The study of more than 12,000 births showed women who had a planned home birth are less likely to run into serious problems ­during labour.

They also have a lower risk of needing ­epidural pain relief, forceps delivery or a ­Caesarean

Jenn Hooper’s … daughter … has severe cerebral palsy and spastic tetraplegia, and up to 200 seizures a day. Two midwives struggled for an hour to correctly intubate Charley when she did not start breathing after being delivered.

Last week Mrs Hooper … told politicians her harrowing story and those of other women whose children either died or were disabled during childbirth, in a bid to have the system changed. Her … submission … backed up a petition the women delivered to Parliament …

It called for the independent review, a database which counts the deaths, disabilities and near misses in childbirth, a review of the training and supervision of lead maternity carers (LMCs), and the creation of a crisis team to support families whose babies die or are disabled during childbirth.

“All we’re after is ensuring healthy, safe, live mothers and babies,” …

Following major maternity reforms between 1990 and 1996, most New Zealand mothers-to-be now choose a midwife who becomes their LMC until they give birth.

… “It’s supposed to be a matter of choice. We’ve actually had our choices slashed,” Mrs Hooper said.

The Good Fight wants bonuses and incentives paid to LMCs who book their client at a private birthing facility or non-tertiary hospital stopped, including a $60 bonus for midwives whose clients do not need to be admitted to hospital.

“It was peaceful, magical, wonderful,” said Mary Georgilas, describing her daughter’s birth at the home.

The couple was able to experience a natural, at-home birth thanks to Nancy Wainer, a longtime midwife who coincidentally lives just up the street from Mary and George Georgilas.

Wainer operates Birth Day Midwifery from her Great Plain Terrace home. She has been a midwife for about 15 years, and has been on her own for about 15 years …

… Wainer began down the path of midwifery and conducting natural births in homes after she decided to give birth to her third child at her home. She preferred the experience to the hospital births of her two older children.

“For most women, being with a familiar care provider, it’s better being in their own environment without technological interferences,” …

… Wainer limits herself to about 35 to 40 births due to amount of attention she feels each mother-to-be needs.

“We get to know the mothers very well,” said Wainer, who has assisted in an estimated 1,400 to 1,500 births during her career. “Many women had their first births at other places and in seven minutes, they see several different people. Mothers get to know who their midwives are, and the birth becomes a loving, caring event.”

Wainer noted she prescreens the mothers to make sure they are healthy enough for a home birth. If she feels they would need special medical attention, she refers them to hospitals. And if a woman does experience complications during childbirth, Wainer would immediately send her to the hospital for treatment. But she said the vast majority of complications can be avoided if precautions are taken during the pregnancy.

“Almost all emergencies are precipitated from a situation that needed to be addressed before the childbirth,” Wainer said. “If it escalates into a complication, we won’t let it escalate to an emergency.”

… “From the very beginning, we wanted to avoid procedures and drugs that could be harmful to the baby,” Ben Ramsey said. “We felt like we didn’t want to fight the system.”

Milly Ramsey described the birth as intense, but doesn’t regret her decision to have the baby naturally and at home.

“I was very comfortable at home,” Ramsey said. “It was intense. … I felt very supported. I felt like I wasn’t alone … they didn’t take him [the baby] away. He stayed with me.”

… Molly Scanlon … plans to have a natural, at-home birth with Wainer. Even though she works at a hospital, she said she feels intimidated by the atmosphere and preferred having the birth at home.

… The purpose of the study was to examine the neonatal outcomes of primary cesarean delivery in women who had no other known complications or medical risk factors. The logical result of this examination would seem to be comparable neonatal mortality rates among cesarean and vaginally born infants. In fact, what the results show is that cesarean independently raises the risk of neonatal death by almost three-fold – .62 per 1000 deaths among vaginal births versus 1.77 per 1000 infant deaths among cesarean babies.

Even more astounding than the simple fact that cesarean section raises the risk of infant death – regardless of the reason the cesarean was performed – is that even when the researchers adjusted for sociodemographic, medical and congenital factors, and removed infants with APGARs under 4, the risk of death was only reduced “moderately”. A stark difference in the death rates between cesarean born infants and vaginally born infants remained even with no medical explanation.

We aren’t talking about babies dying from the few, rare complications that can arise in childbirth. We’re talking about healthy, low-risk mothers electing for a primary cesarean section with no medical indication resulting in a nearly three times higher rate of death than those who have a vaginal birth.

According to Marian MacDorman, the CDC’s study leader, “These findings should be of concern for clinicians and policymakers who are observing the rapid growth in the number of primary Caesareans to mothers without a medical indication.”

Even today, most pregnant women in Germany are unsystematically offered a blood sugar test to identify those women whose blood sugar levels rise too much during pregnancy …

… “We cannot be certain that the tests as currently carried out in the doctor’s surgery yield more benefit than harm.”

Gestational diabetes is a question of definition

During pregnancy it is normal that a woman’s metabolic rate changes and sugar takes longer to be absorbed by the body. In May 2008 an international study confirmed that rising blood sugar levels increase the risk, for example, of a Caesarean section or birth injuries. However, there is disagreement over when increased blood sugar levels should be treated, as there is no threshold where these risks increase dramatically.

Nevertheless, it should be noted that a diagnosis of gestational diabetes has far-reaching consequences for a pregnant woman. Not only does she have to accept the unpleasant news that something is not right, she also has to adapt her diet and take more physical exercise. In addition, blood sugar levels have to be measured several times a day and, if they do not drop to the prescribed targets within a short time, daily insulin injections have to be administered.

