By Dr. Boris Petrikovsky
A while ago, we had an online discussion on COLlive.com about home births. I enjoyed most of the comments and understand that personal beliefs, not science, are behind them.
Two recent events forced me to return to the same topic.
One, another unfortunate victim of her beliefs: a patient whose postpartum bleeding required the removal of her uterus as well as multiple blood transfusions.
Second, two scientific publications by Dr. Amos Grunebaum et al and Dr. Barry Shields et al. Below, please find direct quotes from the articles.
“There has been an increase in home births in the United States over the last ten years. Recent studied have shown that when compared with hospital births, planned home births by midwives are associated with an increase in adverse neonatal outcomes, such as neonatal deaths, Apgar score of 0, neonatal seizures, or serious neurological dysfunction.
The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) have concluded that planned hospital births are safer than planned home births.
Data were abstracted from the US birth certificate database. Because non-identifiable data from a publically available data set were used, this study was not considered human subject research and did not require review by the Institutional Review Board of Weill Medical College of Cornell University.
Between 2010 and 2012, there were a total of 11,905,817 deliveries in the United States. There were 85,318 home births (0.71% of all births in the United States).
The ACOG criteria for home births specifically exclude pregnancies 41 weeks or longer from their home birth eligibility. Post-term pregnancies are associated with multiple, well-known complications, such as labor dystocia, increased perinatal mortality rate, low umbilical artery pH levels at delivery, low 5 minute Apgar scores, post maturity syndrome, fetal distress, cephalo-pelvic disproportion, postpartum hemorrhage, and an increased risk of neonatal within the first year of life.
Selection of patients for home births by countries with midwife organizations, such as the Royal Dutch Organization of Midwives, follows collaborative guidelines with strict protocols for selecting patients for home-births.
It is possible that some pregnant women with risk factors may insist on home births despite the increased risks of adverse outcomes. In circumstances in which home births are contraindicated because of risk factors, physicians and midwives have the professional responsibility to strongly recommend hospital births, to recommend against home births, and to refuse the women’s requests to attend their home births. This is because patients’ requests by themselves do not determine professional responsibility.”
Authors of the second paper stated that:
“Maternal hemorrhage remains a major source of maternal morbidity and death. In the United States, the rate of postpartum hemorrhage has increased steadily; in 2004, 3% of all births were complicated by postpartum hemorrhage. Similar trends have been noted in Canada, Australia, and Europe. The incidence of abnormal placentation also appears to be increasing; in New York State, it is the most common cause of obstetric hemorrhage. “Near miss” events, defined as blood loss of more than or equal to 1,500 mL, occur in approximately 15% of patients who experience postpartum hemorrhage. This suggests that approximately 18,000 women per year in the United States have life-threatening hemorrhages during the course of childbirth.”
Despite the fact that the results of both articles are convincing to the majority of physicians on the risk of home births, it will probably not convince the lay public. Home births have become a sort of religion, where no scientific evidence is strong enough.
Reviewing most of the comments put together by home birth supporters, I can understand the emotional fervor of most of them, except for one, which was written by a doctor who claimed she would like to have a home birth. Doctors should know better and should put the safety of patients above all.
–Boris Petrikovsky is a professor of obstetrics and gynecology and has authored two books and over one hundred research articles. Dr. Petrikovsky delivered over 5,000 babies and performed over 2,000 gynecological surgeries over the past three decades. He is part of the Chabad of Great Neck community where he resides with his wife and children.
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Homebirth midwives reveal death rate 450% higher than hospital birth, announce that it shows homebirth is safe
Trust the professionals, don’t take unnecessary risks. Go to a hospital, this is a matter of life and death. Yes, life and death. It does not matter if it is a “low-risk” pregnancy, all births have the halachic status of life and death. If you have heard from a person who had a wonderful home birth, know that this is not relevant. Past experience is not a guarantee of future results. Your job is to do the best you can protecting the safety of mother and child. That safety is best protected by giving birth in the hospital, where the… Read more »
Statistics in North Europe, 42% homebirth, prove without any doubt that complications during birth and afterwards are much higher in the hospital than at home. The US situation is no proof at al, you cannot compare 0.71% against 42%.
the ignorance is astounding. Obviously homebirth is usually fine. The question is if it’s worth risking a homebirth for the times when it’s not fine and each minute counts.
If you hate doctors, medicines and vaccines you should go back to the woods and share your experience there.
We live with the Rebbe. The Rebbe said to listen to your doctor, and not to your own ego or the mishigaz that some hippies spread.
After having a horrible first birth in a hospital my mother decided to give birth at home. After having a wonderful lengthy meal friday night everyone including guests went to sleep in the house. That night my mother went into labor in her room and the midwife was called. While my father said tehillim. At 6:13 am Shabbos morning i was born. I was nursed (not given immedient cholov akum bottle and vaccines) and checked for vitals etc. When the guests woke up a few hours later they got to meet me. Being that i lived atop a shul at… Read more »
Please see this must watch video, “The Business Of Being Born” on You Tube, about 1hour and 24 minutes. It is essential foe every parent to see about medical vs. midwife births.
