Labor and Birth

10 Homebirth Facts No One’s Telling You

August 25, 2008

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We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit. With 12 children and 20 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth is our space to share it all with you.

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(Note to Free Thinkers: Please don’t make your birth decisions based on statistics alone. Numbers, statistics and studies can be skewed to support either side of most arguments. That’s why you’ll find tons of folks bantering back and forth… quoting study after study after study. Your birth choices are not about “studies.” They are about you. About your life, your baby and your choice. Studies support your choice. They don’t have the power to make your choice.)

If you’re newly pregnant, chances are you have never heard the truth about why homebirth is a safer choice for low-risk pregnancies. And if you’re not newly pregnant, it is never to late to consider your options and give birth to your baby at home.

“The first intervention in natural childbirth is the one that a healthy woman does herself when she walks out the front door of her own home in labour.”

— Michael Rosenthal, OB/GYN (from Midwifery Today E-news 7:24)

1. In studies comparing home vs. hospital births, homebirths supervised by a “trained attendant” indicate fewer deaths, injuries and infections. Respiratory distress in newborns was 17 times higher in the hospital than at home. (1)

2. The US has the highest obstetrical intervention rates of any country. (1) The US is currently ranked 28th for infant mortality (that means 27 other countries have a better rate of infant survival than we do). (5, 33)

3. The superior outcomes seen in homebirths are not because the women are at lower risk or in any way special or different from women planning hospital births. (2)

4. You are very likely to have a c-section if you chose a hospital birth. The WHO concluded that there is no reason for any region of the world to have a cesarean rate of more than 10-15%. As of 2004, the US has a 29.1% c-section rate. This rate is up from 27.6% in 2003. (2, 20) (3) C-section infants also are four times more likely to die than those born vaginally. (5, 31)

5. The newest study, done in 2005 and published in the British Medical Journal showed homebirth with a CPM (Certified Professional Midwife) to be as safe as hospital birth. The rates of medical intervention at home were lower, and the study showed a high satisfaction rate for mothers. (4)

6. The vast majority of woman are 2 to 6 more times likely to die if their babies are delivered in the hospital. (5, 25)

7. If your baby is born at home with a midwife, instead of in a hospital with an OB, he is six times more likely to survive his first year. (5, 29)

8. The longer your second stage of labor, the more likely you are in to receive a c-section when at the hospital. At home, there will likely be no time limit on your pushing stage unless there is a real problem. (5, 46)

9. When your birth is attended by a midwife, your chances of hemorrhaging and/or continuing to hemorrhage are significantly reduced. (5, 58)

10. A study published in the November 2003 of The Lancet found that c-sections double the rate of stillbirth before labor begins, in women who have had a previous c-section (and most likely a hospital birth). (5, 105)

Sources:

1. From Is Homebirth for you? 6 Myths about Childbirth Exposed
http://www.gentlebirth.org/format/myths.html

2. Goer, Henci. The Thinking Woman’s Guide to a Better Birth.

3. ICAN (International Cesarean Awareness Network)
http://www.ican-online.org/

4. http://www.mana.org/CPM2000.html

5. Doubleday, Jock. Spontaneous Creation: 101 Reasons Not to Have Your Baby In the Hospital (e-book available at http://spontaneouscreation.org)

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  1. Natalie says:

    I am writing about natural childbirth on my blog I LOVE the note to free thinkers you put at the beginning of this post. I will be quoting and linking to you if you don’t mind.

  2. Natalie says:

    I am writing about natural childbirth on my blog I LOVE the note to free thinkers you put at the beginning of this post. I will be quoting and linking to you if you don’t mind.

  3. Guest says:

    thanks, but i choose hospital and c-section…. either that or bleed out and lose myself and my 2 children

  4. junebug says:

    thanks, but i choose hospital and c-section…. either that or bleed out and lose myself and my 2 children

  5. I admit I didn’t have homebirths and I can definitely attest to the fact that hospital births increase your chances of intervention. Homebirth is a great choice and it would be nice to see people open up to it. Take care!

  6. I admit I didn’t have homebirths and I can definitely attest to the fact that hospital births increase your chances of intervention. Homebirth is a great choice and it would be nice to see people open up to it. Take care!

