Time magazine has chimed in on the so-called birth wars with a long, nicely balanced piece about the option of home births. Though still rare in America, home births have certainly gained more attention in recent years.
In some countries home births are much more common–they make up a third of the births in The Netherlands and have recently doubled in number in Wales, where home birth is being encouraged by health officials for low risk pregnancies. But in these countries giving birth at home is supported and midwives are fully integrated into the healthcare system. In many parts of America this is not the case.
The Time magazine piece, written by Catherine Elton, covers recent events in the debate about home birth safety including the meta-analysis that came out earlier this summer showing home birth to be better for mom’s health but not as safe for the baby. The study, published in the American Journal of Obstetricians and Gynecologists (AJOG), was criticized for not making clearer distinctions between various circumstances for the home births. Elton writes,
“… two independent experts in meta-analysis who reviewed the paper for TIME concluded that it was weak and methodologically flawed. Other critics say some of the studies included are outdated or misleading, thus limiting the conclusions of the review.”
A 2005 North American study of over 5000 births revealed that home birth for low-risk pregnancies, attended by a certified nurse midwife (CNM) and with good access to back-up care is as safe as giving birth in a hospital, with the mother having fewer interventions.
Elton gets at these issues and makes some strong concluding points:
“The lack of definitive data guarantees that the birth wars won’t soon end. But many obstetricians and midwives can at least agree on one thing: easy and immediate access to hospitals can improve birth outcomes and increase home-birth safety overall. Which is precisely why midwives say they are pushing to expand state licensing of CPMs [certified professional midwives]. In states where licensing already exists, home-birth advocates say, there is, on the whole, good cooperation between midwives and hospitals.”
I was happy to see the Elton go in this direction. We need to be more supportive of midwives if we want to increase safety for laboring women and their babies. As home births are not appropriate for all women, we also need to think about how to better accommodate women giving birth in hospitals. There is no reason women should have to make themselves vulnerable to unnecessary interventions, including inductions, episiotomies, and c-sections, in the name of safety for the baby. We all want safety for our babies, it’s silly to think this needs to be at the expense of the mother’s health or happiness. Mother and baby are quite literally connected through all of this, so it would be nice to think of both bodies as a part of this equation.