"I'd love to give birth with a midwife, but I just don't want to take any risks."

I’ve said that before.

I’ve said that before and I hear it daily on social media platforms.  Women think that birthing with a certified midwife would be amazing and wonderful, but when it comes right down to it, they don’t want to take risks.

These thoughts are common place.

As common as they are though, they are misguided. While there is a need for obstetricians for certain pregnancies and deliveries, women with low-risk or average pregnancies are not safer delivering their babies in a hospital. On the contrary, they are less safe. Their babies are less safe.

The Journal of Advanced Nursing published a piece this year that was a systematic review of reviews. It concluded, “For low-risk women, health and other benefits can result from having their maternity care led by midwives rather than physicians. Moreover, there appear to be no negative impacts on mothers and infants receiving midwife-led care.”

According to the CBC News, a Canadian study by Dr. Patrician Janssen from the University of British Columbia found that all other factors being equal or similar, the rate of death per 1,000 births in the first month of life was:

  • 0.35 for planned home births
  • 0.57 for hospital births with a midwife
  • 0.64 for hospital births with a physician

The Canadian Medical Association Journal explained in their 2009 September issue that planned midwife assisted home births have statistically better outcomes than hospital births. Upon examining over 2,800 planned home  births that were assisted by  registered midwives over the course of four years and comparing the statistics from them to hospital births in the same area of the country, the home birth group experienced significantly less:

  • C-sections
  • Episiotomies
  • Artificial rupturing of fetal membranes
  • Use of oxytocin
  • Electronic fetal monitoring

The home birth group also experienced fewer incidences of:

  • Birth trauma
  • Meconium aspiration
  • Need of resuscitation at birth
  • Need for oxygen therapy beyond 24 hours.
  • Postpartum hemorrhage
  • Maternal health problems
  • Severe tears
  • Death

One reader messaged me, “I think that it’s wonderful that women choose midwives, but I am so thankful I was at a hospital, because I needed an emergency c-section. Without it, my baby would have died.”

When we pull back from a birth and you look at the chain of cause and effect, we find that regularly, emergency cesarean sections are required because of a situation that would not have ever occurred outside of the hospital labor and delivery room. An article in the Journal of Medical Hypothesis and Ideas from this year explains some of the reasons why a midwife assisted birth outside of the hospital room would decrease cesarean rates. It mentions some of the complications that arise simply from the lack of confidence and encouragement that women are given during labor.

Just because a woman’s OB says, “Thank goodness you decided to deliver in a hospital or your baby would have died,” does not mean that if that same woman delivered outside of a hospital that her baby would have died. That woman’s labor circumstances would have been drastically different.

I elaborated more on labor circumstances more in a previous post.

If a woman’s pregnancy is not high risk, then the reality is, if she actually doesn’t want to take unnecessary risks, she might want to choose a midwife.

3 Comments

  1. Pingback: Cesarean rates vary by hospital, and here I thought it was by risk. — Everything Birth's Blog on Midwifery, Attachment Parenting, Cloth Diapers and More

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