Home births at highest level since 1990
May 20th, 2011
05:32 PM ET

Home births at highest level since 1990

The number of women having babies at home increased 20% between 2004 to 2008 according to a new study in the journal Birth: Issues in Perinatal Care.  The change is mainly due to a 94% increase in home births in white women, the authors said.

Home births increased significantly in 27 states during this period; only four states saw declines. Montana had the highest increase. Reproductive statistics expert and lead author Marian F. MacDorman of the National Center for Health Statistics at the Centers for Disease Control and Prevention says home births are at the highest level since 1990.

"Women may prefer a home over a hospital birth for a variety of reasons including a desire for a low intervention birth in a familiar environment surrounded by family and friends," MacDorman said. "Cultural or religious concerns, lack of transportation in rural areas and cost factors may also play a role as total costs for home births are about 1/3 those for a hospital birth."

MacDorman said risks associated with home births also went down during this period. "It might mean home birth midwives and practitioners are doing a better job of selecting low-risk women for home births."

Women with a high risk of complication and therefore not good candidates for a home birth include those over 40 years of age, weighing 300 pounds or more and have high blood pressure or diabetes, MacDorman said.

The American College of Obstetricians and Gynecologists issued a statement in January that says although the risk of planned home births is low, evidence shows it does carry a two- to three-fold increase in the risk of newborn death than hospital births.

"As physicians, we have an obligation to provide families with information about the risks, benefits, limitations and advantages concerning the different maternity care providers and birth settings," said Richard N. Waldman, M.D., ACOG president. "It's important to remember that home births don't always go well, and the risk is higher if they are attended by inadequately trained attendants or in poorly selected patients with serious high-risk medical conditions such as hypertension, breech presentation, or prior cesarean deliveries."

ACOG says the best available data show hospitals and birthing centers are the safest place for labor and delivery.

soundoff (424 Responses)
  1. Hank

    It would have been useful if this article had provided some context. In 2006, the CDC says there were 25,000 home births in the United States, out of about 4.2 million births. That's not quite 0.6%. If that number had increased by 20% (which your article says is what happened between 2004 and 2008, and the 2006 number is right in the middle), there would have been 30,000 home births in the US in 2008. That would have been about 0.7%. 20% looks like a large increase. 20% of a very small number, however, is still a very small number.

    May 20, 2011 at 18:03 | Report abuse | Reply
    • Laura

      In Germany, MIDWIVES deliver babies. Doctors are present, but they only get involved when the midwives instruct them to. In other words, the hierarchy is flipped. Doctors only get involved if a knife or medication is to be used. And because their midwives are trained in how to manage pain, medication is less likely to be used. In contrast, in the US, once you step in the door, they start poking you and tie you to the bed. It is not an accident that my babies born in Germany were all completely natural, and the US birth ended up in c-section.
      I had 3 babies in Germany, and 1 in the US, so I know this firsthand.
      I will NEVER again deliver a baby in an American hospital. There is no doubt in my mind that I am safer giving birth at home than in an American hospital!

      May 20, 2011 at 20:52 | Report abuse |
    • Valentijn

      Thanks for the German perspective. I recently moved to the Netherlands. About 25-30% of births here are at home, and we have one of the highest rates of infant mortality in Europe. It also sounds like obstetricians in the Netherlands aren't involved enough in determining risk factors prior to birth. 1 out of 5 home births develop complications that require going to the hospital, and if that trip takes too long the results aren't good.

      May 22, 2011 at 02:03 | Report abuse |
  2. toddflanders

    Back to this same old story. If you want to takes risks, have your baby at home. Most of these home birthers also eschew vitamin K, erythromycin eye drops and vaccines.

    May 20, 2011 at 18:37 | Report abuse | Reply
    • femfilly

      I don't think that home birth moms are anti anything, they just want the information in front of them. I'm a home birth supporter and I also think that vaccines are a godsend that save millions of children every year from terrible diseases and death. It's all about forming your own informed opinions and trusting your body to do its job.

      May 20, 2011 at 19:29 | Report abuse |
    • Linde

      I dispute this. I only personally know of 3 mothers who had home births (myself included). Out of 8 children, they were all given the appropriate medications to prevent illness and infection, including eye drops and vaccines. I chose home birth because I knew, as a healthy person, the risks were higher in the hospital. My midwife was very selective and had very good outcomes.

      May 20, 2011 at 21:44 | Report abuse |
    • CJEH

      I'd like to see the data proving that.

      May 20, 2011 at 22:00 | Report abuse |
    • mother of four

      Do your homework before you make silly statements like this. Attended home births generally include these as options depending on the parents and the midwife they choose. And-FYI–the only reason to smear erythromycin on an infant's eyes is to prevent infection in the case of a hospital birth due to the germs they are exposed to in this environment. Guess what–giving birth at home eliminates that concern. As for vitamin K there are multiple answers to the advisability of this.

      All my boys, both those born outside a hospital and inside, were vaccinated, but they were vaccinated on a modified schedule. They're all teens and young adults now.

      May 20, 2011 at 22:00 | Report abuse |
    • Lelesis

      Regarding your statement, Mother of four: The actual rationale for use of Erythromycin ointment (per Maternal-Newborn Nursing & Women's Health Care , 7th Edition) is prophylactic treatment of opthalmia neonatorum, which is caused by the bacteria Neisseria gonorrhoeae (ie..gonorrhea). It is also effective against opthalmic chlamydial infections. This is a legal requirement due to possibility of exposure the these bacteria while in the birth canal of the mother.

      May 21, 2011 at 00:32 | Report abuse |
    • Susan

      My theory is that having a baby, surgery, etc. in a hospital these days is inviting disaster due to MRSA. There are only a handful of antibiotics that can "maybe" combat this. And doctors and nurses DO NOT wash their hands every time they see a new patient; just observe, and read the story in Freekonomics talking about efforts to make them do so. by the way, two of my sons are nurses, one in trauma, and one who owns a residential home. We are now back to over 100 years ago when women would not go to a hospital to have their babies because they knew they had a good chance of dying (due to bacteria that doctors refused to acknowlege the existence of at the time.)

      May 21, 2011 at 01:56 | Report abuse |
    • mother of four

      I got that information from a doctor who stated that it was used to prevent various infections which are commonly associated with bacteria found in hospitals (as I had tested negative for all VD and had been in a monogamous relationship for years, I had argued that it was unnecessary. This was the last child I had in a hospital). In a home birth Chlamydia and gonorrhea can be tested for well hand and are not necessary. Quite obviously, if they are absent (and are in most cases), then the erythromycin is still unnecessary.

      May 21, 2011 at 09:20 | Report abuse |
    • momof3

      The homebirthers who eschew vitamin K, erythromycin, and vaccines can very well do the same in a hospital setting. It is possible to make that decision both at home or in the hospital, and the setting is irrelevant. I had a homebirth with my third child, and was offered vitamin K and erythromycin (which I did decline; I also declined after my 2nd child's birth center birth and my first child's hospital birth). Vaccines do not need to be given at birth and can be given at the child's first well visit (my pediatricians always preferred to skip Hep B until the 2 month visit). Birth setting is not tied to whether or not the child gets vaccinations. The same people who are going to decline at home are going to decline in a hospital. The setting is not going to change their decision to vaccinate or not.

      May 21, 2011 at 12:43 | Report abuse |
    • Cathy W

      I had a homebirth, and eschewed the vitamin k drops and the erythromycin eye drops, but my daughter is fully vaccinated. Vitamin K is for a very rare clotting disorder, that can be picked up and remedied when or if it's detected. I turned down the eye drops because I had been tested for various STDs and was clean, and I trusted my husband enough not to worry that he was going to cheat on me during my pregnancy. In either case, both are unnecessary given our situation. If anything had gone wrong, we WOULD have transferred to the hospital, in a heartbeat. It's a very very rare even that something will go wrong with no prior warning, such that not being in the hospital will result in a dead or damaged baby.

      What you don't get is that no matter WHERE you chose to give birth, there are risks that might have been mitigated if you had chosen a different venue. Hospitals are no panaceas.

      May 21, 2011 at 14:10 | Report abuse |
    • Lost

      I had a home birth by accident. No time to get to the hospital...and lucky I didn't have the baby in traffic.

