Sunday, September 30, 2012

The Battle for Homebirth

A couple of days ago, I stumbled upon a blog called A girl named Kevin. Basically, the woman who writes it, Loni, suffered the devastating loss of her daughter Aisley just last month. I obviously don't have all of the details, but what I know from her blog is that she had a homebirth and her daughter was stillborn. The baby's heart tones were steady even while she was in the birth canal. They believe that in the final moments before birth, there was a cord accident. Because this was a homebirth, Loni and her husband have come under attack. So while dealing with their immense grief, they now have to justify the fact that it was NOT their fault that their baby died.

I chose to birth my last two babies with highly trained midwives out of a hospital. I CHOSE. My husband and I CHOSE. Why is it anyone else's business where I, or any other woman, has her baby? Just last week I had to defend my choice of homebirth to the guy who processed my son's social security card. He had a completely negative attitude towards me because of it. Why does it matter to him, a complete stranger, where my baby was born?

Where you choose to labor and birth your baby is an extremely personal choice. One that is the business of the pregnant woman and her partner/baby's father/husband. I had my first child in a hospital and I chose never to do that again. I am not a birth nazi, but I am passionate about birth. I don't care where anyone else births. Well, that isn't entirely true. Pregnant friends close to me know that I will subtly mention how amazing my midwives and my homebirth experience were but I try to stop there!

I know there are women who take control of their labors in a hospital. There are women who don't mind the constant monitoring and mandatory IV and the nurses who tend to ask if you would like an epidural 15 times. Some women feel safer in a hospital. I do not judge this. I know not every hospital is a pit of hell like the one I had my daughter in. There are fabulous doctors and nurses and even midwives that work in hospitals. Just as I'm sure there are midwives that do homebirth that are the exception to the rule as well.

I was fortunate in that I had a supportive husband and family when I chose to birth at home. It is true that not everyone was comfortable with my decision but no one said anything negative to me. A lot of people are unsure about homebirth because they are not educated on it. Most women who chose homebirth end up educating themselves as well as their families and friends on the safety and benefits of it.

Excuse my ramblings. I was up most of the night with a sick baby and all of this on my mind. Please show some love to Loni on her blog if you can. I can't begin to imagine her pain and you can't have too much positive support.

Just for kicks here are some studies on the safety of homebirth:

In case you are looking for a midwife in the Sacramento area:


  1. I came across your blog and I love that you took the time to share your thoughts on this. I am Loni from the blog A Girl Named Kevin. Thank you so much for your support and kind words, from one strong mamma to another.

  2. If you are going to be having a home birth in the United States, you need to look at mortality info from the United States, most of which shows a 2 to 3 x greater risk of mortality at a home birth. The absolute risk is still low.

    Data from other countries, such as the UK, suggests that even there first time moms have higher mortality rates at home.

    1. Becky, Thank you for your research. The main point I was trying to make was that it shouldn't matter to anyone else where another woman chooses to birth her baby. It is a personal choice. Are you an obstetrician? I'm not sure why else you would be crusading against homebirth.

    2. I am not an obstetrician. I am also not crusading against homebirth. I intend to be crusading against misinformation. I was once a natural childbirth advocate -- I took Bradley classes, had two unmedicated deliveries in hospital, one with CNMs at a birth center, then one with a CPM. I was very shook up when at the end of my pregnancy with the CPM I realized that my midwife was practicing in a negligent and dangerous way. What's more, if I hadn't been well read and hadn't previously delivered with CNMs I wouldn't have realized her negligence. I would have had no idea that she'd done anything wrong or dangerous at all. At this point I still wasn't anti-homebirth (and I should clarify that I am NOT anti-homebirth, I am pro-informed consent) but I knew I couldn't deliver again with this CPM or any other in my area, most of whom had trained with her or who had even less experience. I hadn't fully realized the vast difference in training between CPMs and CNMs or the midwives who work in other developed countries. I still engaged in a lot of reading about and discussing birth, but I began to branch out to different sources. Much of what I found indicated that what I had learned from the natural childbirth sources had greatly simplified the evidence, or cherry picked it so that only supporting evidence was seen. I began to doubt a lot of what I "knew." I also saw a few friends suffer from stillbirths or medical complications. After having to heavily rely on experts for a few odd health problems in myself and my family, I knew that my own body could mess up. I wasn't inclined to "trust" it any longer. I no longer felt that I could just assume that I wouldn't be the 1%. I also saw that the natural childbirth and home birth advocates seemed to be getting more and more extreme, and were encouraging more risky behaviors, like breech home birth, and were rejecting more and more of evidence based modern medicine. I saw a lot of people making choices based on falsehoods. I don't like that, it isn't fair. I was misled about many things, and react when I see people misleading others.

