More doctors, nurses, physicians assistants, and health professionals are choosing to birth at home. Image courtesy of Erin Wrightsman, Nurture Nature Photography.
It’s one of the best kept secrets in the medical profession these days: an increasing number of doctors, nurses, physician assistants, and other medical professionals are choosing to birth at home.
For the most part these medical professionals keep quiet about their decision to birth at home.
They don’t want to offend their colleagues.
They don’t want to lose their hospital privileges.
They don’t want to jeopardize their jobs.
But there are about four million babies born each year in the United States and some of the hundreds, if not thousands, of American doctors and nurses who choose to birth at home are starting to speak out publicly about their choice to have their babies at home.
Why would an obstetrician choose to birth at home?
✓ Because home birth is at least as safe or most likely safer than hospital birth. Just ask this Yale-trained M.D. who had all four of her children at home.
✓ Because the choice to birth at home is a gentler choice than hospital birth. Just ask this M.D. who used to fight with his colleagues to allow women to have VBACs and vaginal breech births in the hospital but now attends home births in southern California, including twins and breech babies.
✓ Because they don’t want a C-section. This M.D., Anne Lyerly, had five.
✓ Because they don’t want an induction, an episiotomy, or other harmful, costly, and often unnecessary interventions.
✓ Because they want their baby to come into the world surrounded by love and kindness, not bright lights and anxiety.
One of the medical professionals who chose to have both her babies at home is Jessicca (yes, it is spelled with two C’s, she blames her father) Moore, a 34-year-old nurse practitioner and mother of two from Petaluma, California.
Jessicca (I know that looks wrong but I swear I’m spelling it right) was making a movie about the new trend towards home birth in the medical community when I first published this post.
The documentary film, called, “Why Not Home? The Surprising Birth Choices of Doctors and Nurses,” debuted in 2016.
When she was in the midst of a Kickstarter campaign to help fund the film, I spoke to Jessicca on the phone.
She generously agreed to share a bit of her (awesome, inspiring, envy-producing) birth story on this blog.
I did not have a good first birth experience
As awesome as her experiences were, if you’re like me, Jessicca’s home birth story may be hard for you to hear about.
I had my first baby in the hospital. I did not have a good birth. I still have a lot of regrets and sadness over that choice.
Maybe you do too.
I wish I had been as smart and savvy as Jessicca was.
True, it was before the internet.
True, I knew very few people who were pregnant or having babies.
True, my husband and I were both in graduate school and we had no family support and no way of paying for a home birth.
True, I had no idea about how badly we were going to be treated in the hospital.
But I have no real excuse.
I should have been smart enough to know better. I was young and healthy and fit. I had only gained 20 pounds during my pregnancy. I planned to stay home as long as possible. What could possibly go wrong?
I loved my obstetrician. She was smart and funny and just a few years older than me. She had a toddler and a new baby of her own, a good sense of humor, and a wicked smile. She looked tired all the time but she was always friendly and kind during our (very brief) prenatal appointments.
I didn’t see my OB, not once, during labor
I didn’t know I would not see her, not even once, during my birth.
No one told me she would never follow up with me afterwards to ask me how the labor had gone or inquire about the health of my baby.
Why should she? I was just one of her hundreds of patients.
“Caring” for my pregnancy was her job. Nothing more.
No matter how good a relationship you have with your doctor, she will probably NOT be available during your labor, unless something goes wrong. That is one major difference between the choice to birth at home and the choice to birth in the hospital. During a birth at home the midwife is by your side. During a hospital birth your doctor is MIA.
The vast majority of obstetricians either feel or are told by hospital administrators that their time is too valuable to come in and say kind words to you, rub your back, or offer you a drink of water.
That, after all, is not their job.
So either the obstetrician comes in to do something to you when your hospital labor “stalls” or, if things are going smoothly, she shows up while you are pushing.
Only if you are being seen by a large practice with several doctors, like I was, you may end up with one of your doctor’s colleagues, the only male one, the one with the bald head who berates you for being “selfish,” the only one you’ve never met before.
If you’re lucky and have kind nurses, you may have a good hospital birth experience.
Labor and delivery nurses that are emotionally and physically abuse
But if you end up with the sort of nurses I did, ones who thrust their fingers roughly up your vagina after 15 hours of labor and retort, “Nothing! Not even a dimple” (about your lack of cervical dilation), before disgustedly peeling off their gloves, throwing them away, and rushing out of the room, you may be sorry that you decided to have your baby in the hospital.
I was verbally and physically abused during labor at a hospital in Atlanta, Georgia.
The two obstetricians and the labor and delivery nurse who treated me with so much disdain have no memory of me.
For them my experience was standard procedure.
That the nurses refused to turn down the epidural (the same epidural that I was bullied into accepting, did not want, and was then billed an enormous amount of money for) had no effect whatsoever on them.
That I ended up with six weeks of bleeding hemorrhoids, a numb leg, and a broken heart after my baby was born is immaterial.
They, too, were just doing their job.
