You say that 99% of women "choose" to have hospital births as if homebirth is an equal option available to women all over the country. This is not the case. In many states, the legal status of homebirth and homebirth-attending midwives makes access to quality homebirth care impossible even for interested Moms. Many insurance companies don't cover homebirth despite the fact that it's much, much cheaper than a hospital birth (even a completely natural one with no interventions). Lake isn't saying "homebirth is for everyone," but "everyone should have the choice to birth at home, it can be a great and empowering experience." Is it hospital birth a real choice if it's the only option you're given? I don't think so. The US is the only major industrialized country that doesn't incorporate midwifery and homebirth for low risk women into its standard health care, and I think it's great that Lake is working to normalize this model of birth for the 99% of women who may not even be aware that it's out there. Then if they all want to keep going to the hospital and getting their epidurals -- fine, awesome, that's their legitimate choice. But a lot of us -- more and more, I expect, with the advent of real access and coverage -- are chosing to stay home for our births. Legalize homebirth and incorporate midwifery into our health care... THEN see where the numbers fall.

...where the numbers fall...

Numbers, like, for instance, the doubled infant mortality rate?

What degree of risk is morally acceptable to place in the hands of a mother-to-be? If you're willing to advocate for a choice which doubles the chance of a newborn dying, are you willing to advocate for one that quadruples that chance?

"Numbers, like, for instance, the doubled infant mortality rate?"

It's unfortunate that the author chose to confuse the issue with her biased choice of statistics.

I've studied homebirth for quite a while and the vast majority of homebirth studies from incredible peer-reviewed scientific journals like the BMJ all show that homebirth, as measured by infant mortality, is as safe as vaginal hospital birth and safer than hospital c/sec in many circumstances.

The studies she cherry picks, which I am familiar with, add the caveats that you should not birth at home if you fall under the following categories: breech, multiple, pre-term or post-date (before 37 or after 42 wks). I think that most people would intuitively realize that homebirth is not the optimal in these situations, though apparently in Australia at that particular time they did not.

I think it's really unfortunate that the makers of the movie did not address the really incontrovertible scientific evidence in favor of homebirth. It would have been at least nice in a footnote at the end of the movie. Also they probably did a disservice if they didn't talk about when it is important NOT to homebirth, because then you just get a lot of people saying "Well if I'd homebirthed, I/my baby would have DIED." Well, that's why I had a midwife. She came equipped with equipment (inc. oxygen, meds, etc) for the usual complications, and the experience to know when complications were unusual and required a trip to the emergency room. I had prenatals just like everybody else and would have gone to the hospital had it become necessary.

I agree with the OP, i would love to see better access to homebirth. I had to pay for mine, $5000 out of pocket apiece, which is sadly and obviously out of reach for many women.

I don't know if links are allowed here, but I can link to my homepage if anyone is interested in reading the abstracts of the studies I'm talking about. I'm a scientist myself and thoroughly researched homebirth before attempting it; if my research had brought up only "homebirth leads to twice the infant mortality" I would NEVER have attempted it.

Everyone's births are special.

I've read many of the posts, and folks are up in arms about safety issues, personal taste, & the threat of one-upsmanship ("my birth was better than your birth"). None of these are at issue. Then there are the folks who say "to each his own". But you've got it right, "each" can't have "her own" because there isn't ACCESS.

Here in the D.C. metro area, we have suffered the loss of several birthing centers and midwifery practices recently. THe practice I delivered 3 babies with was a thriving one, and it recently closed its doors. Operating costs plus insurance put them out of business. I am very sorry to see this happen; the care was terrific and it is a shame younger women will not have this option.

Midwifery is viewed with suspicion by the establishment. Though births with midwives cost much less than even an uncomplicated hospital birth, insurance companies would prefer to back expensive, technology heavy hospital births rather than pay for the care received at a free standing birth center. My first birth, a c-section followed by a 5 day stay for me and baby, cost us $28 (19 yrs ago). Subsequently, 3 children were delivered by midwives at a birth center, and 2 were delivered at home (all attended by CNM's). These births cost us $2,000 and up. Insurance practices discourage the use of midwives, by forcing the parents to pay out of pocket for that choice. We voted for midwives with our pocketbook, but not everyone can do that. People who can't afford the option are forced to accept that they have no option but hospital birth.

