St. Petersburg Times Examines Debate Surrounding Home Births

Main Category: Pregnancy / Obstetrics
Also Included In: Nursing / Midwifery;  Primary Care / General Practice;  Pediatrics / Children's Health
Article Date: 17 Jul 2008 - 8:00 PST

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The St. Petersburg Times on Monday examined the controversy surrounding home births, which has pitted some home birth advocates and physicians against each other. While supporters of home births have "flung phrases like 'father knows best' and 'power play,'" opponents have used "trendy" and "the latest cause celebre," according to the Times.

Last month, the American Medical Association passed a resolution saying it supports state laws that discourage home births; the American College of Obstetricians and Gynecologists also opposes the practice. Nevertheless, midwives are pressing for licenses in states that do not allow them to practice. A documentary by former television talk show host Ricki Lake, which looks at the current maternity care system and home births, also has brought attention to the issue, the Times reports.

According to the Times, home birth supporters argue that AMA wants to outlaw home birth and dictate women's delivery choices rather than help them. Steffany Hedenkamp, communications coordinator for the Big Push for Midwives campaign, said, "This is different because now they're targeting consumers," adding, "They're saying, 'We're going to tell you where you can give birth and where you can't.'"

The physician who wrote the AMA resolution said that the debate is not about paternalism, freedom or the comforts of home, the Times reports. Rather, Erin Tracy, an obstetrician at Massachusetts General Hospital and an assistant professor at Harvard University, said, "It's about safety." Tracy also said, "With my own patients, they can have as many people in the room as they want, whatever music, whatever lighting," adding, "But if things go badly, there need to be measures that can be taken to save the life of the mother or the baby."

Risk also is at the center of the debate, the Times reports. A study cited by AMA shows that the death rate for infants born in hospitals is 1.7 per 1,000, compared with 3.5 deaths per 1,000 births for infants born at home. On the other hand, home birth supporters note that women who give birth in hospitals have a significant chance of being given drugs to induce labor or having caesarean sections, which are on the rise in the U.S. Char Lynn Daughtry, founder of Labor of Love Birth Centers, said, "The (induction) drugs are fraught with peril," adding, "It's a safer environment when they're away from the operative tools and the environment of the hospital." Hedenkamp said midwives are more focused on making delivery a positive experience rather than anticipating the worst potential outcome. "Some obstetricians will admit: They're trained in what can go wrong," Hedenkamp said. "They're not trained to be with the women and do whatever they need," she added.

Although physicians ideally would prefer not to do "much of anything at all and just play catcher at the other end," sometimes they "need to intervene and play a more active role," Catherine Lynch, who directs general obstetrics at University of South Florida's College of Medicine, said. According to the Times, home births generally are offered only to women with healthy, low-risk pregnancies, but complications still can occur. Lynch said, "In the hospital, we can get [a] baby out in under five minutes if we need to" (Greene, St. Petersburg Times, 7/14).

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