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I am a practicing ob/gyn who firmly believes in the choice of home birth. Birth outside of a hospital is a safe option but not for every woman. Unfortunately, I think the two "sides" (home birth vs hospital) have misconceptions about the other "side" that results in extremely poor communication and poor understanding of the motivations, outcomes and rationales. 

Having seen both positive and negative results of home births, I can say in my experience, it is appropriate for low risk patients. When problems arise, they seem to come from home birth attempts which I would not consider safe - diabetic patients under poor control, obese patients, breech, twins, preeclampsia. Also, problems seem to happen when the patients or midwives fail to recognize the seriousness of the situation and push for home birth. While not all home birth attempts are successful (ie need delivery in hospital setting), it seems that if the above issues are present chances of successful home delivery are less and the potential complications are greater. Again, based on my experience, the baby seems to bear the brunt of the risk (infection, blood sugar problems, delay in resuscitation).  

I had read through the comments on another discussion about home birth and one of the comments implied that the delay to emergent surgery (ie C-section) was just as long in the hospital as it is at home. This is just not true. I have done a C-section (from decision to baby out) in less than 10 minutes from a patient arriving to the doors of L&D. It is rare that it needs to be done but emergencies by their very nature are unpredictable. The standard should be under 30 min but in a true emergency, it is usually much faster.

It seems that patients who approach birthing with a plan (whether it be home delivery or hospital; low intervention or epidural and induction) but the realization that birthing, (like life) often doesn't follow a plan, have the best experience and best outcomes (healthy baby & Mom). 

I don't think either side presents the information in an unbiased way. Both sides "believe" that they are doing what is best for the patient. Each side seems to think that the other side is in it for the wrong reasons (money, control, power). Each side accuses the other of withholding the real information. I am not sure how this will be resolved but I think that if we keep in mind that our goals probably very similar, that will go a long way.

posted 2 years, 10 months ago
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