      May 21, 2011 at 18:34 | Report abuse |
    • infidelity and eye drops

      I know someone who just cheated multiply on his pregnant wife and there's a good possibility he didn't cover up. Ignoring the appaling moral aspect of this for now, many women (and men) who think they are in a monogamous relationship are not. This is why antibiotic eye drops for the neonate are administered immediately after birth. Many women have STDs and don't know it, not because they fooled around, because their partner did and was stupid enough to not use protection. Don't ever assume when your baby's heath is at stake. Get the eye drops. They can only help. You will feel awful if you find out your partner cheated AFTER your baby goes blind from untreated occular gonhorrea. Yes, men and women cheat all the time and no, most partners don't know.

      May 22, 2011 at 16:23 | Report abuse |
    • HH

      The eye drops are outdated. There's no need for them if the mom doesn't have an STD. Vitamin K is also unnecessary unless the baby has jaundice. Ditto for the IVs given to moms whether they're dehydrated or not, the routine ultrasounds, etc. This is another reason why many couples homebirth....to avoid these "just in case" interventions that are done across the board, regardless of actual need.

      May 22, 2011 at 18:09 | Report abuse |
    • Julie

      I didn't do the Vitamin K. If ALL babies are born without it, it's not really a Vitamin deficiency. My midwife said Vitamin K injections were associated with increased incidence of leukemia.

      May 23, 2011 at 11:33 | Report abuse |
  3. Dawn

    Leave it to CNN to write another one sided article. Neonatal deaths are NOT higher under midwives, in fact, quite the opposite. Perhaps they could have shared some actual statistics and given a reputable midwife to make a statement as well.

    May 20, 2011 at 18:50 | Report abuse | Reply
    • Andy

      The only reason that midwives can claim the same infant mortality stats is that they take their patients (which are usually as low risk as you possibly can get) and compare them to hospitals who take all-comers. If you compare apples to apples, home births are more dangerous. Also you can't just look at mortality, you also have to look at morbidity which is life-long disability, and again, home births are higher

      May 20, 2011 at 20:04 | Report abuse |
    • SLNelson

      Andy – Mortality and morbidity are not higher in home birth babies. Apples to apples, home births are scientifically proven to be as safe as hospital births, according to this published, peer-reviewed study and others: http://www.bmj.com/content/330/7505/1416.full?ehom

      The conclusion of that study: Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

      And yes, midwives are traind to handle emergency situations. I know midwives who have resuscitated babies, stopped maternal hemorrhaging, and handled shoulder distocia emergencies calmly, competently and successfully.

      We forget that in most countries the world over, including in Europe and Scandinavia, most births are attended by midwives and the outcomes are spectacular. The US has the second worst death rate in the modern world for infants in the first 24 hours after birth, and ranks 46th globally for maternal mortality – below many industrialized nations. This despite the cost of hospital births being higher in the US than anywhere else on Earth. If the presence of doctors, hospitals, drugs and technology were mandatory for successful birth outcomes, then the population explosions we are witnessing in third world countries and places like India would not be taking place.

      May 21, 2011 at 10:52 | Report abuse |
    • Cathy W

      Andy, that is simply incorrect. When you compare apples to apples – low risk births in either location, home births are NOT associated with worse outcomes. Quite the opposite – same outcomes, but with fewer interventions, lower c-section rates, fewer complications.

      May 21, 2011 at 14:14 | Report abuse |
  4. Regg

    If you're healthy, there's no reason not to have a home birth if the chance of risks are minimal. Midwives trained for emergency situations or who have a link to a nearby hospital are often the best choice. Birth has become so medically controlled. It's as if doctors have forgotten it's a natural part of life that has been occurring since the beginning of time. With all the pitocin and unnecessary drugs they're pumping into women these days, the outcomes of birth are worse than ever.

    May 20, 2011 at 18:52 | Report abuse | Reply
    • Andy

      I'd like to see how well trained midwives are for emergencies. Have they ever had to intubate a newborn that was having respiratory difficulties? I doubt it.

      May 20, 2011 at 20:05 | Report abuse |
    • Elizabeth

      This to me is the absolute worst argument for home birth. Yes, babies have been born since the beginning of time, but what no one ever seems to remember is that babies DIED since the beginning of time as well. Prior to becoming "medically controlled" childbirth was one of the worst dangers for the mother and the infant, and most DIED.

      May 20, 2011 at 20:49 | Report abuse |
    • momof3

      Mike-women who homebirth are usually highly educated. Get a clue.
      Yes, erythromycin is an option at homebirths. Mom should have the ability to make an educated decision. If she is confident she does not have an STD, it is fine to decline the eye ointment. I have heard that there are many strains now that are resistant to the erythromycin used in hospitals anyway.
      Many midwives are trained in neonatal resuscitation, carry oxygen, and can intubate in order to get baby or mom transferred to the hospital.
      Yes, there are risks when low risk women deliver at home. However, studies have shown that for *low risk* women, it is a safe and viable option. There are risks, but there are also *substantial* risks to a hospital birth. The c-section rate in this country is ridiculously high (and has been demonstrated to be out of line with what is needed by WHO and other organizations). C-sections come with serious risks to both mom and baby (respiratory complications, etc.). Many OBs still push pitocin, which was recently linked in Duke study to increased risk of maternal hemorrhage. Women with a primary c-section (frequently unnecessary, as demonstrated by WHO's statement and other major medical organizations) often do not have birth choices for future births other than repeat c-section, which comes with its own set of risks (now the 2nd or 3rd child is more succeptible to respiratory issues as the result of the c-section). Mom is now more prone to a possible uterine rupture as well from the primary c-section (again, often unnecessary). Hospitals continue to use electronic fetal monitoring strips, which in low risk women, the evidence demonstrates no benefit (other than covering the doctor and hospital in terms of liability), and it increases the c-section rate. Henci Goer's book Thinking Woman's Guide to a Better Birth has a lot of wonderful evidence-based information. OBs in this country often do NOT follow evidence-based guidelines, which is what women should be looking for from their care providers (midwife or OB).

      May 21, 2011 at 12:39 | Report abuse |
    • Cathy W

      Again, Andy, you are speaking without knowledge. Have you done any research at all about what the typical training IS? My CNMs had been obstetrical midwifes in hospitals for years, and had advanced neonatal emergency training. Mine came equipped with oxygen, intubation equipment, and pitocin in the case of maternal hemorrage. My CNMs have delivered 3000 babies over 25 years, and never lost a single infant or mother. Zero.

      May 21, 2011 at 14:17 | Report abuse |
    • natural?

      What is natural: birth, death, diease, morbidity, periods of health. Medicine adjusts the abundance of each and not always for the better. More births and fewer deaths spell disaster for ourselves and the planet. What is "natural" is not always desirable. Another factor making birth riskier these days is excellent maternal nutrition. Babies are now too big for safer, less-assisted birthing. Humans evolved to deliver babies 7 lbs or less through their pelvis and now, babies are frequently >= 8 lbs. Births need to be assisted to get the baby out. It isn't the size of a woman's hips, it's the size of her inner diameter. Availability of food is both blessing and curse for many expectant mothers. Portion control is key.

      May 22, 2011 at 16:40 | Report abuse |
    • @natural?

      LOL wut? You realize that throughout a woman's pregnancy her body creates a hormone called relaxin which relaxes all of the mothers joints, including her pelvis. Between this and getting women up OFF of their backs a woman's pelvis is incredibly plastic, and in some positions (namely squatting) the pelvic outlet can open up to 30%. Add to this, babies heads mould, and sometimes to an extreme amount.

      True cephalopelvic disproportion (CPD) is very, very rare and is often as a result of malnutrition (rickets), injury to the pelvis, or pelvic inflammatory disease. More often what is called CPD in hospitals is failure to wait on behalf of the doctor in attendance.

      Even shoulder dystocia would happen less frequently if mothers weren't confined to bed, and weren't numb from the waist down. Mothers who are mobile are better able to assist in repositioning themselves and their babies to get sticky shoulders unstuck.

      As a mother of 7 macrosomic (10lb+) babies, I chose not to give birth with a doctor or hospital anymore because of this failure to understand BASIC anatomy. YES CPD does exist, but in nowhere near the amounts doctors seem to think it does.

      My 2nd baby, born just over 11lbs, was the biggest baby my ob at the time had ever caught. He said, after he was born, that had he known how big my son was, I would have immediately been scheduled for a c/s. This, after a completely easy, uncomplicated birth – with less than 10 minutes of pushing!

      Babies are NOT getting bigger; doctors are becoming less patient and understanding of the process.

      May 22, 2011 at 17:22 | Report abuse |
    • Jen

      @Elizabeth " Prior to becoming "medically controlled" childbirth was one of the worst dangers for the mother and the infant, and most DIED." Really? Most died? Hmm, how in the world did our earth become so populated then? Women have been giving birth successfully "forever". Even now many women all over the world have labor that is not "medically controlled" and our population keeps growing. Yes, medical intervention is needed at times, but not as often as our medical "experts" would like us all to believe.