      The risks with homebirth are low with a qualified attendant, with strict risk criteria, with thorough prenatal care, with integration into the medical system, with proximity to hospital and relatively high transfer rates. There's still the risk of an unexpected complication that needs an immediate cesarean, but these are rare enough that they don't have a statistical effect on the mortality rate, but just tragedies for those individual families.

      These conditions don't exist in most places in the United States, and data from other countries can't apply to the current state of affairs here. There are flaws in ALL homebirth studies, but the data from the US pretty consistently shows a 2 to 3x greater mortality rate at home. The absolute risk is still low, and I don't believe that a low risk woman is being negligent if she still chooses to home birth with a well trained provider. However, most of the women I'm aware of who choose homebirth aren't aware that they are risking a higher mortality rate. They think that homebirth is as safe or safer than the hospital. Many wouldn't accept an increase in risk of mortality for their baby in return for a better experience or lower morbidity for themselves, even if the absolute risk is low. They have the right to know what they're choosing.

    3. Sorry for the tl;dr. Basically, I care about other women's choices only because I know that my own choices weren't based on all the data, and I've seen other women whose choices weren't based on all the data who have suffered tremendously for it. I respect women's choices enough to believe that every woman needs accurate information in making her choices.

  3. Those links are complete BS, Becky. And you ARE against and an advocate against homebirth. The FACT of the matter is, every well-done study that has ever been done on homebirth shows that it is a safe and valid choice for low-risk women. Every crappy, flawed study done on homebirth "shows" it is dangerous. Your links are an excellent example of that. Did you really just link to anti-homebirth blog to prove homebirth is dangerous?
    Here, if it interests you, these are three very well done studies that have not been refuted by anyone..

    In addition to that, there is the Johnson and Daviss study which also shows the safety of homebirth in the US with CPMs. The ONLY person who discredits this study is one infamous OB.. and I know you know who I am referring to. If you really go by the scientific evidence, and not raw data, assumptions, fear tactics and anecdotes, you will admit that the evidence actually shows homebirth is a completely valid option. Enough of the lies.

  4. Becky is very involved in anti-homebirth crusading and smear campaigning, btw. She is facebook friends with "Dr." Amy.. so that should tell you everything you need to know. She has obviously been swayed by ANECDOTES and fear tactics, instead of actually looking at what the scientific evidence shows.

  5. @ TheSkepticalMother. I'm confused by your assertion that the links Becky posted are "BS". It looks like the last two are conference abstracts, and if so, they wouldn't have been properly peer-reviewed so maybe should be given less weight. But the others look like they are in peer-reviewed journals - admittedly still doesn't mean they are flawless but I think if you are going to say they are BS then you need to say why. Just saying it doesn't make it true.

    I think you also say that Becky linked to an anti-homebirth blog - where was that link? I didn't see it.

    As regards the three studies you list. They are all in countries that have a very different system of healthcare from the US. Midwives are licensed in a different way and are integrated into the healthcare system much better and thus are able to access emergency care more easily than some midwives in the US. By the way, the last study, in the UK, actually states that first-time mothers have a greater risk of poor perinatal outcomes with homebirth.

  6. I don't understand why anyone is crusading against is a WOMEN's CHOICE where she wants to birth. You don't like the homebirth idea? Fine, have a hospital birth. I personally feel all three of my hospital births were TERRIBLE and dangerous for my babies. I believe homebirth is the best choice for some women. The studies can go back and forth all day long (kind of like the VBAC vs ERCS debates) but in the end, the choice lies with the mother and her own power to make the choice best for HER.

  7. Yes , it is the WOMAN'S CHOICE on where to birth, but that CHOICE should be based on accurate information. MANA has not released the data they on the perinatal death rate in homebirths. Why not?

  8. If given the choice of an unnecessary caeserean or a dead baby, I will take the unnecessary caeserean. I think the moms and dads who tell their stories here would, too.