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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. Sarah Educate

    I personally feel safer at home! Among the many reasons I have for staying home, the main one is that more problems arise when you the baby on someone elses clock. At home, birth is considered normal and heatlthy and the whole process is trusted. I see far less risk at home in my experiences. Too bad all studies aren't always complete! The majority of the homebirths that need medical attention are documented and added to the statistics. There are several normal healthy births that are not reported because they are just that, healthy and normal.

    July 30, 2010 at 15:48 | Report abuse | Reply
  2. VBAC Mom

    I had all three of my children in a hospital. My first was an emergency Csection because of fetal distress and a horrible experience for me. It was an HMO hospital that not only put me in the same room w/ a new mom who got to hold her baby and love on it while mine was in NICU, but I had a rude nurse who wouldn't tell health news, prevented me from holding my baby etc. Not a good hospital experience, but not my last.
    The other two were at the same location same OB/GYN. My second was a VBAC which was wonderful. Women who say they would rather have a csection has never had a vaginal birth. She was 2 weeks late, no induction and took my time w/ the birth. My third however was w/ placenta previa so another csection and premie birth, hence no more children. But it was still a wonderful experience. I had epidurals or saddle blocks for each pregnancy with my full faculties.
    I have nothing against home births. I think if there are no complications that is a great experience. My dad was born in my grandparents home in 1932 as a premie weighing 3 1/2 pounds and grew to be 6 foot tall and no major health problems until smoking & ALS caught up w/ him.
    I think a lot of these studies are flawed. I think other posters are correct that they are using outdated info rather than newer facts and statistics. I also think hospitals need to lighen up about VBACs. Women should have a choice, about hospitals, home, OBGYN, Midwives etc.

    July 30, 2010 at 15:49 | Report abuse | Reply
  3. Stephanie Morton

    I have read the copious amounts of "comments" on this article and I am actually extremely dissappointed with the nature of the entire discussion. Why is it necessary for anyone, male or female, to judge another for how they choose ot have their children? It seems that this has turned into more of a forum for people to try o ppush their beliefs on others. I find it sad that no matter what a woman decides she can and usually is chastised by a group with opposite thought processes. Whatever choice you make it is personal and up to you and only you. Hopefully, those decisions come with a level of risk and responsibility that the individual is comfortable with if the outcome is not what was planned.

    July 30, 2010 at 16:16 | Report abuse | Reply
  4. heart@home

    To expect the American Journal of Obstetrics and Gynecology to say anything to the contrary would be like expecting the Ford company to put out a study stating that cars made by GMC are safer. Give me a break! Please tell me people don't actually make decisions about their health care based on articles like this one.

    July 30, 2010 at 16:18 | Report abuse | Reply
  5. Max

    Wonder what the opinion is of the lady who gave birth at home in Texas a couple of months ago and now has no arms, legs and several of her organs due to staph infection.

    July 30, 2010 at 16:20 | Report abuse | Reply
    • Uh...

      I got a life-threatening staph infection from the hospital. Did I make the wrong choice too?

      July 30, 2010 at 17:29 | Report abuse |
  6. Megan

    I am a molecular biologist and the mother of a very happy and healthy 3 year old who was born at home. At the very least, this CNN article fails to give the whole picture on the study cited. To quote the results listed in the article abstract (without omission):

    "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."

    As the study results indicate, there are clearly risks associated with either hospital or home births. However, the phrase "significantly elevated" does not mean "likely". In fact, infant mortality rates in developed countries are extremely low, regardless of where the birth takes place. Adequate nutrition, prenatal care, and better disease prevention all play a huge role in this. What this study still fails to take into account is context. Women plan a homebirth for a variety of reasons. Some can't afford medical care or have no access to medical care (such as in rural areas). Others can't find a doctor who is willing respect their birth decisions (such as VBAC, minimal medical interventions, keeping the baby in the room, and breastfeeding). And others just feel safer and more comfortable outside of a hospital. Many of the interventions taken during birth are much less out of medical necessity and more out of a fear of getting sued. There are situations where hospital births and medical interventions are absolutely necessary to ensure the well-being of both mother and infant. There are other situations where homebirth is just as safe (or safer) than a hospital birth. The cesarean section rate in the United States is alarmingly high, and as my physician friend put it, "C-sections are a major surgery." Many factors need to be taken into account when choosing a homebirth. Homebirth is not a good choice for high and often moderate risk pregnancy. A trained birth attendant should always be present. A hospital should be close enough that a transfer is possible if needed and the mother and birth attendant need to be willing to accept that while not frequent, transfers are needed with about 5% of all homebirths. Doctors and midwives can each make childbirth safer and less frightening for all women if they allow the mother to make educated decisions about what is or is not best for both her and her baby. And doctors and midwives need to stop fighting over who is right or wrong and work together to make the pregancy and birth as safe as possible. Refusing to support the licensure of midwives does not stop homebirth, it just pushes it underground. It is impossible to regulate homebirth and make sure that midwives are properly trained if they have no legal recognition. It also scares midwives and their clients away from seeking the help of a doctor if it is needed.

    July 30, 2010 at 16:29 | Report abuse | Reply
  7. Daddy of 4

    GO MIDWIVES!

    Sooooo much better than hospital deliveries.

    July 30, 2010 at 16:29 | Report abuse | Reply
    • Bella

      Just because you have a midwife doesn't mean you're giving birth at home. Women can have a midwife deliver their baby at a hospital, and many do. Just as there are some doctors who will do a home birth, especially in the more rural areas.

      I hate how people on BOTH sides are judging each other for what is a PERSONAL CHOICE. Funny, childbirth is something that should bring women together, yet more than ever seems to tear us apart.

      July 30, 2010 at 22:28 | Report abuse |
  8. Amanda

    I think we should all be grateful that we live in a society, and a period in history, where we HAVE so many choices available to us. Women who would otherwise die in childbirth can now have their lives, and their babies' lives, saved, by a variety of methods. We should be celebrating this, not tearing each other apart because we don't all agree on "the best way to have a child." The best way to have a child is the one that results in a healthy mother and a healthy baby, PERIOD. For one mother, that might be an unattended home birth. For another, that might be a scheduled C-section. Live and let live, people.

    July 30, 2010 at 16:33 | Report abuse | Reply
    • Vic

      Well said Amanda. I agree completely.

