More New York Moms Choosing to Birth at Home
Categories: Just for moms, Pregnancy & birth, Fun & activities, Playground bureau, Mommy wars, Home remedies
Wow. Here's a loaded topic! Want to have your baby at home? Home birth is a process that has been eschewed--well, OK, to use the word from a recent New York Times article on the subject, "condemned"--by the American College of Obstetricians and Gynecologists since 1975. Wow--the's fightin' words if ever I heard 'em. Adding fuel to the fire, the American College of Obstetricians and Gynecologists recently convinced the American Medical Association to side with them. Home birth is also often viewed by the general public as something undertaken only by uber hippies or the insane. Well, regardless of the stigma associated with home birthing, more and more moms-to-be, especially those in New York City--are choosing to do so, with mixed results.
Many in the medical profession consider home birth dangerous for pregnant women, even those with garden variety pregnancies seen as low-risk. Some doctors say that even a low-risk pregnancy could suddenly become high-risk on a dime, and that homes are not equipped with drugs and other life-saving procedures readily available in hospitals. The other side of the argument, from the moms, is that the women maintain more control of their labor and delivery by birthing at home. Birth, in their opinion, should not be a medical emergency, the way it is often treated by the medical profession. Midwives--at least the one interviewed for the article--point out that a high-risk pregnancy, such as a pregnant woman with preeclampsia, would never be considered a candidate for a home birth.
My main concerns with the home birth plan are shared by many of the moms who decided to do it. For one, New York City apartments are REALLY small. No, really, they are. And when you put a pregnant woman, her family and her attendants--a midwife, a doula--and heaven knows who else (sometimes the other kids too) it can get really cramped in there. But, as the moms point out, you make do. The other concern, which is a lot bigger, is that of germs and cleanliness. I know people say a hospital is full of germs, but should you really be having a brand new baby in any place that isn't 100% germ free, antiseptic cleaned within an inch of its life? I know I am a total germaphobe, but it seems like a hospital would be much cleaner and safer for a brand new baby. There is little to no privacy in a hospital though, and the unique intimacy that comes only for a few moments after birth between mom and child is diminished by all the nurses and interns swirling around.
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Reader Comments (Page 1 of 2)
emjaybee 11-14-2008 @ 5:25PM
Hospitals germ-free? HA. Ever heard of MRSA? If not, seriously, Google it. Lots of sick people, and their germs, their drug-resistant germs, I might add, in hospitals. I would actually rate them as more dangerous, not less, in terms of germ exposure than your house.
And...the baby is going to come home with you eventually, yes? The baby already has your germs, or will soon after birth. There is nothing about the 24 hours after birth versus the day you go home that makes them more prone to be hurt by the dust on your fireplace mantle, or the dog hair on your couch.
What protects baby's immune systems are breastfeeding, contact with a small circle of people at first (instead of the entire staff of City General and their undiagnosed flu bugs) and..more breastfeeding. Other than changing them and keep them warm, there is really not much else you have to do for a healthy newborn. (Sick babies are another story, of course).
I am not rabidly anti-hospital, but "messiness of birth" is not a good reason to use them (the midwives clean up for you! You can have lots of drop cloths and layers of sheets to change off the bed, etc. etc. It's certainly not any worse than a hospital room).
And I always wish when articles quote the AMA and ACOG, that they would point out that homebirth is a threat to their income, and that maybe, possibly, that might have something to do with their opposition. If homebirth was so dangerous, human beings would have died out before hospitals came along.
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ame s 11-14-2008 @ 6:34PM
I would have lost my first daughter if we had tried a home birth and would have had to call an ambulance for daughter the second. I had "normal" pregancies with both of them.
Daughter 1 insisted upon staying on her back despite being turned a couple of times by the doc, then her heart rate dropped alarmingly when I started to push, resulting in an emergency
c-section. The doc was in such a rush, no one noticed my epidural had failed until the incision was made. Oops.
Daughter 2 thought it was a good idea to inhale some fluid and it took quite a while to clear her lungs. She topped it off by having a glucose issue.
I wouldn't risk a home birth, but wouldn't tell someone else they shouldn't try it.
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Kathy 11-15-2008 @ 5:27PM
Many times, just being in the hospital and following their protocol will cause problems you described. Lack of food and drink for mom, being made to lie on your back, being hooked up to machines, epidurals, pitocin, monitors.....all of this can be blamed for problems caused for babies. Most of the time, if you leave a healthy mom alone to move around, get in any position she chooses and keep herself hydrated and well nourished, the babies are just fine.
Karen 11-14-2008 @ 8:30PM
I'm not big on doctors or hospitals, and in fact, think you should avoid both of them whenever possible.
BUT for me the health and safety of my newborn was the number one priority. If you are going to evaluate risk, I think that a hospital is safer even with germs, etc.
