus reinforcing their ideas that birth is dangerous and that their third stage practices are mandatory.

      Still, Glad likely didn't "let them" do anything; they probably did it on their own and would have regardless of her objections at the time. We need to be careful with blame-placing for medical practices. Ideally every woman would have the capacity, time, and patience to research every detail surrounding birth, and doctors would respect all decisions made by the mother. Most don't, for many reasons. That doesn't relieve the doctor of the responsibility to offer informed consent for every procedure. If Glad's bleeding was indeed the result of poor medical management, it isn't appropriate to blame the mother for this.

      As it is, Glad, most bleeding can be easily managed at home. Most if not all midwives carry herbs that are successful at controlling minor bleeding, and many also carry pitocin for heavier bleeding. If the mother continues to bleed to a dangerous level, the competent midwife calls an ambulance and/or takes the mother to the hospital. It is very rare that a mother would have a massive hemmorhage that would result in death before the EMTs could arrive. And when that does occur, birthing in a hospital offers only a very small chance of survival over homebirth anyway. This is one of the risks to take into account in choosing homebirth, and it is appropriate to weigh all the risks of homebirth against all the risks of hospital birth. Many times in our culture, the hospital risks are overlooked or minimized.

      July 30, 2010 at 13:20 | Report abuse |
  9. Andrew

    There are both types of moms out there...the unthining one that does nothing more than what their doctors say and do not educate themselves...there are also those that homebirth because they think it's cool. let's throw out both those stereotypes, they exist but are useless for any real discussion about birthing options. They are just political red herrings designed to inflame.

    Folks should take this discussion in stride. Position A is not an indictment of position B,,,and vice versa. Just because a mother chooses B does not mean anyon ewho chooses A is a monster. This is a very personal subject...folks should discuss it with facts and statistics rather than "I'd nevers" and "you're selfish" staements.

    July 30, 2010 at 12:41 | Report abuse | Reply
    • Tina

      Very well-put! I'm baffled by the amount of judgmental language on here. They're just two different options people can choose, and neither one makes you a better or worse person!

      July 30, 2010 at 12:54 | Report abuse |
  10. AnneS

    More mothers want a home birth because most hospitals and Drs are not as accommodating as the glowing anecdotes here. I'm not sure which insurance plans give so much choice, but I have a nationally known HMO. If I expect insurance to pay, I must go to the hospital my OB is assoiciated with. Both my daughters were born in hospitals, neither birth was attended by my OB because it was not 9-5 M-F. The first one in 2004 was a nightmare in every way. I was tortured mentally and physically by all but one of the staff and then mutilated at the end. This included threats from the nurse that if "you dont get it with this push it's going to be a C-Section". She did later come back and say she was just trying to motivate me. I was haunted by nightmares and thought about it daily for over a year. It was hard to bond with my daughter. I had to change OB practices (which required calling 6 different places to find one within 30 miles accepting new patients even though I live in one of the biggest US cities) for kid #2 three yrs later. It was not a nightmare, but not a good "experience". I saw the Dr on call for no more than the 10 minutes before and 5 minutes after she was born. Both times there was no getting up to walk around or change positions. Nurses get literally mad if you disturb the monitors. Could not have anything to eat or drink – "thirsty? let me get this IV going". Both Hospitals were less than 5 yrs old when I was there, so old equip not the issue. Both times I was yelled at by the on call hospital pediatricians for not authorizing formula. "Do you want your baby to starve?" No, I want her brought to me. Do you want to be worried about upsetting people who hold you and your baby's lives in their hands when they have you at your most vulnerable? That is why most women just lay back and take it. Medicine is a business to most people involved, congrats to those of you who have found people otherwise motivated.

    July 30, 2010 at 12:44 | Report abuse | Reply
  11. PW

    Women have been giving birth for thousands of years without the help of doctors or hospitals.
    The real truth behind all this fuss is that the medical profession is always looking for ways to make more money.

    July 30, 2010 at 12:45 | Report abuse | Reply
  12. kait

    This is PR bs and the STUDIES (not the "articles") show that homebirth is just as safe and sometimes MORE safe than hospital birth!

    Of course, high risk pregnancies should be in a hospital where there's actually a problem. But that happens truly in about 3-4% of pregnancies! It's important that we define "high risk" here, and the actual definition is vastly different from the obstetrics industry's definition!

    “home birth can, after all, be harmful to newborn babies." Oh, and I suppose hospital births aren't ever harmful to newborn babies??? My fourth child is a planned homebirth after three cesareans because NOT ONE of my children NEEDED cesareans, had all the complications that go along with surgical birth, and the experience was horribly traumatic for myself and my children. Staying home is eliminating the harm that goes hand-in-hand with hospital birth! Hospitals are NOT the place for healthy, normal women to have healthy, normal births. They are a place full of disease and foreign bacterias who push drugs (require drugs, in most cases) and a stranger "delivers" your baby for you, instead of you GIVING BIRTH to your own baby, as nature intended. Women have been giving birth all throughout history and NOT in hospitals. When we start to see maternal and fetal death rates increase (which we have now in America, for the first time since the medicalization of birth), it's time to rethink our strategy.

