Why in the world would anyone choose to have their baby at home?

I mean, everyone knows it is safer and nicer to go away to the hospital, right?

Ummm, no, it's not.

Just some background; I have had nine children, all naturally (no C-sections, no epidurals); Four at a hospital and five at home. I have not had any major problems with my hospital births (I had one of the best doctors in town. He was recommended to me by a doctor and labor room nurses). After the fourth I would have told you they were as pleasant as you could expect something like labor and birth to be, (in other words not very pleasant but not a nightmare either.)

I have since changed my mind. Here are the facts.

Home birth is safer. Yes, you read that right. It is safer to have a baby at home than in a hospital. In all the world, America is the 28th safest country in which to give birth, statistically speaking. That means that even though we have the BEST emergency medical care system in the world, it is safer to have a baby in twenty-seven other countries. In all of these countries, most babies are delivered by midwives. The safest countries are in Scandinavia where 70% or more of births are delivered by midwives. In America, it is 4% or less. These other governments encourage the use of midwives (I will get to the reason in a minute).

I have read about many studies done comparing the safety rates of midwife assisted home births with OB assisted hospital births. Only one ever showed the hospital births to be safer. These studies only compared equally matched, low risk pregnancies. Midwives do not generally take high risk patients; OBs do. But high risk patients were not counted in the studies. Only low risk patients from both. Some studies took Family Practitioners into account also. Here is the numbers I have heard repeatedly:

  • Emergency, unplanned home (or back of car, or elevator, etc.) birth...15 out of every 1000 births have complications (infection, injury, death, etc.)
  • OB assisted hospital births...10 out of every 1000 births have complications.
  • Family Practitioner or DO assisted, hospital births... 8 out of every 1000 births have complications.
  • Midwife assisted, PLANNED home births...4 or 5 out of every 1000 births have complications.

The one study that showed midwives to be more dangerous than hospital births lumped unplanned, emergency, out of hospital births (including doped up teenagers giving birth in mall bathrooms and dumping the baby in a trash can) in with midwife assisted home births. The study was conducted by individuals who were trying to get midwives outlawed (the American Guild of Obstetricians).

If you have never studied the differences, these numbers may not make sense to you. Here is the explanation :

Doctors are trained to treat complications (and they do a great job of it, too.)

Midwives are trained to prevent complications. Big difference.

Doctors are trained to believe that pregnancy is an illness, labor an emergency and a woman's laboring body is in need of being acted upon (saved). All births are assumed to have complications until afterwards when they have proven otherwise.

Midwives are trained to believe that birth is a natural, normal part of life, a natural everyday bodily function not generally in need of intervention. They believe all births are normal from the start until they prove otherwise.

Doctors and hospitals make more money the more interventions you have in your birth.

Any interventions (from suture thread to transporting to the hospital) cost midwives, personally, money.

I hate to imply that doctors and hospitals are materialistic enough to use unnecessary interventions so they can make more money. I honestly believe that most doctors and nurses are really doing what they think is best for the mommies in their care.

However certain numbers can't be explained any other way. For example: one HMO run hospital had a 27% C-section rate until they began only paying their doctors the same for C-sections as for natural births. Suddenly their C-section rate fell to 10%. Isn't it interesting how women suddenly got healthy enough to birth naturally when it meant no extra money for the doctor's wallet to do a C-section?

The idea that it is safer to give birth in a hospital stems from the time in the 1800's when "half of all women died in child birth." The problem is that that simply is not true.

Half of all women birthing in hospitals died. You see, doctors of the day scoffed at the germ theory of illness; the idea that microscopic germs caused illness. They went from doing an autopsy to delivering a baby without washing their hands or changing their blood stained lab coats.

The real amazing thing is that they only lost half their patients!

Midwives, though not knowledgeable of germs, would have washed dishes and laundry between births. They would have accidentally been cleaner than the doctors of the day.

We have no way of knowing the exact number of women who died during this time but we do have many personal journals and some death certificates. We can guess from this evidence that it was really a rare event. In fact, the human race could not have survived if the home-birth population died as often as the hospital population.

Even today in the worst third-world nation, with under nourished moms racked with malaria, they only loose one woman in ten, not one in two.

Remember that human beings gave birth for thousands of years with the aid of midwives only, while keeping the overall population growing at a fast rate. They had to have done something right.

