Desire for old-fashioned, peaceful labor at home gaining appeal

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448. Link

For Stephanie Foley ... the home birth of her son Calvin was a "peaceful, great experience."

And while Foley said she's pleased with how her home birth went, and that she would do it again, the issue of the safety of out-of-hospital birth is up for debate.

Statistics show that while the desire for a less sterile, more intimate birth experience is growing, most mothers in the U.S. still have their babies in a hospital. It's the prudent choice, safer if something goes wrong, experts say.

But it isn't a simple call.

Family history, health of the mother and fetus, available and trusted midwives and personal preference all weigh in the decision.

On average, only 1 percent of all births in the U.S. are conducted out of hospitals annually ...

Tori Kropp, a perinatal registered nurse at San Francisco's California Pacific Medical Center, says it's safer to give birth in a hospital.

... hospital births have gotten a bad rap due, in part, to the efforts of home-birth proponents, such as TV personality Ricki Lake.

Lake's 2008 documentary "The Business of Being Born," ignited a fire storm by implying many common medical practices may be doing new mothers more harm than good.

Kropp has participated in 5,000 births, including that of her 9-year-old son Alexander. By participating in so many deliveries Kropp said she has "seen all the things that can happen" during what is still a potentially dangerous event in a woman's life.

Has she been at any homebirths? It's totally ok to have an opinion in something that one has not seen, attended, experienced or directly been a part of. But if Kropp has never been to a home birth, only obstetricially-driven hospital births, who is she to say that home is not at least as safe as hospital for healthy, low-risk women who are attended by a midwife?

"Most of the time it's wonderful, but sometimes it's not," Kropp said. "At the end of the day, it's safer to give birth in a hospital."

Through education and outreach Kropp strives to correct what she says is "misleading" information promoted by Lake's film. "

"The problem with many home births," Kropp says, is that they are performed by midwives "without the support of either physicians or a hospital."

And is that because the midwife has not consulted with the hospital or doctor, or because they were not willing to consult when it was requested?

To spread her message, Kropp is planning a 100-hospital tour across the country beginning in Michigan on Labor Day. Kropp plans to offer free pregnancy seminars at the hospitals ...

Is she planning to get her message out to women who are planning to birth at home? If so, she can talk to the hospitals all she likes, she will not reach her intended audience.

Overall Kropp's mission is a simple one - "helping women feel empowered about the choice they make, and not the choice society wants them to make."

But ... not if they choose to birth at home. It's ok to choose an epidural or a caesarean though!

Regardless of birth location, 8 percent of births in 2006 were performed by midwives, according to the CDC.

Definitely room for improvement there. 80% would be a great target!

When Foley gave birth to her first and only child in December 2007 she and her husband lived in a one-bedroom, second-floor apartment in Lansing.

After about 6 hours of active labor, with the help of a direct-entry midwife, Foley gave birth to her son in an inflatable pool filled with water, which is described as a water birth.

... "Pregnancy and childbirth are normal, healthy events in a woman's life and interventions, such as cesarean sections, should be used only when medically necessary, Winkler said. "Women choose to come to the birthing center for freedom of choice."

But Winkler cautioned that women who have chronic diseases, such as kidney disease, high blood pressure or diabetes are "safest when (giving birth) at the hospital."

Planned home births may have a low rate of complications ...

Among 13,000 planned births studied, researchers found that the mortality rate was similarly low - less than one in 1,000 - among women who gave birth at home with a midwife, women who gave birth in a hospital with a midwife, and women who gave birth in a hospital with a physician.

... "Birth is safe. It is safe to give birth out-of-hospital when a woman is healthy and having a normal pregnancy," Winkler said.

But Kropp says even if a woman is healthy, there is still the possibility of complications in childbirth.

"Our hospital system for childbirth is so far from perfect," Kropp said. "But someone who is completely healthy could very easily have something very unexpected happen in childbirth. Childbirth is still the No. 1 cause of death for women (worldwide), so we can't get too cavalier in saying 'we don't need medical help.'"

It's the leading cause of death for women who are not suited to home birth, such as those in third world countries who experience malnutrition, undernutrition, anaemia, bleeding in pregnancy, high blood pressure and so on. For healthy, low-risk women, the benefits of home birth are enormous.

Foley said she considered safety when making her decision to give birth at home.

"I had had no reproductive issues ... for me I felt that being at home would be as safe as at the hospital," Foley said.

Melissa Maimann, Essential Birth Consulting 0400 418 448