      July 30, 2010 at 17:06 | Report abuse |
  9. Mary T

    I gave birth at home 32 years ago with a Certified Nurse-Midwife. I can not imagine having done it in a hospital. I was 5 minutes from a hospital had my highly-trained birth attendant seen the necessity. There is a lot of emotion surrounding what women have the 'right' to do. It's no-one's business. People get very judgmental about how other people give birth but not a single one of them would babysit for an exhausted mother of an infant or small child. Neither would they lobby to make sure babies and children are protected from second-hand smoke, loud noises, poor medical care, and so on. What is the difference? You care about how a baby is born, but you don't care what happens once the event is over? When MY child had a baby, she wanted to do it in a hospital. I fully supported that because it was her choice. A woman giving birth is a force unto herself. NO-ONE should interfere with that elemental power.

    July 30, 2010 at 17:03 | Report abuse | Reply
  10. Claire

    My first son was born vaginally at a hospital.

    6 years later, we became pregnant again after several fertility treatments. We looked at the options – 2 local hospitals, each with a c-section rate of about 35% versus a midwife assisted home birth. (CNM with a 5% transfer rate.) We preferred to avoid a c-section if possible because of increased rate of respiratory disease with c-section and also increased chance of maternal death. (Interestingly, c-sections are more common for women like myself who have good health insurance.)

    We found a highly trained, experienced CNM. We had a successful home birth, baby boy #2 is happy and healthy. We have no regrets.

    For baby #1, the hospital billed $24,000 for a vaginal birth (no epidural) and 3 days in the hospital. For the home birth, the midwife billed $2,400. Huge cost savings, same outcome.

    July 30, 2010 at 17:29 | Report abuse | Reply
    • gem

      try managing your next heart attack at home too, it's much cheaper....and, perhaps the outcome will be the same if your lucky since many people survive a "little heart attack". Either way, it's more natural and people had them at home for eons before the modern medical establishment came into being...

      August 1, 2010 at 15:48 | Report abuse |
  11. dismayed

    Obstetricians are trained to fix problems. They are a wonderful asset to our society and save tens of thousands of lives every year through advances in medicine. Most of them don't know beans about "normal birth" though. They see a problem to be fixed, a riddle to be solved through the correct sequence of interventions, drugs, and surgeries.

    An obstetrician is as necessary for a normal childbirth as an ASE Master Mechanic is for adding air to your car's tires. Which isn't to say there isn't a place for either of them – thank goodness they're available when something really *does* break.

    July 30, 2010 at 17:45 | Report abuse | Reply
    • Liz

      Sounds like you have an uneducated, biased view of a group of people whose life is about bringing babies into this world, as is the same with midwives.
      Lets stop with the politics and start caring about the best care of the moms and babies.

      July 30, 2010 at 21:39 | Report abuse |
  12. dontstress

    Had a great hospital birth. No infection,no bad attitude of medical staff, no pushing things on me I didn't want. Don't understand all the negativity. My anesthesiologist was a godsend as far as I'm concerned. Whatever you want to do should be fine as long as you fully understand the consequences of whatever path you choose.

    July 30, 2010 at 18:06 | Report abuse | Reply
  13. Melita

    Another example of the "business" of medicine and the medicalization of natural, normal human experiences. While hospitals are important in cases of high risk pregnancies and emergencies, they are not geared toward addressing the spiritual, emotional importance of such an event. Studies have shown that women bond better with babies in a home environment, lessening the incidence of postpartum depression and they often report a spiritual experience that is absent in the cold, clinical environment of a hospital and the the use of possibly harmful drugs is minimized.

    To the writer citing high infant mortality rates of the past – it wasn't just babies – everyone had a higher risk of death because no understood bacteria and the importance of sterilization until modern times.

    I would also add that the same is true for the other end of the issue – death. Death in a hospital is a horrendous experience and lacks real spiritual meaning and closure for the one who is dying or their loved ones.

    July 30, 2010 at 18:29 | Report abuse | Reply
    • Bella

      I bonded just wonderfully with both of my girls...at the hospital, thank you very much. I don't have less of a bond because of where I gave birth to them! And whether a woman chooses to deliver at home or deliver at a hospital, it is ALWAYS a miracle, it is always a testament to our strength.

      July 30, 2010 at 22:32 | Report abuse |
    • Maria

      I bonded wonderfully with my son with my planned csection.

      July 30, 2010 at 23:05 | Report abuse |
  14. Heather Bessent

    Really,,,,what studies? I'd like to see some statistics, because as another poster said, referencing some invisible studies really doesn't do it for me, not when we have had more than one study over the last few decades that even when flawed (not separating accidental homebirths from planned homebirths, and therefore not showing a completely accurate picture of homebirth) but even then....homebirth has shown to be at least as safe, if not safer, than hospital birth.
    Had my youngest child been born in the hospital, she would have had unneccessary antibiotics (because protocol, not our specific case, would have called for it) and an immediate injection of vitamin k (again, protocol, not our specific case); she was actually clotting too much even without the vitamin k shot, but had she been given that k shot, as all US babies are, she could have ended up in a very bad situation indeed.
    The right choice for birth is the one that consider all risks and the well-being, physical and emotional, of the entire family.

    July 30, 2010 at 18:31 | Report abuse | Reply
  15. TheCrux

    Well, as someone who, as the father, has been involved in hospital and home births, I can firmly say that the home birth experience is dramatically better. A home birth is a truly wonderful event. Much, much more pleasant for the mother.

    As to the safety factor, the United States is the only developed nation where a majority of the births occur in hospitals, a pertinent fact elided from this article. Infant and maternal mortiality rates in the United States are quite high. So, the only developed country that uses a hospital birth system has one of the higher infant death rates, but somehow it is unsafe to not give births in hospitals? I am at a bit of a loss as to the logic employed to reach the conclusion that home births are unsafe.

    Most developed nations utilize birth centers and midwifes. Based, once again, on my personal experience, a midwife provides dramatically better birthing support and service than a doctor. Our midwife stayed with my wife for some thirty hours of labor.

    In the hospital birth, I believe the doctor spent about fifteen minutes with my wife before talk of a C-section arose.

    July 30, 2010 at 19:07 | Report abuse | Reply
    • Nicole

      I agree completely. This has been my personal and professional experience as well.

      July 30, 2010 at 19:13 | Report abuse |
  16. CD

    I do not have children yet, but when I do I would like to have them in my home so long as I do not have any medical issue going on with me or my baby. I don't think it's a cost thing, I think people are tired of going to the doctor and being treated like crap.

    July 30, 2010 at 20:30 | Report abuse | Reply
  17. pookey

    Hospitals cause most of the emergencies they (sometimes) fix.My wife has worked as both a homebirth midwife and in labor/delivery in a hospital, oh the stories she can tell! We had a homebirth, it was extraordinary in a way that a hospital birth could not provide. As long as you have a talented midwife who can identify potential complications before the birth, you are safer at home.

