The NY Times weighs in on improving the safety of home births.
Years ago, home births were the norm. In England after the war, a legion of midwives were trained to help many residents in the poor areas of the city have their children safely at home, with the hospital as a back-up just in case things did not go as planned. You can check out a series done about them on Netflix called appropriately Call the Midwife.
There are centers run by midwives in our country that do essentially the same thing; help women have their children in a homelike setting.
The benefits of home births are that you are much less likely to have a c section which can have lifelong side effects such as back pain and other problems in their body as a secondary effect of the surgical scar and its effects on the tissues underneath it. Currently, the hospital based c section rate is about 25%. We help many women with C – section enhanced back and leg issues which is often misunderstood and is a much larger problem than has previously been reported. I am currently writing a paper on the subject I plan to publish in one of the medical journals.
Years ago, doctors would deliver babies many ways but due to concerns about liability and insurance, it is partly the reason more doctors are less willing to take the risks associated with breach babies or babies that are larger. Other times, the reasons given can be questionable, since doctors are reimbursed more for performing C – sections than not, however you can likely screen doctors and find out their rates for the intervention.
Statistically, both hospital births and home births are safe, and recently, there has been a resurgence of interest in home birthing. In England, one out of every two women attempting a home birth ended up in the hospital, which is not necessarily a bad thing. The good news is that most of these women were less likely to have had a C-section, or other hospital based procedure, or be separated from their newborn.
The costs are also higher in the hospital; from the birthing room to the doctor, what does it ultimately cost to have a child in the hospital, and then if a procedure is done or the ICU is used, those costs escalate rapidly. It is hard to suggests all these procedures and costs are necessary, since they are likely just a product of hospital based birthing culture.
Some people want the hospital setting because they want the epidural and feel this is safer for them, but is it really that much safer, and what if you have a C-section and have physical issues later on? A study in 2012 showed that 53,000 births in the USA were done outside the hospital with 35,000 taking place in peoples homes. Statistically, Alaska had the most out of hospital births %6. The rate of perinatal death for in hospital births is 1.8 per thousand while for out of hospital births, it was 3.9 percent, roughly twice the amount, however, when we consider these rates are per thousand births, it is really .002 percent vs .004 percent which shows a high level of safety either way.
The birthing method you choose may influence how you decide to have your children. The Bradley Method teaches you how to choose your doctor and what is and is not necessary and also prepares you for a home birth is you so desire. When our first child was due, we took a Bradley class which helped us find a great doctor. Most people we met who took Lamaze were told what to expect procedure wise and since they were taught by hospitals, the hospital based birthing culture was emphasized.
Our children were born without any interventions except for an epidural, and an episiotomy was not done because the doctor simply did not believe in doing them. The children were both born without any problems or complications. Our satisfaction with our hospital based experience had more to do with Dr. Grabel, Beths OB than the hospital.
Could we have done this at home? Probably, but it was not within our comfort zone.
On the other hand, the data suggests that more natural births done at home are safe, when you have a hospital as a backup just in case. For some of you considering a home birth, this is the way it was done for centuries, and the process was originally designed to not require doctors, but some help is always welcome, weather you desire a midwife or medical assist.
Read more about this fascinating article in the NY Times
How to Make Home Birth a Safer Option
Aaron E. Carroll THE NEW HEALTH CARE JAN. 25, 2016
Many medical students are taught this adage: “œWhen you hear hoofbeats, think of horses, not zebras.” It means that we, as physicians, need to remember that common things are common, and that we shouldn”™t immediately focus on the rare or esoteric.
As a pediatrician, for instance, I have to constantly remind myself that the vast, vast majority of children are healthy. Just because I encounter mostly sick children in the clinic doesn”™t mean otherwise. I see a skewed population.
Recently, a new study comparing the safety of home or birth-center deliveries with hospital deliveries led to headlines proclaiming that babies not born in hospitals were significantly more likely to die. I have no trouble believing that”™s the case.
That”™s the zebra, though.