Her water broke at home. But Mary and her husband didn’t rush to the hospital. They had always planned on having their first baby at home accompanied by a lay midwife. What they didn’t know was that they would soon become one of Dr. Steven Dewey’s newest Emergency Room patients.
Mary, whose name has been changed, had been in a difficult labor for 10 hours before the midwife knew there were problems and finally sent the young couple to the hospital.
Dewey, who was the on-call OB-GYN, quickly discovered a dark-purple arm protruding in the birth canal. At the same time a nurse searched for fetal heart tones. None were found. Dewey performed a cesarean section delivering a lifeless nine-pound boy.
Dewey said if Mary had come to the hospital as soon as her labor began, the chances of saving the baby would have been dramatically higher. He is not the only physician with a story like this. With a growing number of home births each year, physicians worry about the safety of the mother and baby.
Many women, such as Maria Carr, believe the home is a safe, family centered environment where women can have their babies. Carr, a mother of five from Orem, delivered three children at home and feels there is no substitute for home birth.
“It is the safest place to have a baby,” Carr said. “It’s the only place where, if you are really informed and have good attendants, a mother can truly relax. It’s the only place you can have a birth experience that is family centered and do it the way you choose, rather than the way that is convenient for the doctors.”
The number of women who agree with Carr is increasing, according to the Centers for Disease Control and Prevention. The number of women choosing to have a home birth in the U.S. jumped by 29 percent from 2004 to 2009.
One reason home birthing may be increasing in popularity is due to the rise of mommy blogs. Blogs have given women, including BYU graduate Caroline McKell, a place to learn about the type of birth experience she wants for her first delivery.
“Most of the blogs I read are about women having a baby without an epidural, and a lot are actually home births,” McKell said. “For a while it made me feel like it was really common for people to have home births.”
Hospitals, according to Dewey, provide a level of safety and immediate emergency care that cannot be duplicated in a home setting. According to a recent study in the “American Journal of Obstetrics and Gynecology,” medical intervention has been helping mothers deliver their babies more safely. The study analyzed 13 million births from 2007 to 2010 and discovered babies born at home were at greater risk of having a seizure, lacking a pulse and being unresponsive than those delivered at hospitals.
Dr. Amy Tuteur, an OB-GYN and former clinical instructor at Harvard Medical School, has taken it upon herself to inform women about the risk of home birth in articles, newspapers and in her blog, “Hurt by Home birth.” Tuteur’s blog allows women to tell their personal stories about births at home that have ended in injury or death to help people realize how dangerous it can be.
“Two out of three babies who die at home birth could have been saved in the hospital,” Tuteur said. “Zero babies who die in the hospital could have been saved at home birth.”
Advocates of home birth, however, argue that in countries where home birthing is the norm, there are fewer perinatal deaths when compared to hospital births. A study conducted by the Canadian Medical Association confirms their belief. Three groups of women were evaluated based on perinatal mortality. The group with the lowest perinatal mortality (.35 per 1000 births) included the women who planned a home birth. Hospital births on the other hand had the highest perinatal mortality rate (.64 per 1000 births).
Dewey has recently started giving mothers another option for delivering their baby if they do not want to have a hospital birth.
“I have a birthing center designed for low-risk patients only,” Dewey said. “But I also recognize that 5-10 percent of those women, even in a low risk setting, are going to have some kind of a problem during the labor and delivery process that would require them to be in a hospital setting.”
Dewey’s birthing center is a parking lot away from Mountain View Hospital in Payson. If Dewey’s patients have any complications during labor and delivery, it only takes a couple minutes to transport them to a hospital.
“The real problem is out of these births that go bad. If you are at home you are going to have a damaged baby or a dead baby,” Dewey said. “If you are in a hospital you still might end up with a damaged baby, but if things are managed right that shouldn’t be the case.”
Dewey added that the system for delivering babies in a hospital has evolved because that is what works best for patients.
“It’s not because the doctor is trying to make more money or because we’re whimsically saying ‘lets have everyone be monitored,’ or ‘let’s make everybody have an I.V.’” Dewey said. “We aren’t trying to inflict our will on anybody, we are using a system that has evolved over the last 100 years that works the best.”
The hospital system is what the majority of mothers prefer. Although Utah has one of the highest home birth percentages in the nation, only 1.55 % of all the deliveries in Utah were planned home births.
“Life is not without risk,” Carr said. “There are always risk, either way there are risks. I think you have to be prayerful. You have to trust your inspiration. You have to trust your intuition and do what is right for you.”