      May 22, 2011 at 19:49 | Report abuse |
  5. James Armstrong

    There is evidence in the peer-reviewed medical literature that planned home births are associated with a lowered risk of adverse outcomes when compared to planned hospital births http://www.greenmedinfo.com/article/planned-home-birth-attended-registered-midwife-was-associated-very-low-and-comparable-rates-

    May 20, 2011 at 19:09 | Report abuse | Reply
  6. Deb

    Excited to see CNN and other major news outlets picking up the buzz bout homebirth.
    Now...if you all would like to interview a Certified Nurse Midwife with 11 years of practice ( including andaxulry position at The University of North Carolina feom 2006-2009) talk about how happy she is to be the owner of a successful homebirth practice since 1/2010...email me or check out my website
    http://www.carrboromidwifery.com. The jury is in ..homebirth is as safe as it gets for low risk moms and babies when attended by a qualified, experienced, trained attendant.

    May 20, 2011 at 19:38 | Report abuse | Reply
    • momof3

      Hi deb-my youngest (J) was your first "catch" in your private HB practice in NC 🙂

      May 21, 2011 at 14:35 | Report abuse |
  7. Peggy (Registered Pharmacist)

    Three of our four sons were birthed at home (1991-1994) which I much preferred to my hospital birth (for our first son). I had never considered a home birth until I met some women who shared their positive experiences with home births–this changed my stereotype that home births were for the hippies/1960's wannabes and the uneducated.

    Birthing at home was a very "natural" experience compared to the hospital where you're hooked up to an IV and external/internal monitors, confined to labor in bed, and ultimately forced to deliver on your back. Of course the hospital is preparing for potential emergency situations, but for the majority of births over the centuries this intervention has not been necessary. Some people prefer a more natural approach while others like the security of having all bases covered. With my first home birth, the midwife was also a registered nurse, so I got both. 🙂 But I will say that I do recommend natural approaches when possible to my pharmacy patients, including realistic exercise, lots of water, supplements (moderately as needed), and a fairly healthy diet (even recommend and eat 2 Hershey's Dark Chocolate nuggets with almonds daily for those antioxidants). 🙂

    May 20, 2011 at 19:41 | Report abuse | Reply
  8. William

    I acknowledge the article said home births cost 1/3 as much as hospital births and I do believe the total percentage is small as others have posted on this. But could another factor be the economy, loss of employment (especially in 2008) and lost of health insurance. This seems like an obvious factor to consider when writing such an article. But it's left without discussion one way or the other.

    May 20, 2011 at 19:41 | Report abuse | Reply
    • Barbara

      This was my first thought as well. I fully expected the article to draw a connection between the rise in home births and the economy. I would like to see a follow up article that explores whether this is a factor or not. Economic conditions have a huge influence on consumer behavior. Perhaps women are making home delivery a choice from a consumer standpoint rather than the experience factor. Loss of a job and resulting loss of health insurance would be a strong motivator.

      May 21, 2011 at 22:14 | Report abuse |
    • economics

      I would assume that educated people who have lost their job and/or health insurance would choose to defer having children since children are extremely expensive. Even one year of, say, oral contraceptives ($30/month x 12 months = $360) is a heck of a lot cheaper than any home birth, much less the next 18 years of expenses. Should reproductive choices revolve around one's income? Yes! All children deserve a supportive environment and taxpayers should never have to pay for someone else's baby. Just because people can doesn't always mean that they should.

      May 22, 2011 at 16:51 | Report abuse |
  9. Lauren

    I think the increase is largely due increased access to information on homebirth via the internet. I hadn't even considered it until I watched "The Business of Being Born" on Netflix.

    May 20, 2011 at 20:07 | Report abuse | Reply
  10. Lamas

    Why would anyone be surprised by this? That's like saying Hey I needed braces so, boy howdy, I got some metal scraps and DIY instructions online and....what happened? CURSE THESE ONE SIDED ARGUMENTS!!!

    May 20, 2011 at 20:16 | Report abuse | Reply
  11. Ituri

    I love how they fail to mention how hostile the hospital and legal system in the US has been against midwives and homebirthing. They have tried to make both ILLEGAL. Yes, home birthing, illegal, due to "the risk to the fetus in an emergency." It didn't fly, but that they'd try it at all means a lot of scared mothers out there not birthing the way they need to.

    Other civilized countries have much higher home birthing rates WITH professional, standardized midwives. Only high risk women are hospital bound.

    And the US still has horrible rates of birthing survival in comparison, even as we flock to hospitals...

    May 20, 2011 at 20:30 | Report abuse | Reply
    • Miriam Hamsa

      And perish the thought if a baby delivered by a midwife dies – she will be hounded by the legal system – as opposed to the more frequent hospital/doctor delivered infant deaths – where there is no issue. The medical establishment hates home births. Goes back to the witch hunt period – just couldn't have all those women healers and herbalists serving their communities, so they called them witches, burnt them, and enshrined the male medical (and at the time very barbaric) establishment. (Hah! an unintentional pun. In the US frontier at least, many of the "doctors" were barbers.)

      May 23, 2011 at 11:37 | Report abuse |
  12. CJEH

    Yes, trained professional midwives can handle emergencies, including neonatal recussitation, it would be utterly unethical for that not to be part of their training. People who argue that midwives are unsafe, or unskilled have never actually done any research into the sheer scope of training midwives receive. In many cases they are better able to recognize and assess emergencies sooner, because they are doing one on one monitoring.

    May 20, 2011 at 21:55 | Report abuse | Reply
  13. carla

    Nurse midwives are trained to do even small surgical procedures. I started with a doctor for the birth of my little girl and at month 5 switched to a nurse midwife. It was the best decision. They found ways to help me relax, reduce pain and when my labor lasted for ever and ever, they helped me do non medical and medical things to progress my labor. As for home births, do whatever you feel comfortable with. That was definitely not for me but it is right for someone.

    May 20, 2011 at 23:42 | Report abuse | Reply
  14. Henry

    For all the mis infromed mis educated home birth is not only safe it's what birth is suppose to be a hospital is for the sick doctors rush a birth doctors would perfer a csection becuase they can have a baby out in about 20-30 mins time is money doctors see births as quick money birth is suppose to be a wonderful experience and when you give birth at home in the comfort of friends family you feel closer to your child. Not in a rush from a doctor yelling at you to push not from a grey room were the sick sit its disturbing.

    May 21, 2011 at 00:14 | Report abuse | Reply
  15. erich2112x

    There weren't any midwives around when we were swinging from trees and living in caves, and obviously we did just fine.

    May 21, 2011 at 00:53 | Report abuse | Reply
    • BillRubin

      That is a common argument that seems to ignore the decline neonatal and maternal mortality rates over time.

      May 21, 2011 at 08:11 | Report abuse |
    • Alta

      True, but that is as a species not as individuals. However, it is also fallacious to claim that all the advances in maternal health are due to hospital over home birth. The introduction of hospital birth did not lower mortality until the C-section, if I have my history correct. The real "secret" to better outcomes appears to be such things as better pre-natal care, better maternal health overall, access to better care in emergencies and let's not forget fewer births, better spaced and later in life (not teenagers).

      May 22, 2011 at 12:19 | Report abuse |
    • Marie

      BillRubin, the decline in maternal child death might appear to correspond with the trend away from home birth that began in the 1920's. But actually it has more to do with improved living conditions and nutrition and the discovery of antibiotics over the last century. I did my Master's thesis on this subject.

      This is an economic and control issue on the part of ACOG. Anyone who really cares about maternal child health would be flocking to Europe to see what they are doing so right to have such great stats. But the truth is a European model applied here would cut into the megabucks they earn. And the control they exert over birthing women.

      May 22, 2011 at 18:15 | Report abuse |
    • CJEH

      BillRubin: The US infant and maternal mortality rates have actually risen in the past few years, despite the increased use of surgery to, supposedly, save lives. More the maternal mortality rate is over 12%- for the first time since the mid-70s.

      May 23, 2011 at 12:16 | Report abuse |
  16. Screen2011

    I never had an opinion on this subject until my son was born after prematurely ruptured membranes. The nurses at the hospital told horror stories of home births gone bad they had to try to clean up with the babies and mothers going through needless suffering or even death. Saying home birth by a midwife is somehow superior is like saying having your appedndics out by a self proclaimed surgeon is more safe. If there are no complications maybe home birth is ok but you may not know until it's too late.

