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Abby's Magazine - Volume 5 Issue 4 | Page 39 Nearly 30 years ago I gave birth to my first baby at home, followed by three more children via three more home births in the ensuing decade. My four births were beau ful, meaningful, empowering events that supported my smooth transi on into natural mothering. Admi edly, this was long before I was a physician. In fact, I was a home birth midwife. Having home births – and being a midwife – were congruent with how I lived: as close to nature in my lifestyle choices as possible. During labor, I felt the most comfortable being in my home, walking on the golf course behind my house, squa ng during contrac ons, and ea ng & drinking freely to maintain my energy and stamina. It was where I felt the safest and could take the path of least resistance to how I wanted to birth. I also knew I was making an educated decision based on extensive research into the history of birth in many cultures, and the evidence for obstetric prac ces at the me. But what about now that I am a Yale-trained physician and a family doctor with a specialty in obstetrics? Would I s ll have my babies at home? Come take a journey with me… Home Birth is More an a Romantic Choice: It's About Mom's and Baby's Health and Safety Where we choose to have our babies, actually has to do with more than simply personal preference, spiritual beliefs, and roman c no ons. It's a public health and safety issue. Just skimming the surface, we know that planned home births lead to substan ally fewer unnecessary cesarean sec ons than do hospital births. We also know that prenatal care and birth a endance provided by a midwife are more likely to help pregnancy and birth stay on a natural trajectory, and are much less likely to result in unnecessary interven ons of any type. There are very real health reasons for women to consider birthing at home. These include mom's safety, baby's safety, and the economic sustainability of our health care system. What's the Big Deal About Cesareans, Anyway? • The na onal cesarean sec on rate is a shocking na onal average of 34%. At some major teaching hospitals in the US, including one of the ones in which I trained, the rate exceeded 40%. In fact, interviewing at some of these ins tu ons when considering a residency in obstetrics, I was assured that there would be no shortage of cesareans for me to do! • Yet the World Health Organiza on states that C-sec on rates in an average, healthy popula on should never need to exceed 14%! When medically necessary, the benefits outweigh the risks and become acceptable. Unfortunately, most cesareans done in the U.S. are UNNECESSARY, making the risks unacceptable. • Clearly the US obstetrics system missed the memo on appropriate birth interven on rates! • There are not only immediate risks to the mother; we know that babies born by cesarean sec on, miss-out on the benefits of exposure to the vaginal flora that they would otherwise come in contact with, if born vaginally – and this lack of exposure can predispose a baby to disrupted gut flora and significant consequent health problems. Addi onally, babies born by cesarean get a dose of an bio cs before birth via mom's system, adding to the double hit on gut flora! • Birth by cesarean can make it more difficult for mom to breas eed successfully because of physical discomfort. And let's not forget that it is major abdominal surgery with much higher risks of harm for mom than with natural, vaginal birth. Hpital Birth & Ls of Autonomy During the years when I was having my own babies at home, people would comment that I must be incredibly brave to birth my babies at home. My response was always the same: