ST. GEORGE – The age-old practice of having a baby at home is regaining popularity, to the displeasure of some and the delight of others.
Understanding home birth
Though home birth dates back to the first days of humanity, its frequency in the United States declined sharply during the 20th century as medicine was modernized and hospitals and health insurance became more accessible to the general public. An estimated 50 percent of babies were born at home in 1935; by 1955, that number had decreased to a mere 1 percent. Over the last 20 years, the rate of home births has remained at approximately 0.65 percent.
However, this infrequency has not stopped women from seeking an alternative to the now-routine hospital birth. For many, a variety of physical and emotional factors contribute to their choice. A series of interviews conducted in 2009 by the Journal of Midwifery and Women’s Health found five main reasons home birth appeals to mothers: Safety, avoidance of unnecessary medical interventions, past negative hospital experiences, being in control and more comfortable surroundings.
“My biggest fear was having my baby in the hospital,” Bria LeFevre, a St. George resident who had both her children at home, said. “A hospital is a place for sickness and problems and being there (for a checkup during my pregnancy) gave me a glimpse of how cold my childbirth could have been.”
Keeping with this theme, home births are primarily focused on the mother and are tailored to her needs and desires. She is given access, if wanted, to relaxation aids such as a birth pool or birthing ball and the freedom to position herself however she wants during labor, privileges that would not be available in most hospitals. Supporters of natural childbirth also gravitate towards the practice, as many home births are without any type of pain relief.
Modern home births are classified as either attended or unattended. Most are attended, which means that a professional, such as a certified midwife or nurse who can provide minimal medical aid, accompanies the mother. Unattended births occur when the mother is accompanied only by relatives, friends or a nonprofessional such as a doula (labor coach); this method is sometimes called freebirth. Least common are solo births, when the mother delivers her baby entirely alone. But regardless of method, the general goal of home birth is for the mother to enjoy the experience, at least more so than she would in a hospital.
Home birth has both passionate supporters and detractors within and outside of the medical community. Those against it cite a lack of safety as the main concern, as mothers who deliver at home have access only to minimal care and are often not accompanied by qualified medical professionals. And due to lack of education and experience, midwives may not be able to recognize complications threatening the health of the mother and child, or decide when going to a hospital is necessary.
Dr. Robert Fagnant, an obstetrician hospitalist at Intermountain Healthcare Southwest Region at Dixie Regional Medical Center, said that his staff encounters women at least twice a month who hoped to give birth at home but, due to complications, had to abandon their plan. In his 25-year career, he has also seen several babies die during labor and stressed the importance of good preparation to ensure a successful delivery.
“Any woman who has an illness, has had uterus surgery, is before or after their (due date), (is carrying) multiple babies, a large baby or (breech) baby should not deliver at home,” he said. “It’s also important for women to (have an) experienced and knowledgeable attendant so they can know when it’s time to have a hospital birth.”
Those for home birth, who typically include midwives, advocate that healthy mothers with low-risk pregnancies should be able to choose their birth experience. It has been suggested that delivering in a familiar environment reduces stress and pain and may even contribute to an easier labor and healthier baby. A myriad of studies have been conducted on the risks of home birth versus hospital birth with no conclusive results, due mainly to the low percentage of babies born at home.
“I think there just isn’t enough education on home birth, (because) some people have the misconception that midwives are anti-doctors and anti-hospitals,” midwife Janae Sherman said. “We are not. We are here for those women and families who just want a different experience. We support a woman’s choice to deliver where (she wants), and will do whatever we can to accommodate that.”
A professional midwife and doula, Sherman has attended over 200 births during her career and has also given birth to her own three children at home. Only a small percentage of her patients ended up having a hospital birth and she said that while the emphasis is on natural methods, every situation is different.
“As with anything, there are risks involved in birth,” she said. “Parents need to look into all options and decide what is best for them. Education and support are the key issues.”
Finding common ground
In response to the demand for more personal care for expecting mothers, Intermountain’s DRMC has broadened its scope of services beyond just a delivery. A pair of low-intervention rooms was added this year. Amenities such as more space and privacy, music and hot tubs provide a home-like feel, but with doctors and anesthesiologists only seconds away. The hospital also offers childbirth education classes, hypnobirth classes (using hypnosis to reduce labor pain) and aromatherapy.
“If a mother wants to come in with a birth plan, we’ll work with them to give them the experience they want,” said Amy Christensen, director of Women’s and Children’s Services. “We really want to provide a good experience.”
Sherman has collaborated with doctors at Intermountain’s DRMC during her career and said that she is grateful for the respect and understanding the doctors have shown her and her patients; the general attitude is not against home birth, but for a healthy and happy mother and baby. The only way that is possible, though, is by educating oneself on both the risks and rewards.
Dr. Fagnant said, “My preference is for everyone to be born in the hospital, but ultimately it’s every woman’s choice.”
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