homebirth vs. hospital with midwife
 

I recently found out I was pregnant:) I'm currently 6 weeks. This will be my second child. The first child was born in a hospital with a midwife. I have a few questions for the mommys out there. I would really ABSOLUTELY LOVE LOVE LOVE a water birth. I wanted one the first time but that hospital was so overrun I didn't get what I asked for. I told them in the beginning that I wanted to have a water birth. Anyways, I was in labor for a total of 36 hours. At 34 hours I got the epidural...I wish I didn't because she was born 2 hours later!!! This is another reason why I don't want to have another hospital birth. I don't want the temptation there. Especially since the midwife was getting stomped all over by the RN. There was an RN that checked my cervix and then broke my water without asking. I was really upset and I felt robbed of the whole birth experience. Another reason why I would want to have a hospital birth is because I had hypertension all through out my pregnancy. It was horrible. Also, my husband and I are carriers of the Cystic Fibrosis gene. Sometimes kids with CF are born with blocked intestines and need surgery. I'm hoping that this child doesn't have CF, my daughter does. The percentage is so small though, only 20%.

The only reason I would want a home birth is because I can do what ever I want in my own home. I can have a water birth if I want to. I can stand up, squat, etc.

I want this to be a great birth experience because this will be my last child.

What should I do?

I might add that I feel like giving birth to babies in hospitals is only business to them.

C-section rates are soooo high these days. I don't want one Dr telling me that I need a c-section so they won't secretly miss their vacation.

It's also very absurd that women are actually ASKING for a c-section.

Why be treated in a hospital when you're not ill?

Just my opinions. I don't like the idea of giving birth in the hospital again, and I won't do it unless it's necessary.

You said "Another reason why I would want a hospital birth is I had hyperstension all thru out my last pregnancy"..Do you WANT a hospital birth because you are afraid of complications??
Any competent midwife ( I assume that you're not talking about an UNATTENDED birth) will be doing good prenatal care and refer you to obstetricians as needed.
Were you diagnosed as pre-eclamptic? Are of aware of Dr Tom Brew's pioneering work in the 60's and 70s on prevention of eclampsia by increasing his patients daily intake of intake to 100 grams daily?? The women who didn't increase their protein during their pregnancies were much more likely to have eclampsia. The ones who did, didn't have eclampsia.
I happen to think that homes are cleaner than hospitals. The strong antiseptics and patients on antibiotics in the hospitals, kill off the weaker pathogens, but leave the few alive that can resist antiseptics and antibiotics. Those few then multiply and in no time you have a super virulent germ that is almost impossible to kill.
You have good reason to be concerned about somebody ringing in a Csec on you because of their own personal agenda. it happens more often than any of us care to admit. If you don't have security in your relationship...BTW don't sign any bllanket "permissions" if you have to go to a hospital. Strike out any such phrase and write in "after consultation at the occurence".
A nurse breaking your waters on her own is practicing medicine without a license. That can only be done by a physician because if the head is not fully engaged the cord can prolapse. Or maybe nurses are allowed to do this now?? It's been a long time since I had my babies at home- but I am thinking that if a nurse DID rupture your membranes, she had a doctor's order to do so.
If the baby is born at home with an imperforate anus or other bowel blockage there is usually time to arrange surgery within the next day or so. You're not at the South Pole during the winter season, after all.
I hope you and your partner can talk over your options and find a birth attendant you both trust.

First of all, congrats!
I had DD#1 in a midwife center (#2 was in a diff. state and wasn't allowed). It was the most wonderful experience. It was a Sunday, no one was there but us. Got there, she checked me (water had already broke, was at 5cm) put me in the tub (was jetted - nice on the lower back!!) .... hit about 7 cm and I wanted desperately to get out of the tub, did, started pushing and she was born 30 min later. I ended up throwing up so she had to start an IV line to replace my fluids but that was it, took the IV with me in the shower and 1.5 hrs later we were all at Denny's eating (I had to eat afterall, and the only thing else open was whataburger, lol) ... :) The next morning I was up and off to the bank to deposit my check. No issues. Now I realize I am very blessed with a wonderful experience and not everyone's midwife experience is perfect. To do again, I'd have the next baby at home &/or a midwife clinic (non-hospital).
:) Good luck with your decision!

