Where you birth your child seems to be just as controversial to someone who disagrees with you than about the choice to have a natural birth or not.
Your doctor, midwife, family, friends, even your husband may disagree with you no matter where you desire your birth to take place–hospital OR home.
You may feel that sharing the fact that you want to birth at home with others will only bring on bitter disagreement.
I’ve never birthed at home, but I didn’t fully disclose that I wanted a natural unmedicated birth to just anyone unless they distinctly asked. Even though I wasn’t birthing at home, I still got some flack otherwise.
Or maybe you’re still trying to explore your options and learn about what risks are associated where and what will work best for you and your baby. It’s really YOUR call.
But when it comes to home birth safety, there are various views to consider.
The New York Times Debate On Home Birth Safety
I recently came across a grouping of six opinionated articles written by various experts in the obstetrical field: midwives, obstetricians, professors and one mother having experienced a home birth.
They all provide their personal perspective upon the risks associated with having a home birth versus a hospital birth. I found each piece quite compelling even with their varying view points.
They all back their points of view with scientific evidence. (Note they’re all in reference to modernized countries. Third world countries face much different scenarios you can learn more about here.)
I’m going to share with you their pointed mindsets and let you judge whether you agree or not with the discussion. You won’t be bored and they are quick reads!
When Pregnancy is Low-Risk, Home Birth Is A Safe Choice
The first article was written by a certified nurse midwife who is also health sciences clinical professor. She feels that it doesn’t matter which location you choose to birth in and the argument is useless for the sake of argument.
But what really matters is what sort of circumstances are needed in order for a home birth to be a completely safe choice for mothers? If you have a specific pregnancy or mental condition that warrants monitoring for your safety and the baby’s safety, the hospital is of course the optimal choice.
While access to correct information is important for expecting mothers, so is their choice. –Tekoa King
She cites the fact that life threatening emergencies occur in birth cases EQUALLY between home and hospital births. Thus in turn, she advocates for better systems to be put in place for mothers in the United States that assist birth at home needing immediate emergency care.
Home Birth Is Not Safe
The next article was co-authored by two obstetrical directors. They support their belief that the absolutely safest place for you to birth your child is within the walls of a hospital or birthing center, no matter what your individual circumstances and risks are.
They cite a study showing that midwife deliveries at home see a marginally higher rate of issues and infant mortality than those occurring in a hospital setting. Also the fact that interventions such as c-sections are immediately available and save the lives of mothers and babies often that otherwise would not have been had they stayed in their home.
Compassionate care is essential for all births and the profession should strive for home-like hospital births. –Amos Grunebaum and Frank Chervenak
I do like how they also state that minimizing the need for such, if any, interventions needs to be mainstream across all physician’s and hospital practices.
In Home Birth, What Risk Is Acceptable?
The fourth piece was also written from the point of view of an obstetrician. He discusses a bit about the methods and rates of infant mortality between home births and hospital births mostly in European countries.
But his comparison between the United States and European countries still shows that even though greater systems are in place for European mothers to birth at home with lower risks, the rate of infant deaths is barely lower.
But as long as women are being properly educated about the risks and benefits of location of birth, hopefully they are able to make a decision that reflects their preferences. –Aaron Caughey
Thus the trade-off between home or hospital is the increased risk of interventions in the hospital, which you may not think is worth it against the slightly higher chance your baby could have complications at home.
My Experience With Home Birth
I’m glad they included a mother’s story about her home birth. Many of you don’t know anyone who delivered at home–I haven’t.
She expresses the fact that she did have a previous birth in a hospital that she didn’t have a bad experience with, but that having a home option worked better for her family and it was a greater desire.
Having an excellent midwife was clearly important to her and she felt very comfortable and trusting with her midwife.
Supporting the mother is always the key. –Aja Graydon
She liked the freedom of being able to move around without restriction and not having to worry about nurses or staff that would clash with her needs.
* * *
I found this great video interview about a mother’s experiences with both a medicated hospital birth and a water birth at home. You may find it quite interesting.
Emergency Care Can Be Too Urgently Needed For Home Births
The fifth in this debate series was composed by the President of American Congress of Obstetricians and Gynecologists. His view doesn’t vary much from the previous physicians’ about the risks involved.
Knowing that in the hospital, the difference between the speed and availability of an emergency medical team can mean the difference between complete health and safety of you and your baby or the loss of tender life.
But we must be prepared, if need be, to provide mother and baby with the medical interventions they need to survive and to thrive. –John Jennings
But he also is a proponent and supporter of the ideal of bringing as close as possible a comfortable home setting into the hospital or birthing center in order to achieve those same comforts and benefits afforded so.
Hospitals Carry Their Own Risks
The final argument in this debate series was concluded from a professional midwife starting off clearly stating that those who do choose to birth at home are aware of the risks, especially with their own personal circumstances; midwives properly assess all risks for their patients and confer a joint decision with awareness of things that do arise on occasion.