    Obstetricians make big bucks for hospital birth. If you stay home, you're assaulting their wallets and THAT is why there are these pseudo-scientific articles being published.

    July 30, 2010 at 12:46 | Report abuse | Reply
  13. Lady~Dragon

    I have 6 children. We have our two oldest girls, we have twins, and then our two youngest. My husband and I diligently sought out a midwife for the birth of our two youngest daughters.

    My twins are fraternal (one boy-one girl); my baby girl was born with a gastro-schesis – a hole in her abdominal wall that took 4 months, and three surgeries to correct. It was the most gut-wrenching, heartbreaking experience I have ever had to endure as a mother.....but not because of her condition. Her condition is not rare and we were assured that she would be
    well taken care of. Of course, we didn't know then that the battle we faced was not with her condition but with the hospital itself!!

    During her stay she had so many heel sticks her little feet were so raw; she had three site infections from IV's not tended to properly, procedures that were done without consent......... I can't even begin to convey the stress, anger and overall helplessness I felt walking into that hospital every day. I thank God that my husband was a registered nurse that worked regularly with intensive care patients including the NICU; otherwise these people would have been able to do whatever they wanted to my child! We had to go so far as to have meetings with hospital administration over some of these issues.

    My daughter was psychologically traumatized by all this as well. To this day, my 13 year old daughter has terrible fear of doctor's offices, hospitals, needles, stethoscopes.....just the smells associated with the hospital setting causes her to have panic attacks.

    So, a year and a half after the twins were born we were blessed with our fifth (a little girl). We had our fist ultrasound at 15 weeks and she was perfect. It was that day, we decided that we were NOT going to set foot in another hospital and we set out to find a midwife. My two youngest daughters were born at home.

    In our quest to make a decision between home birth and hospital, my husband and I found out some things we didn't really take into account. The one thing that really stuck out to us is the fact that some of the most horrendous germs, diseases and bacteria are found floating around in hospitals......being born at home, the babies are born into the environment they will live in for the rest of their young lives. Another thing that literally shocked us was how affordable having your baby at home really is!! Having babies is BIG business for hospitals, after all. Having your baby at home is VERY affordable; so affordable in fact that we paid out of pocket!

    With home birth, I am in control.....I can eat when and whatever I want, take a bath or shower, go for a walk, watch TV, listen to music. Try doing that in a hospital setting with monitors strapped to you, beeping machines, nothing to eat but ice chips, IV poles and tubing attached to you, nurses and MD's coming in to poke and prod you every half hour until the baby is born........and let me tell you, ENEMAS SUCK!!!

    The labor with home birth was so much more tolerable and relaxed. The midwife was there but remained in the background and was only there to monitor and make sure all went smoothly and step in if an emergency arises......My whole family was able to share in and witness our baby's birth. My second oldest delivered her sister..........it was the most precious experience we have ever had and our family bond is strong because of it.

    I read the article from the American Journal of Obstetrics & Gynecology. It's all crap. I am willing to admit, hospitals do have their place; If we had ANY indication that our first home birth baby was going to require emergency care, we would have had her in the hospital; no arguments.

    These MD's can say or publish whatever they want and people will listen because they don't know any better. Women who are careless enough to get pregnant and seek out abortion are given all the freedom and funding they need to take care of their "problem".

    My husband and I very much love and care for the children we have brought into this world. Unfortunately, we have experienced first-hand how things can go in a hospital setting. It's nice to know that we have a choice as to how and where our children will come into this world and I will have words with any MD that attempts to take that choice away or says I am putting my children at risk.

    Final Note:
    Having had both experiences, hospital and home, I can say with conviction, that I will NEVER have another child in a hospital again. If given a choice, I will choose a midwife every time and I will encourage my children in the same way. They were side by side with us in the hospital and they were there for the birth of their two youngest sisters.......they saw enough.

    My first grandson was born just short of a year ago.........don't ya know the first thing my daughter did was to find a good midwife.

    July 30, 2010 at 12:46 | Report abuse | Reply
  14. Jack

    Yes, most of the time births happen with few complications. If you are willing to take that risk simply out of personal preference, then I have to wonder why. Would you also consider allowing your child to ride in the car without a child safety seat or seat belt? Because you may drive your entire life without getting into an accident. Hey...the odds are in your favor. Why not risk your child's safety, right?

    Do you know what a midwife does in a home birth when there is a life-threatening complication? She calls an ambulance to take you to the hospital. Now you've added a possibly huge delay in treatment that may put you and your baby at risk, all because of some ill-informed prejudice against the doctors who will be trying to save your lives.

    You may want to rethink this whole parenting thing and just get yourself a kitten.

    July 30, 2010 at 12:46 | Report abuse | Reply
    • Pirogi

      Wow, your post is inflammatory and condescending. Thanks for showing the world what a jacka$$ you are.

