Yesterday the Center for Disease Control (who collects National Medical statistics) release a report that detailed information on out of hospital births from 1990 to 2006. I want to stress that the information ended in 2006, there is a good reason, but I will get back to that later in my post. What the information shows is a small, but noticeable increase in home birth, and births that take place in Free Standing Birth Centers. But surprisingly, this study also shows that the majority of women making these choices have already had at least one birth, in the hospital.
The number of midwife attended home births increase from 43% to 63% during this period of time. Which we already know that home birth, when attended by a trained medical professional is as safe as a birth in the hospital, if not safer because the lack of unnecessary intervention that takes place routinely in the hospital setting.
Unlike most people, I sat down last night, and actually read the study, news articles on it from ABC, and other various sources, and really analyzed it to write this post.
A couple interesting pieces of information that I pulled out of this study…..
Just to touch on a couple of these numbers, and pieces of information, what alarms me the most is the people choosing home birth. Mostly white, married, mid-aged women. When studies are showing more and more that the most at risk patients for unnecessary procedures, and some of the highest cesarean section rates are low income, unmarried, women of African American decent. Which is why I believe that in Health Care Reform we should be including more options for home birth insurance coverage, as well as alternative birthing coverage options for mothers who are low income on some form on medicaid.
It also shows that many of the women who are choosing home birth are very educated consumers. We need more child birth education options available to women, especially in the low income bracket. Programs that offer free classes paid by public health funds, WIC programs, etc.
33 of the home births, were to very young women, 15 years old or younger. There could be a lot of different explanations for this. But the one that stands out to me most is young women who hide their pregnancy until the baby finally comes and surprise! It doesn’t seem that in today’s culture too many young women are signing up for any birth experience that doesn’t include someone with MD after their name and an epidural.
6,582 were their second baby. What this shows not only me, but one of the authors of the Study, Eugene Declercq, is that women are opting for their second birth out of the hospital because of what could have been a negative first birth experience, or just did not care for the hospital style maternity care system. Eugene was quoted in the ABC News story as saying “The fact that it’s primarily women who had kids before and had birth in hospitals before, certainly suggests it’s a reaction to their prior birth,”
Which I completely agree with.
The numbers for other subsequent births include, third births at 4,500, fourth birth at 2,851, fifth birth at 1,808, sixth birth at 1,137, seventh birth at 827, and eight or more at 1,438.
Now that groups like ACOG and AMA are seeing these numbers, and this change, they are worrying because these births are taking money out of their own pockets. They have not been shy in recent years about their home birth policy, and how they feel about it even with a number of studies showing the safety. With these new numbers, and developments, they have gone public saying that films such as The Business of Being Born and celebrity home births are having a great influence on the choices women are making for their births, but before opening their mouth, they should do their research.
Remember that little 2006 number I pointed out earlier in my post? Well The Business of Being Born, the first mainstream film that showed home birth, as well as promotes it as a safe option was released in 2007. Oooops!
So how are they going to explain this change, and how it happened before this mainstream film? Maybe the fact that women were fed up with the maternity care system in hospitals long before Ricki Lake decided to work on a project on it? It is nothing new that women do not like the one size fits all care the hospital maternity care system provides.
But that is a whole other post in itself.
A couple other things I wanted to talk about is where home birth is most popular, and rising.
The states with the highest home birth numbers are :
States with notable increases in home births :
I found the number of home births in my own state of Connecticut to be sad, but again, a whole other post in itself.
If you would like to read the full study yourself, the link for it is
http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_11.pdf
Actually, the homebirth rate did NOT rise.
It has fallen every year from 1990-2004. It went up from 2004 to 2005, but only back to the rate is was in 2000. I did not rise further in 2006. It’s still only 0.59% of all births.
Actually it fluctuated over the past 20+ years since 1990. While it may not be as high as it was in 1990, out of hospital birth is certainly turning around, and becoming more popular. I am interested to see the increases for 2007, as well as 2008.
As being reported right now on ABC news, they are discussing the rising maternal mortality rates, and the connection in the rise of cesarean sections.
“While it may not be as high as it was in 1990, out of hospital birth is certainly turning around, and becoming more popular”
No, it isn’t. That’s the point. The increase between 2004-2005 is a statistical blip in a longterm downward trend.
