For the third straight year the United States has fallen in rank in the World Health Organization’s international ranking for maternal mortality. The U.S. currently ranks 58th, meaning in 57 nations women have a better chance of surviving childbirth than they do here. The U.S. fares a little better in infant mortality, ranking 34th in the world at keeping infants alive through the birth process. If this sounds outrageous, consider also that the U.S. spends more money on maternity health care than any other developed nation. Licensed midwife Sondra Londino, who recently opened Birthroot Midwifery, a private practice in the Fall Creek area, explains why out-of-hospital births have increased by 41 percent from 2004-2010 and how a midwifed home birth provides a safe and satisfying birth experience.
According to Londino, there are many reasons why women choose home birth. The most common reasons clients list are a desire to avoid unnecessary interventions; previous negative or traumatic hospital birth experience; increased control over birth decisions; discomfort with hospitals, doctors or medically managed birth; a desire for privacy and to avoid strangers; trust in birth as a normal healthy process; lack of separation from baby; easier breastfeeding initiation; decreased risk of cesarean birth; family involvement during the birth; and decreased risk of infection.
“More mothers and babies die in U.S. hospitals than in many third-world countries,” said Londino, “yet the medical establishment in the U.S. continues to go the wrong way toward more and more interference with the natural process—the very thing that is causing the problems.”
A 2012 study showed that low-risk women who plan a home birth have significantly fewer interventions and complications than low-risk women who give birth in a hospital. Several studies have confirmed that the rates of medical interventions, severe lacerations, operative births, and low Apgar scores were significantly lower in home births.
“Most of the statistics show that in terms of safety home birth is as safe as a hospital birth,” said Londino, “the benefit of home birth is largely in maternal satisfaction and fewer unnecessary interventions. Many of the interventions in the hospital create a cascade of interventions, as each intervention has side effects, more interventions are made to manage all the side effects of the previous interventions.”
The cost of hospital birth versus a midwifed home birth is remarkable as well. According to Londino, in New York State the average vaginal birth with no complications is $9,400, which does not include anesthesia, complications, IVs, or newborn care. In central New York, home birth generally costs around $3,500, which usually includes all prenatal visits, the midwife’s fee for the birth, any medical supplies or medications used during the birth, an assistant for the midwife, and several postpartum visits.
But, Londino warns, home birth should not be chosen primarily for financial reasons. “Home-birth midwives believe that pregnancy and childbirth are best supported with good nutrition, personal responsibility of the mother for her pregnancy and attentive clinical management throughout the childbearing cycle. Before a woman is accepted as a client, the midwife will determine if she is a good candidate for home birth. This includes risk assessment but also the woman’s motivation for choosing home birth, the most successful home birthers are those who truly want the experience.”
Midwived prenatal care generally includes a free consultation interview, a complete physical exam, prenatal blood lab work, access to medical care such as amniocentesis, ultrasound, genetic testing and consultation with an OBGYN as desired or needed, nutritional counseling, and breastfeeding education. The midwife brings specialized equipment to every birth, including equipment to monitor mother and baby, instruments needed at the time of birth in case suturing is required, homeopathic remedies and herbal tinctures, a hanging scale and sling for weighing the baby, vitamin K and Erythromycin eye ointment—given upon request, and the standard gloves, gauze and syringes.
“The mother and baby are monitored during labor and the laboring woman is offered natural pain relief including position changes, massage, hydrotherapy, aromatherapy, acupressure, herbal and homeopathic remedies, and continuous loving support,” said Londino.
Throughout prenatal care and during the delivery, the midwife conducts risk assessments. According to Londino, 10-12 percent of homebirths transfer to the hospital for reasons such as failure to progress, need for pain relief and maternal exhaustion, with very few women experiencing an urgent transfer to the hospital.
“For the vast majority of women there’s not much you need to do,” said Londino, “I think women experience less suffering and less trauma at home. There’s a paradigm shift that happens when you choose home birth, because you know that you’re not going to get the pain medication. Everyone in the hospital is invested in you not experiencing pain. In home birth we understand and accept that pain is part of the process, but when you go into it understanding that’s part of it, there’s less suffering and less trauma. The pain is not pathological, pointing out something wrong, it’s part of the process.”
For more information visit Londino’s website where you can find extensive data and article links: birthrootmidwifery.weebly.com.