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Homebirth is
Safer than Hospital!
Statistics have
demonstrated that, for the majority of women, home birth with the
presence of a skilled attendant is a reasonable and safe option.
"The American Public Health Association's policy statement on Reduction
of Unnecessary Cesarean Births encourages the expanded use of midwives
and out of hospital birth settings." Sakala, Carol. Citing the American
Journal of Public Health 80, 225-2, 1990 in Midwifery
Care and
Out-of-Hospital Birth Settings: How Do They Reduce Unnecessary Cesarean
Section Births? Social Science and Medicine 37, 10 (1993c) 1233-50
A Study of 3,257 out-of-hospital births attended by Arizona-licensed
midwives from 1978 to 1985 showed a perinatal mortality rate of
2.2 per 1000 and a neonatal mortality rate of 1.1 per 1000. Sullivan,
D. & Weitz, R., Labor Pains: Modern Midwives and home birth.
New Haven, CT: Yale University Press, 1988, pp. 125-126
These rates are substantially below those for the U.S. as a whole,
which had an infant mortality rate of 10.5 per 1000 in 1987. Another
study compared 1046 planned home births attended by California midwives
with a similar group of 1046 hospital births attended by physicians.
The two groups were matched for mother's age, education, number
of children, risk status, etc. There were no significant differences
in perinatal mortality between the groups. But the midwives achieved
lower rates of fetal distress, postpartum hemorrhage, birth injuries,
and the need for infant resuscitation. While the hospital sample
had 30 cases of birth injuries, including skull fractures, facial
palsies, brachial nerve injuries and severe cephalhematomas, there
were no such injuries at home. The home birth statistics included
those couples who began labor at home, but ultimately needed to
be transferred to the hospital.
Mehl, L., Ramiel, J.-R., et al., "Evaluation of outcomes of non-nurse
midwives: Matched comparisons with physicians," Women and Health,
5:17-19, 1980
In the United
Kingdom, the 1992 House of Commons Committee on Maternity Services
stated in the Winterton Report that "this committee must draw the
conclusion that the policy of encouraging all women to give birth
in hospitals cannot be justified on the grounds of safety" and further
in the report stated that "There is no convincing or compelling
evidence that hospitals give a better guarantee of safety of the
majority of mothers and babies. It is possible, but not proven,
that the opposite might be true." We realize that, while birth is
inherently safe and that with minimal intervention 85-90% of all
births result in a healthy mother and infant, there are risks associated
with birth that include but are not limited to; maternal or fetal
death, neonatal death, maternal or neonatal morbidity. In order
to minimize those risks and avoid any unnecessary interventions
which may disrupt the normal birthing process, we have chosen to
birth at home with a midwife who is skilled in recognizing circumstances
which require referral or assistance from other health care providers.
Should circumstance
arise that would make it unsafe for us to remain at home, we expect
to transport to Pomona Valley Medical Center Hospital into the care
of Dr. Thomas T. Lee, Obstetric-Gynecological Associates, P.C..
Under no circumstances will we hold you responsible for events that
occur prior to our arrival at PVMC Hospital and we will not hold
you responsible for an outcome that may have been improved with
an earlier admission to the hospital and your care. We recognize
that if hospitalization becomes necessary, interventions in the
birth are warranted, but we expect that you will honor our request
that those interventions be kept to a minimum.
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