A gentler way to deliver a baby: birth at home, surrounded by love
Jessicca has a different story to tell.
She didn’t come to choose to birth at home after a bad hospital experience like I did.
She had the birth she wanted the first time around. A gentle, safe birth in a familiar location.
Of course more and more doctors and nurses are choosing home birth.
They want what I didn’t have. They want what Jessicca did.
Here’s a bit of her birth story and more about her film. I contributed $100 to her movie’s Kickstarter campaign.
I hope you will too.
Jessicca Moore holds her new baby after birthing at home. She is part of a growing trend of doctors, hospital nurses, and other health care professionals choosing to have out-of-hospital births in America. Image courtesy of Erin Wrightsman, Nurture Nature Photography
Off Script by Jessicca Moore
I was always a “good girl.” The oldest in my family, I was a pleaser. I followed the rules, and never got in trouble. I made my parents and teachers proud. My younger brother was another story.
The first time I went off script was when I turned down a scholarship to Washington University in St. Louis at the last minute—during freshmen orientation weekend. Instead I chose to go to a smaller, private Christian University in Arkansas.
I went off script again when I got married while attending college. My parents recovered, but they were initially more than a little displeased at the timing. My dad’s biggest fear was that I would get pregnant and not finish school. I redeemed myself, at least somewhat, when I finished graduate school at UCLA, married and everything. Turns out, my dad didn’t need to worry about me getting pregnant. I would spend four years trying to get pregnant and suffer two losses before I had my two children, both conceived thanks to IVF.
I was a nurse who worked in neonatal and pediatric ICUs. My family and friends assumed I would have my children in the hospital, like nearly 99% of women in America.
With such a high-tech and “wanted” pregnancy, why would I take any chances?
I didn’t make the decision lightly. I looked critically at the data and weighed the risks in various settings. I explored my options thoroughly. And I decided I had the best chance of a safe and uncomplicated natural birth in my own home surrounded by people I knew and trusted.
My family and some of my colleagues disagreed.
But when the time came, the experience of birth was so much more than I imagined it would be.
It was absolutely the most beautiful and powerful experience of my life.
Since then, I have watched friends and family members have dramatically different birth experiences. Experiences that left them feeling powerless, scared, anxious, and defeated.
I have also met more colleagues and hospital birth providers who chose to give birth at home.
Often, they kept their decision quiet, hiding it from friends, family, and colleagues. But theirs is a story I want to tell. A story that has the potential to expand understanding of home birth beyond the fringe practice often portrayed in the media.
So here I am, going off script again. I’m making a documentary film. I’m a practicing clinician and mother of two young children. I never went to film school. It seems a little crazy, but that’s what’s happening.
I started work on this project when my daughter was three months old. I lugged my breast pump to interviews and reviewed transcripts while nursing her. It hasn’t been easy, and it’s still not done. But whenever it gets hard I watch some of the interviews we’ve done or the births we’ve filmed.
There is so much beauty and wisdom, knowledge and power in these birth stories.
I can’t wait to share them with the world.
Off script, it turns out, is the best place to be after all.
Jessicca Moore is a family nurse practitioner and filmmaker in Petaluma, CA where she lives with her husband, two children, and two sheep. She is the director of the feature-length documentary, “Why Not Home?” The film follows hospital birth providers who chose to give birth at home. You can watch a trailer and get more information here: www.whynothome.com.
Published: Sep 24, 2014
Updated: January 1, 2020
Related content:
A Doctor’s Thoughts on Home Birth
Low-Income, Low-Risk, But Denied a Home Birth Anyway
Why This Mom Wanted to Have her Baby in a Lake!
As a Physician Assistant in MD who had a homebirth in 2012, I am in love with this article and the documentary project. Supported and shared!
I am a nurse, an OB nurse. I had all 5 of my babies at home!Despite ridicule, condescending attitudes and downright ignorant opinions and judgements Is there any other way?! I also caught my half sister 27 years ago and my grand daughter 8 years ago at home. Keeping it in the family 😉 lol
Yes! Word by word, phrase by pharse… spellbound by these words, these stories. thank you so much for sharing them.
Erin Wrightsman
ps – i made the images displayed above.
Amen sisters! Nurse-midwife here with 3 babies born “at home on the floor” as I say! Nursed each one x 2 yrs and am currently helping others do the same with my small home birth practice. Can’t wait to donate and can’t wait to watch!!
HOME BIRTH IS 100% ADVISABLE CONSIDERING THE PRESENT HEALTH CARE SYSTEM IN THE HOSPITAL OR IN NURSING HOME – WHICH THEY FOLLOWS. THE STORY AS DESCRIBED > ABSOLUTELY CORRECT.
MY MOTHER WAS A QUALIFIED MIDWIFE & USED TO WORK IN THE CALCUTTA MEDICAL COLLEGE. AT THAT TIME ( SOME 55 YEARS BACK ) 99% MOTHER EXPERIENCED NORMAL DELIVERY & THEIR FEELINGS WERE DIVINE.BUT TODAY – HOSPITALS & NURSING HOME HAS NO TIME TO WAIT FOR NORMAL DELIVERY. TO SAVE TIME & EARN LOTS OF MONEY > THEY PREFER CAESAR ION !