Now the intimacy and those issues just aren't on par with safety in my mind, so those weren't even considerations. I had two WONDERFUL pain free deliveries (with an epidural) and can't imagine how it could have been better in any other environment. The hospital birthing suite looked like a hotel up until the time to give birth when things dropped out of the ceiling and cabinets were opened to reveal medical equipment. It was great.
That said -- women should make the choice that best fits them.
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hairyfrog 11-26-2008 @ 12:31PM
"BUT for me the health and safety of my newborn was the number one priority. If you are going to evaluate risk, I think that a hospital is safer even with germs, etc."
Actually, if you look at the statistics, you'll see that the incidence of neo-natal death is much higher in hospitals that at home. To be honest, an influencing factor is that pregnant women whose babies are especially at risk are sent to the hospital by their midwives. But this is STILL no argument against home birth. As long as you've got a good midwife, she'll REFUSE to recommend a home birth if you ARE at risk.
And try looking at the statistics of countries (such as Holland) where hospital births AREN'T the norm - far from it! The USA has got a TERRIBLE record.
Having said all that, I agree with your last sentence: "That said -- women should make the choice that best fits them."
A big risk factor is maternal stress. If a woman isn't happy and relaxed about home birth, she should consider hospital. I for one would be scared out of my box at a hospital birth. I've heard and read too many horror stories.
Karen 11-30-2008 @ 7:19PM
QUOTE: Actually, if you look at the statistics, you'll see that the incidence of neo-natal death is much higher in hospitals that at home.
I would assume that is because ALL high risk delieveries are done in a hospital. If you know ahead of time that there is a greater risk, like you said, they are going to send you to the hospital. So if that is the case, it seems that is the safer place to start with.
hairyfrog 12-09-2008 @ 12:35PM
Hi Karen!
This is a reply to your reply to me, and your comment:
"I would assume that [the incidence of neo-natal death is much higher in hospitals that at home] is because ALL high risk delieveries are done in a hospital."
Only part of the reason (and one I admitted to contributing to those statistics). I refer you to my third (soon to be converted to fourth or fifth in line) comment (about your own home germs vs. hospital germs), now booted to page 2 (soon 3?) [or the FIRST comment on this thread, posted by emjaybee. Pay attention to her last paragraph, the bit about AMA and ACOG, a point I also made.]
I also refer you to NurseMama's several excellent posts, and to Sarah Perdue's.
And I'll reply to another comment of yours: "Unless of course, something did go wrong and they weren't prepared to deal with it. Happens. And the odds of it happening are MORE if you are home."
Active Management of Labor (see NurseMama) causes stress which can and does lead to complications. I will turn your theory on its head and say that things are more likely to go wrong in a hospital (where they ARE equipped to deal with it - stress on EQUIP[ment]. A good home midwife is prepared to deal with most home emergencies - including rushing you to hospital if necessary.)
Let me give you an example of AML: A friend of mine went into labour in hospital, and went into a squat (one of the best positions for both mother and baby, and one used successfully for thousands of years). She was forced by the (well?-trained) nurses to lie down on her back - one of the WORST positions for mother and baby... but the handiest one for the doctor.
How about THIS for a turnaround? "Many babies who die in hospitals could have been saved if they had been born at home." I'm not saying that the reverse is never true, I'm saying that the AMA and ACOG have a MUCH bigger budget (and vested interests) to maintain the myth that hospitals are safer - or that they REALLY have our best interests at heart.
Heather 11-14-2008 @ 8:34PM
If I tried to have my son at home, I would have died. I'm not being overly dramatic; it's the truth. I had a perfectly normal pregnancy and there was nothing about my health, medical history, or family history for that matter that would have indicated any risk. But regardless, as my baby and placenta exited so did my uterus. Fortunately I was seconds from the O.R. and they were able to put everything back in place and replace some of the blood lost. But had I been at home, in the time it would have taken for the ambulance to arrive and get me to the hospital I would have bled to death. I understand the argument that it's a "natural process" but don't we all remember how many women and babies died during childbirth back before modern medicine?
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khrystena 11-14-2008 @ 9:12PM
One of my girlfriends just had her little girl at home 7 days ago. They had thought about doing it but in the end decided to go to the hospital (it was her first) Ended up that she didn't have time to go to the hospital and had the baby at home. She wouldn't have changed it for the life of her.
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Karen 11-15-2008 @ 11:59AM
Unless of course, something did go wrong and they weren't prepared to deal with it. Happens. And the odds of it happening are MORE if you are home.
Anyway -- I still think women should have the right to choose hospital or home birth, but I also think that stories of it going right, don't make up for the time when it goes wrong.
ninainindia 11-14-2008 @ 9:50PM
I believe home birth is the way to go if you have a normal pregnancy. (Maybe not if the nearest hospital is hours away). Where I'm from insurance only covers hospital birth if it medically needed. Home birth is the standard. I think people also forget that midwives have a degree also, they are not just people of the street.