Congratulations!!
We had number 5 at home with a midwife in a hot tub. For me, there is no other way to have a baby!!! It is SO different from any kind of hospital experience you can imagine. It was just me, husband and the midwife. She had music playing and the room was lit only by candles. The lighting was soft and the hot tub was turned up as high as I wanted. No needles, no breaking of the water, no drugs, no nothing. I loved every minute of it and I thought I would be scared to death with no epidural seeing as I've had one with every other pregnancy, but honestly, it never crossed my mind to ask for one. Yes, it was hard there towards the end, but not unbearable and a totally awesome experience, plus as soon as it was over, the baby and I were allowed to go to sleep, none of all that hospital junk the hospitals feel they need to put your through. The water helped with the contractions immensely!! There was one time when they stood me up out of the water and I couldn't believe how bad the contractions were out of the water. All that warm water and bubbles make a HUGE difference. Our baby was born in the water. No problems and I was allowed to relax in the water afterwards for a few moments before being taken out. It was wonderful and if I hadn't gotten toxemia in the last pregnancy, I would have done the home thing again. Most mid-wives are very good and they keep a close eye on you, but aren't ones to freak out about every little thing.

Good luck to you and I hope you choose to try the home water birth thing. I don't think you'll regret it at all. :)

Congrats!!! My fourth baby was born at home with a midwife. Although there were a few complications, they were handled expertly and competently with my midwife.
I was a beautiful experience. If and when I have any more babies the plan is to continue homebirths as long as the pregnancies are healthy.

I second grandmotherbear. For those dealing with the possibility with pre-e, there has been great things seen with those mothers who up their protein. And as you know, there are warning signs way before pre-e gets bad. And most midwives to urine tests at each appointment. I felt that my midwife was more intune with me and my pregnancy than the OB I had with the first 3.
I regret not going with a midwife and homebirth sooner.

On that thing of pre-eclampsia, we tried the protein thing and every day I had to take in so much and keep track of it, it didn't help. We also tried the TONS of water thing and that didn't help either.

The best piece of advice is that "USUALLY" toxemia only occurs in the first pregnancy and usually won't be a problem after that. Although, I had it in my first and my last with 4 babies in between with no problems. Sometimes it just comes back. But chances are, you won't have problems with the next pregnancy. :)

Search around at the different hospitals in the area if that is the route you decide on. Where I went was very good about options and giving you more control over the process. My Dr. did not do C-sections for money he only raised the price to cover the malpratice insurance increase. The hospital I was at kept me in the same room for everything and the second time they had a stereo for music if you wanted it.

I hemorraged with my first so there wasn't really any choice the second time. I don't think I would have chosen differently even if I hadn't because aside from 1 nurse that I didn't like it was fairly nice.

Chances are.... if you were given an epidural at 34 hours.... thats WHY you delivered in 2 more hours.... Not inspite of it. The human body has a habit of not relaxing when it feels pain. Thats what conditioning and breathing classes are supposed to recondition. Chances are - had you not had that epidural your Labor would have gone on to the point you were set up for a C- section. Just sayin....

Congratulations, if you read over your post, you have pretty much answered your own question. Stay home. But whatever your experience, have a wonderful life with your new baby.

i personally wouldnt risk the pregnancy if i was having hypertension and a possible baby with issues. if you arent sure if this baby has it....and to what extent if she/he does...i would play it safe.

after 36 hours..i would expect them to break your water. thats a long time to be in labor, and it can cause stress to the baby. usually they try to break your water to get the baby out on its on..to speed the labor up. i am surprised they waited that long.

did your water break by her checking your cervix or did she use a stick to do it? sometimes if your water has ruptured it wont come out until pressure is applied

This was essentially my experience in a hospital with a midwife (CNM).

VERY small town in rural South Dakota, my midwife was actually the only "baby doctor" in town. She delivered about the half of the 60-70 babies each year, and the various PAs/GPs delivered the rest.

The week my daughter was born, she was the only baby in the hospital. We had some serious TLC. :)
My midwife had designed the OB wing, and there was no question who was in charge when we were there.

I wandered the hospital at will while laboring, I was allowed to eat, she never pushed drugs or interventions, I labored almost entirely in the whirlpool, etc.


