February 04, 2014

The Safety of Home Birth

I love birth. I particularly love home birth. Considering my longing to be a home birth midwife (in the not so distant future if my husband can stop impregnating me for a couple of years), it is very important to me to uphold the often tarnished name of  "Home Birth". In may circles today, it is considered a scary, irresponsible, strange thing that must be analyzed and critiqued. Since the dawn of time, however, it was simply "How Babies Are Born". But recently there have been studies cropping up claiming that home birth is dangerous, always indicating that the mother's desire for less intervention is really risking the life of her child, and that midwives in the U.S are either not trained well enough or not controlled tightly enough to ensure healthy results. 

THIS IS RIDICULOUS! I'm really, honestly sick of hearing this garbage, especially since it is always flawed in the exact. same. way. They never account for the cause of death! So let me just break this new one down for you. 

First of all, you cannot assume that a blog contains truthful information just because it has the name "science" in its title...just to clear that up. 

Okay, we'll start with the obvious. The last sentence says that the study did not account for the cause of death, so this "study" (and I use the term loosely) is including unplanned and unassisted births. We could be talking dad-delivers-baby-on-side-of-road-in-a-blizzard births. We could be talking moms who don't have adequate (or any) prenatal care, moms who use drugs and don't know they are pregnant, moms living on the street. We could be talking certain religions that don't allow for any needed medical intervention, moms who have super fast labors and don't make it to the hospital, moms who choose home birth because they can't afford the hospital bills. These are very important considerations, because a mom's knowledge and understanding of her birth, as well as her overall health, her views on birth, and her plan for birth, have a huge impact on her actual birth! A mom who is not planning a home birth will not have prepared physically and mentally as a mom who is planning to birth at home. She may not understand what her body is going through physiologically and how to help it or hinder it. She will not be prepared to work through the pain if she had every intention of getting an epidural. She might not have had a good diet, so she could experience complications from diabetes or pre-eclampsia which are hugely diet-related and can be dangerous. The only way to accurately measure the safety of home birth is to only include planned home births in the study. 

That glaring misrepresentation aside, the study was also lead by an obstetrician, and one who clearly has an issue with midwives and doubts their skills by questioning their ability to attend healthy, low risk mamas. He feels that twins, VBACs, and breech births are dangerous, which sets him up to misinterpret the data. If you feel that those conditions make a mom "high risk" then you are going to view the entire labor and delivery process as an emergency waiting to happen. You are going to automatically assume that if a baby or mom dies in a home birth that it was due to those risky conditions. Obstetricians are no longer taught how to deliver twins or breech births because the automatic recommendation is a c-section! So yes, if they don't have any idea how to deliver these babies they are going to view them as dangerous. If you view these, as I do, as variations of normal, then you plan for a normal birth. You learn some additional coping techniques for specific things that may be more likely to occur, but in general you view the birth as normal and the mom as CAPABLE. When you view the mom as capable, she is more likely to succeed! And the amazing thing about midwifery care is that our knowledge has been passed down for generations! We know how to handle things that a hospital would view as an emergency because midwives had to take care of these scenarios before hospitals were around and before c-sections were regularly performed. Midwives know how to diagnose and heal with their hands, while obstetricians are taught to rely on their equipment.

I will tell you that women choose to be midwives because they love women, love birth, love babies, and want to encourage and bless other women with a positive entrance into motherhood. The number of midwives who are severely under-trained and do nothing about it, the number of midwives who do this for the money, and the number of midwives who are just clueless and irresponsible is incredibly low. In addition, it's quite silly to assume that your obstetrician is all-knowing, because someone had to come in at the bottom of every class! Not all doctors go to conferences and special training seminars. Some of these professionals are stuck in the past and do not keep up with new trends, advice, or research!

Lastly, the article even concedes that different results are derived from different studies. If you look at unbiased, comprehensive analysis of planned home birth, you can see that it is just as safe as a hospital birth (many would argue safer), with less incidence of interventions. Look at Ina May's statistics

Truly, this kind of fear-mongering crap is infuriating. STOP telling women that they aren't smart enough, strong enough, capable enough, or shaped right to birth their babies! Stop telling them that they need the man in the white coat to rescue them all the time! Stop telling them that the experience is irrelevant and all that matters is a healthy baby! Can we please go back to women helping women birth wherever they are most comfortable, utilizing experience and wisdom that spans the ages, and trusting the mother's God-given instinctual ability? We were made to birth, ladies! Our bodies are perfectly designed for this task. Do not let unfounded fears dictate your decisions.