Key Facts About Home Birth: by Lamaze International 

  • Home births with a qualified attendant have been shown to be safe for healthy women. Countries with large numbers of home births have less maternal morbidity and mortality than the United States.
  • Hospital birth puts women at considerable risk of preventable cesarean surgery.
  • Hospital birth practices in the United States expose women and infants to unnecessary use of practices and policies with harmful potential. Women who give birth at home are not exposed to these harmful routines and are more satisfied with their experience. Routine or frequent hospital practices and policies may include:
    • Inducing labor, which can lead to cesarean surgery in first-time mothers, as well as premature birth and an increase in harmful medical interventions
    • Restricting a woman from moving around and changing positions during labor, which can hinder the progress of labor and prevents a woman from managing pain
    • Not providing continuous labor support, which increases the risk of medical interventions
    • IV fluids, continuous electronic fetal monitoring and episiotomy, all of which pose risks to mother and baby and none of which have been shown to provide benefits with routine or frequent use
    • Epidural analgesia, which, while effective at relieving pain, poses risks to mother and baby and increases the need for other, potentially harmful medical interventions
    • “Coached” or directed pushing and birthing in a supine (lying on the back) position, both of which have been shown to lengthen labor and cause difficulty during birth
    • Separating mother and baby after birth, which delays the mother-baby bonding process and hinders breastfeeding
  • As of April 24, 2007, 24 states license direct-entry midwives (midwives who attend home births); 22 of those states use or recognize the Certified Professional Midwife (CPM) credential administered by the North American Registry of Midwives as the basis for licensing, and two states have voluntary licensing. No state has ever repealed their midwifery law for any reason. In nine states, licensed midwives receive Medicaid reimbursement for their services. 
  • Many rigorous scientific studies, published in leading medical journals, have found that for healthy women with normal pregnancies, a planned, midwife-attended home birth results in outcomes as good as or better—with far lower rates of medical interventions—than in similar women planning hospital births. The most recent and largest study was published in 2005 in the BMJ
  • Approximately 99 percent of births in the United States take place in hospitals. 
  • The World Health Report (from the World Health Organization) indicates that the neonatal death rate (death in the first 28 days of life) is greater in the United States than in 35 other countries; the United States is ranked 41st among developed countries.
  • No research has ever found hospital births to be safer than home births. 
  • While midwives attending home births promote the natural, normal process of birth and avoid practices that interfere, they are trained and experienced in noticing any signs of problems and taking appropriate action, including transfer to a hospital when necessary. Urgent complications that do arise can be remedied or stabilized for hospital transport with portable equipment and medications available to home birth practitioners.
  • There is no evidence that the rise in cesarean surgery rates is “maternal choice.”  In fact, a recent survey of mothers found that while 1 in 3 first-time mothers currently gives birth by cesarean, fewer than 1 in 252 requested this surgery. By contrast, obstetricians surveyed at one hospital acknowledged that more than 1 in 10 cesareans performed in labor were “physician choice” cesareans, without medical indication.
  • When attending births outside the hospital, both Certified Nurse Midwives and Certified Professional Midwives referred fewer than 1 in 20 mothers for cesarean surgery, while obstetricians performed cesarean surgery on nearly 1 in 5 low-risk mothers in hospitals.
  • Obstetricians today in the United States perform cesarean surgeries for nearly one-third of all births, induce labor in nearly half of all births and administer drugs (most of which pass through the placenta, increasing risk to babies) to more than two-thirds of all women. The same survey of mothers reported that only 1 in 200 women had all six care practices that support normal birth.

Is home birth really as safe as birth at a hospital or birthing center?
For most women with low-risk pregnancies, birth outside the hospital is as safe as—or safer than—hospital birth. The medical attitude of expecting trouble during birth, and the hospital policies that support this attitude, prevent women from giving birth easily and safely in the typical hospital. Routine medical interventions used at hospitals interfere with the natural process of birth and present unnecessary risks that can harm you and your baby. Home is where most women feel safest and comfortable. At home, there are no routine restrictions placed on a laboring woman, which make labor and birth more difficult. At home, you can choose your own caregivers, family and friends to support you, wear your own clothes, sleep in your own bed and eat your own food. Additionally, at home, there are no hospital-borne germs to endanger the health of you and your baby.

How do I know if I have a “low-risk” pregnancy?
Eighty-five to ninety-five of all pregnancies are low risk and can be expected to go smoothly. A low-risk pregnancy is one in which the woman reaches full-term with a single baby in a head-down presentation and who has no serious medical problems. Pregnancy and birth are safer now than ever before because women are healthier going into pregnancy and birth, because hygiene is better and because antibiotics are widely available. If a healthy pregnant woman lets nature take its course, her baby and body are well protected. High-risk medical complications include conditions, such as pregestational diabetes, pre-eclampsia, placenta covering the cervix (placenta previa) or substance abuse,. 
 

What happens during an emergency at a home birth?
Midwives are qualified to manage both simple and serious complications that may arise during a birth. They can administer oxygen and medications, start IV fluids, repair tears and perform

CPR. Midwives also are trained to know when to transfer a woman to a hospital to handle an emergency situation.

How does a midwife differ from an obstetrician-gynecologist?
Midwives are trained to focus on understanding and protecting what is normal and natural in pregnancy and birth, while obstetricians are trained to focus on understanding and looking for complications. Obstetricians’ and gynecologists’ training and skills are best utilized on women with high-risk pregnancies, as opposed to the majority of women with normal pregnancies. A midwife recognizes pregnancy and birth as normal processes and believes that the education and empowerment of pregnant women are just as important as good prenatal care. While prenatal visits with an obstetrician typically last approximately eight to nine minutes, a midwife will spend 30 minutes to an hour with each patient.

How do I know is home birth the right choice for me?
The choice of home birth is one that you and your midwife should make together after evaluating your overall health, obstetric history, nutritional status, home environment and social support. Once you have done that, it’s a matter of trusting yourself to know what is right for you and your baby.

For more evidence-based information on the safety of home birth, read “Home birth is serious business” on the Giving Birth With Confidence Blog, and the Childbirth Connection’s response to the 2006 ACOG Statement of Policy on “Out-of-Hospital Births in the United States.”

 

 

 

 













 

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