I honestly can't believe I would have been happier at home.

I don't want this to sound like I'm coming down on your post...I'm not, there is some serious misconceptions in the information.

If and when the Mom develops hypertension, usually it starts with a mild pre-eclampsia. There are very clear markers and warning signs for it if you and your midwife are in tune to your pregnancy there is plenty of time to go with ob care and try the meds before it develops into full blown hypertension. And even if you are in labor and things go haywire then you have the ability to transfer to the hospital. A home birth is not a sentence. You can transfer at any time.

My sister had preterm labor at 22wks, and pre-e from that point on...controlled some what by meds. At 36wks she developed full blow hypertension and was still able to deliver vaginally with being induced. She was under the care of an OB.
When she was in town between her pregnancies she came to talk to my midwife about what happened and if there was ever a possibility of having a healthy, natural pregnancy. The midwife said that if she were to be her patient, she would take her on, but she would have more frequent appointments and she'd have to be taking her blood pressure daily. But as long as pre-e didn't start up that she could have a very positive homebirth.

Also it is quite normal to be in labor 36-48 hrs. There is really no danger to the baby unless the water is broken in an earlier point in labor. Any danger to the baby is not from the labor, but underlying things.

Find a different hospital. I had my DD in a hospital with a midwife (who also did all my prenatal care). It was wonderful...my midwife told me in no uncertain terms that it was MY birth and I had the right to have anyone in the room kicked out - except the midwife of course. She said if any of the nurses for any reason annoyed me, or if any of my family members got on my nerves, that all I had to do was let her know and she'd have them removed.

It was a wonderful experience! I liked knowing that if something went wrong with either myself or my DD that there was a NICU down the hall and an experienced doc to do the things the midwife isn't licensed to do (like an emergency C-section). I had a very uncomplicated labor, but my DD was born with her umbilical cord wrapped around her neck. If it had been situated a bit shorter, she would have been stuck in the birth canal and strangled....so I narrowly avoided an emergency c-section. I'd hate to think of what would have happened if I had been at home when this was discovered, because she would not have survived the trip to the hospital :(

If you find the right midwife who is willing to stand up for you, and you find the right hospital that will allow her to run the show, there is no reason you can't have your child in a hospital.

There is so much that can go wrong during childbirth that I would never opt to have a baby anywhere other than a hospital. Yes, women have been doing this on their own for thousands of years, but during those years childbirth was very risky with many mothers and children dying in the process. Again - for me, personally - I would choose to have another baby in the hospital without hesitation. YMMV

Bluemoonluck were you in Utah for the birth? I was told that different parts of the country have different norms for dealing with pregnacy in the hospital. I had both mine in Washington where most the hospitals have rooms where you stay for everything except c-section. There is also more of an emphasis on letting things go the way the patient wants it to with minimal intervention.

Nope, I was in Virginia when I had DD. But I'd say that if someone looked hard enough, they'd be able to find an acceptable facility to have a child in any state....just knowing which questions to ask of the facility and the midwife would be important, as would good recommendations.

You know, I really wanted to have a natural birth. I feel that many of the complications in birthing these days are due to interference. Having said that, I am going to voluntarily opt for a c-section my next time around. Here's why.

I have had two children, both born via c-section. My first daughter, I had a midwife at a hospital. I was about 38 weeks and I got pre-eclampsia so off we went to induce me. Two days later, I was still not responding to the induction and only 1cm dialated. They tried to help it along by breaking my water, and I think I went to maybe 1 1/2 cm. About 12 hours later, my midwife came to me and told me she felt it would be best if I did a c-section. I agreed, and my daughter was born.

The second time around I had a doctor, and he was experienced with VBACs but when I hit 40 weeks with absolutely no signs of going into labor, he said he felt it would be best to do a c-section. He told me that once a baby is full-term but is not born at that point, they continue to grow but the danger of complications increases tremendously. So we have it another week and it didn't happen, so I did a c-section.

Two kids, and I have no idea what it feels like to be in labor or anything. It could be that I am one of those odd women who has extra-long pregnancies, since my body didn't seem to want to go into labor, by itself or otherwise. Some women just go beyond the 40 weeks and it's how their body operates. I could be one of them. Or perhaps I am one of the women who would have died in childbirth if it weren't for doctors.

