Why Home Birth?
I mean, seriously! I'm the first one to admit that my experience in labour and delivery has been biased by the fact that both of my obs/gyn rotations have taken place in tertiary care centres, where all high-risk patients end up. Not to say that we don't see run of the mill deliveries as well, but we definitely see more than our fair share of complicated ones.
In the past two months, I've seen some scary shit. I've seen a maternal death secondary to chorioamnionitis (infection of the uterine contents) which also caused baby to be delivered stillborn at 20 weeks. I've seen a uterine rupture when a woman was VBAC (attempting to have a vaginal birth after a previous caesarian section)-- baby ended up with brain damage from sitting in the abdomen for 6 minutes between the time of rupture and the time they were able to get her out of the abdomen. Mom, amazingly, didn't only survive but was able to keep her uterus. I've seen more post-partum hemorrhages than I can count. I've seen the heart rate of full term babies inexplicably plummet during labour, requiring a crash c-section. When things can go SO badly SO quickly, how can you possibly justify giving birth at home? Regardless of how close you live to the hospital, any amount of time is too much when you're talking about a prolapsed umbilical cord or anything else compromising blood supply to the fetus.
Proponents of home birth often talk about stuff like 'feeling more comfortable at home' and 'not wanting to be exposed to germs in the hospital'. Personally, that's crap. So you don't feel comfortable in the hospital? How comfortable will you feel if something goes wrong that hurts your baby... and you have to live with knowing that the outcome could have been different had you compromised your 'comfort' for the sake of the baby? And germs? Please. First of all, we're not sticking women in labour in the middle of the infectious disease ward. Second, I'm sure if you had a microbiologist over to take samples and swabs from your counters, sinks and carpets, you'd be horrified at what's living in your 'clean' house.
Although I don't agree with it (obviously), I can still respect someone who decides to give birth at home if it's not your first baby (so you've proven that your anatomy can handle vaginal birth) and there is no reason to think that you're at risk of any complications. But no one is there to draw the line. Some midwives will allow you to home birth as a VBAC, for God's sake! I know a girl who decided to have a home birth in her parents living room in a hot tub. She's a good 250lbs. As I've learned recently, being obese puts you at much higher risk for a number of complications in childbirth... your risk of needing an emergency c-section is much higher, as is your risk of shoulder dystocia (baby getting stuck after the head is out) and macrosomic (really big) babies. Why would you risk a home birth in that circumstance?
Okay, rant over. For now.