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 (712 Responses)
  1. Anna

    This is ridiculous. Allow women the right to educate themselves then make a decision on what is best for them and their baby. I personally chose a home birth with a certified nurse midwife for several reasons. I wanted to do it naturally, I wanted to be in the peace of my own home, and I felt it was the best and safest option for Baby and me. I researched local midwives and chose one I felt would do well in coaching me and in case anything went wrong. My labor and delivery went great, but Baby came out in an odd position and tore me a bit. Fortunately, my nurse midwife was on the ball and got me to a hospital for a D&C (for retained placenta) and stitches. She could have done the stitches herself, but the amount of bleeding made her suspect there was something else going on. I could have bled out if she hadn't been on the ball, so I'm glad I took the time to find a good midwife! All said, I would definitely choose a home birth again. I just hope the government allows me that freedom of choice. Oh, and here's the results from the study they cite:

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

    July 30, 2010 at 10:49 | Report abuse | Reply
  2. Anna

    (Oops, added an extra known...)

    July 30, 2010 at 10:50 | Report abuse | Reply
  3. fred

    I love reading all these posts from these home birth advocates who have the luxury of hind sight to judge everything. Very few of you people posting have any clue as to what it means to be responsible for the outcome of the birth. The doctors and nurses don't have the luxury of "waiting and seeing" if a problem will resolve. You have the baby's life and mom's life literally in your hands. One mistake can lead to 2 tragedies and a career ending law suit. Sure, most births are uncomplicated, but the reason for the MDs is to handle unforseen problems. Consider them a safety net. And if you want less aggressive care, by all means push for tort reforms so that physicians can practice without worrying about the lawyers looking over their shoulders.

    July 30, 2010 at 10:53 | Report abuse | Reply
  4. Not All Docs Play Golf

    For Pete's sake...people who think the world is flat cannot be swayed by photos from space showing it to be round. The anti-modern-science crowd demonizes modern medicine, and it's a leap of faith that cannot be swayed by statistics or scientific papers. So, we all have choices, exercise yours. As for me, I'll take modern medicine (and a round earth).

    July 30, 2010 at 10:58 | Report abuse | Reply
    • Pirogi

      You do recall that the majority of scientists once believed the earth was flat, right?

      July 30, 2010 at 11:24 | Report abuse |
  5. Reality

    When home births result in complications, the mom races off to the hospital to let doctors resolve a situation over which they had no control. And then the HOSPITAL can be sued for any lingering effects even though they were stuck with someone else's unmonitored birth at home – because the midwife has no malpractice insurance. Maybe, if there are complications, the mom and midwife should resolve them on their own. And if they can't and the baby dies – then that's nature, right? If doctors and hospitals are so bad stay out of them no matter what. If you are so into natural birth, you should accept the cruelty of nature too. Don't bitch about the doctors and wonder why they are unfriendly when you show up in a pinch.

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

      Perhaps I should play sports in the hospital in case there is a "complication" and I get hurt? The point is that childbirth is a normal, natural process that doesn't generally need medical management. If it gets to a point where it does, you go to the hospital. I don't think that's unreasonable. The problem is that if you start a birth in a hospital, it gets managed like a disease from the start, which results in too many interventions that have potentially negative consequences.

      July 30, 2010 at 11:11 | Report abuse |
  6. shareena

    I had my three children at home with midwife, no problems whatsoever. That was 30 years ago, offspring now have offspring of their own. "Home Births" have been the norm for thousands of years, til the medical profession stepped in about 80 years ago.

    July 30, 2010 at 11:04 | Report abuse | Reply
  7. fred

    Another concern with these home birthers is that they are usually anti-evertything. No Vitamin K for the baby to prevent hemmorhagic disease of the newborn, no erythro eye ointment to prevent eye disease, and almost certainly no vaccines. Most of the midwives push these type of "natural" practices that put babies at risk.

    July 30, 2010 at 11:05 | Report abuse | Reply
    • aviekins

      with all due respect, that is because these "necessary" interventions are unnecessary for most babies. Babies at high risk of bleeding, or if a traumatic birth has occurred, should be given Vitamin K (and if the parents don't feel strongly about it, why not give it?). Babies who may have been exposed to STI's on the journey through the birth canal should be given the erythromycin eye ointment; for mothers who have been tested and found to be clear of chlamydia or gonorrhea infection (and who are in monogamous relationships with "clean" partners), this is also an unnecessary intervention.

      Wanting to avoid doing things that are done "just for the sake of doing them" or just "because that's how we've always done it" doesn't make someone irresponsible; it makes you an educated, informed consumer.

      July 30, 2010 at 21:58 | Report abuse |
    • not so extreme

      There are alternatives to the standard approach for these issues that are not so extreme. Vit K can be taken by mouth by the mother so that the baby receives it in appropriate amounts over time through breastmilk. Eye ointment is not necessary if the mother does not have STDs that cause blindness in newborns (you can be tested before the birth). Many people who choose not to have vaccinations at birth DO vaccinate their children on a delayed schedule. These are *informed* choices that a family can make when birthing at home.

      July 30, 2010 at 22:09 | Report abuse |
  8. Jeff

    My wife was a labor & delivery nurse for years (with some time in the neonatal ICU as well). As a result of her experiences, we've had two kids at home. She'd never have a hospital birth unless it was high-risk or we ran into complications. If you are worried about something happening, ask if the midwife can give Pitocin for postpartum hemmorhage, and make sure they have been trained in NRP (Neonatal Resuscitation Program - the standard for getting a brand new baby's heart beating and breathing going if there are problems). The fraction of problems that can't be solved in an out-of-hospital setting, and which can't wait for you to get to a hospital are staggeringly low (but special consideration should be given if you are a long drive from a hospital - we are within 15 mins of two level-1 trauma centers and a children's hospital). And hospital doctors do a shocking number of proven-to-be-bad procedures.