You want to know what I think? I think that yes, while women have been giving birth naturally for centuries without doctors or interference, the death statistics for both women and their babies were tremendously higher. I think that while medical interference does cause a lot of problems, it also saves a lot of lives and my gut tells me that if I had been born 200 years ago I would have already died in childbirth.

I could be wrong about that. I'll never know! But I just weigh it - yes, I could have a body that works just fine but has 10 months pregnancies instead of 9 monthers. But I also could have a body that carries a baby just fine, but doesn't want to give birth. I don't know, and I am never going to know.

When I think about my next baby that will hopefully be conceived soon, I weigh the odds and I will go in favor of a c-section. Yes, I could try again for a natural birth, but the odds are against me and I JUST DO NOT KNOW what is due to interference and what is due to my body not working right. Since I do not know the true reasons why my first two natural births were unsuccessful (doctors will give me one opinion, homebirthers will give me another), I am going to go with what I know - I have two beautiful daughters that were successfully delivered via c-section and they are healthy, vibrant, and neither of them had any issues beyond acid reflux. Both of them were able to nurse immediately and I had absolutely zero problems with latching. If I look at them vs. the unknown, I will choose the familiar and go with c-section for my next one.

Maybe I'm copping out, but I always will analyze my reasons for doing what I do, and my logic tells me that I would be unsuccessful with giving birth the way I wanted to, so I should do it the way I know how to.

Congratulations! Hope you are feeling well :). I only had DD - wish I'd had many more children, but that's a whole other subject. BUT my experience in hospital with DD was pretty bad, sort of like yours - 31 hours and lots of intervention from early on. DD, on the other hand, has happily birthed two children in a small hospital with a fabulous midwife who is part of an ob-gyn group (required in our state). DD and this midwife have a very good relationship - DD knows her midwife will listen to her and keep her and the baby safe at the same time (DD is a RN and would do home birth if necessary, but prefers to be in the hospital). I think we need a lot more midwives! Anyway, I wish you the best in making your choices for this upcoming birth.

Thank you for all of your advice! I decided that it really is to early to say what I want to do yet. I have an appt to meet with a midwife I was referred to by a friend. The friend had an in home birth with this midwife. The friends daughter who is 21 is also pregnant and using this midwife in the hospital. So I have both options with this midwife and I will speak with her about my last pregnancy. I decided that I'm not going to go to a huge major hospital like I wanted to in the beginning. The midwife actually delivers at this hospital so it's a win win! Also the friend's daughter is having a water birth! So I'm hoping that I will be able to take advantage of that also. This hospital isn't very far from my daughters children's hospital. I found out that there are only 6 delivery rooms in the whole maternity ward! That makes me really happy too. That means less nurses to poke and prod at me.

Thank you all for the advice again! I just might have a home birth. I'm going to speak with the midwife first and then decided. Shoot I still have 8 months to decide!

:D

betho- Glad that you are happoy with your decisions and not second-guessing the way things turned out. You are choosing the route that is best for you..and that's what it's all about.
BR- yes, you have time. Glad you are going to speak with the midwife. Be sure to ask HER what HER backup plan is should she be sick/on vacation when you are having your baby.

One problem with counting on a home birth is that, if the expert you were planning on to be there and help you through it has car trouble, you might end up in the middle of a midwife crisis.

Don't forget a doula! (I'm one!) I would LOVE to have a homebirth myself but we haven't done that yet, I seem to have rather rapid/hard labors and never the right kind of support! I HIGHLY recommend Hypnobabies program no matter WHERE you deliver. If I can help answer any questions please PM me. Our bodies were designed to birth naturally, if you read up a lot you will learn SO much that will encourage you and give you confidence in your own body. We are amazingly and beautifully made! Congratulations on your pregnancy!

:rock:

You have to do whatever you feel comfortable with. Personally when I interviewed midwives, I didn't want a homebirth at all costs midwife, I wanted a transfer or refer out as needed midwife. I have friends though that feel that my midwife is too cautious for them and went with someone else, so just like people, there are different kinds of midwives (or OB/GYN's for that matter), so make sure you get what you looking for.

