recent study by the Centers for Disease Control (CDC), home births are on the rise, but the tragic January 23, 2012, death of an Australian home birth advocate highlights a debate over safety. Caroline Lovell, a professional photographer who reportedly petitioned the Australian government to provide funding and legal protection for home births, suffered cardiac arrest while delivering her second child at home. She died the next day after being rushed to a hospital. Yahoo! 7 News reports a private midwife was in attendance.According to a
Between 2004 and 2009, the percentage of American women giving birth at home increased by nearly 30 percent. That number is highest amongst white, non-Hispanic women. For that group, about 1 out of 90 births occur at home.
Women choose to give birth at home for a number of reasons including comfort and privacy. Robin Dunn Bryant, a writer whose daughter was delivered safely at home after 13 hours of labor with the assistance of two midwives, says she did her research and met with a number of doctors before choosing the home birth route. "I wanted to have the most natural and supportive experience possible," she says, adding that her midwives allowed her to do many things that might not have been possible in a hospital including eating, changing position frequently, and napping undisturbed.
Experts also speculate the increase is due to the rising number of cesarean sections performed in hospitals. A 2010 study by the American Journal of Obstetrics and Gynecology reported that one-third of all hospital deliveries for first-time moms was by C-section. Chicago-based labor doula and childbirth educator, Holly Barhamand, points out some women end up having home births because they can't afford to deliver in a hospital. According to the CDC, home births cost about one-third less.
Although more statistics are needed on the safety of home births, a statement by the American College of Obstetrics and Gynecology asserts that, "although the absolute risk of planned home births is low, published medical evidence shows it does carry a two- to three-fold increase in the risk of newborn death compared with planned hospital births." Officially, they do not support home births. If mothers have an underlying medical condition, potentially the case in the Lovell death, or if the baby is breech, trying to deliver at home can be particularly dangerous.
"If an at-home delivery runs into trouble and there's a hospital five minutes away, that probably is not going to be a big problem," Dr. George A. Macones of the American College of Obstetricians and Gynecologists, said in a recent interview with NPR. "But if you're half an hour away or 40 minutes away, then that could really ... be a big problem."
Fortunately, the CDC numbers show that women choosing to deliver their babies at home are generally low-risk candidates who are in their second or third pregnancies. The percentage of pre-term babies born at home is about 50% fewer than babies born in hospitals and the same for low-birth weight babies. The report suggests that home birth attendants are choosing candidates responsibly.
Barhamand, who helps clients both at home and in hospitals says, "A good midwife will have strict criteria about who should have a home birth." She adds that a disadvantage of giving birth in a hospital is that you may be subject to protocols that are not given on an individual basis. "They might be based on experience, but they aren't looking at the mother as an individual case."
As a woman who delivered two out of three of her own children at home, she's observed some of the benefits of home birth personally. Barhamand says, "Being on your own home turf builds confidence," and she has seen many women's labor stop or slow down when they have to leave for the hospital. She points out that a better model might be the one available in Canada. It gives more freedom to a midwife to decide during the labor process whether her client should have a home or a hospital birth.
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