  7. hypatia says:

    junebug,

    No one is advocating that homebirth is the perfect solution for every situation, obviously people with risk factors should be seeking hospital births. However many women go to a hospital without being critical assuming its “the best” because doctors are there. Unfortunately there are many in the medical community who treat birth as a problem that needs to be solved as quickly as possible rather than considering what is in the best interest of their patients.

  8. hypatia says:

    junebug,

    No one is advocating that homebirth is the perfect solution for every situation, obviously people with risk factors should be seeking hospital births. However many women go to a hospital without being critical assuming its “the best” because doctors are there. Unfortunately there are many in the medical community who treat birth as a problem that needs to be solved as quickly as possible rather than considering what is in the best interest of their patients.

  9. Kay says:

    I was born at home almost 30 years ago and now I will be giving birth at home as well. My Mother was in labor with me for over 24 hours and at one point stopped altogether, but since she was at home there were no interventions to “speed things up” and so I was born gently and in the pressance of loving people. When I was born I didn’t even cry and lay peacefully on my Mother’s breast in my first moments of life. I want to give my son the same gift of peace and love and I am very excited to find so much information and support out there for independantly thinking women.

  10. Kay says:

    I was born at home almost 30 years ago and now I will be giving birth at home as well. My Mother was in labor with me for over 24 hours and at one point stopped altogether, but since she was at home there were no interventions to “speed things up” and so I was born gently and in the pressance of loving people. When I was born I didn’t even cry and lay peacefully on my Mother’s breast in my first moments of life. I want to give my son the same gift of peace and love and I am very excited to find so much information and support out there for independantly thinking women.

  11. Sue says:

    Your claims are so ridiculous and really incorrect. There are plenty of hospital facilities that are safe, and peaceful. I think your hospital stats are coming from homebirths gone wrong. I live in a community that favors homebirth and I know a handful of these that have gone bad, and had to be rushed to the hospital and emergency c-section to stillborn b/c that mother chose to try it at home and had she had medical intervention earlier that baby would have survived. C-sections are very safe, emergency ones after things gone badly do not always have the best outcomes. To show the other side, interview women that have lost babies form their selfish desire to homebirth, babies that have been permantley damaged b/c medical intervention was not received fast enough and those that chose to have c-sections b/c the risk is very low with a planned c-section. Put this in your story as well, because your point of view seems narrow. Open your mind to options and the safety of those babies that have lost their lives from homebirth. It is far too many in our community.

  12. Sue says:

    Your claims are so ridiculous and really incorrect. There are plenty of hospital facilities that are safe, and peaceful. I think your hospital stats are coming from homebirths gone wrong. I live in a community that favors homebirth and I know a handful of these that have gone bad, and had to be rushed to the hospital and emergency c-section to stillborn b/c that mother chose to try it at home and had she had medical intervention earlier that baby would have survived. C-sections are very safe, emergency ones after things gone badly do not always have the best outcomes. To show the other side, interview women that have lost babies form their selfish desire to homebirth, babies that have been permantley damaged b/c medical intervention was not received fast enough and those that chose to have c-sections b/c the risk is very low with a planned c-section. Put this in your story as well, because your point of view seems narrow. Open your mind to options and the safety of those babies that have lost their lives from homebirth. It is far too many in our community.

  13. Hi Sue,

    Thanks for your comment. We’re not really interested in debating or arguing, there are plenty of other websites for that.

    Our focus is simply to support moms who want to have a homebirth.

  14. Hi Sue,

    Thanks for your comment. We’re not really interested in debating or arguing, there are plenty of other websites for that.

    Our focus is simply to support moms who want to have a homebirth.

  15. Arielle says:

    Sue, as the homebirthing mother of three children, one of whom was stillborn (during a totally healthy pregnancy, without cause, and weeks before I went into labor, so it had nothing to do with where I planned to birth), I can say that stillbirth, by definition, is something that happens in utero, usually without any warning and mostly without any known cause. (The majority of stillbirths for which they can find a cause are caused by chromosomal abnormalities–i.e., babies who were not meant to survive–but in most cases, even with an autopsy, science does not know why stillborns die.) Stillborns cannot be saved by hospitals or c-sections–they die before labor begins.

    This is not to say babies do not die as a result of labor, or because of missed problems. Problems are missed, and labors go wrong, and babies die in all kinds of birth settings. If you want to look up the data, you will see that for low-risk women (estimated to be between 80-90% of American women), homebirth is as safe as hospital birth: that’s what the studies have proven. Homebirth is not for everyone, but for the women who choose it and qualify for it, the outcomes are as good as they are for women who choose hospital birth.