That said I had #1 in the hospital with an OB, had complications, induced early, ended in emergency c-section. #2 was back when they did VBAC's and I did a "natural" VBAC in the hospital with a midwife, honestly wasn't that much different from the OB though, not really, they are there longer though. #3 I had at home with a direct entry midwife, I labored in the tub but ended up getting out right before I pushed. Personally, I would only do a hospital birth again if there was a medical need for it, just giving birth isn't a medical need, I'm not against the hospital and would go if I needed it but would avoid it if I could. I've done it all ways, home wins hands down, by a long shot.

Congratulations!

I've had six babies; 4 at home. I wouldn't dream of a hospital birth unless it was absolutely necessitated. There is just no comparison between hospital birth and home birth. It's like the difference between a hot house tomato and a garden-grown tomato. Sure, they're both tomatoes and sometimes you just have to settle for a store-bought one but once you've had the latter you just don't want to settle for the former again!

By the way many, many, many complications are created by hospital and/or OB practices - and then they tell you, "oh..thank goodness you were in a hospital!" If you haven't seen it "The Business of Being Born" is very informational. And I *love* this article on taking charge of your birth - whether in a hospital or at home.: http://mothering.com/pregnancy-birth/off-her-back

Good luck and God bless you and your baby!

Just had to chime in here--4 kids, last 3 were homebirth. Actually, 1st one was a birthing center in Topeka, and that was very close to a homebirth, also (just not our home).

My midwives were AMAZING--actually saved me from 2 c-sections (doc confirmed that). One would have been from 'failure to progress' and the other would be from a cord entaglement. By God's grace, all kids are fine and I would do homebirth again in an instant. LOVED IT!!!

Let me preface this by telling you all that I am male.

How hard can it be to deliver a baby, basicly they come out whether you like or not, all we have to do is be there to catch them and then make sure the mother baby are safe. Sounds simple, maybe if I ever have kids, I will deliver them myself.

If I had to chose though, I would prefere to have the kids at home with a respectful and kind midwife rather at some cold hospital where they force the kids out with drugs and treat patients like mechanics treat cars.

Am I the only one thinking I don't WANT to have my kids at home?
I don't want to deal with the mess, I don't want to deal with my other kid(s), I don't want to have to worry about the laundry that has taken over the couch...

I liked being in the hospital (complete with kind, respectful midwife). It's like being in a really expensive hotel.
With room service. :) (and a funky bed that comes apart!)

Erin, you have a point.

Ideally though, you would have family to help out, to wash the clothes, to clean the mess, to watch the other kids, to make you meals and pamper you.
That is what home and family is for, to love you.

But, you have a point the hospital has it's good side also.
maybe the mother should decide, because she is the one going through the situation.

My midwife and assistants did the laundry, changed my sheets, warmed up oil and a poultice. The hubby and kids all helped and were a part of the birth. My sister made me tea and toast after the birth. My midwife did all prenatal's at our home so by the time you actually give birth they are practically family, she knows your husband, kids, house. I don't know about other peoples midwives but mine was there for the entire birth and hours afterwords and then came I think 3 times that first week (starting the very next day) and then every week for 6 weeks. You just can't compare home and hospital, I like the tomato analogy, it's just an entire other experience.

Congratulations! I wish you the best in whatever you decide to do. Personally, I am with Erin on the "mini vacation" idea. It was nice to be able to relax. I know myself, and if I had my children at home, I would be up and moving instead of resting and enjoying the peaceful one-on-one uninterrupted time with my new baby.

I'm with you. I am also thankful that I got to the hospital to have my first that were born at 24 weeks. Had they been born at home, I know they would have died. All the others were overdue. Our hospital is great. I did not feel pushed to do anything I didn't want to do. All were born natural, no epidurals (except the first when I had no choice), & spent every minute with me in my room.

That's another thing! I did want a natural birth but I loved being in the hospital. With a few exceptions, the staff for both my kids has been helpful, attentive, and it's kinda nice having room service :) I also had my first 2 kids in hospitals that put the focus on keeping the kid in the room with mom at all times, etc. Even when I had a c-section, while I couldn't go with my babies during my recovery, my husband was with the babies every step along the way. I suppose it does depend on the hospital, though.

