I cringe at the mere mention of the words Home Birth. As much as I don’t want to offend the exceptional nurse midwives who provide this approach, and do not want to belittle the exercise of self-determination by mothers who choose this route, I worry about the risk. Multiple studies have clearly demonstrated that the baby is at greater risk of injury or death when delivered at home. That fact alone makes home births–scary. 

Home Births Pose Greater Risks

Between 2010 and 2017, almost 14 newborns for every 10,000 live births died following planned home births – that’s more than four times the rate for babies born in hospitals.

Last Friday I had what would have been considered the perfect home birth candidate–young, thin, no medical problems, and had a previous successful vaginal delivery with no problems. For the first 12 hours she labored with no intervention but she did not dilate. Still, we decided to give it more time–we were patient, counting on her pelvis to do what it did with her first baby, give way. But, at 6:30am in the morning, on day 2, when the baby’s heart rate slowed and did not recover, we got her into the operating room and got that baby out in 4 minutes. That’s the difference. When nature takes a turn for the worst, how far away are you from help?

Many people counter, “well women have been having babies for centuries.” Ah, did we forget about all the mothers and babies who died in childbirth? Childbirth can be dangerous, for both mother and child. As an obstetrician, my job is not just to stand there and watch the baby slide out–like poop. Women bleed, women get horrendous lacerations that have to be repaired in the operating room, babies get hurt, and babies die.

Birth Centers

Midwives have a different approach to birth and it is really beautiful. This is often not a question of who did the delivery. Ask the question: is the mid-wife certified? And, did that person undergo training to manage complications?It is always a question of where the delivery takes place. How far and how long will it take you to get help if you need it?  I have been on the receiving end of the drive-by-the-emergency-room-and-dump-the-patient-and-leave. It’s always sad, and usually lends to a devastating outcome.

Birthing centers offer the setting that allows women to feel “at home.” And, most of them (always check) have a tested system whereby they a) have a relationship with the doctors at the hospital, and b) have a tested, and efficient, way of getting mothers to the hospital, if it looks like there is going to be a problem. Check with the American Association of Birth Centers (AABC) for certified centers near you. 

Don’t hand over control of your birth experience to someone else, other than Mother Nature. (You should read “What you can do to avoid a c-section.”) Do be completely informed about the risks and benefits of a home birth by asking the critical questions.

There you have it. Spread the word


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