Natural Childbirth I: Home Birth vs Hospital Birth | Chris Kresser
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Natural Childbirth I: Is Home Birth More Dangerous Than Hospital Birth?

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In this series we’re going to explore natural childbirth (home birth) as an alternative to industrialized childbirth. Industrialized childbirth could also be called “disturbed birth”, which Australian family physician Sarah J. Buckley, MD defines as follows:

Anything that disturbs a laboring woman’s sense of safety and privacy will disrupt the birth process. This definition covers most of modern obstetrics, which has created an entire industry around the observation and monitoring of pregnant and birthing women. Some of the techniques used are painful or uncomfortable, most involve some some transgression of bodily or social boundaries, and almost all techniques are performed by people who are essentially strangers to the woman herself. All of these factors are as disruptive to pregnant and birthing women as they would be to any other laboring mammal – with whom we share the majority of our hormonal orchestration in labor and birth.1

Buckley embraces an evolutionary perspective on pregnancy and childbirth. Such a perspective affirms the natural process of gestation and birth and recognizes a woman’s genetically inherited capacity to give birth without medical intervention.

In the same way that we evolved to eat a species-appropriate diet (i.e. paleo), we evolved to give birth in an undisturbed environment.

This innate system of birth has been refined over 100,000 generations. It involves a complex, finely tuned orchestration of hormones that prepare both the mother and baby for a successful birth and catalyze profound neurological changes that promote the bond between a mother and her new baby.

And just as we experience health problems when we stray from the evolutionary dietary template, women are more likely to experience complications and difficulty in labor when they stray from the evolutionary template of “undisturbed birth”.

Natural childbirth is in our genes

Throughout the vast majority of human history, women have always given birth in a familiar place, with family members or other trusted companions.

Even now, babies are still born at home in most places around the world. And although the move from birth at home to the hospital began in the 18th century, home birth was the norm even in westernized countries until the 1950s.

Think of it this way: humans have been giving birth at home for 999,998 generations, and it’s only in the last 2 generations that hospital birth has become common.

This means that women have given birth at home for 99.998% of human history.

Yet in the U.S. today, fewer than 1 percent of births happen in the home. This abrupt and almost complete transition from natural childbirth toward industrialized childbirth has had profound repercussions on mothers, babies and the culture at large.

My wife Elanne and I have chosen to have a home birth with our first child (who is, as of this writing, due in about 2 weeks!) It has been fascinating to watch people’s reactions – outside of our close friends, who have almost all had home births – when we tell them this.

Some come right out and say “that’s brave!” Others are more suspect, using words like “interesting” or maybe even wondering out loud if it wouldn’t be a better idea to use a hospital midwife. Still others are more direct in their opposition to our choice.

This is evidence that the medical establishment has done a fantastic job convincing people that hospital birth is “normal”, in spite of the fact that home birth has been the default choice for 99.998% of human history.

Doctors and the medial have also managed to convince most people that hospital birth is safer than home birth. But is that really true?

Another myth bites the dust: hospital birth is not safer than home birth

In the Netherlands, where 1/3 of babies born at home under care of midwife, outcomes for first babies are equivalent to those of babies born to low-risk women in the hospital, and outcomes of second or subsequent babies are even better.

A UK analysis found that birth at home or in small family practice units is safer than birth in an obstetric hospital for mothers and babies in all categories of risk.

Other studies have shown that modern obstetric interventions have made birth more dangerous, not safer.

In fact, in terms of outcomes for mothers & babies, studies show that planned home birth has perinatal mortality levels (the numbers of babies dying around the time of birth) at least as good as – and often better than – hospital figures, with lower rates of complications and interventions.

A landmark study by Johnson and Daviss in 2005 examined over 5,000 U.S. and Canadian women intending to deliver at home under midwife. They found equivalent perinatal mortality to hospital birth, but with rates of intervention that were up to ten times lower, compared with low-risk women birthing in a hospital. The rates of induction, IV drip, episiotomy, and forceps were each less than 10% at home, and only 3.7% of women required a cesarean (c-section).

Other studies have shown that women who plan home birth have around a 70-80% chance of giving birth without intervention. And because of low use of drugs, home-born babies are more alert and in better condition than those born in the hospital.

Contrast this with the 2002 and 2006 Listening to Mothers surveys which examined 3,000 births in conventional settings. They found “virtually no natural childbirth” in either survey.

In the 2006 survey, around 50% of women were artificially induced; almost 75% had an epidural; and 33% gave birth by c-section.

Finally, in a review of the safety of home birth by the esteemed Cochrane collaboration, the study author states:

There is no strong evidence to favour either home or hospital birth for selected low-risk pregnant women. In countries where it is possible to establish a home birth service backed up by a modern hospital system, all low-risk women should be offered the possibility of considering a planned home birth…

I agree with the author’s conclusion that hospital birth is no safer than home birth. But if you consider the statistics above which suggest that having a natural, undisturbed birth in a hospital setting is exceedingly difficult, I would argue that there is strong evidence to favor a home birth.

Birth complications are more likely to occur in a hospital environment

A common defense of hospital birth by medical professionals and laypeople is the assertion that it’s necessary to be in a hospital during birth in case something goes wrong.

While it is certainly true that complications may arise during labor that require medical intervention, what is often ignored by proponents of hospital birth is the fact that such complications are more likely to occur in the hospital environment.

In other words, the distortion of the process of birth – what Buckley calls “disturbed birth” – has come to be what women expect when they have a baby and in a way has become a self-fulfilling prophecy.

As Buckley states:

Under this model women are almost certain to need the interventions that the medical model provides, and to come away grateful to be saved no matter how difficult or traumatic their experience.2

TV shows almost always depict birth as some kind of medical emergency, with the woman being rushed down the hallway on a gurney or connected to machines and wires in the delivery room surrounded by medical personnel. Since most people have never witnessed a home birth (or any other birth) before having a child themselves, their impression of what labor is like comes almost entirely from television.

It’s easy, then, to understand why people are afraid of birth and feel the need to be in a hospital setting in case something goes wrong. But that doesn’t mean giving birth in a hospital is safer. The studies I’ve presented in this article demonstrate that it’s not.

I want to be clear: no matter where birth takes place, complications may arise that require medical intervention and I am 100% in support of it in these cases.

When the mother or baby’s life is at risk, we are fortunate to have access to surgical techniques that can save lives or prevent serious complications.

The point I am making in this article, and will make in more detail in the articles to follow, is that the scale of medical intervention in birth today is not only far beyond what is necessary, but is contributing to the very of the problems it attempts to solve.

If you’re interested in learning more about natural childbirth, I highly recommend Buckley’s book Gentle Birth, Gentle Mothering. I’d also suggest checking out her free eBook called Ecstatic Birth and her eBook/audio package Giving Birth At Home.

Note: this series will very likely be interrupted by the home birth of my own child. Elanne is due on the 17th of July, so the baby could be coming anytime. When that happens, I’ll be taking some time off to spend time with my new family. I’ll pick this up again when I return from paternity leave.

Articles in this series:

  1. Buckley, Sarah J. Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices. Celestial Arts, 2009. pp. 96
  2. Buckley, Sarah J. Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices. Celestial Arts, 2009. pp. 96

275 Comments

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  1. This is a great article, and obviously there are many people who are stuck in believing what the hospitals and OB’s want them to. OB’s are surgeons who are very minimally trained in natural vaginal birth, they would much rather be in and out in 20 minutes vs. waiting and responding to the natural birth process. I love it when people say ‘Im glad we were at the hospital’ when most times the problem arose because of medical interventions which were uneccesary. sad. i had my son at the birth center and my midwife has everything she needs in case of emergency, and takes NO risks. ya, the cord was around his neck, normal really considering how the baby moves through the birth canal. He was born at 42 weeks, with lots of meconium in the amnio fluid. he had no problems, was breathing very strong at birth, and was not ‘too big’ to fit through me. Most people think you have some witch doctor chanting over you as you birth, when actually you have the most qualified in natural childbirth person there making sure everything turns out wonderfully. Midwifes are very relaxed, childbirth is an everyday occurence and really no big deal to them! My midwife never lost a mom or baby(who would have lived) in over 4,000 births. bet there arent any OB’s out there with those kind of numbers!
    Baby coming anytime huh?! that’s what I thought! then i found out it’s very normal for 1st babies to go to or past 42 weeks! it’s a guess date, not an actual due date. really are we telling these babies when they are ready???? as we soon find out, everything is on their schedule! best wishes to your family, I’m sure your child birth will be everything you expect it to be and more!

