Very Long Post on Home (or Natural) Birth

So, obviously I've been thinking about birth a lot lately. Why is having a home birth important to me?

We watched The Business of Being Born yesterday and while I did enjoy it, I found that I didn't agree with everything that they said. I started thinking about what I do and don't believe about birth in general... of course many of these things may change after I actually experience giving birth but I'm just talking about how I feel right now.

Several people in the movie said something like "birth is a rite of passage" as if that automatically made it more valuable. I do not believe that natural child birth is inherently valuable just because it can be called a "rite of passage". Our culture has many positive rites of passage such as a marriage or graduation ceremony. There are also (what I consider) harsh or negative rites of passage though like a severe beating as initiation into a gang, fraternity/sorority hazing, and even "basic training" in the military is set up to be a rite of passage (among other things).

Oddly, the fraternities, gangs, and military have hit on something that nature "already knew" - the traumatic experience often does make a person or group feel more bonded, loyal and strong. So, in some senses, it does serve a very real purpose in childbirth. Yet, at the same time, hazing is illegal (in all states?) and I was horrified to read about gang members beating their friends (often 13 or 14 years old) nearly to death for no reason other than to "initiate" them. Birth is not a feminist "macho thing" for proving a point. Women should not feel like they have to endure labor in order to be respected as a mother or feel like a failure if they don't end up with a natural birth. To me, when people say "rite of passage", I feel like they're saying - "you must endure this beating in order to get into the mommy club." Labor is not a natural hazing ritual or initiation. However, those odd benefits of strength, commitment, and loyalty that come with enduring trauma can not be overlooked as completely trivial either.

I do not believe that most doctors just want to turn beds over quickly. I prefer to think that doctors really want to relieve pain. That is why they are doctors. They like solving problems, not just sitting there and watching someone suffer (or go through what looks to them like suffering). They may feel that a shorter or less painful labor is really the most "humane" thing even if it does carry some increased risks. They also may be aware of the risk of a malpractice lawsuit and know that doing something puts you at a far lower risk of being sued than doing nothing.

I don't believe that hospitals are "bad". I believe that the majority of people who work there do genuinely want to help. It may be very common for doctors or nurses to push drugs or c-sections more often when they are tired or anxious to go home but I would still prefer to think of those as mostly sub-conscious decisions rather than blatantly selfish ones.

Ok, so what do I believe are my reasons for choosing a home birth?

Over 30% of births in the US are via Cesarean Section. The World Health Organization states that no region in the world is justified in having a cesarean rate greater than 10 to 15 percent. The US has the second-worst infant mortality rate of all developed nations. If you only look at the 7 countries with the highest populations, the US has the highest cesarean rate, the lowest number of births attended by midwives, the lowest number of home births and the worst infant mortality rate. In the 5 European countries with the lowest infant mortality rates, midwives attend more than 70% of the births.

Studies of planned home births by low-risk women, attended by a trained professional, indicate that home birth is at least as safe as hospital birth (See WHO research here section 2.4 Place of Birth).

Hospital labors tend to be longer, on average, than home labors. My theory - many people can't even pee with someone watching or listening. If the body needs a safe, private environment just to pee, it seems logical that women would prefer not to labor with a million strangers coming and going, bright lights, and strange noises.

Many women who had hoped to have a natural birth in a hospital setting find that their labor will not progress without pitocin. The contractions produced by pitocin are much longer and stronger than natural contractions so women almost always need an epidural to cope once pitocin is given.

If the woman started out wanting an epidural from the start, that often slows contractions so pitocin would likely follow.

The epidural is applied directly to the spine specifically so that the mom gets the drugs but baby doesn't. The pain relief means that mom's body stops producing the endorphins and other natural stamina and pain-management drugs that would normally flow both to her and to the baby.

Side effects of the drugs, stronger and longer contractions, lack of maternal endorphins, etc. all make the labor significantly more difficult for baby to handle. The baby is then far more likely to go into distress and require an emergency C-section.


I have read that women who give birth naturally have far lower rates of post-partum depression. The insane cocktail of hormones released during labor is like a runner's high times ten (or more) and helps women to feel like they can conquer anything. Those hormones also help to tell the woman's body that it is time to start producing milk. Women who have a natural birth tend to have a significantly easier time with breastfeeding (especially vs moms who had a c-section). It seems logical that women who are really struggling with breastfeeding would also be more likely to feel inadequate as a new mom. Some studies also suggest that those natural chemicals produced during labor trigger an intense bonding mechanism. A mother's reduced ability to bond with her baby could also lead to depression.

Trading one day of insane pain for increased risk to the baby's health, increased discomfort for the baby, and months of struggling with breastfeeding, bonding, and depression just doesn't sound like a great trade-off to me.

Well, we'll see how I feel about this 3 weeks from now (assuming I've birthed the little guy by then). These are just my feelings about it all now and it helps me to get them all down in a logical order. I know mid-labor is full of doubts and second thoughts so having a very clear idea of why I'm doing this should help.