Opinions about the safety of so-called ‘home births” range across a wide spectrum. Some are avid proponents of mothers giving birth at their own home, while others argue that births anywhere other than a hospital simply open up mother and child to more risks.
The Slate story points to the startling medical advances related to childbirth, eventually vastly improving safety for procedures that have ended countless lives over the centuries. It is commonly understood that, historically, childbirth was the leading cause of death for all adult women. The same grim statistic persists in less developed areas of the world where pregnant women to not have access to modern medicine.
Yet, many fail to appreciate that the dangers are still quite common, even for women in the United States today. According to data from the Centers for Disease Control and Prevention (CDC) childbirth injuries rank as the 6th most common cause of death for women in prime child-giving age (20 to 34 years old).
Why are these rates still so high? Mostly because factors in human evolution amount to a series of tradeoffs between gestation time, brain development, and metabolic rates (the amount of energy required to support a child in the womb). Pregnancy and childbirth remain a very delicate process, requiring expert medical support to deal with potential complications.
Midwives vs. Doctors
Interestingly, for centuries doctors and midwives have “competed” for primacy in childbirths. In the very distant past, only female midwives were deemed appropriate to be near a birth. However, doctors became more prominent in the 17th through 19th centuries, often winning business by claiming to have new and effective treatments to prevent injury. Sometimes those “treatments” caused more harm than good.
Things finally changed in the 1930s and 1940s when obstetrical standards steadily improved. There was a renewed commitment to safety, and lessons were learned from past problems. The advent of highly effective antibiotics similarly helped quell maternal injury and death caused by bacterial infection post birth.
For the author of the Slate article, the tide has turned sufficiently in the favor of traditional hospital births, with doctors offering the safest support for expectant mothers. She succinctly summarizes her position by pointing to the horrific death rates in the past and remarking that “I’m personally opposed to letting nature take its course–nature will kill you.”
Not to be too one-sided, the author does confess that the available data does not show a clear connection between increased risk of injury or death for home births, but only in cases where the home birth was well planned and involved a mother with low-injury risk. Those mothers with known complication risks are still well-advised to ensure they give birth in a hospital or medical birthing center.
At the end of the day, every family will make their own choice about what setting is best for them. But in all cases, they do have general legal rights; reasonable standards must always be met. When those standards are violated and a birth injury arises, then legal recourse is available.
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