In the recent months*, I’ve heard of three midwife-attended, home birth deaths of newborns involving people I know. As you can imagine, it is heartbreaking.
I’ve cried and cried for the mothers and the children and the midwives. I asked God how He could allow this to happen to people I know and love. And I had to ask myself what I was doing as a home birth advocate. Was it still the right thing to do? What if someone read my blog, and decided to have a home birth, and their baby died? Would I know? Could I live with myself?
I don’t know anyone who has lost a baby in the hospital. I heard of one story a long time ago, the friend of the receptionist at my dentist. But now I know of four babies who died after home birth. One I know no details about, one had nothing to do with the baby being born at home, one likely would have been prevented with a hospital birth but was not due to negligence of the midwife, and one was a direct result of midwife negligence.
As a midwife and home birth advocate, what am I to do? I can’t pretend they didn’t happen. I can’t pretend they didn’t change the way I think about home birth. I can’t lie and say everything I know about home birth is peaches and roses and bliss, because now it’s not. I know better, so I have to do better — but what is doing better?
My feelings about home birth haven’t changed: for low-risk, healthy moms and healthy babies, home birth with a midwife is safe.
This doesn’t mean it isn’t without risk, and in some cases, even with low-risk, healthy moms and healthy babies, a home birth will have a higher (sometimes much higher) risk than a hospital birth.
In my opinion, a good midwife should discuss the risks with you. It’s not a midwife’s job (or anyone else’s) to talk you into doing a home birth with visions of blissful labor surrounded by candles and the wafting scent of essential oils. It’s their job to help you make informed decisions about your pregnancy and birth, and do everything they know how to keep you and your baby safe. And if a midwife is out of the realm of what she knows or what she can safely do, it is her responsibility to tell you, and then transfer your care to someone whose knowledge and expertise extends beyond hers.
I wish I had a magic formula to guarantee that every mother who wanted to do a home birth would get a good midwife. These questions from a Mothering.com forum are a good place to start. I recommend thinking about the types of answers you’d expect or want to receive before you ask them (even write them down!). Then compare your answers to the ones your actually receive from the midwife. The best fit will be someone who has the same philosophy about birth, life, and death as you do. You’re looking for someone who you can literally trust with your life and the life of your most precious loved ones.
The vast majority of midwives are fantastic. They are in the business because they love women and babies. They love being facilitators to empowering natural birth, and they’re humbled by their role of attending them. I feel incredibly blessed to know so many amazing midwives, and I’m so thankful they are able to do the work they are called to do.
So even knowing about the deaths of newborns after midwife-attended home births, I am still a home birth advocate, and still a midwife advocate. Home birth is physiologically normal birth. It’s ideal birth. It’s the type of birth the human race needs to preserve.
That being said — it’s not for everyone. No one should get talked into it — just as no one should be talked into hospital birth. Where to birth isn’t a decision that should be made out of fear, but it should be an informed decision. As an advocate, I have to share the good and the bad. What I know has change, but what I believe hasn’t, and I hope sharing what I know helps others make the right decision for themselves.
Photo credit: Llima on Flickr
*4/9/12 I modified this sentence from the original because I didn’t want conclusions to be drawn from the number of deaths and the timeframe. Although I only heard about these incidents recently, there are years and miles between them.