So you are saying that women opting for births out of the hospital is not becoming more popular? I mean, organizations such as ACOG and the AMA certainly have taken strong stances about the increase since The Business of Being Born was released saying that these films are influencing woman’s choices in birth.
I am not certain what the point of your comments are though, besides the fact that anywhere the words “home birth” is used on the internet, you magically appear.
“So you are saying that women opting for births out of the hospital is not becoming more popular?”
Yes. That’s exactly what I am saying, or, more to the point, that’s what the CDC data shows. Once again homebirth advocates are playing fast and loose with the truth.
The CDC data also shows that women are often choosing to birth out of the hospital once they have had a hospital birth experience.
I can certainly say after my first experience, and second, I won’t be going back again.
Why no address to the link between the rising maternal mortality rates with rising cesarean section rates?
“Why no address to the link between the rising maternal mortality rates with rising cesarean section rates?”
First look at who is dying (age, race, whether they even had a C-section), then you tell me whether there is a connection? If you don’t know who is dying and what they are dying of, you can’t claim a connection.
“That was a nice way to tip toe around the question. Bravo!”
In other words, you have absolutely no idea who is dying, what they are dying of, or whether they even had a C-section. You just threw the accusation out there because it appeals to you.
No, I have sat down and read about it, I have watched reports, listened to speakers, listened to work shops, and attended conferences.
In typical denial, like you are so very used to, you cannot bring yourself to say the number of surgical births, especially repeat cesarean sections, for no medical reason are killing mothers.
It was nice chatting with you “Dr” Amy.
“I have sat down and read about it, I have watched reports, listened to speakers, listened to work shops, and attended conferences.”
Evidently you weren’t paying attention then, were you? If you’ve read about it, watched reports and listened to speakers and still don’t know the facts, what were you doing?
LOL! You are cute, certainly live up to your internet reputation.
Maybe this is why you aren’t practicing anymore, because you simply can’t or refuse to wrap your head around what is taking place in our country.
It’s fantastic to see the growing number of women who are taking back their births, informing themselves and demanding evidence based care. Stats here in Canada are very similar to the US when it comes to home birth but luckily we have a slightly lower C-section rates and better maternal outcomes.
Anyone who can’t see that a change is happening, is just willfully blind.
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I had 2 hospital births, and then a homebirth, I will never go back to a hospital to have a baby again. I was empowered, Safe, relaxed, able to move, to birth how I wanted to, I was not straped down, and rushed through my labor with meds because the hospital had to fill that quota.. it was just me, my husband and my midwives, I called all the shots.
It was more perfect than I even could have imagined.
Of course there are reasons that a woman might risk out of a home birth and for those women we have hospitals, but other wise if a woman is healthy and the pregnancy is low risk, and the baby looks good, she should be allowed to make the informed wise choice to birth at home with a midwife. Just as she should be able to choose a hospital birth if she so chooses. the sad truth about hospital birth today, is that woman are rushed, into a spiral of unnecessary interventions, and each intervention leads to another, for most normal births a hospital is actually overkill.
Really sad numbers don’t ya think?
Maybe one of the reasons we have such a high c-section rate too…
WOW, Amy, seriously??!! Surely someone as educated as yourself must realize that it is you who is playing “fast & loose” with the truth….the goal of any home birth advocate is simply to empower & educate women as to the choices & control they have over their own bodies…part of that mission is to expose the truths those in the medical community prefer to hide away. After decades of being bullied & conditioned in to believeing in a “medical” birth, women no longer seem to realize they have any choices of their own. Doctors perpetuate these myths to ensure the quick & easy route for them, while covering their own butts in the process. Surely you cannot deny that c-sections have risen to astronomical rates, & maternal death rates have also risen, & then with a straight face claim there is no correlation? Or that home births vs hospital births are statistically shown to be equally safe for low risk, “normal” pregnancies, the only GLARING difference being a consistently lower number of medical interventions in home births. Yes, medical interventions…all those unnecessary things done to us & our newborns that CAUSE complications where none would exist had we been left alone to do what came naturally. Most of us do not judge those who choose a “medical” birth…when it is an educated decision. It rarely is. Yet those same women, such as yourself, will happily judge us….yes us, the ones who actually DID put thought & research in to the most important thing we will ever do. Never ceases to amaze me how people blindly do what their doctors tell them, yet will put weeks in to educating themselves on the best TV to purchase.