  2. I had all 3 of my kids at home. I had to laugh when people called me brave because to me the hospital would have been so much more frightening. With my first I had to push for 4 1/2 hours…no way I’d have gotten away with that in a hospital. I’d have been cut one way or the other for sure. That was 23 years ago, my youngest is 14 now. Probably hospitals are even worse nowadays. I think you have the right idea. Go for it. Best wishes to you…

  3. Hello,

    I am a huge fan. I ordered The Healthy Baby Code and love it and was hoping that you would be discussing this matter in that material as well. I think even more importantly then where you have the baby, is the support you receive while preparing and during the actual birthing. Obviously, at home you have more control over who is there and what they are doing (or not doing). If you plan to futher this topic in future posts, I think covering doulas (I like to think of them as birthing angels) could be helpful to those who, for whatever reason, choose to birth in hospitals. The most important thing I did to prepare for my natural childbirth (that took place in the hospital, no intervention or any kind just raw, beautiful birthing) was surround myself with a community of women who had done the same. For whatever reason, people like to tell pregnant women all the birthing horror stories they know. I found my oasis at Blooma, a wonderful prenatal yoga studio in Minnesota. Every week I would go and the teacher/owner, who was also a doula, would tell us about all the amazings births she had been to since the last class. Then she would teach us how to move through yoga big bellies and all, with lots of tips about what movements she had found helpful at recent births. I always left there feeling very powerful and knowledgable about my body. The birth of my son was one long, intense yoga practice where the ending was the most amazing shavasana with my new freshly born baby lying skin-to-skin with me. On that note, please also cover the importance of skin-to-skin contact with the baby.

    Birthing Blessings to you, your wife and your baby!

    • Hi Rachel,

      The last article in the series will cover “third-stage labor” and the importance of skin-to-skin contact after birth.

  4. Congratulations on your up coming delivery!

    My daughter’s dad was adamant that we have our baby in a hospital. I had a terrible feeling that everything would go wrong if we did. I totally hate hospitals and doctors (no offence, of course, you are an unusually awesome doctor). Within the first 5 minutes of entering the doors (maybe 3 minutes) nurses told me they were going to cut the baby out. It was so weird. It was exactly, well actually quite a bit worse, than I had imagined.

    I will definitely have my next baby in my home where I am comfortable, with a midwife who cares about me and isn’t off-call when the baby is born.

    • My first birth was horrible in the hospital. My second two were at home and so lovely. I hope your next birth is wonderful.

  5. Chris,

    A premature Congrats and Best wishes for a healthy and happy birth. Eagerly looking forward to an upcoming post where you put the smack down on the barbarous process of injecting science fiction like ingredients into newborn humans, soon after they leave the safety of the mothers womb. (I am of course referring to vaccinations)

    Best

  6. Two months ago, I gave birth to our seventh child in the grass beside the highway under cover of darkness. This wasn’t Plan A, of course, but it was my favorite birth by far. I don’t know if any studies have been done on outdoor birthing, but I recommend it. 🙂

    This was our first non-hospital birth. It’s given us confidence so that maybe next time we’ll try it at home. Maybe in the back yard.

  7. Thanks for your article. I just want to point out that “people” don’t give birth, women do. Women do not need any more blame or shame thrown at them for decisions involving child birth but I do appreciate how you laid out the options of home birth and hospital birth. Spreading knowledge and information is the foundation for empowerment. It is an extremely personal decision to have a child and a decision made considering numerous contextual factors. For example, having a midwife can often be a privilege for those in a stable financial position. The topics of pregnancy and childbirth need to be discussed with compassion and understanding, perhaps even gratitude.

  8. I totally agree that having a baby in a comfortable/safe/home environment is best – I’m also glad that we have a hospital 3 minutes away in case something happens. My 1st son was born in a hospital and with pneumothorax in both his lungs. Without medical intervention he would have died.

    Still, we didn’t know he was sick until 6 minutes after he was born. I had a horrible experience with my doctor and nurses. Nobody said “good job” “keep going” “you’re doing great” … My doctor told me to shut up! And I wasn’t even screaming. My husband never got to cut the cord and my dr never held up my baby for me to see. I understand soon after they discovered he was sick and I COULDN’T see him. But before those 6 minutes? Why? I was pushing out my son and was reminding the dr between pushes, “make sure Mike cuts the cord.” …. nobody listened to me. I really felt like a nobody.

    I felt like I was a slab of meat on a convener belt. There were no personal connections, no calmness…it was very sterile. I hated giving birth in the hospital. It took me over 5 months to recover from the episiotomy.

    If I wasn’t so afraid about what may happen with my next child, I would consider giving birth at home. I’m about 50/50 at this point. I can tell you my insurance would not cover anything that may happen to my child if it were born at home. That’s another consideration – the “system” basically forces you to the hospital because god-forbid something happens. who has $100,000 cash to pay for medical expenses in case the newborn needs medical care? Our bills for our 1st were around $80,000 – glad our insurance payed for it all …. just because we were in the hospital to begin with.

    It’s all about the money now…and not about the woman or her comfort or her baby. So disappointing. Interestingly, about 80% of my friends had c-sections… why? I think they are so quick to do those. And that’s a whole other post…lol.

    • I’m so sorry you went through all that! Try hiring a doula to advocate for you and be your support – and go with a midwive’s practice, if you can. And interview them thoroughly – some of them are ‘med’wives and aren’t all that great.
      Best of luck!!

      • Great advice! I had a doula and a midwife from a supportive practice and I had an amazing hospital birth….but only because I knew what to expect from medical protocol and didn’t let it interfere with my positive thinking. I also used relaxation techniques learned through Hypnobabies…which allowed me to drown out the unwanted distractions.
        I hope you’ll consider looking into hiring a doula…and I hope you have nurse-midwives in your area! They usually practice under a physician so insurance isn’t an issue…

  9. In general I have no argument, though I did think it was somewhat misleading of you to quote the Cochrane review the way you did. You implied that the review was saying that, despite a body of evidence that is large enough to draw conclusions from, the evidence does not lean strongly either way. What it was actually saying was that the authors did not find enough solid evidence (they included only a single study of 11 subjects) to make any conclusion. Big difference.

    On the other hand, what do you think of this recent meta-analysis that found that, while perinatal mortality is comparable in either situation, neonatal mortality seemed to be three times higher? http://www.ncbi.nlm.nih.gov/pubmed/20598284
    It is a meta-analysis, but it seems worth considering.

  10. Yes, we’ve been giving birth “naturally” for millenia. Infant mortality rates were also stupidly high for most of that time. This is often cited as one of the main reasons that paleolithic life expectancy is so low, even when humans making it past adolescence had a pretty decent chance of living into old age.

    Here’s the thing with home birth: Even *if* there are more complications at a hospital, they’re better-equipped to deal with the unknowns that can arise.

    Eliminating “distractions”, “disturbances” and “interruptions” isn’t as important as giving your child every possible chance to make it past their first 48 hours. Whether the experience is “peaceful” or “traumatic” or somewhere in-between doesn’t matter. What matters is that you leave the hospital with a healthy baby. That’s all.

    —————————————-
    “There is no strong evidence to favour either home or hospital birth for selected low-risk pregnant women…”
    —————————————-

    Home birth is perfectly-safe… if you’re low-risk for things they can easily deal with in a hospital. The problem is, most people don’t know whether they’re low-risk or not.

    While I don’t trust the medical industry (and it IS an industry) to prevent sickness/maintain health, they have the tools and knowledge to deal with emergencies as they arise. The odds are, you’ll never need those tools/experience. If you did, though, could you really say you wouldn’t rather have them and not need them than need them and not have them?

    Related post:
    http://blog.dreamhost.com/2011/03/09/wren-jones/

    • Here’s the thing with home birth: Even *if* there are more complications at a hospital, they’re better-equipped to deal with the unknowns that can arise.

      So what? If there is a serious complication, you transfer to the hospital. Problem solved. That’s not a reason to invite more complications by giving birth in a hospital environment to begin with.

      Eliminating “distractions”, “disturbances” and “interruptions” isn’t as important as giving your child every possible chance to make it past their first 48 hours.

      We’re not talking about touchy-feely “distractions” or “disturbances”. We’re talking about real consequences – some of which I already pointed out in this article, and others which I’ll be covering in detail in the articles to follow. They include: interfering with the delicate hormonal interplay between mother and baby (which has real and measurable long-term effects), increased risk of maternal death (even among healthy mothers) and a traumatic birth experience.

      I agree completely that it’s most important to give a child every possible chance to make it past their first 48 hours. I linked to several large studies demonstrating that perinatal mortality rates are equal for home and hospital births for first births, and actually lower for home births for the second and subsequent children. So I’m not sure what your point is here. Having a hospital birth does not increase the chances that your baby will survive the first 48 hours.

      • Since I don’t have time to read through all of the articles posted (and several are subscription-only, so I could just see abstracts), I’ll just ask:

        The studies you refer to that show hospital births to have higher PNMR’s… How do they count situations where (for example), a home birth is planned, but the child/mother end up going to the hospital? That is, if there’s an issue with a home birth, I would imagine most of the time, the child would get taken to the hospital before it dies, in an attempt to save it. Is that being counted toward the hospital’s PNMR, or the home birth?

        When you say “distraction”, I don’t know what way it could be defined other than the “touchy-feely” sense. Is it a medical term I don’t know about?

        As for transferring to a hospital, sometimes you don’t know there’s a complication until it’s too late (like in the link I posted originally). What, then? Fault of an unskilled midwife?

        • It varies from study to study. The situation you refer to is called a transfer and it is often taken into account. But keep in mind with a home birth rate of 1% in the US, transfers as an overall percentage of hospital births are extremely low. Most of the studies on home birth in the developed world have taken place in the UK and the Netherlands, where home birth rates are much higher (>30% in the Netherlands).

          I explained the negative consequences of home births (above and beyond “distraction”) in my previous reply to you.