      July 30, 2010 at 13:24 | Report abuse |
  15. hobart

    Just read the article. The neonatal death rates are 32/16,500, or 0.193%, for home births versus 32/33.302, or 0.099%, for hospital births. Very low in both cases.

    July 30, 2010 at 12:47 | Report abuse | Reply
    • gem

      Very low....unless you are the "1" more who died.....

      August 1, 2010 at 15:30 | Report abuse |
  16. LaRofromNorthAL

    Reading this article you would think that women hadn't been giving birth for eons without the assistance of medical personnel.

    These days we have midwives available to assist home births, and for a large percent of the population, hospitals & doctors are nearby should something go wrong. Having a baby is taking a medical chance no matter what.

    July 30, 2010 at 12:50 | Report abuse | Reply
  17. FCD

    correction, the united states is actually 44th according to the CIA world factbook:

    https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

    July 30, 2010 at 12:51 | Report abuse | Reply
  18. Amy

    Let people decide what they want, and we still do have a choice. I had my son at a hospital with no meds. The thing I didn't like about the hopital is they ripped him away right after birth to go to the nursery and I wasn't able to nurse right away. I'm considering doing a home birth with #2, but I don't think I will because of the risk of complications. I like that there was a NICU and medical staff right there at the hospital if needed. I wish I could find a midwife who delivers at the hospital. Also, hospitals should try to accomodate mothers who want to go the natural route. My labor went so quickly I couldn't even have the meds if I wanted them!

    July 30, 2010 at 12:51 | Report abuse | Reply
  19. Summer

    I am sorry I have to chime in here, if you choose to have a baby at home instead of in a medical facility then you are being very irresonsible. In a hospital you can have a peaceful birth and you do not have to get drugs if you don't want them. You are the patient speak up! But if something does go wrong then you need to be in a facility that they can help you.
    If you are only haveing a home birth to be more comfortable and to have a better experience then you are a VERY selfish person and I would assume will be a very selfish parent. Grow up people we have teh ability to get medical help so do it!

    July 30, 2010 at 12:52 | Report abuse | Reply
  20. Everdean

    I wonder what percentage of these neonatal deaths involving home births are children born with significant medical problems that would have required highly aggressive.

    July 30, 2010 at 12:54 | Report abuse | Reply
  21. LuLuP

    I think it's childbirth that is risky. Period. How many women used to die in childbirth every DAY? It's going to be risky in a hospital or at home...some risks at home and different risks at the hospital. Things can go wrong in either place, sometimes with tragic consequences. However, I think it is a value judgment, and couples weigh the risks and benefits of each choice against the things that are important to THEM. I find it disturbing that society increasingly seems to think it has the right to pass such judgments on the values and priorities of other human beings, when all I really care about is that they make an informed decision. I believe that even a fully informed person could go either way with their decision based on their personal values, and that they should be able to.

    July 30, 2010 at 12:56 | Report abuse | Reply
  22. CM

    Amanda, this sentence is pure nonsense: "America actually has a higher infant death mortality rate than any other country."
    Please educate yourself a little before saying something so foolish. America doesn't even have a higher infant death mortality rate than most other wealthy nations. http://www.who.int/whr/2005/media_centre/facts_en.pdf

    July 30, 2010 at 12:56 | Report abuse | Reply
    • Liutgard

      MOST?! By what count? The United Nations Population Division lists us as *#33* Even Brunei has better rates than us! And the CIA World Factbook lists us as #46.

      We spend the most per capita and get cr@p results.

      July 30, 2010 at 18:07 | Report abuse |
  23. Brownneck

    I don't believe in this report. I came from a third world country and 99% of babies borned are "home births" I am one of them. I have not seen any deficiencies in growing up. I'm healthy as most of the babies that were born in my generation. So please stop preaching the vast difference between a hospital births and a home births.....it's BALONEY. Hospitals are there to make profit.

    July 30, 2010 at 12:57 | Report abuse | Reply
  24. cavemanstyle

    What difference does it make WHERE you were born anyways? .. How do you think people did it in pre-historic days? .. I'll tell you, I get so frustrated with modern day thinking. It's like you people forgot where you came from or something.

    July 30, 2010 at 13:00 | Report abuse | Reply
  25. MR

    It should be the parents choice/option/right – but so are the consequences. Additionally, risk are also inherent in giving birth in a hospital, so what are we really talking about here?

    July 30, 2010 at 13:03 | Report abuse | Reply
  26. mother of four

    Mother of four boys. The first two were born in two different hospitals, using two different doctors (in two different states as a matter of fact), with hospital created complications and headaches BOTH TIMES. After the second nearly disastrous birthing experience–this one put my son's well-being at risk thanks to medication they gave me while I was in labor–I decided that there hard to be a better way.

    The "better way" turned out to be a birthing center in Reeds Spring, MO. I went on to deliver two boys at the midwife's birthing center three years apart. It was not home, but it was close. I gave birth in an ordinary bed in a room with low lights assisted by my husband, the midwife, and her assistant. No IV, no blood pressure cuff, no fetal heart monitor. I was allowed to walk until the absolute last minute. I ate and drank throughout delivery. Both boys were delivered within a few pushes. Extremely healthy, nursed within minutes. We went home four hours after delivery where I recuperated at top speed and we settled in to being a family.

