I'd really love to love home births. The idea is wonderful. Mom (and whomever she wants by her side) is in a happy, warm environment—no bright lights or scary machines in sight—when she meets her son or daughter for the very first time, with no need to worry about being rushed out of "recovery" or denied the comforts she truly wants. As if those things didn't sound good enough, home births also cut parents' birthing costs by approximately two thirds. And considering that the cost of a hospital birth has tripled since 1996, that's very good news to a lot of families' wallets.
That said? I just can't get behind home births. Why? One simple factor, a factor that I think easily outweighs comfort, ease, and economics--and that's the life of the baby being born. Little ones born in planned home births are two to three times more likely to die in infancy than babies born in a hospital setting (some studies say the risk is even higher, but this number is the most solidly backed up). I'm used to home birth devotees rolling their eyes at these numbers, calling out the fact that women have been giving birth at home since the beginning of time, and that there are no definitive studies on the topic; but I beg them to look at the hard facts: In 2009, Colorado midwives reported performing 637 deliveries, and transferring another 160 pregnant women to hospitals either just before or during labor. As Michelle Goldberg reported in the Daily Beast, the midwives' patients suffered nine perinatal deaths—near double the state-wide infant death rate, which includes high-risk and premature births. Three of those home birth infants died during labor itself, something that's incredibly rare in a hospital setting.
Nine deaths out of 897 pregnancies might seem small, but it's not small at all to the parents who've lost their babies. And those parents are the only thing I can really think of when I hear that yet another one of my friends, or even some woman I meet at a party, is gearing up for a home birth (and more and more of them are—incidents of home birth rose by 29 percent between 2004 and 2009 alone). I know that there's a lot wrong with American hospital births—that many women lack control during childbirth in clinical settings, and that they feel they have no choice about what interventions are used and when. I also know that our health care system in general is broken and that hospital births are dauntingly expensive even to middle class families. I understand the desire for an alternative, but I don't understand ditching the whole system when it still seems to be the safest we've got.
Obviously women need to be free to make their own choices when it comes to prenatal health and childbirth, and I respect women's decisions. Some friends of mine have given birth to healthy, beautiful children at home—but that doesn't stop me from taking a deep breath and worrying when I hear that yet another mom-to-be who I care about is dead set on this option. I tend not to say anything or make a big fuss about it, especially if the mother is close to her due date (at that point, everything's pretty much set and I know I'll just cause more anxiety around the birth, which isn't helpful), but for those women who still have some time to think it through, I do tell them about the increased risk of infant death. I also tell them that if they do still want to go through with the home birth, that they should hire a licensed Certified Nurse Midwife, who has more solid medical training than a Certified Professional Midwife. My thoughts might be unwelcome to women who are really invested in the home birth movement, but as a friend and someone who is professionally focused on all aspects of pregnancy, I think I have to at least say something.
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