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• October 5, 2009 1:51 p.m.

  That kind of discussions make me very angry. As if the researchers did their studies for themselves. All the evidence, all the statistics that they present seem to be ignored even by some professionals. And statistics do not leave space for discussions: for assisted homebirths the neonatal mortality rate is almost double vs. hospital births. And this is for the hospital group of all risk levels. Now, if you make more appropriate comparison and consider only low-risk pregnancies, the mortality rate for the homebirths is three times higher! So, for me personally women who, knowing that, still consider to give birth at home are just selfish to almost criminal extent. They want to gain a “beautiful experience” and “psychological comfort” at the expense of their babies. They try to avoid “unnecessary interventions” (in most cases just a couple of stitches) exposing their own babies to danger. I had a friend, who in spite of all the arguments of her friends and relatives, decided to give birth at home. She had the easiest pregnancy possible, a very healthy baby and a professional by her side. And the baby died in her arms. The midwife (from a very reputed hospital) was unable to pump out the liquid from the baby’s lungs, or maybe was too slow to do it. As much as I wept over the death of this child, I had no pity to the mother whose irresponsibility actually killed the baby. But that’s not all. Now, 5 years later, she is pregnant again and planning to give birth at home…

  - Michelle

• August 25, 2009 12:19 p.m.

  I think homebirths are irrespondsible and risky. It's not about having a pleasurable birthing experience, it's about having a healthy baby. WHY WOULD YOU TAKE A RISK? Go to a hospital and have a "natural" birth there.

  - Mckennah

• October 16, 2008 3:24 a.m.

  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.

  - Kalah

• September 28, 2008 9:05 a.m.

  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.

  - Laura

• September 8, 2008 9:12 p.m.

  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.

  - Chris C

• September 3, 2008 11:21 a.m.

  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.)

  - Elizabeth

• August 24, 2008 11:46 a.m.

  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

  - infomidwife

• August 23, 2008 11:33 p.m.

  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.

  - Noelle

• August 19, 2008 10:35 p.m.

  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

  - gloria

• August 19, 2008 10:08 p.m.

  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.

  - Florence

• August 19, 2008 7:37 p.m.

  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.

  - Julie

• August 19, 2008 5:01 p.m.

  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.

  - Amy

• August 19, 2008 4:14 p.m.

  I could not agree with you more. In fact, I think home births are safer than hospitals.

  - Joan Jaffe

• August 19, 2008 1:49 p.m.

  I am the mother of 2. I had my first natural childbirth in a hospital with a very fast delivery. All was well. My second was in another town at a birth center with a CNM. She was really wonderful and I was home resting several hours later. I feel that a woman should be educated on all choices and make the best one for her situation with the consultation of her Dr/CNM. I had very good pregnancies with no problems, and the birth center was across the street from the hospital so I felt very assured that I and the baby would be well taken care of if there were any complications. I enjoyed the privacy of the birth center and it made the experience very comfortable and generally stressless. I think if a mother wants a home birth and it is well planned with a qualified health practioner, go for it. I disagree that home births are some kind of fad- women have been giving birth in their homes for centuries, hospitals for the masses are a relatively modern development. Thank you for the great discussion.

  - Jill

• August 17, 2008 1:09 a.m.

  As a Labor and Delivery nurse and mother of 3 I would hope that the options we have as women never change. I had one baby in the hospital, premature and the next 2 at home with a CNM. While I love homebirth and would never want anything else for myself, I know it isn't for everyone. I think having the option to choose is the most important thing. I do want people to understand that the midwife who attended my 2 homebirths had everything she needed in case of an emergency with the baby or myself. From a hemmorhage to a full resuscitation. Medicine, oxygen, iv's etc. I think a misconception is that people think of homebirth as a bunch of hippies sitting around with incense and candles discussing the beauty and magic of birth while the woman is in labor, when in actuality we were very prepared. Good prenatal care and preparation for the birth made everything smooth. As a nurse I know that isn't always the case, hospital or home, but preparation makes things easier. Being at home for my births with my last 2 kids was SO great and reassuring. I feel that the births went smoother because I was at home and comfortable with my surroundings, people could visit me when I wanted them to and I had the conforts of home. I love homebirth but I know that isn't everyones preference. Thanks for the good discussion and for those who don't agree with homebirth, please keep an open mind about it. It may not be something you would consider, but it is a wonderful option for many.

  - Robyn

• August 15, 2008 10:25 p.m.

  I agree that it should be a woman's (educated)decision. I successfully birthed all three of my children at home, with a team of lay midwives/R.N.'s, and within minutes of a hospital. I had recognized ahead of time the psychological benefits of being in an environment familiar to me and under my control. I believe that there are potentially many other women for whom birthing would go smoothly and without the need for interventions if carried out in such an environment. I think a good alternative is a birthing center where the practices are much the same as at a home birth.

  - Elizabeth Rivera

• August 13, 2008 7:53 a.m.

