HOME BIRTH CAN BE AN OPTION
JONATHAN LUKE HOLLOWAY
ur daughter Aurora was born at home without any medical intervention, but with the assistance of a lay-midwife. Women have been doing this for millions of years. In Tennessee we are blessed in that the art of midwifery is unregulated (Tennessee Code 63-6-204 1990). This is not true in all states. In Tennessee, birth certificates are easily obtained from the local health department. [This is now changed legally and midwives in the State of Tennessee are now required to be registered.] Midwives can be found through many different sources, including health food stores and alternative health care providers. This is an option for any woman who is in good health and who is not expecting complications with the delivery.
In America today, most babies are born in hospitals under the care and direction of a doctor. There are numerous reasons why babies are born in hospitals, including those which are financial, social, technological and pharmaceutical. My baby could have been born in a hospital at no actual cash expenses to me, all of the medical expenses being covered by insurance. While actual costs involved with hospital births are very high, many women have their babies in hospitals purely for financial reasons. (This demonstrates an idiosyncracy in our health care system.)
When money is no object, some women choose to obtain the finest medical care available. For this they hire highly skilled physicians with the ability to monitor and cope with nearly any complication that may occur. These physicians have very advanced tools, competent nurses, and the finest technology at their fingertips. Many women appreciate knowing that the doctor will control the birth with the assistance the doctor deems as the finest tools available to themselves.
Women have been advised by the American College of Obstetricians and Gynecologists that home birth is dangerous (Brodsky 31). This belief is supported by what Archie Brodsky, a senior research assistant at Harvard Medical School, describes as a 'decline in maternal and infant mortality that coincided with the shift to medicalized, institutionalized childbirth in this century' (Brodsky 31). However, Brodsky goes on to point out that there were many other advances, including sulfur drugs and antibiotics, sanitation and personal hygiene, that occurred around the same time period that most women started birthing in hospitals.
While I believe home birth to be comparably safe to hospital births, no birth is completely risk free. However, there is a mounting body of evidence that the interventionist attitude prevalent in the medical community today is dangerous. Even the very things that the medical community touts as benefits can actually be harmful. Drugs often play a role in women choosing a hospital birth. Doctors have the ability to relieve most of the pain associated with labor. The fear of pain can be a powerful argument for hospital birth. Yet these same drugs can irreparably damage the child or the mother.
Oxford University carried out a study called 'The Pregnancy Project'. For ten years a research team of about forty doctors, mathematicians and health experts, headed by Dr Murray Enkin, Professor Emeritus of McMasters University in Ontario, looked at standard hospital births. Here are some of their findings:
37 were rated 'possibly effective', needing more exploration.
88 had 'unknown effects', requiring more research.
60 were rated 'should be abandoned', as they do little good and are even dangerous.
Monitoring a fetus' health plays a definite role in childbirth. When my wife was in labor our midwife, Miriam, would listen to our baby's heartbeat with a fetal stethoscope periodically. This style of fetal monitoring is very unobtrusive. My wife had the ability to move about freely throughout her labor. Most hospitals, however, use electronic fetal monitors. They use these monitors despite studies published in prestigious magazines like the New England Journal of Medicine and The Lancet that have shown 'that in the absence of specific indications for its use, electronic fetal monitors not only have no demonstrated benefit in reducing disabilities but may even be dangerous' (Brodsky 29). Dr Brodsky was very concerned about electronic fetal monitoring because a doctor would read these monitors looking for problems, and if a problem arose, the doctor would intervene. Brodsky maintains that this contributes to a 24% Caesarian section rate in the United States. 'Indeed, any medical intervention in child birth tends to necessitate further intervention by disrupting the normal physiology of labor . . . ' (Brodsky 29,30).
The Oxford team also criticized common birthing positions used in hospitals. Doctors will have women lie on their backs or with their feet in stirrups and their pelvises tilted. This has been shown to interfere with the baby's blood supply (Ubell 1-3). My wife delivered our baby squatting. She said she couldn't imagine doing it any other way. Our midwife had to lie on the floor on her back to examine my wife and to catch our daughter. Most doctors would have found this position beneath their level of professionalism.
Most midwives believe the use of drugs during labor to be unwise. This feeling goes to the heart of the issue of natural childbirth. I see child birthing as a natural physiological condition not requiring medical intervention. Drugs affect a woman's natural ability to deliver safely. Safety at a home birth depends on encouraging the mother's natural process. Drugs interfere with this process, thereby creating added risks (Brodsky 30). I believe a woman should choose whatever style of care she is most comfortable with, including pain management. However, I recognize pain as my body's way of telling me something is wrong, like a broken leg. Archie Brodsky hopes 'more women may approach the pain of child-bearing in a more positive way' (Brodsky 30). I believe this approach to pain is more easily achieved at home. At home, the woman giving birth is in charge and everyone present is her guest. One thing that needs to be pointed out is that no matter where the woman has her baby, there will be pain - even in a hospital.