    I mean, a local hospital system had to require doctors to give medical reasons for inductions before 38 weeks...because some were doing elective inductions that early. Then there's breaking the water on someone who isn't progressing, which seems to result in a c-section more often than not, using cytotec for inductions against the FDA's warnings, birth while laying on one's back, etc, etc. I'm sure it's different in different areas, but we live in a state with a shockingly high birth rate, and it seems like OBs here are more concerned with assembly-line efficiency than good patient outcomes. Midwives are the exact opposite. And I think they are a fantastic choice for the wide majority of births.

    July 30, 2010 at 11:05 | Report abuse | Reply
    • fred

      People are always looking to nurses for their medical advise. Bad move. Even nurses that work in the OR, DR, ER etc... still don't have a clue as to MEDICALLY what is going on. That is the realm of the physician. If people are stupid enough to believe something medical just because a nurse utters it, well you really can't fix that kind of stupid. It's like trustung the waterboys opinion on how to run a pro foolball team. Just because he has access doesn't mean he has insight or judgement.

      July 30, 2010 at 11:59 | Report abuse |
    • aviekins

      @fred - do you have a medical degree? i'm curious where your level of expertise is coming from here... please consider that when your wife or daughter is in labor, 99% of her care and assessment of her labor, and the assessment of her baby's status, will be performed by nurses, who will report to the physician. in most obstetrics units throughout our country, physicians have very little interaction throughout labor and delivery except perhaps popping in once or twice, maybe to break the bag of waters or give a quick "hello" before office hours, and then come in to deliver the baby. it's the nursing staff that is admitting the mother, providing labor support, assessing labor status, determining whether or not labor is progressing normally or not, and needs to recognize subtle warning signs of impending problems (before they become emergent).

      the average physician, if forced to 'labor sit', would be clueless.

      July 30, 2010 at 22:02 | Report abuse |
  9. Anna (who wrote about the responsible midwife)

    fred, I live with a nursing professor (maternity & neonatal specialist) who oversees students at one of the most popular birthing hospitals in our state. She agrees that in low-risk situations home birth is just as responsible as hospital birth; outcomes are essentially the same for home vs hospital birth, and there are significant benefits to home birth you simply cannot find at a hospital.

    July 30, 2010 at 11:06 | Report abuse | Reply
  10. J

    I am not a mother, but someday I am planning on a home birth. I am a well educated 30yo Bostonian who has watched many a friend struggle in the hospital settings (in some of the best hospitals in the country), doped up, uncomfortable, unable to get up and walk around... On the other side I have watched my cousin who is a midwife walk hundreds of families through the birthing process. Very rarely there is an issue, but in that case there is always a back up plan with a local hospital.

    Many woman who choose the home birth, choose it for the ability to connect with the baby. At a hospital the baby is whipped away, where scientific journals have stated that it is better to place the baby on the mothers breast right away, when you don't, it's harder for baby to latch on, and for the breasts to produce. It is unbelievable heartbreaking to watch a mother unable to produce milk for her child when she is first allowed to feed hours after the birth.

    I am a very big believer in Western medicine and have had much personal success as an orthopedic patient in my local hospitals, I would probably not be walking if it weren't for them. But I think the biggest problem with Western Medicine it is how it discounts the thousands of years of knowledge in other practices such as midwives, acupuncture etc, this country needs more integration. One side is not better than the other, but just think of the progress that could be made if the old and the new could come together! My other big issue with Hospitals is that they dope up mothers, if Mom and the baby are sharing blood, how can the meds not get into the baby's blood stream? I don't need to take that chance. If your avoiding caffeine and alcohol for 9+ months, why throw that all away with an IV full of drugs in the last few hours of pregnancy?

    I personally want a home birth knowing that something could go wrong, but I hear of more deaths of Mothers and babies at hospitals than I have ever heard of deaths with home births. I want myself or my husband to be the very first hands to hold my child, and that is not possible in a hospital. I want my children's birth to be dictated by me, not by hospital policy. This is why I will not give birth to my children in a hospital.

    July 30, 2010 at 11:07 | Report abuse | Reply
    • fred

      You are definitely my favorite type of patient. Always describing themselves as "educated". Unless your degree is in medicine, you don't know squat about what you are talking about. You ask your equally vapid friends about their experiences and take their opinions over those of medical professionals. Try asking people who really know what they are talking about when it comes to taking care of babies and pregnant women.

      July 30, 2010 at 12:06 | Report abuse |
    • J


      Thank you, My degree actually is in Medicine. It's not nice to assume.

      I have often found in my own treatment that even the top Dr's can not know all there is, Patients need to be their own advocates in all parts of their treatment, and I tell my patients that all the time. A patient who is aware of their options should not be a bad thing, patients can put the extra research towards their own treatment that Dr's do not have the time to put towards. Dr's and other medical professionals can not bill out for any extra research they do, only for the tests/treatments. When patients need to be fit into schedule like sardines to fiscally keep offices open Dr's do not have the extra time or energy to research each patients needs. I finally recieved treatment for a medical problem that I was having (not in my field of medicine) and presented it to my team of Dr's. After doing their own research the measure was implemented and I am in a much better place. All because I found what was best for me, and did not accept that what my very talented Dr's had to say, was everything there was to know.

      If a mother has done the research, and decided that one option over the other is better for her, than neither you nor I have a right to tell her otherwise. We have no right to push our belief's on other people. Medicine is not about doing harm, and many woman have found they have negative results from one option or the other, and thus should not be forced to do it in any way that makes them uncomfortable. If a woman is more comfortable, thus more calm at home, the hospital or the birthing center, then it is much better for the baby. Force a mom into a hospital situation and the stress alone may create complications, same in the opposite situation.

      Do not try to use your implied education to keep calling people on this board stupid or idiots, the more you do, the less credit you have.

      July 30, 2010 at 14:27 | Report abuse |
    • fred

      No way you are an MD. You may have a degree in some pseudo-medical field like chiropractic or naturopathy, but no Amercian physician talks about their field as "western medicine". Stop posing and come clean.