    Tara A-This decision wasn't about me or my comfort any more than it is for most women. This was about the babies and what's best for them. I'll spare you both birthing stories and simply leave you with the second one as food for thought. My second born son suffered from oxygen deprivation at birth due to the medication they gave me while I was in labor–about thirty minutes before he was born. He spent a week in the hospital receiving injected antibiotics in his legs every day because they were just "sure" he had an infection. When in truth, once the medication cleared his system–eight hours after birth–he was fine and basically alert. During those eight hours we weren't allowed to come close to him and a nurse explained to me that they weren't sure before that time was up that it would be safe for me to "bond with him". Even though all the tests came back negative for every infection they could think to test him for, they continued to inject antibiotics into his legs because they felt they had to finish out the medication. (He had scar tissue in those muscles for years). Once I finally got him home, I went to the library and checked out every medical book I could get my hands on, talked to my mother who turned to a friend of hers who was a nurse, and sought out information. I learned that the demerol/promethezine they offered me as a pain reliever thirty minutes before he was born was never supposed to be given with four hours of delivery as it was prone to reduce the respiration of the newborn during those vital first hours. What was worse–it took them two hours of my telling them there was a problem before they believed me. Thanks to their irresponsibility my son suffered a brain injury that caused all kinds of delays in his development.

    July 30, 2010 at 13:04 | Report abuse | Reply
  27. mommyof3

    I don't know what hospital some of you go to that they rush you but i've had 2 natural birth, both at the hosptial, and never was i rushed, drugged or told that to have a c-section. my ob monitored me closely and accomidated to any of my needs. unless you are not progressing for a long period of time, you're left with no choice but to have a c-section to save both lives. The choice to birth at home is simply on the mother whether she wants to risk it or not but i wouldn't. i have health insurance and would not risk my life nor my unborn because i have 2 other kids in the home who depends on me as their mom.

    July 30, 2010 at 13:12 | Report abuse | Reply
  28. Homeschool Mom

    80% of my midwife's clients had medical insurance that covered 80%-100% of the cost of a hospital birth. Many of those who had hospital coverage payed OUT OF POCKET for their homebirths.

    July 30, 2010 at 13:12 | Report abuse | Reply
  29. Miriam Hamsa

    The Lancet article says only 1/3 of home births in the US are attended by a certified midwife. I frankly find this hard to believe. The article is rather hard to understand – it says the reason for increasing home births is C sections???? So maybe they are referring to women who are having VBAC and can't find a doctor or midwife who will do that for them??? According to the article both South Australia and the UK support home birth in women with uncomplicated pregnancies. It is the American Journal of OB-GYN that has the most negative report, that impacts the Lancet article. Surprise!!! It further states that a recent Scottish study shows that neonatal death rates in hopsitals are higher outside of "normal working hours" whatever that means.

    July 30, 2010 at 13:13 | Report abuse | Reply
  30. hobart

    Summer

    The death rates, either way, are minuscule, and good midwives have good backup plans with hospitals. In addition, they have good prenatal care plans, are good at anticipating problems, and will advise high-risk mom's against home births.

    July 30, 2010 at 13:14 | Report abuse | Reply
  31. Lisa

    Homebirths can be harmful but so can hospital births.

    July 30, 2010 at 13:16 | Report abuse | Reply
  32. isa

    My brother, sister, and I were all born at home. We have no health problems and zero allergies. My brother had the umbilical cord wrapped around his neck (gasp!) and surprise surprise, the midwives were trained in what to do and delivered him safely.

    July 30, 2010 at 13:22 | Report abuse | Reply
  33. VAJill

    What's wrong is the medicalization of childbirth......induced labors, drugs for mom, nurses who watch the monitor and not the laboring woman, compulsory IVs, the doc swooping in at the last minute, etc. I had 4 babies, all in the hospital (NOT my choice) but for the most part without drugs and certainly not an epidural. (Epidurals slow down labor, I don't care what the studies "prove"...I'm a nurse and I've seen it time and time again) My last one was delivered by the nurse, not the doctor, because she made her arrival a little more quickly than the doctor expected, and it was the best delivery of all of them.Unfortunately the local birthing center, which offered the kind of birth I would have preferred if not able to have my baby at home, did not open until several years after my last was born. In my opinion and experience, doctors are attempting to reserve for themselves what should and could be a very normal process by insisting on all the medical frills. A medical BACKUP is all that is needed for the majority of births. Unshackle the midwives, license them, and let them practice wherever the moms want them to!

    July 30, 2010 at 13:23 | Report abuse | Reply
  34. Autumn

    This article and headline is IRRESPONSIBLE journalism at its finest.