CORRUPTION & NEGLIGENCE EVERYWHERE IN THE WORLD & NEW MOTHER LOST TO FEEL THE ESSENCE OF LIFE WHEN SHE GOES TO GIVE BIRTH HER 1ST. CHILD ++
*** SOME CRITICAL CONDITION IS DIFFERENT.
This is not Calcutta, my friend. Your doctors are excellent but resources don’t compare to ours in the US. So we are comparing apples to oranges, and that is simply bad science.
So well said. I was a healthcare policy analyst who became a homebirth midwife and an now (nearly) a CNM/WHNP who had my 1st in the hospital and decided to never do that again and instead had my 2nd at home. We do so much to impede normal birth in healthy women in the hospital! Homebirth and free-standing birth centers can change this. My hope is to soon be able to bring a birth center/homebirth service to my area with insures coverage (hence getting the CNM). We can turn the tides with more films, media, etc!
I am a Pediatrician and my husband is a high risk Obstetrician. We had three out of four of our children at home after the first birth was not what I had dreamed of. Never ever regretted a moment of that decision! So glad you are doing this. You are so correct on how we kept the whole thing on the down low as to not to cause “waves”
Nurse of 14 years; had my daughter (now 20) in the hospital & my son (now age 4) was waterbirth at home. Wouldn’t have it any other way!
This is such a very important project. My daughter was born at home in 1982 and she recently gave birth to her daughter at home. As a birth worker, I have seen too many human rights violations in the birth places. Too many healthy situations were turned into “high risk”situations. A medically managed birth in a hospital is NOT the optimal way to give birth. More people need to know that.
My husband and I are both vets. After lots of research and.looking at the statistics we decided to have home births for our 2 children. Fantastic and amazing experience both girls were born in the water with our independent midwife present.
We are mammals – mammals like to give birth in the middle of the night somewhere quite and private. Why would humans be any different.
I feel so sorry for the women who have traumatic hospital births.
I’m a pediatrician and have attended many hospital births where unnecessary interventions were done. I knew that I would never let that happen to me. I had two natural births with midwifes, one in a small community hospital with no OB or peds back up and the second in a free standind, midwife opperated birthing center. Best experiences of my life! I am not quiet about my decisions and I speak if them at work ( I work in a ped ED) whenever someone will listen. People need to hear a doctor say “birth is normal, not a disease” so the process of reclaiming birth by women can progress.
I am an OB Nurse and have had two home births (one water birth and one surprise breech birth). I have always felt alone in my decisions, kept mostly quiet about it, and I can’t tell you how amazing it feels to see that there are other healthcare professionals that see it the same way as me. I had the most exceptional care and support I have ever seen in the 10 years I have been working in women’s health. I wish everyday that every woman could have the same kind of care that I received.
Thanks for getting this word out. I am a Labor and delivery nurse and I’ve had my last 2 children at home with a midwife. If I have any more I’ll never step foot back into a hospital to have a baby unless there is a true medical reason.
Old men with bald heads can’t be good doctors?
Would you condone such sexism and prejudice if it were directed at a woman?
You should be ashamed of yourself as a journalist and as a human being.
Dear Max, Thank you for bringing this to my attention. I see how the description “ugly bald head” could be perceived as gender-bashing. I apologize for that as it was not my intent. After being verbally abused by this doctor, who then shoved the labor nurse out of the way, all I saw of him was the top of his hairless head. It is an image that has stayed with me, which is why I included it in the piece. But the word “ugly” seems unfair and sexist and I will edit it out. I have no doubt that male doctors can be just as gentle, kind, and evidence-based as female doctors. Unfortunately that was not my experience with this obstetrician.
My wife had our three children in a hospital. Diana had two different on/gyn’s deliver our babies. Her doctor in all three deliveries was her obgyn. The change in medicine was dramatic over the 12 year difference between the boys and our girl 8yrs after the last boy. Our first boy was in the dark ages of hospitals, yet I was allowed involvement in my wife’s labor and delivery. This was because of the Doctor. I am a veterinarian so he allowed me to be present even with delivery, unfortunately or their dads were in a shabby room. Our daughter was delivered by a different obgyn. My wife changed because of insurance and retirement. Her current obgyn is the best. Labor and delivery was so much nicer and brighter in the new labor and delivery room. More to the point, when my wife got a life threatening leukemia , of all things her obgyn noticed her name on the hospital patients and asked if he could just come and visit her weekly if she didn’t mind, Her hematologist/oncologist was the best also in her 6 month hospitalization and her obgyn came in to visit every week. I guess my wife was lucky!
I’m a RN. Had my first child at home last April and am pregnant with my second now. Planning another home birth this coming January. It was an incredible experience! I’m fully supportive and excited about this movie!!