      August 1, 2010 at 23:03 | Report abuse |
  11. Beth

    The study this article was based on has already been discredited. It was not based on new data, but was compiled from many other studies, most of them out-dated and many with non-scientific data analysis.

    Basically, it's balderdash. Home births have been shown to be much safer than hospital births with lower rates of interventions and complications. The important caveat is that home births are best for women with no conditions that would put them at high risk. If a woman has placenta previa (the placenta blocking part or all of the cervix), she belongs in a hospital – plain and simple.

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

    I had my daughter at a hospital, though all my friends tried to convince me a home-birth was better. Me, I wanted to have my kid with all that life saving equipment and medical staff around. You know, cause this isn't 1908 and I also don't beat my clothes on a rock. Some technological advances are good things, and not all old things are wiser. In the end, it's the mother's choice, but at some point, for some women, I think it's just a selfish ideal.

    July 30, 2010 at 11:11 | Report abuse | Reply
  13. J MD

    Caveat: I am a doctor, but not an OB/GYN.

    I ask one to consider: You've spent 10 months doing all the proper things (incl eating correctly, taking PNV, not drinking, not smoking etc) to ensure that your baby has the best chances to get to delivery. Now you're going to squander all of your hard work, lack of sleep, and significant heartburn issues to play a probability game of having a safe delivery at home? That is sheer stupidity. The birthing experience is special but remember the overall goal: to delivery a healthy baby.............not to ensure that the mother has a NICE experience. Ask the mothers who've had a home delivery gone poorly and ended up with complications to their babies whether it was a NICE experience and how they live with their guilt? Also, ask the women in the third world countries what they would prefer, b/c that's exactly what you are doing with a home birth.

    July 30, 2010 at 11:12 | Report abuse | Reply
    • Pirogi

      Everything is a probability game, doctor. And the sad truth is that in many areas, the outcomes in the hospital are very poor indeed. Women who choose homebirth recognize this and choose a different set of risks.

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

      As long as you are fully informed and are not high risk, you are not risking anything more at home than at a hospital. In fact hospitals tend to increase the risk. The staff there are usually impersonal, and tied down to policy. This leads to questionable decisions, for instance nurses trying to delay or hurry along the birth according to when the doctor is ready, inducing labor when the baby is "delaying" too long, even though each day before birth the baby continues to develop, recommending c-sections that aren't strictly needed, etc.

      This is all fairly common. Also, even though we'd all like to think hospitals are clean and sterile, the sad fact is that they can be breeding houses for germs.

      Neither option is perfect. There is no perfect option. But giving birth at home (with proper care) is no more or less risky than giving birth in a hospital unless you are already high risk.

      July 30, 2010 at 11:56 | Report abuse |
    • aviekins

      on the flip side, ask me, who had a perfectly complication free birth in the hospital setting, if i would have rather had a home birth... h*ll yes. i'm quite certain that i would not have ended up with an IV in my arm for "mandatory" antibiotics (as my midwife would have discussed homeopathic ways of decreasing group beta strep colonization on my perineal area with me), would have delivered much sooner (as i would have been able to relax (thus allowing oxytocin to flow freely, instead of being inhibited by the "fight or flight" chemical release that was set in motion when i was admitted, knowing i *had* to get two doses on antibiotics in or they would force my baby to stay 48 hrs), and been able to breastfeed more freely. would there have been some very slight risks? yes. would i have known that going into it? yes. would i have been okay with that? yes – that is the choice that *i* was making, and i had complete trust in myself, my baby, and my midwife (and the hospital that was two blocks away).

      this is a personal choice. stop making it into a one-size-fits-all ultimatum.

      July 30, 2010 at 22:12 | Report abuse |
  14. nancer

    as an L&D nurse, i think the key is screening. if you have a low risk pregnancy and see a CERTIFIED nurse midwife, i think home birth is a great option. after working in a hospital environment for over 20 years, i can tell you that once they get you in, the things you you wanted will fall by the wayside one by one. you will get pit if you don't progress fast enough, you will be in bed, and you will find yourself caught in the cycle. i saw it every day.
    as for doctors preferring vaginal delivery, they prefer them if they happen during the day, especially M-F. and they will give you reasons that sound good for needing that c-section. you want it over with, so you do it and the baby's fine and everyone's happy. BUT, that doesn't mean it had to go that way.
    a good certified nurse midwife will give you more personalized, better care than you will ever get from an OB/GYN. i'm just telling it like it is.

    July 30, 2010 at 11:12 | Report abuse | Reply
    • J MD

      response to nancer:

      I agree with alot of your points. But the last line in your statement should be provided with a caveat: if a nurse midwife is busy with many patients (and they don't have to handle the surgical ones) then they simply don't have time to provide the personal experience.................it's a time issue, the health care system doesn't allow for "personalization" b/c that is a direct contradiction to efficiency

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

      nancer, if what you're telling is true, it is your responsibility to whistle blow this to the medical board for an investigation. it is true that ob tend to try and schedule deliveries at their own convenience. however, it is unethical and violates code of ehtics. it is your fault who kept quiet for all of these years and allow patietns to be harmed.

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

      She is correct. More cesareans are performed M-F, during business hours than any other time, despite the fact that most mothers who begin labor on their own do so at night. Say she goes to the medical board ... they are doctors. Do you really think they are going to do anything? How will they determine who truly needed a c-section and who didn't? Any doctor can document in a chart to cover his/her butt. Of course no doctor is going to write, "Got tired of waiting for the b!tch to finish, so I cut her open." No, there will always be "non-reassuring fetal heart tones" or "failure to progress" or somesuch.

      The nurse is not to blame for the doctors' wrong-doings.

      July 30, 2010 at 11:31 | Report abuse |
    • Shaun

      It is not Nacer's (or and L&D nurse) responsibilty/fault for the decisions the doctors make in the hospital regarding CS and pitocin orders.. It is up to the patient to educate themselves on their body and their rights. They need to ask questions. Having a baby is a responsibility from the very beginning of conception. I also agree, it must be a CNM, not a lay midwife.

