SO, HERE’S a little more about home birth in our area as I see it, of course.
First and foremost, a planned home birth with a healthy mom, healthy baby and skilled attendant — please note those distinctions — is not inherently dangerous. Birth is not inherently dangerous. Are there dangerous complications that can arise? Sure. But that’s regardless of the setting and, in fact, a lot less likely when you have in place those things I mentioned: prenatal care and planning, healthy mom and baby and skilled attendant. And frankly, dangerous complications might be more likely to arise when you have all or some of the medical interventions that often happen in a hospital.
Terry is correct to note that longitudinal studies on home births can be inconclusive. Some data sets throw in all “home births” — like the ones where mom was headed to the hospital and dropped the baby in the driveway on the way out, which is not the same as a planned home birth. But one cannot find a reliable statistic that says planned home births are any less safe than hospital births. For those of us who weighed our options carefully — Me, me! — many of us would tell you we actually felt SAFER at home.
I do contract work for three, sometimes more, CNMs in Michiana. I can tell you their transfer percentages — meaning women who need to transfer to the hospital during labor for complications — are in the single digits, nowhere near the higher 40 percent number Terry notes is possible. If I were a home-birth CNM and my transfer rate were near 40 percent, I’d be doing some serious work to assess why and drastically change my practice.
Most transfers happen long before there’s anything emergent happening — say a malpositioned baby, a labor dystocia — and not all result in cesarean sections when the receiving hospital or physician is friendly and open to a minimal-intervention-to-get-the-job-done approach. While few or no doctors or hospitals locally have official relationships with home-birth midwives for transfers — yet — IU Goshen Health is one such friendly facility, by the way, and enjoys one of the lower cesarean rates and highest vaginal birth after cesarean (VBAC) rates around. It was my own choice for transfer had I needed it.