Friday, April 16, 2010

Home Birth is Better Than It Was 100 Years Ago

After I had a wonderful home birth experience I was talking with my mom about it. She told me that my grandmother had been really worried that I was planning a home birth, and she was very relieved that all had gone well. I was stunned by this, and felt sad that my grandma had been so worried about my decision that I had felt such peace with.

I thought about the situation. My grandmother was born at home at a time when there was no access to emergency care or hospitals. Sometimes a doctor could make it to the home in time to help "deliver" the baby, but the majority of the time a laboring mother was supported by whichever woman was closest to her and could be there to help. Many times this was her own mother, sister, neighbor, or even daughter. In true emergency situations there was nowhere to go for help, and even the local doctor had huge limitations in what he could do. Birth was a wonderful but potentially dangerous situation, but when there were hard outcomes it was accepted as a part of life.

By the time my grandmother was having babies birth had been moved from home to the hospital. Birth had become even more dangerous due to doctors unwittingly spreading deadly infections because they simply didn't know to wash their hands when going from treating very sick patients and performing surgeries to catching healthy newborn babies. Fear about the pain and dangers of childbirth became even more rampant as doctors and hospitals struggled to find ways of handling childbirth in a new setting. Women were seeking a way to escape the horror of it all, and their doctors were feverishly looking for ways to save the day.

Doctors learned to wash their hands and take safety precautions, and new medications were presented in an effort to "help" women with the process of childbirth. This involved such things as "Twilight Sleep" in which laboring women were medicated during labor, able to feel everything but having no memory of the experience later because of the drugs. Women were tied to their hospital beds and gagged to keep them from wandering the labor ward, thrashing, or screaming out. In other cases women were simply put under with ether or chloroform into a drug-induced sleep during labor, while doctors forcefully extracted their babies using forceps. The mother didn't remember the birth, and would wake alone because her baby had been taken to the nursery while she was still asleep. One can understand why loving partners were not allowed on the labor and delivery ward during this time.

In the years since, there have been huge strides made to improve hospital births. Expectant fathers are now encouraged to be present and supportive while the mother is laboring, and hospital rooms have been made to appear more like a home setting. Other changes include major medical interventions to control and manage the process of birth, such as medications to start labor or make it go faster, and pain medications which numb a woman to the physical experience of childbirth without knocking her out completely or preventing her from remembering the experience. Interventions that can save lives in true emergencies have been developed, but are now being overused to the point that the potential risks outweigh the benefits. It seems that in an effort to improve childbirth it has been taken to the medical extreme in which every step is managed and medicated, and 1 out of 3 newborns in the US is removed surgically.

Those who recognize the extreme medicalization of birth are left wanting for something better. They are returning to "old" ways of birthing without unnecessary interventions, the way my grandmother came into the world. Bringing birth back to the home is a conscious effort to allow women the experience of normal childbirth, as nature is so beautifully designed.

In pursuing a return to old ways women are not simply accepting greater risk than they would face in a hospital setting. Indeed, many feel they are reducing their risks by avoiding the interventions common in the hospital.

So, how is home birth better than it was 100 years ago? Because of the technological and medical advances over the years, we now have access to life-saving interventions which are needed in true birth emergencies. Those interventions which pose greater risk when overused are still valuable and needed in some cases. No woman plans a home birth intending to transfer, but she understands that it is a possibility. For me personally, this was a comfort when I planned my home birth. I knew I would be in a comfortable setting where I could labor and birth my baby in peace, and felt confident in my ability to do so. I felt that all would go smoothly, but I also knew that if for some reason it didn't I had options that my great-grandmother never did.


  1. Awesome, well thought out article. Thank you for sharing.

    I actually knew one of my great-grandmothers for 27 years and was told first hand the stories of her doctor attended home births. She had 2 single births and 1 set of twins. The only child she lost was one of the twins who was much, much smaller than his sister.