I have been absolutely terrified of childbirth my whole life. This makes me feel a bit more at ease. Thanks for sharing, and I would love to hear any follow-ups.
I remember, as a nurse pursuing a higher degree, being the only one left standing (of about 90) in my class of nursing students when the professor asked “if you did or will have your baby at home, remain standing”. He asked if I was working, and I said “Yes, in labor and delivery” at a large local teaching hospital. He said I was probably going to have a better experience than anyone else in the class. I didn’t mention that I had already had a home birth. 😀
I am a vet too. I have seen first hand how “mammals” give birth. Up to 25% expected death rate in any given litter, macrosomic pups that block the canal and kill all the pups to follow, pups that are “too big to birth” so the bitch is euthanized because the owner can’t afford a C-section, horrific rectal tears, sectioning dead calves just to get them out and save the dam, uterine atony, hypocalemia…the list of ways that “birth” can kill a dog or a cat goes on and on. I had my first child at home before graduating and actually practicing medicine, managing dystocias and performing C-sections myself. I will never have another home birth again. I don’t “trust birth” where dogs, cats, cows, or horses are concerned and I don’t “trust birth” where I am concerned either.
Apples and oranges. How many of those animals that you speak of have been so overbred (or bred to have ridiculous traits in the case of cats and dogs) that they physically cannot give birth naturally without assistance? Heck, some of these animals can’t even conceive without assistance because man has abused them so badly with $¢ien¢e! We were made to give birth without intervention. Intervention is helpful when there’s a true emergency, but it should not be the standard of care. I can’t believe you’re even trying to compare what you are…especially after you had a home birth.
Oh you’re right that there are breeds that have a higher incidence of trouble giving birth…but I’ve helped just as many mixed breed dogs and mutt cats. Beef and dairy cattle are MADE to birth. They MUST have babies in order to stay in the herd, otherwise it’s off to market. They are USELESS if they can’t successfully birth calves. And still they have dystocias and dams and calves die.
If we were “made” to birth, there wouldn’t have been a 10% neonatal mortality before modern obstetrics.
And I had a homebirth. I didn’t swear my undying allegiance to a philosophical cult. A true skeptic can recognize and admit being wrong about something they truly believed previously.
Humans don’t normally have multiple birth litters, unlike cats and dogs, so the comparison is pretty well irrelevant. Nor long legs and hooves, although man’s large brain case has made birthing more difficult admittedly. You would be far far better off scientifically comparing human birthing with other primates and in particular the great apes.
Remember also that before ‘germ theory’ but after men claiming to be doctors started getting all technical and interfering in births, they killed quite a lot of mothers by going straight from cutting up cadavers for research to delivering babies without washing their hands in between.
It’s possible a birth may become technically difficult, hence to be on the safe side you should have technical assistance on standby if attempting a home birth or a birth in a more natural wellness centre setting.
I know this feeling. This feeling of being in the closet. I am a CNM. I practice in a hospital. Prior to, I was an OB RN for 8 years. After a traumatic birth of my eldest, I chose to have my twins at home. I have told no one at my new job. It’s sad, really, as it was so empowering.
I am a physician assistant who had a home birth this June after a very disappointing hospital experience. I found many colleagues to be surprisingly supportive, though maybe a bit curious. I got a few raised eyebrows but for the most part, my medical colleagues were respectful and understanding of my choice. I had an amazing, healing experience and I am so thankful this option exists for low risk mamas who wish to choose the path less traveled.
The most common cause of death for women before modern healthcare was “died in childbirth”
I have been searching for a study to support your opinion. All I can find is infection as the number one cause of death in women and men until the middle of the 20th century.
Well, it’s hard to do a “study” on history. So we read…history. Journals, gravesites, etc. It is stunningly ignorant of history to deny the tremendously high maternal and neonatal death rate prior to modern obstetrics.
I am not a medical professional but have friends and family in the field as nurses, midwives, and doulas. After becoming interested in the topic of home birth I took a course at my college, History of Childbirth in America. The class was based around numerous journals, letters, medical records and while it is true many MANY women died from childbirth, the majority of the time it was from unclean doctors. The major spike in death came right around the time when men decided they needed to play a bigger role in birth and so obstetricians became the norm. They promised women the world claiming they could make childbirth painless, quick, and easy. What actually happened was these doctors gave women ether and induced what they called ‘Twilight Sleep’; women gave birth while completely under the influence and often had no recollection of their births. Postpartum was an issue with these types of births. At this point male doctors were the only ones present at births, and many of these doctors had little more than book knowledge — many had never attended a live birth before delivering their first babies. Not only that, it was considered immodest to be seen naked by the doctor, so many times a doctor would examine the patient without looking while the woman remained covered by blankets. The hands were not washed prior to examination, nor during the birth, nor while handling the baby. And then the episiotomies. All without antiseptic. THIS is what caused many deaths from childbirth. Many of these things were not a problem for the female midwives, the cherished members of the community who passed the knowledge of childbirth down among generations.