      July 30, 2010 at 13:22 | Report abuse |
  15. Terry

    My wife and I made a big mistake and chose the hospital for #1. Very scary experience, they did so many "routine" bad things that she never fully recovered from it.

    #2 and #3 were born in our House and they were both wonderful.

    July 30, 2010 at 11:17 | Report abuse | Reply
  16. Shawver

    Elliot O
    " And no one claimed that people don't get sick in hospitals: of course they do. But the fact of the matter is that this study looked at neonatal DEATHS, and the findings were increased deaths."

    The United States has the highest percentage of neonatal deaths in any developed country. Why is that if hospitals are so great?

    I had my daughter at a stand-alone birth center with midwives. No complications and I had a very fast labor for a first time Mom since I was allowed to move around and do whatever I needed to to get through each contraction.

    July 30, 2010 at 11:17 | Report abuse | Reply
  17. Trendiness > Survivability

    The give birth at home movement is just an overly romanticized fad. Self proclaimed gurus (not medical professionals I must add) provide all these flowery anecdotes of natural births and then conveniently leave out the stories of many mothers and fathers that have to live the rest of their lives knowing their decision to have the child at homes means they now have one less child to love.

    I assure you, no matter how paranoid you may be of Western Medicine, the fact that your poor decision KILLED YOUR CHILD can never be worth the bragging rights to your yuppie friends that you had a "natural birth." Because that is what this whole movement is based on, the need to brag to other people about your progressive, post modern birth and how strong you are for not needing meds to get through it. It's not based on logic, science, or statistics, just appeals to emotions and societal pressures.

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

      Its hardly about being "trendy" or in with some vague fad. Sterilized, heartless hospital environments and doctors can easily scare off pregnant women, or just be impossible to pay for. Do you even know how much they bill you for a regular birthing? 8 grannd, poppet, and thats without complications. With complications can top 20 grand with ease.

      There ARE properly trained and certified midwives based in real medical organizations that offer home birthing services. These people can handle many situations in birth (such as cord wrapping round the neck, very common), and they know when to call large scale emergency services if they have to. Comparing them to these "emotional hippy fad" people you have in mind is pretty ridiculous... and its also exactly what the hospitals WANT you to think about them, since they can't suck out your money if you go the midwife route.

      July 30, 2010 at 11:34 | Report abuse |
    • A W

      Our doctor would beg to differ. He has fully supported home births for many women besides our family, and he's an EM-DEE, not a SPG (self-proclaimed guru.) So, I assure you, your conclusions are flawed and you should go and revisit the facts before you demonize people who have taken the time to make informed choices

      July 30, 2010 at 11:48 | Report abuse |
    • Beth

      Sorry, but real statistics say otherwise. For low-risk moms you have the same chance of "killing your child" as you would have in a hospital. And in a hospital, you actually have a higher chance of "killing the mother" because of the distinctly higher C-sec rate that puts the woman at risk of all the complications from major abdominal surgery.


      July 30, 2010 at 11:54 | Report abuse |
    • Pirogi

      What ... what is that? Oh yeah! That's the "dead baby" card again!

      July 30, 2010 at 12:40 | Report abuse |
  18. svscnn

    My wife and I delivered our daughter at home with the assistance of a midwife. The cord was wrapped around her neck and had to be manipulated during delivery, which is fairly common, but was also quite scary. Don't plan to have any more children (divorced now) but, if I did, I don't know if I would want to go that route again. With many hospitals now offering "natural childbirth" programs, I think I'd rather have the emergency resources closer on hand.

    July 30, 2010 at 11:18 | Report abuse | Reply
  19. Anna (who wrote about the responsible midwife)

    Not All Docs, modern medicine is not demonic in and of itself, but anyone can see that in many situations it has become more about liability,efficiency, and routine than complete, progressive care. Many doctors don't have time to stay current on research or examine it carefully for the details and design quality. They might 'learn' more from their pharmaceutical sales reps than scholarly journals. Again, this is not every doctor, but it is a clear trend that in the long run will reduce public confidence in medicine, and rightly so.

    July 30, 2010 at 11:19 | Report abuse | Reply
  20. Julia

    "The editorial continues to say that hospital delivery should be the preferred method of delivery for high-risk pregnancies..." – exactly, but if you are not "high-risk" home births are just as safe as hospitals. And definitely a better experience. Which is exactly what the mid-wifery community has been saying all along. Glad they've caught on.

    July 30, 2010 at 11:21 | Report abuse | Reply
  21. Anna (who wrote about the responsible midwife)

    J MD, we have already established that the statistics are the same; given the same low level of risk, your baby is just as likely to die in hospital birth as he is in home birth. That makes the relative risks and benefits of giving birth at home exactly the same as at the hospital, just different in form. It is not a statistical game, it is a personal choice where statistics have leveled the playing field.

    July 30, 2010 at 11:25 | Report abuse | Reply
  22. Ituri

    The BASE cost for giving birth (NOT pre-natal care, JUST the birthing) in the USA is $8,000. Eight thousand dollars, people. A regular va ginal birth can range up to 12 grand with small problems, up to 18 grand with big problems, and a complicated C-section can top 24 grand. Twenty four thousand dollars!

    Add to this the feeling people have about hospitals and doctors in our society (that we are little inhuman money milking machines that want to give birth in sterile, heartless surroundings), a cruel "only if you can pay" system, and incredibly expensive and hard-to-get-full-coverage insurance environment, and YES, mothers WILL choose to give home at birth.

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

      On the contrary, the average charge for a midwife-assisted homebirth is about $4,000, including ALL prenatal care, labor and delivery, and 6 weeks of postpartum visits.

      Ironically, since most insurance companies won't cover this cost that _minimum_ $8,000 hospital birth is more affordable to most americans who pay their $250 deductible and move on.

