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The question
My wife really wants a home birth, but my parents are insisting on a hospital. We're a few months away, but I'm curious about your take. It's been a healthy pregnancy so far: Are there known advantages to birth at home?
The answer
Ultimately, the decision is up to you and your wife. I can tell you that, from my experience, most women who gave birth at home say they will do it the same way if they had to do it over again, and give many reasons why: They like their privacy; they feel they are in control, they can be surrounded by anyone they choose to have in the room; they feel it is more natural; they claim there is less intervention and fewer procedures; they also fear that they are more likely to be exposed to infections if they deliver in hospitals.
They claim better pain control, less post partum bleeding, a lower risk of infections and tears and more success at breastfeeding. They also like the idea that their caregiver comes to them rather than having to figure out when to go to the hospital. Many moms prefer what they perceive the more natural way of delivering. They also tend have a high rate of satisfaction with their midwives whom they deeply trust.
The popularity of home births varies from country to country. In most developed countries it averages close to 1 or 2 per cent. Countries like the Netherlands and New Zealand have a higher rate of home births.
In 2009 a paper published in the British Journal of Obestetrics and Gynecology stated that home deliveries in 529, 688 otherwise healthy women who received excellent antenatal care and who had help from qualified midwives turned out fine for both the mother and the baby. In 16 per cent of home deliveries, the mom had to be transferred to a hospital for further specialized care.
According to the Canadian Society of Obstetricians the incidence of caesarian sections is climbing. Between 1993 and 2006 Canada's C section rate grew 26.3 For home deliveries, the incidence of mothers who end up needing a C section is as low as 5 per cent. (That's according to the National Collaborating Centre for Women's and Children's Health as Commissioned by the National Institute for Health and Clinical Excellence. London: Royal College of Obstetricians and Gynecologists. 22 March 2007.)
Whatever you choose, I recommend explaining all the facts to your parents and examining the research on all sides. There are certainly advantages to both home and hospital births and the decision lies with you and your wife.
Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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