    May 21, 2011 at 01:21 | Report abuse | Reply
    • toddflanders

      spot on

      May 21, 2011 at 08:13 | Report abuse |
    • mother of four

      So–what –is this multiple stories of home births gone wrong told to you by multiple nurses or just is this a single story repeated over and over by more than one nurse? Nurses, like other professions, have "legends" they like to pass around relaying information like this among themselves and passing on to patients, thinking that they're doing everyone a favor.

      I've delivered four children–two in hospitals, two at home. Both the hospital births were in two different hospitals with two different doctors. The first OB was a control freak who attempted for force an unnecessary induced labor for his own convenience. When I stood my ground (this was days before my due date) he got nasty and threatened me with a court order. Young and frightened, I still stood my ground and wound up delivering with another doctor who–over and above my requests insisted on giving me an episiotomy–instead of gently guiding the baby out. I had to fight to keep the nurses from giving my son bottles, had an in-hospital pediatrician tell me that "we would try this nursing thing" but he made it clear that he didn't expect it to work as it didn't most of the time. I found another doctor and nursed that child with no problems for two years.

      The second experience in a hospital two years later was a near disaster with a doctor (mine was out of town) giving me a pain reliever (I was an idiot and asked for it) that I should never have received so close to birth (less than two hours–if someone had told me how dilated I was, I probably could have waited). My son was born with repressed respirations thanks to this and spent five days in the hospital receiving unnecessary antibiotics because the doctor was just sure he had an infection (???) even though he was breathing normally within a few hours after birth. I did not learn about the connection between his repressed respirations and the medication (promethezine and demerol) until years later, even though I questioned the doctor about it at the time. That son has Asperger's today.

      After this I concluded that there had to be a better way and I found it in the form of a fantastic midwife who partnered with me to create a healthy pregnancy and easy birth with no interference. I was able to walk until minutes before delivery in both cases (with frequent checks from midwife) and delivered in a natural position. Both boys were born without incident and I was on my feet and ready to get on with life within hours. Done right home births are an excellent solution for healthy women.

      May 21, 2011 at 09:46 | Report abuse |
    • momof3

      There are homebirths that go wrong. There are also hospital policies that are not evidence-based and lead to their own set of serious risks. The c-section rate in this country is ridiculously high, at 30-40% or even higher in some areas. WHO and other major medical groups have noted this is inexcusable. Hospitals continue to use electronic fetal monitoring strips for low risk women, which has been shown to increase the c/s rate but not improve outcomes. It does reduce liability for the OB and the hospital. Pitocin is commonly used for unnecessary inductions (convenience inductions or simply to speed labor up for the convenience of the attendant) and was recently linked in a Duke study to increased risk of maternal hemorrhage. C-sections can be life saving, but when the rate is unnecessarily high, we need to acknowledge that this increases the risk of respiratory distress in newborns (and death). Not only does the unnecessary c/s put the newborn at risk, but if mom goes on to have other children, they may be forced into a repeat c/s scenario since vbacs are difficult to come by these days. Not only is the child from the primary c/s at risk of respiratory issues, but that surgical procedure now puts mom and subsequent children at increased risk of rupture, respiratory distress, etc. in the future. That's not a small consideration that needs to be made. Women are still induced in this country regularly for "convenience" (vs. medical need, which obviously IS warranted in many cases), and that comes with the potential for some of the problems of prematurity even if don't at "full term" but prior to 39 weeks.
      Women who homebirth acknowledge there are risks to giving birth at home. However, there are significant risks to hospital birth as well. Studies have shown that for low risk women, homebirth is a viable and reasonable option. Anyone can share their anecdote of a birth gone wrong, and unfortunately that can happen in any setting. Having all of the interventions available in the world doesn't mean that they come without risks. Interventions have their own risk (pitocin, artificial rupture of membranes resulting in cord prolapse or introducing infection, c/s leading to infection or respiratory distress in an newborn...). My husband has a Phd in a chemistry; I have a masters degree in a healthcare field. We are capable of reading the studies and made an educated decision. Home and hospital both have risks that need to be weighed. If only it were as simple as hospital=technology and intervention available=safe. It is a far more complicated calculus.

      May 21, 2011 at 12:54 | Report abuse |
    • Alta

      Giving birth does not necessarily entail surgery but an appendix removal does. So, your analogy is incorrect.

      May 22, 2011 at 12:06 | Report abuse |
  17. K J Guerreiro

    As an intelligent professional woman, I made an informed intelligent decision to birth 2 of my very large healthy infants at home. Quite successfully, I gladly add. It can be a safe alternative to hospital deliveries.

    May 21, 2011 at 01:23 | Report abuse | Reply
  18. NICUNurse

    Most deliveries, regardless of where they happen, have a happy ending. Some don't. Sometimes, immediate medical care is necessary and may make the difference between the life and death of the mother and/or the infant. Other times, it may make the difference between a healthy baby with few complications and a baby who is blind or wheelchair bound. That's not to be overly dramatic, it's just the truth. Meconium aspiration syndrome, HIE, stroke, unknown abruption, etc. The neonatal intensive care unit is full of families who had a birth plan that went awry.

    It saddens me to see so much misinformation regarding hospital births...or births in general. Erythromycin is not given because of hospital germs. It's given as a precautionary measure in the event that harmful bacteria from mom finds it's way into the infant's eyes. Mom may be a carrier of some disease and not even know. The side effects or complications from erythromycin are minimal. The side effects of ophthalmologic bacterial infections are much more dire. "Strap you down"? I'd suggest a different hospital.

    Like any profession, some licensed midwives are fantastic and some are not. Some obstetricians are fantastic and some are not. Then, there's a subculture of "anti-regulation, anti-government, all natural is best" that's exceptionally frightening. We've had several sets of those parents come to our unit from horrid home births at the hands of a "community midwife." Consider having to transfer your baby to a surgical center for the tracheotomy and gastrostomy tube he'll need to survive until it's known whether or not he'll recover from the oxygen deprivation and subsequent stroke he suffered during delivery and the difference a delay in medical treatment cost his brain tissue.

    As is the case with anything, you need to be an educated consumer. Ask your friends about their birth experiences. Research credentials. In your area, you may find a phenomenal hospital or decide that at home is for you. Neither choice is best or worst. If you decide on a home birth, I would just encourage you to consider the cost of the gamble. Labor and delivery is a very short time in your life. The complications from choosing to be removed from life-saving medical assistance may last considerably longer. On the other side – there are hospitals that I wouldn't take my goldfish to for treatment. Be educated. Accept that your baby may need something different than what you would like.

    May 21, 2011 at 02:18 | Report abuse | Reply
    • Jen

      Unfortunately I have spoke with many about their birth experiences. Very few I know (including myself) who have had hospital births have had positive experiences. Everyone I know who has had a homebirth has had a positive experience. Surprisingly I actually no more people who have had home births than have had hospital births. Several of those births have even been unassisted (midwife nearby though).

      May 22, 2011 at 20:01 | Report abuse |
  19. Ressie

    I understand some women don't like the idea of giving birth in a dirty hospital. (Hospitals ARE dirty there r so many studies 2 prove it and just really think about it) but why would u wanna give birth at home with the risk of something happening without proper professionals or equipment around and you have 2 clean the mess up. The blood, mucus, membrane, afterbirth! Just eww! Go 2 a hospital so they can clean the mess up

    May 21, 2011 at 04:27 | Report abuse | Reply
    • Cathy W

      The midwives help clean up. It's really not an issue.

      May 21, 2011 at 15:36 | Report abuse |
  20. BillRubin

    Before comparisons are made, you need to remember that midwives have strict criteria on whom they take on for home births. These mothers are typically healthy and low risk. Hospitals will take in mothers with more medically complicated pregnancies (breech presentation, multiple prior C-sections, gestational age 43 wks, multip pregnancy).

    In Canada, midwives often deliver in hospitals, and consult a doctor if there are any perceived complications. There is much more cooperation between midwives and MD's in Canada than there is in the US. My guess is that this is partially due to the public nature of health care.

    May 21, 2011 at 08:09 | Report abuse | Reply
    • thoshebebutlittle

      That seems pretty much ideal to me... the midwives are generally in charge, with the advantages that can give, but when things do go wrong there's the full resources of a hospital immediately available.

      May 22, 2011 at 13:05 | Report abuse |
  21. Em

    "Erythromycin is not given because of hospital germs. It's given as a precautionary measure in the event that harmful bacteria from mom finds it's way into the infant's eyes. Mom may be a carrier of some disease and not even know."