Back when I had my unnecessary c-section there was hope that the caesarean rate was declining in the U.S. Unfortunately this is not the case. And with the closing of birth centers in our area, I don't suppose these rates will imprve any time soon.

Well praise The Lord we were at the hospital when my second child was born, without the quick actions of the staff on hand, what seemed like a normal delivery turned into lifesaving heroics by the staff for my wife and daughter. My wife’s placenta tore @ 7cm and caused massive internal bleeding. Wife and daughter had a 5 day stay in NICU/ICU. 14 pints of blood later, my wife came out of a coma as if nothing happened. She did not remember we even had the baby. I was there, her BP heart rate and body temp dropped so fast, you would have thought someone turned off a switch. Almost lost her, and would have if we tried to do this at home.

I'm an obstetrician. I think women have the absolute right to a home birth. The ACTUAL scientific evidence is that maternal mortality has drastically dropped as the numbe of hospital births has risen. If you are going to go this route, make sure your midwife has an arrangement with a doctor WITH HOSPITAL PRIVELEGES near your home.

I've seen only about five cases where women or their infants perished, but they've all been tragic and almost certainly preventable. I've seen scores of women lose their fertility or have infants with lifelong problems from home birth.

THOSE don't get headlines.

I had both of my children at home with midwives. One was born in a tub the other was a 'land' birth. Both were incredible experiences that I was in control of the whole time.

Personally, I would never have a hospital birth unless there was a severe complication. I have seen friends pushed around, drugs almost forced upon them and and endless stream of new nurses filtering in and out of the room. A home birth is personal, you can choose who you want there, or not there. You can labor any way, in any position you find comfortable.

I saw a doctor at the beginning of my first pregnancy and hated the experience. I was just another patient being rushed in and out. The doctor even forget things about me from visit to visit such as my tattoos. My midwife came to my home, spent time talking, giving me a chance to ask questions. If she didn't have the answer or needed more information she would find out for me.

To say most people 'choose' a hospital birth and most of those 'choose' an epidural is a lie. Low income people on state assistance don't get to choose. Some states make homebirth midwives illegal! I have heard doctors tell their patients that they should have drugs, they don't have to feel that pain. Sad. Not only do they not feel the pain but they don't feel what is happening to thier bodies. (I've seen statistics that there are more and more severe vaginal tears with epidurals because they can't feel what is happening and they are encouraged to push too quickly.) I can't imagine giving birth and not knowing that my baby is coming out of my body. Sure, it is painful, but that pain passes quickly.

I understand that a home birth is not for everyone but I would encourage everyone to consider it. I even had a friend change from her OBGYN to a midwife when she was almost 7 months along and never regretted it for a moment.

I gave birth at home a month ago. I had a midwife for my first child at the hospital and she just didn't get it when I kept saying as she was telling me to push, "Maybe if I sit up...." As a consiquence that I don't totally blame on her beacue i could ahve spoken up more (I think she just expected everythign to go normally since I never asked for any drugs), the vaccuum extractor was used to help my son since he was becoming stressed and my pushing was not effective on my back. Anyway, New Mexico medicaid is now allowing women to choose to have thier children at home which I think it wonderful. However, the midwives who will accept women who are on medicaid have not been reimbursed for two years. So really, they give care and catch babies for free, including mine.

My home birth went fantastically. My home is a half hour drive to a hospital. It was also a two hour drive for the midwives to get to my house. By the time they got there i was already dialated to nine and a half cm. And I had no trouble pushing and the baby had no trouble moving down. I think it was because gravity was there to help me.

I think the best thing I can add to this list of posts is to note the philosophy that everything happensfor a reason.

16 Years ago I gave birth AT HOME to a beautiful 8.8lb baby girl. However, a home birth is NOT for everyone. First of all if you have a low thresh-hold of pain and you have not practiced for the birth with self-relaxation, yoga, etc., I would not suggest it. I ended up back-laboring my daughter which was extremely painful and it lasted for 13 hours. I was ready and I had a midwife that had practiced with me for months. I had a terrible experience in a hospital with my son 8 years before which was partially my own fault because I was not in good physical shape; which is why I was home-birthing the 2nd time. If you are over-weight or have not trained for the possible MARATHON of birth I would not suggest even considering a home birth. If you want to have the most natural and wonderful experience of your life, that brings the joy of a calm, quiet, and loving environment for your child. Prepare, and you'll do fine!