    What has also been scientifically proven is that c-sections are not always safe, and they always come with risks NOT associated with vaginal delivery but with surgery, which makes sense, since a c-section is major surgery. It’s also been shown that once a country’s c-section rate goes over 15% (America’s is currently double that), that MORE women and babies are injured and/or die during labor than if the c-section rates stay below 15%.

    Hospitals have their risks, and homes have their risks. Birth is never without risk, and not all babies can be “saved” by medicine, nor can all births be successful at home. But the place we are in America right now–with an incredibly high c-section rate, worse outcomes than any other industrialized nation, and women being given high-risk drugs and surgery instead of undisturbed, peaceful, well-supported birth–is not acceptable. There are lots of great books on this topic, and the medical research has been done. I urge you to research further.

  16. Arielle says:

    Sue, as the homebirthing mother of three children, one of whom was stillborn (during a totally healthy pregnancy, without cause, and weeks before I went into labor, so it had nothing to do with where I planned to birth), I can say that stillbirth, by definition, is something that happens in utero, usually without any warning and mostly without any known cause. (The majority of stillbirths for which they can find a cause are caused by chromosomal abnormalities–i.e., babies who were not meant to survive–but in most cases, even with an autopsy, science does not know why stillborns die.) Stillborns cannot be saved by hospitals or c-sections–they die before labor begins.

    This is not to say babies do not die as a result of labor, or because of missed problems. Problems are missed, and labors go wrong, and babies die in all kinds of birth settings. If you want to look up the data, you will see that for low-risk women (estimated to be between 80-90% of American women), homebirth is as safe as hospital birth: that’s what the studies have proven. Homebirth is not for everyone, but for the women who choose it and qualify for it, the outcomes are as good as they are for women who choose hospital birth.

    What has also been scientifically proven is that c-sections are not always safe, and they always come with risks NOT associated with vaginal delivery but with surgery, which makes sense, since a c-section is major surgery. It’s also been shown that once a country’s c-section rate goes over 15% (America’s is currently double that), that MORE women and babies are injured and/or die during labor than if the c-section rates stay below 15%.

    Hospitals have their risks, and homes have their risks. Birth is never without risk, and not all babies can be “saved” by medicine, nor can all births be successful at home. But the place we are in America right now–with an incredibly high c-section rate, worse outcomes than any other industrialized nation, and women being given high-risk drugs and surgery instead of undisturbed, peaceful, well-supported birth–is not acceptable. There are lots of great books on this topic, and the medical research has been done. I urge you to research further.

  17. mummyl says:

    I had a home birth and it was the easiest, calmest and best birth I’ve had, it was way better and more relaxed than any of my other births and my baby was the biggest I’ve had at 10lb 1oz. I would recommend a home birth to anyone who is healthy enough to go ahead with it.

  18. mummyl says:

    I had a home birth and it was the easiest, calmest and best birth I’ve had, it was way better and more relaxed than any of my other births and my baby was the biggest I’ve had at 10lb 1oz. I would recommend a home birth to anyone who is healthy enough to go ahead with it.

  19. Rhonda says:

    I had my first homebirth this year, after 4 hospital births. Yep, I have 5 children. The homebirth was the most gentle, peaceful, meaningful, and overall best experience. I did hemorrage, and the midwife was prepared to help with that. The baby's cord was wrapped twice around his neck. Again, the midwife knew just what to do, and gently unwound the cord. I've had all the hospital interventions, and now to have a natural birth…. there is no comparison. Natural birth is AMAZING!!! Birth works!

  20. Amber C says:

    A good majority of people who choose homebirths…. that is, to choose to let natural processes happen naturally, of course are devastated if the outcome isn't what they had hoped, and it is tragic when a life is lost, but that isn't BECAUSE they chose to birth at home, it is because that is nature's way. There are as many people, most likely many MORE on the other end of the spectrum, that probably would have been fine without medical intervention, and end up with many problems because they birthed in a hospital.

  21. acs says:

    Then why are you contributing to a home birth discussion?

  22. HB says:

    No one is telling people these things because most are factually false. Your references are abysmal and completely biased (and are well known for just making things up without basing them on any factual information). You just took other people saying things you want to believe and cited them as if they are scientifically valid references representative of a valid study or other useful source. It’d be like citing the McDonalds website, The Fast Food Awareness Organization, and a book about why fast food is better for you written by someone that makes lots of money off of fast food as proof that their food is nutritious and healthy.

