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Sensationalizing Homebirth is the Real Danger

I’m doing something one shouldn’t probably do as a blogger…responding emotionally to another piece circulating on the internet.  Recently there have been several stories that have classed midwife attended births as “trendy” or “chic” or even a “status symbol” (case in point the recent NY Times Style piece).  Today a friend linked to this Daily Beast piece disparaging homebirth as “dangerous.”  And recently my home state of North Carolina has taken steps to halt legal homebirths altogether in the midst of a campaign to legalize CPMs (currently only CNMs are legally allowed to attend homebirths in NC; recent actions by the state medical board forced the physician providing “supervision” for 7 NC homebirth CNMs to break his association with those providers).

While I have not personally chosen homebirth for myself, I have many friends and acquaintances who have made an informed choice to birth at home and I fully support homebirth as a safe and responsible birth choice.  I’m a huge advocate for the midwifery model of care and chose a midwife attended delivery (one in a hospital setting; the other at a birth center) for both of my children.   I could present here dozens of peer reviewed studies that demonstrate the efficacy of the midwifery model and support homebirth for low risk, healthy pregnancies.   But right now I want to address briefly why the articles linked above are so problematic…and even irresponsible.

Michelle Goldberg, author of the Daily Beast piece, really should be ashamed to call herself a journalist.  Sensationalist tabloid writer might be more appropriate.  Way to present a one sided story and oversimplify the issue.   Certainly bad things can happen during a homebirth (although it is important to remember that those bad things could have and in many cases do happen in hospitals – and outcomes may be just the same).  But you know what?  I could write an equally scary story …based in fact…about why hospital births are “dangerous.”  And of course that would be a biased, slanted, and un-journalistic piece – just like Goldberg’s.  The families she profiles did have tragic outcomes – and this is in no way intended to minimize that fact.  But they were also victims of subpar medical care (if the story as she presents it is true).  That bad care wasn’t a result of choosing homebirth; it was the result of bad care.  There are subpar members of every profession; to pretend that those cases are representative of the entire profession is insulting.

Of course it isn’t acceptable to have subpar professionals responsible for any aspect of medical care, much less birth.  Which is one reason why instead of making homebirths difficult or even illegal, states should work to make sure that licensed midwives can safely practice without jumping through a bunch of hoops.  They should be subject to the same sort of rigorous standards that obstetricians or hospital based midwives are – and I don’t think you’ll find any competent homebirth midwives who would complain about that.  When homebirth midwives can’t practice legally, the risk of shoddy practices spikes dramatically as people go “underground” to receive care.

It’s also important that parents-to-be considering homebirth know what to look for and what questions to ask – so they can spot “red flags” in advance.  This is no different than what parents choosing obstetric care for a pregnancy would/should do.  For this to happen we have to stop sensationalizing homebirth – whether it’s to say “it’s so dangerous!” or “wow, all these cool models are doing it so you should too!”  Women and their partners should have access to UNBIASED information about all birth choices – everything from what should risk one out of choosing homebirth to the risks of a cesarian section (and, yes, there are plenty of risks there too).  There is no such thing as risk free birth; any expecting mother should know and understand all the choices in order to make the most informed and best choice possible for her and her child.  Writing biased “scare” pieces doesn’t do anything to make homebirth (or any birth) safer; level-headed education does.

Midwives, homebirth or otherwise, aren’t status symbols or trend setters.  They are practicing a time-honored model of care, a model that has been enhanced over time by both our improved understanding of medical science and centuries of experience and observation.  Smart midwives – like the ones I know – blend both of these effortlessly in a way that provides truly patient centered care.

 

 

 

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Published in Birth

10 Comments

  1. Sandy McG-B (NZ)

    Sandy McG-B (NZ)

    Perfectly said, you are so correct. I have recently read the book “into their hands” which shares amazing stories about midwives from the US and I was shocked by the hoops, and legal issues there are just for midwives to carry out their time-honored craft in some parts of the US. I am so glad that here in New Zealand women choose between a midwife or an obstetrician and home births are a valid option, even though most women still think they’re better off in hospital. If all goes well, we’ll be in a birthing centre with my midwife in a few months for this baby (our first) and we want to have Number Two at home when the time comes.