My midwife (delivered 3500 babies thus far) says that most women of old died in childbirth because of two reasons. 1) rickets from vitamin D deficiency causing pelvic deformity 2) unskilled help during birth (most trained midwives stayed in the “Old Country” and weren’t among the immigrants in our great- grandparents generation). These two problems are unheard of today.
Yes, infection from DOCTORS not washing their hands, was a big cause of death.
See also, our current maternal mortality rate in the US. If we are doing so well with our current ‘standards’ in the hospital, why are we behind many 3rd world countries when it comes to our maternal outcomes? I believe the last update put us at 60th or something ridiculous! Good heavens. Stacy, you are a Dr, do some research. The stats are clear.
“The stats are clear”
Perhaps you’re right. Maybe I’m wrong looking at the increased neonatal death rate in MANA’s study, the increased risk of HIE in January 2014 ACOG, the increased risk of Apgars of 0 at 5 minutes (Grunebaum 2014) at homebirth as compared to hospital birth.
Perhaps you can show me these stats.
While I’m waiting, here’s some light entertainment on the risks of childbirth before modern obstetrics. Anyone here want to go back?
http://www.youtube.com/watch?v=zvQp_hCPKjI
That the number one cause of women’s death ever was childbirth is utter and complete bullshit. Women for most of the history did quite well with a female helper that had seen birth before and midwives as that grew as a profession. This unfact JD brought up was started around the turn of the last century when OB hospitals began to spring up in the US. If you read actual history, women did not die frequently due to childbirth until it was starting to be handled in hospitals–mostly due to infection.
I have been an RN since 1972, a nurse practitioner since 1985, and worked as an independent midwife (kind of on the side!) for 22 years. I had my three children at home, helped other women have theirs safely at home, and had the privilege of catching two of my three granddaughters and being present at all of their wonderful births. I can’t imagine wanting birth to be anywhere but safely at home!
Another nurse here (intensive care). When I was planning my first out-of-hospital birth (freestanding birth center), I had co-workers tell me I was an outright fool for risking my baby’s life and my life too. Paired with a charge nurse who seemed bent on giving me every obstetrical complication patient we had in the months leading up to the birth, including assisting a mother to birth a 22 week old stillborn. They find it hard to remember that we see the worst of the worst complications. But I knew that, like my mother and grandmother before me, I would be able to birth my baby without medical intervention. I didn’t hide my experience, though. I told everyone I could about it. And in the 8 years since my first birth, at least 15 of my coworkers chose midwifery care for their pregnancies and half of them had out-of-hospital births as well (more planned to, but the babies had other plans).
CNM- all four at home. Wouldn’t change a thing.
MD with 5 home births, first in 1990 when a medical student, and naively open about my choices. Looking back, the harassment within my profession was intense…but not as damaging as how many women are treated during hospital birth. Now, as an ER doc and outside the political fishbowl (mostly), I see more clearly a sad truth: As long as greed drives our birth care, our personal decisions become political, feared, and attacked. It’s still very risky to speak this truth to power and not get “burned at the stake”. Glad your work is making future change more likely!
Hi,
I am looking for obstetricians who do homebirths and cannot find any. Are there many who do homebirths?
Can you please send me a list of obstetricians who perform planned homebirths.
RN here; had my two kids at home while working as an OB nurse. I was “under the radar” at work with both pregnancies because I didn’t want to have to defend myself against judgements. In retrospect, I wish I’d been more “out” about it, but I felt really sensitive and vulnerable. I know several RNs and CNMs who’ve birthed at home.
I’m an nurse practitioner and had my third child at home. My first birth was an unnecessary c-section, 2nd unmedicated hospital vbac. If we have more, they will also be born at home! There is no comparison between my hospital births and home birth. They are like night and day the differences are so vast. My daughter did have some trouble breathing initially but my capable midwives were able to get her going quickly. They had the tools and knowledge to take care of her even in a more dangerous situation. Birthing at home doesn’t mean that “modern medicine” isn’t utilized if needs be.
I am a L&D RN who had all her children at home with CPMs.
Caveat: I was not an RN at the time of my children’s births – and I think my naivete contributed to my feelings of safety in giving birth at home.
Aviva Jill Romm was NOT an MD when she gave birth at home. Do you think her perspective on OOH birth has not changed at all? In fact, Aviva is not attending births at all any more. Which is somewhat disappointing. I wonder why she is no longer attending births.
Dr Stu is not attending births in hospitals because his license has been reprimanded by the state and he is forbidden from doing so. He seems to be attending OOH births as a necessity, rather than a choice.
Would I give birth at home again? Maybe….Probably. But my perspective on safety and the “skill” of CPMs has changed significantly since I gave birth. I do not believe that breech and twin deliveries at home are “safe” and there is absolutely no data to show that is true. Low-risk, normal labors without any identifiable risk factors are *somewhat* safe at home. (I will never parrot the phrase that these births are “as a safe as, or safer than” hospital birth, because I have never seen evidence that this is true. On the flip side, I’ve witnessed the “normal, low-risk” labor turn into a bona fide, life-threatening nightmare in seconds. It’s rare, but it happens. And when it does, the OOH site of birth will be at a distinct disadvantage.
