News / Health

Home Birth Movement in the US Challenges Norms

More US Home Births Challenge Normsi
X
January 22, 2014 5:07 PM
While the vast majority of births in the United States still take place in a hospital, a home birth movement continues to grow. VOA’s Carolyn Weaver has more.
Carolyn Weaver
In the United States since the 1940s, most births have taken place in the hospital, attended by obstetricians employing the full armament of modern drugs and technology.
 
In the last two decades, the rate of Caesarean surgical deliveries has shot up dramatically, to more than one in three births today. Partly in response, a home birth movement that began in the 1960s has sprung up again.
 
New York medical student Emilie Jacobs and her husband, Rowan Finnegan, parents of 22-month-old Elias, are planning another home birth for their second child. “If it’s a healthy pregnancy, and there’s no reason you would need more stringent medical care, more advanced procedures, then why not?” asked Jacobs.
 
The same licensed nurse-midwife will attend her, bringing along the emergency equipment of a paramedic, just in case. Although most problems in labor are detected in plenty of time, several top hospitals are only a few minutes away, Jacobs noted. Ten percent of planned home births do end up in the hospital, usually because labor has failed to progress. But if all goes well, Jacobs will have a peaceful, unmedicated birth - with no high-tech monitoring, surgery or drug-induced labor.
 
As a doctor in training, Jacobs has attended hospital births. She says they are determined more by hospital protocols, both medical and financial, than meeting the needs of women in normal labor.

“It’s not an illness to be pregnant. The hospital’s a place where people go when they’re sick,” she said. “There’s infection there, there’s a greater chance of having some kind of extra requirements placed on you, in terms of the speed of your labor and medications being offered or encouraged, and higher C-section rates. And higher procedure rates, such as episiotomies.”
 
Jacobs is one of about 30,000 women who will give birth at home in the U.S. this year. Although the numbers have risen in the last 10 years, home births still represent less than 1 percent of all U.S. deliveries.
 
The Business of Being Born, a 2008 documentary by Ricki Lake and Abby Epstein, helped publicize the movement, with scenes of uncomplicated midwife-assisted births at home, often in a tub of warm water to ease labor pains. Other advocates have spread the word with online video of their own water births - usually with fathers present, and often with older siblings, too. 
 
Women who choose home birth over hospitals often say, like Jacobs, that they want to avoid hospital requirements, such as fetal monitoring or the need to turn over beds quickly, that can divert a normal labor into a surgical one. Caesareans are major surgeries, they note, with serious risks to the mother, including the chance of uterine rupture in future pregnancies. 
 
However, there is disagreement among some experts as to whether home births are safe. A recent study in the American Journal of Obstetrics & Gynecology reported that babies delivered in planned home births in the U.S. are 10 times more likely to be stillborn and four times more likely to have seizures or other serious neurological problems. The study found that in about 60,000 planned home births from 2007 to 2010, 98 infants had no pulse and were not breathing five minutes after birth, a rate of 1.6 per 1,000 births. The rate in hospital births was .16 for every 1,000 infants.
 
Co-author Frank Chervenak, director of Maternal Fetal Medicine at New York-Presybyterian/Weill Cornell Medical Center, said that some of the deadliest complications in labor can happen with little or no warning.
 
“We here on our labor and delivery unit fight for seconds when an unexpected fetal distress occurs; we do drills, so we plan an emergency Caesarean and fight for seconds,” he said. “Because literally, seconds -- if someone is as much as one block away from this hospital, it’s too far,” he said.
 
Chervenak acknowledges that the incidence of serious problems in planned home births attended by midwives is rare, but argues that they are too grave to be risked, and that obstetricians should counsel "strongly" against them and refuse to participate.
 
Advocates say that is comparable to advising obstetricians not to perform the diagnostic test of amniocentesis, because of the 1 in 200 to 1 in 400 risk that it will cause a miscarriage.
 
Tina Johnson, director of professional practice and health policy for the American College of Nurse-Midwives, contends that the AJOG study was based on unreliable birth certificate data from the Centers for Disease Control.
 
“[It] used a lot of flawed data and drew a lot of conclusions that are inconsistent with all of the other research that’s out there currently, including another recent AJOG article, citing that planned home births with certified nurse-midwives are just as safe as midwifery deliveries in the hospital,” she said.
 
