Home Birth Vs. Hospital Birth
great evidence to support this assumption. What ever happened to the old natural way of childbirth? Deciding where to have a baby is a very personal matter and every woman should be given an option to decide for herself. A woman has to be completely happy and consider all the aspects of her choice, because an unhappy woman who does not know whether she is doing the right thing may find it difficult to go through the labor and enjoy building a relationship with her new baby. A lot of health care professionals try to talk women out of natural birth due to supposed elements of risk. If a woman is healthy and has a normal pregnancy there is no reason why her delivery should be stopped from happening at home. After all, birth is a natural biological function and does not have to a medical event.
In her article Judith Lothian (2001), discusses the advantages of home birth as opposed to giving birth in the hospital. According to Lothian (2001), home births can greatly benefit the woman and provide certain benefits that are not present in a hospital setting. The woman needs to have confidence in her ability to give birth. Having confidence is an essential part of natural child birth. Giving birth is a natural physiological process, and both the woman and the baby have a natural instinct to make birth possible. Since birth is a “normal, natural and healthy process” (Lothian, 2001, p19), the author stresses the importance of the mother’s participation in a home birth setting. Lothian (2001), also states that the woman needs inherent freedom to give birth. She needs continuous emotional and physical support. By giving birth in the hospital, the woman has to follow hospital policies, thus undermining her confidence, restricting her freedom to find comfort and limiting the availability of physical and emotional support.
There is no evidence to conclude that home birth holds a greater risk than hospital birth. Based on the authors point of view and research studies, “Every woman should have an opportunity to:
-Have a healthy joyous birth experience for herself and her family regardless of her age or circumstances.
-Give birth as she wishes in an environment in which she feels nurtured and secure, and her emotional well-being, privacy, and personal preferences are respected.
-Have access to the full range of options for pregnancy, birth , and nurturing her baby, and have accurate information on all available birthing sites, caregivers, and practices.”: (Lothian, 2001, p.20).
According to the author the process of giving birth in a hospital setting, and the procedures used within that setting are, “at worst harmful to the natural process and at least most likely to be ineffective”, (Lothian, 2001, p.17). Hospital interventions such as induced labor and stimulation of labor by oxitocin have greatly increased in the last nine years. Also, “Ninety percent of American hospitals with 100 beds or more provide 24-hour obstetric anesthesiology services, and the epidural rate in some tertiary hospitals is now approaching 100%”, (Lothian, 2001, p.16). Without the presence of specific scientific need the use of many procedures, technologies, medical tests, and multiple medications are unwarranted. Many of these interventions care risks to both mother and baby. Lothian (2001) stresses the importance of physical support and emotional comfort and reassurance in the process of labor, yet when giving birth in a hospital the nurses do not provide the needed comfort, attention and information. There is a need for change in the work of the perinatal nurse. The perinatal nurse should be more attentive, sensitive, understanding, supportive, and informative to the woman in labor. ” In addition to providing labor support, nurses will need to help create environments in which women’s efforts are supported, by hospital policies that reflect best evidence”, (Lothian, 2001,p.21). Other routine hospital procedures such as restricted eating, drinking, movement and the use of intravenous fluids have little if any positive effect. All in all the standard hospital procedures that have become a common way of giving birth go against nature’s design.
In my opinion home birth is a better option for child delivery. It is a safe, natural way of giving birth that is beneficial both to the mother and the baby. “The study was conducted to evaluate the safety of home birth by comparing perinatal outcomes for planned home births attended by regulated midwives with those for planned hospital births.” (Janssen et al., 2002). The researchers found a number of women who planned home births attended by either midwives or physicians and they compared them to the women who were selected from hospitals where they chose to give birth. All subjects were matched according to their age, parity and lone parent status. “Exclusion criteria were applied to eliminate subjects with any conditions that would render them ineligible for a home birth. These conditions included the following: multiple births, heart disease ( class 1-4 or class unknown), hypertensive chronic renal disease, PIH with protenuria (more than 30mg/dl) diagnosed in the ante partum period, IDDM, either pre-existing or gestational, ante partum hemorrhage after 20 weeks, active genital herpes, breech or other abnormal presentation, gestational age less than 37 weeks or greater than 41 weeks at the onset of labor, more than one cesarean section, mother transferred to the hospital from another facility.” (Janssen et al., 2002). The conclusion of the study showed that women who underwent home birth during delivery needed significantly less medications, fewer inductions of labor and less analgesia. “Pain medication given too early may prolong labor and depress the fetus. If given too late it is of minimal use to the woman and may lead to respiratory depression in the newborn. High drug doses may remain in the fetus for long periods because fetal liver enzymes and kidney excretion are inadequate for metabolizing analgesic agents.” (Ladewig,London, Moberly, & Olds, 2002). They also had fever cesarean operations. Episiotomy was less frequently used.
In my opinion women giving birth at home have a greater benefit as opposed to women in the hospital. Giving birth in a familiar surroundings makes a woman more calm and relaxed. One of the benefits is that she can invite anybody she chooses to be present, even her own children can observe the process. At home, the woman has the freedom to move around and to choose any position that makes her comfortable. It could be anything – sitting, squatting, standing, where as in the hospital supine position with head of bed elevated mostly used. The hospital position is really not the best option compared to the natural physiologic position. The freedom to move is another great benefit the woman’s experience with home birth. When her contractions get stronger in frequency, intensity and duration she can take a bath or a shower, walk around the house, go outside to get fresh air, listen to music or get a massage from a significant other. Without the use of analgesia she can naturally fell the contractions and she will know when to push with the help of a midwife, as opposed to hospital delivery after administration of epidural block she is really clueless and relies on the doctors directions when and how to push. “One of the most common complications of an epidural block is labor process and fetal descent may be slowed, pushing efforts in the 2nd stage may be less effective and the use of forceps or a vacuum extractor is more common.” (Ladewig, et al .,2002). All of the above mentioned factors are available during home birth, but are very limited in the hospital.
“The study also concluded that there is no neonatal risk associated with planned home birth under the care of a regulated midwife.” (Janssen et al., 2002). Rates of perinatal mortality, 5-minute Apgar scores, meconium aspiration syndrome or need for transfer to a different hospital for specialized newborn care were very similar for the home birth group and for birth in the hospital attended by a physician. .” (Janssen et al., 2002). The particular study suggests that there are no indications of increased risk associated with planned home birth attended by regulated midwife compared with those attended by either midwives or physicians in the hospital.
Giving birth is a process that has existed since the dawning time. The woman and the child know what to do to make it a safe, healthy experience without the interference of medical care professionals. The use of multiple medications in hospital births limits the woman’s ability to experience childbirth to the fullest. Also, according to a few studies hospital births are not necessarily safer than home births. Healthy low risk women who wish to deliver at home have no increased risk either to themselves or to their babies. For low-risk women, home birth should remain a safe and natural option.