People who are considering giving birth at home should be encouraged by credible studies showing the relative safety of a lay-midwife-attended home birth. A community in Summertown, Tennessee, called 'The Farm', was the subject of an extensive scientific study that suggested that 'support for home birth should not be withheld on the grounds that this option is inherently unsafe' (Durand 252). A. Mark Durand, M.D., found that the 1700 births attended to by lay-midwives at 'The Farm' were statistically as safe as comparable hospital births (Durand 451). Durand contributed some of 'The Farm''s success to an atmosphere that nurtures the mother's natural ability to deliver (Durand 452). He even went on to suggest that hospitals 'encourage passivity . . . diminishing her [the mother's] ability to deliver spontaneously' (Durand 452).
My wife made the choices involved with giving birth to our child, recently. She was blessed with the opportunity to choose between having a doctor-attended birth in a hospital or staying home and having her friend, a lay-midwife, come over and assist her. There was considerable pressure to go to the hospital to deliver - pressure from my wife's mother, her doctor, and from the community at large. My wife weighed her options, and when she considered the risks of hospital birth compared with the empowerment of home birth, she chose to stay home. This choice has turned into a living thing - by that I mean my daughter Aurora Violet - but I also mean the living knowledge that laboring mothers are, as Ina May Gaskin puts it, 'an elemental force . . . like a hurricane . . . with their own laws of behavior' (Gaskin 348).
mother-in-law, who came
into her granddaughter's home birth with a very critical mind, left the
birthing with the knowledge that a hospital is no place for the
force that is a healthy woman giving birth.
Jonathan Luke Holloway
Brodsky, Archie. 'Home Delivery - Midwifery Works - So Should Midwives'. Reason (March 1992), 28-34.
Durand, Mark A. 'The Safety of Home Birth: The Farm Study'. American Journal of Public Health, 82:3 (March 1992).
Gaskin, Ina May. Spiritual Midwifery. Summertown, Tennessee: The Book Publishing Company, 1990.
Tennessee Code 63-6-204, 1990.
Ubell, Earl. 'Are Births as Safe as They Could Be?' Parade Magazine (7 February 1993).
the name 'Luke ', that of the Physician
Gospeler, hoping he would be, like her grandfather, a doctor. Her
had delivered her mother in a tent in South Africa. She had desired
for her three sons, Richard, Colin and Jonathan, but this was not
She almost died at twenty-one as the result of both a doctor's and a
interfering interventions in a hospital with the birth of her first
She had begged for home-birth, failing that, for natural childbirth in
the hospital. Instead that birth, with dangerous spinal anesthesia
by her doctor, in a hospital for millionaires, resulted in
kidney damage, and ironically coincided with the natural - and
- childbirth, without anesthesia, of a baby in the waiting room of the
same supposedly sterile hospital by a gypsy
mother, accompanying a seriously ill gypsy prince. Her second son,
Colin, when twenty, delivered her first grandson, Akita Mani-Yo, at
She agrees with her third and second sons that home birth should be
Moreover, that mothers should nurse
children at the breast, as she did with all three sons, though
criticized for this as un-hygienic and un-American by her doctor, the
nurses, her children's father, her husband's mother. We are not sterile
machinery, we are mammalian and definitely human; our bodies are the
of the Spirit, of God. If we, in the First World, like the Virgin Mary,
lovingly and in public can nurse our babies at the breast, then will
World mothers do so, their progeny not dying of unboiled water and
milk fed to them in plastic bottles, next placed on their tiny graves.
(Alas, with AIDS, Third World mothers should no longer nurse their
dying babies.) We need to re-humanize and deify the Holy Family
Julian of Norwich speaks of
Christ as Mother, in whom we are all born and to whom we shall all
speaks of a great secret that God shall do at the end of time, that
shall make all things well. Perhaps it is that time will run backwards,
that we shall each return to our mothers' wombs, like Russian dolls,
undoing all trauma, back to Eve and to Christ the Creator, creating us
that morn in Eden's fair Garden.
This was painted by Eileen
Mary Bolton , the Christmas my first son, Robin/Richard Ben
was born. In it she shows her contemporary Welsh shepherds keeping
sheep, and a mother sheep, her baby lamb, recalling the Anglo-Saxon
Nunburnholme sculpted cross which has a mother and baby centaur
the Holy Family, joking with Jerome's text on 'St Paul and St Anthony',
in which even pagan mythical centaurs proclaim Christ.
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