In this series we’re going to explore natural childbirth (home birth) as an alternative to industrialized childbirth. Industrialized childbirth could also be called “disturbed birth”, which Australian family physician Sarah J. Buckley, MD defines as follows:
Anything that disturbs a laboring woman’s sense of safety and privacy will disrupt the birth process. This definition covers most of modern obstetrics, which has created an entire industry around the observation and monitoring of pregnant and birthing women. Some of the techniques used are painful or uncomfortable, most involve some some transgression of bodily or social boundaries, and almost all techniques are performed by people who are essentially strangers to the woman herself. All of these factors are as disruptive to pregnant and birthing women as they would be to any other laboring mammal – with whom we share the majority of our hormonal orchestration in labor and birth.1
Buckley embraces an evolutionary perspective on pregnancy and childbirth. Such a perspective affirms the natural process of gestation and birth and recognizes a woman’s genetically inherited capacity to give birth without medical intervention.
In the same way that we evolved to eat a species-appropriate diet (i.e. paleo), we evolved to give birth in an undisturbed environment.
This innate system of birth has been refined over 100,000 generations. It involves a complex, finely tuned orchestration of hormones that prepare both the mother and baby for a successful birth and catalyze profound neurological changes that promote the bond between a mother and her new baby.
And just as we experience health problems when we stray from the evolutionary dietary template, women are more likely to experience complications and difficulty in labor when they stray from the evolutionary template of “undisturbed birth”.
Natural childbirth is in our genes
Throughout the vast majority of human history, women have always given birth in a familiar place, with family members or other trusted companions.
Even now, babies are still born at home in most places around the world. And although the move from birth at home to the hospital began in the 18th century, home birth was the norm even in westernized countries until the 1950s.
Think of it this way: humans have been giving birth at home for 999,998 generations, and it’s only in the last 2 generations that hospital birth has become common.
This means that women have given birth at home for 99.998% of human history.
Yet in the U.S. today, fewer than 1 percent of births happen in the home. This abrupt and almost complete transition from natural childbirth toward industrialized childbirth has had profound repercussions on mothers, babies and the culture at large.
My wife Elanne and I have chosen to have a home birth with our first child (who is, as of this writing, due in about 2 weeks!) It has been fascinating to watch people’s reactions – outside of our close friends, who have almost all had home births – when we tell them this.
Some come right out and say “that’s brave!” Others are more suspect, using words like “interesting” or maybe even wondering out loud if it wouldn’t be a better idea to use a hospital midwife. Still others are more direct in their opposition to our choice.
This is evidence that the medical establishment has done a fantastic job convincing people that hospital birth is “normal”, in spite of the fact that home birth has been the default choice for 99.998% of human history.
Doctors and the medial have also managed to convince most people that hospital birth is safer than home birth. But is that really true?
Another myth bites the dust: hospital birth is not safer than home birth
In the Netherlands, where 1/3 of babies born at home under care of midwife, outcomes for first babies are equivalent to those of babies born to low-risk women in the hospital, and outcomes of second or subsequent babies are even better.
A UK analysis found that birth at home or in small family practice units is safer than birth in an obstetric hospital for mothers and babies in all categories of risk.
Other studies have shown that modern obstetric interventions have made birth more dangerous, not safer.
In fact, in terms of outcomes for mothers & babies, studies show that planned home birth has perinatal mortality levels (the numbers of babies dying around the time of birth) at least as good as – and often better than – hospital figures, with lower rates of complications and interventions.
A landmark study by Johnson and Daviss in 2005 examined over 5,000 U.S. and Canadian women intending to deliver at home under midwife. They found equivalent perinatal mortality to hospital birth, but with rates of intervention that were up to ten times lower, compared with low-risk women birthing in a hospital. The rates of induction, IV drip, episiotomy, and forceps were each less than 10% at home, and only 3.7% of women required a cesarean (c-section).
Other studies have shown that women who plan home birth have around a 70-80% chance of giving birth without intervention. And because of low use of drugs, home-born babies are more alert and in better condition than those born in the hospital.
Contrast this with the 2002 and 2006 Listening to Mothers surveys which examined 3,000 births in conventional settings. They found “virtually no natural childbirth” in either survey.
In the 2006 survey, around 50% of women were artificially induced; almost 75% had an epidural; and 33% gave birth by c-section.
Finally, in a review of the safety of home birth by the esteemed Cochrane collaboration, the study author states:
There is no strong evidence to favour either home or hospital birth for selected low-risk pregnant women. In countries where it is possible to establish a home birth service backed up by a modern hospital system, all low-risk women should be offered the possibility of considering a planned home birth…
I agree with the author’s conclusion that hospital birth is no safer than home birth. But if you consider the statistics above which suggest that having a natural, undisturbed birth in a hospital setting is exceedingly difficult, I would argue that there is strong evidence to favor a home birth.
Birth complications are more likely to occur in a hospital environment
A common defense of hospital birth by medical professionals and laypeople is the assertion that it’s necessary to be in a hospital during birth in case something goes wrong.
While it is certainly true that complications may arise during labor that require medical intervention, what is often ignored by proponents of hospital birth is the fact that such complications are more likely to occur in the hospital environment.
In other words, the distortion of the process of birth – what Buckley calls “disturbed birth” – has come to be what women expect when they have a baby and in a way has become a self-fulfilling prophecy.
As Buckley states:
Under this model women are almost certain to need the interventions that the medical model provides, and to come away grateful to be saved no matter how difficult or traumatic their experience.2
TV shows almost always depict birth as some kind of medical emergency, with the woman being rushed down the hallway on a gurney or connected to machines and wires in the delivery room surrounded by medical personnel. Since most people have never witnessed a home birth (or any other birth) before giving having a child themselves, their impression of what labor is like comes almost entirely from television.
It’s easy, then, to understand why people are afraid of birth and feel the need to be in a hospital setting in case something goes wrong. But that doesn’t mean giving birth in a hospital is safer. The studies I’ve presented in this article demonstrate that it’s not.
I want to be clear: no matter where birth takes place, complications may arise that require medical intervention and I am 100% in support of it in these cases.
When the mother or baby’s life is at risk, we are fortunate to have access to surgical techniques that can save lives or prevent serious complications.
The point I am making in this article, and will make in more detail in the articles to follow, is that the scale of medical intervention in birth today is not only far beyond what is necessary, but is contributing to the very of the problems it attempts to solve.
If you’re interested in learning more about natural childbirth, I highly recommend Buckley’s book Gentle Birth, Gentle Mothering. I’d also suggest checking out her free eBook called Ecstatic Birth and her eBook/audio package Giving Birth At Home.
Note: this series will very likely be interrupted by the home birth of my own child. Elanne is due on the 17th of July, so the baby could be coming anytime. When that happens, I’ll be taking some time off to spend time with my new family. I’ll pick this up again when I return from paternity leave.
- Buckley, Sarah J. Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices. Celestial Arts, 2009. pp. 96 ↩
- Buckley, Sarah J. Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices. Celestial Arts, 2009. pp. 96 ↩
{ 130 comments… read them below or add one }
Thanks for the article – I hope all goes well! Congratulations!
I’m keeep 90% paleo and do believe in the basic philosophy behind it but this is just ridiculous. Most people in the world have natural birth most people in the world, in 3 world countries do not have access to hospitals. Are you seriously trying to say that they do it by choice??? what kind of dumb thing to say is that??
“I want to be clear: no matter where birth takes place, complications may arise that require medical intervention and I am 100% in support of it in these cases.”
DUH!!!!!!!!!!!!!!!!!!!!!! well wouldn’t it be nice to do it in a hospital where you do have access…JEEZ…no wonder paleo has a tough time catching on, because of dumb things like this!!
You can argue that you shouldn’t use drugs but what is the advantage of not being in a hospital? there is always a risk…when my baby was born his umbilical cord was wrapped around his throat thank god we had a doctor…
I guess you didn’t read the article. I listed several advantages of not being in a hospital, including fewer complications, lower rates of induction, lower rates of forceps use and c-section. In the articles to follow, I’ll be explaining several other advantages in great detail. You are clearly misinformed, and haven’t provided any evidence to support your objections. You’re just spouting off conventional wisdom, with nothing to back it up.
And, in the Netherlands, where people do have access to modern medical care, 33% still choose home birth and perinatal mortality rates there are as low or lower than low-risk births in hospitals.
A nuchal cord (the umbilical cord wrapped around the baby’s neck) doesn’t necessitate medical intervention, except in extreme cases. A nuchal cord occurs in 20 to 30 percent of births, and is usually easily loosened, or the baby can be “somersaulted” through, as described by Mercer et al.. Cutting a nuchal cord removes the baby’s blood and oxygen supply, which can have devastating effects (such as cerebral palsy) if the baby’s first breath is delayed by shoulder dystocia or other birth difficulties.
Chris, I’m going to stand in defense of this woman because I too am really grateful that when we needed an OB there was one. I lost 4 pregnancies before having my son and lost 1 following him. You can say all day long that the natural way is the best way on whatever topic it applies but there is always an exception. You can’t tell a woman who’s baby was at risk that her’s shouldn’t have been intervened. My son was frank breech, two common problems with frank breech first babies are the cervix closing down on the neck and hip dysplasia. You would probably say, I shouldn’t have gotten a c-section because this is only a problem with X percentage of frank breech births. I would disagree that for me, if I can avoid that risk by having a c-section, its a no brainer. Especially after 4 miscarriages. Some of us are quite grateful that someone intervened and made sure that our baby was born safely.
I think what a lot of people forget about our homebirth only past is that a LOT of women died before their time due to childbirth. It was the most common cause of death historically for women. I wish I could remember where I read it but there is a blog regarding a 3rd world county with limited hospital access and the women there with the use of lay midwives will sometimes labor for days at home because the hospitals are so far and hard to access. They often lose their first babies and develop bladder and rectal incontinence. They leak waste all over their legs and become outcasts of their society. OBVIOUSLY, this is not happening in the US…..thank goodness, we’ve come further than that in our society. This is though what can happen when things are left to nature.
So please don’t patronize her by giving her a statistic. She had good reason for her response, maybe she didn’t go about it the best. Ok. I’m done.
FWIW, I really feel that if I had attempted a homebirth I would have risked my life. I have a clotting condition related to pregnancy (antiphospholipid antibody syndrome), which is why I lost so many babies in my past. I also had an abnormal septate uterus which required surgery to correct and likely had a part in my son’s breech position.
I have friends who are fans of homebirths and have had very successful ones, I think thats great. I wanted one too once upon a time. Then I had all this trouble. I would offer a friendly reminder to the ones who are big homebirth fans to not be insensitive to the ones who cannot. If I were a woman of the 1800s, I would be a barren woman. Possibly considered a witch because of all my losses.
