Some are choosing it because it's cheaper, others fear unnecessary intervention in hospitals especially women who've previously had caesarians or have minor medical concerns that might make doctors keen to press to interventions. White women seem to be taking more control of their births with 1 in 98 giving birth at home. Compared to 1 in 357 black women and 1 in 500 Hispanics.
Some doctors say that home births can be unsafe especially if there is no hospital nearby or the mother has high risk conditions, or the birth attendant is inadequately trained. Doctors pose the question if the home birth ideal isn't a "Feminist Machismo" but while there are bound to be horror stories, most of their concerns are issues that can be planned out in advance. There are also plenty of examples to be found of mothers in hospitals being pushed to accept interventions. In one example a mother in labor was told she must sign for the Caesarian because vaginal birth carried too high risk of infection, as if a Caesarian was somehow magically safer, and her friend who had a Caesarian from the same doctor is still in a coma. The risk of surgery is clearly much greater for the baby with nearly two in one thousand babies born by elective Caesarian not surviving past four weeks old, against only 0.6 in 1000 for regular births.
Home birthers in general say they want to be free from drugs, fetal monitors, IVs and pressure to hurry their labor to satisfy busy doctors and maternity wards. They prefer labor in water on hands and knees, some walk around the living room or lie in their own bed with friends and family and relaxing music playing. Hypnosis is also popular, as are what is known as "doulas" women who are not medical professionals but serve to support the mother through her labor. Clearly though things get a little fanatical when mothers to be, choose to go without any professional care at all, replying soley on a husband or friend.
Julie Jacobs, 38, of Baltimore, who has multiple sclerosis, said :
"[ I ] chose midwives and hypnosis because I wanted to surround myself with people who would support me as a birthing mother, rather than view me as an MS patient who would be a liability in need of interventions at every turn."
Her first two children were born in an independently run birth center operated by midwives. When the center closed, she decided to have her third child at home in 2007.
She continues :
"If I had been in a hospital I probably would have had C-sections for all three," she said. "With the first, I would have been terrified to try a home birth. After the second one I was like, hey, I can't necessarily walk in a straight line, but I can do this."
Dr. Joel Evans, the rare board-certified OB-GYN who supports home birth, said the medical establishment has become "resistant to change, resistant to dialogue, resistant to flexibility."
He continues :
"Women are now looking for alternatives where they can be treated as individuals, as opposed to being forced to comply with protocols, which however well meaning, have the impact of both medicalizing childbirth and increasing stress and anxiety around delivery,"
Evans is the founder and director of the Center for Women's Health in Stamford, Connecticut, and an assistant clinical professor at the Albert Einstein College of Medicine in New York.
Looking back in history in 1900, 95 percent of U.S. births took place at home. That slipped to half by 1938 and less than 1 percent by 1955, although it wouldn't be fair to compare survival rates, as sanitation and medical understanding was much less than it is today.
In 2005 The British Medical Journal gathered data from around 5,500 home births involving certified professional midwives in the United States and Canada. The study one of the largest for home births, showed 88 percent with no problems, while 12 percent of the women transferred to hospitals, including 9 percent for preventive reasons and 3 percent for emergencies. The study showed an infant mortality rate of 2 out of every 1,000 births, about the same as in hospitals at the time.
Today, most midwife-attended births occur in hospitals and most midwives are licensed nurses. It is worth noting however that there are also close to 1,700 midwives who practice outside of hospitals. In 27 states, so-called "lay" midwives who lack nurses' training but are licensed and certified as professional midwives can legally attend births. The main issue is clearly being educated and informed. Davis-Floyd one of the researchers of the BMJ report said :
"Women who are truly educated in evidence-based maternity care understand the safety and the multiple benefits of home birth," she said.
Rupert Shepherd for Medical News Today.com