Midwifery is one of the oldest professional arts in human history. For the majority of history Midwives have attended births at home. It wasn't until the early 20 th century that doctors and hospitals became the norm in childbirth. In today's society hospital birth is often considered the only safe option, however research has shown that for up to 90 percent of women home birth is equally or more safe than hospital birth. In the book The Thinking Woman's Guide to a Better Birth , Henci Goer states that no study has ever shown that out-of-hospital birth resulted in worse outcomes provided women were prescreened for risk factors and had a planned out-of-hospital birth with a trained attendant. Midwives do extensive screening of potential clients to make sure than homebirth is the safest option for each particular family.
There are several factors that make homebirth an attractive and SAFE option. Perhaps the most pressing factor is basic routine interventions that do not happen in homebirth but are ROUTINE in hospitals. At home the labouring mom is in her own environment rather than a foreign hospital, she is able to move around as she pleases rather than being confined to a bed, she can eat and drink as she pleases rather than being denied food and given ice chips, she can be monitored at her comfort rather than being strapped to monitors and IVs, pain is managed by breathing techniques, position changes, and other techniques rather than by medication, massage and oil is used to protect the perineum and the baby is born rather than episiotomies being cut routinely, babies are given directly to their parents and any examination happens at the bedside rather than babies being whisked away to be cleaned off and examined. The lack of interventions not only benefits the mother's experience and safety it also benefits the baby. Babies born to non medicated mothers face fewer trials when transitioning to life outside of the womb. They have fewer breathing problems and often don't even require suctioning which is standard in hospitals. Moms who have labours that progress slowly are able to work with their bodies in a home environment. At the hospital often a slowly progressing labour will be augmented with pitocin. Pitocin produces much more intense and unnaturally strong contractions which will often leave the mom with an epidural. Epidurals often lower the mom's blood pressure and further slow labour leading to more medication and pitocin. This snowball continues to grow and often leads to forceps or vacuum assisted deliveries and even cesarean births. The hospital cesarean rate varies across the country from approximately 15 percent to over 30 percent in some places. The cesarean rate for births that are planned homebirths is between 0.5 to 5 percent.
The question then remains what happens if an emergency does occur? How are emergencies handled and managed at home? The truth is that most situations that would require hospital facilities are slow building with many early signs that are assessed by the Midwife and discussed with the family so that a decision can be made before the situation becomes dire. For the rare occasion where an emergency arises quickly the midwife is trained to manage the situation and transport to the hospital. A point that should be remembered is that many hospitals are not really better prepared to handle such emergencies. In order to be truly prepared the hospital would have to have 24 hour a day obstetric, anesthetic, and pediatric staff and many hospitals do not and when they do it still takes time to prepare and coordinate everyone. Lack of nursing staff has an effect as well. Cutbacks and other cost-cutting measures have led to a lower nurse-patient ratio and even when there are enough nurses they are often busied assisting doctors or performing their own procedures and their attention is diverted from their patients.
For most women and most babies homebirth is a safe and reasonable option. The most important thing to remember is that homebirth is safest when the family is committed to it and they find a provider who matches their needs and their philosophy about birth. There are a variety of providers available to pregnant women and their families and the most important thing is to find one that matches well with your needs and desires.
For more information please consider the following:
The Thinking Woman's Guide to a Better Birth by Henci Goer
Obstetrical Myths vs. Research Realities by Henci Goer
Spiritual Midwifery by Ina May Gaskin
Ina May's Guide to Childbirth by Ina May Gaskin
Birth Your Way by Sheila Kitzenger
Homebirth by Sheila Kitzenger
Birth Veronica Wagner
Anything from The Farm and Ina May Gaskin
* These are only a few of MANY resources out there for you to explore. Please do not take these as exhaustive lists.
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