For A Natural Birth, There's No Place Like Home
By Mary Lou Singleton, LM, CPM
The miracle of birth: it creates babies, changes women into mothers,
and turns individuals into families. Being born and, in turn, giving
birth are the most transformative and miraculous events human beings
experience. Yet in our society, most families experience birth as
a technological and medical event, fraught with the possibility
of disaster. Currently, 25% of babies born in the United States
are surgically delivered from their mothers’ bodies. Another 50%
are born to mothers who are numb from the waist down and tangled
in a web of tubes and wires. The rate of Cesarean section in the
United States has more than quadrupled in the past 30 years, with
no corresponding improvement in neonatal outcomes. In the midst
of all of this birthing technology, the US maintains one of the
highest rates of maternal and neonatal mortality among all developed
nations.
Every expectant family desires the safest possible passage through
birth for both mother and child. When it comes to birth, most American
families equate “safe” with the sterile, closely monitored, technological
environment of the hospital. These families may be shocked to learn
that giving birth in a “sterile” medical environment designed to
monitor and control the birth process does not improve the quality
or safety of birth. In fact, study after study conducted on the
issue has shown that for healthy women with low-to moderate-risk
pregnancies, giving birth in a hospital is actually less safe than
giving birth at home with a trained midwife. One comparative study
matched over 1,000 women planning to birth at home with the same
number of women planning hospital births. The women were matched
for age, number of previous births, economic status, and medical
risk factors. Women in the homebirth group who transferred to the
hospital due to complications remained in the homebirth group for
analysis. Though the two groups had no statistical difference in
maternal and neonatal mortality rates, the results of the study
showed that planned hospital birth resulted in greater numbers of
birth injuries, maternal and infant infections, hemorrhages, and
low apgar scores than planned, midwife-attended homebirth. (1) Many
other studies support these findings, and no study has ever proven
hospital birth to be safer than planned, midwife-attended homebirth.
(2)
As they become aware of their choices, more and more families are
choosing to birth their children in the comfort of their own homes
with the help of midwives. In most places, families are fortunate
to have the option of hiring independent midwives to provide comprehensive
maternity care and home birth services. Independent midwives specialize
in caring for healthy women throughout their childbearing years.
The care provided by independent midwives differs from that of hospital-based
midwives in many important ways. Unlike hospital-based midwives,
who receive their training and practice primarily in hospitals,
independent midwives train and provide care in home and birth center
settings. Constrained by hospital and managed care policies, hospital-based
midwives typically are unable to spend large amounts of time with
individual clients in prenatal visits. Large hospital practices
leave clients unsure of which particular midwife will attend their
births.
Independent midwives work in private practices and are able to
dedicate great amounts of time to their clients. They recognize
that birth is a profound rite of passage and needs to be treated
as more than just a medical event. Independent midwives offer hour-long
prenatal visits, providing ample time to perform the necessary checks
on mom and baby’s physical well-being, as well as to address the
emotional and spiritual needs of the mother. Families who hire independent
midwives choose and know who will attend their births, as independent
midwives do not work in shifts and remain on call for each of their
individual clients.
In addition to personalized care, birthing at home offers many
distinct advantages over birthing in the hospital. In nature mammals
instinctively seek out quiet, dark, familiar places to give birth;
their labors stop if their space is disturbed. Humans also birth
best in privacy, and one’s own home is the ideal place to create
such surroundings. Most women innately choose to move around during
labor, finding the most comfortable positions in which to give birth.
At a home birth, midwives encourage such position changes and a
woman’s freedom of movement is limited only by the size of her house
and yard.
Independent midwives also offer their clients the choices of laboring
and birthing in water, delivering their babies with their own hands,
or having the father catch; none of these options are routinely
available at most hospitals. After birthing at home, mother and
infant may bond without interruption. A comprehensive newborn examination
is done right on the family bed next to the mother. Home birth also
allows for greater sibling involvement in the birth process. If
the parents desire, older children can be present at the births
of their new siblings, an option that is not routinely available
at hospitals, especially during the cold and flu season.
The familiar comfort of home makes it the safest birthplace for
healthy, low-risk women. In the safety of their own homes, women
are less likely to experience complications of labor, such as hypertension
and meconium staining, which may be brought on by stress. The freedom
to move about as desired decreases both length of labor and the
need for pain medications, therefore lowering the risk of maternal
exhaustion, fetal distress, and cesarean section. Whereas a woman’s
home usually contains only microbes to which she and her baby are
immune due to daily exposure, the hospital is full of disease-causing
microbes, many of which are resistant to most antibiotics. In fact,
any person being admitted to an American hospital has a 4 to 10
per cent chance of acquiring a hospital based infection.
(3) Newborn babies are especially susceptible to such infections
due to their immature immune systems. Birth is by nature unpredictable
and in some instances families who choose to birth at home may have
to transfer to the hospital for technological assistance. The small
chance of such a transfer being necessary should not deter women
from planning to birth at home.
Families who birth at home with the help of midwives generally
report far greater satisfaction with the birth experience than those
who have given birth in hospitals. Women who birth at home and the
midwives who attend them understand that birth is as safe as life
ever gets, and that attempting to control birth actually causes
more complications than it prevents. Midwives maintain the safety
and sanctity of the natural birth process, mainly through the practice
of non-intervention. When excellent prenatal care has been given,
addressing all aspects of a woman’s life and relationships, a mother
is well equipped to birth her baby with minimal assistance. Midwives
specialize in normal birth, and they are quick to recognize any
deviation from normal and to use the appropriate measures to help
correct the situation. Midwives and families who birth at home are
not anti-hospital, but feel that the hospital should only be accessed
when truly needed. Midwives trust in women’s ability to give birth
normally and they help instill and reinforce this same trust in
the families they serve. Far from being a medical event that must
be suffered in order to receive a baby, a midwife-attended homebirth
is a joyful celebration of life and the family.
1 Mehl,
Lewis, et al. “Outcomes
of Elective Homebirths.” Journal of Reproductive Medicine.
November, 1977: 281-290.
2 Olsen,
Ole. “Meta-analysis of
the Safety of Home Birth.” Birth. Volume 24, Issue 1, March
1997.
3 Garrett,
Laurie. The Coming Plague.
New York: Farrar, Straus, and Giroux, 1994.
Mary Lou Singleton LM, CPM is a mother, midwife, and herbalist
who lives and practices in Albuquerque, NM. She has served as an
officer in the New Mexico Midwives Association and as a member of
the Board of Directors of the Midwives Alliance of North America.
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Use the information provided on this site as an educational resource for determining your options and making your own informed choices. It is not intended as medical advice or to diagnose, prescribe, or treat any specific illness.