New Life for Home Births

For some people, the do-it-yourself movement is a congenital condition.

As reported recently by the Centers for Disease Control and Prevention, after a decline of several years, the number of women choosing to give birth at home boomed from 2004 to 2009. That’s interesting, but the number of women overall who give birth at home remains modest-fewer than 1 in 100.

Why would someone prefer to give birth at home instead of in a hospital? Some women dislike the “medicalization” of the birth experience. They question the wisdom of, for example, inducing labor. Like a growing number of laypeople and professionals, they question if C-sections sometimes are ordered for reasons of expedience instead of medicine.

Other reasons for giving birth at home include the desire to be in a familiar environment surrounded by family and friends. Some women express cultural or religious concerns as the driving force to stay home. Expense also can be a factor: A home birth costs about one-third as much as a hospital birth.

Most at-home births are planned, and are the province of women who are mothers several times over. Generally, women who give birth at home have given birth also are:

  • often older than 35;
  • white;
  • married;
  • considered low-risk for complications;

People who give birth at home also have help, generally from midwives, although family members and emergency medical technicians also attend. Midwives are present in only 7 of 100 hospital births.

Physicians attend only 5 in 100 home births; when a doctor is involved, it might indicate an emergency situation. Nine in 10 hospital births are attended by physicians.

Although giving birth at home can meet a lot of emotional and financial needs, it’s not without risk. The American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) do not support planned home births.

According to WebMD,ACOG says that planned home births are two to three times likelier than planned hospital births to risk newborn death. Former ACOG President Richard N. Waldman said that “… home births don’t always go well, and the risk is higher if they are attended by inadequately trained attendants or in poorly selected patients with serious high-risk medical conditions such as high blood pressure, breech presentation or prior cesarean deliveries.”

Professionals who take issue with home birth are concerned that if something goes wrong, such as an abnormal fetal heart rate, a quick response is critical. And that’s more difficult if you’re at home. Things can go wrong quickly, and unpredictably. See our web page about birth injuries.

Women who have no particular risk for pregnancy problems and want a home birth must be rigorous about getting full prenatal care. Such care often can identify problems in advance that would preclude a safe home birth.

Apart from having normal blood pressure and a record of problem-free previous births, women should consider home birth only if:

  • they are able to carry the baby to full term;
  • are well-nourished;
  • are carrying a fetus that’s developing normally.

If you’re interested in a home birth, do your homework. Research midwives-some are certified, others aren’t-and their histories. Make sure you have access and quick transportation to a hospital if you change your mind or in the event of a problem, and that your obstetrician can attend at that facility.

Instead of giving birth at home, consider doing so at a birthing center. These facilities are warmer and less intrusive than a hospital and delivery room, but have trained staff affiliated with a hospital. Find out more about birthing centers here.

Like all other medical care choices, women must be very careful in assessing the benefits of home birth against its risks. Remember: You’re deciding for two.

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