I support OOH birth. But I do not support deceiving women in efforts to get them to choose to deliver in a home or birth center setting. Women deserve full informed consent – not propaganda.
“Full informed consent”?? Do you not understand how little consent women have at a hospital? This is not propaganda. I have quite a few friends in the medical profession that chose to give birth at home safely and happily. My completely normal and natural birth almost turned into major abdominal surgery because the doctors and nurses felt the need to put multiple monitors up inside me and constantly check me for progression. I was lucky that I had my head about me when they told me that and told them that they need to check the baby’s head engagement or I could have very well ended up in an unnecessary C-section. I also told my doctor that I wanted to let my placenta birth itself, her response? “oh, its coming out right now” as she shoved her arm up inside me to the elbow and scraped it out. There is no “informed consent” there. Sorry, but if you are advocating full informed consent, you need to fight to fix the system instead of bashing on articles about medical professionals choosing homebirth. And no, my story is not at all exclusive. Almost all of the women I know had traumatic birth stories from hospital births due to care.
Hi Stephanie – well, yes, I am aware of the numerous problems in obstetrics including lack of fully informed consent. I work in L&D; I see it everyday. I am equally appalled with it, and am quite adamant about including my patients in any and all discussions regarding the plan of their care.
But I was not talking about hospital birth, I was speaking of out-of-hospital birth. Blanket statements such as “OOH birth as safe as, if not safer, than hospital birth” is misleading at best, and morbidly deceptive at worst. Parents opting to give birth out-of-hospital deserve to know and understand ALL the risks, benefits, potential outcomes of making this decision – specific to their unique circumstances. Just as they do in the hospital setting.
An out-of-hospital setting is a low resource setting, by definition. Parents deserve to understand and be fully informed of what equipment and personnel is NOT available at an OOH birth, the likelihood that these resources may be needed, and any potential risks in delay of accessing these resources if they become necessary for a safe birth.
I think we may agree more than we disagree here – the right to fully informed consent and decision-making should not be limited to the in-hospital setting. ALL women deserve this, regardless of provider or setting.
Also, I don’t know how I’m “bashing.” I am a healthcare professional – and I had my children at home myself. I even said I’d probably do it again. Is this really “bashing”? Are we too delicate to have a frank discussion about the real risks of OOH birth without moving the goal posts and carping about certain poor practices in hospitals. Like I said, I’m not talking about hospitals, I’m talking about home birth. Home birth is not a perfect system, nor a perfect solution to hospital birthing practices. We should all strive to make every place of birth EXCELLENT, and strive for the best outcomes, every time. We can’t do that if we can’t admit our weaknesses.
Post-obstetrically trained Aviva Romm MD addresses her current thoughts on homebirth here:
http://avivaromm.com/choosing-home-birth#.VCxy1vcM3d4.facebook
A midwife or doctor might choose to quite attending births for any number of reasons. As a student-midwife, I find the hardest part of my work/studies no to be dealing with complications, but rather constantly living life on-call. I have heard other midwives express similar feelings. While I love midwifery, I don’t know yet if it will be a life-long career for me, as I have other aspirations in life too. I will have to see where the roads lead me. If a midwifery business and my art business were to both reach points of taking up so much time as to conflict with each other, I would have to decide to scale one back in favor of the other. Not to mention family obligations…
So she supports homebirth…and attended them as a midwife…but as a doctor she doesn’t. Interesting.
NICU RN here though wasn’t a nurse prior to my home birth with my third child. Blessed to be attended by Homefirst Family Practice Unlimited in the Chicago area. To the doubters here…read ‘Give Birth at Home with The Home Court Advantage’ by Dr. Mayer Eisenstein. If you can find it, the book succinctly explains why giving birth at home is safer for mom and baby. If you think that giving birth in the hospital guarantees safety, you have never worked in a hospital!
As a Dutch women I would have loved to have a home birth. But due to living abroad I was forced to give birth in hospital. my interest stayed however and I have been reading a lot about it, to defend the Dutch way of giving birth towards people who thought it was barbarism.
I would love to recommend a book (not sure if that’s possible ) which I enjoyed reading very much about this subject;
‘a pleasing birth: midwives and maternity care in the Netherlands’ by Raymond de Vries
I planned a homebirth, but due severe pre eklampsia ended in a wonderful hospital. I was very very afraid about birthing in a hospital, because of all these horrerstories. However, yes I had during these 36+ hours different doctors and nurses. It was a high intervention birth, but they tried to stick to my birthplane as much as possible. I am beyond of thankful, that there was a hospital who saved mine and my babies live. I think home birth is wonderful thing to do, or a low intervention birth in a hospital, but bashing all about the hospital birth doesn’t help either. It gives mother to be so much fear and that isn’t helpful as well.