  I really enjoyed Catherine's post.. all of you should read it. I wish she had enough room to say more, as it was very succinct. I can tell she has put a lot of thought and research into this issue, as all mothers-to-be should do. Phyllis, thank you for the story of your births, and the food for thought there, as well. But to say that homebirth is "a fad" does not seem to me a reasonable conclusion to draw, regardless of ones feelings or thoughts (two very different things, by the way; the difference needs to be sorted out in one's own heart!). Hospital birth is really a much more recent development, and it remains to be seen whether "this, too, shall pass". We're not here to discuss world history, but let's try to keep things in perspective and remember that things have not always been as they are now, and will not always be as they are now. Let's not stop learning and making improvements.

  - Kelly

• August 12, 2008 9:47 p.m.

  A WOMAN WHO WILL BE BIRTH FOR FIRST TIME SHE MUST SELECT FOR HOSPITAL,BUT AN EXPERIENCE MOTHER SHE CAN CHOOSE AT HOME FOR BIRTH A BABY IF BOTH ARE NO SEVERE PROBLEMS WILL BORN BEFORE BIRTH.

  - DR NEKIB UA YAMANEH

• August 11, 2008 8:36 a.m.

  I must respectfully disagree with those who want home births. I think it is a bit self-indulgent. I say have the baby at the hospital, and then go home an hour later. The risks to your child are too great to gamble, and your child has no vote in this. My Dutch pediatrician told me that in Holland mothers have home births, but as the birth approaches an ambulance comes and sits outside the home just in case. The ambulance has all life saving equipment available, an EMT and of course can get to a hospital pronto if necessary. (I had two babies, one with a doc and one with a midwife. Good experiences, both, at a hospital.)

  - Wendy

• August 7, 2008 9:19 a.m.

  I agree that the mother should chose her place of birth. The point that I disagree with is when it is stated that home births are safer. Lets not forget that the figures for home vs. hospital birth include all births. What I am saying is that a woman that knows that she is at risk is not going to deliver at home. Us mothers that know that our babies have holes in their hearts or severe defects chose to give birth in the hospital. These births are also included in the stats. Now if they only take stats from "normal" pregnancies for home births vs hospital I think the stats would be very different.

  - Jennifer

• August 6, 2008 2:01 p.m.

  I would really like to see better care at the hospital. For those who think that hospital births are completely safe, it just isnt' so. I am grateful for the services available, but I think real safety would lie in giving home birth care in the hospital. We have way to many c-sections for one thing as a nurse, I have seen some pretty dangerous outcomes from that. Rachel

  - Rachel

• August 6, 2008 7:27 a.m.

  I have 2 sons. The first born in South America in a hospital, everything went smoothly with no problems and it was a wonderful experience with wonderfully trained staff. The second born in Oklahoma, again in a hospital, wonderful experience until the baby was born. I hemorraged so badly that if I had not been in the hospital I don't think I would have made it as we lived 20 minutes from the hospital. There was no way for anyone to know if I would hemorrage so my experience and opinion is to opt for a hospital birth. It is sanitary, professionl and they have the drugs and equipment if it is needed. Also in case of problems with baby or mother time is truly critical. I know of cases where "throughly trained mid-wives" refused to call a doctor or ems when problems arised in home births that caused the loss of mother or baby or both. To me it is not worth taking a chance and I don't see how a home birth could be more comfortable. But of course, everyone is entitled to make their own choice. I personally feel that home birth is a new fad and will wane eventually.

  - Phyllis

• August 5, 2008 7:32 p.m.

  I have had 4 children, the first was in the "conventional, safe" hospital.I spent a week there bacause of the infection I got because of "standard preactice". The next two I had at home with an acredited Medical Doctor, both pregnancies were monitered completely to make sure that I was in the "low risk" category. The fourth I had in the hospital because the insurance company refused to pay the fee for my doctor, even though the total cost was less than half what they had to pay for the hospital setting and doctor combined. I feel that if the mother and baby are monitored for health problems before the birth then there should be no reason for them to be forced to give birth in a hospital if the mother does not want that setting. Women have been giving birth for a lot of years without hospitals, and with the infections that are very much alive in hospitals that does not seem to me to be the best setting for a newborn. Although mothers and babies that have risk factors should be in the hospital, the same as any other person who needs extreme medical care. It is unfortunate,but babies do not always survive even with the best medical care. This country has been brainwashed into thinking that hospitals are best for everything when the fact is that is not always the case.

  - Kathleen

• August 5, 2008 9:47 a.m.

  The statistical evidence seems to be slightly in favor of home births attended by a qualified midwife. The sad fact is, we will always lose a few babies no matter what. For every baby that is lost perhaps because they were not in a hospital, I wonder how many more or lost as the result of unnecessary medical interventions. It is so hard to quantify either. Overall, home births appear to be safe for healthy mothers and their babies. Thank you for a balanced opinion.

  - Alanna

• August 5, 2008 8:17 a.m.

  I do believe that this option should be a woman's choice, but saying that there are dangers. My niece did a home delivery with a very experienced mid-wife. Everything was going well, but when the baby was born she didn't breathe. The mid-wife did everything she could but they had to call EMS and have her transferred to the NICU at the hospital. Because of the lack of oxygen she has Cerebal Palsy. Would the outcome have been different at the hospital? No one knows for sure, but at least they would have been ready to do emergency treatment.

  - Donna