Jennifer Block, who recently gave birth to her own first child at home, is the author of Pushed: The Painful Truth about Childbirth and Modern Maternity Care.
 
“I knew from my own research that planning a home birth with emergency obstetric backup, if necessary, is the birth plan that was most likely to result in a spontaneous vaginal birth, with the least trauma to me and the best start for my baby,” Block said. “I knew that if things weren’t going well that we would transport to the hospital.”
 
“I think we forget when we focus on the perceived risks of home birth is that there are risks to being in the hospital,” she observed. In addition to the chance of contracting an infection or having a Caesarean, she said, there’s a risk of “having the baby end up in the NICU (Neonatal Intensive Care Unit) for days because labor was sped up, and hyper-stimulated, and the baby was in distress. So, I think focusing on those tiny rare risks, even though they’re very significant, doesn’t really give us the whole picture.”
 
Block notes that women choose home birth for the baby’s health as well as their own. “If the mother has a spontaneous vaginal birth, that’s absolutely the best-case scenario for the baby,” she said. “We know babies benefit from vaginal birth: their lungs, their respiratory health, their gut health; they are colonized with good bacteria; the breastfeeding relationship has a much better start.”
 
Both opponents and advocates of home birth point to the Netherlands and some other countries as support for their cause. In Australia and Britain, for example, most pregnant women are cared for by midwives, and see a doctor only if there is a complication or risk factor. “That’s the model that exists in the countries in Europe that have the lowest Caesarean rates,” Block notes.
 
Chervenak notes that in the Netherlands, where home births attended by midwives have long predominated, hospital births are on the rise. Many women there, however, also choose to pay extra to have midwives attend them. 
 
He thinks the answer for the U.S. is to “let midwives either deliver in the hospital or adjacent to the hospital. Bring home births into the hospital.”
 
“You can get a much better experience in the hospital in northern Europe and the Netherlands than you can in the U.S., frankly,” Block says. “If I could go to the hospital and get into a birth tub, and not be told that I have to be monitored continuously [and be] in bed, then maybe I would do that.”

You May Like

WHO: Anti-Ebola Efforts Should Focus on West Africa

Official says WHO is 'reasonably confident' countries bordering those hardest hit by the Ebola outbreak are not seeing the virus crossing their borders More

South Sudan Crisis Threatens Development

Economic costs and lost development opportunities in South Sudan have erased what little progress the country has made since independence in 2011 More

Ukrainian PM Warns: Russia May Try to Disrupt Sunday Poll

Arseniy Yatsenyuk orders full security mobilization for parliamentary election to prevent ‘terrorist acts’ from being carried out More

This forum has been closed.
Comment Sorting
Comments
     
by: Tammy Hamiel from: Ohio
January 22, 2014 3:24 PM
You need to check out Family Beginnings Birthing Center, located inside the Berry Women's facility at Miami Valley Hospital in Dayton, Ohio. I believe it is the only birthing center located inside of a hospital. I have had three grandbabies by two daughters deliver there with wonderful experiences. Water births are available as there is a tub in every room. A completely drug free, episiotomy free, midwife assisted birth. Anyone that you want in the room is welcome, one of our births had mom, dad, 2 aunts, and both grandmothers in the bathroom with the tub. Two uncles and both grandfathers in the bedroom area of the room where they could hear everything and come in whenever the mom was ready. The placenta is delivered I. The bedroom on a double bed, where both mom and dad sleep during their stay. I cannot say enough good things about these three births. My oldest grandchild was born the traditional way in the maternity ward of a different hospital and her experience was terrible.


by: Ruth Briggs
January 22, 2014 2:17 PM
In my humble opinion, for healthy, uncomplicated pregnancies, there is no safer place to give birth than home. Hospitals are staffed with medical doctors, nurses, etc. to care for people who are sick. The course of labor in a healthy woman requires an environment in which the mother can safely surrender to her birthing body. My first two children were born in a small community hospital, without any intervention for pain or delivery. Both were positive experiences until I had the last two at home. I strongly encourage healthy women who believe in their bodies that home birth is healthier for both mom and newborn.