    Yeah, like the STD that I know I don't have? Thanks, hospital policy, for assuming that myself or my husband has been unfaithful. Must we always cater to the lowest common denominator?

    May 21, 2011 at 08:09 | Report abuse | Reply
  22. wakeup

    most midwifes in my state by law are nurse practioners with aa ob speciality.. These are the same vveducational level as the np you see at your family practice, or the e.r. where you ASSUME your talking to a doctor. Because of the current m.d. shortage, you are going to see more and more of them. Why? Your insurance company gets to pay them about 1/4 less for a visit. Home births are much safer than the hospital if the patients are chosen carefully. The American College of Obstetrics recomends no more than 1 c-section per 1000 patients are NECCESSARY! That means only 1 patient per 1000 births require actually a c-section. The rates here are almost 50%. That means 50 women in 100 are receiving them in one of our local hospitals. These women are not high risk. Both doctors and patients choose them for convience! Why stay up all night with a long labor patient when you can be done in about 1/2 an hour with 4 grand extra in your pocket? Ah, modern medicine what an advancement! lol. After my 2 kids, I would never have a baby in a U.S. hospital again. Nightmarish doesn't begin to describe it. I delivered one of my own grandchildren in the hospital because the nurses were too damn busy to come and help! Guys, its a natural thing. HOWEVER, if you do have certain conditions that make uou high risk-Go to the hospital please!

    May 21, 2011 at 09:31 | Report abuse | Reply
  23. Rural area

    An interesting question about intubation. Did you know rural hospitals and small hospitals usually don't have a pediatrician in house 24-7 available to do intubations either? For most normal deliveries, the pediatrician is not required to be there–they are home sleeping, or in their office seeing patients. Probably are not even advised about the birth in process. Do you know who is in charge of the baby at delivery? The RN. Not the obstetrician, he/she has probably not dealt with a baby's resuscitation for years, if ever, and wouldn't feel comfortable intubating the baby. If an intubation is needed, a rare situation, either they have alerted the pediatrician to come in since the delivery was expected to be high risk, or they call the pediatrician in when it is needed. Meanwhile, the RNs are doing what is needed to resuscitate the baby, and waiting for the intubation. Sometimes the person to intubate the baby in other cases is a specially trained flight nurse ready to transport the baby to a higher level of care, and the pediatrician defers to the flight nurse's skills. Why is this acceptible? Well, it does seem to work out alright. In the same way that in the rare case of an unexpectedly sick baby born at home can be rushed to the hospital. Surgical experts and multiple emergency personnel do not actually always need to be hovering about for low-risk situations.
    An interesting side note about the way in which physicians are finally catching up to midwives in safety and health is importance of delayed cord clamping, rather than the artificial immediate cord clamping which has been done at the insistence of physicians in hospitals in recent years. Delayed cord clamping allows newborns to receive their full volume of blood, and to continue to be oxygenated by the mother for the transition to extrauterine life. Now that physicians are finally starting to realize this, I wonder if credit to midwives and home birth advocates will be properly given.

    May 21, 2011 at 10:05 | Report abuse | Reply
    • MidwifeMama

      It's important to to note that by leaving the umbilical cord intact, the need to intubate is unnecessary as mom is still providing o2 through the cord (as long as it's pulsating) this gives midwives (or nurses, or even OBs, if they practice it!) time to work on baby before it becomes a crisis. I've seen cords pulse for up 20 minutes after birth, that's a heck of a lot of time to have to help get baby stable and transport!

      I will never cut a cord on a baby that isn't doing well – it's easier to put a pulse oximeter on and keep track that way

      May 21, 2011 at 17:11 | Report abuse |
  24. milokisses

    Having a healthy child is not a guarantee. No matter where the child is born it is up to the parents to make a well informed decision that is right for them. I am pro homebirth and pro hospital birth. What a wonderful thing to have a choice.

    May 21, 2011 at 10:14 | Report abuse | Reply
  25. Amy Tuteur, MD

    Homebirth increases the risk of perinatal death. That's not surprising, because in the US, a substantial homebirths are attended by certified professionall midwifes (CPMs) who have so little education and training that they are do not meet the requirements for licensure in ANY other fiirst world country. Unlike American certified nurse midwives, and midwives from Europe Canada and Australia, all of whom have a university degree, CPMs have only a post high school certificate.

    Indeed, the death rate at homebirth is so high that the Midwives Alliance of North America (MANA) the organization that represents CPMs refuses to release the death rates of the 23,000 planned homebirths in their database. The data has been offered publicly, but only to those who can prove they will use the data for the "advancement of midwifery," and sign a confidentiality agreement promising not to reveal the rates to anyone else.

    No doubt MANA is correct that revealing how many of those 23,000 babies died at the hands of CPMs will not "advance" homebirth midwifery. When American women learn just how deadly homebirth with a CPM has been, they will be far less likely to choose homebirth.

    May 21, 2011 at 10:20 | Report abuse | Reply
    • mother of four

      Amy, I don't know where you live at, but in my state, to be a licensed midwife one must fulfill the following requirements:
      http://www.missourimidwivesassociation.org/cpm.html as well as have a degree in nursing.

      Further more, your reputation precedes you as being a doctor who is against home births (not a big surprise, really). I remember your arguments against this from some years ago. Interesting that you're STILL spreading lies. Good luck to you.

      May 21, 2011 at 11:58 | Report abuse |
    • Cathy W

      Dr Tuteur – you aren't quoting any reliable stats here:
      "Majority are CPM". Says who?
      "The death rate of home birth is so high...." Says who?

      You are quoting lies and propaganda, and there is zero basis for your claims. If you are really a doctor, you should know how to read studies, and look at the research. Look for confounding variables. You should be ashamed of yourself for using such blatant emotional scare tactics. Putting an MD after your your name (if indeed you have one) means you are at a GREATER responsibility to do your homework.

      May 21, 2011 at 15:41 | Report abuse |
    • MidwifeMama

      Ms. Teuter, when will you stop including MD after your name? You haven't been licensed in how long now?

      As for your assertion: " ...(CPMs) who have so little education and training that they are do not meet the requirements for licensure in ANY other fiirst world country"

      About 2% of the midwives in Canada are there through the CPM bridge program and are American CPMs.. care to try again?

      As for the rest of your attack on MANA, if you don't have the numbers to show, why are you maligning them? Because they wont give them to you? It's well known in the homebirth arena that you are well capable of twisting even the most innocuous study to fit your aims – even if it goes directly against the studies own conclusions. MANA should give their numbers to you so you can point and say "LOOK! Babies have died!!" without putting it in context?

      If only you held OBs to the same standards you hold CPMs – mothers and babies everywhere would be better off!

      May 21, 2011 at 17:21 | Report abuse |
    • Babylady4

      Then there should be licensure that states a Professional midwife needs to have more than just the two years of training, but also a BS in Human Biology. My CPM had a BS in Biology and also two years of training at a school for Midwives. Do consumers need to be educated? You bet! Look at credentials, listen to past patients, ask a LOT of questions. I would wager that the majority of issues arrive when a non-certified 'midwife' attempts to assist at home deliveries and runs into issues they are not equipped for. Birthing at home with a qualified trained midwife is perfectly safe.

      Have you ever attended a home birth? Interviewed a midwife? They have many 'tricks' on how to deal with birthing mothers (and make them more comfortable) that doctors do NOT follow or just do not care about. Having a baby is NOT an illness! The AMA needs to realize this! Yes there is a time and a place for a doctor to intervene, but OB's need to go back to their roots and remember that the root word of Obstetrician means 'stand by and wait'. Something few do.

      May 22, 2011 at 11:53 | Report abuse |
    • CJEH

      Oh look Dr Amy has arrived, what a coincidence. An anti-homebirth fundamentalist, she has an inability to accept scientific fact that doesn't say what she wants. She shows up in the comments of any news article that even hints at the positive nature of home birth. She's like the Fred Phelps of the birth world, just ignore her, and eventually she goes away.

      May 23, 2011 at 12:19 | Report abuse |
  26. Mike

    I am glad they are having babies at home. Helps to keep MEDICAID costs down by having babies in trailers.

    May 21, 2011 at 10:33 | Report abuse | Reply
    • Emmie

      There are also a lot of highly educated people making wonderful arguments, which if you had read any of them, you would know. There are also a lot of uneducated people making ridiculous statements, of which yours may be the most asinine! Please don't comment if you don't have anything intelligent to contribute.