    July 30, 2010 at 21:33 | Report abuse | Reply
  18. AH

    Home birth is a safe option for healthy, low-risk women, and reliable studies indicate that outcomes for moms and babies are as good if not better when babies are born at home with a skilled midwife attending the birth. I have had a baby in a hospital with an OB, a baby in a birthing center with a midwife, and a baby at home with a midwife and a doula. All three were uncomplicated, and I did it without pain meds each time. The best birth by far was the home birth because, as a healthy, low-risk woman, I had every resource I needed right here: my body, my baby, my husband, my midwife and my doula. My baby and I were safe and were being closely watched by my highly-skilled midwife, but I did not need any intervention, and almost as importantly, there was no fear of unwanted or unnecessary intervention!

    July 30, 2010 at 21:36 | Report abuse | Reply
  19. Atrag

    Families should be able to chose to have their baby wherever they wish. I had both children in a hospital...or should I say, an Embassy Suites that staffed doctors and nurses. I felt like a queen, was treated like one, was catered to with care, concern and kindness. Every choice was ours from 4 weeks of pregnancy until the day we went home. We are in the $50k – $75k income bracket, so lower middle class. Money played no role for us, fortunately. However, I work for a Chiropractor and see many many families who have home births. There are some out there who just can't afford to pay $4k – $6k to have a child. A doula or midwife is 60% less in our area. In these economic times, it certainly is the reason for home birth for many families. And of course they should be able to make this choice. In the hospital, I was not forced, coerced, or even an opinion given to take drugs. Where are these horror story hospitals at where they are forcing c-sections and drugs on women? What I really want to know is, why some of you crazy women think there is something wrong with an epidural?? Why is it perfectly acceptable to have anestesia when you have surgery but it's not ok when going through something as horrifyingly painful as childbirth? Be my guest and opt out if you want, but why the heck would you?? Do you also get fillings in your teeth without anesthesia because it's how 'god' intended? Hooray – you gave birth naturally. Here's your round of applause and a gold star and 35 stitches. If you are lucky enough to be able to afford a hospital birth, shop around and find the hospital that will fit your expectations. If you live in an area where Dracula is the doctor and his indentured servants are the nurses and they charge thousands of dollars and force you to get c-sections....home birth may be best. But isn't it so nice to have the CHOICE?

    July 30, 2010 at 22:01 | Report abuse | Reply
    • aviekins

      "why is it perfectly acceptable to have anesthesia when you have surgery but it's not ok when going through something as horrifyingly painful as childbirth?"

      because, atrag, childbirth *is* a natural process of life. as oxytocin is released in waves and the mother copes with the pain of labor, moving into different positions to assist the baby to maneuver through the pelvis, her body release endorphins, which are natural painkillers. (the same hormones that are released after exercising, or when you hang out with a great bunch of friends and are laughing like crazy – "feel good" hormones) the more oxytocin is released, and the more the mother is able to work with her labor, the more endorphins are released – creating an almost dreamlike stage. if a woman can allow herself to just let go of control and let her body do what it needs to do, labor is anything but "horrifyingly painful".

      (these endorphins are DEFINITELY not released when having surgery or teeth extracted, btw. as much as anethesiologists or doctors try to compare childbirth to medical procedures, it's bs.)

      as a p.s. – women with epidurals are more likely to receive episiotomies and/or perineal lacerations (and cesarean births)... so watch out for those stitches! 🙂 i have nothing against epidurals, and was open to using one last time around if it came to that - but was happy to find out that all of a sudden i was 9.5 cm and ready to push. **shrugs** it's amazing what you can do when you work with and trust your body. (i don't want a medal or a gold star, it's a just a personal warm-fuzzy feeling)

      July 30, 2010 at 22:34 | Report abuse |
    • Bella

      I have to defend natural birthers on this statement, even though I opted for an epidural both times...

      If a woman wants to go through birth without pain relief, that is HER choice, and you know what? More power to her! I proudly admit I was a wuss and couldn't deal with the pain. I held out as long as possible...but I chose what was right for me.

      Also, whether or not a woman chooses an epidural or similar pain relief has no bearing on whether she tears and needs stitches or not. I ripped both times and required plenty of stitiches.

      Women who give birth deserve a gold star, period. Whether they give birth at home, in a birthing center, in a hospital. Whether it's in a tub, on a ball, on all fours, on our backs, screaming, yelling, silent, laughing, crying, puking, pooping, in pain or pain free. Pushing a baby out or having a baby exit through a slit in her stomach. She has carried and incubated a wonderful, beautiful life inside of her, and however she decides to bring that life into this world is HER choice, and no woman should be blasted for how she decides she wants HER birthing experience to go.

      July 30, 2010 at 22:43 | Report abuse |
    • Nicole

      2 Homebirth Babies. Both perfect and beautiful experiences. Birth was definitely not horrifyingly painful. Its sad that you think so. I do not want a freakin gold medal. I just want women to realize that birth can be such an empowering and beautiful experience – but when you add in the interventions (such as an epidural) it completely changes the natural chemistry of birth. When you interrupt this natural chemistry birth is more painful. When women are forced to birth on their backs it is more painful. When women are given Pitocin it is more painful. It is wonderful we have the choice – you can have the empowering and natural experience or the horrifyingly painful experience. Which would you choose?

      July 30, 2010 at 22:49 | Report abuse |
  20. aviekins

    "She has carried and incubated a wonderful, beautiful life inside of her, and however she decides to bring that life into this world is HER choice, and no woman should be blasted for how she decides she wants HER birthing experience to go." 🙂

    i agree – as an OB nurse i am all for epidurals, IV/IM pain meds, non-pharm pain relief, whatever works. it's not my birth story – it's the mom's, i'm just there to help.

    July 30, 2010 at 22:46 | Report abuse | Reply
  21. Bella

    Also, Aviekins, I did not want an episiotomy either time, instead opting for perineal massaging, and if I ripped then so be it! (I saw no point in cutting me when I felt that if I was going to rip, then I wanted it to happen on its own. Plus I did research on episiotomies, and they can actually make tearing worse. But I still would blast a mom for opting to have one.) And my wishes were respected. And I tore both times...let me tell you, I spent a lot of time using that squirt bottle to clean my stitches! 😀

    July 30, 2010 at 22:48 | Report abuse | Reply
    • Bella

      ^^^^^^But I still would NOT blast a mom for opting to have one.^^^^^ *forgot the 'not'* oopsie!

