Is Your Choice To Have A Homebirth Hazardous To Your Child?

April 2, 2012  |  
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You’re expecting. And if one of the biggest life changes you’ll ever experience wasn’t enough to stress you out, you’ll probably soon get an earful of hospital horror stories courtesy of the world-wide web and even some close friends.  You’ll hear about the perilous pressure to have unnecessary C-sections and epidurals that caused more pain than they relieved.  Throughout all this you may start to question your options and what kind of delivery will work best for you.  Many women are choosing to forego the traditional hospital delivery altogether in exchange for a home birth with the assistance of a midwife and/or doula.  But should you doula or is this experience a delivery-don’t for you?

In her article, “Why You Should Have Your Baby at Home, and Not at a Hospital” writer Charing Ball broke down how the expensive cost of hospital births, women’s increasing lack of medical coverage and expectant mothers’ high dependency on Medicaid funds have all led to more women seeking out alternative birthing options.  Many women, like me, though can’t picture having a baby anywhere but a hospital.  While I’d like to imagine the often portrayed natural bliss of giving birth to a baby in a tub of water surrounded by loving friends and family in the comfort of my home, I’m still terrified at the thought of, “What if?”  And while medical technology definitely has its faults and biases, why not take advantage of something that many women in third world countries wish they had access to? It’s true, women’s bodies are simply doing what they were made to do since the beginning of time before episiotomies and epidurals.  In the U.S., however, midwives and doulas lost their status at the end of the 1800’s, and doctors took over the reins. With knowledge about hygiene and the latest medical procedures, doctors had a higher success rate of keeping both mom and baby alive than midwives did.  Yet in this day and age, you truly have to question whether your doctor is doing what’s best for the health of you and your baby or what’s more convenient for his/her schedule.  Don’t be quick to assume that because you’re in a hospital with medical staff who have years of schooling behind them that you will have a safer more “professional” experience.  Your choice of a midwife or doula doesn’t mean you’ll have a barefoot yogi chanting with candles either. Although, homebirths are viewed as more “natural” you can choose to have the procedure be as laid back or structured as you want it to be.

If you’re considering having a home birth with the assistance of a midwife or a doula (Midwives oversee the medical parts of the birth, including the actual delivery, while doulas provide constant emotional and physical support and comfort to the mom-to-be.)  For example, you could choose to have the assistance of a doula even if you opt for a hospital birth since they are mostly present for emotional support, but a midwife is necessary if you choose to have a home birth with no doctor present.

All births are different, even for individual women, so even if a home birth was a positive experience for your first-born you may not feel the same way about your next pregnancy.  The following pros and cons might help you decide works best for you:

1.  Pro: Home births allow you more options of you want involved in the actual birth.

Home births are less controlled than hospital births, and this can be a good thing if you’re someone who is turned off by the structure and rules of hospitals.  While many hospitals will only allow you to have 2 or 3 people in the actual delivery room, a home birth means your home your rules.  You can have Grandma, Cousin Craig and you mother-in-law all there to welcome your beautiful bundle as he/she debuts into the world.  Though more isn’t always the merrier, and the question is: Do you really want all those people there while you’re sweaty and spread-eagle?

2. Con: Home births can get pricey.

This isn’t the 1800’s and with home births growing in popularity, many midwives and doulas aren’t shy about charging for their services.  While by comparison home birth is not as expensive as hospital birth, it isn’t cheap.  Data gathered in 2008 by the Agency for Healthcare Research and Quality shows that the charge for an uncomplicated cesarean section in a hospital birth is approximately $15,800, while an uncomplicated vaginal birth runs about $9,600.  Home birth costs anywhere between $1,500-3,000.  Some maternity insurances cover the whole cost of home birth or at least a fraction, but others don’t cover it at all.

3.  Pro: You’ll have more of a say in what you get to do during labor.

Midwives are usually more flexible in allowing the mother-to-be to walk around without intravenous access, monitoring the baby and contractions, and what she is allowed to eat or drink.  In hospital births, food and drink are discouraged in case emergency surgery has to take place.  A midwife may be able to provide more one-on-one attention than a physician in a hospital with multiple patients.

4.  Con: Home births may not be an option if your pregnancy is complicated.

If you experience any medical complications such as high blood pressure, preeclampsia or premature labor you may want to consider delivering in a hospital where staff is better equipped to deal with a variety of circumstances. Even if you have a seemingly uncomplicated pregnancy, keep in mind that if an emergency does arise it may be necessary to seek the care of a physician, even if you had your heart set on giving birth at home.  Also keep in mind, that epidural and midwife are not oxymorons. Some midwives are associated with hospitals and are legally able to provide options for pain management.

5.  Pro: Your labor time may be a bit shorter.

Studies have shown that labors with the support of a doula are 25% shorter than those without, and woman who have had the support of a birthing assistant were rated as more sensitive and nurturing to their newborns. (Gilbert, Susan “Benefits of Assistant for Childbirth Go Far Beyond the Birthing Room.” The New York Times, May 19, 1998)

6.  Con:  “Dad” may feel replaced by the doula.

Pregnancy can be a difficult time for the expectant father, who can sometimes feel overlooked and unheard when much of the fuss is made over the mother.  They may feel like their role as a supporter and comforter is being replaced.  But doulas can be helpful for fathers who are not involved or fathers who have difficulty finding their place within the whole pregnancy process.

These are only a few of the factors a woman may need to consider when deciding between a homebirth and a hospital birth.  You’ll still need to do your homework on your search for a midwife.  If possible, contact former clients and ask them questions about their experiences.  Research the certifications and training regimens that your potential midwife or doula has undergone .  Exercise the option to change your mind, and while word of mouth can be a useful tool, keep in mind that just because one person had a less than favorable experience at a hospital or birthing center doesn’t mean that you will too.

Would you ever consider a homebirth?  Do you think hospitals are safer?

Toya Sharee is a community health educator and parenting education coordinator who has a passion for helping young women build their self-esteem and make well-informed choices about their sexual health. She also advocates for women’s reproductive rights and blogs about everything from beauty to love and relationships. Follow her on Twitter @TheTrueTSharee.

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