Now to be totally fair, birth was more dangerous then, even in the home.
  • Fashion dictated that women have milk-white skin; something only achievable if you stayed inside at all times. 
  • Many women, especially in the upper classes, suffered from Ricket’s deformed pelvises (those horrid corsets didn't help either). 
  • Eating meat, going outside when pregnant, and birthing while squatting were considered vulgar. 
  • Fruits and vegetables were simply not available to most city women. 
These things combined made birth more dangerous, at least for upper class women. (Lower class women couldn’t afford to be fashionable and had to go outside (and get Vitamin D) and work (exercise), eat vulgar, high protein meat, and had “old fashioned” midwives who knew about squatting in birth, thus removing many of the causes of complications.)
Birth in general became safer at the turn of the century, not because of more women going to hospitals (the death rate fell BEFORE that began to happen), but because we began to understand the need for proper nutrition and exercise, and the invention of indoor plumbing (and the passing of corsets from fashion). Homebirth midwives had the same decrease in complications the doctors had (factoring in that the doctors started washing their hands.)

In the late 1800's our entire society fell in love with science. Anything "new" or modern was better than anything old fashioned or natural, especially after c-sections were perfected.

This stems from the growing belief in evolution. Of course intelligent human beings could design everything better than random accidents.

The problem is that evolution is not true. The all knowing God designed our bodies and this world. He designed us to give birth and nurse our babies. He knew what He was doing.

Midwives spend more time with their patients (45-60 min with midwives compared to 10-15 with doctors) during prenatal visits and discuss things like diet, exercise, and stress in and out of the family. These all make a big difference in how labor goes.

Doctors just do not have the time nor training (besides that they are usually men. Who wants to sit and gossip with a man?:-) My midwife did all the same medical things, such as blood pressure, chemical level checks, and checking baby's heartbeat, that the doctor did. But she also discussed nutrition and exercise, as well as what was going on in other areas of my life.

If a mammal is scared during birth their body will stop labor until the danger is past. Many a woman has been well into labor only to have it stop when she arrived at the hospital. Few people are as comfortable and feel as safe at the hospital as they do at home. Thus, those at home don't need artificial help to keep labor going.

Can you pee in front of people? Few people can. Yet the same muscles that control pee, control childbirth. So now imagine what happens to those muscles at a hospital when people you have never met before come into your room and start staring at and touching your private parts!

Fear causes the release of adrenaline which enhances pain to aid the "fight or flight" reflex.
Laughter increases endorphins, the bodies natural pain killers. Where are you more likely to laugh? Where are you more likely to feel fear?

Labor is allowed to begin by itself at home. Midwives actually believe that God didn’t forget to tell the body how to go into labor.

Doctors seem to think the “estimated due date” is an expiration date! The rate of prematurity in this country (the major cause of death in babies) has skyrocketed since it became common practice to induce instead of waiting for nature to take its course.

Midwives use no medicines to "keep things on schedule." Medicines used to induce or hurry labor can cause uterine prolapse or rupture, plus they are more powerful and thus more painful than the natural equivalents. (80% of women birthing in the hospital are given Pitocin, and that is just one drug commonly used!)

Hospitals routinely use pain killers. It is hard to resist them when someone is coming in every hour asking you if you are Really SURE you don' want any.

Besides, due to fear, embarrassment, and limited movement, it really hurts more in the hospital.

Analgesics (the ones that go in through the IV) slow labor and can cause breathing problems in the baby if given too close to birth. Besides, they do not actually take the pain away (I know! I had them for four births.) They just make you not care so much that you are hurting. They made me feel dizzy and cold.

Epidurals (80% of all hospital births) are the numbing of the woman through her spinal column. She feels nothing from belly button to knee (unless the technician misses, of course. Then she is numbed from the belly button up making it difficult to breath.) You can't push if you can't feel, so epis are associated with more forceps and vacuum deliveries (both associated with more tearing) as well as more c-sections. They also cause more complications with the baby (and forceps and vacuums cause birth injuries otherwise known as birth-defects) and potentially permanent life long disability (everything from headaches to paralysis) for the woman.

What are the side effects of the pain of child birth without pain killers? Ummm, you hurt. That's it.

And you know what? Just pain won't kill an otherwise healthy woman. It simply is not worth the risk, in my opinion.

In addition, contractions of labor are "clean pain." When labor is over, you don't hurt anymore. C-sections, episiotomies, and headaches from epidurals continue to hurt long after childbirth.

Once labor begins, the midwife stays with you for the whole time.

A doctor is in and out of the room, taking care of other patients and even going home for a nap (Don't blame him, really. Being an OB is a hard job.) You are attached to monitors that the nurse out on the desk watches all the time. This is supposed to get you help when you need it. If the monitor is working right. And no one went on coffee break. And they aren't too busy with other patients to notice you need help.