      July 30, 2010 at 22:49 | Report abuse |
  22. Janet

    Every birth is different...How joyous and wonderful it would be if we all had beautiful home births like Nicole, but, alas, that isn't the case. There are women who can just fly through pre-labor without any knowledge it is happening, and the baby comes right out in a subway station. There are those who struggle mightily with a baby in breech that doesn't want to come out. Some women's water breaks and it is all said and done. Others aren't so lucky and struggle through much pain. You can plan the perfect birth, complete with mid-wife, doula and warm bath and have all the intention to go through naturally, and NATURE has different plans for you. We are all different! Life happens along with all its complications! A hospital delivery does not automatically make you a candidate for pain, misery, epidurals and horror. It too can be empowering. Barring complications, I am sure a home birth can be a wonderful experience. Unfortunately, we can't just clap our hands and make all the problems and complications go away as we give birth. Just opening our minds to the experience of natural, home delivery will not make the experience perfect and beautiful. Sometimes our bodies and our babies have different ideas. It is important for women to see their care providers as advisors, not dictators. We choose our course and our advisors help us. Birthing is a dramatic experience...so much can happen. We need to see our caregivers as partners. When we have a good relationship with that person, whether it be a doctor or mid-wife, we are empowered. They should respect our wishes, provide support and good counsel. We should also be willing to be flexible when necessary. We cannot control the course of events, as we all quickly learn as parents! Let go of expectations!

    July 30, 2010 at 23:35 | Report abuse | Reply
  23. Threetimes

    I have to wonder if the study mentioned in the article applies in the United States. In anticipation of my first birth I did a tremendous amount of research on PubMed. Based on many studies, the experience of the entire country of The Netherlands, statistics comparing birth outcomes among countries, and other sources, I came to believe that in the United States homebirth with a qualified midwife was safer than hospital birth - safer for the baby and, even more so, for the mother. I have now had three homebirths. My first and third required intervention, which the midwives ably provided, and I have three healthy children. I am reasonably sure that our outcomes would not have been as rosy with standard hospital birth. I chose homebirth primarily for its safety., not for a more poetic experience. And I am glad I did.

    July 31, 2010 at 00:35 | Report abuse | Reply
  24. Bud

    At the risk of sounding pompous I submit that the reason we had all our children at home, successfully is that we got pregnant, we were not sick and we studied very diligently the current literature on childbirth. There was no one more concerned over our child's fate than we were. Doctors and their expertise vary as in any profession so the dilemma is who to choose. Rather than spend time researching physicians we educated ourselves. We took responsibility to learn about the birth process by studying medical texts. Our children were in the best hands. We had no motive for being "natural" no disdain for Doctors or hospitals. We had more at stake than anyone else.
    For those of you who will want to place "Luck" as a factor may I suggest in fairness, you give equal weight to "Misfortune". Clearly, in fact, we made the correct decision, all three times. Taking sides on this issue and claiming intellectual superiority, calling people fools is sophomoric. I submit that for the most part couples in pregnancy want healthy children to love. Their choice and the consequences are not to be judged by anyone.

    July 31, 2010 at 00:50 | Report abuse | Reply
  25. Deborah

    I was born at home here in eastern Kentucky in the National Boone National Forest. I remember being born! I was so shocked I didn't talk for almost a year! LOL Seriously, there was no hospital in our area in 1961 and I'm fine. Really! I think I'm fine. Well maybe if the flying monkey's would stop bothering me. -- Ok, really seriously...this being born at home is dangerous, etc, is non-sense! I am a former RN and I never once had a patient come into the ER from a home birth gone bad. Gee, how did we make it all those centuries without a hospital birth? Did you know that Princess Diana was the first Princess/Queen, etc., to give birth in a hospital. If it's good enough for royality???? I know hospitals are necessary but this is NOT an 'abnormal bodily condition'. If you feel better in a hosptial, go for it, if you feel better giving birth at home...go for it! Your right.

    July 31, 2010 at 00:57 | Report abuse | Reply
  26. Family Medicine MD

    -CNM's do a great job and are considered by everyone I know (I am a family medicine MD who delivers babies) to be valuable colleagues. reasonable people would never debate their proficiency and skill.
    -home births are safe the large majority of the time in low-risk situations. in rare instances, there will be unpredictable issues that merit immediate intervention. a home birth COULD place those moms/babies at risk. severe shoulder dystocias, severe post-partum hemorrhage, uterine inversion, undetected major cardiac abnormalities (which have a dismal detection rate even by moden ultrasonography), respiratory distress, amniotic fluid emoblisms etc.
    -all of the above are rare but do happen, rarely. there would be no time for 911 to help. you are in trouble even in a great hospital if these happen.
    -if you look hard enough, the data will probably bear out that there are small differences, because these are risks that are oftentimes unforseeable, and immediate intervention would improve outcomes. so maybe the data is politically charged, but not flawed. I dont know.
    -there is some slight analogy to SIDS: sleeping on back only reduces sids risk to 1/3 of belly sleeping for infants. SIDS is very rare, but when it happens, it is devastating. so back sleeping is recommended to reduce SIDS even though in both cases it is a very rare event. statistically there is a real difference, but it is small. (see statistics concepts relative risk reduction vs absolute risk reduction)
    -I have no personal problem with appropriate home births, and if you are willing to accept the above risks, then great. if not, then come in to labor and delivery. I have yet to work in a Evil Hospital, but it sounds like they are out there.

    July 31, 2010 at 01:00 | Report abuse | Reply
    • aviekins

      thank you, Dr., for your level-minded and calm perspective. i have a feeling that you are very well loved by your patients and colleagues, given your caring and thoughtful response to this very 'hot' thread of comments. women need to be able to accept an active role in their care and become informed, educated partners with their providers (whether that provider be a family doctor, licensed midwife, certified nurse midwife, or obstetrician) in order to make the best decisions for *their* situation. thank you for being supportive of that.

      July 31, 2010 at 12:41 | Report abuse |
  27. desubluxator

    Alright folks, the Dr. is IN! 14, 11, 9, 6 and 6 months. 8 pounds, 10 pounds, yep even 12 pounds! You have got to be kidding me, the thought of taking my HEALTHY wife and future newborn to a hospital? Don't get me wrong, hospitals are necessary for emergencies. But childbirth...and emergency? You have 9 or 10 months to prepare.

