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Harvard Health Blog
Where is best for birth: Hospital or home?
- By Jeffrey Ecker, MD, Contributing Editor
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Hi every one…
This seems to be a great article!
I want to share my experience of home birth here.
It is so amazing when another phase of life begins to breathe. The moment we see another life on earth, the place where a new child is born is a great experience.
The hospital is a place where financial issues trouble you. Midwives offer you place where ideal care promises great competency.
Midwives always perceive and integrate proper assessment, heartily diagnosis, good planning, right implementation. Midwife are qualified enough to handle all types of low risk pregnancies.
The midwives play a great mother like role in the delivery.
Midwives aim to deliver the paramount understanding about rules and regulation during deliveries which are necessary to carry during birth. These midwives can stay with you even after your delivery and can look after your newly born for 28 days. The midwives understand the emotional and social state of the pregnant lady.
These midwives spend quality time with their patients unlike the physicians. These midwives update the patient and their significant others the situation the patient is undergoing, the needs they can give, the emotional and spiritual support and other necessary information that are essential and desirable.
These midwives are a great friend and a guide at the same time. The pregnant lady can lie in her favorite position while the delivery.
You are correct: there is much data speaking to the safety of delivery in birth centers (I’m a give fan of the AHRQ funded San Diego Birth Center Study). In the case of the this current study, the way the data was collected by the State of Oregon did not permit separation and separate analysis. The authors recognized this limitation: “… a major limitation is the inability in the case of planned home births to distinguish between transfers from birth centers and transfers from home. Although there are important differences between these two settings, most state offices of vital statistics do not as yet distinguish between them in the case of transfers.”
Why is the out of hospital data only related to home birth? There is no discussion or even mention of birthing centers as a safer choice for women choosing out of hospital. Birthing centers, licensed and accredited, are a recognized basic level of maternity care. Yet, the data lumps together all out of hospital births. There are studies that demonstrate that there is a difference in better outcomes at a birth center than home birth. While absent in home birth, there is definitive criteria in an accredited birthing center to help identify good candidates and standards to ensure adequate training of those attending birth centers. Included in the NEJM were 11 birth centers in the state of Oregon, but only 2 are accredited. It is unfortunate that the study does not differentiate between out of hospital births at home or at an accredited birth center.
I find it puzzling and concerning that the study you reference did not report the differences between home birth and birth center births. They lumped them together. They data on this third option, birth center, was available. Accredited birth centers, who are required to have adequate transfer protocols, may be the “just right” in-between option for low risk moms.
Of course, midwives deliver babies without anesthesiologists. Are you sure that obstetricians still recommend prepared childbirth to their patients?
Yes. Most of the women in my childbirth class were seeing an OB, not a midwife.
I’m concerned about the current lack of dialogue about prepared childbirth, that was so popular in USA during late 20th century. This seemed to fill the demand for at-home-style births within hospital settings, considered by many to be the best of both worlds. Classes that included Lamaze techniques, as well as other information useful for those about to start a family, were ubiquitous and recommended by obstetricians for first time mothers and fathers. Nowadays, they are too few and far between.
That dialogue still very much exists. When I gave birth last year, I did so in a hospital setting with a midwife. She suggested a variety of childbirth preparation and newborn care classes. There’s no shortage of classes or birthing options (at home, childbirth center or hospital) available to women today.
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