In Defense of Irresponsible Home Birth

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I read a lot of online posts and very rarely feel compelled to join the conversation. The drama, judgement and bantering that typically follows is never worth it. But every once in a great while, I think a comment warrants a response. This week I came across such a post. It sparked something in me. It sparked in me a desire to inform, educate, and empower others to do more research and really think critically. It made me realize that the information most readily available on birth is flawed and sub par. It made me want to advocate for change.

Under a post about the midwifery bill currently in legislature a woman posted “I simply do not understand why one has to have a baby at home. Just go to the hospital. It’s not 1890.”

I responded because I think it is important to understand why people choose home birth. Often times, home birth is not a choice to birth at home but rather a conscious choice not to birth in our current hospital maternity system. For most families, home birth is not a rash or selfish decision but one based on research, evidence based care and lack of other choices.

While home birth is not for everyone, neither is the hospital. There are many reasons not to go to a hospital to birth a baby. The debate always becomes the safety of a home birth but really there are lots of risks to choosing a hospital that no one ever talks about. Our country has deplorable birth outcomes compared to other industrialized countries (who have much higher midwife and home birth rates…just saying.) There are significant risks to both mother and baby when they enter an American hospital to give birth. A risk I wasn’t willing to take. I chose home birth. I would have considered a birthing center but didn’t have one close enough. And if hospitals had better policies, humanized birth and better outcomes, I would have birthed at a hospital. The real home birth debate isn’t about location of birth. It’s about humanizing birth. It’s about trusting a woman’s body to labor naturally without intervention, in a comfortable, calm environment and providing access to care only when actually medically warranted. It’s about instating policies that are actually evidence based care. When hospitals begin to offer that for normal, healthy, low risk pregnancy, I’ll go to the hospital. Until then, the hospital isn’t worth the risk for me.

She responded, “I’ve never disagreed more with a post on Facebook than I do yours. I don’t even see a valid argument. “Humanization” of birth? Lol. Birth situations change on a dime. Home birth is irresponsible.”

At first it infuriated me. My thoughts were angry and defensive. No valid argument?!? But studies and data back me up! Irresponsible?!? Why irresponsible? Because there is a risk of death or injury? As if I knowingly chose something that would kill my baby. Really? Irresponsible?!? I have a risk of killing my baby or causing him brain damage every time I get in the car. Am I irresponsible to drive? Should we all stop driving because our baby might die? I began rationalizing my thoughts. Should we stop living or is there acceptable risk in everything we do? What makes it acceptable risk? Who decides?

I acknowledged that everything comes with risks and we must individually decide what risks and choices are best for our family. Then I realized I wasn’t infuriated anymore. I was just sad. Sad that so many women are misinformed.  Sad that the medical system fails to present women with true informed consent, contributing to the misinformation at hand. Sad that women trust this system to the point of researching cars and computer purchases more than they do birth choices and outcomes.

Then the anger returned. Not anger directed towards the people who believe in this system of birth, but anger towards the system itself. Anger and sadness so deep it inspired me to advocate. Advocate for better information. Advocate for better birth. Advocate for change.

The fire has been sparked. I will defend home birth. Not because I believe every women should have one (some shouldn’t!) Not because I believe home birth is the ideal option (I don’t!) I will defend home birth because it will change the way we approach birth. I will defend home birth because every women deserves a birth filled with respect, dignity and choices. I will defend home birth because it is time for change.

 

For more information on our decision to birth at home including birth statistics and birth choices,  read here.

 

 

14 Comments

Amen! I feel the exact same way — “Sad that so many women are misinformed. Sad that the medical system fails to present women with true informed consent, contributing to the misinformation at hand. Sad that women trust this system to the point of researching cars and computer purchases more than they do birth choices and outcomes.”

Yes. yes. yes. It’s not just about birth, but about health in general. Our entire health system and government needs a major overhaul, and birthing “policies” would likely follow suit…hard to imagine that happening, but it has to…soon.

Let me start with I don’t necessarily disagree with you. However, in reading your message I am no better informed about options or risks. I realize I can do a google search, but if your goal is to reach out and inform/change people’s minds, please include specifics or links to studies, otherwise it just sounds like an opinion which is no more helpful than the persons post who inspired you to write this.

