Homebirth vs. Hospital Birth - The Gloves Are Off

Birthing babies is what I love most in the world. The fact that I now have women ask me "is it really bad for me to have my baby in a hospital?" breaks my heart and has forced me to come out swinging. Enough is enough. I can no longer sit back and listen to this dialogue about homebirth come up again and again without inserting some badly needed facts and a serious reality check.

The argument is always the same by homebirth advocates. Hospitals are loud, hectic, bright, insensitive, uncaring machines full of greedy doctors and overworked “medical personnel” – (I am pretty sure as a nurse, that means me) who are just waiting to hook women up to unnecessary medications and prevent them from “trusting their bodies”. The argument goes on to state that homebirth is safer, more satisfying, more loving, more empowering, less interventive, healthier for the baby, more spiritual and on and on. Anyway you shake it that very implicitly pronounces that to give birth at home is… “better”. Period. But always, at the end of any article, blog or comment about it by it’s proponents, are the words “but a woman should be encouraged to give birth wherever she feels most comfortable, including a hospital”.

Wait a minute. Is that what you just said? Let’s assume I am having my first baby. I am very excited and I want to learn everything I can, and of course, I want to do what is best for my baby and myself. Do I choose to have the "scary, cold hospital birth" that I was told about or the "loving, empowering, spiritually-fulfilling homebirth"? I am very likely to make the choice to give birth in either a birth center or a hospital but wow - what a set-up for feeling badly about my choice.

Let’s look at some actual facts about birth in the United States:

Over 4 million women give birth each year
97% of women choose to give birth in a hospital
2 million women live below the poverty line and have limited access to adequate maternity care
100 years ago, a woman had a significantly high chance of dying during childbirth . Medical advances, including the use of antibiotics, oxytocin to induce labor, safe blood transfusions and better management of hypertensive conditions during pregnancy, are directly responsible for the decline in maternal death rate.

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Today, around the world, every 60 seconds, a woman dies during pregnancy or childbirth, often from an avoidable cause. There are no well-documented, large-scale studies that show that homebirth is either safer or more satisfying than hospital birth. We have “far from perfect” health–care in this country when it comes to taking care of moms and babies. However, there is truly a disconnect with what is really important here. Perhaps those who exert so much energy on faulting the U.S. maternal/health care system could spend even ¼ of their time working to provide better access to care for the 2 million underprivileged women here who really need it.

I have shared in the births of several thousand women at homes, in birth centers and in hospitals. I have seen miracles, tragedies, difficulties and wonder in all of those places. What angers me so deeply is the direct insinuation that giving birth in a hospital denies a woman a safe, positive and life-affirming birth experience. What kind of support is that? A woman deserves to feel nurtured by other woman, not faulted, questioned or criticized. There is no “better or best” way to give birth and I am no longer going to be quiet about it.

homebirth, hospital birth, nurses, childbirth (all tags)