Homebirth IS about the baby

Contributed by Heather Burke, Co-Moderator

"The likelihood of fetal distress is decreased by simply NOT giving an epidural, NOT introducing pitocin, and NOT rupturing the membranes."

It is being said that homebirth is about the mother, never the baby, and that homebirth is less risky for the mother and moreso for the child. This inaccurate remark is based on statistics comparing home and hospital mortality rates, predominantly the ones funded by hospitals, obstetrics and gynecologists, and drug companies to show the superiority of hospital birth. Studies exist concluding the opposite, which were mainly funded by midwives and homebirth advocates; however, those against homebirth discredit, disregard, and dismiss those studies and chose only to recognize the ones in favor of hospital birth.

For the purposes of this article, which studies are correct is irrelevent, as this is not an argumentive piece debating statistics or the validity of statements. The purpose of this piece is to provoke thought and to introduce concepts to the reader that studies do not consider, to disprove this false statement that hospital birth is safer than homebirth, and to demonstrate how homebirth is most assuredly about the baby who is being born. Homebirth just might be the most loving and protective thing a woman and man can do for their child.

Let us first discuss birthing environments. While safety is certainly an issue and will be discussed later in this piece, many women chosing to homebirth do so because of the comfort factor--not just for them, but for the baby. The child has, for the last nine months, been living in a slowly-moving world of warm liquid, soft yellow glow, and faint echoing sounds. He has felt very little discomfort as he's floated in the waters, cushioned, protected from the outside world. He has known no pain, fear, or hunger. Life is gentle and predictable. He is always with his mother, always in solitude but never alone. Leaving this world, his home for nine months, is a very dramatic change. The world outside of the womb is full of sensations that are completely new to the infant. Our fast-paced world is dry and full of a variety of sounds, smells, and colors. The transition from womb to world is a difficult ordeal, but we can seek to lessen the trauma and make birth much less overwhelming for the infant.

Why would we want to do this? Our body must constantly adjust to its surroundings to maintain stability, and we react to any change that threatens this equilibrium. The stress response causes hormones to be released, which has several effects, such as causing sounds to resonate more loudly in our brains. Our heartbeat speeds up, blood pressure increases, and breathing quickens. Stress has many effects on the mind, the most pertinent to this discussion being confusion, which inevitably clouds the mind of any child so overwhelmed by new stimulus. The physical effects of stress include headaches, digestive problems, muscle tension and pain, sleep disturbes and fatigue, chest pain, weight gain or loss, asthma or shortness of breath, skin problems, immune system suppression, and more.

There is no reason to elaborate on how any of these effects would be detrimental to the well-being of the infant. Some of these things are caused immediately, and some are the result of chronic stress. With all of these issues being linked to stress, which is caused by change, and with stress being so definitely related to birth, is it possible that some children who fail to thrive or develope digestive problems in the early years do so because of stress related to their birth? This is only a theory; there is no real proof, only a common sense link. There is also quite a bit of speculation suggesting that birth trauma contributes to cholic. (Read more here.) The fact of the matter is that stress is caused by change, that birth is a tremendous change which inevitably causes stress, and that stress is proven to not be very healthy for anyone.

In a typical hospital environment, a child is born into a cold, sterile room of bright lights, loud and unfamiliar voices, and beeping machines. The umbilical cord is immediately cut, and the child passed off--generally handed roughly--to strangers who suction her nose, place her on a cold scale, scrub her with a rough cloth, and tightly wrap her in dry blankets, evaluating her before finally placing her in her mother's arms. She is denied skin to skin contact and immediate nursing, which faciliatate the bonding process and comfort the child. Even without medical intervention, a hospital is not a very comfortable place to be born and can in, and that environment itself cause quite a bit of stress.

Over the next few days, the child is subject to many uncomfortable procedures from needle pricks to circumcision, often separated from his mother, before finally being allowed to head home to adjust again to another new environment. When an epidural is used, the child is often groggy, has breathing problems, and is a bit doped up throughout the process. When pitocin is given, the child is compressed by violent contractions much stronger than ones that occur naturally, which can cause fetal distress and result in a C-section. This is especially true if an amniotomy has been performed, which destroys the natural protective cushioning of the amniotic sac that would have absorbed most of the shock of the contractions. There is no denying how stressful a birth in a hospital must be for the infant, who is in constant discomfort and even pain because of the meddling of the doctors.

At a homebirth, the child can be born into a warm, dimly lit room of soft, familiar voices and friendly faces. He is received by the gentle hands of a midwife, or one of his parents, and usually immediately placed skin to skin on his mother's chest to nurse. He is wrapped in soft blankets, suctioned if necessary, and weighed only after he has bonded with his parents and been comforted by their touch. In a water birth, he transitions from one liquid environment to another, emerging into the world clean and not needing to be scrubbed vigorously to wash off the residue from the womb. Generally, vaccinations are not given, and circumcision is not performed--at least not for a few days, if at all.

