Home Birth
From Encyclopedia of Sex and Sexuality
An overwhelming majority of the world’s people alive today were born at home despite the nearly universal adoption of hospital birth in Western societies over the past half century. Yet, even in the United States, hospital birth is a relatively recent practice; at the beginning of the twentieth century, only poor and destitute Americans gave birth in hospitals. At that time, women whose families could afford to provide satisfactory home care and who had access to physicians or midwives preferred to have their babies at home.
The shift from home to hospital birth was dramatic and practically universal in the West by the 1960s and 1970s, and yet even in the United States home birth was never entirely eradicated. Just when the practice of hospital birth appeared to have become universal, a small but significant group of women again began looking to their homes as an alternative place to give birth. Largely middle class, these women typically were well informed and highly motivated. Some came from a feminist women’s health background and others had ideological or religious convictions that supported the idea of home birth. All shared the desire to avoid or minimize the medical interventions in childbirth commonly in use, not be separated from their newborn babies, retain control over decision making in the childbirth process, and respect the private, spiritual, and familial aspects of childbirth. In the past twenty years, the home birth movement has grown to include women and men from all walks of life.
The keys to safe home birth are comprehensive prenatal care to reveal any risk factors and the choice of a skilled and qualified birth attendant. The attendant must be qualified to recognize whether a pregnancy and birth are in the range of normal. The mother’s and baby’s conditions are generally monitored during labor—the fetal heart is checked intermittently, the color of amniotic fluid noted, and the mother’s blood pressure taken. Equipment must be available for dealing with emergencies should they arise, and the attendant must be competent to recognize when transfer to a hospital is necessary and be prepared to do so quickly. The decision to give birth at home is not the norm in the United States or in most industrialized countries, although it can be a safe and appropriate choice for many responsible parents. Home birth attendants are available in all fifty states although it may take investigation to locate an appropriate and licensed care provider in some communities.
