Is it safe?
Even the most ardent home-birth advocates agree that what counts most is safety. Studies published in Britain and the Netherlands show that for a healthy woman with a low-risk pregnancy, home birth is a safe option, says Paul Van Gorp, M.D., a family physician in Long Prairie, Minn., who helped the American Academy of Family Physicians write its policy on home births.
Conditions that make a hospital the safer choice include high blood pressure, gestational or insulin-dependent diabetes, severe anemia, preterm labor, unexplained vaginal bleeding, carrying twins, a pregnancy that goes beyond 42 weeks or a baby in the breech position.
To help ensure the safety of mother and baby, many midwives require that the woman’s home be no more than 30 minutes from a hospital. Based on a Columbia University study published in Obstetrics and Gynecology, transfer to a hospital occurs in only one in 10 planned home births attended by certified nurse-midwives. The most common reason is failure to progress, which occurs most often with first-time mothers.
The American College of Obstetricians and Gynecologists holds firm that the hospital is the safest place for mother and baby. “You can screen people, but there are still [dangerous] things that can happen that you can’t predict,” says Hal Lawrence, M.D., director of the obstetrics and gynecology department at Mountain Area Health Education Center in Ashville, N.C. For example, in about 1 percent of pregnancies, the placenta separates from the wall of the uterus; in other cases, the umbilical cord precedes the baby and becomes compressed, cutting off the oxygen supply.
Still, Garringer says, for her, having a baby in the hospital didn’t compare to her home births. “I loved being in my own bed and nursing my babies right after they were born,” she says. “It changes your life.”