Giving Birth at Home: A Good Idea?


An increasing number of women are foregoing hospital births and opting for a natural-feeling, non-medical process, reversing a century-old trend


The headline in the passenger's Washington Post Express newspaper two seats in front of me on the Metro caught my eye: "Home Births Up 20%." Wow, I thought, that's impressive.

Inevitably, the headline brought back memories of my children's births. Three of our four daughters were born at home, and the fourth would have been, but I went into labor while visiting my mother in McLean, Virginia. Instead of rushing back to Baltimore, I hustled across the Potomac to the Bethesda Birthing Center, where Kerry Sophia was born.

Since the turn of the last twentieth century, the trend has been toward hospital births, and now less than 1 percent of all births are at home. Still, that 20 percent increase reported by the Centers for Disease Control is stunning.

Expense may have something to do with the uptick. One woman quoted in the Associated Press article that ran in the Express said that her home birth cost $3,300 as opposed to over $10,000 in a hospital.

But the trend toward home births is not just about cost. It's about the kind of experience one wants. That's why my husband, David, and I chose to have our children at home. The decision took a lot of thought and consideration.

When I was pregnant for the first time, I'd never considered a home birth. My mother had given birth 11 times, each time in a hospital. Without knowing the alternatives, I imagined that was where I would have my own children.

But, like the more than 24,000 women who chose to give birth at home between 2004 and 2008, I reconsidered my options. David and I had been canoeing down the Rio Grande with our friends, Marie and Philip Long. Marie was a big proponent of home birth. (She eventually became a midwife and worked for Mothering magazine.) She suggested we have our baby at home.

My first concern was my child's safety. Marie pointed out that home birth is safe. Most problems are identified during the pregnancy, and if something happens during labor, one can get to the hospital quickly.

Her point about safety is grounded in facts. In 2005, the British Medical Journal published the results of a study based on nearly 5,500 home births involving certified professional midwives in the United States and Canada. Eighty-eight percent of the women had positive outcomes at home. Twelve percent of them were transferred to hospitals, 9 percent for preventive reasons and 3 percent for emergencies. The study showed an infant mortality rate of two out of every 1,000 births.

This is about the same rate as in hospitals at the time, according to Robbie Davis-Floyd, a medical anthropologist at the University of Texas at Austin and researcher on global trends in childbirth, obstetrics, and midwifery. The fact is that hospitals aren't failsafe either. Even medical professionals make mistakes, and there's always the risk of infection.

Marie and I also talked about the kind of experience I wanted. She made the point that birth is natural and that, absent complications, there's no need to medicalize it.

Today an increasing number of women agree. They want their children's birth to be intimate and personal, without the intrusion of monitors and IVs. They prefer not to speed up the process, as often happens in hospitals. The home setting is more familiar, comfortable, and relaxing. Hospitals can be stressful, and anything you can do to reduce tension during the birthing process is a major plus.

I took Marie's suggestion. I liked the idea of owning my health decisions. I wouldn't have to worry about a medical professional telling me what to do. I wouldn't have to be in an institutional setting where I was simply one more patient.

Each of my home birth experiences was different. The first labor was very long. I took a couple of showers, and when I got hungry, I ate. The third time, I walked around the house, up and down the stairs, made the beds, and even had time to watch The Taming of the Shrew with Elizabeth Taylor and Richard Burton. I liked Elizabeth Taylor's character so much that I decided to change my new daughter's first name from Rose to Katherine. She was born while I was standing up. My husband caught her before she reached the floor.

Clearly, home births are not for everyone. When it came time to decide about her own child's birth, our second daughter, Maeve, who had been born at home -- delivered by my husband, because the midwife didn't make it on time -- recently opted for the hospital. There her husband, Dave, two of her sisters, Kat and Kerry, her mother-in-law, Dinah, Dinah's husband, Dennis, and I stayed through the day as she labored and then to our delight gave birth to a marvelous little boy, Gideon Joseph Kennedy McKean. We were happy to be with her and to give her our support. The hospital staff was attentive and helpful.

Still, I'm happy that home birth is growing more prevalent. Women have different desires and needs at this most miraculous moment of childbirth. Most, like my daughter, choose the hospital, but for those who prefer their own home, I'm convinced it's a great alternative.

Image: Eyeliam/flickr

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From 1995 to 2003, Kathleen Kennedy Townsend served as Maryland's first woman lieutenant governor. She now works in finance in Washington. More

Townsend is chair of the Institute of Human Virology, where scientists and researchers are leading the fight against HIV/AIDS under the direction of Dr. Robert Gallo. She also serves on the board of the Center for American Progress, the Brady Campaign to Prevent Gun Violence, the Center for International Policy, the YMCA of Greater New York, the Sheppard Pratt Health System, the Robert F. Kennedy Center for Justice and Human Rights, and the John F. Kennedy Library Foundation. In 1983, she founded the Robert F. Kennedy Human Rights Award.

A member of the Council on Foreign Relations and the Inter-American Dialogue, she has been a visiting fellow at the Kennedy School of Government at Harvard and currently is an adjunct professor at Georgetown. She graduated from Harvard and received her law degree from the University of New Mexico.

As lieutenant governor of Maryland, Kathleen oversaw the state's economic development, transportation, public safety, and juvenile justice programs. Earlier, as deputy assistant attorney general of the United States, she helped found the Police Corps, which gives college scholarships to young people who pledge to work as police officers after graduating. She also was the founder and director of the Maryland Student Service Alliance, where she led the fight to make Maryland the first--and still only--state where community service is a high school graduation requirement.

Kathleen lives in Baltimore with her husband, David, a professor at St. John's College in Annapolis. They have four daughters, Meaghan, Maeve, Kate, and Kerry. She is the author of Failing America's Faithful: How Today's Churches Mixed God with Politics and Lost Their Way.
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