    July 30, 2010 at 13:25 | Report abuse | Reply
  35. Elena

    Just wanted to provide a counterpoint to everyone who says that they had terrible experiences with a hospital birth – I had a hospital birth, and my experience was wonderful. The nurses were friendly and caring, the epidural took away my pain but did not prevent me from pushing out my baby or feeling her being born, my ObGyn had my complete trust and confidence and I was very calm through the whole experience because I knew my baby was being monitored (external heart monitor, not internal) and any sign of distress would be immediately addressed. My baby was born kicking and screaming and I got to hold her right away. I needed a few stitches for a very minor tear, but I could not feel them because the epidural was still doing its job. My husband was by my side the whole time, and he was not traumatized by the sight of me groaning or screaming from excrutiating pain or tossing about (like you always see on these home births that people love to overshare with the world). Nobody pushed a C-section on me (even though I had an induction with pitocin) and overall I had the exact birth experience I wanted. I do think that it made a difference that I went to a hospital with just 12 L&D suites, only 3 of which were occupied during my labor and delivery, so I got plenty of individual attention and was not rushed in any decision or out the door after the birth (we stayed 3 days because we wanted to – it was nice to be cared for and to have help with the baby).

    If you are all in favor of women educating themselves about their options, why not mention that not all hospitals are alike? I would encourage women to check out different hospitals as well as birthing centers or midwives and see if you can't find a hospital at which you will feel just as comfortable. For me, knowing that help was seconds away if baby or I needed it was crucial. I would never choose a birth at home for that reason.

    July 30, 2010 at 13:26 | Report abuse | Reply
    • Pirogi

      Just wanted to mention that with my homebirth, I groaned and grunted and screamed during the second stage, but it was not the result of excruciating pain. Giving birth with no medication is just primal. There was no controlling my voice, I wasn't hurting, but I had to vocalize. It just came out.

      If vocalization scares a woman or her partner, maybe that needs to be examined by those people. Sometimes birth is just loud. Being loud doesn't equate to being in danger or in pain, during birth.

      Oh, and I haven't shared my birth video with anyone except my sister, who asked to see it when she was preparing for her own in-hospital birth.

      July 30, 2010 at 13:31 | Report abuse |
    • Elena

      Pirogi – sounds like you had exactly the kind of birth experience that I did not want. You think I need to have my head examined – guess what I think? Good thing it's a free country and we can each get what we want and not be forced into each other's birth experience.

      July 30, 2010 at 13:48 | Report abuse |
    • mother of four

      Elena–I can appreciate why you wanted the epidural, but–for what it's worth–a natural delivery is actually not as painful as one you're forced into by medical procedures i.e. induced labor, etc. If you're allowed to progress naturally and deliver in an upright position it's actually not all that bad. I've done it both ways. And–quite frankly–what's a little pain in light of the results? Unencumbered by IVs or interfering medical procedures, able to immediately hold your baby without someone insisting on injecting them with stuff, smearing crap on their eyes or sewing you up. By the way–if you'd had a doctor or midwife worth their salt–you probably wouldn't have torn enough to require stitches. That's something else. The epidural interferes with your ability to judge when to push (which your body does naturally on its own–all you have to do is get out of the way). I've done it both ways and can't recommend the natural way highly enough. Woman up, girl.

      And for anyone that thinks epidurals are low risk–you've been duped. After watching a couple of young mothers suffer from the after effects–I did some studying. Turns out that a fair portion of those who receive epidural suffer from migraines that continue to plague them for months afterward. Also, if it's not done exactly right, it can interfere with her ability to walk for several months. Something else I watched yet another young mother go through just recently. Her legs would fail her at random while she was walking–and she became afraid to carry her own child for fear of dropping him. In some–relatively rare–cases, the damage is permanent.

      July 30, 2010 at 14:22 | Report abuse |
    • Pirogi

      Elena – I don't think you need to have your head examined. I am truly happy that you were able to have the birth experience that you wanted. I fully support your right to choose for yourself.

      My only point was to dispel the idea that vocalization during labor means the woman is distressed or in pain.

      July 30, 2010 at 14:27 | Report abuse |
  36. brent

    good one Glo, state your credentials and pile the fear on,...you medilcal professionals never learn do you, never learn, you know it all cause you went to "school". You will induce labour, you will interfer, make the mom lay on her back, half of you don't even wash your hands properly and you will sit there and tell people their new born may die at home from a heart defect. i despise your attitude, your arrogance and your almight god like dogma.

    July 30, 2010 at 13:32 | Report abuse | Reply
    • fred

      I want to see you espouse that philosophy when you are in a car accident, having a heart attack or stroke, or if one of your family members is gravely ill. Complain about the MDs all you want, but they'll still save your ignorant a$$ when the time comes. And your the type of person who won't even thank them.

      July 30, 2010 at 13:45 | Report abuse |
    • Pirogi

      Those situations are completely different than labor and birth. Birth is a normal, natural bodily function. Those other situations are emergency situations, with trauma involved. Western medicine is great at treating traumatic situations, including those 3-4% of births that turn traumatic. Western medicine as practiced in the US is not good at helping babies enter the world with the least amount of risk, interference, and trauma.