      July 30, 2010 at 17:34 | Report abuse |
  23. Bonniejean

    Not sure if this has already been mentioned. But for those interested in more information, read "Birth," by Tina Cassidy and watch the documentary "The Business of Being Born."

    July 30, 2010 at 11:30 | Report abuse | Reply
  24. A W

    A number of research savvy people have criticized the Wax study as being sloppy in it's process and conclusions, and that the results are politically motivated. From what I recall, New York and another large state (Massachusetts perhaps?) will be voting on allowing women more freedom of choice with respect to having home births. I believe the conclusions and timing of these poorly conducted studies was chosen to sway the public and political opinion for the upcoming legislation. The medical establishment doesn't want to give up their income from hospital births, especially c-sections.

    Our first child was born in a womens hospital in Germany, with a midwife-nurse in attendance. Our next 5 children have all been born at home with an attending midwife, here in the US. All are healthy and normal.

    July 30, 2010 at 11:37 | Report abuse | Reply
  25. JPaul

    My wife and I had 3 children in a nursing center attached to a hospital using a midwife, 5 children with midwives at home, and 1 hospital birth. By far, we were most concerned about the health of our child during the birth in the hospital. My wife was not allowed to move around and get off the table to help move the baby along, the doctor was on the cell phone with other business during the labor and was obviously wanting to "get things moving" or get a C-section going to minimize her inconvenience, and the excessive regulations to avoid litigation all added stress and risk. Fortunately, the nurses were caring and partially offset the institutional problems and attitude of the doctor. Conversely, our experiences in the birth centers and at home were much less stressful – all producing healthy children. I would recommend either of these two options over a traditional hospital birth.

    July 30, 2010 at 11:38 | Report abuse | Reply
  26. Liutgard

    This article (and the article it is based on) is seriously flawed, as many here have pointed out. I would like to point out one small statement they made at the end however: "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.”

    Yes, high risk deliveries should be in the hospital. No one will dispute that. But the rest of the article is based on the idea taht *low risk* mothers belong in the hospital. Why are they making conclusions for low risk mothers based on high risk outcomes?

    I had a high risk pregnancy the first time, and I was in the hospital as was appropriate. My second pregnancy was low risk, and we planned for a home birth. We weren't progressing well during labor, and my midwives had a hard and fast rule- if *anything* was iffy, you went to the hospital. Well the baby's head simply wasn't quite in the right position, the car ride in jiggled him around a bit, and he was born without incident less than ten minutes after we arrived, in the bed in the birth center. My youngest was a planned home birth, everything went smoothly, and it was a delightful experience.

    With a trained midwife, good backup, and a very closely monitored pregnancy, a home delivery is an appropriate option for a low risk mom. If anything changes, the hospital is the responsible place to be. And a high-risk mom should be in the hospital.

    There is too much 'henny-penny' in the medical model and far too many women leave the hospital having heard the scary 'you would have died if' stuff, when in truth it was not as they were led to believe. Articles like this are promoting that atmosphere when it is really not necessary.

    July 30, 2010 at 11:39 | Report abuse | Reply
  27. Here we go again

    This sounds like hospital propaganda. I was born at home, and my siblings were born in hospitals. I was the only one with no problems after the birth. Because of common hospital practices, and germs in the so-called sterile environments, my sibling each had problems after their births. One even had an extensive stay in I.C.U. because of the actions of one of the nurses.

    If you are responsible and work with a trained mid-wife, a home birth can be not only safe, but more comfortable and more stable for both the mother and the child. If you are high-risk, of course, you need to be much more careful and probably do need a hospital. Otherwise, you should be able to choose to have your child at home.

    Hospitals get HUGE payouts for the delivery of a child and the after care. Even more if something does go wrong and the child or mother needs more intensive care and a longer hospital stay. Is it any wonder they're trying to convince us all that giving birth at home is so incredibly risky?

    July 30, 2010 at 11:41 | Report abuse | Reply
  28. Paul

    I bet Lancet didn't say anything about "Moms." The British are less cutesy than we are. They probably referred to women. And the British probably don't eat veggies – they eat vegetables.

    July 30, 2010 at 11:42 | Report abuse | Reply
  29. Margaret

    I disagree – I strongly do not feel that hosptial births are inherently safer. My own son's difficulties at birth were a direct result of being in the hospital. I was in labor (induced) and asked for pain meds, got IV stadol and his heart rate crashed within minutes. Had emergent c/s under general anesthesia, not only that but there was no anestheisologist available took 30 minutes to get one. Nobody ever tells you this about pain meds and how they can be dangerous to your baby.

    July 30, 2010 at 11:46 | Report abuse | Reply
  30. Aubrie

    I'm a bit confused by this article. I had both my boys 26 and 22 years ago respectively. So this isn't "modern" and up to date stuff I'm talking about. The first was in a hospital delivery room. Not so great of an experience. The second was at the same hospital, but I elected the birthing room. I had no drugs, delivered in the natural squatting position, my friends and family were free to come and go as they pleased. Even my 3 year old was allowed in. We were left to peacefully bond in a darkened room after the birth. The baby was not whisked away for washing and weighing immediately. My husband cut the umbilical cord. I even had a water birth available to me if I wanted it. I chose not to. Many hospitals offer options and variations to the birth experience. You just have to find a doctor willing and a hospital willing. the second birth was WONDERFUL and I was IN a hospital in case of emergency.

    July 30, 2010 at 11:47 | Report abuse | Reply
  31. terbrearo

    No, homebirths aren't dangerous when a qualified midwife is there to deliver the baby. Hospitals can be dangerous when the Doctor manipulates the Mother to have a C-section so they aren't inconvenienced by time. This is propaganda to smear the good work that midwife's do. Besides it's the choice of the parents not some "Journal"

    July 30, 2010 at 11:50 | Report abuse | Reply
  32. rebba

    I know quite a few people who have done home births, and it does certainly come with risks. Many people who undergo home births, also forgo the usual prenatal ultrasounds which can catch many serious issues that would alter their birth plan. Skip the ultrasound and common delivery monitoring technology (such as to monitor the heart rate of the baby)and give birth to a baby with serious issues at birth puts both the baby and the mother at risk. I know of two cases that both involved a 911 call immediately after birth – and in one case, they had a difficult time getting the infant to breath and nearly lost him. How as a society have we forgotten the past? Maternal and infant birth morality was a COMMON occurrence back in the day when birthing was most commonly done "naturally" in the home.