    Besides the silly argument that women have been having kids for quite some time, and GOD Himself giving them the tools to do so...can anyone explain why a hospital would choose lying on your back as the preferred method of delivery? Unless you are some kind of porn queen (no offense intended), lying on your back with strangers looking at your private parts has got to be a little unnerving. Did noone ever put 2 and 2 together. Fear, uncertainty, doubt, privacy, etc cause muscle contraction. What is the main reason for C sections, stalled labor, pain, etc....could it possibly be abnormal (read unnatural) bodily reaction? HMMM...so delivering a baby in a safe, comfortable, ergonomically correct setting might actually be BETTER for baby, mom, and family?

    I'll take my home births anyday. Nope, they are not for everyone. My last kid cost me over $4,000, but could have been $25 co-pay at the hospital. Hands down, no question in my (or my wife and kids') mind...just like boobies (yeah we breatfeed, too) natural is better than artificial.

    In case this hasn't persuaded you, check out any one of the sites dedicated to how atrocious hospitals are in the US (http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate)

    July 31, 2010 at 01:17 | Report abuse | Reply
    • Bldrtreehugger

      The hospital infant mortality rate is not the total picture.
      When a home birth goes bad, they call an ambulance. The dead baby is delivered at the hospital and considered a hospital death. I've seen this happen.

      Yes, home births can go well. But, if the mother or child need immediate care, it is not available at home.

      July 31, 2010 at 10:42 | Report abuse |
  28. SweetPea

    Please do not accuse HB mothers of sacrificing safety for the 'mother's experience'. Elective inductions & epidurals clearly increase risks for the sake of 'the experience' just in a different way.

    I have had two HomeBirths, one with a CNM, one with an OB. At the very worst, homebirth with any type of midwife increases perinatal mortality from .7/1000 to 2.7/1000 (from Dr. Amy leading Homebirth Hater). That is why I choose a provider that is significantly more educated than the average homebirth provider.

    I feel fortunate to have had one of the safest births in the civilized world! Low risk for the baby and nearly zero morbidity for myself.

    Only a very barbaric nation would accept the current level of maternal morbidity that we accept. Evidence based medicine is not being
    practiced in our hospitals. Convenience inductions, overuse of amniotomy, episiotomy, vaginal checks, pitocin, & section absolutely abound!

    July 31, 2010 at 03:13 | Report abuse | Reply
  29. Mizbster

    This article is biased, plain and simple. In an uncomplicated pregnancy with a home birth attended by a midwife, the mortality rate for mother and baby is less than in a hospital, and the stats show that whether the Journal wants to admit that or not. My midwives have monitored my pregnancies better than my OB ever did–and they would not deliver me at home if there was a complication.

    The problem with the hospital is they treat everyone like they have complications, even if you don't. If I had a complication, I'd want to be in the hospital. No complication, and I'll take home birth any time. I've had 3 kids–one in hospital, one in a birthing center, and one at home. The hospital was horrible. They committed their first medical error with me 1/2 hour after I arrived and committed another medical error later with my son that led to him being put in the NICU. None of my midwives ever committed such errors, and I was allowed to be so involved in our care, that I would have caught any error and been able to correct it before it caused harm–the hospital tried to hide their errors. To top it off, they basically tried to hold our son hostage–discharging me and refusing to discharge him, even though he'd been given a clean bill of health, due to "discharge hours in the NICU." And people wonder why I don't want to go back? It was traumatic.

    Women who choose home birth are generally very well educated about the birth process, what their options are, and what constitutes good care. My home births cost me $3600 out of pocket, since insurance won't cover them. It would cost me much less to go to a hospital because I do have insurance, but you can't put a price on good care and on the health of me or my baby–that's why I willingly pay for home birth.

    July 31, 2010 at 07:32 | Report abuse | Reply
  30. Linda

    As an NICU nurse I have seen the home births gone bad results. Babies don't care where they are born so do it in the safest place for them, where help is available immediately. No one wants a baby in NICU or anything to go wrong. I am sorry for everyone's "bad hospital" experiences, it is not what you plan for.

    July 31, 2010 at 08:47 | Report abuse | Reply
    • desubluxator

      Linda thank you for being a nurse. But to be fair, would you not also say that you have seen the results of hospital births gone bad, too? I think we could all agree that a reckless home birth is unnecessary. So, why then could we not conclude that a low risk birth would not be best done in a natural setting? The entire process of creating, growing and delivering a baby is not a medical procedure (ok, I'll give you a small percentage), it's a normal bodily function.

      July 31, 2010 at 09:26 | Report abuse |
    • Peds

      For all of us who have worked in NICUs we have seen the reality of how a homebirth can have an inappropriately bad outcome, as opposed to everyone who thinks that having a theoretical discussion counts for being "educated."
      True, there are some infants that would have been sick no matter where they were born. BUT, there is a VERY big difference between babies who are sick because they did not get the appropriate (and sometimes so simple!) treatments and those who are sick DESPITE all attempts to prevent/treat.

      July 31, 2010 at 23:13 | Report abuse |
  31. concernedparent01

    The more I read, the more upset I get by some of you folks. Most of these arguements for "peaceful" home births are downright selfish. You are endangering your child's life because the mother wants a "peaceful" time of it. People who try to make vague links between drugs and their child's development are grossly ignorant of these drugs, just because you "feel" like the drugs would be harmful doesn't mean that they are.

    Bottom line, choose a good doctor (that decision is your responsibility). Good doctors will not pressure you to take drugs or consent to C-section unless it is a matter of life/death, they only have the health/life of both the mother AND child in mind. Chances are you could very well have given birth at home BUT if the birth suddenly becomes complicated (you cannot predict this) then you need a doctor for your child's sake.

    July 31, 2010 at 08:57 | Report abuse | Reply
    • dismayed

      Getting upset because of your own ignorance is out of the control of rational people.

      A hospital is NOT statistically safer for a low-risk woman than the same birth performed under the care of an experienced licensed midwife at home. At least not in the United States. The idea that researching the facts, understanding all of the pros and cons, and making an informed, educated decision is "selfish" is just plain stupid.

      I suppose you call every woman who opts for an epidural or other pain medication selfish as well, since they quite clearly put their own interests ahead of their baby's....

      July 31, 2010 at 11:55 | Report abuse |
  32. samantha

    Really it doesn't matter if women who want to have home births and end up having complications in which the infant dies or the mother and she or the family can live with that decision than go for it
    When it comes to the well being of the infant or mother money shouldn't be an issue. I have three children at three different hospitals the first completely natural, no drugs or anything the other two were born by C-section and would have died if not been, so you see C-Section are not always bad and people need to stop preaching like they are. But like I said if one can live with themselves being selfish and having the greatest possibility of putting their babies at risk than go for it. Your the one who has to live with it. Complications can pop up at any time and your fooling yourself if you don't believe it.