I don’t imagine anyone would question your decision not to homebirth!! You are exactly the type of woman that the hospital system is there to serve.
The one thing that everyone keeps talking about is the women of 1800 and earlier. Most people think that just because Doctors were slowly beginning to be in the childbearing realm, is that these doctors saved the women and babies. Not so, you can easily read the history and see that once women started going into “laying in hospitals” for the births or Doctors came to your home. The women died by the 1000′s very easily under the physican’s care.
Why were things so bad then…. the germ theory just started to be thought of, many physicans did not wash their hands or aprons from patient to patient. They in fact were killing these mom’s and babies and it was easy for these infections to go from woman, to woman and affected the baby’s. As the advent of science came about to test for certain diseases and conditions, the”odds” at coming through birth alive got better.
The true fact that has been shown in thousands of studies is: home births are as safe if not safer than a hospital for a woman who is lower risk. Hosptials are there for a reason, and can often save the lives of women and babies who would not have made it through their process a hundred or more years ago. To the woman who had the clotting problem, this would have been found in normal bloodwork and then followed up to see the extent of the clotting problem, so you would not have been acceptable for a home birth anyway. I too have a clotting problem but I went on to have my children at home with no problem because it was dealt with. I have deal with other women with these problems also. I’m glad women who want to have their babies in the hospital can, and those of us want a out of hospital birth center or a home birth can also have that option. I am a Midwife of 32 yrs and have attended several thousands of babies. never lost a mother or baby to date. I do not attend births in the hospital because I do not choose to do so. By the way I lost 10 babies because of my clotting problem that was not picked up by the doctors. Once I found out because a Midwife ordered the right testing, I was treated.
Midwives know how to take care of a nuchal cord ( cord around the neck), such as described by MERCER et al. Nuchal cord is quite common and rarely does it need to be cut prematurely.
I think you can voice your opinion without being so rude. It’s a sign of maturity to show respect for the author of this post – whether you agree or not.
Having the cord wrapped around the neck is a very common thing (approximately 1/3 of babies are born this way). It is almost never a danger to the baby. I caught one baby unexpectedly in a very non-traditional setting (very fast labor and second stage) in the caul with the cord wrapped and a hand presenting with the head. In a hospital this scenario would have been considered an emergency. Yes, we were lucky. But this scenario is just a variation of normal birth, not an anomaly, and doctors are just too narrow minded to see it that way.
Great article, can’t wait to see the rest! And best of luck on your child’s birth!
My first baby was born at home, with his cord around his neck. My midwife moved it. My second baby was born at home and I suffered a hemorrhage afterwards due to retained placenta. My midwife fixed that too. I am utterly convinced that I would have been worse off in a hospital, both times, due to the prevalence of unnecessary interventions as well as the lack of control of the atmosphere in which to give birth.
My second daughter was born unassisted (accidentally… it was REALLY fast) at home with a nuchal cord and I had to somersault her through. I didn’t even have to think about it. My husband was just standing there in complete shock
Great work, Mama! If this ever happened to me I would hope my “instincts” would kick in, too! (and I would assume my husband would faint).
A midwife can unwrap a cord too. And the midwife is there throughout labor, not just for the last few minutes like the doctor, and will know early on if something is not going well. They are so much more in tune with the mother and baby. The stress of being in a hospital (read about the hormonal response of any animal in labor when a stranger approaches…how many times does that happen in the hospital? Try every couple of minutes), the body position during labor (in a bed, mobility limited by monitors, so labor slows, the pelvis can’t fully open, etc.) contribute to all the complications that the hospital then needs to fix. Take away the hospital, and you take away a lot of the complications of labor and birth.
About 1/4 of all babies are born with their cords around their necks, but as long as the cord is not clamped they are fine. My second homebirthed child had a cord around her neck, and the midwives unwrapped her. No emergency, just action. There are many advantages to being at home. The germs in one’s home are one’s own, meaning a laboring mother already has immunities and antibodies to the germs/bacteria in her space. In the hospital setting there are many contagious bacteria that the mother is not immune to, increasing her and the babies chances of Post Partum infection. The chances for episiotomy or cesarean section in the hospital are far greater than at home, in most studies homebirth transfer patients had a 5-10% csection rate vs a33% and up rate for moms choosing to deliver in the hospital setting. Up to 30% of women recieve genital cutting, i.e. episiotomy in the hospital, with individual doctors rates going as high as 100%. There is no medical reason to do this. Tears heal better, but evidence based care is not generally practiced in American obstetrics. Women who feel safer at home should deliver at home. Those who want the hospiatl can have it.
you don’t need a doctor to unwrap the umbilical cord. That’s a thing that happens all the time and I saw many midwifes unwrapping it and everything was fine! (by the way I’m a midwife student working in a hospital and I’ve seen MANY things I wish I had never seen. It makes me ANGRY what doctors do with laboring women in hospitals…and the women are just thankful and don’t realise how DIFFERENT it could be!
It’s ur own choice, but after what I saw the hospital is the last place I want to give birth to my child (it’s just good for emergencies)!
or just watch this:
http://www.youtube.com/watch?v=qbai-yBRyHg
It’s also telling that OB/GYN insurance is the most expensive to obtain and maintain, due to the high legal risks. This will undoubtedly affect practice style. When your goal is to produce an alive baby, the mother’s wishes and opinions can suddenly seem beside the point.
I feel very fortunate to have a hospital locally that encourages natural birth, provides access to water births, provides doulas free of charge, but also has the ability to perform interventions when needed.
I encourage all potential mothers to do their homework, and your primer here, Chris, seems like a good complement. And to contrast the popular imagery of childbirth, as you mentioned, I highly suggest reading examples of mothers giving birth in natural ways and settings. Ina May Gaskin’s books, while a bit giggle-inducing due to the hippie language, are also full of birth stories that gave me confidence I could have an undisturbed birth. And I did.
Thank you for contributing to the wealth of information out there about birthing without interventions.
“I feel very fortunate to have a hospital locally that encourages natural birth, provides access to water births, provides doulas free of charge, but also has the ability to perform interventions when needed.”
I wish more hospitals would be like this: combining the natural with the medical (when it is needed).
Dear noon,
I’m a glad that you have a healthy child and were satisfied with your hospital birth. Your reason for thanking God that you were in the hospital though, the cord around the neck, is one of the biggest birth myths out there. Babies are born with cords around their necks often. Midwives are just as skilled, perhaps more skilled, at dealing with this as doctors. Often the cord around the neck is not a danger at all as the oxygen supply is still coming to the baby through the cord and baby does not yet need to breathe through the nose, trachea etc. My niece was born at home with only my brother and her two grandmothers in attendance. The cord was wrapped around her neck and it was very simple to unwrap it and watch that little one begin to breath easily on her own. No problem.
Women are told in the hospital that the reason their baby is having troubles is that the cord was wrapped around the neck. This is just not seen in home births. Babies in hospitals have troubles breathing because they are doped up on the epidural drugs and pitocin.
As for women in many countries around the world not having home birth by choice, this is true. Sadly and to their detriment much of the rest of the world is eager to follow in our “advanced” footsteps. And it is also true that in many non-industrialized countries perinatal mortality rates are much higher. This is likely due to malnutrition and poor health. We know that how a woman is nourished through her pregnancy has a great effect on how she will give birth, her own health and the health of her baby. Weston A Price and others who studied traditional peoples eating their traditional diets noted how easily mothers give birth, often simply wandering off by themselves and returning hours later with a healthy baby. For much of the non-western world people are no longer able to eat their traditional diets and are in very poor health.
There is a lovely African saying, ““The goat has no midwife but delivers with ease, the sheep has no midwife yet brings forth a live offspring, and you, little mother, will give birth to your baby.” To me this indicates a true understanding of how birth can be.
oh my, I love the African saying so much. Thanks for sharing that.
“Often the cord around the neck is not a danger at all as the oxygen supply is still coming to the baby through the cord and baby does not yet need to breathe through the nose, trachea etc.”
If anyone has ever studied the unadultered birth process, they’d know that babies get their oxyegn from the umbilical cord until from 10-30 minutes or so after birth, when the cord starts pulsing, and the baby learns to breathe on it’s own. Cutting the cord in a nuchal cord birth, would actually deprive the baby, still half way in the mothers womb, of the oxygen. Usually the cord is cut with only thehead out, and the baby;s chest is still inside the mother – leaving no room for the chest to expand for breathing. This, in turn, causes the baby to have oxygen deprivation, which the doctors then blame on the nuchal cord, when in fact, the doctor’s themselves caused the oxygen deprivation. The cord was still supplying the baby’s needs.
Now, that being said, it’s not a good idea to leave the cord wrapped around the neck of the baby and continute pushing! Doing so would leave the mother at risk of the placenta being ripped from the womb, rather than detaching naturally.
Expertise – I’ve birthed 3 babies in a hospital setting with the cascade of interventions, 1 peaceful birth in a hospital setting where we refused to allow un-necessary interventions, and my husband and I are currently preparing for an unassisted homebirth of our 5th child, to be attended by our doula. Not being able to afford insurance can change your mind about what is acceptable and what is not.
I had all my kids naturally and 2 of them at home. I’m having my fourth in December, as a child I presenced many births at home and helped once or twice. I had the chance to go to Holland where almost 80 % of birth are at home. Women need a private, quiet setting, with minimum interruptions. Congratulations! your wife will do wonderful! great article!
I had a homebirth 3 years ago, and it was the best choice I ever made. I have a huge fear of hospitals and allopathic doctors, so I would surely have had a stalled labor, just because of fight or flight hormones pouring out of me in such a frightening setting. But I also had a 63 hour labor, with my water breaking 2 days before delivery. No U.S. hospital would tolerate laboring for more than 4-6 hours, especially after the water breaking (despite the fact that it is natural for women to labor longer, especially on a first birth), and I would have surely been induced and very possibly c-sectioned unnecessarily, at grave risk and cost to me and my family.
At home, on the other hand, I was allowed to labor in the peace and comfort of my home, bathe, walk, and eat as I pleased, and finally give birth to a beautiful baby girl that really needed NO medical intervention to come into the world happy and healthy. In fact, my husband and I labored alone for all but the last few hours of it, truly owning what should be a transformative, if not spiritual, process for families. I was also able to rest and breastfeed in my own bed, within just a few minutes of delivery, while the cord was still attached and giving up its last pulses of blood and oxygen to my child. There is no way to describe this experience, it still makes me cry in joy to think about it.
I cannot say enough good things about home birth for low-risk women.