          Yes, babies do die in childbirth. If you think that doesn’t happen in the hospital you’re kidding yourself. As I’ve pointed out repeatedly, the PNMRs are the same in hospital and home births.

          • So I’ll jump in with a little perspective. I am a licensed homebirth midwife. I have personally had three home births. I have worked in the hospital as an employee and attended about 40 births as a labor doula. Home birth midwives monitor mother’s vitals and baby’s heartrate, amongst many other responsibilities. We protect the laboring mother’s space and bodily integrity so she can labor without disturbance and develop effective coping techniques. We are trained in resuscitation and management of hemorrhage. We can accomplish a transport to hospital, in most cases, in less time than a community hospital can call in an OB, CRNA, and Ped for a c-section for an on-site labor. (Please realize that almost no community hospital has the on-site staff for continuous on-site surgical staff for cesarean surgery. Does this mean these hospitals are unsafe for laboring women?) If my client lives farther from the hospital than 20 minutes, we discuss conservative decisions. When I have to transport, I always call ahead and give the hospital staff as much notice and information as possible.

            The biggest issue with the hostile atmosphere that divides home and hospital birth is the fact that hostile receptions lead to delayed transports and worse outcomes. Homebirths, even unattended births, will continue no matter the vitriol of critics. Many, many of us believe that we can have the best of safety and normal, undisturbed birth with midwives as primary care providers. I participate in the US’ largest homebirth prospective (as opposed to retrospective) research study, conducted by the Midwives Alliance of North America, which does account for every client that begins care with a midwife and tracks her story… healthy home birth, transfer to an OB for prenatal complications, or labor/ postpartum transport for medical care.

            About “distractions” and “touchy feely”: It takes a lot of effort for a laboring mother to maintain effective coping when hospital procedures mandate frequent EFM fiddling because “it just isn’t picking up well when you are in that position”. I have had many clients who were also veterinarians… and commented that no mammal would be able to give birth without surgery in the conditions of a hospital LDR room. The hormones just don’t work.

            And finally, a loop of cord around baby’s neck is extremely common! It’s one of the safest places for the cord to be… it is protected and MUCH less likely to be compressed in the course of labor and can be easily unwound after the birth.

      • Do you think that hospitals should allow natural births AT the hospital (making it as comfortable to the mother as possible) and that doctors should only intervene when serious complications occur? Transferring to a hospital might take far too long and be hazardous to the mother and child.

    • The related post tells a tragic story that doesn’t support the argument against home birth because that mother should have been informed of the risks, and advised to deliver in hospital. Being positive for strep B makes you high risk. If the obs/gyn had forgotten to order antibiotics before or during the labor as he or she forgot to inform the parents of the significance of the positive strep B result, the outcome would have been the same. Babies die in hospital the same way from the same thing when staff miss the dx. There’s no time for an emergency because no one knows anything is wrong until it’s too late.
      In hospital, healthy, low risk women are routinely induced. Under the influence of the drugs used for induction of labor, there is no time for the mother’s levels of endorphins to rise to the occasion. Labor is more painful, and epidurals are usual. Labor can stall after an epidural, and intervention becomes necessary. Intervention HAS resulted in injury to and deaths of too many babies.
      Unfortunately, hospital isn’t a place where a woman is permitted to deliver in peace and safety with the security of professional health care just outside the door in case she needs it. In hospital, delivery is often pathologized and the medicos can take over, just because they can.
      For low risk women and their babies, the risks of unnecessary intervention in hospital are real.
      The negative effects of trauma from a bad birth are real, too. What you dismiss as touchy feely disturbance can contribute to post-partum depression. As post-patum depression is rife, and suicide seems to be the greatest cause of perinatal maternal mortality, you’d think more attention would be paid to whether the mother’s experience was peaceful or traumatic.

    • Ricki Lake the maker of the film The Business of Being Born lays out very clearly why undisturbed birth is important for the health and future health of of our children and our relationships with them. http://www.huffingtonpost.com/ricki-lake/mothers-deserve-options_b_884900.html

      I want a home birth because I want a healthy child. One who didn’t receive drugs during birth and one who’s hormonal and neurological template are set and attuned to mine because our communication during the birth process was allowed unimpeded. A very complex cocktail of hormones are released during birth that help the birth process along. Disturbances, as any person who has worked with animals will tell you, interrupt the proper release of those hormones and the proper functioning of neurological processes. Animals interrupted in birth will halt the birth process or have difficult births. Many times they won’t bond well with their offspring after this happens.

      Those hormones that get released in undisturbed birth are there to facilitate not only the birth but the process of bonding and breastfeeding after the birth, both crucial to the physical and emotional health of a child and a mother.

      Proponents of industrialized birth are often thinking of health in extremely limited terms. As is true of industrialized medicine as a whole.

      • hurtbyhomebirth.com there is two sides to every story… I believe in a persons choice to home birth just know things can happen in any situation…

    • “Whether the experience is “peaceful” or “traumatic” or somewhere in-between doesn’t matter. What matters is that you leave the hospital with a healthy baby. That’s all. ”

      Very well spoken by a MAN who has never birthed a baby. A traumatic birth affects mother AND baby in ways that sometimes don’t show up until weks after birth. With each of my “intervened” births, I had severe depression. With my 4th, I had a natural delivery, refusing doctor’s help, because it wasn’t needed (in the hospital), and I had not one bit of the “baby blues” – AND – my other children weren’t affected by it, and neither was my husband. The birth was a joy and a blessing. Our next will, Lord willing, be born at home, in December.

      • There is no need to bring up gender/sex when trying to prove your argument. You certainly can’t do the same thing when talking to a woman who has given birth, too. Some women have had good experiences with hospital births, so keep that in mind.

    • I know it is several years after this comment, but I HAVE to respond because it completely rubbed me the wrong way. I must say, as a WOMAN, it is a very “man like” thing to say, “Whether the experience is “peaceful” or “traumatic” or somewhere in-between doesn’t matter. What matters is that you leave the hospital with a healthy baby. That’s all.” You know what? YES, IT DOES MATTER. A lot, for different reasons. We as women are not just “incubators”, we are still people who have needs and we all deserve to have the BEST and most comfortable, peaceful birthing experience we can. We bring life into this world and more people, men especially, should realize how big of a deal that is and have more respect for women and what they go through even though it is a natural process. I am Cherokee and my people have so much respect for women because they bring life into the world. So however we choose to birth to make ourselves more comfortable and at peace is how we do it and we are commended by the educated for our decision to do so. It IS about having a peaceful, wonderful birthing experience for the mother because that experience equals the baby being brought into the world in a peaceful, non-traumatic way as well, and it gives them the best start in this world. My great grandmothers had many children at home with a midwife only. One had 11, the other had 9. No complications and they were out working the fields the next day. Guess what? No children died and both great grandmothers lived to be over 100 years old. Both of my grandmothers had natural births but they felt pressured to be in a hospital, but there were no complications and all survived. Then you look at my mother for example. I am her only child. She decided to go to a hospital because of being told statements like yours that “all that matters is that you have a healthy baby and it doesn’t matter what happens to you in the process.” She had no respect for her own self, took the ill informed advice of others against her own wishes, and in the process lost confidence in her ability to birth. She went to the hospital and was lied to that she was not “progressing” and that I was supposedly in distress and also that she supposedly had a pelvic deformity where I couldn’t fit and she was also given the false excuse of my cord being wrapped around my neck being an emergency when all of us (besides Noon obviously) know that isn’t an emergency. My mother has wide set hips, has had no pelvic injuries and never had rickets or any health issues at all. Her pelvis is perfectly fine. But guess what? She ended up having a very traumatic C-section where she felt every bit of it because of false interventions and the medication not working. So that being said, you are saying that a woman is of no worth basically and it only matters that the baby is healthy because it doesn’t matter if the birth is peaceful or traumatic? WRONG!!! It does matter. Out of respect for my mother and all women who have had painful, unnecessary hospital interventions, it matters. So I am choosing to birth my first baby in February like my ancestors did, and my great grandmothers did. They have given me faith in my body that I was made to do this and everything is fine. I have a midwife and see her twice a month and couldn’t be happier. So please, think before you speak and realize, YES, it matters.

      • My comment was in response to JUSTIN ROSS by the way. That part of my message was cut off for some reason but I wanted to clarify.

  11. Hi Chris, great article.
    I too had my first baby at home with an incredibly experienced midwife. the birth was smooth and amazing, if not also really painful 🙂 Its so interesting to see the venom spewed at people that are proponents of natural birth or choosing to homebirth, as exhibited by Noon. She attacks your personal opinion on this subject and then holds you accountable for her observation about how popular the Paleo diet. It is sad to say that this behavior is very common. The fear that people now associate with birth, and seeing it as a medical condition instead of a natural part of life, goes to show how well the medical community has been able to manipulate people around this subject. In a situation like this one where “noon” felt it was appropriate to insult you directly and call you and your decision stupid, it is clear that no amount of information can educate a person on this topic. In my case some of my family members were so opposed to homebirth that we outright lied to them and told them our baby was born in a hospital. It is then ironic to me that all of my births have been fast and problem free while ALL of my relatives who have birthed in the hospital have ended up with major intervention, complications from the interventions, and about 50 percent of them have had c-sections (because the doctor felt that 12 hours was too long to birth.)
    I applaud and support your decision to birth at home, I wish that more of the west would engage in real conversation and thought that might help us return to a place where our children enter this life in a gentle, natural way. The subtle processes of human birth have been evolving for 100s of 1000s of years. The hospital births I have attended appear to me like the medical staff is constantly picking at a scab and then getting mad when it wont heal.
    Blessing on the birth of your child!

