Cesarean Epidemic Conclusion: Homebirth is Not the Only Answer

We need to work to improve hospital-based maternity care. There are models in the US and around the world for good maternity care. Yes, there are hospitals that have <15% cesarean rates, high VBAC rates, offer breech and twin vaginal birth, and even hospitals offering water birth. There are doctors and hospital-based midwives who treat pregnant women with respect and offer informed consent.

We need to look at these models and expand them. This means building positive relationships with our local hospitals, no matter how much they make us want to pull our hair out. We need to encourage women to bring information about evidence-based models to their care providers. We need to encourage hospitals to employ midwives so that home birth is not the only option for midwifery care.

Why? Can’t everyone just have a home birth? Well, no, actually. Let’s set aside the issue of risk. Obviously, many women are not home birth candidates. There are women who have health issues and babies with health issues, as well as women who will develop complications during pregnancy. But I want to talk about the women who don’t feel safe at home. This is our reality. Even in countries with high home birth rates, and a midwifery model of care, some women choose to have their babies in the hospital.

It’s where they feel safe. Some women (and their partners) will always feel safest in the hospital. For some women, eliminating fear of childbirth means being in the hospital. We know that women usually can’t dilate or progress in labor unless they feel safe. Ina May’s “Sphincter Law” works both ways. While for many of us, we can’t open up in the hospital with strangers walking in and out and monitors buzzing, for other women, they cannot relax enough to birth at home. I’ve also worked with women who desperately wanted a homebirth, but their partners were not willing to explore the option.

If we want to truly improve outcomes and empower women, then I believe we need to work toward a maternity care system that allows collaborative care, focuses on evidence-based medicine, and encourages women and their families to make educated decisions and take responsibility for their health care decision.




About Brielle

I am a Licensed Midwife and doula/monitrice in Austin, TX and a very happy homeschooling mama to my two amazing children.
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2 Responses to Cesarean Epidemic Conclusion: Homebirth is Not the Only Answer

  1. Ruth says:

    I think as a, albeit very very new, birth professional, it’s important for me to make it a point to show the care to the mom that I want the nurse/OB/MW to show. When the OB is in the room talking about Pit/CS/Epidural, and the mom says she doesn’t want those and is worried about them, instead of trying to convince her that those may be or are needed, really stop and ask her why. What makes her concerned about those interventions? I think if she can voice the concern and address the fear it will at least help her birth and her as a being. It will also the OB a way to more gentle treat the woman, that she’s not just a vessel harboring/expelling a baby, but a person, a woman, a mother, a laboring woman who is very vulnerable and sometimes just unsure and needs extra tenderness.

    I think this is where I can start.

  2. Ame says:

    I will join your crusade. :)

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