Hi Elanne and Chris!
Congratulations with the soon delivery; I was born at home myself (20 years ago), and thought for many years that it was the normal procedure. My friends were always stunned when I told them I was born in my parents’ bedroom.
Birth was quick and completely free on complications. There was a midwife present (oh, and the rest of my family; my siblings at age 4, 6 and 8 years – they thought it was VERY exciting).
I believe it’s much easier for the woman to relax in familiar surroundings; not that I really know, but it would seem natural to me.
I believe you’ve made a wonderful choice, and I hope the birth of your son/daughter will be (relatively) smooth.
Oh, and my baby was born with the cord was wrapped around her neck, twice. My midwife didn’t even flinch, just calmly removed it, and my baby was fine.
Hi Chris, great article.
Its so interesting to see the venom spewed at people that are proponents of natural birth or choosing to homebirth, as exhibited by Noon. She attacks your personal opinion on this subject and then holds you accountable for her observation about how popular the Paleo diet. It is sad to say that this behavior is very common. The fear that people now associate with birth, and seeing it as a medical condition instead of a natural part of life, goes to show how well the medical community has been able to manipulate people around this subject. In a situation like this one where “noon” felt it was appropriate to insult you directly and call you and your decision stupid, it is clear that no amount of information can educate a person on this topic. In my case some of my family members were so opposed to homebirth that we outright lied to them and told them our baby was born in a hospital. It is then ironic to me that all of my births have been fast and problem free while ALL of my relatives who have birthed in the hospital have ended up with major intervention, complications from the interventions, and about 50 percent of them have had c-sections (because the doctor felt that 12 hours was too long to birth.)
I too had my first baby at home with an incredibly experienced midwife. the birth was smooth and amazing, if not also really painful
I applaud and support your decision to birth at home, I wish that more of the west would engage in real conversation and thought that might help us return to a place where our children enter this life in a gentle, natural way. The subtle processes of human birth have been evolving for 100s of 1000s of years. The hospital births I have attended appear to me like the medical staff is constantly picking at a scab and then getting mad when it wont heal.
Blessing on the birth of your child!
Yes, we’ve been giving birth “naturally” for millenia. Infant mortality rates were also stupidly high for most of that time. This is often cited as one of the main reasons that paleolithic life expectancy is so low, even when humans making it past adolescence had a pretty decent chance of living into old age.
Here’s the thing with home birth: Even *if* there are more complications at a hospital, they’re better-equipped to deal with the unknowns that can arise.
Eliminating “distractions”, “disturbances” and “interruptions” isn’t as important as giving your child every possible chance to make it past their first 48 hours. Whether the experience is “peaceful” or “traumatic” or somewhere in-between doesn’t matter. What matters is that you leave the hospital with a healthy baby. That’s all.
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“There is no strong evidence to favour either home or hospital birth for selected low-risk pregnant women…”
—————————————-
Home birth is perfectly-safe… if you’re low-risk for things they can easily deal with in a hospital. The problem is, most people don’t know whether they’re low-risk or not.
While I don’t trust the medical industry (and it IS an industry) to prevent sickness/maintain health, they have the tools and knowledge to deal with emergencies as they arise. The odds are, you’ll never need those tools/experience. If you did, though, could you really say you wouldn’t rather have them and not need them than need them and not have them?
Related post:
http://blog.dreamhost.com/2011/03/09/wren-jones/
Here’s the thing with home birth: Even *if* there are more complications at a hospital, they’re better-equipped to deal with the unknowns that can arise.
So what? If there is a serious complication, you transfer to the hospital. Problem solved. That’s not a reason to invite more complications by giving birth in a hospital environment to begin with.
Eliminating “distractions”, “disturbances” and “interruptions” isn’t as important as giving your child every possible chance to make it past their first 48 hours.
We’re not talking about touchy-feely “distractions” or “disturbances”. We’re talking about real consequences – some of which I already pointed out in this article, and others which I’ll be covering in detail in the articles to follow. They include: interfering with the delicate hormonal interplay between mother and baby (which has real and measurable long-term effects), increased risk of maternal death (even among healthy mothers) and a traumatic birth experience.
I agree completely that it’s most important to give a child every possible chance to make it past their first 48 hours. I linked to several large studies demonstrating that perinatal mortality rates are equal for home and hospital births for first births, and actually lower for home births for the second and subsequent children. So I’m not sure what your point is here. Having a hospital birth does not increase the chances that your baby will survive the first 48 hours.
Since I don’t have time to read through all of the articles posted (and several are subscription-only, so I could just see abstracts), I’ll just ask:
The studies you refer to that show hospital births to have higher PNMR’s… How do they count situations where (for example), a home birth is planned, but the child/mother end up going to the hospital? That is, if there’s an issue with a home birth, I would imagine most of the time, the child would get taken to the hospital before it dies, in an attempt to save it. Is that being counted toward the hospital’s PNMR, or the home birth?
When you say “distraction”, I don’t know what way it could be defined other than the “touchy-feely” sense. Is it a medical term I don’t know about?
As for transferring to a hospital, sometimes you don’t know there’s a complication until it’s too late (like in the link I posted originally). What, then? Fault of an unskilled midwife?
It varies from study to study. The situation you refer to is called a transfer and it is often taken into account. But keep in mind with a home birth rate of 1% in the US, transfers as an overall percentage of hospital births are extremely low. Most of the studies on home birth in the developed world have taken place in the UK and the Netherlands, where home birth rates are much higher (>30% in the Netherlands).
I explained the negative consequences of home births (above and beyond “distraction”) in my previous reply to you.
Yes, babies do die in childbirth. If you think that doesn’t happen in the hospital you’re kidding yourself. As I’ve pointed out repeatedly, the PNMRs are the same in hospital and home births.
So I’ll jump in with a little perspective. I am a licensed homebirth midwife. I have personally had three home births. I have worked in the hospital as an employee and attended about 40 births as a labor doula. Home birth midwives monitor mother’s vitals and baby’s heartrate, amongst many other responsibilities. We protect the laboring mother’s space and bodily integrity so she can labor without disturbance and develop effective coping techniques. We are trained in resuscitation and management of hemorrhage. We can accomplish a transport to hospital, in most cases, in less time than a community hospital can call in an OB, CRNA, and Ped for a c-section for an on-site labor. (Please realize that almost no community hospital has the on-site staff for continuous on-site surgical staff for cesarean surgery. Does this mean these hospitals are unsafe for laboring women?) If my client lives farther from the hospital than 20 minutes, we discuss conservative decisions. When I have to transport, I always call ahead and give the hospital staff as much notice and information as possible.
The biggest issue with the hostile atmosphere that divides home and hospital birth is the fact that hostile receptions lead to delayed transports and worse outcomes. Homebirths, even unattended births, will continue no matter the vitriol of critics. Many, many of us believe that we can have the best of safety and normal, undisturbed birth with midwives as primary care providers. I participate in the US’ largest homebirth prospective (as opposed to retrospective) research study, conducted by the Midwives Alliance of North America, which does account for every client that begins care with a midwife and tracks her story… healthy home birth, transfer to an OB for prenatal complications, or labor/ postpartum transport for medical care.
About “distractions” and “touchy feely”: It takes a lot of effort for a laboring mother to maintain effective coping when hospital procedures mandate frequent EFM fiddling because “it just isn’t picking up well when you are in that position”. I have had many clients who were also veterinarians… and commented that no mammal would be able to give birth without surgery in the conditions of a hospital LDR room. The hormones just don’t work.
And finally, a loop of cord around baby’s neck is extremely common! It’s one of the safest places for the cord to be… it is protected and MUCH less likely to be compressed in the course of labor and can be easily unwound after the birth.
Do you think that hospitals should allow natural births AT the hospital (making it as comfortable to the mother as possible) and that doctors should only intervene when serious complications occur? Transferring to a hospital might take far too long and be hazardous to the mother and child.
The related post tells a tragic story that doesn’t support the argument against home birth because that mother should have been informed of the risks, and advised to deliver in hospital. Being positive for strep B makes you high risk. If the obs/gyn had forgotten to order antibiotics before or during the labor as he or she forgot to inform the parents of the significance of the positive strep B result, the outcome would have been the same. Babies die in hospital the same way from the same thing when staff miss the dx. There’s no time for an emergency because no one knows anything is wrong until it’s too late.
In hospital, healthy, low risk women are routinely induced. Under the influence of the drugs used for induction of labor, there is no time for the mother’s levels of endorphins to rise to the occasion. Labor is more painful, and epidurals are usual. Labor can stall after an epidural, and intervention becomes necessary. Intervention HAS resulted in injury to and deaths of too many babies.
Unfortunately, hospital isn’t a place where a woman is permitted to deliver in peace and safety with the security of professional health care just outside the door in case she needs it. In hospital, delivery is often pathologized and the medicos can take over, just because they can.
For low risk women and their babies, the risks of unnecessary intervention in hospital are real.
The negative effects of trauma from a bad birth are real, too. What you dismiss as touchy feely disturbance can contribute to post-partum depression. As post-patum depression is rife, and suicide seems to be the greatest cause of perinatal maternal mortality, you’d think more attention would be paid to whether the mother’s experience was peaceful or traumatic.
Ricki Lake the maker of the film The Business of Being Born lays out very clearly why undisturbed birth is important for the health and future health of of our children and our relationships with them. http://www.huffingtonpost.com/ricki-lake/mothers-deserve-options_b_884900.html
I want a home birth because I want a healthy child. One who didn’t receive drugs during birth and one who’s hormonal and neurological template are set and attuned to mine because our communication during the birth process was allowed unimpeded. A very complex cocktail of hormones are released during birth that help the birth process along. Disturbances, as any person who has worked with animals will tell you, interrupt the proper release of those hormones and the proper functioning of neurological processes. Animals interrupted in birth will halt the birth process or have difficult births. Many times they won’t bond well with their offspring after this happens.
Those hormones that get released in undisturbed birth are there to facilitate not only the birth but the process of bonding and breastfeeding after the birth, both crucial to the physical and emotional health of a child and a mother.
Proponents of industrialized birth are often thinking of health in extremely limited terms. As is true of industrialized medicine as a whole.
“Whether the experience is “peaceful” or “traumatic” or somewhere in-between doesn’t matter. What matters is that you leave the hospital with a healthy baby. That’s all. ”
Very well spoken by a MAN who has never birthed a baby. A traumatic birth affects mother AND baby in ways that sometimes don’t show up until weks after birth. With each of my “intervened” births, I had severe depression. With my 4th, I had a natural delivery, refusing doctor’s help, because it wasn’t needed (in the hospital), and I had not one bit of the “baby blues” – AND – my other children weren’t affected by it, and neither was my husband. The birth was a joy and a blessing. Our next will, Lord willing, be born at home, in December.
