The rate of home births is dropping in England. Cue finger-pointing.
According to the Guardian, the rate of home births in England dropped from 2.9% in 2008 to 2.7% in 2009. Cathy Warwick, general secretary of the Royal College of Midwives, blames scientists and the press: she calls out "researchers from across the world, who seem to be collaborating with the media … publishing studies which suggest home birth is not safe and give the impression that hospital birth, on the other hand, is completely safe." She criticized a Lancet article that cited higher mortality rates for home-birth babies and argued, "Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk." She also got in a little dig at US home births:
The fact of the matter is that home birth in the UK is a very different concept to a country like America. Midwives in the UK are highly trained, highly competent and very able to relate to obstetricians — who actually support home birth in the UK.
It's true that the politics of home birth are different in the US and the UK. As the Lancet article points out, Britain's Royal College of Obstetricians and Gynaecologists supports home birth for uncomplicated pregnancies, while the American College of Obstetricians and Gynecologists doesn't. ACOG argues that "choosing to deliver a baby at home [...] is to show preference for the process of giving birth over the goal of having a healthy baby." Their language is a little lady-blaming — childbirth is a pretty major fucking process, and it's not surprising that women care how it goes down. That said, women deserve facts as well as choices, and if home births are indeed more dangerous for babies, that's something moms should know about before they decide.
Unfortunately, it's nearly impossible to separate data from politics here. Birthing options are right up there with abortion on the list of Surefire Argument Starters. And for every hospital-birth advocate who says home births are more dangerous, there's a home birth aficionado arguing that hospitals "medicalize" childbearing and overuse C-sections. More research might help — as Lancet says, "the evidence is contradictory for outcomes of newborn babies delivered at home. These data come from small observational studies that are subject to confounding." But in order to really put this research into practice, both the UK and the US will need to balance respect for peer-reviewed science with support for the wishes of women — who, let's not forget, are the ones pushing out babies in the first place.
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