    I've heard second-hand stories of another great-grandmother who delivered 6 single births and 2 sets of twins at home with a doctor. Unfortunately, she passed away due to hemorage when she delivered her 3rd set of twins at the hospital (her normal doctor was out of town). Both great-grandmothers were delivering their babies in the 1930s.

    I've also heard stories of my Father's Mother's births (during the 1940s & 50s. She delivered all 6 of her children in the hospital, but was asleep for all of them (I don't know if she was knocked out or if she had twilight births).

    My mother delivered all 3 of hers in the hospital during the late 70s & early 80s. I remember when my baby sister was born and what a big deal it was that my father was aloud to be in the labor and delivery room when she was born (the only one of us he got to see delivered).

    I my-self have delivered one in the hospital thinking it was the only way to deliver babies. Then I've delivered 3 more at home, going back to the "old ways" and using a mid-wife. Some family and friends were a little worried because they had heard bad stories of the dangers of homebirths, but others were ok with it because they'd heard the good stories and knew of good outcomes.

    It was nice to be able to educate my younger sisters so that they had safer, more natural deliveries in the hospital.

    It is amazing the responses I get when I tell someone that I deliver my babies at home. Sometimes I get the fearful responses telling me how dangerous it is. Sometimes I get curious questions from people who really want to learn. I really enjoy being able to teach people that there are ways to have babies other than what has been taught mainstream.

    Again, thank you for sharing this awesome article detailing the history of homebirthing and why it may have been more dangerous in years past than it is today.

  2. Rebecca, thank you SO much for your comment! I really love reading about other people's experiences and feelings, especially when they resonate with my own.

    I realized when I wrote this that it wouldn't be an exact historical piece, but more of an overview of birth in the last 100 years. Since writing this post I've discovered a book called "Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank" by Randi Hutter Epstein, MD. It was SO interesting, and really opened my eyes to how childbirth has been through the history of the world. I also learned more about twilight sleep, and that it was actually part of a women's movement of the time. Feminists at the time wanted to forget the pains of birth and demanded that their doctors medicate them. It's so interesting, because there's now a movement going back to natural ways. I'm glad to be a part of that.

  3. Just wanted to add that a century or two ago many women had pelvic damage from being malnourished - rickets were common and many doctors' journals contain notes on the fact that these were the women who had problems with birth and dystocia. Much of the hemorrhaging issues can be related to malnourishment and/or (farm/poor) women being expected to get back to work and given no rest after birth, too. Birth is safe and normal for healthy women!!! We are the result of millions of years of evolution and natural selection.

  4. Thank you for pointing that out :)

  5. Thanks so much for this post. I am 38 weeks + and will have a home birth. My first birth ended up being a emergency c-section at the hospital, I originally chose the hospital for the birthing center but never made it there. I believe that because of the medical intervention and stressful atmosphere and pressure I ended up having the c-section. However, I am grateful to God that I am healthy and my baby is healthy and this time I will give birth in the comfort of my home. My grandmother actually feels the same way...I plan to post about this, do you mind if I link to your post?

    Thanks again!

    PS: I have been contemplating on becoming a natural birth instructor (Bradley Method), I also thought about becoming a doula in the future but was concerned about how this would effect my schedule with my family, how do you manage your time with your family and as a Doula?

  6. A. Muschette,

    Please feel free to share links to any of my posts! To answer your question about managing time with my family and doula work: I'm only doing doula work very part time right now. My youngest 3 children are ages 5 and under and I'm extremely busy taking care of my kids and the house. Right now my family has to come first, and I take doula clients occasionally. I'm not actively promoting myself as a doula until I know I'll be more available for my clients, but I take clients as they're referred to me. For now I'm making some extra money writing about pregnancy for the Pampers website, and I'm continually reading and writing about pregnancy and birth on my facebook fan page and this blog. It's important to me to keep myself up to date and fresh on everything birth-related. I think it may be easier to manage time with family as a birth educator rather than a doula, because you can schedule your time away rather than being on call 24/7.