But she also concedes the alarming fact that hospital rates of c-sections has climbed steadily over the years and argues whether or not the need for such a high rate is indicative of medical necessity.
We firmly believe that all women should be actively encouraged to explore the place of birth that is right for their family and risk profile. –Marinah Valenzuela Farrell
She presents organizations and refers to developed guidelines that certified midwives follow when determining even minor needs for a mother and her baby that would be best served in a hospital setting, whether during labor or after a birth.
My Conclusion
You may already know what position I support. I feel that birth in a hospital or birthing center is the best option, personally. I have had two births, both in the hospital, and BOTH were completely natural and unmedicated as far as I could control.
Yes, you can read the find details of those studies referred to in these arguments about safety. Yes, you can agree that the occurrences of c-sections is much higher in hospitals, obviously.
But from my perspective, even in just a scientific manner, the statistics showing that the safety of infant mortality is just slightly higher in the hospital is enough for me. I would rather know that I have a better chance, however minute, of bringing home my baby after its arrival in safe and loving arms no matter how it arrived.
In my book, the fact is cesarean sections DO save lives and for good reason. Yes there are risks. Yes things can go wrong. But knowing that I can still bring home my child is worth it if the case is ever presented to me.
I may not have my younger sister, younger brother, and possibly even my own mother today if such a modern procedure didn’t exist.
I believe that being able to achieve the kind of natural birth you desire is STILL possible in today’s world.
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And I believe it to be the best of both worlds.
However….
Do not take just my point of view as your final decision or even as offense against me. I am just ONE person with one set of experiences and knowledge.
I WANT you to make the best decision for yourself and for your family.
℘ If you choose to birth at home … WONDERFUL! I applaud you. It is a magnificent thing to be able to share.
℘ If you choose to birth in the hospital … there is absolutely NOTHING wrong with doing so. I know you’ve made the best choice for you and your family.
I need to hear from you. Has anyone here birthed at home?
I believe each woman should make the choice that is best for her. Almost all of the time, if you are low risk and have a licensed provider, everything will turn out fine no matter which way you choose. There is a tiny chance that some emergency will happen at home that would have been better dealt with in the hospital and there will be severe and unwelcome consequences. There is also a tiny chance that something will happen in the hospital that wouldn’t have happened at home and there will be severe and unwelcome consequences. For example my first daughter got a staph infection in the hospital when she was born. Fortunately she was treated and is okay today (but the antibiotics wreaked havoc on her body that lasted for many months). While it is possible to achieve a natural hospital birth, interventions that are pushed can lead to complications (for example cervical exams, which were involved in both my hospital births but in neither of my home births did I have even one cervical exam) increase risk of infection and even the 20-minute monitoring strip at the beginning of labor increases C-sections without improving outcomes (and C-sections can sometimes have dire consequences for mother and/or baby).
I have had two natural hospital births and two homebirths. I am currently planning my third homebirth. The continuity of care of a midwife who knows me is very important- it’s easier to tell if something is wrong if it’s a woman you know than just some numbers on a chart of someone you met briefly (I realize some hospital midwives attend the entire labor/delivery of women they know well, but this is not the norm). And a midwife transferring a woman urgently can call ahead so the OR is ready and 30 minute “decision to incision” is also possible with a homebirth because of this. My midwife carries many emergency supplies including Pitocin (for hemorrhage, not induction) and other hemorrhage medications and the equipment for advanced neonatal resuscitation (which she is certified in).
When it comes down to it, though, every woman should give birth where she feels comfortable. There are small risks both ways, so either choice is perfectly acceptable.
You raise a lot of great points, Erin. And I completely agree that women should birth where they feel comfortable. I wish more women had the same view points as you, then births would be a much better experience. Thank you so much! ?
We wanted a very natural birth but also wanted to be safe about our pregnancy. So we found some mid-wives who were attached to a hospital. Ideally the mid-wives would have done everything during the delivery, but we had some complications and ended up having to have a c-section :-/
Thanks for sharing your insights Sarah.
Sorry that your child’s birth didn’t turn out exactly as hoped. But I’m glad that everything turned out okay for your. Thank you for visiting Jared. It’s always nice to hear from you.
Hello Sarah!
Personally I would be to scared to give birth at home. If there were a problem and something happened to the baby I would never forgive myself.
I’ve talked to a couple that had their second child at home. They described it as something wonderful. For them, it is impossible to imagine a birth at the hospital again.
I think it is good that we have different options and can choose what we prefer. Thanks for an interesting blog.
I like how you put that, Marie: I think it is good that we have different options and can choose what we prefer.
That’s exactly the point! Many mothers and parents feel like it’s just the doctor’s way or the highway. Getting the knowledge about what can happen and what we can all choose is key.
Thanks for your comment, dear. Look forward to hearing from you again.
Hello Sarah,
Every mother to be needs all the information they can get in every topic related to child birth, rearing, raising, so it’s nice to see that there’s someone providing them with information on a very important topic.
Beautiful site as well….
Thank you Alma. Mothers create better worlds because it all starts with our children.
