This may come as a surprise to many but the correct answer is C. Women who choose homebirths are driven by safety, just like the vast majority of women who choose to birth in the hospital. According to one study that used an online survey that sampled 160 women who planned home births. They categorized the 508 statements choosing homebirths into 26 common themes. A sense of control, avoiding unnecessary medical interventions, as well as being in a comfortable familiar environment were all common themes. However, safety trumped all others.
Culturally speaking, hospitals are considered the safest option in the event something goes wrong during the childbirth process. Many feel that since there are no guarantees in birth and it is impossible to predict exactly what will happen, all women should birth in the hospital as a precautionary measure.
Here is the catch: Although more than 85% of women who deliver at the hospital are low risk, 1 in 3 ultimately result in a cesarean-section, and the vast majority have medical interventions. Medical interventions begat more medical interventions, and the king of interventions in the cesarean section. From a medical standpoint vaginal birth is preferred for both the health of the mother and the baby. Cesarean sections increase the risk of a number of issues that can otherwise be avoided. Women who have cesarean sections lose more blood, have increased risk for placenta previa, infection, organ damage, admission to intensive care, pain, blood clots, additional surgeries, and respiratory issues. Cesarean sections increase the chances of a baby being born early placing them at risk for complications, including breathing problems. Maternal and infant mortality rates are lowest with vaginal birth.
And of course, all of these factors play a role in breastfeeding. Mothers who have cesarean sections are less likely to get immediate skin-to-skin contact after birth, can have a delay in their breastmilk volume increasing, and have more difficulty with mobility post-surgery. The aforementioned factors contribute to these mothers being less likely to breastfeed. So, Cesarean sections are wonderful procedures that can be lifesaving. However, mothers and babies are much healthier with vaginal deliveries unless absolutely necessary. When taking all of this into account it is easy to see why home birth may be considered the safest option for mothers who desire a vaginal delivery with no medical interventions. The vast majority of these mothers will have a vaginal birth. There is also the option of birthing in a birth center. A free standing birth center allows women to birth outside of the home, but remain less likely to have interventions.
The most important factor is having options. Living in the fourth largest city in the country, women here in Houston have access to health care providers who deliver babies in home births, hospitals, and birthing centers. Depending on location and other factors such as insurance and expense, some women do not have very many options to choose from. But no matter the circumstance, informed decision making is a must! Childbirth is a very personal topic and there can never be a one size fits all approach. Women must make the decision that is best for them, and the only way informed decision making can occur is if mothers are informed. So do your homework! How a women has her baby is one of the first major parenting decisions one will make. It extends into breastfeeding and life beyond.