  12. Oh, and my baby was born with the cord was wrapped around her neck, twice. My midwife didn’t even flinch, just calmly removed it, and my baby was fine.

  13. Hi Elanne and Chris!

    Congratulations with the soon delivery; I was born at home myself (20 years ago), and thought for many years that it was the normal procedure. My friends were always stunned when I told them I was born in my parents’ bedroom.
    Birth was quick and completely free on complications. There was a midwife present (oh, and the rest of my family; my siblings at age 4, 6 and 8 years – they thought it was VERY exciting).
    I believe it’s much easier for the woman to relax in familiar surroundings; not that I really know, but it would seem natural to me.

    I believe you’ve made a wonderful choice, and I hope the birth of your son/daughter will be (relatively) smooth.

  14. I had a homebirth 3 years ago, and it was the best choice I ever made. I have a huge fear of hospitals and allopathic doctors, so I would surely have had a stalled labor, just because of fight or flight hormones pouring out of me in such a frightening setting. But I also had a 63 hour labor, with my water breaking 2 days before delivery. No U.S. hospital would tolerate laboring for more than 4-6 hours, especially after the water breaking (despite the fact that it is natural for women to labor longer, especially on a first birth), and I would have surely been induced and very possibly c-sectioned unnecessarily, at grave risk and cost to me and my family.

    At home, on the other hand, I was allowed to labor in the peace and comfort of my home, bathe, walk, and eat as I pleased, and finally give birth to a beautiful baby girl that really needed NO medical intervention to come into the world happy and healthy. In fact, my husband and I labored alone for all but the last few hours of it, truly owning what should be a transformative, if not spiritual, process for families. I was also able to rest and breastfeed in my own bed, within just a few minutes of delivery, while the cord was still attached and giving up its last pulses of blood and oxygen to my child. There is no way to describe this experience, it still makes me cry in joy to think about it.

    I cannot say enough good things about home birth for low-risk women.

  15. I had all my kids naturally and 2 of them at home. I’m having my fourth in December, as a child I presenced many births at home and helped once or twice. I had the chance to go to Holland where almost 80 % of birth are at home. Women need a private, quiet setting, with minimum interruptions. Congratulations! your wife will do wonderful! great article!

  16. Dear noon,

    I’m a glad that you have a healthy child and were satisfied with your hospital birth. Your reason for thanking God that you were in the hospital though, the cord around the neck, is one of the biggest birth myths out there. Babies are born with cords around their necks often. Midwives are just as skilled, perhaps more skilled, at dealing with this as doctors. Often the cord around the neck is not a danger at all as the oxygen supply is still coming to the baby through the cord and baby does not yet need to breathe through the nose, trachea etc. My niece was born at home with only my brother and her two grandmothers in attendance. The cord was wrapped around her neck and it was very simple to unwrap it and watch that little one begin to breath easily on her own. No problem.

    Women are told in the hospital that the reason their baby is having troubles is that the cord was wrapped around the neck. This is just not seen in home births. Babies in hospitals have troubles breathing because they are doped up on the epidural drugs and pitocin.

    As for women in many countries around the world not having home birth by choice, this is true. Sadly and to their detriment much of the rest of the world is eager to follow in our “advanced” footsteps. And it is also true that in many non-industrialized countries perinatal mortality rates are much higher. This is likely due to malnutrition and poor health. We know that how a woman is nourished through her pregnancy has a great effect on how she will give birth, her own health and the health of her baby. Weston A Price and others who studied traditional peoples eating their traditional diets noted how easily mothers give birth, often simply wandering off by themselves and returning hours later with a healthy baby. For much of the non-western world people are no longer able to eat their traditional diets and are in very poor health.

    There is a lovely African saying, ““The goat has no midwife but delivers with ease, the sheep has no midwife yet brings forth a live offspring, and you, little mother, will give birth to your baby.” To me this indicates a true understanding of how birth can be.

    • “Often the cord around the neck is not a danger at all as the oxygen supply is still coming to the baby through the cord and baby does not yet need to breathe through the nose, trachea etc.”

      If anyone has ever studied the unadultered birth process, they’d know that babies get their oxyegn from the umbilical cord until from 10-30 minutes or so after birth, when the cord starts pulsing, and the baby learns to breathe on it’s own. Cutting the cord in a nuchal cord birth, would actually deprive the baby, still half way in the mothers womb, of the oxygen. Usually the cord is cut with only thehead out, and the baby;s chest is still inside the mother – leaving no room for the chest to expand for breathing. This, in turn, causes the baby to have oxygen deprivation, which the doctors then blame on the nuchal cord, when in fact, the doctor’s themselves caused the oxygen deprivation. The cord was still supplying the baby’s needs.
      Now, that being said, it’s not a good idea to leave the cord wrapped around the neck of the baby and continute pushing! Doing so would leave the mother at risk of the placenta being ripped from the womb, rather than detaching naturally.
      Expertise – I’ve birthed 3 babies in a hospital setting with the cascade of interventions, 1 peaceful birth in a hospital setting where we refused to allow un-necessary interventions, and my husband and I are currently preparing for an unassisted homebirth of our 5th child, to be attended by our doula. Not being able to afford insurance can change your mind about what is acceptable and what is not. 🙂

  17. It’s also telling that OB/GYN insurance is the most expensive to obtain and maintain, due to the high legal risks. This will undoubtedly affect practice style. When your goal is to produce an alive baby, the mother’s wishes and opinions can suddenly seem beside the point.

    I feel very fortunate to have a hospital locally that encourages natural birth, provides access to water births, provides doulas free of charge, but also has the ability to perform interventions when needed.

    I encourage all potential mothers to do their homework, and your primer here, Chris, seems like a good complement. And to contrast the popular imagery of childbirth, as you mentioned, I highly suggest reading examples of mothers giving birth in natural ways and settings. Ina May Gaskin’s books, while a bit giggle-inducing due to the hippie language, are also full of birth stories that gave me confidence I could have an undisturbed birth. And I did.

    Thank you for contributing to the wealth of information out there about birthing without interventions.

    • “I feel very fortunate to have a hospital locally that encourages natural birth, provides access to water births, provides doulas free of charge, but also has the ability to perform interventions when needed.”

      I wish more hospitals would be like this: combining the natural with the medical (when it is needed).

    • Yeah, I’m going to let an ignorant comedian decide for me what’s the best and least dangerous way to birth my child instead of doing my own research and using that smart brain of mine.

  18. I’m keeep 90% paleo and do believe in the basic philosophy behind it but this is just ridiculous. Most people in the world have natural birth most people in the world, in 3 world countries do not have access to hospitals. Are you seriously trying to say that they do it by choice??? what kind of dumb thing to say is that??

    “I want to be clear: no matter where birth takes place, complications may arise that require medical intervention and I am 100% in support of it in these cases.”

    DUH!!!!!!!!!!!!!!!!!!!!!! well wouldn’t it be nice to do it in a hospital where you do have access…JEEZ…no wonder paleo has a tough time catching on, because of dumb things like this!!

    You can argue that you shouldn’t use drugs but what is the advantage of not being in a hospital? there is always a risk…when my baby was born his umbilical cord was wrapped around his throat thank god we had a doctor…

    • I guess you didn’t read the article. I listed several advantages of not being in a hospital, including fewer complications, lower rates of induction, lower rates of forceps use and c-section. In the articles to follow, I’ll be explaining several other advantages in great detail. You are clearly misinformed, and haven’t provided any evidence to support your objections. You’re just spouting off conventional wisdom, with nothing to back it up.

      • And, in the Netherlands, where people do have access to modern medical care, 33% still choose home birth and perinatal mortality rates there are as low or lower than low-risk births in hospitals.

        • I worked in high-risk delivery/NICU in a Canadian hospital for 7 years.
          Get a mid-wife. Get a doula. Stay at home.
          Midwives are VERY well educated and will take excellent care of you. If you don’t like the risk of being too far away from a hospital, take your ‘birth team’ with you.
          They will at least give you a fighting chance from all of the standard hospital interventions that lead to C-sections.
          Don’t be fool and blindly trust the hospital system. Read. Read a lot! Then decide what you think is best for YOU.

          • In Canada (and in Europe/Netherlands/UK), midwives are educated nurse-midwives. Not so in the majority of states in the US.

            Recent data (2012 and 2014 CDC data) shows that, in the USA, 2x to 4x more babies die per 1000 births at home than in the hospital–when delivered by midwives.

            According to the Midwive Associaton/MANA’s own data, over 22% of first time moms had to be transferred to the hospital, and 3 out of 1000 infants died–much higher than the rate in the hospital (with higher risk pregnant women).

            • Elaine, your information is inaccurate.

              In Canada, Registered Midwives (R.M.) are NOT nurses.

              One can be a nurse, but the 4 year university Midwifery Education Programme is required for practice. An RN is definitely not required for midwifery practice.