I’m an MD, and have delivered many babies easily in the hospital uneventfully. Awesome. I also witnessed my first home birth with midwife present infant death due to a prolonged labor and tight nuchal cord that was not reduced. This baby suffered severe anoxic brain injury and later died.
As for my own. I never even entertained the idea of home birth, because I had miscarried my first and bled nearly to death one night on call. I bleed easily and when you lose half your blood volume in a matter of hours, I’m talking about sitting in a pool of blood that formed around me in seconds, you don’t feel safe to try it at home. My next two pregnancies were both high risk. I developed severe preeclampsia and had my son induced 5 weeks early, born with an undetected heart defect, and spent a week in NICU. He was dead at the time of delivery, and thankfully rescucitated by the neonatologist. Otherwise that likely would have been 2 lost babies for me. My daughter was looking perfect until it was finally determined there was no way she could make it through my pelvis. Her head was bigger than my pelvic outlet. She started to show signs of fetal distress, and so I had an emergency C-section. She came out perfect. I’d do that again in a heartbeat if I had to, or could. I’m only 45 now, but had a hysterectomy due to a disease called adenomyosis in my uterus that caused severe pain and severe anemia from heavy menstrual bleeding.
So my point is you can’t make blanket statements about home birth being safer. For women who are health and normal, it’s most likely safe, and if I could have done it safely, I would have loved to have had a home birth. But my two children and I are alive today BECAUSE I was in a hospital. I made an informed decision based on my individual case. I’m not a bad person because of my medical circumstance. Medical technology is not inherently “bad”. And no, the so called “medical-industrial complex” is not out to get you. Individual doctors want to help people, and recognizing an individuals right to decide for themselves is key. Many patients make terrible decisions, example drunks who choose to keep drinking and end up dead. Diabetics who don’t take their medication, exercise or diet, people who smoke two packs a day. But it’s still their right to make that choice. I think that’s where many of my colleagues need a reminder, it’s not their choice to decide for the patient, and patients are allowed to make decisions and live with the consequences. Basic Human right stuff here.
Another RN here. I work med/surg but I knew I always wanted a home birth. I had my first two in the hospital, and they weren’t terrible experiences, but my home birth with my third was wonderful. I’m not pregnant again yet, but we will have another home birth when that happens. :h
Final statement, no one here has mentioned anything about infant and maternal mortality prior to modern obstetrical care. I still think women should be able to choose, regardless of the outcome, because it is their body, their baby, and their life. No one should be forced to give birth in a hospital if that is not their wish. But again they should be informed of at least the risk of fetal or maternal death in their specific case. And we have one thing our foremothers didn’t have, 911. Let mothers decide for themselves.
First, infant mortality is the wrong statistic. Infant mortality includes deaths up to 1 year of age. You want perinatal or neonatal mortality, deaths in the first 28 days or so.
Before modern obstetrics roughly 1 in 1000 women died in birth and 100 in 1000 babies. Now it’s something like 7 in 100,000 women (0.07 in 1000) and 0.38 in 1000 low risk hospital born babies, 1-3+/1000 homebirthed babies.
But of course hospitals and OBs are terrible people and women did just fine without them.
As reference:
Increased neonatal deaths at homebirth: http://www.ncbi.nlm.nih.gov/pubmed/24662716
MANA’s voluntary survey (to compare to previous link, since they conveniently left out hospital neonatal death numbers from their paper). One also needs to add early and neonatal death rate since MANA chose to splice it even though that’s not how neonatal death rates are typically reported: http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12172/pdf
5 minute Apgars <4 at homebirth: http://www.ncbi.nlm.nih.gov/pubmed/23791564
5 minute Apgars of 0 at homebirth: http://www.ncbi.nlm.nih.gov/pubmed/23791692
Increased risk of HIE at homebirth: http://www.ajog.org/article/S0002-9378(13)01604-9/abstract
I am a family nurse practitioner, and I had 3 of my 4 babies at home. The 1st baby was intended to be at home but we transferred after a very long labor, and the hospital experience completely reinforced why I wanted to birth at home. It was a horrific experience in the very hospital I worked at as a nurse. My 3 home deliveries were amazing, and very smooth.
I think the reason more health care professionals are choosing home birth is that they tend to be more healthy (or at least health conscious) and have the educational privilege and professional experience to look for other options. I don’t think home birth is for everyone, but I think it would be a good option for many more.
If asked, I recommend it to friends, but its a big step to move outside the birth mainstream. As health care professional we should do like we always do and that it is educate and guide, but not push.
I love this article! Our last birth was a home and my husband is a physician. We did it for all the reasons mentioned in this post and we will do it again!
Now if we could get them to NOT be quiet about birth and infant circumcision……. Maybe homebirth would be more accepted and infant circumcision would be done away with.
Great article and I cannot wait to see the film.
I had all four of my children at home (two in Japan and two in Canada) and I cannot imagine any other way of birthing babies. Mine were born in 1979, 1982, 1985 and 1992. I chose who I wanted to be present and I have no regrets. My children were present at each subsequent birth and assisted in cutting the cord of their new sibling.