    July 30, 2010 at 11:55 | Report abuse | Reply
  33. amy

    wow cnn....nothing like regurgitating garbage ACOG feeds to you.....did ACOG pay to do it? What ever happened to investigative journalism? It takes one simple search to see all the valid critiques of this flawed and failed study. Do your homework, people are already suspect of your reporters bias and skills.

    July 30, 2010 at 11:59 | Report abuse | Reply
  34. James

    Add another vote FOR Home births.
    My daughter now 13 and brilliant, was born here in the east village NYC.
    In fact our whole building knew about our plans and were completely supportive.
    We interviewed midwives here in NYC and of the 13 we spoke to everyone of them was also a registered nurse and had a minimum of 15-20 years pediatric and ER experience.
    Granted not everyone has this many options but knowing that our midwife was attached to 2 hospitals and 4 doctors did not hurt.
    Our daughter was born perfectly and naturally.
    I cant imagine going to a hospital and dealing with the chaos or bureaucracy.

    July 30, 2010 at 12:00 | Report abuse | Reply
  35. Edwin

    DId they correct for other factors in their studies? Home births WOULD show an increased risk if you include those people who don't go to hospitals because they cannot afford it or because they simply don't trust doctors. But that says nothing about whether it is less safe to have a home birth if you have anticipate an uncomplicated delivery and have competent help nearby.

    We would never have done home birth - our daughter was born by emergency C-section - but I think this statistic could be explained better. If it does not account for other factors, it may be misleading to the point of portraying false information.

    July 30, 2010 at 12:01 | Report abuse | Reply
    • Pirogi

      No they didn't control for this. Actually, the study referenced in the article is a meta-analysis of many different types of studies, some of which were retrospective, some data taken from vital records, some data taken from different types of locations (rural, urban, etc), and some studies as old as the 70's (obviously a lot has changed in emergency care and infant health practices since then). Many of the studies/vital records from which the data is taken did not identify if the homebirths were planned, low-risk, or attended by a competent caregiver. This study isn't only comparing apples and oranges, it is comparing apples and bananas and kiwis and oranges and papayas and grapefruits and cantaloupes and cherries and pears and pineapples. It's a veritable fruit salad of misinformation.

      Other large and rigorous studies (which this study certainly was NOT) show that attended homebirth and hospital birth are equally safe for mother and baby.

      July 30, 2010 at 12:55 | Report abuse |
  36. JG

    My son was born in a hospital. My son was born healthy, but they insisted on keeping my wife and son there for 48 more hours. my wife didn't get to sleep at all. The nurses kept coming in and turning lights off and on and messing with her adjustable(and very squeaky) bed while she tried to sleep. i finally had to stand outside the door and block entry. We are looking into other options for the next child. Fathers, you need to protect your wives from getting poked at. Disable light switches with tape, unplug TVs and adjustable beds.

    July 30, 2010 at 12:03 | Report abuse | Reply
    • fred

      Would you like some cheese with your whine???? Sounds like a small price to pay to help ensure the birth of a healthy baby. And, as usual, you have no idea as to the rationale for keeping a baby and mom for 48 hours after birth nor did you have the brains to ask someone as to why this was necessary. Ask sme questions before you go whining publicly about inane things like squeaky beds and bright lights.

      July 30, 2010 at 12:10 | Report abuse |
  37. VL

    Sounds like someone is worried about losing marketshare again. ACOG must be feeling the pinch, now that people have figured out the whole C-Section racket and are saying 'no' to it.

    July 30, 2010 at 12:04 | Report abuse | Reply
  38. Tina

    Wow, people are nuts! Who cares!?! Make whatever decision you like, and then have your baby however you like. You don't have to launch an impassioned defense of either decision. For the record, too, a medical study comes out every three seconds claiming everything from "eggs are bad for you," to "asthma is caused by tiny t-rexes in our bloodstream." Calm down. Please, or I'll start to feel bad about being female, by proxy.

    July 30, 2010 at 12:05 | Report abuse | Reply
    • There is a reason

      People care because the medical community has incredible clout. There are already some places that don't allow you to plan for a home birth. You cannot hire a mid-wife. You must go to a hospital.

      If you choose to go to a hospital, that's great. If you choose to plan for home, that's good also. What's not good is when you don't get that choice any longer. That's why these open discussions are needed.

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

      Yes, a sane and normal discussion is fine. Most of what I'm seeing on this forum, though, is a rough approximation of this:

      Mom 1: "Omg omg I had my baby at home because I love it. Only a fool would have their baby delivered by cold evil doctors!!!"
      Mom 2: "I had my baby in a hospital so it wouldn't die! You are clearly an idiot!"
      Mom 1: "You fool! You were clearly drugged by the evil hospital overlords!"
      Mom 2: "Midwives are stupid hippies, you stupid hippy!!!"

      Rinse, wash, repeat.

      July 30, 2010 at 12:50 | Report abuse |
  39. Carl

    When did childbirth become a medical problem? We're the only mammals that interfere with the process. When you offer a "solution" (hospitals) you need a steady stream of problems to fix. Hospital stress lengthens childbirth, inducing labor makes c-section more likely, children are born drugged, and hospitals and insurance companies get rich.

    I'm the parent of two home-birthed children. The experience and the results are both fantastic.

    I need a bumper sticker: "My home-birthed child is smarter than your stoned hospital baby".

    July 30, 2010 at 12:11 | Report abuse | Reply
    • fred

      Actually you need a bumper sticker that says "I'm a moron stay far away from me". You dodged a bullet twice. Consider yourself lucky not smart.

