When Tiffany DeLancy of San Clemente learned she was expecting her second child, she knew exactly where she’d be delivering: at home. As a low-risk, second-time mom who is also a trained and certified birth doula, DeLancy is an excellent candidate for out-of-hospital birth. Still, it was not a hurried decision but an informed and educated choice supported by her husband and physician. Out-of-hospital births are on the rise, reaching their highest level since 1975 at 1.36 percent of total U.S. births in 2012, according to the CDC’s most recent data. Despite the growth, the American Academy of Pediatrics maintains that hospitals and birthing centers are the safest settings for birth, although the organization supports and encourages women to make their own informed decisions.
“For the low-risk pregnant woman, home birth may be a safe option,” says Lisa Sherwood, a nurse practitioner and certified midwife at Saddleback Valley Hospital. “However, some women are not low-risk and should not attempt to give birth at home. It is important to evaluate one’s resources for how a woman’s care will be managed in the case of an emergency requiring transfer to a hospital or involvement of a physician for the woman, fetus or newborn. These strategies need to be planned in advance and easy to implement.”
Many women plan home births in order to have more control during the birth process, save on medical costs and eat, move or shower during labor. Additionally, the CDC reports that cesarean sections now include a third of all births in the U.S., which is much higher than the 10 percent to 15 percent recommended by the World Health Organization. Many home birth supporters argue that medical professionals often intervene during labor too early, causing an unwanted birth outcome. For women exploring birth options, the idea of a home birth might inspire images of hippie bathtubs and an overall goopy mess, but the practice has come a long way in the last few years.
Licensed midwife and O.C. local Lauren Slak opens up about the education required: “Becoming a licensed midwife included two bachelors degrees from USC, three years of didactic education at the Nizhoni Institute of Midwifery, thousands of clinical hours as an apprentice in both home birth and birth center practices, and a rigorous licensing examination from the Medical Board of California.” A recent study of 17,000 planned home births by the Journal of Midwifery & Women’s Health showed that when under the care of highly trained medical midwives, low-risk women required very few medical interventions, successfully delivered healthy babies with an average birth weight of 8 pounds, and incurred only a 1 percent hospital transfer rate for mostly non-urgent conditions. Midwives should have the medical knowledge to identify if a pregnancy or labor qualifes as normal, or low-risk. “Some disadvantages of any out-of- hospital setting are delayed access to emergency surgery and blood products,” explains Slak. “Midwives mitigate the need for these resources by carefully screening clients to ensure they are low-risk and therefore good candidates for out-of-hospital birth. Midwives also carry anti-hemorrhagic drugs, antibiotics, oxygen, supplies for IV therapy, and newborn resuscitation equipment for mothers and babies who require assistance.” Beyond the lack of access to hospital resources, risk factors for home births include diabetes, chronic hypertension, seizure disorder or chronic medical condition diagnosis. Women who have previously had C-sections, are less than 37 weeks pregnant or are carrying multiples are considered high-risk, according to the Mayo Clinic.
The general consensus among birth professionals is that a woman should deliver her baby in whichever environment is truly the most comfortable for her. “Home birth may not be in everyone’s comfort range, and that is perfectly OK,” DeLancy says. “I just want women to know they have options. If that means an unmedicated, home water birth, amazing! If that means a natural hospital birth, wonderful! If that means choosing to have an epidural, perfect! Just know it’s your right to experience birth exactly the way your heart feels called to.” As DeLancy explains, “We (mothers) are capable of so much more than we realize. When you recognize and acknowledge the fact that the female body was designed for the birth process – and has been doing it successfully for an unfathomable amount of time – it makes it easier to accept and surrender to it, rather than fear it.” By: Elaina Francis is the mother of one boy and two girls. She lives in Irvine with her husband, Kedric, who also writes for us.