    July 31, 2010 at 08:59 | Report abuse | Reply
  33. lorien816

    Even in the healthiest female, medical complications can arise. With home births, having a hospital close by is a must. It saved my life.

    July 31, 2010 at 09:57 | Report abuse | Reply
  34. Wizard

    We are responsible for our own lives. A doctor is just another man/woman with flaws and bad days. Medical technology can be the cause of hospital borne infections. Can you trust the $10/hr guy to properly sterilize the tools or machines? Ever read a book on Pharmacology? Majority of drugs usage determination are from "clinical trials" snappy term for hit or miss and when you look to see how they actually work in the body it's "mechanism unknown" snappy term for golly I don't know. Point is giving godly status to a man/woman cause they have a white coat is not a good thing. I guess all you that say find a good doctor have sat down in front of your potential MD and asked "what school did you go to? What was your grade point average? Were you in the top 10 of your class? can I see your license? Give me three people I can contact as references.Can I watch you do a couple of deliveries? More likely some friend or relation suggested him and you took it as gospel and are now in the docs referral group. This is America if a woman wants to give birth at home or a hospital it is none of your ignorant self righteous business. Fact is NONE of you know with certainty what is best. Get off the soapbox let them figure it out for themselves. The day you walk on water you can tell me all about it.

    July 31, 2010 at 11:35 | Report abuse | Reply
  35. ktvw

    Articles like this are what's really harmful. There is no one-size-fits-all protocol for giving birth.

    I personally know three people who had home births. All the births were uneventful and the babies were healthy. Two of them had joyous experiences with friends and family, the third felt that the midwife did not listen to her and thus had a less than satisfactory experience. I know many people who went to the hospital, including me. Two of these friends and I had similar circumstances with very different results. One of them was pre-eclamptic like me. Our blood pressures were soaring. She was admitted to the hospital for best rest and, after two days, was delivered prematurely by C-section. Her baby was in the NICU for two weeks, with undeveloped lungs, and other problems associated with premature birth. I was at home on partial bed rest for six weeks, expected to drive myself to the hospital every three days for blood pressure checks and fetal monitoring. My other friend's water broke early in the morning and was green in color, showing meconium in the amniotic fluid. This also happened to me. Though a fetal monitor showed no baby distress, she was immediately taken to surgery for an emergency C-section and delivered of a healthy baby. I was placed in bed, strapped to a fetal heart monitor, and encouraged to go through labor. After ten hours, including three hours of pushing, the entire time confined to the bed because of my high blood pressure situation, my baby went into distress and I was taken to surgery for a C-section. I declined a spinal because I have had reactions to local anesthetics and was informed by a previous anesthesiologist I should avoid spinals and other blocks. I spent nearly thirty minutes arguing with the current anesthesiologist about the issue, and it took my husband and my OBGYN's intervention to get the arrogant man to agree to my demands. My baby was born with an apgar of 1, and I was told by a nurse in OB it was because I refused a spinal. Fortunately my baby was fine, thanks to the immediate care of the standby pediatrician, and I was ok thanks to my OBGYN. My hospital experience was far less than joyous, but I know I would have probably died, and my baby too, had I insisted on a home birth.

    Incidentally, when I became pregnant a second time, I was declared a risky pregnancy, and there were only midwives in the area, no OBGYNs at all, due to various circumstances, including my own doctor moving out of state. The midwives wouldn't see me, not even for a hospital birth – which in this area, they are allowed to do – and a doctor had to come out of retirement to oversee my pregnancy and birth. I was told in no uncertain terms that there would be no discussion about a 2nd C-section – I was going to have a "normal" birth this time. (The first baby had not been delivered after 3 hours of pushing because he was too large for my pelvis.) This second time I was in labor on and off for a week, and finally had three full days of hard labor before they agreed that this second baby, who was nearly two pounds larger than the first, was not going to come out that way. I had a 2nd C-section and had to go through the whole spinal refusal discussion again. Fortunately this second time was during the day, not during the night when all I had was the on-call team, and I could ask for a different anesthesiologist who would not waste my time arguing. The second baby was born without incident. Back in OB, I had a nurse who suggested that I was one of those impatient women who refused to give labor enough time, opting for "the easy way out" with a second C-section. Needless to say, the second hospital experience was just as unsatisfactory as the first, but once again, if had tried to deliver at home, with the size of the baby once again a factor, we might have died waiting for him to be born. I'm grateful to be alive, and I'm grateful for my two healthy children, but oh so tired of these articles that promote 'one right way' to go through this.

    July 31, 2010 at 12:37 | Report abuse | Reply
    • aviekins

      thank you for sharing your story, it sounds like everything was handled appropriately in your case. you wouldn't have been able to birth at home – there's no way you wouldn't have been "risked out" due to your eclampsia, and it sounds like your second pregnancy was also appropriately risked out due to the midwives in your area.

      as you said, there is no one good answer that applies to everyone – it's very frustrating that so many posters are taking this so personally. each of us needs to examine the matter and make our own decision (not based on the anecdotal experiences of others, but rather the evidence-based knowledge that's out there, combined with our own values and experiences).

      July 31, 2010 at 13:28 | Report abuse |
  36. aviekins

    in the end, this debate is not about hospital birth versus home birth; it is arguing the need for autonomy and informed consent during pregnancy and childbirth. women need to be able to accept an active role in their care and become informed, educated partners with their providers (whether that provider be a family doctor, licensed midwife, certified nurse midwife, or obstetrician) in order to make the best decisions for *their* situation.

    women and babies die in and after hospital births, and they die during and after home births. the majority of times, these deaths cannot be predicted or prevented. it's terrible, unfortunate, and devastating... and thankfully rare. despite what this irresponsible study shows, the odds of losing a mother or baby in one birthplace or the other are not significantly different (for a low-risk pregnancy). the choice of a birthplace and birth attendant needs to be based on the values and beliefs of the parents, not strong-armed upon them due to scare tactics and falsely-inflated statistics of bad outcomes. if a woman values having an operating suite and NICU staff immediately available, she should opt for a hospital birth at a level III hospital; if she prefers a lower-intervention birth where she is likely to have more control over the experience of welcoming her child into the world (but not immediate c/s access), she may prefer a home birth with a skilled, experienced midwife trained in neonatal resuscitation and emergency treatment.

    there is no "one-size-fits-all" answer; quit bashing and name-calling and accept that each woman is entitled to choose.