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Naomi 11-15-2008 @ 10:06AM
Had a hospital birth with my first, and a home birth with my second. AMAZING experience, and I would do it again if the situation presented itself.
Then again, I live less then 10 minutes from the hospital, should there be a problem.
But the midwives are trained to handle whatever comes up, and they are overly cautious, in my experience. But homebirth isn't for everyone.
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NurseMama 11-15-2008 @ 12:53PM
Karen said:
>> But for me the health and safety of my newborn was the number one priority. >If you are going to evaluate risk, I think that a hospital is safer even with germs, etc.
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NurseMama 11-15-2008 @ 12:58PM
(cont'd.)
I think we can all agree that their baby's health and safety is the number one priority of every birthing woman, regardless of where she gives birth. I don't know anyone who thinks a good experience is more important than a safe birth. But the idea that you are trading safety for a good experience by choosing a homebirth is a myth.
NurseMama 11-15-2008 @ 1:00PM
>>If you are going to evaluate risk, I think that a hospital is safer even with germs, etc.
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NurseMama 11-15-2008 @ 1:02PM
This, also, is a myth. If you are to truly evaluate the risk, then you have to look at the research, and it just doesn't support this claim.
Also, regarding the stories women are sharing about the "emergencies" they encountered during their hospital births, which would have been a "tragedy" had they attempted a homebirth....While I haven't had time to read all the stories yet, those I've read so far sound like the result of Active Management of Labor. Do a search on it. It is difficult to find any OB in any hospital in the US who does *not* practice AML.
AML is the anti-thesis of "normal" labor. It causes complications, causes emergencies, but fortunately, the staff is there to "fix" the problem (and is deemed a hero by the unsuspecting mom). Ironically, since AML is all obstetricians know, they think this is "normal" birth. Is it any wonder they consider birth to be fraught with danger?
I have worked in Labor and Delivery in many good, well respected hospitals. I have yet to find one that is safer than my home.
NurseMama 11-15-2008 @ 1:17PM
P.S.--I liken ACOG's position on homebirth to that of a convention of restaurant owners and managers that issues a statement declaring restaurants to be the only safe place to eat a meal. After all, the food is prepared by specially trained professionals, in a "sterile" environment, under the guidelines and supervision of the state. How could you consider eating a meal anywhere else?!
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mamaloo 11-15-2008 @ 4:01PM
Labour and delivery is alike a game of Jenga. Stepping into a hospital (when you and your baby are otherwise perfectly healthy) is like pulling the first piece out of the stack. Get an IV, take another piece, get constant EFM, take another piece, etc. Eventually, somewhere along the line, the stack falls and your baby is delivered surgically (via c-section or forceps or vacuum).
You will never know whether the pieces you pull out will make the stack topple. And you'll never know whether one piece or 7 will make the stack topple. But stepping into the hospital is the first step towards requiring intervention, for women and babies who are otherwise perfectly healthy.
And, about germs: how many docs and nurses walk into your room and wash their hands before they approach you? How man do it on the way out the door? It's called the Universal Precaution and docs in particular are notorious for not following it. It is the most effective way to control the spread of infection and virus but it's practiced least by the people who should be doing it the most.
When a child is born at home - where mothers and babies are healthy and do not require medical supervision for pre-existing problems - they are born into their home bacteria, the bacteria that is friendly to their parents, the bacteria that they will build their first immunities to, the bacteria that is safe for them. Whether they encounter it at 1 minute old or 1 week old makes no difference.
I just don't think well people belong in hospitals. That's where sick people go? Are all pregnant women sick?
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Sarah Perdue 11-16-2008 @ 8:13AM
Many of you have said you "think" the hospital is safer, but there is a significant body of research that demonstrates otherwise starting with the Johnson and Daviss CPM 2000 study published in the British Medical Journal in 2005. By comparison, it is very difficult to find data demonstrating that home births planned by healthy mothers attended by trained professional midwives are unsafe or less safe than hospital births for healthy mothers experiencing normal pregnancies. There is a significant difference between "thinking" and knowledge based on many hours of research.
The American Medical Association and the American College of Obstetrics and Gynecology are increasing their legal challenges to women's rights to chose out of hospital birth where they have it and continuing to oppose efforts to legalize it where they don't. Whether or not you wish to birth out of hospital, these efforts to restrict our rights to chose where we birth and what kind of provider attends us will have a greater impact than where and how women give birth.
If you want to maintain choice in other areas of healthcare, please support midwife attended out of hospital birth.
Sarah Perdue
The Alabama Birth Coalition
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Terri 11-17-2008 @ 12:42AM
Well said!!