There is no need to bring up gender/sex when trying to prove your argument. You certainly can’t do the same thing when talking to a woman who has given birth, too. Some women have had good experiences with hospital births, so keep that in mind.
In general I have no argument, though I did think it was somewhat misleading of you to quote the Cochrane review the way you did. You implied that the review was saying that, despite a body of evidence that is large enough to draw conclusions from, the evidence does not lean strongly either way. What it was actually saying was that the authors did not find enough solid evidence (they included only a single study of 11 subjects) to make any conclusion. Big difference.
On the other hand, what do you think of this recent meta-analysis that found that, while perinatal mortality is comparable in either situation, neonatal mortality seemed to be three times higher? http://www.ncbi.nlm.nih.gov/pubmed/20598284
It is a meta-analysis, but it seems worth considering.
The Wax meta-analysis has been pretty well torn apart as poorly done research. It doesn’t really tell us anything, except that ACOG is bothered enough by the growing popularity of homebirth to print and support weak research if the outcome is in their favor. And clearly it worked because headlines everywhere said that homebirth has 3xs the neonatal deaths of hospital births. It doesn’t matter if it’s not true because it’s made the headlines and people remember it.
For critiques of Wax’s study see here: http://www.scribd.com/doc/34065092/Critique-of-a-meta-analysis-by-Wax
and here: http://www.scienceandsensibility.org/?p=1349
So it would seem! Good to know.
Plenty ‘o critiques of the faulty Wax analysis available on the web.
I totally agree that having a baby in a comfortable/safe/home environment is best – I’m also glad that we have a hospital 3 minutes away in case something happens. My 1st son was born in a hospital and with pneumothorax in both his lungs. Without medical intervention he would have died.
Still, we didn’t know he was sick until 6 minutes after he was born. I had a horrible experience with my doctor and nurses. Nobody said “good job” “keep going” “you’re doing great” … My doctor told me to shut up! And I wasn’t even screaming. My husband never got to cut the cord and my dr never held up my baby for me to see. I understand soon after they discovered he was sick and I COULDN’T see him. But before those 6 minutes? Why? I was pushing out my son and was reminding the dr between pushes, “make sure Mike cuts the cord.” …. nobody listened to me. I really felt like a nobody.
I felt like I was a slab of meat on a convener belt. There were no personal connections, no calmness…it was very sterile. I hated giving birth in the hospital. It took me over 5 months to recover from the episiotomy.
If I wasn’t so afraid about what may happen with my next child, I would consider giving birth at home. I’m about 50/50 at this point. I can tell you my insurance would not cover anything that may happen to my child if it were born at home. That’s another consideration – the “system” basically forces you to the hospital because god-forbid something happens. who has $100,000 cash to pay for medical expenses in case the newborn needs medical care? Our bills for our 1st were around $80,000 – glad our insurance payed for it all …. just because we were in the hospital to begin with.
It’s all about the money now…and not about the woman or her comfort or her baby. So disappointing. Interestingly, about 80% of my friends had c-sections… why? I think they are so quick to do those. And that’s a whole other post…lol.
I’m so sorry you went through all that! Try hiring a doula to advocate for you and be your support – and go with a midwive’s practice, if you can. And interview them thoroughly – some of them are ‘med’wives and aren’t all that great.
Best of luck!!
Great advice! I had a doula and a midwife from a supportive practice and I had an amazing hospital birth….but only because I knew what to expect from medical protocol and didn’t let it interfere with my positive thinking. I also used relaxation techniques learned through Hypnobabies…which allowed me to drown out the unwanted distractions.
I hope you’ll consider looking into hiring a doula…and I hope you have nurse-midwives in your area! They usually practice under a physician so insurance isn’t an issue…
Thanks for your article. I just want to point out that “people” don’t give birth, women do. Women do not need any more blame or shame thrown at them for decisions involving child birth but I do appreciate how you laid out the options of home birth and hospital birth. Spreading knowledge and information is the foundation for empowerment. It is an extremely personal decision to have a child and a decision made considering numerous contextual factors. For example, having a midwife can often be a privilege for those in a stable financial position. The topics of pregnancy and childbirth need to be discussed with compassion and understanding, perhaps even gratitude.
Two months ago, I gave birth to our seventh child in the grass beside the highway under cover of darkness. This wasn’t Plan A, of course, but it was my favorite birth by far. I don’t know if any studies have been done on outdoor birthing, but I recommend it.
This was our first non-hospital birth. It’s given us confidence so that maybe next time we’ll try it at home. Maybe in the back yard.
wow! now thats a birth story i want to hear!
Chris,
A premature Congrats and Best wishes for a healthy and happy birth. Eagerly looking forward to an upcoming post where you put the smack down on the barbarous process of injecting science fiction like ingredients into newborn humans, soon after they leave the safety of the mothers womb. (I am of course referring to vaccinations)
Best
Congratulations on your up coming delivery!
My daughter’s dad was adamant that we have our baby in a hospital. I had a terrible feeling that everything would go wrong if we did. I totally hate hospitals and doctors (no offence, of course, you are an unusually awesome doctor). Within the first 5 minutes of entering the doors (maybe 3 minutes) nurses told me they were going to cut the baby out. It was so weird. It was exactly, well actually quite a bit worse, than I had imagined.
I will definitely have my next baby in my home where I am comfortable, with a midwife who cares about me and isn’t off-call when the baby is born.
My first birth was horrible in the hospital. My second two were at home and so lovely. I hope your next birth is wonderful.
Hello,
I am a huge fan. I ordered The Healthy Baby Code and love it and was hoping that you would be discussing this matter in that material as well. I think even more importantly then where you have the baby, is the support you receive while preparing and during the actual birthing. Obviously, at home you have more control over who is there and what they are doing (or not doing). If you plan to futher this topic in future posts, I think covering doulas (I like to think of them as birthing angels) could be helpful to those who, for whatever reason, choose to birth in hospitals. The most important thing I did to prepare for my natural childbirth (that took place in the hospital, no intervention or any kind just raw, beautiful birthing) was surround myself with a community of women who had done the same. For whatever reason, people like to tell pregnant women all the birthing horror stories they know. I found my oasis at Blooma, a wonderful prenatal yoga studio in Minnesota. Every week I would go and the teacher/owner, who was also a doula, would tell us about all the amazings births she had been to since the last class. Then she would teach us how to move through yoga big bellies and all, with lots of tips about what movements she had found helpful at recent births. I always left there feeling very powerful and knowledgable about my body. The birth of my son was one long, intense yoga practice where the ending was the most amazing shavasana with my new freshly born baby lying skin-to-skin with me. On that note, please also cover the importance of skin-to-skin contact with the baby.
Birthing Blessings to you, your wife and your baby!
Hi Rachel,
The last article in the series will cover “third-stage labor” and the importance of skin-to-skin contact after birth.
I had all 3 of my kids at home. I had to laugh when people called me brave because to me the hospital would have been so much more frightening. With my first I had to push for 4 1/2 hours…no way I’d have gotten away with that in a hospital. I’d have been cut one way or the other for sure. That was 23 years ago, my youngest is 14 now. Probably hospitals are even worse nowadays. I think you have the right idea. Go for it. Best wishes to you…
This is a great article, and obviously there are many people who are stuck in believing what the hospitals and OB’s want them to. OB’s are surgeons who are very minimally trained in natural vaginal birth, they would much rather be in and out in 20 minutes vs. waiting and responding to the natural birth process. I love it when people say ‘Im glad we were at the hospital’ when most times the problem arose because of medical interventions which were uneccesary. sad. i had my son at the birth center and my midwife has everything she needs in case of emergency, and takes NO risks. ya, the cord was around his neck, normal really considering how the baby moves through the birth canal. He was born at 42 weeks, with lots of meconium in the amnio fluid. he had no problems, was breathing very strong at birth, and was not ‘too big’ to fit through me. Most people think you have some witch doctor chanting over you as you birth, when actually you have the most qualified in natural childbirth person there making sure everything turns out wonderfully. Midwifes are very relaxed, childbirth is an everyday occurence and really no big deal to them! My midwife never lost a mom or baby(who would have lived) in over 4,000 births. bet there arent any OB’s out there with those kind of numbers!
Baby coming anytime huh?! that’s what I thought! then i found out it’s very normal for 1st babies to go to or past 42 weeks! it’s a guess date, not an actual due date. really are we telling these babies when they are ready???? as we soon find out, everything is on their schedule! best wishes to your family, I’m sure your child birth will be everything you expect it to be and more!
And I think people who birth in the hospital are the ‘brave’ ones! keep me the heck outta there, I hate those places! talk about being uncomfortable and feeling uneasy! whew
I recently heard a podcast with Dr. Art Ayers ( http://livinlavidalowcarb.com/blog/the-llvlc-show-episode-476-dr-art-ayers-and-his-anti-inflammatory-high-fat-low-carb-diet/10925 ) where he discusses gut flora and bacterial infections in hospitals. Patients and babies in hospitals get invasions of Clostridium Difficile (CD) as they spend more time there. If you don’t need to go to the hospital, perhaps it is a good place to avoid.
I hate to play devil’s advocate here, but it seems to me that people choosing home births are more likely to have an interest in health – so it’s no surprise that their births/babies are healthier.
Of course, this doesn’t mean that there’s any benefit to industrial birth, just something to think about.
You are right Kit. As a traditional midwife the families who call me are very health conscious and very connected to their bodies. They eat well, exercise, do yoga, meditate and usually have done lots of research on their own. They are very self-directed in their own well being.
Thank you for posting this. I gave birth for the first time last year. I was determined to have an unmedicated and low intervention birth and spent my pregnancy preparing for that. I chose to give birth in a hospital under midwife care. Never again! I am not sure Whether I would choose a home birth or some kind of birthing center. But I will definitely not do it in a hospital a second time. Even under midwives the monitoring, the bright lights, the shift change right before I started pushing, the monitoring of the baby after birth, being separated from my child for routine procedures like weighing and measuring, I could go on! And then they forced us to stay despite us both being perfectly healthy for 36 hours because of a policy! I was so upset and longed to be in my own bed at home. I am convinced my labor (8 hours start to finish) would have been faster and easier on me had I not gone in to the hospital. I did have a drug free birth – didn’t even have an IV even though the nurses insisted on it because the nurse placed the cath in my hand and completely misses my vein! I was howling in pain not from my labor but from them trying to run saline into my flesh! But i also think it’s important for a woman to birth wherever she feels safe and comfortable even if that is the hospital. Anyway congrats on your upcoming birth!
