Choosing a
supportive birth place.
"When a woman in labor relaxes in a warm tub,
free from gravity's pull on her body, with sensory
stimulation reduced, her body is less likely to
secrete stress-related hormones. This allows her
body to produce the pain inhibitors 'endorphins'
that complement labor.."
~ Barbara Harper, RN, author Gentle Birth
Choices
Most
Americans assume that the safest place to have a
baby is in the hospital with a doctor and that
births outside of the hospital, attended by a
midwife, just aren’t safe. The scientific data
shows that planned, midwife-attended home and birth
center birth for healthy women carrying healthy
babies is at least as safe as hospital births
for the same population. Here's a
recent study about home birth safety in North
America which was published in the British
Medical Journal.
Consider
the following facts:
-
Midwives are
extensively trained and experienced with normal
birth and know how to handle the occasional
complication should one occur. Midwives
know how to screen out women and babies who are
at higher risk for complications and refer them
to the care of an obstetrician (who is trained
in the pathology of birth and knows how to treat
more serious pregnancy and birth complications)
when medically indicated. Midwives are trained
and experienced in treating variations of
normal with natural methods that pose no risk to
the mother or baby. Midwives are trained and
experienced in monitoring the baby’s heart rate
and the mother’s vital signs before, during, and
after the birth.
-
Midwives are
trained and experienced in spotting more
serious complications during labor with plenty
of time to transport the mother to the hospital.
Because midwives stay with their clients
throughout the labor and birth process, they are
more likely to catch a potential problem much
sooner than the staff at a hospital would, since
women do not receive continuous care from their
doctor or nurses.
It is extremely
unlikely that a midwife would ever need to call
9-1-1 for an emergency transport since
midwives know how to spot potential
complications early on.
-
No study has
ever shown worse outcomes for planned,
midwife-attended out-of-hospital births than for
hospital births when women and their
babies are appropriately screened for risk
factors. Numerous studies have shown that
planned, midwife-attended out-of-hospital birth
is at least as safe as hospital birth for
healthy women carrying healthy babies.
-
Midwives are trained and
experienced in newborn resuscitation, just like
doctors and nurses in the event that a baby is
not breathing well at birth. In fact,
midwives often
take the same newborn resuscitation classes as
doctors and nurses. Midwives also bring
oxygen with them to the birth and deep
suctioning equipment to help a baby who is not
breathing well.
You may be surprised to learn that
planned, midwife-attended out-of-hospital births
have been scientifically shown to be at least as
safe as planned hospital births for the same
population (normal healthy women and babies).
Outside of the hospital, you are more likely to have
a truly natural, no intervention birth without
sacrificing safety to get it. After all, a natural,
no intervention birth is safer than an
intervention-filled, medically-managed one. Each
intervention into the birth process carries risk.
Often, these risks include the risk of needing more
interventions. This is called "the cascade of
interventions".
If you look at the infant mortality
ratings around the world, you'll see that the
countries that have the best outcomes (the ones that
lose the fewest babies) also have a much, much
higher percentage of midwife-attended,
out-of-hospital births than the United States does.
In the United States, where our love-affair with
technology has permeated our birth rooms as well as
every other aspect of our lives, we have a
significantly higher incidence of infant deaths (the
US is ranked 36th).
Why do we have such poor outcomes in
the United States? There are likely a number of
contributing factors, but the medical approach to
birth and underutilization of midwives and
out-of-hospital birth are two of the biggest ones.
Obstetrics is one field of medicine where
evidence-based care isn't practiced. Why is
this so?
"Just as with parents, it comes
back to fear and faulty beliefs. They [doctors
and nurses] spend a great deal of time learning
about pathology and very little about normal
natural birth. They then see what they expect
to see" (Kim Wildner, Mother's Intention,
p. 123).
Don't let fear and misinformation
guide your birth choices. Follow the facts
and your own instinct to make the choices you
know are best for yourself and your baby. If
you do this, you will have no regrets.
Some of the Reasons Women Choose
Home or Birth Center Births
-
It's at least as safe as a planned hospital
birth, if not safer.
-
Home birth is much more convenient for the
mother. People to come to her instead of her
traveling while in labor. There's no mess to
worry about because the midwives take care of
that.
-
It's private and personal and the care given by
a midwife for normal pregnancy and birth is more
comprehensive.
-
Laboring women tend to be more comfortable at
home, which has a positive effect on labor and
birth..
-
They don't
have to
worry over interventions being forced on them or
their babies.
-
They don't
have to worry about forced separation from their
babies.
-
Waterbirth is
an option as are any other natural comfort
measures a woman wishes to use.
-
They and
their babies won't be exposed to hospital "super
bugs" (hospitals are far from sterile). All the
germs in their homes are germs they're familiar
with and they have antibodies to protect
themselves and their babies.
-
Their
partners and other children can be more
involved.
-
They don't
have to worry about accidental circumcision or
administration of unwanted substances or
procedures.
-
No chance of
their babies being switched with someone else's.
Out-of-hospital Birth Safety (just a few of the many
resources available)
Short List of Studies
(There are dozens more!)
“Perinatal
mortality was not significantly different in
the two groups.
The principal
difference in the outcome was a lower
frequency of low Apgar scores and severe
lacerations in the home birth group….No
maternal deaths occurred
in the
studies.”5
“The results
of this study suggest that, for relatively
low-risk pregnancies, home birth with
attendance by lay midwives is not
necessarily less safe than conventional
(hospital-physician) delivery.
Support by the medical and legal communities
for those electing, and those attending,
home birth should not be withheld
on the
grounds that this option is inherently
unsafe.”2
-
Anderson RE and Murphy
PA. Outcomes of 11,788 planned home
births attended by certified
nurse-midwives.
J
Nurse Midwifery
1995;40(6):483-492.
-
Duran AM. The safety of
home birth: the Farm Study.
Am J
Public Health 1992;
82(3):123-129.
-
Janssen PA, Holt VL, and
Myers SJ. Licensed midwife-attended,
out-of-hospital births in Washington
State: Are they safe?
Birth
1994; 21(3):141-148.
-
Mehl LE et al. Outcomes
of elective home births: a series of
1,146 cases.
J
Reprod Med 1977;19(5):281-290.
-
Olsen O. Meta-analysis
of the safety of home birth.
Birth
1997; 24(1): 4-13.
-
Schramm WF, Barnes DE, and Bakewell JM.
Neonatal mortality in Missouri home
births.
Am J
Public Health 987;77(8):930-935.
Books
The Birth Book by Dr. William Sears
and Martha Sears, RN
Gentle Birth Choices by Barbara
Harper, RN
A Good Birth, A Safe Birth by Korte
and Scaer
Obstetric Myths vs. Research Realities
or The Thing Woman's Guide to a Better
Birth by Henci Goer
Links
Gentlebirth.org's Index on Homebirth Safety
National Association of Child-Bearing
Centers
Citizens for Midwifery
Homebirth Movie/Slide show Jude Roman
Fairbanks
|
