The Birth Myth of our Generation...

"Basically what the medical profession has done is convince the vast majority of women that they don't know how to birth" - The Business of Being Born 

There was such a great response from the post earlier this week of the story of Cadence's birth that I wanted to write a bit more about it. I'm so happy that reading it affected so many of you in a positive way. And I wanted to address a theme I saw in the comments: fear. 

When Nate and I decided to have a planned home birth, we didn't make the decision lightly. We researched statistics and maternity care history in the US. We researched intervention rates, infant mortality rates, and success rates. And we found that for low risk women in the United States, having a planned home birth is actually seemed safer than going to a hospital. 

I know many of you are scoffing at that last sentence. That's okay. I didn't believe it at first either. Because here in the United States we are programmed to believe that birth is a serious medical emergency full of fear and screaming and a doctor to come in and save the day. (And sometimes, yet it is, but that is the vast minority.) But the truth is that birth is a natural process that, when cared for in a way that supports the mom and baby, can happen without interventions in an experience that isn't terrifying. In most other countries of the world births are attended by midwives, not doctors, and rates of interventions, cesareans, and even mortality are much lower than here. 

Here are some statistics for you... 

>> A recent World Health Organization report found 33 countries with lower maternal death rates than the US, 37 countries with lower newborn death rates, 40 with lower infant death rates. There are only 4 countries with higher cesarean rates than the US (Currently if you go to a hospital to give birth your chance of having a cesarean, whether you are admitted as high or low risk, is close to one in three!).

>> 85% of US women enter labor in hospitals as "low risk" for problems but nearly 100% have at least one interventions (Listening To Mothers Survey, Childbirth Connections 2002)

>> There is no justification for c-section rates over 10-15% (Recommendations WHO Consensus Conference on Appropriate Technology, 1985) but the US rate is 26.1%! (National Center for Health Statistics, June 2003)

>> WHO recommends an induction rate of 10% or less but studies have found induction techniques attempted in 44% of women. In addition to increasing the likelihood of fetal distress, inducing labor doubles the chances of cesarean in first time mothers (Elective Induction of Labor 2002)

Intervention rates:

Induction | Home birth 2.1% | Hospital 21%

Electonic fetal monitoring | Home birth 9.6% | Hospital 84.3%

Episiotomy | Home birth 2.1% | Hospital 33% (WHAT?!)

Vacuum Extraction | Home birth 0.6% | Hospital 5.5%

Cesarean | Home birth 3.7% | Hospital 19%
(from the largest study of home births published in the British Medical Journal)

The What Ifs

I know many women are terrified of home births for the sake of the "what ifs". What if there is an emergency and I need to go to the hospital and can't make it in time? That seems to be the biggest fear. But here's the truth... of women attempting planned home births, only 12.1% are transferred to hospital. 5 out of 6 of those transfers were BEFORE deliver most for failure to progress or exhaustion. Once your water breaks you have to go into labor in a certain time frame if you want to give birth at home. If you don't, they have to transfer you. Not because you are in any sort of immediate danger, but because your risk of infection goes up. 5 out of 6 transfers were for something that wasn't a huge emergency. Do you see how low the chances are of something being seriously wrong? It's not that scary when you look at the facts. (From the same study published in the British Medical Journal)

So why is it that hospitals rates for interventions are so crazy high?

Because birthing is a billion dollar industry. Home births cost around $5000. Hospital births cost closer to $16,000. And hospital births via cesarean cost closer to $25,000. Cesareans are doctor and hospital friendly. They are fast, controllable, and can be invoiced for much more cash. When you look at it from a business perspective you can quickly see why the US has such an insanely high cesarean rate. It's not because American women can't birth babies correctly. It's because hospitals are putting women through a corrupt system based on dollar signs instead of true concern for the women and babies. 

Women receiving hospital-based midwifery care spent less time in the hospital, have few cesarean sections, fewer vacuum and forcep assisted deliveries, fewer episiotomies, are less likely to be induced, and experience less interventions. Knowing these results, it is clear to see why many hospitals have have refused to allow Certified Nurse Midwives to attend births as they lessen the hospitals' opportunities to make money off of unnecessary procedures done to laboring women.

The bottom line:

Every woman has to decide what is right for her, and where she feels comfortable delivering her baby. Hospitals are not the devil. Being uninformed is. And getting "put through the system" is an unfortunate and sometimes dangerous result of women being uninformed of their rights during birth, of the power of their own bodies during birth, and of the way the system works. Whether you choose to work with an obstetrician in a hospital, a midwife in a hospital, at a birth center, or at home with a midwife, just know that you are more powerful than you think and you can do it. You don't need a savior for your birth. Trust yourself and the generations of women who have done it before you. And please please please find an advocate that will coach you and stand up for you if you need someone to. Also of utmost importance is mutual respect. Home birthing mamas need to respect hospital birthing mama's decisions and visa versa. Calling each other names and mocking each other's choices is not helpful. Every mom does what she thinks is best and she needs to be supported in her decisions. Rock on mamas!

xo,

B