If the baby's monitor slips the doctors or nurses read that as the baby in distress and rush you into a C-section (Since hospitals began using continuous fetal monitors, the rate of c-sections has skyrocketed and the rate of infant morbidity has also risen!).

Babies born by C-section have more problems, especially with breathing, even if the surgery was preformed because the mom just wanted it that way, not because of a problem. In fact, none-emergency c-sections have a HIGHER rate of respiratory problems. It seems the baby needs to experience labor contractions in order to squeeze the fluid out of their lunges and get them ready to breath air.

Once an hour or so someone (a complete stranger) comes into your room and checks how far along you are (Anyone who has had a baby knows what I am talking about. Yuck!) You just hope things don't go fast between checks or that the monitors are all working correctly, which they usually are.

Carla Emmery, author of “Old Fashioned Country Recipes,” (a book on natural, self-sufficient country living) and mother of seven, points out that the place you are most likely to give birth unassisted, though, is at the hospital.

At home, once the midwife arrives at your house, she will stay there with you, attending to you until your baby is a couple of hours old and you are both OK and resting in your own bed. The midwife is always there, even following you to the bathroom if you are close to your time. (You noticed the studies said Family Practitioners have fewer complications than OBs? Family Practitioners usually only have one patient in labor at a time, just like a midwife, and can pay them more attention.)

Midwives are far more likely to let labor progress at its own pace. Doctors don't really like to wait more than around twelve hours. Insurance companies don't like them to let you go longer. It makes them loose law suits.

Midwives will hang around for a couple of days as long as you are progressing (If you are not progressing, however, she will suggest several natural ways to "pick up the pace" so to speak, such as position changes or even taking a nap. Only if that doesn't work will she suggest a trip to the hospital. This is the time to be thankful for our modern medicine).

She will let you labor anywhere you want to in any position you want to as long as you and the baby are doing fine (The midwife, though not using continuous monitors, does keep an eye on your blood pressure and the baby's vital signs, same as a hospital. She doesn't need the continuous monitors because she is there looking at you all the time and is trained to see a problem. Monitors are made to replace experienced human eyes looking at you. They are cheaper than hiring more nurses but not as reliable.)

She will help you with natural pain controls such as focusing and breathing exercises. (Though in one study I read, teenage girls in labor needed half as many pain medications if they just had another woman sitting in the corner of the room. It may be that we just find another woman being in the room to be more comforting and thus our pain is decreased.)

She will let you deliver in any position you want to. The whole "lay on your back and push the baby out up hill" thing started with King Luis the IVX who wanted to watch his baby born so they put mom in the best position for the king- on her back! This is the WORST position to give birth in (next to maybe hanging upside-down)! It cuts the oxygen off to the baby (Beep! Beep! Fetal Distress! Rush her to the OR!), your tailbone is pushed into the birth canal up to four centimeters, and you have to push up hill with your muscles all in the wrong place to do it effectively. Contractions just can't do their job right.

The best position? Either squatting, kneeling, on all fours, or even standing. Any position where gravity can pull on the baby. The midwife will let you pick based on what you feel will be the best at the moment (your body will tell you how it needs to be). She will accommodate you by lying on the floor or squatting or chasing you all over the house while you walk it through if necessary. Doctors don't really want to do anything but stand at the end of the raised table and catch.

Doctors don't like being thrown up on, so they won't let you eat when you get to the hospital. Besides, you don't want food on your tummy if you need general anaesthesia for a C-section (Now at 33% in this country! Gee, what did those women do a thousand years ago? Cross their legs until hospitals were invented?).

Midwives encourage you to eat to keep your strength up and just keep a bowl handy for catching. And since she can’t do a c-section, there is no danger of you choking to death while under anesthesia (Actually, they seldom use general anesthesia in hospitals anymore. They use epidurals. But they still don't let women eat. No reason. Just "It's the way we've always done it.")

One of the biggest killers of birthing mothers in this country today is infection of the episiotomy (an incision made in the opening to the birth canal to allow the baby out. Like, God didn't know how big to make it?)

9 out of 10 hospital births have an episiotomy (though I never had one. My doctor was unusually good).

1 out of 10 home births have episiotomies.

Guess which one looses more moms to infection? And guess which group has the most serious tears? It seems violating the integrity of the perineum by giving an episiotomy severely weakens it, CAUSING greater tears. Think about a piece of cloth. If you try to rip it with your bare hands, odds are good you can’t or at least find it very difficult. But snip just half an inch into the side and it rips with ease.