    1, 2, 3, 5, 7, and 10 are factually false. The BMJ study has been totally debunked and even the authors admitted they did not compare apples to apples (they did not compare low risk home birth to low risk hospital birth for the same year, but instead used a mish mash of stats from hospitals going back 20 years to get the numbers they wanted). When numbers from the same year are compared home birth has a death rate 3x higher. The WHO has stated there is no scientific basis for their c-section rate suggestion, it was just a number plucked out of thin air. You could say you are very likely to have a repeat section, as those account for the vast number of sections performed. Most doctors have a first time section rate in the 15-18% range. C-section infants are NOT 4x more likely to die than vaginally born infants. Any disparity in survival is almost always related to the the medical reasons for the section, not the section itself. Babies born via emergency c-section at 28 weeks obviously have a lower survival rate than term infants born vaginally. Recent numbers from Colorado and Wisconsin show babies born at home with a midwife had both a 3x higher death rate and a lower 1st year survival rate than ALL babies born in hospital, which includes every horrible health problem one can imagine.

    The rest may or may not be true depending upon the circumstance and ones location and health. If you are 300 pounds, have out of control BP, GD, and smoke cigarettes you are A) more likely to give birth in a hospital, and B) more likely to have complications resulting in your or your baby’s death than low risk participants in home birth.

    Nonsense like this is why people think CPMs don’t have any education or grasp on scientific information.

  23. Staceyjw says:

    WOW, these things are not true! You are giving mamas false information, which is dangerous. I’m disappointed, as I thought this would be an informative article.

    If you want to HB or UC, I fully support this, but to say it is safer is not accurate at all, and mamas need to know this. HB in the USA is 2-3x more dangerous than in a hospital- even so, the odds are still on your side if you are properly evaluated and truly low risk.

    You don’t have to believe me, for example, go look at the stats for Colorado (on the DORA site, so obviously not biased) and WI (state site) and see their high rates of mortality, up to 6-8x higher in fact!

    An the USA dies good on perinatal mortality BTW, which is the proper indicator of pregnancy, labor and birth stats. It is infant mortality that we do so poorly on, but that’s babies from one month to a year, and is an indicator of pediatrics and social issues, not obstetrics.

    PLEASE correct this.

  24. Wendy Garcia says:

    No one is telling these facts because they are not facts, they are lies. Try some sources and you will see what a crock of BS this entire piece is. If home-birth is really so safe why won’t MANA release their stats? Why aren’t you citing unbalanced and peer reviewed and current sources?

  25. Scash20 says:

    Hello i was wondering where you got all of you information and numbers from.

  26. Are you not allowed to join the discussion if you have a hospital birth?

  27. get your records and find out why you have a history of bleeding!! I bled with my first (hospital birth) and they gave me pit in my second (hospital birth) just in case. With my third, fourth, fifth and sixth I had no issues with bleeding (unassisted home births) and the only difference in my labors really was letting the placentas come out on their own, in their own time, where the 2 hospital births they were forced prematurely by cord traction. My first was out within 2 min of his birth…. the third took an hour,  the fourth and fifth were twins and both came out after the second twin was born, and with my youngest I just didn’t pay attention to how much time anymore 🙂 

  28. jennanicvonh says:

    here’s my thoughts…each of us can be empowering. i will support your idea’s even though i may not agree with them for myself. it is YOUR body, what is best for you is for you to decide, NOT me, nor anyone else. i am not into fear based thinking. no matter what birth idea’s you have, i know we all want the best for the baby and ourselves. as for myself I am for home birth, natural birth, this is my choice and i feel the most comfortable with this…i will not attempt to talk anyone into doing a home birth, or any of my birth plan. and i greatly appreciate you being supportive of mine…

  29. birthapocalypse says:

    The problem isn’t that people shouldn’t make decisions based on studies, but that they don’t know how to read them critically. Like the comment below by Staceyjw that home-births are two to three more times more “dangerous” than hospital births–that’s probably because of the recent study that indicated that morbidity and mortality is two to three times more likely to occur with first-time home-births–though most articles discussing that study point out that its conclusion is far from theory range and needs to be further researched. The newest studies also seem to point that home-birth m&m tends to happen a lot more with CPM or CMs than hospital births, but are _less_ likely to happen in a home-birth with a CNM (which is a bachelor’s degree nurse with a masters in midwifery)–but if you don’t read about the difference, you’re more likely to assume that all home-births are more dangerous than hospital births.