    • Meredith

      Meredith

      Hope the birth goes beautifully for you! I really loved our birth center birth (although I had a good hospital birth experience as well) – it was a very peaceful labor 🙂

  2. Thank you for your article.

    You are completely correct that the sensationalism of around the risk of giving birth in an out-of-hospital setting (home or birth center) IS the real danger. I think it is scandalous that Michelle Goldberg and other who have picked up her article, adding their own sensationalist “spin” are exactly what you called it… “Sensationalist tabloid [writing]” (emphasis mine).

    Sub-par care is the over-arching issue is each case that is highlighted. And the stories are not about one midwifery credential but include both CPMs and CNMs providing that sub-par care.

    You are precisely right when you state that states (meaning legislators) should, “make sure that licensed midwives can safely practice without jumping through a bunch of hoops.” Safe practice and accountability can only be effective with sound regulatory process that recognizes practitioner “Scope of Practice” and “Standards of Care”.

    Thank you, again, for your “spot on” description of Michelle Goldberg’s article.

  3. Great points! I had a hospital and a home birth. When I met my midwife and was going through the tons of questions I had at the end I asked if she had any questions for me, she said Yes, you need to take some respoinsibility for this as well. You need to eat right (gave me specific recommendations) no alcohol, no drugs, and exercise. This stuck in my head throughtout pregnancy-this is a time to take care of ourselves so our bodies are ready for birth. My midwife really believed good nutrition helps with a healthy birth.

  4. Cara

    Cara

    Thank you! This post is spot on about how I’ve been feeling lately. My husband and I were in the middle of interviewing homebirth midwives in NC as we were planning a pregnancy, when all of their support got pulled two weeks ago. We are very happy and impressed with the Birth Center in Chapel Hill, but I had my heart set on a planned homebirth. I feel so frustrated and upset that my choice was taken away. We had been researching and discussing homebirth and natural birth options for over a year before we even tried to conceive (we’re big planners) It was something we put a lot of thought into and felt was the best choice for us–and now that choice doesn’t exist.

    I also agree that all the sensationalizing misses the point of the issue. It is especially frustrating when trying to share our choice for a med-free natural birth to family and friends. With a void of unbiased and informed information on these topics in the media, I get met with a lot of criticism from people, who I know love me, but are basing their opinions on sensationalized, biased, and uninformed media.

    • Meredith

      Meredith

      Eleanor was born at WBWC and we really had a wonderful experience – if you do end up going that route! But I agree it is very frustrating to have choices taken away, particularly when those choices have been well researched. I know several other women locally who have been put in the same position because of the recent actions of the state medical board – very frustrating.

  5. I’m saddened by how often the public dialogue about women’s healthcare seems to take such a dim view of women’s ability to make rational decisions about their health. It’s ludicrous and insulting to equate choosing a birth plan with buying a pair of shoes, yet that’s exactly what the Times piece does. (Would an article about men’s healthcare ever make such an analogy? I doubt it.)

    I don’t believe a woman can carry a pregnancy for nine months and not grasp the importance of the decisions she makes about giving birth. We may all chose different things–I happened to love my OB and my hospital birth–but it’s all coming from the same place of love and concern for our babies and our bodies.

    • Meredith

      Meredith

      I agree completely! And that’s one reason that it is so important that women both continue to speak out about the need for choices and for us to educate ourselves about all of our options – and advocate for what we feel is best for ourselves and our babies!

  6. Zoe

    Zoe

    Thanks for speaking out against “journalism” of this sort. It makes me sick to read such biased “writing” that could possibly scare women off of not only home birth, but even low-intervention births in hospitals. She states, “There are small but real hazards involved in C-sections and other procedures that women often feel pushed into in hospitals.” SMALL hazards?!! Give me a break. Also, Goldberg’s HIGHLY photoshopped headshot makes me suspicious that she’s probably a guy using a female persona as his pen name! (Just kidding but who knows!) Also, “Jones and Kau are in no way anti-science.” Home birth people aren’t anti-science, we’re pro science when it is necessary and pro letting nature do its work the rest of the time. Anyway, I’ll shut up now… but this article is really frustrating and pushes the natural birth movement back a long way.

    • Meredith

      Meredith

      I agree it is absurd to depict homebirth or low intervention birth as anti-science. I think sometimes we confuse science and technology; a birth with loads of interventions is not necessarily a more scientific one. Science is about observation – we would do well to observe and learn from the way our bodies are designed to birth and intervene just enough to ensure the safety of mother and baby. Too much technology in the room when it isn’t needed simply has the opposite effect.

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