      July 30, 2010 at 13:48 | Report abuse |
    • fred

      Actually death is a very natural process too. That doesn't mean it has to be accepted when the time comes if medical intervention is available. By your logic Perogi, there should be no consequences when a baby dies during natural child birth. It should be regarded as a perfectly natural outcome for some pregnancies. Most people would not want to see a baby die due to mom's concerns about keeping her environment natural. It always comes down to the same scenario: people want what they want until something goes horribly wrong, then the MD has to ride to the rescue. And if they can't save someone, well just watch the attorneys line up to collect their fees.

      July 30, 2010 at 14:12 | Report abuse |
    • Pirogi

      FWIW, I would never sue a midwife if my baby died during birth. Taking responsibility for your birth means just that. It isn't the midwife's job to save me or my baby.

      July 30, 2010 at 14:29 | Report abuse |
  37. Johanna

    I recently gave birth at a Birthing Center. After being born at home myself and having never been treated at a hospital, the thought of going to a hospital made me more nervous than giving birth. Some of my friends and neigbors found me a bit insane but I assured them that my body could handle it if I could move around turning labor and was not given any labor "enhancement" drugs like pitocin. Their biggest concern seemed to have been "What if there is a problem?" My Center would not have allowed me to give birth there with only a midwife present had I been high risk. Plus I had all the paperwork for the local hospital filled out in case I need to go there ASAP. In the end, I gave birth squating in a hot tub (it's what my body told me to do and it seemed most efficient).

    Six hours later we were home and neither myself or my daughter had any issues; the midwife even did a home visit a few days later. During my experience I never felt like a number or like there was a disaster waiting to happen. I never felt like we were on a set time schedule or that I might not be able to do it. My daughter never cried there (I think that she liked the natural light and calm envirnoment). My husband liked that they brew him a pot of coffee upon arrival, he never had to see her behind a glass wall and that we remained the decision makers the entire time. After comparing experiences with my friends and neighbors, the majority of them will chose a Birth Center for baby number two. I certainly will.

    That being said, my best friend was very high risk and had a scheduled C-section 10 days after my delivery. I am thankful that OB/GYNs and hospital births do exist but they certainly are not neccessary for everyone.

    July 30, 2010 at 13:32 | Report abuse | Reply
    • Liz

      Thanks for sharing your experience Johanna – I hope that this option becomes more readily available for women!

      July 30, 2010 at 21:24 | Report abuse |
  38. Bob C.

    Before the 20th century, when most children were born at home, the odds of a woman dying giving birth were around 1%. Now, in the U.S., when almost all births are done at hospitals, it's around 0.013%. Neonatal mortality (0-28 days) in the U.S. is 2%, in Africa, it's 10%. Guess which one has more home births?

    Giving birth at home isn't as safe as giving birth in the hospital. Hospitals, though, need to make the experience more calming and comfortable. Birthing centers next to or inside hospitals are the best solution, as you get the best of both worlds. (FYI, even in birthing centers there is higher perinatal mortality than in a hospital, and even though women are deemed low-risk before being allowed in, 12% of women will end up transferring to the hospital while in labor).

    July 30, 2010 at 13:43 | Report abuse | Reply
    • Pirogi

      Comparing birth outcomes in Africa to birth outcomes in the US is a logical fallacy. Most women in the US have access to nutritious food, clean water, shelter, freedom from war, pestilence, and disease. The same is not true for most women in Africa. The high mortality rate for mothers and babies in Africa is not a result of homebirth. If you want to compare birth outcomes, you need to look at developed nation #1 vs developed nation #2.

      July 30, 2010 at 13:50 | Report abuse |
    • Pirogi

      Also, the rate of hospital transfer is NOT a reflection of risk status during birth. Women transfer to the hospital during birth for many reasons, and different care providers have different rates of transfer. First time moms are more likely to transfer. Women with long (but completely normal) labors are more likely to transfer. People who weren't 100% committed to natural birth are more likely to transfer.

      What is your source for claiming that birth centers have higher rates of neonatal mortality than hospital births? I haven't seen many studies that compare birth center statistics to hospital statistics; usually the focus is on homebirth.

      July 30, 2010 at 13:55 | Report abuse |
    • Desi

      You need to take into account how many of those numbers are actually multiples such as twins and triplets born too early that come as a result of fertility treatments that were not around in the early 20th century nor are common in Africa. The number of multiples has gone way up, but it also poses the risk of preterm labor. Many of these little preterm premies don't survive.

      July 30, 2010 at 18:38 | Report abuse |
  39. birth professional

    I think the anti-homebirth commentors are generally missing the fact that homebirth usually has a midwife present, and that midwives are typically exceptionally well-trained people. They not only have a degree in midwifery, they also show up with medical emergency kits that include oxygen, medicine, sutures, etc. In this area they also screen their patients so that they don't usually take moms who have any health concerns, those women are referred to a hospital (where it's in the mom's best interest to be). Homebirths can be beautiful experiences, but it is advisable to only try it with an experienced educated professional, and only if you have no prior health concerns. I'd also be more comfortable if I labored close to a hospital.