I also had a hospital birth with a nurse-midwife, however my experience was a positive one. I am not saying you shouldn’t look into home birth, as I am, but you may be able to find a better midwife and hospital. I went to a practice where the midwife attended the whole birth (not just labor) and there were only 2 so I knew one or the other would be there the whole time. Shift-change did not happen. Also, we had low-lights, a tub and I kneeled with a birthing bar while pushing. I spent as little time as possible in the hospital before and after due to the support of a doula.
If possible, look into your options, especially a doula, and learn how to make a hospital or home birth what you want it to be.
I had my youngest two children at home with a midwife and it was an amazing experience both times. I can’t imagine ever choosing to give birth in the hospital again, unless of course there were complications.
And by the way my daughter had the cord wrapped around her neck. It was no big deal- the midwife just unwrapped it.
If you are the mother of a child that died during a home birth you have a totally different opinion. Your child died and society views you as the evil mother who killed her child. It destroys all your family relationships, sometimes it ends in divorce. Family members point fingers and whisper. If you are the “ONE” that this happens to, you have a whole different opinion of the dreaded “hospital”. Statistic speech, only works when it’s not you.
Mothers like me who have lost the child, we don’t usually speak, because we are so consumed with guilt and grief. Ask a mother that’s lost her child what she would do and then act on that.
Joann: I’m so sorry that happened. I can’t imagine anything more difficult to go through.
Unfortunately, babies can and do die in the hospital, so the same rationale could be used to avoid hospital births. The idea that you are 100% protected from bad things happening when having a baby in the hospital is exactly the myth I am debunking in this article.
Joann, I’m sorry for what you went through.
Chris Kresser, I don’t think that any rational person would argue that hospital births are 100% safe. However, the advantage of hospitals is that they can intervene when things go wrong. I wish that more hospitals would allow natural births in their hospitals, only intervening when things go wrong.
however, when a baby is lost in a hospital it is seen as a medical complication and the blame is placed on the doctor who is then protected by the medical community and insurance…when it happens at home, the mother is vilified and, as Joann has experienced, carries the guilt for the rest of her life. I think the point is, society views home birth as irresponsible and dangerous, while the hospital is “safe” and there is so much less guilt when things go wrong!
Joann, I hope you are able to share your experience with other moms….what you said certainly made me think about it from a different perspective!
Joann,
I am so sorry to hear about your loss. I am also a mother who lost a child during a homebirth. Unless you’ve been through it, you just can’t understand it. In my case, none of my family or friends supported my choice to have a homebirth. They all warned of the horrible things that could happen and told me how foolish it was to choose to birth at home. I spouted the statistics and reassured them that everything would be fine.
Family came to the funeral, and offered their concolences, but I knew what they were all thinking. I made the decision. I killed my son. Not one person ever said to me “it could have happened even in the hosipital.” My baby was gone. I was dead inside, overwhelmed with guilt and depression, and had no one to turn to for help because I knew what they all thought.
We also had the awful experience of dealing with the hospital staff when we transported. I was treated horribly. The doctor pulled my placenta out while I was screaming at him to stop, the nurse catheterized me when I told her I didn’t want to. I was in such a state of emotional shock that I didn’t have the willpower to argue. When my husband took a stand for me and tried to make them stop, the doctor called security and threatened to have him thrown out.
At the OB’s insistance, the medical examiner held our son’s body, so they could decide if they had any legal premise to file a wrongful death suit against me. They didn’t, and no legal action was taken against me, but he almost missed his funeral. My midwife had legal action taken against her, even though she had not violated the law in any way.
Imagine the recourse from our family when we became pregnant with our second, and again chose to have a homebirth. If it hadn’t been obvious before, it was now very clear who they all thought held responsible for our first son’s death.
At first, I didn’t want to consider a home birth again. But the more I did consider it and re-researched it, the more I knew that I couldn’t give birth at a hospital. We were the one in a million. Yes, it had gone horribly wrong: our son was lost. But there was no gurantee that he would have been saved at a hospital. Giving birth at home gave us the best chance of having a healthy baby, and that was the only thing that mattered.
Our second son was born healthy and happy at home. So was our daughter. And if we have more children, they will be born at home aswell.
The decision to birth at home isn’t for everyone. It’s immensly important that the woman is comfortable wherever she chooses to birth. If she isn’t comfortable at home, things will not go well there, and the same is true at the hospital.
Joann, you are 100% right about mothers of lost homebirth babies not speaking up. We broke the societal “norm” and ended up losing the thing that is most precious to any mother. But you did not kill your child and anyone who blames you is simply ignorant. Would they still blame you if it had happened in a hospital? Of course not. You made the choice that you felt was best for you and your child. No one should ever blame you for making an informed decision, about your or your child’s healthcare.
Joann and Christina–
I know you have only shared a snapshot of what you have experienced, but I was so moved! If I was an agent, I would make sure your stories were published to help open the eyes of others! I know what I’m saying sounds cheesy, but you have been through the worst-case scenarios of childbirth and had to depend largely on yourself to recover. You’re right, in a hospital, the finger-pointing and guilt would be so different. I want to thank you for helping me think of childbirth from a rarely-heard perspective. Christina and Joann, I hope you’ll reply with some insight for mothers who are thinking about homebirth and may have been swayed by your stories…that includes me!
Christina, you are an amazing woman I imagine, with an equally amazing partner.
We were fortunate to have a wonderful home birth room experience at a local hospital. I would like to think that it may be the best of both worlds for those who choose to be closer to medical help if needed. I was also wondering if people who want home births might be better informed and practicing positive lifestyle habits that would influence having fewer complications.
I had 3 homebirths and 3 hospital births. It was the intervention in the first that drove me to have the next 3 at home. I hated being invisible; they only wanted to look at the monitor, not take care of me. The third at home came quickly and was unattended by the midwife, though she was there to take care of my massive hemmorhage, and she did an amazing job. My last 2 births in hospital stalled both times because of the constant interruptions and my fear of hospitals. They both involved pitocin, but the first midwife watched me and saw how little it took to do the job. With the next, they paid absolutely no attention to me and just kept turning up the dosage every 15 minutes until I put a stop to it!
I know bad things can happen, and we were within 10 minutes of a hospital in case of emergency, but I would never say everyone should birth at home or vice versa. Every mother should give birth where she feels safe and comfortable. Unfortunately, that’s too often a hospital with an astronomical c-section rate!
I wish there were more birthing centers where you could have all the comforts of home and the skills of a well-trained midwife, but emergency equipment seconds away.
I wish you luck in your birth, Chris and Elanne. I hope it will be beautiful!
What about birthing centers? I guess I wish I could have backup access to medical intervention AND am environment supportive of natural methods.
Great article. My wife and I went for the home birth (via a midwifery) complete with birthing pool and doula. fwiw here’s my wife’s blog post from the frontline, so to speak:
http://petalandthornhandmades.blogspot.com/2011/02/sienas-home-birth.html
I just posted a response to this article on my blog.
http://theprimalhome.blogspot.com/2011/07/home-birth-my-experience.html
It’s about my positive home birth experiences.
Thanks for the post. I agree that the most important outcome of birth is to have a healthy mother and healthy baby. Both of my births were at home and afterward I felt strong and empowered. I feel that the mental/emotional aspect of a woman’s birth experience is so important. Have you come across research comparing the rates of postpartum depression in women after homebirth vs. hospital or c-section? I personally know of many women whose traumatic hospital experiences seem to have contributed to postpartum depression. Best wishes!
ps- sleep will soon be your weakest link!
Great article! I wish you and your family the best for your upcoming birth. Home birth is amazing. I had my second at home and it was unbelievably fulfilling and beautiful. If you’re interested in reading my birth story, go here: http://primalandgreenoc.blogspot.com/2011/01/bijons-birth-story.html
I have had all three of my babies naturally (no inductions/drugs/forceps/etc). The first was born in an ambulance (on the way to the hospital -long story) while the second two were born in a hospital. I had a doula with all three and I was fortunate to be able to labor and birth exactly how I wanted with minimal monitoring/intervention. I was mobile right up until delivering and was able to deliver in the position of my choosing as well. Perhaps this isn’t the case with some hospitals, but I felt wonderful about all my deliveries and did not feel they were “disturbed”. I think with a good doula and a good birth plan – it is possible to have a great “natural” child birth in a hospital.
All the best for a wonderful peaceful birth, Elanne and Chris. As someone who fell victim to ‘the system’ with my first child, then had a wonderful VBAC at home 3 years later, attended by wise women who understood and trusted birth, I totally support anyone’s choice to home-birth. One thing my husband noted was the amount of medical equipment the midwives brought with them (none of which needed to be used) – they are very astute at observing, and dealing with, complications, rather than creating them by interfering with the process. Unfortunately, changes to the maternal healthcare model here in Australia mean that it will soon be against the law to birth at home with an independent midwife.
The ‘Paleo’ diet gets a lot of press, but pregnancy, birth and childrearing is a whole other part of the picture – something which the likes of Sarah Buckley, Michel Odent etc have shared so much on. Carrying the baby, co-sleeping, baby-led and gentle introduction to (REAL!) food, full-term breastfeeding etc. Babies have not evolved beyond needing these crucial elements, and neither have we, no matter how clever we think we are in our priveledged Western society. Looking forward to more posts in this series, Chris.
Happy birthing and baby rearing – a wonderful journey awaits.
PS being at an ‘alternative’ school we are surrounded by home-birthing families and only one transferred to have the baby in hospital.
This is a response to distractions being touchy feely:
A woman giving birth is very vulnerable, and often the positions she wants to be in or is forced to be in, anyone would find vulnerable. Strangers coming and going in your space, uncomfortable temperatures and clothes, all the loud noises in a hospital; these things all make it hard to relax, which is exactly what you need to do during birth. The vagina is a sphincter, would you find it easy to use the bathroom laying flat on your back with your feet in the air, people coming in and out, bright lights in your face and cold air blowing on your nether regions? I have known people that couldn’t pee if someone might hear them.
“Distractions” can slow the pace of labor, then the interventions start, such as pitocin, and more risk is introduced.
For the record, I don’t view distractions as being touchy feely. I was responding to an earlier comment. As you point out, distractions can lead to medical intervention, such as induction, epidurals and c-sections, which have real, measurable and lasting physiological and psychological consequences.
I went in having read the pros and cons. I didn’t want pain medication, went to Lamaz classes. I read 13 books about pregnancy and labor (my OB/GYN said, “it’s not a test” when he walked in and saw me highlighting the book).