      July 30, 2010 at 12:17 | Report abuse |
    • Reply to Fred

      Just because you do not agree with home birth does not mean that you have the right to call people idiots. People who do a planned home birth with a trained midwife do not go into it lightly, they plan out every detail, thus making even first time parents very aware of how it all works. If parents are working with a trained/certified midwife they don't go in blind, the Moms still get medical tests and treatment.

      Parents should make well educated decisions based on their individual situations and for each pregnancy. Some people should not have hospital births, some should not be be at home, but it should not be up to you or I to decide for them.

      July 30, 2010 at 12:57 | Report abuse |
    • fred

      Practice what you preach: calling a baby "stoned" because they were born in a hospital actualy counts as name calling. People can do as much "research" as they want. It always amazes me that people spend a few hours looking at info on the web and all of a suddent they are medical experts. Whatever research you do, it does not compare to the work that the MD did in college, med school, residency and professional practice. I'll take the experts advice over your research any day.

      July 30, 2010 at 13:36 | Report abuse |
    • fred

      When lawyers started suing physicians for every "natural" complication of childbirth.

      July 30, 2010 at 13:38 | Report abuse |
    • Reply to Fred

      Please do only listen to the medical advice, and not try to educate yourself on the subject. Obviously every Dr knows everything right out of residancy, where even 30 year veteran midwives obviously know nothing. It is your choice to believe everything that is spouted to you by someone, or to follow up and educate yourself.

      Wether you use a Dr or a midwife DO THE RESEARCH, if you are an expectant mother or father you should know the deal, and not blindly follow ANY care giver. The Dr's and midwives are often wonderful people who only want the best, but some are better than others in either setting, do not just settle and expect the best.

      July 30, 2010 at 15:32 | Report abuse |
  40. Tara A.

    A home birth is completely irresponsible. It isn't about YOU, Mommy. It isn't about YOUR comfort. It isn't about YOUR biases and preferences. It isn't about a holistic experience for YOU. It isn't about YOU and YOUR avoidance of the unpleasantness of a hospital. It's about the baby.

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

      What an obnoxious comment. Birthing IS about the mother, and there is no negating that influence. If the mother is under undue stress, the birthing may well be effected. You want people to ignore the needs of the mother for relatively tiny risks? Absurd. The baby is the mothers to have as she will, and your obnoxious, anti-mother attitude means nothing.

      July 30, 2010 at 12:16 | Report abuse |
    • Really?

      I think what's completely irresponsible is blindly believing any hype that's fed to you without any knowledge of the subject at all, and then attacking anyone who feels differently from you.

      For the record, the mothers that choose to give birth at home are largely very responsible. It's not only for their comfort, it's for the overall health of the BABY and the family. As long as it's properly researched and executed, it's as safe as being at a hospital. In some ways safer.

      July 30, 2010 at 12:18 | Report abuse |
    • VL

      Tara, you can have your baby anywhere you like. Keep your hands, religion, morality, and laws off my body and reproductive choices. It's that simple.

      July 30, 2010 at 12:18 | Report abuse |
  41. Homeschool Mom

    If a midwife fails to do her job correctly she is criminally prosecuted. Notice that it said, "hospital delivery should be the preferred method of delivery for high-risk pregnancies."

    I have never heard of a homebirth midwife who takes high risk pregnancies and I've met a few women who were not accepted by midwives as patients because they were not in the low-risk category. Maybe this article should have been written to reflect that. Maybe, "Homebirths Good Option For Low Risk Women."

    Chances of a c-section with my homebirth midwife: 1 in 80. Chances at most hospitals in AZ: 1 in 3 or 1 in 2 depending on which you go to. Why go somewhere that increases your need of "lifesaving" intervention that much?

    We had a normal homebirth with out first child and we transferred to the hospital for a c-section with our second child for a complication (complete placental detachment) that has the same OUTCOME whether you labored at home and transferred to a hospital or labored at a hospital. With my second a small quarter sized portion of the placenta tore off at 14 weeks into the pregnancy. The back up OBs (standard with a homebirth in AZ) pointed out that they would not expect a baby to survive it either way at any stage of gestation no matter where the mother labored if it completely detached. They also pointed out that the chances of a placenta completely detaching was so incredibly rare, the complications from a c-section were far more likely. They said they both recommended a vaginal delivery to all their patients in that situation. All homebirths have a hospital transfer plan just in case. So, the midwife agreed to let try a homebirth.

    At 40 weeks the contractions were 10 minutes apart (too early to go to the hospital anyway) and the midwife came to stay with us. After a few hours of monitoring me she picked up a drop in the baby's heart rate and called the number to triage as my husband and I got in the car. We arrived at the hospital 10 minutes later. They were ready and waiting for us. We were stable (normal vitals) for about 15 minutes and the OB was planning an epidural (takes about half an hour) and c-section, but then it began tearing off again, so they gave me a general. They pulled her out right after the placenta came out.

    We were both just fine. The OB who did the surgery (not a back up OB for the midwife) said he didn't expect the baby to survive that situation even though we were in the hospital, knew what was about to happen, and had an operating room ready to go. C-sections and hospitals are beautiful things only when they are necessary.

    July 30, 2010 at 12:15 | Report abuse | Reply
  42. Sara

    My first child is a natural hospital birth (with a midwife) and second one is a natural home birth. Both are great experiences and I felt safe in both options. I had to go with a midwife to avoid doctors who act like they dont have time for you.

    July 30, 2010 at 12:17 | Report abuse | Reply
  43. Patrice

    All four of my children were born at home with the help of a highly trained, attentive midwife. Over the course of her career that same midwife has safely delivered thousands of babies. She has a good relationship with local doctors and the local hospital and does not hesitate to transport a mom at the slightest sign of danger. Home birth has its risks, however so do hospital births. It should always be the up to the parents to weigh the risks of both situations and choose the one that is right for their family. I will encourage my daughter and daughters-in-law to do their homework and choose home birth.

