How Safe Is Home Birth? Ctd

How Safe Is Home Birth? Ctd:
A reader writes:

I just wanted to thank you for the follow-up responses from readers on this question. This is what makes your format really great; dissenting opinions from the mainstream can be aired without being drowned out by the status quo.  This is an issue important to me. While I chose to birth my two daughters in the hospital, I greatly respect home birth and would have loved to be at home in a familiar and loving place. I chose not to because I was able to find a hospital with a very low C-section rate and a group of professional midwives who support natural childbirth that could deliver there. The majority of expectant mothers would be challenged to find this combination.
The hospital where I gave birth is known for their acceptance of natural birth, or delivery without painkillers.

It is extremely difficult to have natural unmedicated childbirth in the hospital setting. It involves a lot of preparation on the part of the parents and a great deal of support from the attending practicioner and, in my case, a wonderful doula (Greek for "mother to the mother"). The hospital system is not built around natural childbirth and if that is what one wishes to have then one must choose to fight the system (and fighting is not exactly conducive to natural childbirth, by the way; it produces the wrong hormones) or to have a home birth.
It is a great shame that, as your other readers have pointed out, our medical establishment has mostly chosen to vilify midwifery and dismiss natural childbirth. Having experienced the great empowerment of natural childbirth twice, I so wish every woman could know just how amazing and strong the female body is. Instead they are told that they aren't strong enough to do it.

A reader who did choose home birth:

My first child was born at home on April 15. When I turned up pregnant last year at the ripe old age of 35, my husband and I knew that I would be considered "high risk" by virtue of my age alone. While our local hospital has a relatively low C-section rate (18%), it is still far above the 10% rate recommended by the World Health Organization - and we knew that my age, coupled with a rare genetic disorder that has no impact on pregnancy or birth but that most doctors have no experience dealing with, I would be a prime candidate for highly managed labor and delivery.
As we investigated our options, I found a lay midwife who has attended more than 700 births and never lost a mother and lost only 3 babies. (Find an OB with a similar record and I'll be shocked.) She did all my prenatal care and I had a wonderful, healthy, textbook pregnancy.
My labor was not quite so by-the-book. My water broke in the wee hours of April 8 (my due date), but contractions did not start within the 24 hours required by most hospital birth centers. My midwife came to our home that day and every day after to check my and the baby's vitals, as well as to check the small amount of amniotic fluid that continued to leak for signs that our son was in distress. There was never any sign of distress or infection (the biggest risk after the bag of waters has ruptured), so we continued to wait for labor to begin - which it finally did, on Friday afternoon.
My son was born early Sunday morning, naturally and with no drugs or other interventions, after 38 hours of the hardest work I've ever done. If we had been under the care of an OB, however, you can bet your baby booties that he'd have arrived in an operating room the previous week - and instead of recovering from a couple days of hard work, I would've been figuring out how to care for an infant while recovering from major abdominal surgery. I also would've been on the hook for tens of thousands of dollars in medical bills since my weak-ass insurance doesn't cover maternity (but that's another rant altogether).
Home birth is not for everyone - it's not safe for everyone - but it was the right choice for our family. And yet it is not legally considered a choice in my state of Indiana. The lay midwives who attend the majority of Amish births and a small minority of the rest can be arrested and prosecuted at any time for "practicing medicine without a license" - even though pregnancy and birth are medical issues by matter of opinion.
Home birth is as safe as the birth attendant is qualified. And the medical establishment does women no favors by considering qualified midwives criminal.

Update from a reader:

Just want to push back at your reader who writes: "I found a lay midwife who has attended more than 700 births and never lost a mother and lost only 3 babies. (Find an OB with a similar record and I'll be shocked.)"
The neonatal mortality ratio for the USA is just over 4 neonatal deaths per 1,000 births and the maternal mortality ratio is 21 maternal deaths per 100,000 live births [pdf].  Basically, her midwife is exactly in line with what you would expect.  Not bad at all, but I'm sure we could find plenty of OBs with similar or better records.   I work on maternal health issues in developing countries and the data is notoriously bad so I can't stand when people just ignore good data gathered from vital registration.

Another corrects the first reader:

"a wonderful doula (Greek for "mother to the mother")"  Actually, it's Greek for "slave".

DIGITAL JUICE