Treatment can have positive effects

… treatment reduces the risk of certain rare birth complications in pregnant women with a marked metabolic disorder. One such complication is shoulder dystocia …

Potential disadvantages of routine screening have not been researched

Even if there is an indication of benefit from treatment, this does not automatically mean that routine screening is also useful for identifying pregnant women with gestational diabetes. Although some professional associations have been recommending this type of screening for many years, potential harms have not yet been sufficiently investigated. IQWiG could not find any studies which directly showed that routine screening was of more benefit than harm.

In view of this uncertainty, the Institute considered a long list of potential disadvantages. However, the potential risks were not assessed as being so serious that they might cancel out the potential benefit. Thus, the Institute has indirectly deduced an indication that routine screening for gestational diabetes leads to a reduction in perinatal complications.

… Experts around the world are not agreed on how women with a metabolic disorder should be routinely identified.

… Consequently, many tests for gestational diabetes that are already being offered to pregnant women should be viewed critically. “These tests label many pregnant women as being at risk, without it being clear whether they would actually profit from having treatment”, explains Sawicki. A harm is particularly likely if a woman with a mild metabolic disorder during pregnancy is recommended to have treatment which is too strong.

The baby … is 62 centimetres (24.4 inches) long, was born by caesarean section …

“This heavy baby made the surgery really tough …

The boy is in a healthy condition despite having to initially be given oxygen to overcome breathing problems …

“He’s got strong appetite, every minute, it’s almost non-stop feeding,” he said.

“This baby boy is extraordinary, the way he’s crying is not like a usual baby. It’s really loud.”

The boy’s massive size was likely the result of his mother, Ani, 41, having diabetes, Sitanggang said.

She had to be rushed to hospital due to complications with the pregnancy, which had reached nine months. The baby, her fourth, was the only child not delivered by a traditional midwife.

Canadian and Dutch studies have found that home births attended by qualified midwives appear to be as safe as hospital births for low-risk women. However, many groups still oppose the practice because of safety concerns …

… women who have just one abortion in either the first or second trimester of pregnancy have a 35 percent increased risk of having a low-birth-weight baby in the next pregnancy and a 36 percent increased risk of having a baby born prematurely.

Women having multiple abortions have a 93 percent increased risk of subsequently having a premature baby and a 72 percent increased risk of having an underweight baby.

… the Shah meta-study showed “very strong evidence [that] the most common induced abortion procedure, ’suction’ abortion” has a “risk of a later preterm birth or the low birth weight baby.”

… there were 1,096 newborn babies in the United States born at a low birth-weight, and who developed cerebral palsy, due to their mother’s prior induced abortions.

The cerebral palsy link is important because “babies under 32 weeks’ gestation have 55 times the cerebral palsy risk as full-term (at least 37 weeks) newborns.”

As a result, if abortions increase the risk of a low birth-weight baby and low birth-weigh significantly contributes to an unborn child having cerebral palsy, then the performance of abortions clearly results in more children diagnosed with the condition.

“Swingle reported that women with prior induced abortions raised their relative odds of a birth under 32 weeks’ gestation by 64 percent,” …

… “All the prenatal care was done at home,” says Ms. Hirsch … [I] had leisurely visits, I made tea, and they answered all my questions. You really got the sense that they love what they do,” she says.

Home birth has become a hot topic these days … but the question of home birth itself, whether it is safe, better for the baby or simply a recent fad, is contentious.

“There is definitely a resurgence of interest in home births,” says Alice Bailes, a certified nurse midwife …

Both the American Medical Association (AMA) and the American College of Gynecologists and Obstetricians (ACOG) have reiterated their opposition to home births, citing safety concerns and the expertise of the midwives who attend them. Nevertheless, a recent study of 13,000 births published in the Canadian Medical Association Journal, which prompted a number of the most recent news stories, says home births are as safe as hospital births for a low-risk population. Other studies make similar claims.

Both sides acknowledge that home births are not for everyone, especially if a woman has had a previous Caesarean section, is diabetic, has high blood pressure, or has given birth prematurely. But even low-risk pregnancies can have unforeseen complications.

“Everyone knows, and everyone understands, that there needs to be a mechanism to transfer a mother to a hospital setting,” says Ms. Bailes, who notes that about 11 percent of her clients end up being transferred to a hospital.

To be sure, a hospital experience can be daunting, especially these days when procedures such as episiotomies and enemas, IV hookups, and fetal monitors are routine. So are C-sections, once seen as a last resort, now performed with increasing regularity.

What moved women into the hospital, and made the hospital birth experience routine … was safety, along with the availability of medicines and procedures not accessible to the midwives of the time. Today, she notes, many home birth advocates opt out of the hospital because there is “too much medicine.”

… For Emily Scherer … a home birth was a more natural experience than the ones she had seen in the delivery room during her labor and delivery rotation.

“I was convinced that that was not how I wanted my baby to be born,” she says.

… Both Ms. Hirsch and Ms. Scherer ended up with healthy babies and a very positive birthing experience …

… The greatest risk was conferred by having a sibling with diabetes. Indeed, women who had a sibling with a history of diabetes were at much greater risk of gestational diabetes than were women whose parents (either or both) had a history of diabetes.

… adjustment for body mass index attenuated the link between paternal diabetes and gestational diabetes but did not affect the association between maternal diabetes and gestational diabetes.