Are Home Births Riskier? Study Finds Higher Stillborn Rate at Home
Even though I never wanted a home birth for myself, I was still stunned to read the stats about stillborn babies born at home.
I never wanted a home birth. It never even occurred to me to have a home birth until my Italian doctor suggested it. We lived in Rome and with the same OBGYN, one of my closest friends had already delivered two healthy babies in the comfort of her own apartment. “No way, that’s not for me”, I said. “Too scary.” I couldn’t even picture it. Our apartment was where we watched movies and hosted dinner parties, not where the messy business of birth should take place. “Doesn’t it need to be more official?” I kept thinking.
Then I went into labor with my second child. My first came fairly quickly, about four hours of active labor, so we knew this might be a speedy situation. But it wasn’t. My water broke at midnight and we called the doctor. He came over (because he lived in our neighborhood and also this was Europe where doctors do that). He took one look at my calm face and said, “You’re not in labor yet.” And it was true, sort of. I had contractions but none were long or hard enough to get us anywhere.
So we waited.
By the following evening, he was back. This time with a midwife in tow, but still maintained that if we went to the clinic now, with my water already broken but only a couple centimeters dilated, the chances of a C-section were astronomical.
So we waited.
But 9pm, almost 24 hours after my water broke, he said, “Okay, let’s go.” That’s when I said, “I can’t go anywhere.” The baby had moved down so far that walking was impossible—and on the way.
I had the baby right there in my own bedroom, in my own bed (answering my earlier the question of where). My doctor was present, so was my husband and also my mother-in-law, who’d come to Rome to help with our toddler after the baby was born. A retired neo-natal nurse, her experience suddenly came in very handy, if a little awkward.
Labor was quick and much less painful than with my first. Between the two births, I’d become a religious student of The Bradley Method, which definitely helped. The fact that this baby was a pound and a half smaller probably helped more.
There were no complications, none for me, none for the baby and my pregnancy had been equally uneventful. But this experience is the scariest thing that’s ever happened to me. Particularly this part: When Estelle was born, she didn’t move right away. Like all babies, she was all wrinkly but this one was pretty blue. Our doctor rubbed her back and in the silence had enough time to say, “Come on! Come on!” The she breathed, then she cried, and I did the same. And in those moments I had one thought: THIS is why I wanted to be in a clinic! But in the end, everything worked out fine. Scary, but fine.
Even with this experience, even with my own reservations about home births, I was stunned to read the latest findings that home births are still considered so dangerous. This is according to a study published in the October issue of the American Journal of Obstetrics and Gynecology. Earlier this week Good Morning America reported the details:
“Among their findings: Babies born at home were nearly 10 times more likely to be stillborn, and the risk of stillbirth increased to 14 times for firstborns. Babies born at home were also almost four times more likely to experience neonatal seizures or serious neurologic dysfunction compared with babies born in hospitals.”
My experience was unusual because regardless of what happens in the movies, most people who have babies at home plan to. My sister-in-law had her baby at home and described the experience as “magical”. My cousin had four babies at home, every one of them healthy.
Home births are popular in Europe. And the growing movement of families who feel that the business of birth is overly medicalized was a message that resonated with me. But still. I wanted to be surrounded by experts in their own environment, a team if needed. That’s a fact that seems especially relevant in this study:
“Grunebaum said that the study associated risk with the location of a planned birth, rather than the credentials of the person delivering the baby. When a child is born at home, typically there is only the midwife or doctor to address any unpredictable circumstances that arise, but in the hospital, a team of specialists can be mobilized in seconds if needed, he said.
He also said that the study probably underestimated the dangers of home births because the data didn’t account for babies transferred to the hospital when difficulties arose during at-home labor.
‘For transfer cases, the birth certificate is attributed as a hospital birth,’ he explained.”
Even though I was never comfortable planning my own home birth – and amazed that I lived through one, even two years later–I’m still shocked to hear this. I know several people who had successful home births, and a few who tried to deliver at home then needed to be transferred to a hospital. Anecdotally, I’ve never heard of someone having a home birth problem but I have heard of all sorts of issues with hospital births (infections, high rates of C-sections and so on.) Besides, midwives typically won’t take on deliveries where complications are anticipated, so what’s going on?
To be clear, these are babies born in the US (where only 1 percent of births take place at home anyway). But it’s also a massive study, including “13 million of the nearly 17 million singleton full-term births in the United States between 2004-2007. These included births to parents of all races, ethnic groups and income levels.”
In the end, this study doesn’t pinpoint exactly what’s at fault, or how to fix it. So like the task of parenthood ahead, expecting mothers have to use their best judgment for their first parenting decision. Choosing a location for childbirth that makes her feel safe.
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