At the time, I was fully aware that 25% of births resulted in c-sections, so I refused the epidural. I was really sorry I did, because when I needed it the anesthesiologist was not available. I thought I was going to die of pain. No one talks about this, and no one even in the family would let me talk about it. It was unbearable, and after it was over, my mother told me she thought she was going to die in childbirth too.
I would much rather have had a c-section than go through that bloody, horrible, hell. I was angry that my mother didn’t warn me about how bad it was going to be.
So, I had natural childbirth. What are the consequences of this? Think about this. It’s called incontinence. No one talks about this either. Now in my 40′s, I’ve had surgery to “correct” this, which helped only a little for two years, and now it is almost as bad as it was.
If I could do it over, I would ask for a c-section. Seriously.
I am so sorry that you feel so obviously traumatized by your experience. I never advocate suffering, only coping with effective support from loving people. Labor is incredibly hard work, and can be intensely painful. Anyway, I wanted you to know that incontinence is common even with women who have cesarean births and also women who have never born children at all. I hope you find both physical and emotional healing.
Apparently your Lamaze classes were not very good! I teach natural childbirth classes and we discuss everything you mentioned in great detail!
Natural childbirth does not only mean un-medicated. It means natural in every way – the support, the treatment, the respect, and the trained care. It doesn’t sound like you had that.
Incontinence is not an effect of vaginal birth. It also afflicts nulliparous women. In women who have given birth, it is usually because of being coached to push in an unnatural and prolonged way. I don’t have the names of the studies, but I was just reading an obstetrics textbook on the subject. And surgery to correct it, according to this book, is unsuccessful at least 25% of the time.
I wish you the best of luck in finding a good doctor who can successfully help you.
I’m sorry for what you went through, but I can’t comprehend why you’d be surprised that giving birth can be extremely painful and can cause incontinence, especially after reading so much about pregnancy. I know this and I won’t be having children. It is bad that no one really talks about the disadvantages of pregnancy. I don’t know why. Also, a C-section might have been worse because it’s a lot more risky than vaginal birth. It all sucks basically. LOL.
Incontinence most likely occurs because of stress on the pelvic wall during pregnancy, not just during childbirth.
Because all women are different, it stands to reason that all labors are experienced differently. I have given birth 5 times, all at home. First baby, Twin A, terrifying, painful , intense, overwhelming. A half an hour later, baby B second twin, absolutely NO PAIN. It was peaceful, relaxed, almost pleasurable. Third baby 3 years later, labor and delivery very hard. 5 years later, 4th baby, wonderful labor, hard pushing because of shoulder dystocia. 5th baby, hard labor wonderful pushing. So one woman, 5 different experiences. Women can’t “warn” you of the pain, because they may be doing you a great disservice, it may not hurt you. There is no way to know, until you do it.
Having a home birth will be a fantastic experience for most who opt for it. However for the few who have a medical emergency good outcomes are measured in minutes and even seconds. That shouldn’t stop people from making the choice to home birth but it should be taken very seriously and planned for as well as possible.
Long term LC dieter,
I have had 5 children. 2 unmedicated deliveries, 2 epidurals, and one unmedicated emergency c section.
The pain of labor is more intense than the average c section [mine excepted obviously] but the recovery from a c section is just dreadfull. I’d take a vag delivery any day. However I’d take it with an epidural if I had my ‘druthers.
PS during my 2 unmedicated L and Ds I would have gladly received an epi when those contractions got “for reals”. There comes a point where pain is so intense and unrelenting for such a long time that all philosophies fly right out the window leaving me to admit fully and unblushingly that I would not care one whit if they had to stick that needle in my eyeball as long as there were sufficient drugs on the other end of it.
It’s a bit of a western notion that drugs are to be avoided, tribal people certainly make good use of them and have for a very long time. YMMV
congratulations on your upcoming birth! I’ve had 3 hospital births, but wish they could have been home births. My most recent birth (feb) was a gorgeous experience, until the Dr decided for no reason at allt hat ten minutes was long enough to push and pulled my baby. The pain was excruciating. The damage was horrible, and preventable. Recover was long. This was my best hospital experience yet.
A CNM is the way we’d go if we had a chance, but it is important a person does their research prior to choosing a homebirth. Knowing what could possibly go wrong, and what they want done. For us there is very little that could go wrong at home that couldn’t be resolved at home as well – in the small chance that a hospital was needed, we’d transfer. We also know that in the majority of cases there are indications prior to delivery that something is amiss.
In the case of GBS it is easily treatable, it is highly unfortunate that a family did not receive proper care, but IMO that is an omission of that individual care provider and not an over all picture of home birth. Of course, here, only CNM are allowed to practice and standard protocol is that all women are screened (and if mom isn’t screen, then baby is deemed positive), if mom is negative, then no worries, if mom is positive, then she is treated, if she is not treated IN LABOUR, then baby is deemed positive and treated – or if parents refuse initial treatment, then baby is monitored closely, with antibiotics standing by. In other words, as long as the midwife follows protocol, then GBS is no more of an issue than in the hospital.
My random thoughts
In preparing for the birth of our first of two my wife and I really enjoyed reading Ina May’s Guide to Childbirth. Birth in Four Cultures by Bridgette Jordan is also very interesting.
The most alarming thing to me related to this whole topic is the growing rate of c-sections. At our local hospital it’s nearly 50%!
Despite our prejudice towed natural childbirth, we know plenty of mothers who had perfectly acceptable birthing experiences at hospitals.
Bear in mind that in industrialized countries the average age of first-time mothers is increasing which means those moderate to high risk pools are growing too.
One thing we really liked about the birthing center we used is that we didn’t have to clean up after the birth!
@ LC dieter – sorry to hear about your experience. I had a vaginal birth and have no incontinence issues whatsoever. I even had a 2nd degree episiotomy but was downhill skiing 3 weeks later. Everyone is different, but most vaginal birth recoveries are much less heinous than a c-section recovery. Then again, some people recover from c-sections quickly too. You can never know which you’ll be. I guess I’d just rather go through that pain again than have my abdomen sliced open and baby ripped out of me, but that’s just me.
That’s the thing about childbirth. No matter how much you prepare for and educate yourself, it is so totally unpredictable. I knew from the beginning of my pregnancy that I really wanted a natural, unmedicated childbirth. I checked out every book from the library on the subject, spent countless hours researching online, practiced the Bradly method exercises, kept working out and eating healthy while being mocked for not just indulging in cravings because I was ‘going to get fat anyway’, etc. . Well…I won’t go into the full story, but I did end up getting medical interventions, and the moment of her birth was more of a drugged up fog with a room full of NICU staff and others than the moment of love I had really dreamt of. I don’t know how it would’ve gone had I tried a home birth or birth center, if it would’ve been alright and the hospital staff were just making it more dire, or if I would’ve been one of the emergency hospital transfers. In the end, I guess I don’t believe it’s fair to say any one birth choice is ultimately ‘safer’ or ‘better’. Whether you’re the type to schedule your c-section in advance to work for your life, or have a homebirth with a doula + midwife attending, the safest birth is the one where mom and baby both end up healthy. You just have to decide what is right for you, but also be open to the possibility you may get a wild card.
To Elanne and Kris – I think your choice is an awesome one and I can’t wait to read your birth story. Hopefully you will post about it. =) It is really such a beautiful experience.
The way incontinence statistics are presented varies. There is a lower rate of incontinence with c-section. You might find that the way you feel about it depends on your problem and how it progresses as you get older.
Women are expected to bear the pain and be silent about it.
Fecal incontinance is higher with csections. Some urinary incontinence is due to genetics, and if you were told to push for an extended period of time, or you aren’t a walker or don’t spend time squatting, you could end up incontinent anyway. A csection is by no means a fool proof way to avoid that.
This is one of the best approaches to healing incontinence. It’s an excellent program. Also good for general recovery after childbirth. http://www.learningforhealth.com/pelvichealthcds.cfm
Through her own experience Deborah Bowes has become one of the leading authorities in the functioning of the pelvic floor.
My second daughter was just born at home last weekend, and subsequently rushed to the community hospital, and then airlifted to another hospital (where she is now), because of a variety of lung-related issues (number one: not breathing on her own). Definitely not the original plan!
Was it scary? Yes… incredibly. Would we do homebirth again? Yes… not because we’re crazy and “committed to the cause” but because we’ve gone over and over everything during those long hours watching our child fight determinedly as we stood helpless, or driving back and forth to the hospital that’s an hour away…
We believe that we did the best we could have for our child – that she wouldn’t have received better care anywhere else. We are grateful for the midwife who helped provide the best birth environment and immediate care possible, as well as all the skilled doctors and nurses who provided the best emergency and intensive care possible.
I wasn’t worried about the “what-if” before this birth – I knew that there was a 99.5% chance we’d have a safe homebirth and stay at home. Well, we hit the 0.5% – but it was still not only “OK” but as good as it possibly could have been.
I pray that your experience is what we wanted for ours… and for what it is worth, though it is hard to think of now, the 4-hour labor (yes… just 4 hours) that my wife had went EXACTLY as she wanted, and it was truly an awesome (in the full sense of the word) experience rather than an awful experience.
I had two hospital births – I am obviously very comfortable in hospitals having spent many years in them. Decent hospitals nowadays really focus on you having your choices, I was asked about a detailed birth plan prior to the deliveries, skin to skin contact right at birth and immediate nursing were highly encouraged. I spent quite a lot of labor unmonitored, the rooms included a birthing tub if you wanted to go that route. My only issue was a pushy nurse after the delivery of my first who kept critiquing the breastfeeding. After my second the nurses pretty much left me alone, which was fine by me – I was out of the hospital kid in hand about 36 hours after each one. We were strongly encouraged to room in with the baby also. Neither child had complications (knock on wood) – mostly I was glad that after a hospital birth I wouldn’t be the one doing the laundry
(I’m hopeful laundry is arranged for a home birth – I’m sure it is, oddly enough that is what I think about though!) In medical
school I participated in the delivery of many babies so was very familiar with the hospital process. Having also seen many complications (I worked in an inner city southern hospital where many of the mothers were ill or had no prenatal care at all when they showed up in labor) – that it obviously a skewed sample but that sort of training does bias doctors against home births. It is not a fair sampling or a cochrane review by any means. Even in that hospital there was a midwife ward and a doctor ward – there are over 15,000 babies a year born there so everyone is exceedingly experienced and of
course there would be complications with so many… but when I had a child I was glad to be minutes from a NICU though more glad it was never needed. However, hospital germs were a concern of mine as well!