    And it’s a terrible idea to put in someone’s head they should only go with studies that support their decisions, so shame on the author.

  30. Birth Nurse says:

    I love a good home birth.  But please don’t show up to the hospital when you realize you have made a bad choice, exsanguinating, with a cord prolapse, with a FHR in the 50’s and ask the awful, uncaring, scheming medical staff to help you.  You either believe in us or you don’t.   If you want to do it then I think you have to commit to it and all of the risk you are taking on.   If you want the home birth experience I believe you should have it, but be ready to hold a dead baby in your arms, as the risk for getting just that is higher than in a hospital.  If your convictions tell you that your birth experience is more important than the life of your child then I say go for it.  It is your choice, but don’t go spouting bad “data” and false information to sway otherwise reasonable people into what they think is as safe as a hospital birth.  It simply isn’t true.  

  31. birthapocalypse says:

     @Birth Nurse  That’s a terrible thing to say! In a lot of other industrialized countries, it’s the norm for a significant portion of the population to birth at home, with transfer to hospital if needed.
    You really need to look at yourself and figure out why you’d  rather have someone have a dead baby or die themselves than to come into a hospital when complications arise. People die at hospital too–a lot. The US has the WORST maternal and neonatal death rates for industrialized countries–so why do you think the rates are really better in hospital versus home? And by all accounts those states for our country are _under_-reported.

  32. 7thhouse says:

     @Birth Nurse Did you just tell women you would rather kill their children than help them should an unforseen emergency arise in a homebirth setting? Wow… Thank God not all nurses are as heartless and miserable as you seem to be.

  33. CassandraNadeau says:

    “Support” that contains inaccurate, incomplete, and misleading information is not the type of support women need to make informed choices.

  34. CassandraNadeau says:

    You chose unassisted home birth of twins with a history of postpartum bleeding? 

  35. SaraRWM says:

    I refuse to sacrifice my children on the alter of nature.  

  36. KatrinaStidd says:

    My first homebirth was #4 after 3 hospital births and I couldn’t agree with you more. #5 is due in November and I can’t wait to birth another baby the way God designed.

  37. KatrinaStidd says:

     @Birth Nurse It seems you have forgotten, like most of the medical community, that hospitals are actually for sick people and people that need intervention beyond natural aid. Women’s bodies were designed to birth babies just like we are designed to have  bowel movements. Most often, this does not need help, however sometimes, it does. Thankfully, we do have the medical community for when it does. Birth in and of itself, is a natural body function. This is why women’s bodies will deliver babies regardless of anything they are or are not doing. Our bodies know what to do. Sometimes, the woman’s body needs help. Enter medical community/hospital. I’m so incredibly thankful that if my son breaks his arm (aka – not a natural body function) that there is medical doctor to help us at the hospital. I’m also incredibly thankful that when my husband needed his appendix removed, again, medical doctor and hospital to the rescue! I’m also incredibly thankful that as I prepare for the natural body function of birthing my 5th child this November, that my body will do what it does and that my midwife and I will recognize if additional help is needed beyond her skill set in which case we would arrange a hospital transport. I just pray that I don’t find a nurse like you waiting for me to berate me for trying to perform a natural body function, I don’t know, naturally.

  38. Homebirth is child abuse!!

  39. birthlover says:

    I have to completely disagree with you on this one. It could just as easily be claimed that an Interventory Hospital birth is child abuse!!! My aunt has had 2 boys. The first was in a hospital and was sooo interventory. They started with breaking her water (which shot the pain up) and then gave her an epidural (so the baby didn’t have gravity on his side), and then they had a catheder, because she couldn’t get up to go pee, and all in all, the baby didn’t breath for 2 minutes after he came out, he was all blue, the cord was squished, his head was un-naturally squished, it was a completely unhealthy birth. He now is 5 years old, and is fearful of many things, and deals with being scared and anxious about life. His brother, who is now 1 1/2 had a non-intervention birth in a hospital, and it was one of the most beautiful births I’ve seen. This guy is extremely curious and excited to discover things, and doesn’t have half of the nervousness that his older brother had/has.

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