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.