Wednesday, April 18, 2012

Why I Support Out of Hospital Birth

I've never had a home birth and I'm not sure I ever will. I thought I should get that out at the beginning, just in the interest of complete honesty, because what I want to address is the topic of out of hospital births and I think it's important for others to know that I don't have personal experience with out of hospital births. What I do have personal experience with is the anxiety a mother feels while making her birth decisions and I think every woman should have the right to choose the birth environment that makes sense to her.

I have known at least four smart, well-researched women who have had births at home or free standing birth center births and I fully supported them in those births and would support anyone else who also chose to birth outside of a hospital and here's why: Home birth does not equal a nineteenth century birth that eschews all modern medicine. Home birth just means a birth that occurs at home. (If any interventions had seemed necessary or if complications such as infection, bleeding, or anything else had arisen, I know that each of them would have been at the hospital in a minute! In fact, one of my friends did have some hemorrhaging and she did not hesitate to go to the hospital because that is what hospitals are for--helping people who need modern medicine or interventions before, during, or after birth!) People who choose to home birth are not necessarily anti-interventions and anti-medicine, they are just anti-interventions unless they are necessary and appropriate.

A person who home births is no less anti-necessary medicine than a person who tries safe, effective home remedies for a cold or an injury before going to the hospital. The truth is that for most healthy women who are at low risk for complications and whose baby is at low risk for complications, the hospital with all of its bells and whistles is not necessary and being in the hospital (many argue) puts that low risk woman in danger of interventions that might be unnecessary in a lower stress, more familiar environment like the home. Home is also usually within a comfortable driving distance of a hospital. After all, we trust our home to be safe enough that if any kind of dangerous accident happens there (like a tree falling, or a poisoning, or a fall down the stairs, or a knife/chainsaw/lawn mower incident--all of which, by the way, are more common than a catastrophic birth experience), we will get to the hospital in time or we wouldn't buy that home to begin with.

I get why people are nervous about home births. The thought of anything happening to a newborn baby is too awful to contemplate. If you are that afraid that something will happen in your birth or with your newborn that it will need immediate attention and cannot wait the ten or fifteen minute car ride to a hospital (or whatever distance the nearest birth center or your home is from the hospital), than you are absolutely correct to birth in a hospital. You have decided that you are fine with a twenty percent increased risk of getting a c-section and a much higher risk of having some other kind of intervention, and I don't think anyone will judge you for it. You weighed your risks and your options and you made a choice that the ability to have interventions if you need them is more important to you than the risk of having interventions you don't need. That's fine. Conversely, if you have researched it and you are willing to take the risk that the distance your house is from the nearest emergency room might be too much if something catastrophic happens in your birth, than I think you should have the right to take that risk without judgment as well. A mother who chooses home birth or an out of hospital birth has probably weighed her risk options and used the same kind of reasoning, love, and care to come to her own decision. No one should assume she hasn't. She isn't being selfish. She just chose to take a slight risk of something happening without immediate intervention, over a much higher risk of an intervention happening without it being necessary.

I also understand why many doctors and nurses are anti-home birth and don't understand why anyone would choose it. I have known a couple of nurses who work in NICUs or labor units in hospitals and they cringe to think about babies born outside of hospitals because in their line of work they have only ever seen home birth babies and mothers with complications. However, that's because the only time out of hospital birthing babies or mothers come to the hospital is when there is a complication. Nurses and doctors know very little about healthy home births because they have never been involved in them. Because only about .67 percent of women in the US had home births in 2011, I have to believe that most hospital interventions and NICU resources are used for hospital births. In fact, elective inductions (choosing to have your labor induced when it is past your due date or for another non-medical reason--a trend that has grown to nearly 30% of all births in some hospitals) result in more babies being placed in the NICU than home births.

However, what I don't understand is people who get angry with women and try to take their right to choose their place of birth away from them simply because they would not make that same choice themselves. It is not as if most of these women are denying medical help when they need it; they are simply denying medical help unless or until they need it. There is a world of difference between those two statements. I respect women's rights to make their own, educated medical decisions no matter if their choices agree with mine or not. Other people should do the same; it's not like they are trying to take away the right to choose birth in hospitals.

Thanks for reading,



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