We will be having a home birth, and this revelation has gotten a variety of reactions from our friends.

We are not anti-medical in general, and would go to a hospital in the case of a significant complication.  Ann has worked at a hospital chaplain at the Alta Bates-Summit Medical Center, and has counseled mothers/families after neo-natal deaths.

Certainly, there are risks to having a birth, whether one has them at home or in a hospital.  A number of medical studies have been performed to compare the risks of low-risk births in hospitals (attended by doctors) vs. those outside hospitals (attended by midwives).  A study of over 5,400 home births was just published last year showing deaths at 1.7 per 1000 home births (vs. 1.9/1000 average at hospitals).  This study, which also surveys other past studies, can be found here

While medical intervention can be life-saving and we intend to take advantage of it if we find ourselves in a high-risk situation, it it not always the best option.  Unfortunately, hospitals can be very aggressive at pushing for medical intervention when it is not the best option.  Unnecessary epidurals, episiotomies, C-sections, etc. can significantly increase the risk of giving birth.  The study found these kinds of interventions much lower with intended home births compared to planned hospital births: episiotomies (2% vs. 33%), caesarean (4% vs. 19%), vacuum extraction (0.6% vs 5.5%).  That's 16x, 5x, and 9x higher rates for hospital births than planned homebirths.  The rates of death/health problems were about the same (if not lower) for home births.  Rather than letting nature take its course, hospitals are more concerned with hastening births. Also, the rate of infections for mother and baby increase 1% every hour that someone is in the hospital. Thus if mom and baby are in the hospital for 2 days, there is a 50% greater chance that one of them will contract an infection from all the germs going around at the hospital. 

We interviewed a number of midwives, and decided on a team of two who have performed over 1,100 home births between them (more than many doctors). They draw blood for tests, can give IVs if necessary, have certification in neo-natal resuscitation, can supply oxygen to mother or baby, give medication to stop hemorraging, do stitching, etc.  They have seen all the complications, and we trust their judgment in recommending a hospital transport.  We also feel we are getting excellent service and attention, and get at least 1 hour pre-natal visits every three weeks (more frequently closer to the birth) and six post-partum visits.  Unlike being in the hospital where it is not guaranteed that your ob-gyn will be at the delivery and nurses pop in and out frequently, we are assured of having our midwives with us during the entire labor process as soon as we request their presence.

While home births may sound like something from another time, medical studies show them to be as safe or safer than hospital births for low-risk pregnancies.  This is not to mention all the other advantages of home births, such as giving birth in a comfortable space, having a greater sense of control and decision-making in the birthing process, and avoiding psychological effects of aggressive intervention on mother/baby. Almost all of Ann's friends in Oregon gave birth to their children at home, and as one of them remarked "It is the most empowering, gentle, and loving way to give birth that we can imagine." We are definitely looking forward to the experience.