The Case for Home Birth

by Anne Mason

Two hours after our daughter’s birth.

Both my kids were born at home. People have often remarked on the courage I must have had to have made that choice. It wasn’t courage––it was a desire for a comfortable, supportive birth environment I knew was the best bet for my kids and me to avoid unnecessary trauma and intervention. There are times when medical intervention is necessary, but most of the time, the medical system itself and its medicalized birth practices create the issues which lead to intervention in the first place.

Our bodies are designed to give birth. Fit, healthy women in most cases should be able to deliver their babies naturally––if only they are allowed to. I was 37 years old with my first pregnancy and 40 with my second. My husband and I eschewed all the tests and screenings recommended for “a woman my age,” as we were committed to bringing our children into the world, regardless of what abnormalities or issues such screenings might suggest. And we were blessed with two wonderfully healthy children born without complication or intervention.

I remember being questioned about our choice to birth at home when I was pregnant with our eldest. Well-intended friends pointed to historical maternal and infant mortality rates as an argument for hospital birth. A closer look at the history, however, largely implicates hospitals and doctors in the staggeringly high maternal mortality rates from puerperal fever in the 17th, 18th and early 19th centuries––in which it was common practice for the medical profession to examine pregnant women and deliver babies after performing autopsies, WITHOUT WASHING THEIR HANDS. As Suzanne Humphries, MD and Roman Bystrianyk emphasize in their landmark book “Dissolving Illusions: Disease, Vaccines, and the Forgotten History,” puerperal fever’s massive maternal death toll profoundly impacted the fabric of society. It is no wonder this tragic and largely avoidable episode in recent human history influences our fears surrounding childbirth.

Poverty, lack of sanitation, lack of nutrition and poor standard of living during that time period also contributed to overall mortality rates, life expectancy and birth outcomes. When determining the risks of childbirth in this day and age in the US and other developed nations, it’s critical to examine our history and whether those risk factors still apply. Further, it is paramount that we look at the actual statistics involving home birth here in the US. Among low-risk women, planned home births result in low rates of interventions without an increase in adverse outcomes for mothers and babies.

It is becoming common knowledge that the US medicalized birth practices are a factor in the United States’ increasing maternal mortality rates. The only developed country with an increase, the US maternal mortality rate has more than doubled from 1991 to 2014. Earlier this year, Harvard Business Review cited these statistics and more in its piece The Rising U.S. Maternal Mortality Rate Demands Action from Employers and advocated for non-hospital birth options for low-risk pregnancies.

Furthermore, the medical system in the US is the cause of so many deaths that researchers from Johns Hopkins wrote an open letter to the CDC to request that CDC change its record collection criteria to accurately inform the public of this alarming statistic. With medical errors being the 3rd leading cause of death in our country, the hospital hardly seems a sensible environment for a healthy expectant mother to deliver her healthy baby into. On the contrary, the mother and baby would seem at less risk of fatal complications in the safety of their own home, attended to by trained midwives.

Beyond the health and safety of the mother and child, there are many more reasons to deliver at home. In the privacy of her own home, the mother is allowed to labor at her own pace. She can labor in the comfort and quiet of her own bedroom, bathtub or birth tub. While her midwives monitor her and the baby’s vitals throughout, they are unobtrusive and respectful, and they accommodate her timing, not theirs. She is not surrounded by or attached to any machines and monitors, and she is able to move her body freely.

Without intervention or epidural, labor proceeds naturally, as baby and mother coordinate their rhythm and contractions to bring the birth. The midwives do not pressure the mother to take Pitocin to induce labor. She is allowed to proceed as her body and her baby’s body dictates.

Family members or chosen friends are the only other people in the home, quietly and respectfully on-hand to support the laboring mother and whatever she may need at the time. A hushed reverence pervades the scene. And when the baby arrives, he or she is welcomed into the quiet, warm room, surrounded only by loving family, friends and trusted midwives the mother has gotten to know well over the course of her pregnancy.

Newborn baby and mother remain together in the comfort of their bed, while over the next couple of hours the midwives gently monitor, record birth stats and care for the mother (one of my midwives even brought me a plate of scrambled eggs after the birth of our daughter, as she felt I needed the protein). Once they determine all is well, they pack up their oxygen and equipment, hug the new mother, kiss the new baby and go home, only to return the next day and beyond to continue post-partum monitoring and care.

Mother and baby, big brother and father fall asleep in the comfort of their own beds. What a lovely way to welcome this new member of the family. And what a lovely way to come into the world.

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