Once marginalized in a post-industrial age as a fringe choice reserved for the all-natural crowd, home births in recent years have been gaining new legitimacy among an increasing number of U.S. women, according to a Centers for Disease Control and Prevention study.
Along the way, the findings are reigniting an age-old debate over what’s best for mom and baby: giving birth at home or in the hospital.
Marking the largest increase in home births ever recorded, the CDC study found that the number of women giving birth at home grew by 29 percent between 2004 and 2009. In Florida, home births grew by 10 percent. The increase was more prominent among married white women, especially those 35 and older and moms who have had other children.
Moms like Miami-Dade County’s Jamie Althoff. After delivering her first son in a hospital, with nurses yelling at her to push and ignoring her request to hold the baby, Althoff knew one thing: She would have her next child in the comfort, and freedom, of her own home.
On Feb. 16, with her midwife and husband by her side, the Doral mom made good on her pledge, delivering her second son her way — on her knees, screaming to her heart’s content, on beach towels and a painter’s tarp covering her living room floor.
“I still almost cry thinking about how amazing it was,” said Althoff, 28, an assistant professor of optometry at Nova Southeastern University. “The whole process was treated like it was a normal but miraculous event for our family. It was absolutely the most amazing moment of my life.”
While home births still represent a tiny fraction of all deliveries across America, growing from .56 percent to .72 percent, the rising numbers reverse a decades-long trend that experienced a dramatic decline between the 1930s and 1960s and continued at a more gradual downward pace until 2004, according to the CDC.
Marian MacDorman, lead author of the study, thinks the uptrend can be attributed to a growing interest among women wanting to take control over the birthing experience.
But many OB/GYNs continue to frown on the practice, calling home births risky and saying their growing popularity is based on myths and misinformation about the hospital setting. The American College of Obstetrics and Gynecology has long opposed planned home births, saying in a January 2011 opinion that the risk of newborn death, while low, is two to three times that of hospital births.
“Everyone has the right to take their own risks,” said Dr. Mark Scheinberg, an OB/GYN in Coconut Creek who serves as the backup physician to area midwives in case of an emergency. “Delivering at home is riskier than delivering in a hospital because if something goes wrong, the hospital has the facilities available to take care of that.”
Women can hemorrhage “at any time” after giving birth, he said, and the baby can inhale contaminated amniotic fluid that could prove life-threatening if not detected quickly.
“But that doesn’t happen often, so it’s a question of numbers,” Scheinberg said. “It’s like playing Russian roulette.”
While such statements sound ominous, Delray Beach midwife Miriam Pearson-Martinez said they do not reflect an accurate picture of midwifery.
“When you’re in the hospital, you give up a lot of your ability to control the situation. What happens at home is the mother calls the shots, as long as they are medically safe,” Pearson-Martinez said.
She said she’s had four emergency transports to the emergency room in 10 years, and all turned out OK. “I’ve never lost a mom, and I’ve never lost a baby.”
By Florida law, to have a planned home birth, expectant moms must be healthy, maintain a low-risk pregnancy, have only one baby in the womb, attend childbirth classes and have an adult stay with them for three days after delivery.
The law also dictates strict guidelines on when to consult with a physician, under what circumstances the mom must be transported to the hospital, and what kind of postpartum care must be provided in the days and weeks after birth.
“Women want control over what happens to their bodies,” said Debbie Marin, owner of the Hollywood Birth Center, where business has grown in the past few years, especially among middle-class, college-educated women. “They don’t want to be coerced into doing drugs or having C-sections.”
Florida’s C-section rate is the second highest in the nation at 37.2 percent and a major concern for moms like Sara Green, who had her second child at home in West Palm Beach on Valentine’s Day.
“All I heard were horror stories about C-sections and inductions,” said Green, a former teacher who writes math lessons for an education software company. “Midwives, in my opinion, it’s a higher calling. They take any means necessary to keep it natural and keep it safe, without any drugs. I felt I was in the best hands.”
Christina Costa, a La Leche leader who is planning another home birth after delivering three of her other four children in her Sunrise home, said she has seen too many mothers’ well-laid plans go awry while delivering in the hospital.
“This [La Leche work] has been a big real-life experience for me seeing all these women who did all the right things but were just not in the right setting,” Costa said, adding that she would not give birth at home if she thought it was unsafe. “I would not jeopardize the safety of my births, of my children or my own health.”
Still, Scheinberg said he has seen, and responded to, tragedies resulting from home births. He called the concern about being pressured into pain meds misplaced, saying the patients have the last word on whether they are medicated or not. And as for avoiding C-sections, the doctor said moms are better off seeking out physicians, like him, who are known for low Caesarean rates.
“I respect everyone’s right to make their own choices,” Scheinberg said. “Whether I agree with them or not is not important.”
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