I have always been singing the praises of home birth as women have been doing it naturally from the beginning of time.
I look forward to watching this film. I couldn’t help but cry reading this article. I had a negative birth experience with my second child, so much so that I quit my hospital job, instead of returning after maternity leave, because just walking into a hospital created such anxiety I couldn’t go back. I wish I had fought harder, been less afraid, so many things I wish had been different. I hope to see the culture change, people do not even know what normal birth is but I hope for more for my daughter. Thanks to those working to make birth better!
A dear friend of mine had her baby at home with what she didn’t know at the time were unlicensed midwives. They allowed the labor to go too long, discouraged her from going to the hospital and abandoned her when the baby was born dead. She will have her next baby in a hospital this fall.
No amount of a bad birth experience will ever be worse than a dead baby.
Awesome awesome awesome! It is refreshing reading everyones story! Be loud and proud about being educated and doing what is in the best interest of baby and mommy! 🙂 As pediatric and pregnancy specialty chiropractors we know what its like to be harassed and judged as whacky uneducated people! We birthed our first daughter at our office and our second one was birthed in a tub in our basement! My wife and I wouldnt of had it any way!!!
I’m a home birth mom and I’m currently working on a book on home birth (a guidebook for those planning home births) and I love what you’re doing here! I can’t wait to read your book… As soon as I complete this comment, I’m ordering a copy:) Thank you for helping to get the word out about home birth.. I am also a healthcare professional who chose to birth at home. Being intimately acquainted with the inner workings of hospitals, with two low risk pregnancies, I just couldn’t imagine giving birth in one if I had the choice!
So many thoughtful and poignant stories- I feel I must chime in as one who works in “medicine” and had a home birth. I have been a L&D nurse for 10 years and am in midwifery school now. My first birth was a cesarean in the hospital, I believe because I felt that I was healthy and trusted my OB too much. As a new OB nurse at the time I didn’t know better than to be more skeptical and do my research. After that, I did my research (five years’ worth, just saying) and knew that if I wanted ANY chance of having a normal birth the second time I would have to stay out of the hospitals. Granted, VBAC- especially home birth VBAC- is not ideal for everyone. But for me it was the most healing and amazing experience, and due to my research I knew I was as low-risk as I could be.
That said, the comments that have been made about maternal/neonatal mortality and “modern obstetrics” being the savior of mothers and babies… ? How about modern sanitation, proper nutrition, and basic health/prenatal care? I accept that mother nature sometimes needs some help from science- but as medical workers we need to be able to determine when this is appropriate so that our interventions are truly beneficial and not overused out of fear/greed/litigious concerns, and causing more problems than they solve. And, sadly, many less-industrialized countries have better outcomes than the U.S. (https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html) because our maternal morbidity is RISING because of the excessive interventions (http://apps.who.int/iris/bitstream/10665/112682/2/9789241507226_eng.pdf pg. 43). So is it really apples and oranges? The countries with the best outcomes blend the resources beautifully, offering midwifery care for low-risk women to minimize interventions (often with home birth as an option) and OB’s retain their rightful place as experts in complications.
I am a Family Physician. At one point in my career I realized there had to be a better way to treat a woman in labor and her baby who is emerging from the womb of creation, than the active management I was taught at medical school, where doctors are the controllers. I changed my paradigm from the technocratic model to the physiological natural model, where mom, dad and baby are the protagonists of their birth, in an atmosphere of love and reverence. For the last 22 years I have followed the midwifery model of care, and became a male midwife (some call me “partero” or “mid husband”). Well, my wife and I had our three children at home, one of them water birth.
This really has nothing to do with the article itself, but just a little FYI for the author, it’s ‘physician assistant’ not ‘physician’s assistant.’ It’s a common mistake but one that only leads to further confusion and misunderstanding of what a PA actually is. Just thought you’d like to know, for future articles and such.
Thank you for pointing that out. I’ve corrected it now.
I had always been a “rule follower” and my husband is a Pathologist but after research and Bradley classes we were convinced to birth at home . Four beautiful births later we are huge home birth advocates for low risk moms.
In 1910 when you had no choice but natural birth 140 in 1000 births the baby died. Why go to such extremes how bout midwife led birth backed up by obstetricians in a birthing centre attached to a hospital. Why attached to a hospital because as I age I worry about waiting for an ambulance during my heart attack because it is busy transporting a home birth mom to hospital. This from an obstetrician who has snatched babies from the jaws of death occasionally but seen far too many interventions frequently
I was an LVN working at Queen of the Valley hospital in the Los Angeles area in 1979 when I decided to have my baby at home. All of our EMT friends offered to park an ambulance in our driveway. It was not legal for the midwife to sign the birth certificate. She had an agreement with Paul Fleiss MD, pediatrician in Hollywood, a longtime advocate of breastfeeding and father of famous Madam Heidi Fleiss. We had to take the baby to him the next day after birth for an exam, and he signed the birth certificate.