      May 22, 2011 at 20:23 | Report abuse |
  27. cew

    IF HOME BIRTHS ARE SO SAFE, why was the "midwife" arrested and charged with manslaughter in Virginia last month/? Ah....ah....ah....is was because she KILLED a baby during a substandard childbirth....And oh by the way she WAS a "licensed midwife........and by the way she was an experienced midwife....Go Figure.
    How many of your respondents want to support this midwife and her license to kill....the good news is she will soon wear stripes behind bars.....

    May 21, 2011 at 12:40 | Report abuse | Reply
    • mother of four

      And how many OBs have had their licenses suspended because of malpractice? How about the one who injured the young woman during an abortion? And the one who lost theirs because they drank on the job? And another in New York who was finally suspended after multiple complaints concerning substandard care she'd given to patients? And the list goes on and on. Incompetence is everywhere.

      May 21, 2011 at 13:19 | Report abuse |
    • MidwifeMama

      Oh look! I can play with anecdotes too! What about Claudia Mejia, the young mother in Florida who lost all of her limbs have a massive MRSA infection gained in the hospital after the birth of her son? Or Angela Carder who was court ordered to have a cesarean section which killed both her, and her baby?

      There are bad doctors. There are bad midwives. There are good doctors who have occasional bad outcomes, and there are good midwives who have occasional bad outcomes. In any health related field if you practice long enough, you're going to hit the statistical limit and experience something truly bad. The question is: Did the midwife react appropriately when that breech baby got stuck? Since I don't know the details of the case, I'm going to hazard a "no, she didn't" and that's why she was found guilty.

      May 21, 2011 at 17:38 | Report abuse |
  28. Cathy W

    CEW – how many babies have been killed by OBs due to substandard practices during childbirth in a HOSPITAL???? OB malpractice rates are the highest among ANY medical specialties for a reason – because there are always quacks out there. Midwives nor doctors are not immune, unfortunately.

    May 21, 2011 at 15:43 | Report abuse | Reply
  29. TJ

    FYI – the actual article is available here

    May 21, 2011 at 16:13 | Report abuse | Reply
  30. MidwifeMama

    "ACOG says the best available data show hospitals and birthing centers are the safest place for labor and delivery" – Except the "best data available" DOESN'T show that. The best data available show that home birth with a trained professional is as safe, or safer than hospital birth.

    The study that shows the 2-3 fold increase in neonatal death is well debated as having flawed methodologies, but it fits ACOGs party-line so they use it. Just like they continue to use the Hannah breech trials to support their opinion that breech babies should always be born via cesarean. Despite other Obstetrical Colleges reversing that opinion (SOGC being the most recent)

    ACOG is being dragged kicking and screaming into admitting what the rest of the world already knows – homebirth for low risk women is optimal. Hospital births are best for mid to high risk women. A well trained midwife with a good network of providers behind her is best for the safety of both mother and babe, because fear of repercussion for transfer becomes non-existent, and moms that need to be transferred GET transferred.

    May 21, 2011 at 16:29 | Report abuse | Reply
  31. Amanda

    I used to think home births were an unnecessary risk. I chose to have my son in a hospital. While I'm not sure I would be ready to do the home birth thing, the hospital experience was awful, and has been for all of my son's health problems since. I used to believe in the American healthcare system, but now, it feels like you check your soul at the door. If you question anything, instead of getting helpful information, you get a lecture. My son has an upcoming surgery, at one of the purported "best hospitals in the country," but after having endured so many scheduling screw ups, rude people, lack of information, and general frustration, I don't know if I trust them.

    May 21, 2011 at 16:39 | Report abuse | Reply
  32. Nic

    I'd rather give birth at home in my own bed rather than go to a filthy germ ridden hospital and get handled like cattle by arrogant doctors!

    May 21, 2011 at 18:36 | Report abuse | Reply
  33. sonja

    I have three daughters that were born in the hospital..I had a doctor with the first one and the same midwife with the last two in the hospital. I would have them in the hospital again. MY experiences were positive.

    May 21, 2011 at 23:09 | Report abuse | Reply
  34. Marina

    I had my two oldest daughters in the hospital. With my third daughter, I was 38 weeks pregnant in January when I faxed a letter to my doctors, telling them that I decided to do a home birth. I had talked to them on numerous occasions about declining the IV, being able to drink water or eat nutritious snacks during labor, not being induced, etc. They told me that I had to thank the lawyers and insurance companies for the mandatory IV, and no, I could not eat or drink anything. Women in this country are expected to run this marathon on empty. They get exhausted, the labor slows down, they are given pitocin, the pain gets much more intense, so they get an epidural. Pitocin results in much longer and stronger contractions that often put the baby in distress, which results in c-section. There is a cascade of routine medical interventions that the woman has to endure and everyone is acting like, "Thank goodness, we saved your baby!" I found an excellent midwife, and my daughter was born at home, in my bed, with my husband by my side, right on her due date. It was the most exhilarating experience of my life. The cord wasn't cut for 2 1/2 hours, until the baby got all of the blood (it contains 10% of their blood volume). The cord was completely drained and my daughter was perfect pink. I believe that a hospital birth is helpful for first-time moms because that's when problems could surface, such as a narrow birth canal, etc. But, if you have had prior healthy pregnancies and deliveries, a home birth is WAY better than at the hospital. It sure was for me.

    May 21, 2011 at 23:52 | Report abuse | Reply
  35. Tellmenolies

    I had two home births,one with an MD and one with a certified nurse midwife.I had retained placenta during the second one and the nurse midwife handled it like the highly trainedmedical professional she was...The babies are perfect ( they are young adults now)... I would recommend a home birth to any low risk woman...

    May 22, 2011 at 00:56 | Report abuse | Reply
  36. S1N

    That's fine. Let them have a home birth, on one condition. If something goes wrong, and the baby dies due to being too far away for a hospital to treat, the parents should be immediately executed.Yes, professional midwives are trained to handle emergencies. However, they do NOT have access to the same resources or equipment as a hospital. The risks are low, but the parents should be held accountable, preferably cruelly and unusually, should their decision cause any harm to the child.

    Hell, just execute them anyway for falling behind the evolutionary curve. Science, medicine, and technology were created for a reason. Use them, or go live in an Amish village... and still die.

    May 22, 2011 at 02:44 | Report abuse | Reply
    • mother of four

      You are, of course, allowed to believe whatever you want to about pregnancy and delivery. However, suggesting there should be some kind of punishment for those who have suffered the very same tragedy that many others have during hospital births, demonstrates a complete lack of understanding of the process. Our country has a higher infant mortality rate than any other industrialized country and guess where most of those children were born? Though it is by no means the only cause, a contributing factor is the number of C-sections. Additionally induced labors (did you know that this done routinely now?) increase health risks to both mothers and infants and also increase the likelihood of C-sections. In fact the risks associated with both are so well known that everyone assumes that the various "norms" of hospital births (emergencies) are the norms of birth in general. They're not.

      May 22, 2011 at 09:39 | Report abuse |
    • Cathy W

      So the parents who elect to have a hospital birth, and then contract a hospital-born infection should be executed for birthing their babies in a disease-ridden environment, too? You hospital-only folks seem to think that it's a binary equation – unsafe at home, and safe at the hospital. It's just not like that. There are risks at either location. Why do you think OB's carry the highest malpractice rates of any medical specialty? Because a few of them screw up and kill babies and mothers in hospitals.

      May 22, 2011 at 11:14 | Report abuse |
    • Beth

      Should the hospital staff have a similar fate if the baby contracts MSRA and dies as well? There are deaths at hospitals that would not have happened if the birth had been at home and vice versa. Thankfully your idea is just an idea and you don't decide legal matters in this issue.

