Homebirthing in the USA

The latest issue of Newsweek features an article about homebirthing. The article discusses the AMA's push to outlaw homebirthing, and, of course, there is the obligatory scare comment from an ob/gyn about how women come in half-dead from hemorrhaging while attempting to homebirth, this one courtesy of Dr. Ellen Tracy of Massachusetts. " 'We've all seen scenarios where mothers came in, after very major blood loss, in a very catastrophic state,' she says. 'By the time they arrive in the hospital, you're sort of behind the eight ball in trying to resuscitate these patients. The same thing with neonatal outcome.' "

Ok, I'm not going to say that there aren't scenarios like this. But if Dr. Tracy is going to pull out the worst-case scenario card on home-birthing, I think turnabout is only fair. I would love to ask Dr. Tracy or the AMA or ACOG to produce the numbers on the women who ended up hemorrhaging due to unnecessary interventions, such as cord traction and c-sections. How many women have experienced disastrous outcomes due to the use and misuse of drugs like Cytotec and Pitocin? I am sure I will never hear the numbers - I mean this is an industry that refuses to even voluntarily make public the c-section rates of various hospitals and doctors so that patients can make an informed choice - but I have a strong hunch that the numbers of poor outcomes in the hospital setting are much higher than than for a homebirth situation. And yet, I have not heard about the AMA sponsoring a resolution encouraging more restraint and fewer routine interventions during hospital birth.

More from the Time article: "Doctors argue that what may seem like a low-risk pregnancy can go very wrong at the time of delivery--and that making home birth easier to access could lead to a huge step backward. After birthing moved to hospitals en masse in the 1950s, the maternal mortality rate plummeted, from 376 per 100,000 live births in 1940 to 37.1 per 100,000 in 1960. The most recent statistics show 15.1 deaths per 100,000." Yeah, I won't even rehash how unnecessary interventions are often the reason for low-risk pregnancies suddenly going "very wrong at the time of delivery." But I do take issue with the author just throwing out the statistic about maternal mortality rate dropping at the same time that birth moved to hospitals and implying that the two are related. Fact is, when birth initally was moved to the hospital setting, mortality INCREASED due to poor handwashing and sanitation in the hospital-setting. The time period being highlighted by the author also happens to coincide with improvements in nutrition and prenatal healthcare within the United States - with those statistics, the author is comparing a group of women who were at the end of the poverty and paucity of the Great Depression to women in the gleam of the post-WWII era, but that is not mentioned. Is it possible that these improvements could have had something to do with the decrease in mortality?? Hmmm...

One thing is for sure, this issue is not going be fought quietly. As midwife Joan Bryson states in the article, "Legislating against home birth is totally un-American and unfair." Amen, sister.

Power to the people!