Especially with my first, since I didn't have family around to help me. I briefly thought about a homebirth but we lived in a tiny cramped apartment and there was NO WAY I wanted to have a homebirth there - I wanted very much to have the baby in a nicer more luxurious environment. I even convinced them to let me stay an extra day because I didn't want to go home. This next time around my mom will be here like she was with my second, and it's a HUGE help at home, but still not the peaceful environment I had at the hospital.

The hospital that I'll have my third is a brand new one with a nice new "family birth center" that has big bathtubs, oversized sleeper chairs, and a nicely furnished suite with windows overlooking the mountains. Now I just need to find good OB :)

I'm with Erin- I liked the vacation. I see a homebirth like I see a staycation (you know, where you don't go off anywhere for vacation)- you're THERE, so whether you want to think about the work and stuff pilin' up, you DO.

But honestly, I think too much emphasis is put on how a mother feels when she is laboring and while her baby is being born- the point is to get the kid here, SAFELY- the method used to do so doesn't make a difference to me.

From the moment that child is concieved, it's all about the baby- it ceases to be about you.

FWIW, I had a very nice, uncomplicated, natural hospital birth. There was one witchy nurse when I first checked in, who got all ----y because I didn't want to wear a hospital gown (and didn't!). Other than that, all the nurses were kind, understanding, and pretty much left me alone. I found out later that my midwife has certain nurses that are accustomed to working with her and will request her "patients". Those nurses understand that there are people who are trying to avoid interventions and want to have an un-hospital-like experience. I was prepared for an awful hospital stay during which psycho nurses would try to force things on me and my child, but I was pleasantly surprised. I also wrote up a birth plan, just in case, explaining what I did not want (offers of an epidural, episiotomy, hospital gowns, etc). I highly recommend that, if you decide to go with a hospital birth. It's nice to just hand them a paper so you don't have to try to explain yourself while you're busy having a baby.

I also had a doula. I'm not sure that she made a huge difference, since my hospital was already pretty comfortable working with my midwife, but it was nice to have someone ready to advocate for me if the need arose.

I'm with the others, in that I think I prefer a hospital birth, or at least a birth center. But next time, I want to go home ASAP. There's no way I'm staying 48 hrs. I have a hard time sleeping away from home, and it didn't help that they kept wanting to check my baby's vitals and blood sugar. If I hadn't lost so much blood (minor hemorrhage), I'd have been GONE.

Good luck to you and your unborn baby. I hope you're able to find the experience you're looking for, whatever that ends up being!

Unfortunately, I do not have children and am well past the age of making home deliveries, but I do have over 4 years experience as an OB nurse and am going to tap in on that in what I say.

Obstetrics have come a long way since the late 70s when I worked OB. Back then, it was pretty sterile and impersonal. But that has changed. Most hospitals have birthing units now that are more like hotel suites than hospital rooms. They offer water birth, midwife assisted births, you name it.

I have to think of the practical here. Like Erin said, for many women this is the last break they will have before then return home to full time mother hood or resume mother hood to not only the new baby but to 2 or three kids that are eagerly awaiting the return of momma and the new brother or sister. They relish those meals they do not have to cook, the house they do not have to clean and the good nights sleep they are allowed to get before they go home. Not every one is lucky enough to have an extended family to help them.

Yes in most instances, giving birth is as natural as breathing. A womans body was made to give birth, but emergencies do happen. I have seen hemorrhages that would have meant the death of the mother if modern hospital facilities were not in play. I have seen babies that at the last minutes of labor went bad and were alive only because they could be transported to an intensive neonatal unit immediately upon birth. And yes, there has even been the maternal death from amniotic embolisms, and strokes from eclamptic strokes.

Yes, everyone has the right to make the decision of where and how to have their babies. The birth of a child is one of the most beautiful experiences in life. How much risk are you willing to take with your life and the life of your child. Ask yourself that question and keep an open mind. If you decide on a midwife. Make sure she is well qualified and experienced. If you want to deliver at home, what are the contingency plans if things go sour. How close is the nearest emergency facility? What sort of communication does the midwife have with an OB/GYN? Finally, scope out some OB units that offer alternate forms of delivery such as birthing rooms, and water delivery. They are out there.