I would just like to say that my two worst birth experiences were my first two kids both born in hospital delivery rooms. My third child was born at home. That was a wonderful experience even though there were some problems. The naturalpathic doctor was very good having delivered about 1200 babies at home. He knew what to do without drugs bringing about a positive experience. He did say that in our case if we had gone to the hospital he was quite sure they would not have known the natural techniques he used and would have resorted to a C section. At no time was the baby at risk as his techniques got things right back on track.

This 3rd child was breastfeed almost two years and was always a very healthy well adjusted child. After we moved from Portland, Oregon to Southen Californa our 4th and 5th babies were born in hospital birthing centers which are certainly better than traditional delivery rooms but not as good as at home. We could not find a highly qualified person to do a home delivery here. Home delivery is not always a choice one can make in this country especially if you want a highly qualified person to do it.

I work in a hospital that delivers approximately 1800 babies a year. We also have a level 3 nursery.

Many women will communicate with us what they want from their labor and delivery experience. The majority of clients want an epidural for pain management. Even with interventions, your hospital staff can meet your needs for as natural an experience as possible if these needs are communicated.

We have 2 waterbirth tubs, but only have 1-2 water births a month. Staff would like to have more waterbirths as these patients are one to one during labor and we can be the doula with hands on care.

Most labor RNs would rather labor our patients instead of machines. It is safer to have a natural labor without interventions with mothers walking, showering or soaking in the tub, changing positions,using birthing balls, ect, however, most patients want IV pain meds or epidurals. Inductions or labor wantabees also interfer with the natural process.

Many of my co-workers will stay over the end of their 12 shift to stay through the delivery so that the mother and her family do not need to meet a new nurse while pushing.

I guess what I am trying to say to the 99% of women who choose to delivery at the hospital, you can make requests so that the hospital staff can meet your birth expectations.

Childbith may be natural, but so is death. By giving birth at home, you assume a "natural" infant mortality rate, which is higher than I would accept for my child. As a pediatrician, i have seen my share of horrible outcomes from home births. For anyone to claim that home birth is as safe as hospital births is absurd and shows a poor understanding of outcomes research. Take the population of those infants that are born at home: healthy, previously uncomplicated pregnancies. Now take the population of infants born to C-section: where the majority of them obviously had something go wrong to get to the OR. You cannot compare those outcomes. Another thing to consider is that mortality is not the only bad outcome. What I have found to be more common than death from a delivery gone wrong is a child that survives, but has a hypoxic event, rendering them severely mentally disabled for the rest of their life. In my mind, electing home birth because it makes the mother "feel more comfortable" is utterly selfish. The infant doesn't know the difference, but is being put in harm's way so the mom can feel "natural". If a mom wants to put herself at risk, that is her choice. But putting her infant at risk is irresponsible. In fact, I would go so far as to say that it is neglect. If someone is going to make a so-called documentary about home births, they should interview those moms who had their infants die or who are now disabled after a complication of a home birth. The vast majority of all births go smoothly, whether they are at home or in the hospital. However, simple complications (like shoulder dystocia or failure to progress), which are treated routinely and easily in the hospital, can be devastating if there is no easy access to a hospital. My solution for those parents that insist on a more nature birth or those that feel like the medical community is somehow trying to invade their lives: deliver "naturally" with a midwife, but do it in the hospital where there is immediate access to OB docs and pediatricians.

There are many schools of thought on this subject and if you do the research you will find that world wide the infant-mortality rate in the US where most childbirth is done in the hospital is much higher than in countries where the majority are birthed in the home naturally. I'm not up on the latest statistics but when I was we were about 36th on the list, I would hope it has improved!

I've been closely involved with childbirth for many years and gave birth to 9 children at home naturally without as much as an aspirin. They were all very different experiences from the length and intensity of the labor to the deliveries as well, as different as the children themselves. Then my 10th one decided to flip breech at nearly 10 pounds prior to starting labor. I ended up in the hospital with a c-section and a beautiful healthy baby girl. I can say I much preferred the previous deliveries as I can remember them, but that wasn't my main focus at the time, a healthy baby was as my children tend to have large heads. For myself, I'm grateful for the contrast. I have 10 healthy children and extremes of experience to draw from.