    Just my 2cents...

    July 30, 2010 at 13:44 | Report abuse | Reply
  40. Bella

    I had hospital births with both my children. And I had epidurals after waiting as long as possible. My second was induced due to a medical issue that necessitated an induction. I was never pressured to have drugs, and I was never pressured for a C-section. With my first, I labored from beginning to end for 50 hours. Yes, 50. All but 6 hours of that was spent at home, and all but 2 hours of that was drugless. I had my epidural and had my baby 2 hours later. My midwife kept asking if I had energy, and said she'd let me labor as long as I had the stamina, or unless the baby was in severe distress. With my second, I had a doctor, but she was wonderful. If you want a hospital birth, do your homework. Not all doctors push crap on you. I felt safe knowing that if something necessitated either of my babies needing emergency care, that I was right down the hall from the NICU...I didn't want to worry about getting to the hospital in time in the dead of winter, especially if the weather was inclement.

    That said, I have nothing against home birthing. I think it's a wonderful thing for low risk moms. It's up to a woman where she wants to have the baby...I really don't appreciate the fear-mongering on EITHER side. Everyone saying that hospitals pressure you...maybe that was your experience, but I knew from the get go that it was MY birth and barring any complications, this was going to go MY way. And to the people dissing home births, With a good contingency plan in place in case of emergency, and with a skilled, trained midwife (you can get a Certified Nurse Midwife, you know...) it's possible to have a safe home birth. Should high-risk women have a home birth? Probably not the best choice, as most ALL the home-birthers have stated. It's a matter of personal preference, and neither choice should be made without diligent research, including meeting with doctors or midwives or doulas.

    July 30, 2010 at 13:45 | Report abuse | Reply
  41. Doula Nicole

    Bottom line – this is an editorial, not a scientific study. If you are going to pass judgment on those that responsibly choose to give birth at home, you should check your facts first.

    July 30, 2010 at 13:47 | Report abuse | Reply
    • MKNC

      Or vice-versa on those of us who choose hospital birthing. It goes both ways.

      To each her own and knowing the trade-offs, physically and emotionally, makes this a personal and individual decision.

      July 30, 2010 at 14:13 | Report abuse |
    • Nicole

      Absolutely. My comments were mainly aimed at comments like those from Summer. Very judgmental, very ignorant. I believe everyone should fully educate themselves on all the risks and benefits of both sides, and choose what is best for their situation and family. There are risks with birthing in a hospital, too.

      July 30, 2010 at 19:04 | Report abuse |
  42. Mary

    Sigh. Ignorance just goes on and on and on. Studies, research and experience has proven that homebirth is NO MORE dangerous than hospital birth and in many cases, much safer. Women and babies die because of hospital error and even just because that sometimes happens. Hospital birth does not guarantee safety and yes homebirth can even be safer. That said, as said, it's personal choice. Frankly for me, it's the best choice, I don't deign to make that choice for others, but I know it is best for me and my babies. They are safer at home than at the hospital. I consider hospitals for emergencies, not normal birth. Before making blanket statements like this, do your research. The research shows homebirthers know what they are taking about.

    July 30, 2010 at 14:16 | Report abuse | Reply
  43. SMH

    There is also a small faction that wants to keep their children "off the grid" without being registered and w/o SS#'s.
    Since they probably do not file tax returns, they dont care if they get an exemption.
    They do not want their children in public (or private) schools.
    Most get caught when neighbors see the child.
    No government likes having a population under its radar. Even undocumented aliens are tracked.

    July 30, 2010 at 14:20 | Report abuse | Reply
  44. Hester

    I was born in 77 at home with an experienced midwife in attendance. I came out in "frank breech" position and had to be resuscitated by the midwife. My younger sisters were born in 79 and 81...same midwife. My youngest sister had her cord wrapped around her neck. The midwife deduced this and then reached up inside my mother and unwrapped it so she could descend on the next push. I didn't find it harmful.
    Just a sarcastic aside....Interesting how CNN is nothing but a big discussion forum free-for-all these days full of nothing but conversation starters disguised as article links. I remember when CNN was a good place to go for actual news.

    July 30, 2010 at 14:24 | Report abuse | Reply
  45. sandi

    The bottom line about the safety of home vs. hospital birth will not be solved easily or soon. This is not a condition that can be randomized so any study done on this topic will be observational and will have major flaws, including major selection bias (the type of people and the medical conditions of those choosing home vs. hospital birth differ) which will influence the results.

    And for the hospital birth-naysayers: It is possible to have a natural, no-pressure, empowering, intervention-free birth in a hospital. IF you are educated, aware, have a good support team (including doc, nurse, partner and/or doula), and are proactive about it.