Remember, the United States has one of the lowest instances of maternal deaths due to pregnancy in the world.

Most of all, be happy, have a healthy baby and an uneventful delivery, not to mention pregnancy.

I helped deliver 348 babies in my career as an OB nurse, two of them with my own hands and the hands of another nurse when the doctor didn't show up in time to play catch. Each one is a miracle and I am sure that most of them went on to have babies of their own.

The circle of life is a beautiful thing.

But of the industrialized countries, the US has the worst maternal death rate by far. Of 1600 maternal deaths in all industrialized countries in 2008, 1000 were in the US. See WHO stats:http://www.childinfo.org/maternal_mo...ountrydata.php See also Amnesty International's concern for US pregnant women:http://www.amnesty.org/en/news-and-u...ate-2010-03-12

Unfortunately most hospitals take a medicalized approach and the natural birth gets subverted in well-meaning interventions intended to prevent the worst possible outcomes.

I have been present at 7 hospital births (5 different hospitals, 6 different medical teams, 2 GP's, 3 OB births, 2 midwife plus hospital staff) and 6 home births. Without exception, in the hospitals, there was a chain of interventions leading to distress for the mothers. 3 of them were threatened with C-sections that fortunately didn't happen. Hospital staff are trained to help in danger situations. They often don't recognize that their helpfulness causes many of these situations to happen.

In one home birth, there was a required transfer to hospital of the baby after birth. This was smoothly accomplished with no danger to the baby.

If you and your midwife know the hospital will allow delivery without any monitoring other than the midwife's, then consider that. Otherwise, if there are no outside reasons, go for a home birth with midwives.

Studies I have read lists the US at 40 or 41st with one maternal death reported for every 4,800 pregnancies. That may seem high but look at the third world countries. I wasn't talking about just industrialized countries, I was talking about worldwide death rates.

There are countries whose stats on such things are so under reported that you would probably be shocked by the percentage.

With that thought in mind, whether it be one in 5 or 1 in 4,800, no woman wants to be that one who dies giving birth. Yes, the maternal death rate in the US is up. One of the leading causes of maternal death is due to cesarean procedures but maternal obesity and hemorrhage also figures in.

What would I do if I was a younger woman and pregnant? I wouldn't have a choice. I have a history of rheumatic heart disease and would be a high risk pregnancy under any circumstances. I would want the best possible care for myself and our unborn child and that child's best chances of survival along with my own.

I would have to go the hospital route, but if I was young, healthy and enjoy an uncomplicated pregnancy, I would use a midwife, but probably NOT at home.

I'm like ERIN, I want that short vacation to recover my strength before the regime of reality hits me in the face. :)

I had my youngest at home. I found it much nicer. It's quiet, relaxing, no machines with alarms going off (I have very low blood pressure naturally, I make the blood pressure monitors freak out), no IV's to freak me out. My midwife was aware of my medical history and also was willing to listen to what I was saying about the baby. I don't have textbook births--I go from seven cm to pushing in about 2 contractions, and it's very hard to get the medical professionals to believe that.
The doc who delivered my first two was great, the nurses so-so. The doc who didn't deliver my third was, well, not there. The nurses did catch the baby but didn't want to believe he was coming. They panicked very efficiently when my husband convinced them he was, but dumped two useless liters of saline into me--that was how long it took us to convince them to actually read my records they had right there. My normal blood pressure is around 88/42--we joke that I don't have blood pressure.
My youngest did have to be transported to the hospital for transitive tachipnia (which I probably misspelled) and spent twelve hours on oxygen. But since I wasn't a patient the hospital didn't feel it necessary to wake me up every two hours and I could stay with him in the NICU--since he was admitted they fed me and let me sleep in 'his' room.
That said, with your potential health issues, I doubt my midwife would have delivered your baby at home. She doesn't deliver high risk pregnancies as she doesn't have hospital privileges. I'd talk to your midwife first about what she wants to do. Do you have the option of a freestanding birth center? That might be a nice middle ground in your situation.
I wanted to have a water birth, but wasn't able to get the tub transported and set up--it was at another gal's house and she was late and I was early, had she delivered on time or me on time I would've had the water. So there's still no guarantee that you'll get that at home.