I wrote this in response to a NICU nurse who, after witnessing the tragic death of a baby during a failed homebirth attempt, posted on Facebook her belief that women choosing homebirth are making a "stupid, stupid decision." I can understand her sadness and anger, but I wanted to explain the viewpoint of why women choose homebirth. It's for the very same reason other women choose hospital birth--they want the best outcomes for mom and baby.
I won't deny that things can go wrong during childbirth and that hospitals have saved many lives in those situations. I'm very grateful for medical technology when it is needed. And I completely agree that women who choose homebirth need to be self-educated with correct, unbiased information, use a qualified midwife with good judgment, and know when to seek medical attention if necessary. I think I would add one more "requirement" to having a safe homebirth. That is the ability of the mom and the midwife to recognize and follow inspiration. For my part, I never would have had the courage and trust to give birth at home had I not had the divine reassurance that all would go well. It was a reassurance that I sought several times throughout the pregnancy and also once labor started because I know that things can change quickly.
With that reassurance, I felt that giving birth at home would be safer for me and my baby than giving birth in a hospital. Contrary to the opinion of many in the medical community, most, if not all, women who choose to give birth at home are making that decision because they want the best outcome for mother and baby. We do this because we have learned through personal experience and a great deal of research that many of the routine medical interventions done to women in labor actually cause the very complications that we're all afraid of. Not always, but far too often the "perfect situation goes south" because of interventions like too much pitocin too fast, induction before baby is ready, pushing a baby out in the ineffective lithotomy position, sudden drop in blood pressure at the injection of an epidural, interference in the natural flow of oxytocin and endorphins when drugs are given, etc. My emergency c-section was iatrogenic in nature (medically caused). My c-section experience is a very common one and, sadly, it's becoming more common all the time. A cesearean rate of nearly 32% is evidence of that.
My wish is that the medical community would acknowledge and recognize that many of the routine interventions done in the hospital are not in the best interests of mom and baby. In the absence of true complications, nature is much better at delivering a healthy baby than when we interfere with the process. And actually even with minor complications, nature knows how to adjust and adapt as was the case with my daughter, Talita's, birth. Unfortunately, because of a lack of experience with truly natural childbirth, this viewpoint is not shared by most ob's and L&D nurses. If the unnecessary interventions were not pushed on women in labor, I believe you would see less women choosing to birth at home. Of course, I realize it's not always that simple because of the legal/political climate in this country. I don't put the blame on OB's and L&D nurses, necessarily. I believe that most of them truly want to do what is best for mom and baby and are instead restricted by malpractice insurance regulations. I think the risk of being sued is the major cause of the misuse and overapplication of medical interventions.
I think we can learn a lot from the countries who have a more balanced approach to childbirth and obstetrics. For example, in Holland, expectant women are carefully screened and only those who are high risk see obstetricians and deliver in the hospital (as well as those women who just want to deliver in the hospital and are willing to pay extra for it.) Women who are low risk use the care of a qualified midwife and deliver at home, but are within 15 minutes of a hospital. Flexibility and careful monitoring is used should a low risk woman become high risk. The maternal and infant mortality rates are much lower there than they are here in the US. For a country where 99% of women give birth in the hospital, why are we losing so many moms and babies? We have some of the worst maternal and infant mortality rates for a developed country. Why are women so "defective" here in the US that one third of them "can't" give birth vaginally? Something to think about.
The other thing I like about the Netherlands is the respectful working relationship between lay midwives and ob's. It's pretty hostile here in the US. I believe fewer moms and midwives would wait too long to transport to the hospital when necessary if they knew they would be treated respectfully, rather than with contempt and branded with labels like stupid, reckless, selfish, etc. As women we need to seek to understand where each other is coming from rather than blindly labeling women who choose differently than we might.
I'm passionate about this issue because I've lived both sides of it. I really just want all women to have strong, healthy babies and safe, empowering birth experiences. For me and my last 3 babies, that meant giving birth at home.
It wouldn't have to be that way if we all opened our minds and took a serious look at why more and more women are choosing to give birth at home. It's not to be "trendy" like the ACOG contends. We all just really want healthy, undrugged moms and babies and quicker recovery times. A "side benefit" is the truly wonderful and spiritual experience of peacefully and gently welcoming our children into the world.