Jessica, you are totally right! This piece is just an opinion piece on how often the decision is not about location but about wanting choices and evidence based care. It’s disappointing that the current system is failing mothers and babies. I am in the midst of a lengthy follow up post on why we chose home birth that does have links to studies and empirical evidence. It should post today. Thanks for reading!

Oh my..since when on this earth was an opinion not worth anything? Nowadays its all “studies show” but human communication is what this world is all about.

My whole thing is as long as you have confirmation of a safe and healthy pregnancy why not have it at home and be in the safety of your home? Free of germs and things like bottles the nurses shove in their mouths even though you asked them not to! I stayed at home for most of my labor but due to high risk pregnancys had both my babies in the hospital, ALL natural and no I don’t mean just vaginally… No Iv, drugs, etc NATURAL and the nurses pushed anything and everything on me non stop…. If I didn’t have my mother saying no for me I’m sure they would have just given it to me! So why not do it at home if you can??!! I’m sure my birthing experience would have been an easier and better one. My main point is get the real care you need and make sure it’s a healthy pregnancy before you go that route, now you’ve lost the irresponsible part

What proof do you have of the reason for poorer outcomes in this country? The rates of maternal obesity in this country are among the highest in the developed world. Maternal obesity has been clearly shown in numerous studies to correlate with higher risk of infant death. Why is it assumed that the hospitals are to blame rather than the unhealthy American lifestyle?

My follow-up post gets into some of the studies and explains why we ultimately chose home birth and how it has nothing to do with location. I agree that there are many factors that contribute to America’s poor birth outcomes including obesity, poor nutrition and sedentary lifestyle. But the medical model of birth is a significant contributing factor. As you said, studies show the caregiver, not the setting, makes all the difference. There are some amazing American hospitals that have focused on evidence based care and a midwifery model approach to birth, and their birth outcomes reflect the significant benefits. CNMs and FPs regardless of birth setting/location do show significant decreases in interventions and better outcomes. Unfortunately, the CNM group we had access to had a couple wonderful midwives among a practice of CNMs that practiced more along the medical model than the midwifery model of care as evident in the answers and care I was receiving. As it was a rotation schedule and I couldn’t guarantee who would attend my birth, we ultimately chose home birth out of lack of other choices. Ideally more hospitals would offer a comprehensive approach to birth focused on a midwifery model of care resulting in better prenatal education, less interventions and better birth outcomes overall.

I should add that many of these developed countries have many midwives in hospital settings. The caregiver, rather than the setting, makes the difference in the medical interventions. The medicalization of childbirth and increased c-section rate has corresponded with the rise of obstetricians being in charge of birth rather than family doctors. Numerous studies have shown that births in hospitals attended by fp’s and cnm’s have lower rates of intervention than those attended by ob’s.

This is a topic that is difficult to articulate concisely……You have done a GREAT job!
I have been doing birth for 30 years, my oldest is now more at risk of death during childbirth than I was when I gave birth to her.
We MUST educate our country on the TRUTH of our maternity “care” system.
Thank you for a succinct post.

Thanks for reading and for sharing the link with others! Education, knowledge, and honest facts are so important in empowering women and allowing them to make informed birth choices that are right for their situation.

Thanks for writing this! I have recently gotten married and have started thinking about these things…Cloth diapers versus plastic ones, formula versus breastfeeding, homeschooling versus outside schooling…It’s really good to get a new perspective on birth that is so counter-cultural :) It’s so easy to just do what everyone else is doing without thinking things through.

Congratulations on your marriage! It’s such an exciting time but all the information and choices can be overwhelming. I’m glad to hear you are getting an early start thinking about things. We love cloth diapering, breastfeeding, and baby wearing. We feel very blessed to have had such an amazing birth experience. We haven’t really gotten that far yet, but have started researching homeschooling versus traditional schooling. As you go along you’ll get lots of advice from everyone (I’m sure you saw that in wedding planning!) but keep one thing in mind: Do what feels right for you. Sometimes it can be discouraging doing things that are counter-cultural. Some days you feel like you are swimming against the tide and question your choices. But in the end doing what feels right for you and works for your family is so rewarding!

If you have any topics in particular that interest you, I would be happy to write more about our experience so far. Stay tuned for more about our journey – like Cave Mama Unlabeled on Facebook for even more fun stuff :) Best of luck with your research and choices!

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