I found this great post on another birth blog that answers the questions of "Why homebirth?" and "What if something happens? " She articulates so well the very same reasons I chose homebirth and how I dealt with my questions and fears of "what if something goes wrong?"
"I’ve been planning a few Q&A posts to answer questions I am frequently asked. This first post will examine two questions that tend to come together. How did you decide to have your babies at home? What if something happens?
The answer to the first is fairly short, but needs some explaining. I decided to have my babies at home because statistically, it is the safest place to give birth. Though I enjoy stories, opinions and philosophies of childbirth, I’m more of a numbers person when it comes to making decisions that impact my health or that of my children. I’ve spent a fair amount of time looking at research on childbirth statistics and outcomes. Interestingly, every study out there shows that midwife-attended homebirths have better outcomes compared to hospital births.
Better outcomes outside of the hospital? How could that be? What if something goes wrong? It is true, there are risks involved with homebirth, but there are also risks involved with hospital birth. The most recent and largest (to date) study examining the two was published by the British Medical Journal (BMJ) in 2005. The conclusion? Planned home birth for low risk women using Certified Professional Midwives was associated with lower rates of medical intervention and no higher likelihood of death than that of low risk hospital births in the United States." This was an important piece of research because it is the largest homebirth study that also matched women for risk (meaning the hospital births were of low-risk women who would have qualified for birth at home).
This may not make sense at first, especially with all of those emergency cesarean stories we've all heard. With so many emergencies, how could it be safer to birth outside of a hospital? Pay attention, the next time you hear one of those stories, chances are, the emergency was preceded by an intervention of some sort. Common examples: Labor wasn't going quickly enough so we started pitocin and then the baby crashed and we needed and emergency cesarean. After they did several internal exams and broke my water (both increase the likelihood of infection), the mother got a fever and the baby's heart rate sky-rocketed so we needed an emergency cesarean. She got an epidural and the baby’s heart rate dropped. They put on an oxygen mask, gave her a shot of something and had her rolling from side to side, but the baby didn't recover and we needed an emergency cesarean. Hearing story after story like that, hospital birth does sound dangerous.
But sudden reactions to medications and invasive procedures don't exist at home because the medication and procedures that cause them are not used in the first place. In the absence of medical intervention, the majority of complications in childbirth arise slowly with plenty of time to notice them and seek medical care, if necessary. Common examples: The baby gradually becomes less tolerant of labor. Labor is prolonged and the mother begins to wear out. When non-emergent complications do arise at a homebirth, a skilled midwife can help resolve them through a variety of non-medical techniques; she can also provide some medical treatments like, oxygen for neo-natal resuscitation or drugs to manage hemorrhage. In the rare event that a complication cannot be handled at home, she has a transport plan and will recommend transfer to a hospital (in the BMJ study 12.1% of the homebirth group transferred to the hospital, but less than half of a percentage of women had urgent transfers).
Looking at the BMJ study, the effectiveness of this gentle approach to complications was clear:Induction or Augmentation of labor (with pitocin or prostaglandins) 4.8% vs. 39.9%Episiotomy 2.1% vs. 33.0%Cesarean Section 3.7% vs. 19.0% (it is worth mentioning that the national cesarean rate is now over 30%)
With so many risky interventions at hospitals and no improvement in outcomes, many women planning hospital births also like to "stay home as long as possible" to reduce the likelihood of unnecessary intervention. I guess my preference is to stay home as long as possible too. I just prefer to do it with a skilled attendant present to catch any signs of trouble. If my midwife recommends transferring or I just feel I would rather be at a hospital, I can always go. But if not, staying home as long as possible turns into just staying home.
As I ponder homebirth, privacy, comfort, support, convenience and a positive birth experience have been nice perks, but they are not the reason I stay home. I stay home because I know the risk of death is the same in or out of the hospital, but the risk of injury, infection and intervention are significantly lower at home. I prefer my body and my baby to be uninjured, uninfected and left alone and that is why Johannes and Willem were born at home.
You can learn more about midwives and homebirth here. Full results of the BMJ study."