      May 22, 2011 at 14:16 | Report abuse |
  37. Dawn

    Any educated soon to be mother (if she was truly educated on birth in America) would NEVER step foot into a hospital and allow a Dr to deliver her baby. Why? Its a drug war. The only way they know how to shut you up in labor is to drug you and your baby. This is the way they are trained, this is all they know and you are a victim of their narrow minded educational views. The average expecting couple spends MORE time researching and picking out a home stereo, than they do researching the birth of their child. Americans are so brainwashed, you go into labor, you go to a hospital, you open your legs and you let a random group of strangers who happen to be on call that day drug up and deliver your
    precious newborn. Why? Because you did not take the time to review your options of birth. You do as the rest of the lazy Americans. There is no way I would ever have a baby delivered with drug happy DR and nurses. And I am married to a DR.
    P.S. And don't even think about having a "natural birth" around 4pm" in a hospital, that's when our Dr husbands tell you something is wrong with the baby, you must do a c-section NOW(never mind the fact that Dr's make A LOT more money off of your c-section than your "natural birth").....because he knows he will be home by 6pm, just in time for family dinner : )

    May 22, 2011 at 07:40 | Report abuse | Reply
    • Beth

      This is an overreaction. I had a drug-free hospital birth that was quite nice. If you make a birth plan and research your providers and choose one who does interventions only when needed and wanted and who has a low c section rate you can have a nice hospital birth and a drug-free one if that is what you wish. Not one time did anyone mention me using medication while I was in labor. Have a homebirth if you like but you must do a lot of education as well. No matter the choice education is a good way to go so you can have a better chance to have the birth you would like to have. It can't always go as we like but often it can and education helps.

      May 22, 2011 at 14:14 | Report abuse |
  38. jan

    Oh my...I'm in trouble for sure.
    My last two were born at home in 1975 and 1977 by choice. Friend there for the first one and husband handled the second one. Both babies were fine and are wonderful adults with no health problems related to their births. The only difficulty we had was registering their births since "you cannot have a baby without a doctor."

    May 22, 2011 at 08:21 | Report abuse | Reply
  39. Ang

    I would have relished the chance to give birth at home but I had placenta accreta and the placenta did not detatch after birth (something we were unaware of until I actually delivered – I didn't exhibit any symptoms). I was very lucky to be in the hands of a capable OB in a hospital that I could be rushed directly to surgery.

    May 22, 2011 at 10:17 | Report abuse | Reply
  40. Ali

    Jan, it's not that "you cannot have a baby without a doctor." A baby is not considered a newborn unless it was delivered in the hospital. I personally delivered both my children in the hospital, however that was over 20 years ago, given the fact that with the onslaught of MRSA that is prevelent in our hospitals today, I would now opt to have my babies at home, even if they weren't considered "newborn".

    May 22, 2011 at 12:01 | Report abuse | Reply
  41. violet

    I work in a hospital where midwives are allowed to deliver babies. Funding was cut and now they were ousted unfortunately. I am a NICU/ nursery nurse and I absolutely loved our midwives. She bridged the gap between what parents sometimes viewed a cold and sterile environment in the hospital. Birth plans were followed and our staff adhered to most of the parents requests. The only one we could nit honor was when parents wished to refuse the 48hr newborn screen... This is a state law so our hands are tied on that one. Most of what the mom and family requested was honored... We even had several families bring in their own birthing tub...(I'm in the Midwest)! Overall, it was amazing and an honor to work with these midwives and families. Yes, sometimes our natural births there ended up being a NICU patient. It was frustrating for the parents when they were told that they could not breastfeed or hold their infant when hooked up to a vent to help them breathe. It was heartbreaking to them and us because of this and other treatments that interfered with the bonding process however the infant needed the intervention. We NICU nurses feltnlike the bad people as well as nursery nurses who take the wrap for being "anti-breastfeeding and bottle pushers". I cannot tell you how many times that parents would come in and state that they were told that the nursery was a bad place. Yes, there are exceptions... There are bad nurses, doctors, and hospitals. There are also bad midwives and mis-informed families being taken advantage of in the fact that not all options are presented to them clearly for them to make a decision about home birth vs. hospital. We personally always had a wonderful, experience with our midwives and we now miss them. On the other side, there have been instances where our NICU has saved infants from unexpected issues.... There is no definite way to tell if a pregnancy is truly high risk or not. An example of one is a normal and natural delivery of an infant with a diaphagmatic hernia... No warning or no heads up. It is a gamble and yes, life is full of gambles. Overall, I applaud parents for take g a proactive role in decisions concerning the birth of their child... It is a personal one. I wish all parents out there to have a safe, beautiful, and positive birthing experience no matter where they choose. I also want to point out in this "lawsuit-happy" time that professional must be very vigilant about preserving their licenses... If there is a couple who wish to have a home birth and decline any and all intervention and there is not any resources to turn to should an infant be delivered with complications then I think that all parties involved discuss liability if the infant dies as a result of not getting to a hospital in time. Suing a professional for delivering substandard care is one thing... Suing because because a home lacked the proper resucitation equipment ( sometimes you need more than just an o2 canister) is not. As fR as vaccinations, they are the choice of the parents and their rightsboncebagain should always be valued. The only drawback is the the child contracting one of those terrible diseases or the public schools denying them entry. As far as vitamin k and ilo... They are standard in every hospital and reccomended to all regardless of race and socioeconomic status. We are not implying your husband is unfaithful... Again, you can decline. Now lastly, as a mother of a son with ASD... I seriously hope that the woman who implied that her son had Aspergers because of a hospital birth is not being serious... Concern over vaccines causing it is one thing... But a hospital birth? Silly. If your child suffered from u2 deprivation you will be more concerned about CP. I do hope parents continue to push for the cause and cure of autism... Don't let that fire die... Best wishes to you all.

    May 22, 2011 at 13:20 | Report abuse | Reply
    • MidwifeMama

      You should look into providing Kangaroo Care in your NICU, it's a little more difficult but the outcomes are generally better. (If you already do, never mind 🙂 , it just sounded from your post like you don't)

      May 22, 2011 at 14:42 | Report abuse |
    • mother of four

      That was me. And perhaps you should do some more homework before speaking to someone concerning the cause of their child's ASD. I did not blame it on "hospital birth"–I blamed it on the hospital's response to our situation. Perhaps you missed the part about the medication they gave me.

      Asperger's–in our case–was not caused by vaccinations, nor is it genetic. Recent studies have indicated that as many as 50% of patients with Asperger's have some history of oxygen deprivation at birth. It was a relief to learn this, in a way, as I had long suspected that it had contributed to his problems, which were apparent from early on.

      My son was born at the end of a normal, healthy pregnancy, after just a few pushes– blue and cyanotic. He had received a "snoot ful" of the demerol and promethezine they'd given me less than an hour before delivery. After giving him the standard "run down" he was handed to me to nurse. While he was moving and had cried a little, he was limp and disinterested. The nurses and doctor ignored my concerns about his coloring and limpness for over an hour. (We were the only ones on the ward, by the way). I think they assumed I was being over protective. When I finally convinced them to come check on him, the nurse finally took note of the fact that he was not breathing normally and whisked him away to the nursery and put him on oxygen. Suddenly, there were questions, tests (he was given a spinal tap among other things), fearsome speculation, and no answers. They would not let us into the nursery during these eight hours. At the end of this period, they finally brought him to us, stating that he appeared to be progressing normally. One nurse's words were "We think it's safe for you to bond now." I will never forget those words.

      I stayed in the hospital in order to nurse and care for him as they insisted on keeping him for five days for multiple injections of antibiotics in his upper legs while we waited to see what the cultures they took revealed. The cultures turned up nothing and he was nursing like a barracuda by the second day and though "low tone" demonstrated most normal new born behaviors. The doctor insisted on finishing the injections (four times a day of two different antibiotics in two different syringes–two different needles). I quizzed the doctor as to the cause and if brain damage was possible. He stated that this kind of thing happened once in a while and that they never knew the cause. By the way–this doctor lost his license two years later.

      So–no–I am not silly. I an experience parent who has spent a fair amount of time wondering what my second born's life would have been like if the staff in this hospital had done a better job of communicating with one another and had paid attention to my concerns the first time I'd expressed them. At eighteen, he is a fine young man, who graduated from high school today, but our road was a long one and his childhood was rocky.

      May 22, 2011 at 22:43 | Report abuse |
  42. violet

    Sorry for misspelling... iPad has mind of its own. Home births are beautiful and I hope this can truly become a safe and accepted practice everywhere. Please educate yourselves and ask for resuscitation equipment and NRP certified providers there on standby.... Good luck!