The bottom line Amy, for most women like me, is to simply encourage, support, & educate women as to the choices involved in having the safest & most positive birthing experience possible for them & their baby, wherever & however they ultimately choose to do it. Unfortunately, your agenda seems typical of most in the medical community….scoff, bully, deny anything that takes away from what you do. The medical establishment has a very valuable role to play in high risk pregnancies & has saved many lives with the amazing tools at hand today….but for the average, normal, low risk pregnancy, often it’s the medical intervention that causes the risk in the first place. I am grateful to live in Canada, where my government has not only embraced the role of midwives & home births, but also covers it under my government health care…my 4 kids were all attended by midwives, & I wouldn’t have it any other way…despite the ignorance of those who think it’s dangerous & ridiculous…yet are unable to answer me even the most basic of questions about their own medical births, & the risks involved, never mind having any knowledge whatsoever on my midwife births. Maybe if doctors got on board with empowering women in their own birth experience instead of taking it away from them, ALL of these poor stats would turn around, & more women would be happy to have a hospital birth that is NOT medically interfered with, but rather supported & monitored, left to run it’s natural course unless an ACTUAL reason came up to intervene. It’s such a shame that there are still women out there who are seemingly so archaic in their views.
“Yet those same women, such as yourself, will happily judge us”
Of course I judge homebirth advocates. They have no idea what they are talking about. They tell themselves and each other that they are “educated” but most of what they think they “know” is factual false.
This article is a perfect example. Danielle fell for the propaganda put out by homebirth organizations that the rate of homebirth is “rising.” But it is not rising, it is falling and has been since 1990. The fact that it recovered a bit from 2004-2005 within the midst of a long term downward trend tells us nothing.
Danielle never bothered to read the actual paper. Most homebirth advocates never do. They simply believe the stuff that other homebirth advocates make up.
It’s bad enough not to know what you are talking about, but it’s even worse to think you are “educated” at the same time you are spouting nonsense.
First things first… I am not a home birth advocate. I am a BIRTH advocate meaning, ANY birth a woman feels is right for her. I am for women being educated on ALL of her available options. Simple as that. I am a 2 time hospital birth mother, by CHOICE. And next time around, I will make an educated DIFFERENT choice because of the two experiences I have had.
Second, I read the report before the vast majority of home birth advocacy groups press releases. I made a post, with these statistics before noon yesterday, which can be found at http://birthactivist.com Then I sat down last night once my children were in bed, as well as my husband and read this in full.
Apparently your reading skills, or at least reading comprehension skills are lacking because it is apparent from ALL the information in my post that I read the entire study, and I specifically spoke about that, and burning the midnight oil at the start of my post.
I know exactly what I am talking about, and I do not need an MD or a shitty internet blog that is the laughing stock of the majority of the medical community to make me feel better about myself.
“I know exactly what I am talking about”
You do not have a clue what you are talking about as you have made embarrassingly clear. You simply copy the things that other people tell you without lifting a finger to find out if they are true.
First you claim that homebirth rates are rising when they are actually falling. Then you claim that C-sections have led to an increase in maternal death, but have literally NO IDEA which women are dying, what the causes are and even whether they have had a C-section or not.
Homebirth advocates don’t understand even the most basic facts about birth, and don’t make even the tiniest effort to find out. You’ve demonstrated that quite clearly.
Everyone was right. It is like talking to a wall, you simply do not get it, nor do you take the time to actually read and think outside the box.
You constantly harp on the same, or off topic things.
You did not read a word I wrote.
I hope you had a nice visit here, because like I should have done the first time around, I will not be approving anymore of your comments. You are simply an internet troll, just one with an MD which is pretty pathetic.
