Despite skepticism from the medical establishment, more and more women are opting for home births. Although home births declined from 1990 to 2004, over the subsequent four years, the rate of home births rose by an astounding 20 percent. The increase is due to what experts identify as a natural birth subculture among white women who want more control over the birth experience. The results of the CDC’s study were highly racialized, with 1 in 98 white women having babies at home in 2008, compared to 1 in 357 black women and 1 in 500 Hispanic women.
These statistics are particularly interesting because they show that the new popularity of home birth among a small subculture can have a significant influence on the numbers. While home births are appealing because they’re less expensive, especially for the uninsured, they’re also safer for low-risk births than going to a hospital. Women who want a more individualized experience with fewer medical interventions are increasingly opting for birth at home, under a midwife’s care. These women are, for the most part, affluent and well-educated, and informed about the potential benefits of home birth. This signals a changing perception of what, before, seemed like an unsafe, illogical decision.
Medical anthropologist Robbie Davis-Floyd explained, “At first, in the 1970s, it was largely a hippie, countercultural thing to give birth outside of the hospital. Over the years, as the formerly `lay’ midwives have become far more sophisticated, so has their clientele.
Authorities like the American College of Obstetricians and Gynecologists warn that home birth can be dangerous, especially in high-risk situations. But midwives are also concerned about the skyrocketing cesarean section rate in the United States, saying that this is one compelling reason to give birth outside a hospital, where women may be given a dangerous and unnecessary surgical procedure.
The “hipness” of home birth was signaled in 2008 by the release of The Business of Being Born, a documentary produced by Ricki Lake, which extolled the virtues of home birth. The film was polemical, demanding, “Should most births be viewed as a natural life process, or should every delivery be treated as a potentially catastrophic medical emergency?” But it was also popular. And although it was released at the end of the period from which these statistics were taken, it represents the possibility that home birth, once so controversial, could start to be seen as mainstream.
Women have home births for a wide variety of reasons. Some react to bad hospital experiences and opt for home births with later children; others respond to cost; others want, in the words of one woman with MS who chose home birth, to “surround myself with people who would support me as a birthing mother, rather than view me as a…patient who would be a liability in need of interventions at every turn.”
Most studies of home birth are too small to accurately assess safety, so more research may be required before women can make a truly balanced decision about whether or not to have a home birth. And of course, there are many gradients between home birth and overmedicalized hospital birth. Women can give birth with midwives in hospitals, or in birthing centers. But as home birth becomes more accepted, the more options women have. Because of opposition from the medical establishment, midwives are having trouble creating a place for themselves as legitimate medical figures. But one thing’s for sure: women deserve the ability to make the choice about what kind of birth they want, and having more options on the table can only be a good thing.
Photo from o5com via flickr