Birth...its about informed choices

As most of you have heard already we are planning a midwife attended home-birth for our second child. Turns out to be quite a controversy! Whether spoken or not the opposition to home-birth is strong. Why?
Generally people develop beliefs based on information or lack of information and personal experience. I'd say that home-birth and hospital birth is one event that gathers the most amount of misinformation!
If you read nothing else, know this. Homebirths are proven to be equally safe and in many cases safer than hospital births. Babies born at home are less likely to be in poor condition at birth, less likely to have birth injuries and less likely to need resuscitation. Healthy outcomes happen because the mother is laboring in a calm and comfortable setting. Emergencies do not normally appear out of thin air. A trained and professional midwife knows and understands the warning signs of distress and will always transport the mother to a hospital. Even if laboring in a hospital it generally takes 30 minutes to prepare an operating room in the event of an emergency. (National Childbirth Trust) We have a hospital at 2.2 miles (a 7 minute drive) away from our house.
Lets talk more!
Probably the biggest misinformation comes from how safe hospitals are. The important thing to remember about hospitals is that they are a business owned by corporate chains and they are applying business principles to their practices. Medical decisions are being made for monetary and legal reasons, not because they are good for the mother or the baby (The Business of Being Born). I am absolutely not against hospitals and I am thankful for the services they provide and the lives they save. However birth is a natural event that has been happening successfully since the beginning of time and should not (unless medically necessary) be treated as a "problem" to "solve". Somehow women have become convinced that they don't know how to birth.
Speaking of medical decisions, is it not true that many adverse side effects occurring from medical practices don't show up until later? In the 1930s doctors where x -raying women's pelvic area only to find that this caused cancer in children so they discontinued the practice in the 40s. The 50s and 60s produced many armless and legless children thanks to the wide use of Thalidomide during labor. Hundreds of ruptured uterus' and death are associated with the 1990s induction drug Cytotec. (Marsden Wagner, M.D. Former Director of the Women's and Children's Health for the W.H.O). Yes of course you could talk about the success stories but the problem is the lack of careful study done on obstetric drugs.
Now this so far is argument worthy opinion so lets talk facts and some statistics.
I found this chart on a birth advocacy website that best describes what happens to woman in labor in the hospital. I have read and seen this information everywhere and it is widely admitted by health care professionals. Most woman that labor in the hospital begin by induction or or given an induction drug during labor. "Most of" yes that would be close to 90 percent of women (Business of Being Born).
I'm not even going to mention the insane amount of side effects associated with the two main drugs used we will just stick with the birthing process. When interviewed for a documentary an obgyn states, "there is clearly an association with induction of labor and cesarean delivery." How does this happen? Here is the skinny on how things work. An epidural contains a drug that slows the process of labor, that's not it's purpose of course but it happens. Pitocin is a drug that progresses labor. Pitocin progresses labor because it is synthetic oxytocin. Oxytocin is the chemical the body produces in labor that create contractions. Pitocin then creates contracts only longer and harder than those the body would produce. As these two drugs fight it out who loses? Mom? okay yes, but what about baby? Mom has the epidural so bring on the intense pain of pitocin. But little baby inside does not and is feeling these unnatural contractions. Where does that go? Fetal distress (compressed blood and oxygen flow due to the length of pitocin induced contractions) , rush to the the ER, slice the baby out and all praise that they were in a hospital and they saved the day!
Alright, lets back up. You might say, "fine then decline the epidural". Okay, except that in hospitals you aren't allowed to have long labors and the pressure for pitocin comes at your fast from oncall nurses and obgyns. Interventions were never intended to be used at such frequencies that occur today. The vast majority of medical literature does not support the use of these medical practices in such frequency (Geeta Maker Clark M.D.).
The c-section rate in the United States jumped from 10-15 percent in the 70s to 31 percent and rising today. This is shocking because a c-section should be avoided AT ALL COSTS. A c-section is major abdominal surgery!! Aside from the 6-8 week recovery period, it inhibits mother/child bonding (since the final rush of birth hormones is not released), breastfeeding, respiratory problems in the infant at birth and later in childhood asthma (the liquid is expelled naturally as the baby is pushed through the birth canal), increased infertility rate, greater chance of future miscarriages etc. The hospital system is generally set up only to handle one kind of birth (Tina Cassidy, author of "Birth"). If a woman is giving birth in a hospital and does not want to be swept up into these interventions and procedures they have to be very informed and extremely assertive (and sometimes even downright aggressive) about their rights.

Naturally, the most common concern about homebirth is infant or maternal fatality. Most importantly many studies have shown that the infant and maternal fatality rate of homebirths is equal to that of hospitals. In some areas of the United States and in many countries the death rate is lower for homebirths.
Here are two studies that can be found in the medical journal archives online. The first is from CMAJ and the second from BMJ.
The first study concluded:
"Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician"
This study had 12,982 women giving birth. They were divided into groups of women birthing at home, in the hospital with a midwife and in a hospital with a physician.
Some things they found:
~Perinatal death rate for homebirth was .35 and hospital birth attended by a physician was .64
~78.8% of the women planning a homebirth had no need for transportation
~Those who planned a home birth were significantly less likely to experience any of the obstetric interventions
~Those who planned a home birth were less likely to have a newborn who had birth trauma
That study is here

This study looked at 5418 woman who planned to give birth at home with a midwife.
Some things they found:
~Zero maternal deaths
~1.7 infant deaths per 1000 births
~12.1 % of laboring women were transported to the hospital and only 3.4 percent were considered urgent.
~(Interesting side note that I won't talk about because it is not applicable to my decision) Of the 80 planned breech births only 2 died.
They concluded that the maternal and infant death and intervention rate among low risk pregnancies was similar to that of low risk pregnancies in the hospital. The abstract of this study is here.

Let's address infant mortality for a moment. The United States with 98 percent of it's women delivering in hospitals) is 28th on the list of infant mortality rate in the entire world! (Pregnant in America). Seems strange that one of the most technologically developed (medically speaking) countries with one of the highest rates of people birthing in hospitals has such a horrible infant mortality rate.

There are many different kinds of midwives. My midwife is a certified professional midwife. Here is the definition given by the Midwives Alliance of North America:

A Certified Professional Midwife is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwifery model of care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings.

The midwifery model of care is based on the fact that pregnancy and birth are normal life events. For each pregnant woman they provide personalized and individualized care, safe and watchful decision making, and minimal interventions.
The US is the only industrialized nation in the WORLD that uses surgeons to deliver in normal births. Throughout history midwives have been treasured parts of the community. Their knowldedge of women, babies, birth, death and labor unsurpassed. These are men and women who devote thier lives to delivering babies in a healthy environment. An obgyn on the other hand is a surgeon with an obstetric specialization. Gynecology is one of many surgical specialties.

There is so much more to say, and that is why there are countless articles, debates, and documentaries out there. I hope I made a fairly concise summarization of them for you, if you are indeed still reading!