Home birth: Why more moms are choosing it and doctors' warnings
Nina Criscuolo, WISH – INDIANAPOLIS (WISH) — Women choosing to give birth at-home is drastically on the rise, according to the CDC. In Indiana, two to three percent of births happen at home. It's the highest amount since 1975.
Each year, more than 26,000 babies are born at home with a certified midwife, according to the American College of Obstetricians and Gynecologists, or ACOG. It's an option some mothers believe gives them more control and comfort.
"Once labor started, I just headed to the bed, laid there and got as comfortable as I needed to, put on some soothing music," Mia Pahl said.
She delivered both of her daughters at home, one in 2011 and one in 2014.
"This is just exactly what I was looking for," Pahl said.
She described her home births as peaceful and intimate, compared to her son's 2008 birth in a hospital.
"When the day arrived a lot of the things that we requested were either ignored or never paid attention to… It was just less than ideal," Pahl said.
Pahl's water births were attended by a certified nurse-midwife, which is the only way to have a legal, planned-home birth in Indiana. Brandi Wood of Home 4 Birth is one of those legally practicing midwives.
"The trend is definitely up," Wood said.
The number of home births were consistently on the decline in the 80s and 90s, but in 2004 the trend reversed.
"Just wants more autonomy, wants to get to choose who's there, wants a little more control over their environment, wants the option of a water birth, because in many hospitals that isn't available," Wood said.
The CDC said in 2012, if the steady increase of home births continues, it could affect how labor nurses are trained and how much it costs to have a baby, even in the hospital, and doctors are taking note.
"She may want to have the option of being able to get up and move at her leisure, walk around, get in her shower," Dr. Kelly Kasper, board certified OB-GYN at IU Health, said.
Some hospitals are even adapting their practices to better address mother's wishes during labor and delivery.
"The baby is born and baby goes directly mom's chest skin-to-skin, we encourage breast-feeding during that first hour after delivery, first 24 hours no baths for the baby. We've learned from research that's not a good thing," Kasper said.
Still for many, a hospital setting spells medical intervention. According to a study by the Midwives Alliance of North America, home births have a remarkably low cesarean rate of just 5.2-percent, compared to the U.S. national average of 31-percent.
Like Pahl's daughters, the study says 97 percent of home birthed babies are carried full-term, have a healthy birth weight, and nearly 98 percent were being breast-fed at the six-week post-partum visit with their mid-wife.
"It was just very calm, very peaceful, and there was no sense of hurry up, hurry up, hurry up or something was going to go wrong. It was really wonderful," Pahl said.
Pahls' births were successful, but both midwives and doctors say home births are not for every woman.
The American Congress of Obstetricians and Gynecologists released its first opinion on home births in more than five years this week. Research by doctors, midwives and even the CDC align to say home births often result in fewer medical interventions during labor.
"For healthy low-risk women, particularly first-time moms, the odds of cesareans are less, the odds of pain management are less, which have an impact on the baby. The odds of successful vaginal birth and successful post-partum period are higher," Wood said.
But ACOG's new opinion states that babies are twice as likely to die at home and three times as likely to have a seizure soon after birth, compared to hospitals. To put that in perspective, researchers base those figures off every one-thousand births. In a hospital, two babies out of every thousand are likely to die, at home that number is four. A low rate in both instances, according to the primary author of the opinion.
If you are considering a home birth, doctors and midwives alike say they are factors to consider.
"Very, very low risk, very healthy women that we would even encourage to attempt to try a home birth," Kasper said.
That means no health problems before or during pregnancy, and a favorable position of the baby. Doctors also warn women with previous cesareans or a multiples pregnancy, like twins or triplets, about trying a home birth.
"If something falls out of that normal range, it's not only in her best interest to be somewhere else, it's in our best interest as well," Wood said.
ACOG also suggests mothers only consider midwives who work with a cooperating physician at a nearby hospital in case of emergency.
"You can have amazing providers wherever you are, home or hospital… Find somebody and learn way before hand whether that person has a similar belief or philosophy as you, whether they are invested as you are for you getting the birth that you hope for."
Aside from the health factors involved in choosing where to give birth, some say finances can play a role. Home births are at times covered under insurance through a certified midwife and can cost less than a hospital birth.
(Photography courtesy: Jennifer Tinkham with Tiny Bird Photography)
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