Being Pregnant
Study Shows Women Can Safely Choose Where to Give Birth
I was talking with my mother-in-law on Thanksgiving about the hospital where I’ll be delivering the baby this Spring. She is very much of the anti-medical intervention camp (ironic since her son is a doctor) and repeatedly suggested a home birth. She had one 32 years ago, although not intentionally, and raves that it was the best of her 3 birthing experiences.
I am very much on the opposite side of the birth location fence. Being in the medical field, I am very pro-medicine, and being a bit anxious, I am very pro-hospital because I want medical professionals at the ready if something goes wrong. Thankfully our hospital is a nice middle ground in that they are the first “baby friendly” hospital in the country, and they do a great job of merging alternative delivery methods with traditional hospital deliveries.
I’m really happy to be able to deliver there, though I was pleasantly surprised to read a new study that indicates that the alternatives are equally safe for low risk mothers.
The article was published recently through the British Medical Journal and it showed that though there are a few risks to consider, mothers who are considered “low risk” should be allowed to choose their birth setting, whether that is at home, in a birth center, or in a hospital.
They found that the rate of negative outcomes for all the mothers they followed was about 4.3 for every 1000 births in all of the settings they examined, and that there was no significant difference between the births in a labor and delivery ward of a hospital verses the non-traditional settings. However, the rate of adverse events for first time mothers who had planned home births was higher, at 9.3 per 1000 births. It’s obviously not a huge risk, but it was notably higher than the rate of adverse events in first time mothers who had hospital births.
I think the idea of a home birth is lovely, but at the same time, as a first time mom, I feel like I have so little experience and so little knowledge that I want a medical team there to make sure that everything is going as it should be. I know that midwives are well educated and I do not mean to imply otherwise, but for me the lack of equipment in my home combined with the time it would take to get to a hospital is worrisome. Obviously, on the flip side, I know that hospitals births are more likely to become c-sections and that the rates of infection are higher in a hospital, so it’s not without its risks either.
Personally I think the greatest part of the study is that it demonstrates that women have an important say in their birth experience. This study really proves to us that if your pregnancy is considered low risk, you aren’t confined to any one setting, but instead are able to pursue an experience that fits your needs and desires. And when it comes to delivering a baby, I’m pretty sure that any control you can have is a good thing.
Where will or have you chosen to give birth and why?
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8 Comments
Sarah Partain commented on Nov 27 11 at 10:12 pmAfter two hospital births, I considered a homebirth with this one, also due in the spring, but didn’t feel comfortable with it. Even though my mom, who is a midwife, considered me to be low risk after a csection then VBAC, I still didn’t feel comfortable. My sister, a doula, confirmed this and said it’s all about birthing in an environment where you want to be. I appreciate what you said and think it is important to make an educated choice. My sister has had two wonderful homebirths and my mom delivers in homes all the time. My VBAC in the hospital was also awesome. I think it really depends on your hospital and doctor too.
erniebufflo commented on Nov 27 11 at 10:39 pmLike yours, my husband is a pediatrician. I have high respect for the medical profession, and I am technically ‘high risk’ because I’m having twins. I know the odds are that nothing will go wrong, but if they do, I want to be somewhere where the babies or I can get resuscitation, infusions, surgery, whatever we need. Things may not go wrong at all, but when they do, they go wrong fast. A friend had a hemorrhage and would have died if she had been birthing at home– no one could have predicted it, she was not considered “high risk.” Her life was saved because she was in a hospital. I think everyone should be free to choose the birth they are most comfortable with, but I am not personally comfortable risking a home delivery.
Samantha commented on Nov 28 11 at 1:57 amThe debate on whether the hospital or home/midwife birth is safer, better, etc is a useless. There is no right answer since every woman will feel differently and different things work for different people. I think the problem in America today though is that women don’t KNOW about other options. They dont’ know about the potential benefits of home birth or even delivering with a midwife at a midwife center. It might be the birthing experience they are looking for. Women should rightly have the choice in how they experience their birth but there is a lack of education that should exist to empower every mother to know all their options, the benefits and risks of each and to make their own decision. I plan on delivering with a midwife but I respect your choice of going to the hospital. At the end of the day, where you will feel more comfortable and safe will produce a happier, less stressful delivery.
leah commented on Nov 28 11 at 9:58 amWe had a homebirth with our first, it was the right choice for us and everything went beautifully despite some complications – stuck shoulders and a small hemorrhage – our midwives were very equipped to deal with both. Personally I was not comfortable with the risks associated with a hospital birth, however I know it’s the right choice for some.
lonek8 commented on Nov 28 11 at 11:09 amI’ll be giving birth in a hospital, because A) that’s where the epidurals are and B) that’s where they clean up all the mess.
Claire commented on Nov 28 11 at 11:56 pmI’ve had two homebirths. That’s what felt safest for me, and they were both awesome and I have two beautiful healthy boys. It’s not for everyone – some people want pain relief (the midwives clean up the mess for you – even take the washing home to do in their washing machine) and doctors on hand – and that’s awesome because that’s their decision. For me to have a homebirth was my decision and easy for me to make but harder for other less well read people to understand (I did a lot of reading and talking to other homebirthers, doctors and midwives to make my decision). But what this article is really about is that no matter what, women should be well informed of what their choice involves, and birth in what they believe to be the safest place – this will give the best outcomes. After all, it is their body, their baby. Be informed and comfortable with your choice, and be well supported by your midwife or OB, and that is the very best you can do. If a woman is high risk, she also has the right to birth where she wants, as long as she is well informed of her risks and benefits. She’s not going to put her life, and her child’s life, deliberately in jepordy, and will choose the safest place for her. That might not always sit well with the medical establishment if she chooses to birth outside of hospital.
Mama Wrench commented on Nov 29 11 at 6:40 amThe problem with that study is that primips who birth in a hospital are also more likely than women with at least one previous vaginal birth to have a c-section. Since many OBs and midwives consider a woman high-risk if she has a single c-section in her history, even if she’s successfully birthed vaginally before and/or had a VBAC, insisting on a woman giving birth in hospital before she is “safe” to choose home birth will still eliminate a third (or more) women from being able to choose that option if you follow their advised protocol.
I’d really like to see the original data, as well as their criteria for “risk” and how they break down women with a history of 2 or fewer c-sections and/or vaginal birth.
Mama Wrench commented on Nov 29 11 at 6:44 amOh, also, since you’ve mentioned “home birth” and “equally safe” on a blog, I hope you’re prepared for “Dr Amy” and her hoard of psuedo-statisticians to crash your party.
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