    July 31, 2010 at 12:57 | Report abuse | Reply
  37. Evil hospital worker

    I work in labor and delivery at a hospital that delivers more than 8,000 babies a year. While I agree that everyone should have a choice as to where and how they deliver their babies, I wish people would take some time to really become educated, instead of just listening to their neighbor or gym partner that just had a baby. I have personally been involved in the saving of many babies that would certainly have died if their parents had chosen home birth. And sometimes folks, death is a kinder option than saving a child that has been without oxygen for an extended period. I will never understand how these parents to be think they can make childbirth about them...it is about your child! I would think all parents would want to do only what is safest for their child.

    July 31, 2010 at 13:12 | Report abuse | Reply
    • aviekins

      i'm a labor and delivery nurse, and work in labor and delivery too. i have personally been involved (sadly) in many labors/deliveries that were more traumatic for mother and babe than a home birth ever could have been. artificical rupture of the membranes, causing the cord to prolapse - not good for baby. "pit to distress" (not something we practice, but done in many places, more or less) – definitely not good for baby. early induction/elective cesarean – *definitely* not good for baby.

      birth is about birth, for the mother, the baby, and the family. it's not for you or i, or the doctor, or society, to define. give mothers a little credit, please.

      July 31, 2010 at 13:23 | Report abuse |
    • Katie

      To the LD nurse that has saved many babies that would have died at a home birth... what did you do that a midwife couldn't do?

      July 31, 2010 at 17:23 | Report abuse |
    • Liz

      To Katie and all those who say "what can you do that a [homebirth practitioner] cannot do?"
      If you honestly think that they have all of the life saving equipment as the hospital you are wrong.
      For one, we clear blockage that is far into the airway. We see meconium ALL THE TIME. Many many times the infant cries immediately (at which point my heart returns to my chest and I can take a huge sigh of relief knowing that I don't have to deep suction) but many many times it blocks the airway, far past where any usual suctioning methods can get at. At that point we need to look down the trachea (windpipe) and the area just above and suction the stuff out of it. I WISH I didn't have to do this as often as I do, but I do. Without the "fancy equipment" and suctioning supplies, the infant cannot breath and I think we all know what happens if an infant cannot breath.
      That is what a hospital can do that a homebirth cannot do – and don't convince yourself that this is a rare occurance.

      On a side note, I hate the fact that we are lumping midwives together with homebirths as if they are all in one – I know of many midwives (in particular, certified nurse midwives or CNMs) who deliver in birthing centers; I feel that they provide excellent care and are an excellent option for expecting mothers.

      July 31, 2010 at 22:59 | Report abuse |
  38. Charm

    Notice it says "The editorial continues to say that hospital delivery should be the preferred method of delivery for high-risk pregnancies." A midwife is not going to let you have a home birth if your high risk. Any one with common sense knows this.

    Maybe if hospitals loosened up on what was allowed during labor and gave them more choices women wouldn't be running to midwives.

    July 31, 2010 at 13:43 | Report abuse | Reply
  39. against all odds

    This debate could go on for days, and obviously it is. Obviously there are some individuals who feel home birth is right for them while other's feel a hospital birth is more safe. Is one better than the other? It really depends and every birth is different. For the moment I knew I was pregnant I was determined to have a 'natural birth.' I still went to an OB to insure that my baby was growing properly and that both she and I were healthy. At one of my last appointments I was tested for GBS and unfortunately tested positive. I knew it would be best in my situation to be given antibiotics to prevent any harm to my baby. Later that week I had some leaking from what I thought was my bag of waters. I actually had broken my 'forebag' which still contains amniotic fluid but doesn't signal labor beginning, I wish I would've known that earlier.

    So here I am in the hospital hooked up to IV antibiotics as well as pitocin, mind you it was not what I had wanted for myself but the doctor thought it was best for me and my baby. I dialted to 7 cm and then completely stoped. Hours passed and nothing happened- not to mention my baby was sunny side up causing ridiculously painful contractions. I took no pain medication until the end when I found out I was going to have a c-section.

    I felt like a complete failure and out of control of my own body. I had my hope set so high for a natural birth. My OB was NOT pushing anything on me but informed me of the situation and what would be best for my baby and I. Seeing as I have not had training in the field of obstetrics, I put my trust into her. Would I do it all over again? In a heart beat. I am the proud mommy of a healthy happy flourishing baby girl. I recovered quickly from the c-section and had no complications.

    I don't think the answer here is black and white. So what is the point in bashing natural births or hospital births? At the end of the day don't you just want a happy healthy baby and mommy?

    July 31, 2010 at 13:46 | Report abuse | Reply
    • Liz

      Thank you for sharing your story and amazing insight. I was very sad to read that you felt like a "failure" – its sounds like you, with your OBs assistance, made an incredible effort to keep things natural but made thoughtful and educated decisions about what was best for the baby. Thank you for taking GBS seriously – it is becoming a trend that people don't want to believe how bad it truly is and I have had to see an increase in this devastating disease that can be so easily prevented. So happy to hear that you and your little girl are doing well!

      July 31, 2010 at 22:43 | Report abuse |
  40. Katie

    Did anyone bother to read the actual Journal or editiorial they pulled their quotes from for this article? Everything on this page is out of context and inaccurate. Also, if you look at the statistics, the risks are minimal and you are in no way putting your child at risk if you give birth with a midwife at home. They are talking about unattended home births, and this article DOES NOT specify. Shame on CNN.

    July 31, 2010 at 17:20 | Report abuse | Reply
  41. Goodness

    I'm not sure why there is so much animosity towards hospital births. I had one and it was fine. I had no epidural either. You don't have to have one–I'm not sure why so many people on here are claiming basically that you do. The key to an easy (ier) labor and delivery is exercise and no gaining too much weight. After weeks of walking in the summer sun it was actually easier to give birth than to do long walks!

    July 31, 2010 at 17:28 | Report abuse | Reply
  42. Floris

    Riiiiiight They're harmful to the bottom line of hospitals, but that's about it.

    July 31, 2010 at 18:55 | Report abuse | Reply
  43. Jennifer

    Oh, my goodness! I cannot believe that CNN is reporting on this paper that has already been refuted several times! The methodology used was highly questionable and included unintended home births (ie: woman didn't make it to a birth attendant in time whether hospital or birth center) as well as planned home births. This country has a ridiculously high c-section rate (over 30% at last count) and is ranked #27 in the world for maternal care/outcome. Why doesn't CNN do some stories on that instead of vilifying women who make the choice to stay home with a midwife, as the majority of women did in the past?