              Most homebirth transfers are for long labours (usually the baby is persistent posterior “aka back labour” – an occurrence that is about 30% of births). A homebirth transfer is not, in and of itself, a problem and most transfers are medically boring.

              The model of care chosen in Ontario specifically identified the need for midwives to be competent in both home and hospital settings. In fact in Ontario, Registered Midwives are required, by law, to meet minimum numbers for homebirth deliveries.

              While the models throughout the US vary, there is ample research other than what you are citing to show the safety of planned homebirth.

              For more information, check the AOM website at: http://www.ontariomidwives.ca/care/birth/home

      • Hello. Thank you for providing this article. I’m currently doing research about the safety of home birth vs. hospital birth in the United States. I noticed that the studies you provided were located in Britain and Denmark where the birth culture is considerably more positive towards midwives and natural birth. Also, only the study from Denmark had a date on it that was satisfactory for my needs. Do you think that you could provide me with some recent statistics in the United States, where in many states, practicing midwifery still isn’t even legal? I haven’t been able to find any that haven’t had strong indication of biases after further investigation. My thanks if you can assist me.

        • It’s legal to practice midwifery — in some states, it’s illegal to NOT be a trained medical professional and practice midwifery (nurse midwife).

          In Europe, all midwives are highly trained, there is universal prenatal care, AND all high-risk mothers are mandatory opt-outs of home births. This is not the case here, to the detriment of the babies who die because of the lax policies.

          (He didn’t include US studies, because they show the opposite conclusion of safety than do those from developed countries with universal care and high midwifery standards).

          • I want to know what happens when there is a problem, undetected before birth, with the baby or the mother. What the doctor or the nurse or dula do, if the baby need resuscitation? what if they need oxygen? how the do resolve the emergency?
            how do you know, even if the baby would die anyway, if it was possible to do something else to save his life?

            • Ahani – you are asking very good questions.

              First – a doula does not provide any medical care and would not be involved in any newborn resuscitation or providing care in any emergency .

              Anyone who attends birth (i.e. doctors, nurses and midwives) are required to be trained in newborn resuscitation and have the appropriate equipment on hand.

              Also, they have the exact same questions you do and all their training and care provided is to ensure the best outcome possible. Just know, however, that medicine is not an exact science and, for the most part, there are typically many correct solutions for any given problem.

              The short answer is that the majority (over 90%) of babies are born healthy and breathing. Apart from the fact that giving oxygen to a newborn can cause damage, it is vital that a baby is breathing within the first minute of birth. Drugs such as narcotics (demerol, morphine) that can be used in labour act as respiratory depressants and can chemically prevent a baby from breathing. The safest birth is one that is without medications to start labour, move labour along or provide pain relief because all medications affect the baby.

              There are many types of emergencies, that while rare, require immediate attention and health care providers receive training for this. For example, midwives in Ontario re-certify on a regular basis in Emergency Obstetric Skills.

              Nobody ever knows for sure how a birth will unfold, which is why a practitioner with appropriate skills and training is a good thing. It is the responsibility of the parents-to-be to become informed in pregnancy by asking specific questions of the health care provider.

    • A nuchal cord (the umbilical cord wrapped around the baby’s neck) doesn’t necessitate medical intervention, except in extreme cases. A nuchal cord occurs in 20 to 30 percent of births, and is usually easily loosened, or the baby can be “somersaulted” through, as described by Mercer et al.. Cutting a nuchal cord removes the baby’s blood and oxygen supply, which can have devastating effects (such as cerebral palsy) if the baby’s first breath is delayed by shoulder dystocia or other birth difficulties.

      • Chris, I’m going to stand in defense of this woman because I too am really grateful that when we needed an OB there was one. I lost 4 pregnancies before having my son and lost 1 following him. You can say all day long that the natural way is the best way on whatever topic it applies but there is always an exception. You can’t tell a woman who’s baby was at risk that her’s shouldn’t have been intervened. My son was frank breech, two common problems with frank breech first babies are the cervix closing down on the neck and hip dysplasia. You would probably say, I shouldn’t have gotten a c-section because this is only a problem with X percentage of frank breech births. I would disagree that for me, if I can avoid that risk by having a c-section, its a no brainer. Especially after 4 miscarriages. Some of us are quite grateful that someone intervened and made sure that our baby was born safely.
        I think what a lot of people forget about our homebirth only past is that a LOT of women died before their time due to childbirth. It was the most common cause of death historically for women. I wish I could remember where I read it but there is a blog regarding a 3rd world county with limited hospital access and the women there with the use of lay midwives will sometimes labor for days at home because the hospitals are so far and hard to access. They often lose their first babies and develop bladder and rectal incontinence. They leak waste all over their legs and become outcasts of their society. OBVIOUSLY, this is not happening in the US…..thank goodness, we’ve come further than that in our society. This is though what can happen when things are left to nature.

        So please don’t patronize her by giving her a statistic. She had good reason for her response, maybe she didn’t go about it the best. Ok. I’m done.

        • FWIW, I really feel that if I had attempted a homebirth I would have risked my life. I have a clotting condition related to pregnancy (antiphospholipid antibody syndrome), which is why I lost so many babies in my past. I also had an abnormal septate uterus which required surgery to correct and likely had a part in my son’s breech position.

          I have friends who are fans of homebirths and have had very successful ones, I think thats great. I wanted one too once upon a time. Then I had all this trouble. I would offer a friendly reminder to the ones who are big homebirth fans to not be insensitive to the ones who cannot. If I were a woman of the 1800s, I would be a barren woman. Possibly considered a witch because of all my losses.

          • I don’t imagine anyone would question your decision not to homebirth!! You are exactly the type of woman that the hospital system is there to serve.

          • The one thing that everyone keeps talking about is the women of 1800 and earlier. Most people think that just because Doctors were slowly beginning to be in the childbearing realm, is that these doctors saved the women and babies. Not so, you can easily read the history and see that once women started going into “laying in hospitals” for the births or Doctors came to your home. The women died by the 1000’s very easily under the physican’s care.
            Why were things so bad then…. the germ theory just started to be thought of, many physicans did not wash their hands or aprons from patient to patient. They in fact were killing these mom’s and babies and it was easy for these infections to go from woman, to woman and affected the baby’s. As the advent of science came about to test for certain diseases and conditions, the”odds” at coming through birth alive got better.
            The true fact that has been shown in thousands of studies is: home births are as safe if not safer than a hospital for a woman who is lower risk. Hosptials are there for a reason, and can often save the lives of women and babies who would not have made it through their process a hundred or more years ago. To the woman who had the clotting problem, this would have been found in normal bloodwork and then followed up to see the extent of the clotting problem, so you would not have been acceptable for a home birth anyway. I too have a clotting problem but I went on to have my children at home with no problem because it was dealt with. I have deal with other women with these problems also. I’m glad women who want to have their babies in the hospital can, and those of us want a out of hospital birth center or a home birth can also have that option. I am a Midwife of 32 yrs and have attended several thousands of babies. never lost a mother or baby to date. I do not attend births in the hospital because I do not choose to do so. By the way I lost 10 babies because of my clotting problem that was not picked up by the doctors. Once I found out because a Midwife ordered the right testing, I was treated.

          • melody d. i also have antiphospholipid antibody syndrome. the apparent risks are miscarriage, intrauterine growth restriction and preeclampsia, none of which affected me! the medical protocol is to take blood thinners and be induced at 38 weeks. instead i undertook preconception care and took herbs to counteract it and suffered no ill effects, then went on to have 2 homebirths with healthy babies weighing 3.95kg and 4.49kgs. its a shame you trusted the medical model instead of looking into natural therapies for treatment!

        • “You can’t tell a woman who’s baby was at risk that her’s shouldn’t have been intervened.”

          That’s the thing, he didn’t say that. Not once in the article did Chris say that people shouldn’t use hospitals.

          If you’re at risk, go to a hospital. If you have a low-risk pregnancy, be mindful that the hospital might not make your delivery any safer or easier.

          Either way, the fact remains, that you are free to use a hospital. However, the AMA is increasingly aggressive about limiting access for midwives, and lobbying to make home births illegal.

        • In response to above where women become outcasts, it wasnt due to childbirth that these women leak waste its because they have been brutally raped and their bodies dont function properly because of the rape not from childbirth, women are meant to give birth its a natural process if everytime a women birthed our bowels and bladder stuffed no one would be having babies, rape however especially brutally like these women endure from soldiers etc does damage lots of it

          • It’s more complicated than that. Birth does actually cause “Obstetric fistula”. But it’s usually a result of malnutrition during the mother’s development. Conditions such as rickets, during childhood, can cause deformations in the hips that allow the baby to become stuck in the birth canal for long enough to cause tissue death.
            I myself had 2 homebirths, am an aspiring midwife, and barring a real problem would encourage my daughters to birth at home.

            • Obstetric fistula can happen to anyone. Even a healthy woman in an industrialized country. If you search, you will find groups of these women everywhere suffering from one the most horrific complication for a woman postpartum.