The majority of problems connected to home delivery can be weeded out with good prenatal care. Whether you have a baby in the hospital or at home, no one can guarantee you a good baby or delivery! That's a fact! If it were otherwise, mal-practice insurance wouldn't be so high. Every delivery brings it's own experience with it... I've seen women who did every little thing they could possibly do to guarantee them a good home delivery from reading all the right books to eating right to moderate exercise and walking to prenatal classes and end up in the hospital with a c-section. I've also seen the other extreme where women don't exercise, they live on a take out diet and deliver in very short periods of time at home naturally without complications.

The human race has gone on for as long as it has with babies only being born in hospitals for less than 100 years. Prior to that there was no back up plan, so let's be thankful for technology!

On the other hand, the way I see it, money and fear are at the root of most babies being born in the hospital because there are very few insurance companies who will pay for a baby to be born at home. Hospitals are aware that childbirth for the most part is a relatively easy money maker since the complications are the exception rather than the rule and you aren't dealing with sick people, so there is no encouragement from that direction to do it at home.

There are few Medical Professionals who endorse home childbirth, thus, the difficulty getting insurance or finding someone to assist as backup. Where is one to get the information they need to make an informed decision and have the back up plan they require along with adequate care?

This is not a question of right or wrong, but a question of whether or not people have the right to choose...

Let me first say that I am a labor and delivery nurse with over 13 years experience. I have two children, which i had in a hospital, naturally, before I became a nurse. So I am speaking my opinion in both a professional and a personal manner.

Hospital versus home birth is becoming an ever more popular and contraversial topic. With the internet becoming more accessible, I hope that any mother-to-be out there that is considering home birth really does their homework and doesn't just take information that they see on threads like this or the other thousands of other natural childbirth websites for their word. Believe me I have visited alot of these websites and it scares me to death to think that people might actually believe everything that they read on these sites.

Hospital births may not be for everyone, but neither are home births. Emergencies are called emergencies because that is just what they are. In a true emergency during labor, with fetal distress, there is exacly 8 minutes to get a baby out before brain damage might occur. Despite the technology that we now have in a hospital setting, the fact remains that labor is and always will be highly unpredictable. The fact also remains that infant and mother mortality has been drastically improved since the move to hospital birthing.

Most of the labor and delivery nurses that I know are always willing to give patients the delivery that they want within reason. The problem is that most patients are not as willing to be reasonable. They expect their labor to go exacly as they planned it. Refer back to labor being unpredictable. The one thing that everyone wants in labor and delivery is a healthy mom and baby. Keeping that in mind, I hope that anyone that is considering home delivery does the research and makes sure that they are a good candidate with no risk factors.

AGREE 100% Lolacat!!!

What do we mean by 'natural childbirth'? Indeed. We mean the absence of butchery. We mean no appeasiotomy. We mean no forceps. We mean no scissors. We mean no stirrups. We mean no cold, violating hospital gowns. We mean a comfortable, familiar environment, caring, dedicated midwives, and a beautiful experience a woman will WANT to remember.

"Most hope for a vaginal delivery if possible, while accepting that unforeseen circumstances may lead to an emergency C-section." How can Dana Stevens be this misinformed?

I would rephrase: Most hope for a vaginal delivery, however when the doctor's son has a 5 o'clock hockey game to attend, or when the doctor has a 1 o'clock golf game scheduled, he breaks the water early, thus ensuring a C-section within the next 24 hours, which earns him more money and sees that he makes his 'appointments'. It also leaves a woman with a huge deforming scar across her abdomen and a traumatic delivery instead of a beautiful experience.

"What bugged me most about The Business of Being Born may have been Ricki Lake's insistence that home-birthing advocates, happy as they may be with their own experiences, know what's best for the rest of us. 'So many women are missing this amazing opportunity and this life-altering experience,' she lectures early on, explaining her motivation for making the film."

Absolutely Ms. Stevens. Women ARE missing out on home-birth because they don't know of an alternative to hospital butchery.