Ahhh Amy, bowing once again, I see, to condescending holier than thou crap….& again, such a shame that there are actually women who cannot support the free choices & empowerment of other women over their own bodies. It’s clear to me that our 2 countries are quite different on this issue, so I cannot speak to a lot of what goes on there…except to say that it’s too bad many states don’t yet train, recognize, & use midwives. Here, our midwives are highly trained professionals, & they can administer almost any medical care at home aside from narcotics. Here, it is a symbiotic relationship between the midwife & the medical community, using both when & as needed. I, like Danielle, am a FREE CHOICE advocate, who happens to have a genius level IQ & I became highly educated, thank you very much, (since you seem to know me so well), on these issues when the time came that I was pregnant. On BOTH sides…THEN made my choices. You claim that it is advocates for choice that spout nonsense & beef up the stats for “our” side while “downplaying” those for the other side, yet not once have I seen you offer up anything to show the risks involved in the constant intervention in the birthing process. Why does a low risk, perfectly normal hospital birth require drugs, episiotomy, monitors, & being strapped to a bed???? And by the same token, of course there is inherent risk in a home birth….but if there is not a hint of trouble, a certified midwife is in attendance, & the mother has made the conscious choice to do it, who are you to judge that?? And why exactly do you seem so threatened by it?? Because we like to encourage open discussion of the pros & cons, & risks associated with birthing choices? Because we like to remind women that their doctor is NOT God, & will not always tell them what they need to know?? Or maybe it’s because we support women in being active in their own care.
2 of my births wound up being sent to hospital because my midwives were trained well enough to know when that became necessary. The other 2 were born at home. My 2nd was delivered early, due to my routine 20wk ultrasound showing her to be “small”. After an OB consult, my midwife was forced to transfer my primary care to her, but still remained involved & active. The OB continued weekly ultrasounds & stress tests & finally decided I had IUGR. She induced me at 33wks, thinking my placenta was dying. Never occurred to her that at 5 feet, & 100 pnds my whole life, I wouldn’t have big babies, even my 1st born, at home, AND a boy, was only 6 & 1/2 pnds at 1 wk overdue. OR that the baby was only measuring 2wks behind, & only in the legs….OR that NO OTHER test showed ANY problems with me or the baby….long story short, she is required to test the placenta after the fact with suspected IUGR to rule out drugs & glue sniffing & what not…& she was wrong. When she told me the next day that the placenta was functioning perfectly normal & I didn’t need to have any concerns for future pregnancies, I was livid…her response? Better safe than sorry! Tell that to my 4 pound preemie who then spent 2 weeks in an incubator while I waged a constant battle to be allowed to breast feed her, then 2 years in & out of hospital with pneumonia & RSV, & at 9 years old, STILL has asthma, thick glasses, & is tiny & scrawny, all from being a preemie, that she never should have been! Side note, my next 2 daughters ALSO measured TWO WEEKS behind, the entire pregnancy…thankfully I had the same midwife for all, & she knew NOT to involve an OB this time. Bottom line is, mistakes can & will be made, on either side. Being involved & knowledgeable can help every women ensure she has the best possible birthing experience for her, not solely what her doctor dictates she have. I am amazed that you can spout such poison at women who truly value & appreciate the birthing process & the opportunity to support other women through it…maybe you’re not as educated as I thought….
As for Danielle, I have no doubt that you did your due research & diligence with your posts….the medical community will put their own spin on it to once again cover their own asses & protect the giant money making machine that is big medicine.
This is just one of dozens of articles I found in the span of 10 minutes, from major news sources, & medical journals, discussing the growing problem of rising c-sections & maternal mortality rates…yes, there are other causes, but Amy seems to be the only one in complete denial of THIS cause, over those folks all over the news who are far more experienced & qualified to comment than she is….but then again Danielle, we DO just tend to believe everything we read, even if we do read it dozens of times from dozens of sources…oh wait, we’re not at all educated, so we must not even do that much….sigh, I just shouldn’t stoop to that should I?? Ah well, maybe THAT is Amy’s draw, she’s controversial, & in her own way, she DOES get the conversation going! So thnx for that Amy, since my youngest is now 4, I have really moved away from these areas of discussion & on to the much harder areas of raising 4 kids, 2 of them tweens!! I have enjoyed revisiting my thoughts on this!
Actually Amy, the Palo ALto Medical Group (I believe) just did a story on the jump in maternal deaths here in California. Those doctors, who practice in hospitals, are saying they believe the increase in maternal death IS related to the increase in cesarean sections, many of which are probably unnecessary. For instance, they said doctors are more likely to push c-sections on overweight or obese women just b/c of their weight, when the surgery is actually more likely to cause complications because of their size. And according to WHO, the c-section rate is the US is about twice what it should be.
And for the record, I had my son in the hospital and will be having any subsequent children in the hospital.
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