        • Melody, as a midwife I would never argue about your right to have a C/S in hospital if that is your choice. The problem is that women’s choices are being killed off by downright lies and misinformation about homebirth and breech vaginal birth, for that matter. The Term Breech Trial, which is the reason most breeches are now born by C/S, has been shown to be suspect and unethical, and there are many vested interests who would like to shut down homebirth altogether – not because it is not safe, but because it takes control and income out of medical hands. I have a few medico friends who have admitted to me that they like C/S because they get more money for doing less, it is quicker and they don’t have to hang about for hours waiting on Nature to take its course. This is NOT evidence -based practice! This is criminal and wrong-headed and women are being scared into unnecessary surgery which can impact badly on them and their children for the rest of their lives. The main cause of death in developing countries, by the way, is not obstructed labour but anaemia followed by post-partum haemorrhage. Women need perinatal care (so that problems can be picked and dealt with before they become life-threatening) and they need proper food – with both these things, the incidence of maternal and infant mortality would plummet. Obstructed labour does happen, but one of the main reasons is totally preventable – FGM. If there were enough well-resourced and trained midwives in every country, with nearby hospitals for extra help if needed, 3rd world countries would be much better off. The other problem is that people think that S**t doesn’t happen in hospitals – Oh Yes it does! Mistakes get made, infections get acquired, babies and mothers die – sometimes it can’t be helped and sometimes it is iatrogenic. Every women is entitled to make an uncoerced informed choice about how, where and with whom she will birth – and that includes out-of-hospital birth!

          • I completely agree. As a military member, I’m being told that I need to give birth in a hospital “for my own protection.” I’m angry, and I’m trying to find a way around it. I do not believe it is a valid stance, especially one not based on research favoring hospital births over planned home births (key word being “planned”).

            It’s horrible not having choices.

            • Erin, I am a military wife and I had three babies at home. Talk to the pediatrician instead of the obstetrician. I have found the peds doctors to be supportive. 🙂

              • Sherry,

                I’m not a military wife – I am a military member. Tricare specifically refuses to cover anything “in home.” I can’t even go to a hospital off base. It’s one of those things I wish they would make VERY CLEAR to enlisted female members upon joining. Had I known this a few months ago before I got pregnant, things would be very different right now. As in I honestly wouldn’t be pregnant. It, excuse my language, is quite the crock of sh*t.

                • Erin, maybe you should just quietly labour at home as long as possible and go to hospital at the last moment. Can you hire a private midwife to keep an eye on you? Anyhow, what are they going to do if you give birth at home? They surely can’t fine you or sack you? If your insurance doesn’t cover it (just like here in Australia for the most part) can you just pay for a midwife out of your own pocket?

        • Melody,
          I really agree with you 100% a friend of mine, just have suffer the death of her baby because it was not time to do anything at home. This terrible thing that happen to my friend, didn’t happen in USA, but anyway all over the world people is doing this, and can be pretty dangerous. I don’t think we are the same people we were 200 years ago, and our bodies even less , if we have babies at home we should try to be prepare for everything and anything!

      • Midwives know how to take care of a nuchal cord ( cord around the neck), such as described by MERCER et al. Nuchal cord is quite common and rarely does it need to be cut prematurely.

    • I think you can voice your opinion without being so rude. It’s a sign of maturity to show respect for the author of this post – whether you agree or not.

    • Having the cord wrapped around the neck is a very common thing (approximately 1/3 of babies are born this way). It is almost never a danger to the baby. I caught one baby unexpectedly in a very non-traditional setting (very fast labor and second stage) in the caul with the cord wrapped and a hand presenting with the head. In a hospital this scenario would have been considered an emergency. Yes, we were lucky. But this scenario is just a variation of normal birth, not an anomaly, and doctors are just too narrow minded to see it that way.
      Great article, can’t wait to see the rest! And best of luck on your child’s birth!

    • My first baby was born at home, with his cord around his neck. My midwife moved it. My second baby was born at home and I suffered a hemorrhage afterwards due to retained placenta. My midwife fixed that too. I am utterly convinced that I would have been worse off in a hospital, both times, due to the prevalence of unnecessary interventions as well as the lack of control of the atmosphere in which to give birth.

      • Yup, mine came out with cord wrapped twice around the neck. I caught him myself in the water and just intuitively unwrapped him before bringing him up.
        I hemorrhaged with my first in the hospital and with the second baby, at home, I was afraid it might happen again. So much so that I subconsciously refused to push out the placenta for several hours. When I did finally do it, I placed a small cut out piece of the placenta inside my cheek. I didn’t bleed much.

        I cannot imagine ever giving birth in a hospital again. The homebirth was just as painful as the hospital one, but because I was left in peace, I was able to handle it quite well. Bi labored completely alone for four hours, no disturbance–luxury.
        Pushing was done on *my* terms and lasted 15 min compared to 2 hours with the first hospital birth, where I was forced to be in a reclining position, as well as instructed to restrain from the urge to push for 3 hours before eventually starting the second phase. It was a busy night in the hospital and my midwife probably didn’t mean to keep me hanging for that long. Industrialized birth, for sure.

    • My second daughter was born unassisted (accidentally… it was REALLY fast) at home with a nuchal cord and I had to somersault her through. I didn’t even have to think about it. My husband was just standing there in complete shock 🙂

      • Great work, Mama! If this ever happened to me I would hope my “instincts” would kick in, too! (and I would assume my husband would faint).

      • I’m so glad you shared this. When people think of Midwives for some reason they are under the impression they have no formal education. That is absolutely not the case. Any licensed Midwife has formal education (Certified Nurse Midwives are Registered Nurses first and foremost) and is trained to deal with the “emergencies” that may come about during labor and delivery. Thank you for sharing your experiences of homebirth with complications and highlighting that a Midwife is trained and prepared to handle such complications!

    • A midwife can unwrap a cord too. And the midwife is there throughout labor, not just for the last few minutes like the doctor, and will know early on if something is not going well. They are so much more in tune with the mother and baby. The stress of being in a hospital (read about the hormonal response of any animal in labor when a stranger approaches…how many times does that happen in the hospital? Try every couple of minutes), the body position during labor (in a bed, mobility limited by monitors, so labor slows, the pelvis can’t fully open, etc.) contribute to all the complications that the hospital then needs to fix. Take away the hospital, and you take away a lot of the complications of labor and birth.

    • About 1/4 of all babies are born with their cords around their necks, but as long as the cord is not clamped they are fine. My second homebirthed child had a cord around her neck, and the midwives unwrapped her. No emergency, just action. There are many advantages to being at home. The germs in one’s home are one’s own, meaning a laboring mother already has immunities and antibodies to the germs/bacteria in her space. In the hospital setting there are many contagious bacteria that the mother is not immune to, increasing her and the babies chances of Post Partum infection. The chances for episiotomy or cesarean section in the hospital are far greater than at home, in most studies homebirth transfer patients had a 5-10% csection rate vs a33% and up rate for moms choosing to deliver in the hospital setting. Up to 30% of women recieve genital cutting, i.e. episiotomy in the hospital, with individual doctors rates going as high as 100%. There is no medical reason to do this. Tears heal better, but evidence based care is not generally practiced in American obstetrics. Women who feel safer at home should deliver at home. Those who want the hospiatl can have it.

    • you don’t need a doctor to unwrap the umbilical cord. That’s a thing that happens all the time and I saw many midwifes unwrapping it and everything was fine! (by the way I’m a midwife student working in a hospital and I’ve seen MANY things I wish I had never seen. It makes me ANGRY what doctors do with laboring women in hospitals…and the women are just thankful and don’t realise how DIFFERENT it could be!

      It’s ur own choice, but after what I saw the hospital is the last place I want to give birth to my child (it’s just good for emergencies)!

      • Thats the thing- homebirth sounds a lot better but emergencies are just that- emergencies! they aren’t planned and when it comes down to the possibility of the mother or child dying or having lifelong complications because they don’t have quick access to a surgical team or blood transfusion whatever, I think it is irresponsible to think the answer lies in avoiding the safest place and not in changing the methods/processes/attitudes that are so common and negative in the vast majority of hospital births. My guess is that as homebirths increase sadly so will homebirth tragedies and the medical community will have to start getting the message. It is just unfortunate that people stand on one side of the fence or the other not realizing you could just walk the rail and enjoy the view. There are complications that arise unforeseen which a midwife does not have the tools or training to handle and the attitude on this board is one of “a midwife can handle anything just as well as a doctor” which simply isn’t true. However I completely agree that doctors and nurses in hospitals typically make the birthing process extremely uncomfortable and basically force “treatments” on the vast majority of women who would probably be blown away by the high of the experience if they were encouraged and properly supported to handle it naturally as is the norm in home births

        • Like what? You say there are complications that midwives don’t have the tools or training to handle. Can you give a few examples?

          • How about a spontaneous pneumothorax (collapsed lung) with meconium aspiration into the chest cavity. My pregnancy was completely low risk, yet my perfectly healthy boy would be dead if it weren’t for the presence of a NICU team. And this isnt even that rare, 1 in 100 babies. It’s absolutely mind numbing to me that anyone would take a risk like this. For what? Candles and soft music in your living room? Grow up.

            • LB – I am so sorry that this happened in your birth. It must have been very frightening for you.