I fully support hospital birth if that is where the birthing woman feels safest, assuming she understands her options and has made an informed choice. Just wanted to say, though, that here in Australia, trainee midwives complete their course having never even witnessed a natural birth (unless they are one of the few who train with an independent midwife). So what are they learning exactly??? How to interfere and then how to mitigate inevitable complications (usually more interference). They do not learn what a natural, unhurried, unintervened birth (and labouring woman) looks like. They do not learn to sit back and observe, they do not learn about the hormones etc. Their training is medical in nature, which, as we know, ignores the very nature of birth.
I can fully understand your comfort with hospitals. It’s a good thing you’re comfortable there
But as a doula witnessing births and hearing lots and lots of birth stories from other women, I know that OBs may be comfortable with hospitals but not many of them are comfortable (or familiar) with natural childbirth where interventions aren’t used unless necessary. And by interventions I mean all of it, heplocks, gowns, birthing on the bed, routine vaginal checks, intermittent monitoring (10-20 min of each hour) vs. doppler monitoring for a few minutes, limitations on eating and/or drinking, etc. A friend just recently had her fifth baby, unmedicated, and her midwife decided not to break her water this time. She just sat back as mom had her baby (born in the caul). Nurses kept coming in and looking at her because it was so unusual. Afterwards her midwife said something to the effect of, “It’s really good sometimes to just sit back and watch what a woman’s body can do if we don’t interfere.” Amazing to hear and yet a little scary that that sentiment comes from a midwife, implying the truth that we too often meddle (and I know she does, I’ve attended births with her) instead of patiently waiting and watching. Another friend gave birth without medication and her nurse, who was pregnant, said, “You know, I think I could do that.” We don’t see enough normal to know what normal really is.
I never saw a soiled twoel, sheet, nightgown etc. My midwife whisked them all away before I was ever aware of their existance
Chris, I really love your research usually, but it seems to me you dropped the ball on this one. You sound as if you have swallowed the homebirth propaganda without your usual skepticism. You say if there’s a problem, “just transfer to the hospital” – it is really not that simple! If you are with a laboring woman with a catastrophic problem (for example, placental abruption) you have to get her into the car, drive to the hospital, get checked in at the hospital with paperwork, be examined by an OB and nurses there, and finally transferred for a c-section. Even if you live 5 minutes from the hospital, transport can be a very time consuming process and unfortunately can end with tragic consequences.
I highly recommend you check out the blog “The Skeptical OB” – the web site is http://skepticalob.blogspot.com/ – her tone is unpleasant but the information there is invaluable. She addresses so many of the exact homebirth lines you throw out in this article, and backs them up with studies too, for example, the claim the Netherlands statistics show it’s safer to homebirth.
No, the Netherlands has, and has had for some years, the HIGHEST perinatal mortality rate in Western Europe. It also has a high and rising rate of maternal mortality. The Dutch government is deeply concerned about these high mortality rates and a variety of studies are underway to investigate.
The most recent study published in the BMJ is early November 2010 revealed and astounding finding. The perinatal mortality rate for low risk women cared for by midwives is higher than the perinatal mortality rate for high risk women care for by obstetricians!
Her “10 things” article rebuts many of your claims point-by-point:
http://skepticalob.blogspot.com/2010/11/ten-things-you-shouldnt-say-to-dr-amy.html
But there is a lot more to read than just that snarky summary. Please get past her tone, because the information is important, and I think you are doing women a disservice by downplaying the risks of complications, and the ease of solving problems during homebirth.
I started to write a point-by-point rebuttal to Dr. Amy’s ridiculously biased and myopic post, but after scanning the comments found that someone (Ellie) had already done that. So I’ll reproduce it for you here:
On top of that, I will be explaining several other ways that “industrialized birth” can negatively impact not only birth itself, but the baby’s health during infancy and for the rest of his/her life. As an example, we are now beginning to understand that early changes in the gut flora of an infant can predispose him/her to lifelong health problems like obesity, diabetes, asthma and allergies. These changes are far more likely to occur in a hospital environment. The comparison of hospital vs. home birth goes far beyond perinatal mortality rates, as I will demonstrate in future articles.
I had one child in the netherlands, and one in the US. The baby in the Netherlands was a planned home birth with a totally excellent midwife. I pushed for half an hour on a birthing stool before the midwife called a halt and proceeded to drive me to the hospital for a vacuum extraction (baby was 9lb 9 oz and I could not push it ’round the corner’). She stayed with me the whole time, and was the one who visited the next 10 days (Dutch perinatal care is very good). I was grateful for the hospital, but I would have opted for a home birth again with the second, as I thought my midwife was brilliant.
However, with the second one we were in the US. I had to fight very hard not to get a preemptive IV, the nurse told me to push in the wrong direction, (resulting in a bruised sacral nerve which took 12 months to heal – the midwife in NL had indicated in which direction to push by touching me in the correct place), the doctor was at lunch when it came time to deliver so there was panic in the room when push came to shove (heh), it was not a great experience. (I also don’t get the insistence on rough cotton open-backed, short-sleeved hospital gowns designed to freeze many parts of the body here, what is that all about?)
Overall though I agree that people have to go where they are comfortable and feel safe, but then they have to be prepared for the environment they choose.
BTW the perinatal mortality in NL could be higher due to a different policy on the very very early preemies. There is not an automatic “keep it alive at all costs” policy. The parents are told the risks of serious disabilities of various kinds with these barely viable infants, and I believe that many parents choose to let the child go. I’d have to look up the reference on that, heard it during a lecture on preemies and developmental disabilities.
Thank you for sharing your perspective! great comparison! And good point about the premies…
Kris, I enjoy your podcast and posts very much and am learning so much. This one really resonated with me as I was going to have a home birth 28 years ago after participating in both of my sisters home births with their children. I didn’t have to be convinced, I just instinctively felt that it was the right thing to do for mother and baby. But dangerously high blood pressure and no progress in dilation forced us to the hospital for an emergency C-section. I was glad my midwife had insisted on a doctor back-up but at that time not even my husband could go into surgery with me. Except for a very compassionate nurse who missed her son’s little league game to stay with me through the whole ordeal, I felt so completely alone. I had to fight for the doctor to let me stay awake to greet my new son and was heartbroken to not be able to hold him for almost 4 hours! After they brought him into my room, I had to fight to keep him with me and let him nurse as he pleased. Yes, I was glad we were both alive but the psychological damage was long lasting and took me by surprise. It took a bit of therapy and 5 years to have the courage to try again. Longer story than we have room for here, but my second and third were also C-sections but planned so the experience was a bit better. Still, I couldn’t wait to get home and have my babies to myself despite the pain and long recoveries. Your last comment about the infant’s gut flora hit me like a ton of bricks since my first son born so traumatically has been a type 1 diabetic since he was 5 with absolutely no family history and a fairly good diet with what I knew at the time. I will look forward to reading your future articles as you go into more depth. Sincere best wishes for you and your wife to have the home birth experience you all deserve. I still believe it is the best way to welcome your most precious gift.
Chris -
Another GREAT post!
I’ve taken your Healthy Baby Code course (AMAZING!) and wanted to see if you have a good book recommendation for pregnancy. Preferably something more in tune with your philosophies than I’d find on a mainstream “best sellers” list….
thx! Kari
Birth & breastfeeding by Michel Odent.
Another one would be Gentle Birth, Gentle Mothering by Sarah Buckley.
Congratulations on your upcoming joyous event!
I just wanted to say that the natural birth of my son was the most beautiful, serene event of my life. I experienced no pain at all–just a sense of pressure. In fact, it took me a couple of hours to even realize I was in labor. Once we got to the birthing center, while I was walking around and around outside the building, I entered a trance-like mental state. My son was born after about 10 hours of labor, where I spent much of the time in a big, comfy tub and my husband, my sister, and my mom in the room with me. My doula was wonderful and made me feel completely safe. I knew that she knew what she was doing, so I could just relax. I did end up with an episiotomy and a third-degree tear, but I didn’t feel a thing and that healed right up after a couple of weeks, so it was no big deal.
I ascribe my glorious experience to big hips, excellent health, fantastic care, a reassuring location (birthing center right across the driveway from the hospital ER), and positive expectations: All of my life my mother told me that my (natural) birth in a hospital was like a religious awakening for her, so I was predisposed to think positively of childbirth.
My experience makes me wonder if the fear of childbirth causes pain, but the rational side of me points out that fear is more likely driven by the pain. I just got lucky. So on the one hand, I am reluctant to tell other women about how easy and painless my birth was, because I don’t want to sound like I’m judging or bragging or telling them they “did it wrong.” On the other hand, I want other women to know that childbirth isn’t always a painful event to be endured, and I hope that openness to the possibility might allow them to experience something beautiful.
Great post Chris. I have recently discovered your blog and love the topics and insight that you provide for your readers. My wife and I are also planning a homebirth, which should be happening literally any day, and are very excited about the opportunity to start our family and welcome our baby in that setting. One of the most influential pieces of literature, not the whole book but some very well presented theories, I have come across is Dr. Grantly Dick-Read’s book “Childbirth Without Fear.” This book was published in 1949. Specifically the presentation of the Fear-Tension-Pain cycle that speaks to the “distractions” and “disturbances”. From a perspective of an expectant father I am amazed at the capability of the human body and more importantly the brilliance of a pregnant woman’s body. Pregnancy is unknown territory for most people, even if you have had previous babies, and the current medical system capitalizes on that unknown and, unfortunately, justifies many of the procedures based on the risk, real or perceived. Keep up the great work and I look forward to seeing the rest of this blog series. The world needs more people like you supporting the natural biological process of childbirth.
Please, please remember that not everyone lives in California or other metropolitan or forward thinking areas. Can a home birth be safe? Yes. Can a hospital birth be beautiful, serene and natural? Yes. I have had 2 births in the hospital, one with no interventions one with pitocin and epidural (labor had to be induced because water broke and did not start after 2 days). I noticed no difference in either child at birth, both calm and alert both nursed immediately and are very healthy and intelligent. Bonding was actually easier with the one born with epidural because I was not hindered by the pain of labor and tearing. I know the medical system in my area having worked in it for 13 years and if anything had happened (living 30 minutes from a hospital) I know that our paramedics rarely encounter a newborn in need of advanced resuscitation or airway management. I also know that the midwives who will assist with home births in my area have little to no medical background and minimal education. How is the lay person to know this? It can be safe to deliver at home but take advantage of the good the medical community has to offer. A skilled and talented practioner will facilitate the kind of delivery you want (or think you do – hey things change in the heat of the moment) but they also know every possible scenario and are prepared to deal with it.