    July 30, 2010 at 12:19 | Report abuse | Reply
  44. Rainy Stegall

    This is just silly...in every delivery there is a chance of problems. The USA has the highest incedence of infant mortality, isnt that crazy? My first child was emergency c section, second natural with a doctor, and third midwife in a hospital. I would take a midwife anyday. I wish I had been more informed about the options. as far as midwifes and home births. Women have been giving birth since the begining and we did not NEED doctors to FIX our problem. I think that is the problem. Pregnnancy and birth have come to be viewed as a problem or a condition that must be treated, rather than a natural and beautiful part of being a woman. The thing is midwives today are trained far better than they ever were in the past and quite frankly they had a pretty damm good record then, they can only be improved as of now. Every other industrialized country uses midwives on a regular basis and OBs as a back up if things go wrong. We have twisted and perverted this so much that over the years in order to try to fix this "condition" women have been given drugs that ended up, causing birth defects, and brain damage to the children. LEAVE IT ALONE. It is a natural process.

    July 30, 2010 at 12:23 | Report abuse | Reply
  45. alix

    CNN, this article is really an opinion piece. Your writer did NOT do her homeowork or provide any sort of valid research. The homebirth dialogue has alot of positives. While homeborth may not work for High Risk woman, your article makes it seem like homebirth is dangerous for all woman, when, in fact, with a licensed midwife present, it is not.
    This article reflects poorly on you CNN! Please have your writer's do more research into this topic. The USA ranks lower than many other westernized and developed countires. This article is pathetic. It spreads misinformation and fear.

    July 30, 2010 at 12:24 | Report abuse | Reply
    • Pirogi

      I agree with your points for the most part, Alix. However, licensure does not guarantee competence in a midwife, and licensure is largely at the whim of the medical board on a state-by-state basis. Some states will license only CNMs. Some states will license other types of professional midwives (eg CPMs) who have proved competence by taking a written exam, demonstrating practical skills, and documenting birth attendance experience. Some states give license to lay midwives as well, and I would venture that many of the best midwives in the country have never been certified by any organization. The key isn't licensure, it is competence.

      July 30, 2010 at 13:05 | Report abuse |
  46. Johnny B

    When my ex wife got pregnant, I was in the military. We had maybe 4 scheduled visits to a doctor (not the same as the doctor who was assigned to us...in fact we NEVER EVER met OUR doctor). That was it. Just 4 visits the whole time. Everything was going fine until one night, 37 weeks into the pregnancy, my wife started having pains and couldn't feel the baby kicking. We went to the civilian birthing hospital emergency room assigned to us by the military. Some nurse hooked her up to a machine that supposedly monitored contractions and we didn't see the nurse again for about 2 hours. The nurse came back, disconnected the machine, and told us there was nothing wrong and we could go home. A few hours later, the pains were worse and she still couldn't feel the baby kicking. We went back to the hospital, she hooked up by a different nurse who also ran an ultrasound. The nurse was unable to find a heartbeat and informed us we had lost the baby. Devastating news as you can well imagine. We aren't together anymore but I have 2 kids with another woman and she has 2 kids with another man. Since we vowed to never use a hospital for birthing again, all 4 children were home birthed. I'm not sure about her pregnancy, but with the mother of my kids, we had an awesome midwife with whom we had weekly appointments with for checkups and ultrasounds. We were schooled on proper health of the pregnant mother as far as diet and exercise and supplements. It was much more personal of an experience using a midwife and the births of the children went flawlessly. We always had an emergency standy should something happen that could only be handled at a hospital. Thankfully, it wasn't needed. Both of my kids and both of hers are strong healthy children. We still miss what would have been our first child, our first son, but we are thankful to have our other children with us now. I'm not saying hospitals are worse or better than home births. I'm saying that if a home birth is something you'd like to do, don't let "professionals" try to talk you out of it. Yes, bad things can happen during a home birth and hospitals are often times able to prevent some things more readily than a midwife can at your home, but there is no guarantee that things will turn out any different a hospital.

    July 30, 2010 at 12:25 | Report abuse | Reply
    • Johnny B

      Also, 10 years after my son was born and 4 years after my daughter was born, we still often visit with the woman who was our midwife. She calls and checks up on the kids. She treats each of the children who she helped birth as one of her own. Have you ever heard of a hospital doctor stopping by someone's house 10 years later for a check up?

      July 30, 2010 at 12:29 | Report abuse |
  47. Sandy

    If I could do it all over again, I would pick a home birth any time. Hospitals are so rough with babies and to me it's just a crime what they do to mother's to be and babies in the hopsitals.

    July 30, 2010 at 12:25 | Report abuse | Reply
  48. Anon

    It may sound like I'm the exception to the norm in this forum, but I did not have a horrible experience giving birth at a hospital. I was always aware that I had choices in drugs and/or procedures. My husband was always present. My OB is excellent. The hospital was very good. My baby was always with me unless I decided otherwise. We were not "rushed out the door." In fact, we had a 3 day stay because my blood pressure was a bit elevated and my daughter had jaundice. If anything, I couldn't wait to be home with my baby. I'm sorry for those who had bad experiences. Now that we are going to have our 2nd baby, I would not consider anywhere else.

    July 30, 2010 at 12:26 | Report abuse | Reply
  49. Concerned parent

    What's the death rate of babies delivered in hospitals who would have otherwised survived a homebirth experience?

    July 30, 2010 at 12:26 | Report abuse | Reply
  50. Can we keep this calm?

    When I was pregnant, I read all I could about this controversy. Frankly, I was nervous already. But this was just the tip of the "how to do parenting right" debate. I take great offense from the attitude that you must crush your opposition by belittling them and frightening women who are already in a vulnerable position.

    Please take a deep breath! Both sides deserve to offer input. You do not deserve to criticize others for the informed decisions they make. Also–don't forget that women and children need support long after the birth is done with.

    July 30, 2010 at 12:28 | Report abuse | Reply
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