The child is with his mother or father almost constantly. He is not nearly as overwhelmed by the sensations, as the home environment is much closer to the womb world than a hospital, and thus not as stressed. He is safe from drugs, violent contractions caused by artificial hormones, and sheltered throughout the birth by an intact amniotic sac.

There is not nearly as much intervention at midwife-attended birth, and there is no doubt that a homebirth is much more comfortable and less stressful to an infant than a birth in a hospital as things stand now. With stress having such real effects on health, it is obviously beneficial to make birth and life as stress-free as possible for the fragile newborn.

We could attempt to duplicate the environment of the womb as much as possible in a hospital birth, and eventually make hospital birth much less stressful and more gentle on the baby. This would be wonderful for mother and child. However, the current reality is that it is next to impossible to have this type of birth in a hospital. The rate of interventions is quite high, and the risk of C-section is 30%--even higher in some hospitals.

These interventions and risks are not just unfavorable for the mother but for the child as well. Amniotomy, as we have already established, causes contractions to become stronger and much more violent than natural ones, as does pitocin. With the bag of waters broken, the baby has lost the cushion protecting him from the force of the compressions. This can cause the infant to go into fetal distress, resulting in other interventions or even C-section.

Epidurals often slow down contractions, leading to pitocin or amniotomy, and causes serious side effects for the baby, such as the inhibition of after birth bonding because both mother and child are doped up. Babies born under the influence of epidurals are more likely to have breathing problems. Once on an epidural a woman can no longer get out of bed to walk around to speed up labor, and she usually must lie on her back to birth. This is one of the worst positions despite its popularity with ob/gyns, as it doesn't open up the pelvis near as widely as squatting or employ the natural force of gravity to assist with the birthing. Women birthing on their backs are much more likely to be assisted by forceps or vacuums, which can injure the infant and at the very least cause a bit of pain and stress.

IVs inhibit a woman's movement and thus increase the likelihood of amniotomy or pitocin being given to speed up labor; they can also overload a woman with liquid and/or drugs, causing negative effects for the child. Fetal monitoring increases the likelihood that a woman will be given an emergency C-section, due to fetal distress, when it could be true that a child is just having heartrate dereases as a natural response to the contractions. The likelihood of fetal distress is decreased by simply NOT giving an epidural, NOT introducing pitocin, and NOT rupturing the membranes. Eliminating these practices could make fetal monitoring much less necessary. The only consistent finding of studies of fetal monitoring is a higher rate of cesarean birth and no declines in cases of cerebral palsy.

Vaginal checks are likely to cause infection, as they give bacteria in the vagina a free ride up to the cervix. Instructing a woman to breathe as the doctor or nurses instruct can cause her oxygen supply to decrease, thus decreasing the oxygen supply of the infant making him much more likely to have breathing problems after the birth. Disallowing a woman to eat can cause her level of energy to decrease, and with her not getting any nutrients, the baby isn't getting any nutrients either. With labor often lasting more than 15 hours, this obviously is not a safe or healthy practice. Not allowing a woman to drink water can cause her to become dehydrated, which can cause a number of symptoms including fainting, which could lead to doctors deciding to do Caesarian rescue.

C-section can cause surgical adhesions which may interfere with subsequent births, which may not be a problem for the baby rescued by Cesarean section but could be one for his future siblings who will be babies at some point, too. Adhesions develope in 93% of pelvic surgery patients and are very common after C-sections. Uterine rupture can occur during subsequent births following cesarean sections, endangering the child and increasing the risk of another C-section. C-sections may be contributing to the number of babies born 2-4 weeks prematurely, who are usually healthy but are still likely to have medical problems. C-section babies are more likely to have breathing problems. They are less likely to be breastfed, which deprives them of the wide spectrum of enormous benefits of nursing.

Cesarean also causes side effects in the mother, sometimes so severe that they hinder her ability to care for her child, which is definitely not good for the newborn. The risk of maternal death is much higher, and besides the death of the infant is, in this writer's opinion, the highest price for an infant to pay for a overly medicated birth. Women with prior C-sections are at higher risk for placenta previa and accreta in subsequent pregnancies, which tremendously endanger the lives of her future babies as well as their birth experiences. Clearly C-section is a danger not only to mothers but the babies born by them, as well as the babies of tomorrow.

A more comfortable environment means a much less stressful transition into the world. Allowing a mother to trust her own instincts and birth in the way that feels right to her results in a much healthier mother, baby, and mother-child bond. A lower rate of intervention, unnecessary meddling, and harmful restrctions on the mother means a safer birth not only for the baby being born but for his future siblings. With all of this to consider, how could anyone make the claim that homebirth is about the mother rather than the baby? There are most certainly many benefits for the mother of birthing at home, but homebirth is also greatly beneficial and much safer for the infant in a wide variety of ways--regardless of what statistics doctors like Amy Tutuer chose to quote.

Sources include Helpguide, March of Dimes, Pregnancy-Info, Henci Goer's "A Thinking Woman's Guide to a Better Birth," and the writer's own common sense.

Copyright © 2006 Heather Burke