Hospitals are where sick people go. There are germs in hospitals that don't exist anywhere else in the world. You are already immune to all the germs in your own home and have passed that immunity on to your baby.

And my favorite, no one will steal your baby at home. At the hospitals where I gave birth they made you sign papers saying you wouldn't let anyone without a certain badge take your baby out of your room and you are to call a nurse whenever you need to go to the bathroom after delivery so she can baby-sit.

When I "felt the call of nature" after my first home birth I looked around to see what I should do to keep my baby from being stolen. It dawned on me that the only people on the planet that even knew she had been born were my husband, my mother (who we had just called) and the midwife. Wow! No one could take her!

Midwives are highly trained personnel that are trained to spot a potential complication before it IS a complication and stop it. If it is beyond her ability to stop, she recognizes it and gets you to the best emergency medical care in the world; your local hospital.

Home birth is cheaper. We didn't consider this a deciding factor, just a nice bonus. Our midwife charges about what a doctor does for a birth. But our home does not charge us like a hospital does. Since we had no insurance, we would have had to pay at least as much to the hospital as we would have paid to the doctor; twice, total, what we paid the midwife.

This is why foreign countries encourage midwife births. They have socialized medicine so their governments like to save money wherever they can. Lower initial cost and lower costs over all because of fewer complications with midwives. This is great from a politician's point of view. Well, from mine too, to tell you the truth.

Home birth is more pleasant and you have more control. You don't have total strangers coming in your room and sticking their hand up you to see how far you have dilated (the midwife will do checks sometimes, but you have at least had some lovely visits with her during your pregnancy, unlike the nurse that just happens to be on duty at the hospital. And if you really don't want to be checked? Most of the time the midwife will honor that. Hospitals can't.)

I controlled what noises were going on and I was able to read or walk or even clean house (or, in the case of my fifth baby, paint the cradle) during labor if I wanted to. It was entirely my choice.

After the baby is born at the hospital the nurses take him away to the nurse's station, give him tests, clean him up, then bring him back to you. You get about an hour with your baby, then they take him into the nursery for tests and "observation". They wheel you to your room and will bring you your baby when their schedule says to or when he cries so much they can't stand it anymore. After a few hours they will take you to the door of the hospital, make sure you have a properly installed car seat and send you home.

At home, my midwife flips the baby onto my tummy (just like a doctor does) and encourages me to nurse...before she even cuts the cord! (delayed cord cutting allows the baby to receive oxygen from me while he is still learning how his lunges work)

She lets me be the one to check "who we have here, Johnny or Janey."

After the baby has nursed, she does all the same tests they do in the hospital but right in front of me, (most while I am still holding him). My baby never leaves my sight.

During the whole time with four home births the only time she took my baby out of the room was when that little one was a little messier than the others had been. She took her to the bathroom to wash her up a little better than she could do in the living room (Yes, I gave birth on my living room couch.)

After she was sure the baby and I were alright, she tucked us into bed, threw a load of laundry in the machine while her assistant cooked me an egg and toast, gathered up her equipment and went home. I hardly knew when she left because I was already dozing off.

As far as post-natal care, she has me take my and my baby's temperature every hour in case of infection and she comes back the next day to check us out. I really feel I was better monitored at home than I ever was in the hospital, and as I said, I had good care in the hospital!

My husband doesn't like it when we walk into a hospital when I am in labor and the receptionist asks which one is the patient. You see, he has "White Coat syndrome." He doesn't like doctors and turns green in a hospital.

I remember when we were taking birthing classes in a building in the parking lot of the hospital before our First was born. During a break we decided to go to the hospital cafeteria to get a bite to eat. We got just past the reception area and he turned green. I barely got him out before he passed out.

Now, he was present at all of our children's births, even the hospital ones. But he feels a great deal healthier after the home births. Besides he has something to do during the part of labor when I need to be monitored but I don't really need him yet. At home he can go play the computer or read his newspaper. When I need him (and, ohhh, he is so much help during transition) he is right there.

All in all, the home births are far more pleasant and less stressful. The whole thing seems so much less like major surgery and more like a normal part of life. This normality removes fear and that makes it safer.

Of course, home birth isn't for everyone. Some have medical conditions that really do require the attention of a doctor (about 10%). Praise the Lord we have that available.

Pray. God will guide you to what is best for your family. Just remember that God designed your body to give birth. He made it that way. If left to itself there is a very good chance it will perform just as it should all by itself.

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