For a Natural Birth, There's No Place Like Home

For a Natural Birth,
There's No Place Like Home
by Mary Lou Singleton LM

The miracle of birth: it creates babies, changes women into mothers, and turns individuals into families. Being born and, in turn, giving birth are the most transformative and miraculous events human beings experience. Yet in our society, birth is experienced by most families as a technological and medical event, fraught with the possibility of disaster. Currently, 25% of babies born in the United States are surgically delivered from their mothers' bodies. Another 50% are born to mothers who are numb from the waist down and tangled in a web of tubes and wires. The rate of Cesarean section in the United States has more than quadrupled in the past 30 years, with no corresponding improvement in neonatal outcomes. In the midst of all of this birthing technology, the US maintains one of the highest rates of maternal and neonatal mortality among all developed nations.

Every expectant family desires the safest possible passage through birth for both mother and child. When it comes to birth, most American families equate "safe" with the sterile, closely monitored, technological environment of the hospital. These families may be shocked to learn that giving birth in a "sterile" medical environment designed to monitor and control the birth process does not improve the quality or safety of birth. In fact, study after study conducted on the issue has shown that for healthy women with low- to moderate-risk pregnancies, giving birth in a hospital is actually less safe than giving birth at home with a trained midwife. One comparitive study matched over 1000 women planning to birth at home with the same number of women planning hospital births. The women were matched for age, number of previous births, economic status, and medical risk factors. Women in the homebirth group who transfered to the hospital due to complications remained in the homebirth group for analysis. Though the two groups had no statistical difference in maternal and neonatal mortality rates, the results of the study showed that planned hospital birth resulted in greater numbers of birth injuries, maternal and infant infections, hemmorhages, and low apgar scores than planned, midwife-attended homebirth. (1) Many other studies support these findings and no study has ever proven hospital birth to be safer than planned, midwife-attended homebirth. (2)

As they become aware of their choices, more and more families are choosing to birth their children in the comfort of their own homes with the help of midwives. In New Mexico families are fortunate to have the option of hiring licensed midwives to provide comprehensive maternity care and home birth services. Licensed midwives specialize in caring for healthy women throughout their childbearing years. The care provided by licensed midwives differs from that of nurse-midwives in many important ways. Unlike nurse-midwives, who receive their training and practice primarily in hospitals, licensed midwives train and provide care in home and birth center settings. Constrained by hospital and managed care policies, nurse-midwives typically are unable to spend large amounts of time with individual clients in prenatal visits. Large hospital practices leave clients unsure of which particular nurse-midwife will attend their births. Licensed midwives work in private practices and are able to dedicate great amounts of time to their clients. They recognize that birth is a profound rite of passage and needs to be treated as more than just a medical event. Licensed midwives offer hour-long prenatal visits, providing ample time to perform the necessary checks on mom and baby's physical well-being, as well as to address the emotional and spiritual needs of the mother. Families who hire licensed midwives choose and know who will attend their births as licensed midwives do not work in shifts and remain on call for each of their individual clients.

In addition to personalized care, birthing at home offers many distinct advantages over birthing in the hospital. In nature mammals instinctively seek out quiet, dark, familiar places to give birth; their labors stop if their space is disturbed. Humans also birth best in privacy, and one's own home is the ideal place to create such surroundings. Most women innately choose to move around during labor, finding the most comfortable positions in which to give birth. At a home birth, midwives encourage such position changes and a woman's freedom of movement is limited only by the size of her house and yard. Licensed midwives also offer their clients the choices of laboring and birthing in water, delivering their babies with their own hands, or having the father catch; none of these options are routinely available at any Albuquerque hospital. After birthing at home, mother and infant may bond without interruption. A comprehensive newborn examination is done right on the family bed next to the mother. Home birth also allows for greater sibling involvement in the birth process. If the parents desire, older children can be present at the births of their new siblings, an option which is not routinely available at hospitals, especially during the cold and flu season.

The familiar comfort of home makes it the safest birthplace for healthy, low-risk women. In the safety of their own homes, women are less likely to experience complications of labor, such as hypertension and meconium staining, which may be brought on by stress. The freedom to move about as desired decreases both length of labor and the need for pain medications, therefore lowering the risk of maternal exhaustion, fetal distress, and cesarean section. Whereas a woman's home usually contains only microbes to which she and her baby are immune due to to daily exposure, the hospital is full of disease-causing microbes, many of which are resistant to most antibiotics. In fact, any person being admitted to an American hospital has a 4 to 10 per cent chance of acquiring a hospital based infection.(3) Newborn babies are especially susceptible to such infections due to their immature immune systems. Birth is by nature unpredictable and in some instances families who choose to birth at home may have to transfer to the hospital for technological assistance. The small chance of such a transfer being necessary should not deter women from planning to birth at home.

Birth is a family event and, with very few exceptions, happens most naturally and safely in the mother's home. Families who birth at home with the help of midwives generally report far greater satisfaction with the birth experience than those who have given birth in hospitals. Women who birth at home and the midwives who attend them understand that birth is as safe as life ever gets, and that attempting to control birth actually causes more complications than it prevents. Midwives maintain the safety and sanctity of the natural birth process, mainly through the practice of non-intervention. When excellent prenatal care has been given, addressing all aspects of a woman's life and relationships, a mother is well-equipped to birth her baby with minimal assistance. Midwives specialize in normal birth, they are quick to recognize any deviation from normal and to use the appropriate measures to help correct the situation. Midwives and families who birth at home are not anti-hospital, but feel that the hospital should only be accessed when truly needed. Midwives trust in women's ability to give birth normally and they help instill and reinforce this same trust in the families they serve. Far from being a medical event which must be suffered in order to receive a baby, a midwife-attended homebirth is a joyful celebration of life and the family.

1. Mehl, Lewis, et al. "Outcomes of Elective Homebirths." Journal of Reproductive Medicine. November, 1977: 281-290.
2. Olsen, Ole. "Meta-analysis of the Safety of Home Birth." Birth. Volume 24, Issue 1, March 1997.
3. Garrett, Laurie. The Coming Plague. New York: Farrar, Straus, and Giroux, 1994.

Mary Lou Singleton LM, of New Life Midwifery, is a mother, midwife, and herbalist who lives and practices in the Albuquerque area. She is the Secretary of the New Mexico Midwives Association and Regional Representative to the Midwives' Alliance of North America.

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