I started researching and realized there were a lot of articles on the issue and got very involved contrasting and comparing different studies. Finally, I realized this was taking up too much of my time. The paper was only supposed to be 3 to 5 pages and I was getting carried away.
So I forced myself to focus only on two articles, including the infamous "Wax" study. After obsessing about my bibliography for way too long, I finally handed it in today. Now all I have left is my final and I will have successfully completed my first pre-requisite.
The paper is too long to post but I will share some excerpts here. If you are interested, you can comment here or email me and I will send you the whole thing. Without further ado:
...The results showed that the rate of
perinatal death per 1000 births was similarly low in all three groups. It was .35 for planned home births, .57 for
planned hospital births attended by a midwife, and .64 for planned hospital
births attended by a doctor.
78.8% of the women who planned to give
birth actually did, the other 21.2% were transferred to the hospital. The rate
of interventions, including fetal monitoring, episiotomy and cesarean section,
was significantly lower for the women who had planned to birth at home. Additionally,
adverse maternal outcomes such as postpartum hemorrhage or third degree
perineal tears were less common at home. The same goes for adverse outcomes for
the newborn, such as birth trauma, required resuscitation at birth, meconium
aspiration and others (Janssen et al., 2009, p. 379). The full charts comparing
birth outcomes as well as level of intervention can be found on page 381 of the
article....
In summary, Janssen et al.’s (2009)
study showed that planned homebirth with a registered midwife is associated
with “very low and comparable rates of perinatal death and reduced rates of
obstetric interventions and adverse maternal outcomes compared with planned
hospital birth attended by a midwife or physican” (p. 383)....
In conclusion, Wax et al. (2010) repeat that
there is significantly less maternal and newborn intervention and morbidity in
homebirths, especially if they are attended by highly trained and regulated
midwives who are integrated into the healthcare system. Unfortunately, this is
not always the case in the United States because midwifery is not regulated the
same way in every state (p. 243.e7).
This rate of low intervention makes
sense because women who chose homebirth do so in part to avoid the many
interventions they may be subjected to in a hospital setting. Women who birth
at home are considered to have low obstetric risk and so are more prone to having
more favorable outcomes. Additionally, midwives have a different model of care
than obstetricians, which has been shown to consistently lead to less medical
interventions and improved perinatal outcomes (Wax et al., 2010, p. 243.e7)....
Giving birth is a very important
milestone in the lives of all women. There are many physical, emotional and
psychological aspects that need to be taken into account when choosing a care
provider and a place of birth. Most
women feel that their needs will be best met in a hospital setting. Both
articles state that there is an aspect of self-selection present in homebirth.
Women who choose homebirth are looking for a different model of care and for a
lower level of medical intervention that not all pregnant women are comfortable
with.
While homebirth is not the right
decision for all women and the United States will not be encouraging the
midwifery model of care like other European countries, an analysis of the
available data does indicate that planned homebirth with a highly trained and
certified midwife is a safe and viable option for the women who chose it.
AWESOME POST. Is it ok if I link to it for our Sunday Surf on Mothers of Change? You did an excellent job. Could I post the whole paper on MC, if I credit you? It sounds awesome. =)
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