    May 22, 2011 at 13:27 | Report abuse | Reply
  43. Beth

    Part of this is caused by the INSANE c-section rates in this country, now over 50% in many hospitals. This is just CRAZY high and unnecessary. There are hospitals that will not allow women to have VBACs, etc. Women want to have choices. We don't want to be pressed to have c-sections or other interventions if they are not needed or for the doctor to CYA. Unfortunately we live in a litigious time and that probably has pushed doctors to push Csection rates up so high. Too many women are told they must come in and be induced when they are still safe to wait. First babies come on average at just over 41 weeks but we are lead to think over 40 is 'overdue.' There are first time moms pressed to induce at 38 and 39 weeks! Wh? They have pitocin, terrible pain and then a c-section as a result of 'failing to progress'. How about waiting for the baby to be ready unless there is a true medical need to induce. These same people would not want a cake to come out a minute early from an oven. I recommend 'the thinking woman's guide to a better birth' to anyone who wants as good a birth as possible. Good book. I personally prefer hospital birth in a place where I have people working with me who aren't going to push unnecessary interventions but those hospitals are getting much more rare these days. The trouble with homebirth is that there are a few very rare situations where if you are not in a hospital your baby and maybe you are going to certainly die when you could have easily survived if in a hospital. The trouble with hospital birth is that there are very bad infections, etc that you and your baby can catch and that can cause death that you would not have gotten if birthing at home. Also, you have a risk of having unneeded interventions that can cause complications and even fatalities. The rate of death for mothers who have c sections is much higher than those who do not, for example and operations open a person up to infections. But overall I think the risk scale comes out with hospital birth slightly safer than home birth. I hope OBs will listen to this and stop being so intervention happy. Interventions are great *when needed*. They are a blessing then but birth is a special time and being poked, prodded and cut needlessly at that time is very sad to me.

    May 22, 2011 at 14:09 | Report abuse | Reply
  44. Fokjoudoos

    Not by choice...

    May 22, 2011 at 15:31 | Report abuse | Reply
  45. BB in Kansas

    My wife and I have had ten kids at home. The first four were with a mid-wife; the last six were my wife and I. Ten perfect preganacies; ten great deliveries. Two had wrapped umbilicals, otherwise no real excitement. The last labor went seven hours with contractions closer than four minutes. Any pin-head doctor would have taken all of our children by C-section, probably resulting in population-control-Kool-Aid-drinkers having six less people to pay their social security.

    My wife has enjoyed the freedom of homebirth. In a nod to the liberals in our midst: Her body; her choice. I always enjoy the hysteria of liberals who are against homebirth. As if a preganacy ending in a dead baby is not the litmus test of all good liberals. It has oft been my comment that were something to go wrong with a homebirth, in order to avoid prosecutiion at the hands of some lib who made it through law school with a couple of abortions, shall we say, under their belt, I would simply shop vac the baby's brains out and plead to practicing medecine with out a license, rather than face a more serious charge of second degree murder. In any case, we allways rtake a degree of comfort from the training manual that used to be employed by the Seattle fire department. It reads: 95% of emergency child births could be handled by a competent eight year-old. Let's hear ot for more competent eight year-olds and less over-educated doctors.

    May 22, 2011 at 16:55 | Report abuse | Reply
    • Cathy W

      Uh, this liberal thinks homebirth is a great thing. I had one myself. Not everything is about politics.

      May 22, 2011 at 22:23 | Report abuse |
    • Gloria

      Actually, most liberals are pro homebirth. Our Bodies Ourselves Supports it, as well as Pllanned Parenthood, both very liberal organizations. We (liberals) believe that women are smart enough and should be able to make their own choices, including where to give birth. So, I don't get why you would think otherwise.

      May 23, 2011 at 07:52 | Report abuse |
  46. Teresa

    It is unfortunate that CNN did not speak to a Certified Professional Midwife (CPM) or Certified Nurse-Midwfe (CNM) for this article. They would have received better information regarding statistics and home births. The study conducted by ACOG, took ALL home births, planned/unplanned, attended/unattended, those to teens who had received no prenatal care and told no one, those born in cars, ect. Any researcher is going to tell you, you will not get a good representation, using such a poorly crafted sample population. The Netherlands, has most of it births at home, and has one of the lowest infant/maternal mortality rates in the world. A good study to look at can be found at: http://www.bmj.com/content/330/7505/1416.long

    May 22, 2011 at 18:46 | Report abuse | Reply
  47. Kauai

    I recently had my baby at a hospital and I was glad that I did. It was the best experience for me and my daughter. The DRS and NURSES were awesome. Very kind, considerate and personal attention all the time. It may be due to the fact that I live on an island that here is more compassion in the hospital than in a busy urban hospital but I was so glad to be in a hopital with all the right people and technologies available IMMEDIATELY! I was what all would consider a healthy mom-to-be. No diabetes, hypertension, braxton hicks...nothing! But after 32 hours in delivery, pitocin, and tablet in the cervix my daugther still wouldn't come. In the 32nd hour the drs and nurses came in and I had to have an emergency c-section because the cord was wrapped around my baby's neck. When my daughter finally arrived, she was blue and I didn't hear her make any nosies for at leat a good 40 seconds.

    I know that everyone has a choice, what I don't like is that many people are now looking down at hospital births. I commend those that are making 'educated' choices and having the babies at home or at birthing centers but at the same time- you can have your baby naturally in a hospital, have a midwife present, doullah etc... and still be close enough to have the emergency care you may need in case the worst happens. Why do women not take advantage of this ability? It seems like they think something so diferent is going to happen at a hospital than a birthing center...they are both the same, except one tells you as it is-the other decorates the pain, and entire experience with selfish reasoning(for the mother's benefit). Birth is about the safety of the baby not just the comfort of the mother. And after a lot of investigation into this (albeit on this island I live on) I noticed that the birthing centers had a lot of extra costs that had to come out of pocket. Even the birthing classes were over double the cost of the hospital's 6 weeks course. It just seems like a new age thought– that is a money making program to entice those that are easily persuaded by fear.

    May 22, 2011 at 18:57 | Report abuse | Reply
    • @Kauai

      I'm almost surprised you're the first to drag out the "selfish mother" argument. Talk to any mother who home births and the first reason she'll give you is safety. The second might be comfort. But at that, the comfort is comfort because you're at home. You're able to walk around naked if you want to, and nobody cares. Try that in a hospital and see what happens. If you want to talk "selfish", and I use quotes because I don't really consider it selfish, look at all of the mothers who chose epidurals? That option is 100% for the comfort of the mother.

      I am terribly sorry for your cesarean, but it doesn't sound like you were unable to give birth – it does sound like you/your baby weren't ready yet. In first time moms induction has a 50% chance in ending in a cesarean. The ironic thing is, at 42 weeks you were only barely post-term. Women fail to realize (or aren't told) that they aren't even over due *until* the 42nd week. If your doctor had been wise, he would have sent you home and had you come back another day, while monitoring you and your baby via biophysical profile until then. Of course if he broke your water, then it's kind of end game whether your induction fails or not. I do think, in light of there being no NICU on your island that your doctor was being very brash.

      I hope you had an easy recovery after your cesarean, and I'm glad it all worked out for you in the end.

      May 22, 2011 at 19:29 | Report abuse |
    • @Kauai

      Oh and cord wraps (nuchal cord) happens in about 1/3 of all births – it's not an emergency, or a reason for a cesarean section. There are some theories that babies with long cords wrap it around their neck as the safest place for it to be. The head and shoulders protect the cord from compression during labor and birth, which helps protect baby's air supply. An old teacher and friend of mine use to say that babies who wrapped their cords were the smartest babies 🙂

      May 22, 2011 at 19:35 | Report abuse |
    • Cathy W

      I don't doubt that you needed your c-section. But I'd like to correct something – cord wrapped around the neck is really common, and isn't necessarily a reason for a section. My daughter was born (at home) with her cord around her neck. After her head was out, the midwife found the cord, pulled the loop over the baby's head and then had me resume pushing.

      Another thing – had you been at home, you would have merely transferred when the labor failed to progress. That's what homebirthers do. Then you have the baby at the hospital, and everything is good. The instance of "do or die" are incredibly rare – most of the time, the midwife spots a problem, and you transfer. And lemme tell you, had my midwife told me to go, or even just suggested it, we would have transferred in a heartbeat.

      May 22, 2011 at 22:29 | Report abuse |
  48. Kauai

    I must add that I was in my 42nd week and because there is no neonatal unit on the island my doc wanted to be in the hospital (just in case), and good onmy doc!!

    May 22, 2011 at 19:01 | Report abuse | Reply
  49. Wew

    After two births in Mercy Hospital in Portland Maine – I have never been encouraged to "stay in bed" or take medication! In fact they have supported and encouraged my plan to be medication free during birth! Other countries can continue to slam mortality rates of countries like the US – however I would not be surprised if other countries mortality rates were not skewed!

    May 22, 2011 at 20:27 | Report abuse | Reply
  50. Emmie

    I will never have another baby in a hospital. But I do not judge people who do. There are risks everywhere. It is a personal choice and should always be a choice.

    May 22, 2011 at 20:34 | Report abuse | Reply
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