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
After Decades of Pressure, Luxembourg Drops Bank Secrecy Rulesi
X
October 21, 2014 12:20 AM
European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video After Decades of Pressure, Luxembourg Drops Bank Secrecy Rules

European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video Kobani Refugees Welcome, Turkey Criticizes, US Airdrop

Residents of Kobani in northern Syria have welcomed the airdrop of weapons, ammunition and medicine to Kurdish militia who are resisting the seizure of their city by Islamic State militants. The Turkish government, however, has criticized the operation. VOA’s Scott Bobb reports from southeastern Turkey, across the border from Kobani.
Video

Video China Political Meeting Seeks to Improve Rule of Law

China’s communist leaders will host a top level political meeting this week, called the Fourth Plenum, and for the first time in the party’s history, rule of law will be a key item on the agenda. Analysts and Chinese media reports say the meetings could see the approval of long-awaited measures aimed at giving courts more independence and include steps to enhance an already aggressive and high-reaching anti-corruption drive. VOA’s Bill Ide has more from Beijing.
Video

Video US ‘Death Cafes’ Put Focus on the Finale

In contemporary America, death usually is a topic to be avoided. But the growing “death café” movement encourages people to discuss their fears and desires about their final moments. VOA’s Jerome Socolovsky reports.
Video

Video Ebola Orphanage Opens in Sierra Leone

Sierra Leone's first Ebola orphanage has opened in the Kailahun district. Hundreds of children orphaned since the beginning of the Ebola outbreak face stigma and rejection with nobody to care for them. Adam Bailes reports for VOA about a new interim care center that's aimed at helping the growing number of children affected by Ebola.
Video

Video Young Nairobi Tech Innovator on 'Track' in Security Business

A 24-year-old technology innovator in Nairobi has invented a tracking device that monitors and secures cars. He has also come up with what he claims is the most robust audio-visual surveillance system yet. As Lenny Ruvaga reports from the Kenyan capital, his innovations are offering alternative security solutions.
Video

Video Latinas Converting to Islam for Identity, Structure

Latinos are one of the fastest growing groups in the Muslim religion. According to the Pew Research Center, about 6 percent of American Muslims are Latino. And a little more than half of new converts are female. VOA’s Carolyn Presutti travelled to Miami, Florida -- where two out of every three residents is Hispanic -- to learn more.
Video

Video Exclusive: American Joins Kurds' Anti-IS Fight

The United States and other Western nations have expressed alarm about their citizens joining Islamic State forces in Syria and Iraq. In a rare counterpoint to the phenomenon, an American has taken up arms with the militants' Syrian Kurdish opponents. Elizabeth Arrott has more in this exclusive profile by VOA Kurdish reporter Zana Omer in Ras al Ayn, Syria.
Video

Video South Korea Confronts Violence Within Military Ranks

Every able-bodied South Korean male between 18 and 35 must serve for 21 to 36 months in the country’s armed forces, depending upon the specific branch. For many, service is a rite of passage to manhood. But there are growing concerns that bullying and violence come along with the tradition. Reporter Jason Strother has more from Seoul.
Video

Video North Carolina Emerges as Key Election Battleground

U.S. congressional midterm elections will be held on November 4th and most political analysts give Republicans an excellent chance to win a majority in the U.S. Senate, which Democrats now control. So what are the issues driving voters in this congressional election year? VOA National Correspondent Jim Malone traveled to North Carolina, one of the most politically competitive states in the country, to find out.
Video

Video Comanche People Maintain Pride in Their Heritage

The Comanche (Indian nation) once were called the “Lords of the Plains,” with an empire that included half the land area of current day Texas, large parts of Oklahoma, New Mexico, Kansas and Colorado.The fierceness and battle prowess of these warriors on horseback delayed the settlement of most of West Texas for four decades. VOA’s Greg Flakus reports from Lawton, Oklahoma, that while their warrior days are over, the 15,000 members of the Comanche Nation remain a proud people.
Video

Video Turkey Campus Attacks Raise Islamic Radicalization Fears

Concerns are growing in Turkey of Islamic radicalization at some universities, after clashes between supporters of the jihadist group Islamic State (IS) or ISIS, and those opposed to the extremists. Pro-jihadist literature is on sale openly on the streets of Istanbul. Critics accuse the government of turning a blind eye to radicalism at home, while Kurds accuse the president of supporting IS - a charge strongly denied. Henry Ridgwell reports from London.

All About America

AppleAndroid