    July 30, 2010 at 14:27 | Report abuse | Reply
  46. Jason

    Dad of two beautiful homebirth children and would not have it any other way. I encourage people to read and watch various information sources the cover both sides of this debate so your are well informed about all the issues and outcomes. Without knowledge you can't make informed decisions about the care your are receiving. As "homebirthers", we picked the care we thought would be best for our family. Plus we did not burden the medical establishment with our natural birth and paid out of pocket for our midwife services ($3500) since the Medical insurance we pay $400 a month for does not cover birth. Pregnancy is one of those nasty pre-existing conditions we all have to deal with. Read, learn, do want is best for you.

    July 30, 2010 at 14:41 | Report abuse | Reply
  47. Caryn Weber

    Dr. Gupta – I really wish you would do your homework before publishing an article such as this one. If a mother and pregnancy are low-risk, it is much safer for mother and baby to be home for labor and delivery. Nothing good comes from unnecessary interventions (continuous fetal monitoring, pitocin, and forced breaking of waters).

    July 30, 2010 at 14:51 | Report abuse | Reply
  48. dee

    I am choosing to give birth to my second child at a birth center with a midwife. I had a non-emergency C-section with the first due to a vaginal septum blocking my cervix that was not discovered until I got to the hospital after 9 hours of labor at home. It has since been removed. Unfortunately, I have moved from Texas to Shreveport, Louisiana which apparently is vehemently against VBACs. Yes you can have one, but you must be confined to your hospital bed with an IV and continuous fetal monitoring and you must be babysat by your OB and the anesthesiologist must be in the hospital. Hospital policy, I'm told. With those restrictions, I might as well just schedule another C-section because there is no way I'm going to be able to have my baby naturally. I need to be able to get up and walk! If VBAC has been deemed safe in most cases, then why did my OB (who was 1.5 hours late for my appointment!) use all these scare tactics against me, when she came recommended as the most VBAC friendly doc in town? Yes I would give birth in a hospital again. I had one all picked out. But I DO NOT want another C-section. A good friend of mine had a VBAC with twins – almost unheard of! Why can't I give it a shot? Am I worried about the risk of uterine rupture? Sure, but there is a hospital right across the street from the birth center, with a doctor that my midwife trusts and has a partnership with. I think I would rather still give birth at a hospital, but I want to be free to give birth as I choose, the way that I KNOW is best for my baby, and as I won't have that option here, I will drive (ok hubby will drive) across the border to Marshall TX where the birth center is located. Oh, plus the midwife will cost several thousand dollars, where the hospital is free to me, since we are a military family. Worth every penny in my opinion. PS – my husband and his 5 brothers and sisters were all born at home, and only the last one was attended by a midwife – she apparently was in bad shape but made it just fine, thanks to the midwife.

    July 30, 2010 at 15:02 | Report abuse | Reply
  49. Avery

    In the 1980's I home delivered TWO babies.
    I considered my midwife (with close to 1000 home deliveries and NO deaths) more competent than the local MDs and my house was cleaner than the hospital...
    No problems.
    This article is more of the same medical propaganda that CNN has has been dealing for a number of years.
    Seems to me that the corporate medical community feels threatened by folks who don't want to buy into the program and become addicted to the medical model and all the drugs they deal.
    By the bye? My un-immunized kids were raised without television and competitive team sports as well. They seem to be doing Very Well – which indicates that the "norm" that the corporate culture wants to impose on us all is irrelevant in the face of reality.

    July 30, 2010 at 15:05 | Report abuse | Reply
    • Aunt

      So you're saying my baby nephew, still too young to be immunized, who almost died of whooping cough because his older brother brough it home from someone at his high school who was not immunized and was sick but still coming to school, is not reality? I find your comment deeply offense thinking about that little baby struggle to breathe.

      July 30, 2010 at 15:16 | Report abuse |
    • Future mom

      Thank you for putting my future infant(s) at risk because of your failure to immunize.
      Medical propaganda? What on earth are you doing? Your experience is with only 2 babies (glad to hear that they are healthy)- are you telling us that the hundreds of thousands of births that are happening in this country are all going to be exactly the same as yours? Thats the worst propaganda that I've heard.

      July 30, 2010 at 22:13 | Report abuse |
    • Bella

      Future mom, she said that the baby nephew's brother got it from SOMEONE at that kids high school came to school sick with it, because he wasn't immunized. Not the brother.

      July 30, 2010 at 22:22 | Report abuse |
  50. Vic

    Statistics and stories will never influence us more than our own experience. I did not have a nightmare experience giving birth in the hospital. That's where I plan to be in Feb when baby #2 is due.

    Unfortunately, not every has a "low risk" and "perfectly smooth" pregnancy or delivery. If l was going to be all natural, I would have any kids at all. My husband and I needed some western medicine help to even get pregnant. And then we needed more help to bring them into the world. If nature delt you an easy peasy hand, be thankful. You have some choices. Some of us did not get those cards, but that doesn't mean we gullible sheeps eating up whatever is dished out to us. Nature made some choices for us.

    Like everything else, the best choice is an educated one that you made for yourself.

    July 30, 2010 at 15:07 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.