I am pregnant and I am also a federal government employee. We are getting ready to move back to Colorado, where my husband and I are from, and because my HMO here does not cover that area I get to switch insurance policies (yay!). There are many different options and I was just wondering if anyone had a home birth that was covered by your insurance. If so, I would love to hear the details (insurance provider, whether they covered the hospital transfer if there were problems with the delivery, mom, or baby, etc.).
Thanks!
Chris,
You say 100,000 generations, but then you count up to almost 1 million in your mathematical example. Simple error, but I think you meant to put 99,998.
-JK
Hmm, when my son was born 32 years ago *no one* was talking about home births! I was born in a hospital in the 50s, my parents were both born in hospitals in the 20s. Home birth seemed so 19th century to me at the time, LOL. But I guess I was pretty lucky as hospital births go. I only had a 5-hour labor from start to finish. No IVs, no drugs, no episiotomy. My son just popped out and the doctor caught him despite his being nearly 9 pounds! After a quick once-over by the medical staff he was laid on my stomach, still bloody from delivery, and the entire medical staff left the room and left me alone with him for some 60-90 minutes to give us “bonding” time. I did have a 4-day hospital stay (standard at the time) but I enjoyed it. I loved being waited on and having meals brought to me, LOL. Since I was breast-feeding I was allowed to have my son with me as much as I wanted. The nurses were all great at giving me, a first-time mother, tips on care and feeding and diapering, etc.
My son was also born almost 3 weeks after his supposed “due date”, but my obstetrician merely said, “You don’t think their’s anything magical about that due date, do you?”
Things do seem very different today though. When my grandson was born 2 years ago my DiL was induced because she had gone 10 days past her due date and the doctors refused to allow her to go longer than that. She did deliver vaginally at any rate – and she is a tiny woman and my grandson was nearly 9 pounds at birth, so who knows what size he would have been if he had come at his appointed time. But he was one of about 20 babies born in the hospital that day, and was the **only** one not born via C-section, and that only because my son and DiL fought against it – as her 18-hour labor exceeded the hospital’s standards.
My sister delivered her first vaginally and her second via emergency C-section, and to this day says if she’d know the difference she would have demanded a C-section for the first too! Said it was far less painful, far easier, and her recovery was so much easier and so much faster. She says a C-section made all the difference in the world to her with how easy and painless it made the experience. So funny how we all differ.
Hi Chris
If a baby has to have antibiotics after birth, would you recommend using a probiotic designed for babies, or is it better for mum to use them and pass it on in the breast milk ? (we planned a natural homebirth, but my partner got an infection after her waters broke and needed a c-section as our baby girl was in distress) . It is a bit dissapointing to not do the natural home thing but we are glad for the hospital in an emergency situation. The difficult thing is once you are in hospital there are so many interventions they want to do and it is hard to work out which ones are absolutely necessary. For instance, our girl had an increased respiration rate which was getting worse which could be a natural process but also could be from infection so she was put on antibiotics. She is doing great now, but I am a bit concerned the antibiotics could lead to problems with allergies and autoimmunity if we dont address it. All the best, its an amazing feeling to be a dad even though everything we didnt want to happen with the birth process did
I would do both. Ther-biotic Infant is the brand I use here – not sure if it’s available in NZ, but you can check the strains it has in it and try to find something similar. For mom, a good multi-species probiotic like Ther-biotic Complete plus a prebiotic like Biotagen would be good.
Sorry to hear about your difficulties with the birth. The reality is we don’t always have full control over our circumstances, and sometimes things don’t turn out as we would have wished. In that situation we do the best we can with what we’ve got – which is exactly what you’re doing. The good news is that human beings are remarkably resilient, and I’m sure with good nutrition and a healthy environment your girl will live a long, happy life.
Hi. Thanks for the kind words. Mum and baby are home now and doing great, so good to get away from the hospital although everyone was amazing there. Overall, it was still an amazing experience and has changed my perception about medical care- they do a good job at risk management in emergency situations.
I will see if I can get those supplements shipped over, I found a probiotic with similar strains but it also contained rice maltodextrin,silica and short-chain oligosacchrides which I am not too sure about.
thanks again for all your help.
PS: on the day she was born it was 6foot and offshore here which must be a good omen : )
I’m proud of your decision to birth this way! The truth is, most “birth emergencies” are completely fictional, created by hospital personnel (and I’m an experienced medical professional working in a hospital environment). Very rarely is there a true emergency. Women are created to birth and every aspect of birth serves a purpose. As a woman who has given birth 3 times in a hospital and 1 time at home (the last), I cannot overstate how much easier the unmedicated home birth that was allowed to proceed at its own speed went compared to the hospital births.
All of my hospital births were induced, 18+ hours of horrible discomfort, people constantly poking you or sticking their fingers somewhere, a Dr announcing to me how I should be birthing and telling me to stop making noise, after birth being woken up every hour for something, being told what i can and can’t do with my baby. Recovery of weeks before feeling like human again.
My home birth…my body and baby went into labor on their own, very mild labor from 3 am to 8 am, a little tougher from 8-9 and some harder labor from 9-10:20. Baby was born then, in the water, midwives cleaned up while I crawled into bed. Midwives were gone a few hours later and despite thinking I should rest, I couldn’t stay in bed, I was up and doing things, nearly no recovery time at all because my body was allowed to adjust at the speed it needed to.
We were designed to do this without interference and although I once would have gasped at the thought of home birth, and I once would have felt the same way as many of the others do, that it would be a “stupid” thing to do; once I educated myself, I saw the light. Having birthed at home, i would NEVER EVER EVER go to a hospital to birth. Not unless there was a true, forseeable emergency that required it, and being overdue is not an emergency.
Which brings me to my last point. I’m sure you know this already Chris, but not every baby comes before 42 weeks, so if yours doesn’t, don’t let them push you into going to a hospital. Babies come when they are ready, not by a calendar.
Congrats on the new addition, I can’t wait to read your posts after baby is born!
I love this post. Thank you and Congratulations!
Chris,
Have you seen this course? Looks quite similar to yours, but of course yours looks way better!
http://nutritionforpregnancy.com/
My daughter (who lives overseas) had her first child 3 years ago as a homebirth in my bed! There was a midwife present and a student midwife too! It was a beautiful experience for all. My granddaughter and I have a special relationship.
My daughter then had her 2nd child in her home in Israel as a homebirth with an obsetrician who only does homebirths now. I was at her house about a 1/2 hr after my grandson was born and stayed to help them out for a week or so.
My daughter and son in law fully embrace homebirth and the natural quality and ability to bond with each other and the new baby (and the older toddler too)!
I only wish I knew about these options when I was having my own children.
My daughter was born at home 6 years ago. I loved it. It was an amazing, intimate experience between me, my daughter, her father, and our midwife, and I would do it again in a heartbeat. The one and only time labor became unbearable was when I decided to lay down for a few minutes, which incidentally is the position you are in while laboring in the hospital. I get the same reaction as you when I tell people she was born at home. Outside of a few who “get it” mostly I get the “wow, you were brave! I would never…” (when I suspect what they really mean is “wow, you were careless!”). But there are so many reasons to birth at home, I can’t even begin to list them all. Another good read is Ina May’s Guide to Childbirth. Best wishes to you and your wife Chris. It’ll be the coolest experience of your life. I almost wish I could do it again
I had an extremely easy labour with my first child and no complications. When i became preganant with my son there were no problems throughout my pregnancy, however during labour things went downhill quite quickly, and to put it bluntly, if we had not been in hospital we both would have died. So whilst the idea of a homebirth appealed to me, I was more than happy that I had decided to use my local hospital.
Linda: nowhere in the article do I suggest that we shouldn’t make use of the hospital when necessary. In fact, I highlighted the following sentence in bold text in the article:
The issue is not whether to use medical intervention at all, but when medical intervention should be used. Right now, it begins the moment a laboring woman steps foot in the hospital. I’m simply arguing that “undisturbed birth” should be the starting place, and medical intervention should only be employed when necessary.
There are so many types of breech births, a few can be dealt with even at home, but many do require a hospital. The author does not think that if you are high risk you should have a home birth. He does not even say if you are low risk you should. He is saying that if you are low risk you ought to know what the benefits and risks are for each kind of birth and make an informed decision.
A midwife will refer a mother to the hospital if they have a frank breech. It is part of their training. On the other hand, my friend had a c-section for a posterior baby. Maybe she would have needed the c-section anyway, but the docs didn’t even bother to see what position he was in at any point during her pregnancy and labor. In her second pregnancy, she had a hospital midwife who informed her before she was even due that she needed to turn the baby to prevent a posterior birth. They were sucessful, and my friend went on to have an unmedicated vaginal birth after c-section. Midwives have a ton to offer, whether at home or at the hospital, and know things OB’s do not! OB’s in general ought to be available for surgery, but unless they have training beyond what is required to become an OB, have no idea what to do for a natural normal birth.
I’ve given birth three times at a hospital in Finland. I would call the births undisturbed and natural, no drugs. It’s quite a normal Finnish hospital. It has several big rooms where the mother-to-be and father can stay together, and are interrupted almost only when needed. In each room, there’s a rocking chair and other furniture that help you select the position you want. There’s a private shower in each room, too. There’s a radio, magazines, etc, and the walls are painted in happy colors. And there are bath tubs outside the room, if one’s available you can have that too. I’ve used it all three times.
If you seem to have very many hours left, you will be guided into another kind of room before the birth room, as there’s a limited number of these. This first room has a double bed, TV, etc. Like a hotel room.
When you arrive at the hospital, you are asked what kind of birth you want, do you want an epidural, how do you want to deliver (on chair, lying down, on all four, etc.) and if you have special wishes.
I had three wonderful births, they’re the coolest things I’ve ever experienced. Even though they were hospital births.
I have no idea what U.S. birth hospitals look like, but if they looked like mine did there would probably be a lot less need for the home births, which I don’t object to either. Home births are very rare in Finland.
I gave birth to four of our seven children at home. They weighed between 10.5 lbs to 11.5 lbs, the cord was around my son’s neck (no problem for my midwife), and having experienced both options, I DEFINITELY choose home birth over hospital birth. I didn’t have to listen to the doctor talking to his assistants about his last golf game – I was surrounded by family and friends and it was a positive atmosphere in which to bring new life forth.
My sister almost lost her life giving birth at a hospital. It was an unforseen problem after a normal, low-risk birth. Home birth sounds nice sometimes, but in her situation, minutes counted, and she would be dead if she had not been in a place where doctors could help her immediately. I am thankful for hospitals and doctors, even though they drive me nuts. I think if all the effort people put into publicizing how wonderful home birth is toward making changes in hospital culture and having better hospital births, we would really all be better off. I am not against home births per-se, just happy to have my sister alive.