    July 31, 2010 at 19:00 | Report abuse | Reply
  44. Kim

    After three miserable hospital experiences I had my fourth at home. What an amazing wonderful day. My nurse/midwife had I backup doctor I met with once. She would not take me if I was in anyway high risk. I was extra careful about my eating because I had been gestationally diabetic during one of the previous pregnancies and didn't want her to turn me away. I had all the regular medical tests. She was very attentive to my health emotionally and physically at all stages. She also stood firm with her terms that if at any point she had concerns, she wanted me to agree to go to the hospital without question. I was all too happy to answer yes to this condition. I received great medical care and had an emotionally and physically healthy outcome for both my son and me. The first three were each a nightmare in their own way.

    July 31, 2010 at 21:13 | Report abuse | Reply
  45. BDiane

    God willing, we will have our next at home. Our hospital birth with our first was horrific. I consider the “care” I received nothing more than malpractice although it would be considered protocol or standard of care. I try my best to not blame the doctors and nurses , they are only doing their best to implement what they have been taught. We were naïve and should have been more informed. We didn’t understand we were giving consent , not informed consent.. Never again. As the saying goes, “... Fool me twice shame on me.” For us , it is a hostile environment. We don’t agree with the protocol so why would subject ourselves unless it is absolutely necessary.

    July 31, 2010 at 22:15 | Report abuse | Reply
  46. jeremy

    It's easy to say that everyone should have their child in a hospital, but the reality is that many people cannot afford it. Maybe if you can get the costs of a hospital birth to somewhere south of 10k you'll begin to see the home birth trend reverse itself.

    July 31, 2010 at 22:48 | Report abuse | Reply
    • dismayed

      The idea that the rising trend in the number of home births has anything to do with the soaring cost of hospital births is complete myth.

      Despite the average homebirth costing 5-10x less than a hospital birth, it's a substantially more expensive proposition for most people because rarely will insurance cover them. If you have no insurance, or need financial assistance, every state in the nation has subsidized or free prenatal and delivery care for mothers – assuming of course you're willing to give birth in a hospital.

      The homebirth trend is being led primarily by highly educated white couples with above-average income.

      August 1, 2010 at 10:23 | Report abuse |
    • desubluxator

      I administor our company insurance. In the last year, our company has paid for 2 childbirths (one of them mine). For the other employee, BCBS of Texas paid approx $17,000 to Seton Northwest Hospital. My employee paid $25 copay. I paid over $4,000 to Austin Area Birthing Center. BCBS of Texas reimbursed me for exactly $11.

      So, there you go. It costs nothing (ok $25) to have an abomination of a childbirth, and $4K for the most Blessed event on Earth. Anyone want to debate how "waiting til the last minute", or "letting the ER staff decide" can create complications that the hitler's of the world are going to exploit? Educate yourself, or be subject to tyranny and gouging.

      August 2, 2010 at 00:09 | Report abuse |
  47. Ellen

    I experienced beautiful easy flawless home birth... four hours after I gave birth, in the middle of the night., I started to bleed. Ended up in the hospital for 6 days. My baby girl was septic and was also hospitalized in NICU. I had an excellent midwife.Next time I wil have a real doctor and go to the hospital. Risking Joanna was not worth my "natural experience"

    July 31, 2010 at 23:30 | Report abuse | Reply
  48. Julie

    I find it interesting that this article included this quote from the Lancet, "Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk." But didn't include this text that immediately follows that quote:
    "There are competing interests that need to be weighed carefully. Hospital delivery should be the preferred method of delivery for high-risk pregnancies, even though it is not without risks—a recent study from Scotland showed that rates of neonatal death are higher in hospitals when births occur outside normal working hours. “Home delivery is an option for mothers with uncomplicated pregnancies, provided they are advised of the risks involved, have one-to-one midwife care(that includes good resuscitation skills and accreditation by a local regulatory body), and live in a location that allows quick access to obstetric care.”

    Home birth, with a skilled birth attendant and a healthy, low-risk pregnancy, is safe. After being an avid reader of related scholarly literature, and after working L&D and Mother-Baby units and in perinatal public health for many years, I don't know that the same is equally true in most hospitals in my state. Having given birth 3 times, in the hospital with an MD, in the hospital with a certified nurse midwife, and at home with a certified professional RN midwife, my personal experience was that home birth is a superior, more physiologically appropriate, more evidence-based, and far more civilized way to give birth. I wouldn't trade my family's fully-informed home bith for all the money and medical intervention in the world.

    July 31, 2010 at 23:36 | Report abuse | Reply
  49. KevinD

    I always find it informative to note which side off an argument contains the bulk of the vitrol. In this case it is cleary those of you who support home births. It is the same with breast feeding. Those who propose that the "natural way" is best are also the mean ones. If you disagree with someone fine, don't be nasty about it. We had both our childen in the hospital since it was nice to know that iff something did go wrong we were 30 seconds from help. If you don't want help to be that close fine, but in the end that as the deal breaker for us.

    July 31, 2010 at 23:48 | Report abuse | Reply
    • Katie

      I'm not sure that "mean" is the right word- and agreeing with someones choice or opinion is different from agreeing with someone stating 'fact' that is not factual at all. This CNN article is trying to point people in the direction that home birth should not be a choice, and the evidence that is provided to support that argument is flawed- to the point that there are many studies that fully support just the opposite, that more families should have home births and that there would be better outcomes for mother and baby.

      I do understand the wanting to be 30 seconds from help, and I fully support that in pregnancies with signs of complications this is great. And if it's your personal choice after calculating all the risks and benefits, that's great- you may hold different benefits as higher priority than the risks which make me choose home birth for whatever reason, previous experiences or exposure to certain stories or problems with friends or family. The problem here is informed consent. No doctor will share with you their rates of interventions or the wording they use that coerces mothers into doing whatever they suggest without knowing the true risks, or the studies that prove those interventions lead to ceseareans and then your risk for infection and maternal mortality skyrockets. It's bad for business.

      August 1, 2010 at 13:00 | Report abuse |
    • ihh

      With a competent midwife, there is also help. Stop inferring that patriarchal medicine and its unnatural interventions are better than the knowledge and care of someone who has been through the birthing process herself. Male OBs like to yank the kid out so they can get to the golf course by noon.

      August 1, 2010 at 15:35 | Report abuse |
  50. Grammy

    My daughters have had 4 home births. I was nervous about them at first. And then got educated on the pros and cons by reading extensively. When my first grandchild was born, I distinctly remember rocking her in the living room and thinking "What a beautiful way to come into the world." Anyone with a high risk pregnancy obviously shouldn't try this at home (and reputable midwives would never let them try).

    August 1, 2010 at 00:37 | Report abuse | Reply
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