I support both, but as long as the parent/s are open to moving to the hospital in case of any complications. My last child was born in the hospital. Unfortunately, there were a few complications but we were in the right place to receive the help ASAP! My partner and new-born had to stay in the hospital for the next 3 days, if we were at home who knew what could’ve happened.
I’m glad everything worked out for you, Paul. It’s hard to know sometimes even when pregnancies are considered low risk. Thanks for your comment.
Hi Sarah
I am not a big fan of home birth, but then again I wonder how people in the old days had to give birth when transport and hospitals were not as available as today.
There is so many complications when it comes to birth.
And think about how for thousands of years women gave birth right on the ground or in their own homes, and billions survived just fine. Our bodies are much more capable at doing things that I think we give them credit for.
There are risks associated with hospital birth of which many are unaware. The idea that emergency care is more readily available isn’t universally true. In a hospital birth, during much of your labor you are attended by a labor & delivery NURSE, who has never met you, NOT a doctor. You are alone in your room, usually checked hourly. The nurse updates your physician or CNM by phone who is likely not even on campus. The nurse monitors your vital signs, your cervical dilation (increasing chance of infection), and the baby’s heart rate. About once per hour until the end of first stage.
I had one hospital birth. It was wonderful as far as hospital births go. If I had never had a subsequent home birth, I would never have known the difference.
At home, the midwife, YOUR midwife, who has been meeting with you throughout your pregnancy, who knows your medical history, your personality, your typical appearance and demeanor, is with you throughout labor. Watching. Observing. Thinking. Anything troubling is almost always addressed long, long before it becomes an emergency. Food, drink, positioning, herbs, homeopathic remedies, and possibly transferring to a hospital. My midwife knows what my complexion should look like. What my ankles looked like at my last prenatal. What my blood pressure normally does when I’m stressed or tired. How to talk to me.
In a hospital, by the time a problem is noticed by the nurse collecting a bunch of numbers on a chart, it is often an emergency because no one has been watching and trying to get the labor back on to a good course.
I feel much, much safer in the capable care of my midwife in my home than in the hands of total strangers who see me as a set of vital signs and have no idea what to duo if baby’s heart rate takes a dip when I’m in a certain position– because they have no idea what positions I’ve been in.
I’m glad that you are so passionate about your experiences and are devoted to birthing at home with your midwife. No matter what any mother’s decision is, I’d rather one be defined and supported than it left unawares. With my current pregnancy now, I have a certified nurse midwife. I’ve only met with her a few times and I already feel like she knows how to help me better than I did with my previous doctors. So I think I’m going to enjoy this experience with her, even if I still desire to birth in the hospital.
Thank you SO much for sharing, Lisa! This is what I was hoping for–new mothers to be able to hear about experienced mothers’ feelings about such differing options when it comes to birthing their child. If you’d like to contribute more, I look forward to hearing from you again.
Great article Sarah! You seem to be very knowledgeable and experienced mother:) and have some great material here. I think many people can benefit from your practical recommendations since they come from your own experience and you probably can answer many of their questions.
Thanks for your comment, Rufat. You are welcome to share with others in order to help me reach out to those looking for help in anyway. Have a great day!
Thank you Sarah for a very professional and well presented post. Although my kids are now adults, I couldn’t help but be drawn in from your passion on child birth and it’s various implications and methods.
Great site! I will follow with interest.
Paul Nobes Author
I appreciate your candor Paul. I look forward to hearing from you in the future too!
Beautiful website very informative love love love.
I love that you love it, Misty. 🙂
Be sure to subscribe so you don’t miss anything. I look forward to hearing from you in the future. Best!
I support your choice. Not that I would do it myself; I would be alsolutely terrified, but It’s been done for centuries.
If your pregnancy is high risk, I think the mom should reconsider, for the safety of both her and her baby, but if it’s a low risk pregnancy I would feel a lot better.
Thank for some really great information.
You are a brave woman, Sarah
Thank you so much, Debra. I support and respect any woman’s choice if she truly understands the risks and circumstances that she is accepting.
I’ve never had to deal with having a risky birth circumstance or personal complication making it difficult to achieve a natural birth. But I know that research doesn’t usually lie either when it comes to biology.
Using both together to determine one’s personal best path to take is what I hope others will do too. Thanks for commenting!
Great post Sarah. My wife and I actually had our last child at home with a midwife and as worried as I was at first, it turned out to be the absolute best experience ever. I have had 2 children born in hospitals prior and I wish we had them all at home. There really was nothing like the comfort of home for the whole thing and being able to just enjoy your new bundle of joy in that comfort zone was a blessing.
That is so WONDERFUL to hear! I don’t know anyone personally that has had a home birth, but I thank you for sharing. Many families are fully blessed with the births of their children no matter the setting. And you are proof of that.
I guess for me I have a slight anxiety about things and actually being in the hospital relieves that because I know that I have the best chances no matter what could happen. But that’s not to say I would ever need the assistance in the first place. Thus, it comes down again to personal feelings and preference. Thanks!