              There are standard protocols of care for meconium regardless of who the primary careprovider is (MD or Midwife). The College of Midwives of Ontario, for example, require all midwives (by law) to follow specific standards for meconium. Particulate meconium is a Category 2 automatic consult with a physician. In the event of a planned homebirth, the midwifery team would transfer from home to hospital so that respiratory therapists are available if needed. See Mandatory Discussion, Consultation and Transfer under Standards at http://www.cmo.on.ca/policies.php

              There are experts who would even argue that with undisturbed birth (far more likely with a home setting), the rate of meconium is dramatically reduced because the mother`s autonomic nervous system is calm and capable of calming the baby`s bowels. Drs. Michel Odent and Sarah Buckley are well-known leaders in the obstetric community in this regard for anyone who is interested in learning more. The presence of medicine does not automatically mean the elimination of risk; medicine actually adds to risk in ways that we are just beginning to understand. For example, as a wonder drug, antibiotics are revolutionary. But Chris would one of many who explain more eloquently than me the damage they do the gut and more.

              It is not my intent to change anybody`s mind, especially those who are inherently frightened by birth. Fear always trumps logic and reason.

              The reason for my reply is your “grow up “` comment.

              You do not get to make medical decisions for me. I am an intelligent woman who has thoroughly reviewed the research and I am fully capable of deciding for me and my family.

              By all means, make comments (especially if you can resist doing do in a shaming way). However, please refrain from dictating what the rest of us can and cannot do – it is NOT your decision to make.

              • Apologies for sounding so condescending, but having “been there” it’s hard for me to understand how people wouldn’t give their baby the best opportunity for survival. So you are saying that at the time meconium is found in broken water, that means an automatic transfer to the hospital in the case of home birth? I find that hard to believe but perhaps.

                My point is, in this debate the rare “what ifs” are often cast aside as something that will not happen to you. Well, it happened to me, and a hospital transfer once a midwife had discovered the pneumothorax would have been too late. My baby quite literally would have suffocated on his own feces. And this is not rare. REAL serious consideration of the risks need to be involved. My personal advice? Find a midwife practice that operates in a hospital setting. Do it for your baby, and relinquish the utopian notion that your birth won’t be the rarity.

                • LB – those of use who have planned homebirths have done so because the review of the science has convinced us that this this the safest approach for our babies. I realize that this may sound incredibly foreign to you, but when you really look at the research and you really know how many problems are actually caused by the hospital system, this starts to make sense.

                  For example, I was at a hospital birth about two years ago where the women declined Pitocin after the birth (she has some rare biochemical pathways that do not process meds appropriately) and because the MD had never delivered a placenta without this particular pharmaceutical, he totally messed up the process…long story short, she ended up with a serious postpartum hemorrhage about a day later….and a nightmare in terms of recovery after.

                  Hospitals are known for iatrogenic infection and many Americans and Canadians die every year just because they picked up a hospital induced infection (if you look at the actual figures, it is really quite alarming). We know that some obstetric drugs have actively killed healthy women (i.e. Cytotec)…so please, do not assume that “hospital” equals “safe.” All settings have risk…no setting is risk free. Parents need to review the research and decide for themselves what risks are acceptable.

                  Yes, absolutely, in our system in Ontario, meconium is a homebirth transfer. All Ontario midwives are required to have hospital privileges and homebirth transports are handled professionally as a result.

                  The reason that Ontario midwifery requires, by law, competence in both the home and hospital settings, is that Ontarians saw a fractured midwifery model in the US that resulted in homebirth midwives in one corner of the “boxing” ring and hospital birth midwives in the other. We decided that the best midwives work in both settings. I agree with you that your midwife should also have hospital privileges.

                  Again, I am so sorry that you experienced this very, very difficult situation for your baby. I am so glad that your baby is doing well. And while you perceive that your experience is a 100% incidence (because it happened to you), heavy meconium that causes severe respiratory distress is actually not common. In the old days, the MD would physically prevent the newborn’s first breath by pressing all of his/her weight on the chest. Today, this would be barbaric and is no longer done. The old protocols of suctioning and intubating regardless of the type of meconium have been updated based on research and are no longer considered standard practice. In fact, most newborns can handle light meconium in the lungs without distress. These babies have their sterile feces in the lungs and it is ok. Heavy meconium is usually problematic, of course and best dealt with in a setting that has intubation capability.

                  It is like saying that “all fever is dangerous.” But a fever of 38 degrees Celsius is different than one of 41 degrees. Also, the other signs are relevant (age of the person with the fever, other illnesses, etc). And most fevers are actually beneficial because the body uses the heat to “burn off” the pathogens. Today, more health care providers advise against using over-the-counter anti-febrile chemicals to reduce a fever that is under a certain level – the fever is a good thing.

                  I drive on highways that have rare chances of catastrophe. And I have my children with me in the car. Thee are lots of decisions that we, as parents, need to make that weigh to decisions of risk. Again, as much as we like to believe that a particular choice “guarantees” protection, place of birth (home or hospital) is never a guarantee.

                  For all the trauma that I’ve seen and all that I know about serious obstetric consequences that are possible, if I were to have another baby, I would definitely choose homebirth again. And this is my choice.

                  It is not my decision to decide for another. Nor is it your decision to decide for others.

                  You may not understand it, but intelligent, well-educated and well-informed parents are deciding what is best for themselves and child and it is not our place to tell them what they can and cannot do.

                • You may need to relinquish your naive notion that no one dies in a hospital… People die in hospitals, including new mothers and newborns. People are injured and harmed in hospitals, including new mothers and babies. That’s just reality. Humans are not immortal.

                  I choose to home birth partly because I knew it would be safer. Some women may feel completely at home in a clinical setting with strangers poking and prodding her with regular intervals while birthing her baby, but many find it difficult. Humans are not unlike other animals in that they intuitively seek out solitude during labor. Michel Odent, and I see he’s been mentioned before in this discussion, has written extensively about how labor complications often arise from having this need unmet. Ina May Gaskin also likes to refer what she calls the sphincter reflex. Imagine taking a crap in front of strangers, or anyone really. It’s just not as efficient. Lack of efficiency has its consequences. Physiologically, that baby is meant to come out rather quickly. Hospital births aren’t known for being quick, though certainly many are. For me, hospital birth was 27 hours, home birth 4. And sure it was my second child, but my kids are 6 years apart. The first time, my midwife was so busy with other moms that she left me alone for 3 hours with instructions not to push because there was a lip. After I struggled with fighting off the urge for who knows how long, my labor stalled. That I hemorrhaged quite badly after the birth may have something to do with that. I was completely exhausted. My son had jaundice.

                  Fast forward six years. I labored for 4 hour. When I felt the urge to push, I pushed. And I did so without reclining in a bed. For the first time I felt what pushing is supposed to feel like and I’m certain that me being able to act out my animal instincts (I won’t go into details here, but suffice to say, whatever I did then I would not have had the decency to do with strangers around me). That lasted 10 minutes. My baby was healthy, no jaundice, no complications.

                  My hospital experience was much more unsafe than my home birth experience. At home, I was able to labor completely undisturbed for the whole duration of first stage (save for a couple of short intrusions from hubby) and it made a huge difference. While the pain was extreme, due to some back labor, I was able to manage it as long as no one was around. Whenever my husband appeared, the pain would become intolerable and I would panic. It felt like at the hospital, only there, the panic lasted for at least 20 hours compared to a few seconds at home!

                  According Odent, it’s this that easily can lead to complications because of the increase in stress hormones. And yes, the presence of meconium is one.
                  I’d much rather not have complications than expose myself to an environment that is known to increase the risk. The vast majority of women are obviously unaware of this, but something tells me most of them would still choose the hospital. Because it’s likely not so much about what is truly the safest option, but that we follow the norm. Well, the norm can be heavily influenced by misinformation.

            • Our first son was the product of a completely uneventful full-term gestation. He was OP as we began delivery, so three hours of positional pushing ensued, followed by the discovery that the cord was wrapped. He was 8 lbs. 8 oz. and suffered a spontaneous pheumothorax unrelated to mecomium aspiration. It was immediated diagnosed in the NICU, and he was intubated, and mecahnical ventilation through his chest wall not only saved his life, but within 24 hours he was out of the box and feeding, with his very relieved mother. Had we not been in a hospital setting, his exposure to delayed diagnosis, delayed treatment, and potentially catastrophic infection and anoxic brain injury would have increased exponentially. He’s a perfectly healthy happy four year old today. Two takeaways, no-one and nothing, not your midwife or your ob/gynor all the books you want to read, can prepare you for all the unforseen possibilities of childbirth. Put yourself in the best position to avoid catastrophic injury by going to the hospital. Yes people die in hospitals all the time – becuase they have conditions that put them there in the first place. Yes people get infections in hospitals, but attributing the general rate of infection in hositals to the labor and delivery suites is just clever marketing by midwifes. The second takeaway – confirm that your midwife has a lot of professional negligence insurance. The lifetime cost of a newborn with anoxic brain injury is about $13 million, conservatively.

          • Just a few complications midwives can’t handle (at least, not without calling 911):

            Post-partum hemorrhage. Midwives can’t give transfusions or IV fluids.

            Anything that requires an emergency c-section.

            Anything that requires vacuum extraction or forceps.

            Anything that requires prescription drugs.

