Hospital Birth vs. Home Birth: A Debate on Choices

Mr. Henderson's Response

Before I begin, I would like to thank both you and BabyZone.com for accommodating this debate. Too often people on both sides of the home birth discussion will simply talk at each other, rather than talking to each other. While I would be misleading all of the readers to say that I was not passionate about the topic, I hope to persuade you through reason and science that the decision to give birth at home should not be met with trepidation and concern, but with excitement and hope and the knowledge that the mother is not disrespecting herself or her new baby.

[For the ease of the readers, and not out of any disrespect, I will refer to you in the third-person throughout this response.]

Furthermore, all of my statements (both here and in my earlier letters to Dr. DiLeo) are subject to the following two crucial assumptions: (1) that a mother choosing a home birth is herself healthy and that the pregnancy has been healthy; and (2) that the home birth is both planned and attended by a midwife or doctor. Dr. DiLeo is correct that high-risk conditions would contraindicate a home birth; I would not try to argue otherwise.

(1) Dr. DiLeo, along with obstetricians around the country, consistently repeats that the decision to give birth at home puts the "new life at higher risk" than giving birth in a hospital. THIS IS SIMPLY NOT CORRECT.

Obstetricians, whether through personal belief, what they were taught in medical school, or fear of losing business, will loudly and repeatedly state that home birth is dangerous. In a curious attempt to allay anxiety, Dr. DiLeo writes on page 380 of his book: Home delivery still remains one of a baby's biggest threats. It poses significant risk to you as well. Well, if I didn't know better, i.e., if I simply wanted to take his word for it, that might convince me to head straight to the hospital at the onset of labor. But I do know better, and an established body of science indicates quite clearly that Dr. DiLeo is, at best, misleading his readers.

Given the assumptions stated above, the science shows that birth at home is AT LEAST AS SAFE as birth in a hospital (in fact, for multiparous women, some studies have shown that mother and baby are SAFER at home than in the hospital). I will not bore you here with an in-depth scientific analysis (there was a reason I stopped studying science and went into the law), but here are some key citations and websites that are the basis of my assertion:

• Wiegers, T. A., M J N C Keirse, J. van der Zee, and G. A H. Berghs. 1996. "Outcome of Planned Home and Planned Hospital Births in Low Risk Pregnancies: Prospective Study in Midwifery Practices in the Netherlands." British Medical Journal 313:1309-1313.
• Ackermann-Liebrich, Ursula, Thomas Voegeli, Kathrin Gunter-Witt, Isabelle Kunz, Maja Zullig, Christian Schindler, and Margrit Maurer. 1996. "Home versus Hospital Deliveries: Follow-up Study of Matched Pairs for Procedures and Outcome." British Medical Journal 313:1313-1318. [NB: I trust Dr. DiLeo would agree that the British Medical Journal is one of those "prestigious medical journals."]
• Schlenzka, Peter F., "Safety of Alternative Approaches to Childbirth", Stanford University, 1999.

I challenge Dr. DiLeo, or any student of birth-related issues, to provide a cogent critique of these studies.