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With Mayo Clinic certified nurse-midwife Mary Murry, R.N., C.N.M.
Home birth: A woman's right to choose?
Hello, ladies. I am sorry to have been absent for so long. Life goes by at 100 mph sometimes.
Today I wanted to say a little something about home birth which has been in the news lately. It evidently began because of a film that Ricki Lake produced about birth that included her own home birthing experience.
The American College of Obstetricians and Gynecologists introduced a measure to the American Medical Association's annual meeting. In the original "Resolution on Home Deliveries" Lake was named. The eventual resolution removed her named. The resolution states the safest place to labor and deliver and recover is a hospital or accredited birth center.
Do I truly believe that? Not in every case. In my rather long career I have done 2 planned home births, 1 unplanned roadside birth and a couple of car births. I don't think that qualifies me as an expert. I am a woman though and I will claim to be an expert at that.
I believe that a woman should have a right to choose where she delivers her baby. I don't think any legislative body should dictate that to her. I believe it is a woman's responsibility to educate herself about birth, home, hospital or birth center.
I believe she should have a qualified person to be with her and care for her and the baby. I believe it isn't so much about the place where we have our babies, but more about the comfort, care and support we receive when we are so experiencing such a life changing event.
Please, let me know what you all are thinking about this. I look forward to some discussion.
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I am a mother and an OB RN practicing in a hospital. I am posting in response to some of the comments here.
I think that the AMA Resolution on Home Deliveries is out of line. It is more about keeping OB doctors well paid then about the safety of mothers and babies.
For a normal, healthy pregnancy, a planned home birth with a qualified attendant is safer than hospital birth. This is particularlly true in respect to the baby. For the 80% of births that require no medical intervention, a doctor and hospital increase the risk to both mother and baby due to unnessesary interventions. For pregnancies at risk it is safer to be at the hospital.
At the hospital, if an emergency c-section is needed, it takes about 30 minutes. If you are at home and can get to the hospital in less than 30 minutes then your c-section would not be delayed by the attempt at a home birth. Any home birth should be attended by an midwife with neonatal resusitation training and equipment.
The option to birth at home is the right of every woman. Women should educate themselves and weigh the pros and cons of all their birthing options to make the best choice for themselves and their babies.
Women have an inalienable right to birth in the environment of their chosing. The exception would be gross negligence or outright danger such as in a trash bin. That's a very different situation than a low-risk mother chosing a home birth. I birthed my first child 2 years ago (She was 10# 2 oz.) at home with a certified professional midwife, who of course monitors closely the well-being of mom and baby, holds neonatal resuscitation credentials, and carries emergency medications, IV equipment, and oxygen. I also see my family physician for consultation, and my back up plan is the hospital where I work (I'm a registered nurse). I often monitor the post-anesthesia recovery for women right after C-section (only unplanned ones on nights and weekends) and know the cascade of interventions which occurs in hospitals, under physician care, leading to poor outcomes and/or surgery (C-section). In my opinion, I am safer at home with an unmedicated, calm, empowering birth. I'll never choose a hospital as my place of birth without a medical necessity, no matter that I know the nurses at my hospital and trust them to be competent and that I know my physician and can communicate my preferences very strongly. I am right now in active labor, at home, with my second child, timing contractions on the internet and distracting myself until my midwife arrives.
I certainly think women should have the right to choose where to have her baby, but I also think she has the right, and perhaps the obligation to her unborn child, to make an informed choice, taking into account the risks of each choice - hospital, home or birth center. If she does choose to have her baby outside of the hospital, she should have a plan in place in case something goes wrong that is beyond the midwife or home specialist's expertise. Regardless of your choice, I'd recommend having a birth plan that details the key decisions and information you'll need when the time comes.
I definitely think the government should stay out of a woman's right to have her baby where she wants to. The more legislature you introduce into it the more you'll have women afraid to seek out trained professionals. I had my daughter in a hospital with only a cervical block after 10 hours of her being stuck on my tailbone. I'm glad we were in a hospital because she spent the first 24 hours of her life in the NICU with depressed respirations. I also hemorraghed right after she was born. (When the doctor muttered "Where the heck is all this blood coming from?" I got a little concerned.) However, this doesn't mean home births aren't a great thing for those people who are educated and have the support of their families. (Personally, my husband would've called the men in the white coats if I suggested a home birth.)
We have these same issues in Australia. We have also been showing Ricki Lakes documentary on her birth experience - I could not agree with you more when you say that women should have the right to choose where they give birth and that they should be fully informed.
Pauline WA Australia
I personally would not consider a home birth for myself because the most important thing to me is the safety of the baby. I've spent a lot of time in hospitals and have seen how quickly problems can develop. Also, I thought it was very relaxing to have a whole team of people to take care of you, bring you food, change the sheets,etc. Reading the comments below about hospital birth 30 years ago, I can see why some people have negative feelings, but most hospitals and doctors now practice with a more modern philosophy.
I had my son 36 years ago in a hospital, back when they were still baring husbands in the delivery room. They even made him leave my room when they examined me...what did they think that he hadn't already seen? I spent 3 days wandering around the hospital trying to figure out why I had to stay there, and they were feeding him sugar water in the nursery between breastfeedings. Three years later when I was pregnant with my daughter, there was no discussion about if I would go back to the hospital. No, I didn't tell my OB, but I faithfully went to all my exams & the first delivery was picture perfect. My husband had been a medic in Vietnam & delivered a few babies for the locals while there. I also had discovered the joys of laying in a warm tub to relieve the labor. The delivery went fine, we went to the doctor for a checkup the next day & register the birth with the state. The hospital called me about 3 months later and asked me why I had opted out of hospital and taken the "risk" of home delivery. I told them that my grandma had delivered all of her kids at home 50 years before, it's not like it was a new idea. I very clearly told him about my first experience & everything that was ridiculous & wrong from my point of view. We were a whole different generation & not willing to let the white coats dictate what was "best" for us. He said that they were thinking of letting husbands in the delivery room---thinking. I never r
Fifty-nine years ago my first was born in a hospital and they denied me a drug free delivery. Two years later had a drug free delivery at home, two years my third at home. A woman should educate herself about home birthing and have the right to choose.
I sincerely hope home birth is not a fad, and that state legislatures will permit it in all states. The statistics show that the infant mortality rates for countries that practice home birth or home-like births with a midwife are lower than countries we would consider modern. In fact, the US is 24th on the list--lower than many European nations. I had my first child at home and plan to home birth again. It was an empowering experience.
A home birth only takes into consideration one person - the mother. How does one truly know if there baby will need special care until they are born? Babies have been born for hundreds of years without hospitals, true - but what was the maternal and fetal death rate? Certainly it was much higher than it is now. Also, when looking at hospital statistics, keep in mind that many women giving birth these days are much older and have more health problems (obesity for example) as they did back then.
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