        • It is *not* irresponsible to avoid hospitals when giving births, on the contrary. Many life threatening things happen *because* a woman was in the hospital in the first place. It’s called unnecessary medical interventions that end up where it shouldn’t have ended up. Most true birth related emergencies don’t require attention within seconds or minutes, thus a home birthing woman usually has time for a transfer.
          You admit yourself that hospital staff force treatments on women–do you understand what consequences this may have? It’s *not* merely a question of having a ‘high experience’ or not. It’s a question of safety. And this is one major reason I decided to birth at home. Read the article to find out why this is so. I would recommend to anyone objecting to the title to first read the article before commenting.

          • Jo – your births are an important teaching about the understanding that both Ina May Gaskin and Dr. Michel Odent provide – birthing women need to feel safe and protected.

            I am so sorry to hear about your difficult birth. It must have felt wonderful to know that your body is capable of birthing naturally. 🙂

            • Thank you Shawn! Yes, it was probably the most amazing experience of my life. In a very non-hippie, non-touchy-feely, non-utopian kind of way;).

              If it wasn’t clear, my response above was directed to LB. It looked like it was to you Shawn, maybe. I forgot to mention her by name.

          • No one during my (complicated) hospital birth “forced” anything on me. I was unmedicated, and coached in laboring how I pleased.

            Your experience was a bad one; just as many home birth experiences go badly–in my state, the latest numbers show 4-5x the rates of death in home births than in hospital births. That is the bottom line for me. Many women choose “unnecessary” interventions, such as pain medication, because it’s there choice. I chose not to, but don’t begrudge women who do.

          • Where did you get the idea that, as you say, “Most true birth related emergencies don’t require attention within seconds or minutes, thus a home birthing woman usually has time for a transfer”?

            Here are just a few of the most common birth-related emergencies that require attention within seconds or minutes:
            – Shoulder dystocia
            – Cord compression
            – Placental abruption
            – Post-partum hemorrhage

            Also, when was the last time you tried to get a woman in active labor from her laboring room (or pool) into a vehicle? Any thoughts on how many minutes that might add to the hospital transfer process? And how much time do you think it adds to the process to get her from the front door of the hospital to an emergency room with emergency obstetricians, and to get the doctors to understand what’s wrong with her (if she’d been laboring in the hospital they would already have blood pressure, fetal monitoring, etc. info and would know what was wrong as soon as the problem arose)? And how long would it take to (if needed) get an anesthesiologist over to ready her for an emergency c-section?

        • Seriously? O.o Midwife’s can help you just as much as a doctor if not more. The doctor is only in the room for the birth the whole time it is a nurse. And there are also alternatives like home birthing centers which give you the advantages of home birth with a midwife, but there is still a doctor on hand, one day when I have kids I think that is option I will choose.

          • Midwives can certainly help *with a normal birth* as much as a doctor if not more.

            But if anything goes seriously wrong? That’s what the doctors are for. And BTW birthing centers generally do not have doctors present, at least not in the US.

            There are plenty of hospitals where you can get all your prenatal care from midwives and deliver with midwives, so if your birth goes fine you have the midwife experience you wanted… but if something does go wrong there are doctors right there to save your baby’s (or possibly your own) life.

    • My 4th child had her cord around her neck 3 times- it was even something I knew would happen at the birth in early pregnancy and I told my midwife that. I had her at home without any complications, we just flipped the cord over and then the rest of her body was born safely.

    • Cords wrapped around the neck are no emergency. They are long enough to not choke and a midwife in a home can just as easily unwrap the chord as a doctor can. The author just wants to dispute any misconceptions about their belief in westerb medicine all together. It’s just that unnecessary interventions of all kinds, especially in birth, have been proven to be dangerous, and it tends to be overused in hospitals everywhere. There is a ton of research to back all of this up. I think you misunderstand the whole article. Re read it and check the resources cited.

      • The mother can easily unwrap the cord as well, which is what I did. I caught my own baby and upon feeling the cord I unwrapped it. I don’t really remember it because it was an act of complete intuition. My husband is the one who remembers those details.

    • One thing I learned from having two babies in the hospital with two different doctors is that doctors do not know much about childbirth. If you expect a surgeon to deliver your baby, you should expect to be cut. I was cut with both doctors. With my four other babies, including a set of identical twins, I used midwives, had normal physiological births, and there was no cutting involved, no stress at all, and so much less pain! I would never tell someone I love to birth in a hospital. As far as I am conserrned, hospital birth is not a viable option.

      • Those two doctors and that hospital don’t represent all doctors or all hospitals. I’m delivering at a major teaching hospital and their episiotomy rate is like 4%, so 96% of mothers there do not get cut. To quote the doctors I’ve been seeing there, they “NEVER” do episiotomies unless it’s the only thing left, short of a c-section, that can get the baby out.

    • My birth story:
      My son was compelatly healthy, perfect pregnancy, everything. I went to my MIDWIFE and told her I was uncomfortable at 38 weeks pregnant. She offered to induce me. Being a first time mom I didn’t know anything about my options, what things did, nothing. So I assumed, like any new mom, pitocine was just as good as natural labor.
      I was wrong…. So wrong

      I went in at 6am on a Sunday, started the pitocine. My sons heart starting dropping at a fast fast rate. So fast he almost didn’t make it, the first time….
      They took me off the pitocine and started it again at 7am. Things where better then, but monitored close. I was on the monitor for the heart and contractions, on an iv of pitocine and on an iv for fluids so the pitocine would not dehidrate me. The contractions where bad, worse then anything I have ever felt. I sat at 3cm for 24 hours. 24 hours went by and still strong contractions and no change. What was happening is my body was being forced to go into labor and it didn’t want to. So I was suffocating my son with these contractions that where doing nothing for me. SO they where trying to push C secion I mean PUSH C section because the strain on my body was nearly killing my son. The doctors said either do a C section or get an epedural to relax my body. They said kept saying when I would be second guessing that it was “the best” for your baby. Like they where using my baby as a tool to get what they wanted. They where at this time sassy with me, cranky, tired didn’t want to even come help me. My midwife refused to give me a C secion so I got a epidural. The epidural relaxed my body enough to start dialating me. I finally got to a 10 after 6 more hours of labor. I didn’t however feel a thing. I started pushing at 11pm and had my son at 1:09 am on 1-11-11. I opened my eyes after the last push and seen blood all over my midwifes face, all over my spouse, my sister my whole family! The umbilical cord ripped in half when he was coming out because someone tried forcing it off of his neck the wrong way. He was not breathing…. not breathing at all… after 7 minutes of not breathing they finally resuscitated him and I was not allowed to see him for 8 hours. My son is alive… but I don’t no who to thank… I guess I can just say my son was strong on his own because I was to dumb to do any research.

      All of this happend from being induced and not given the proper knowledge and understanding of what pitocine does. Pitocine pushes your body into over drive to deliver your baby as fast as possible. Your body is being forced to go into labor, which puts lots of strain on your baby every contraction you have. Your babys heart goes higher and higher with each contraction. That was killing him. After 24 hours of that he was nearly dead because of the medical intervention. I couldn’t get up, was not offered the tub, was not offered anything but a C section. Thats all they offered, not anything natural to relax me to get me to dilate. I feel like I should have been told, I should have been notified what that stuff can do to you. I should have never done it and being hooked up to the machines and not able to walk around made it worse. Everything in this article was right.

      I can say from EXPERIENCE that doctors and intervention and that hospital almost killed my son and I wish I would have known better.

      I am due in less then 5 days from now with my second. I am doing a hospital birth, but I will have a sign on my door that says absolutely no intervention unless asked for BY ME, I will have a tub and I will be LEFT alone.

      Do your research before you have children. I can honestly say having children is more then just feeding and bathing. It starts before they’re even born, it starts with the parents and there knowledge. Taking care of a baby starts way before there even thought of.

      I can proudly say I nursed for a whole year even though doctors told me not to, that it was making my son fat. I didn’t listen. My son is now 2 years old and probably smarter then a 5th grader these days 😉 Thank you for this article. Made me feel better about my natural decisions.

    • Our new little boy is now almost 24 hours old and our 7 year old rock solid specimen of a human being is also injection, chemical and immunization free!! These lucky boys have a Mom who realized that nature and She have this figured out. Midwives know so much more about child birth than profit driven institutions.

      Fear in birth is certainly understandable but like all things it only blocks our natural strengths.

      • Oh, your midwives didn’t charge you any money? That’s funny, most midwives charge $4000-$6000 to do a birth. Which, coincidentally, is also about what my local hospital charges.

    • Most newborns have cord wrapped around the neck. It is not a big deal, simply pull and lift over the head, or keep head at perineum and let baby flip down as the birth progresses if the cord is to tight to resolve it. America has the worst outcome for moms and babies, and yet Drs and hospitals take care of most. In countries where midwives and homebirth are the standard, the outcomes are SO much better

    • What happens when the baby has meconium aspiration and the midwife is unable to suction his lungs out? I’ll tell you. 20 minute ride to hospital with barely alive baby. 17 day stay in NICU because of HIE. And then Cerebral palsy. For life. That’s what we’re going through. Fuck home birth.

      • Zac, home birth has things present to take care of these types of things. A GOOD midwife can control those situations. You can’t blame home birth. It’s not home birth, it’s the doctor you choose.

        Terrible things are just as likely to happen at home than a hospital.