Many women unfortunately rely too much on the docs and forget that HASHEM is the one in charge. When you remember who’s in charge, then you can be more relaxed and have a more comfortable birth whether you’re giving birth- at home, birth center, or hospital; and the outcome we’ll be so much better for everyone. IMPORTANT POINT: Use a Doctor/midwife who is a ירא שמים !!! Yes, there are Doctors/midwives who are not Jewish who are ירא שמים
Not one person who is pro home birthing in these comments even has a right to say stuff like what does science know or what do studies know or what do MD’s know. If you want to do a home birth because it’s more comfortable or whatever and risk you any your babies life that is fine. But if you don’t even know the slightest bit about what MD’s have studied for between 5 and 15 years and what is scientifically proven than shut your mouth. Same way you probably know about what ever profession your in better than others… Read more »
Many are not aware of all that you in Hatzala see. Thank you for helping keep us safe!
you are clueless. Just for starters, if their is a serious complication in a hospital maternity ward, the doctors show up within seconds. If it takes them minutes, you have a real media story/lawsuit, or it wasn’t really an emergency and the medical staff present just wanted a second opinion for a non-emergency concern. Regardless, you acknowledged that there is a difference of minutes, you know what a difference of minutes can mean in so many medical complications? And to those who claim that c-sections skyrocket at hospitals due to lazy doctors on the way to a cocktail party, that’s… Read more »
The hippies moms brag us to do “do our own research and make a decision”. Sorry but this is not only very stupid but it shows that you did not learn anything in school. In good chassidishe schools and homes we are thought to be humble to accept things from trustworthy sources when we are not able to understand the matter in hand. We learn to let go of our ego and be aware of our own faulty perception of reality. When a hippie mommy, brags to us to “do our own research” it is obvious that if you have… Read more »
A birth is not about “an experience!” a birth is about bringing new life into this world… ! Would one G-d forbid, rather sacrifice their child on the altar of comfort blabla, because they wanted a wholesome “experience?”
You can plan your birth plan but it’s all in G-ds hands – birth id UNPREDICTABLE
I must commend #10 who opted for hospital birth with the gentle knowledge that she has no total control over life. Not to generalize, but I can’t help seeing a pattern among some who possibly see home birthing as a way to control every aspect of childbirth. It must be on their terms or else. Or is there an underlying feminist bent — somehow the hospital is the province of evil patriarchy? Just my .02. If I were a doctor, I would find these women very difficult to treat on account of their control issues. Part of the hospital experience… Read more »
Why are all the home birthers that ended up in the hospital due to problems during birth, not speaking out against home births. I know at least three in our CH community that occurred in the last two years. Why not educate your peers and possibly save a baby??
Thank you for a clearly non-biased thought provoking comment. I wish everyone did the research you recommend. There are numerous reason why data from birth certificates cannot be used to conclusively give information on specific groups. one reason is that it is up to each state to determine what information needs to go on birth certificates and surrounding laws.
Why would normal, sane people want to revert back to the old days, before modern medicine; when too many women died in childbirth, high infant mortality was normal, and the average life expectancy was half of what it is today? Does the koolaid taste that good?
PEOPLE, PLEASE STOP LISTENING TO YOUR LOCAL HIPPIE FRIEND THAT SPEAKS AS SHE KNOWS A LOT ABOUT HEALTH. THIS NEW MISHIGAZ OF GOING BACK TO NATURE IS NOTHING ELSE BUT A GOYSHE TREND. IT HAS NOTHING TO DO WITH REAL YIDESHKEIT THAT ALWAYS WALKED HAND IN HAND WITH DOCTORS, SPECIALISTS AND LATEST TECHNOLOGIES TO DEAL WITH HEALTH RELATED SITUATIONS.
Its not a botched home birth. A woman being transferred mid labor is not a sign of a mess up. It’s a sign that they have decided based on symptoms that there might be a risk of some sort and to go to a hospital to take care of it. Just like if a woman were laboring in the hospital and the nurses decided based on symptoms to call the doctor… In both situations it takes a few minutes for the help to come ( in the hospital it will probably be quicker, which is why most choose hospital over… Read more »
On the contrary, a laboring woman put herself at an OVER THIRTY PERCENT c-section risk just by walking in to a hospital to give birth. And that’s just one of the terrible risks.
Homebirth should be viewed the same as abortions are. People are doing it anyway, so the sensible thing to do would be to establish standards of care, to make it safe as possible. It would be similar to certain countries abroad where midwives must work in groups, may not deliver women with certain small risk factors at home, and must have delivery rights in a hospital – all of these which are currently not necessary in NY. Another thing to do would be to set up mom and baby friendly hospitals in Brooklyn. There are a couple in Manhattan but… Read more »
I think it’s due time hatzolah speaks out about all the “botched homebirths” they’re called to deal with that never gets spoker about!
No matter how adamant home birthers are. Nothing can replace a modern american hospital loaded with state of the art facilities. A homebirthing nurse doesn’t have a CT scan machine , an MRI machine, she has no way of doing a C-section if necessary.
I would argue that NOT going to a hospital to give birth is a breach of your responsibilities as a parent and CONTRAVENES Halacha.
When you have the facilities available to prevent terrible tragedies, and you don’t use those facilities – shame on you
You took the words right out of my mouth. Could you please write up a full post To make it more official.
Also so many people talk about “what if there is an emergency”.how many people do they know, that had a planned home birth, had an emergency?
Birth can be risky, in homes, birth centers and hospitals. By being an educated consumer and knowing the questions to ask your doctor or midwife you can help to minimize risks to yourself and your baby. Understand that statistics can be manipulated to support the agenda of the author of any published article. The author did not give the references for the articles, but I was able to find one of them, which lumped all home births together. This would include unplanned home births, planned home births with no provider (unassisted), planned home birth with a non-licensed provider or midwife,… Read more »
You asked about doulas carrying monitoring equipment. To clarify, a doula is a birth assistant trained in providing comfort for the laboring woman, not administering medical care. Doulas perform massage, suggest positions and many use herbs as well. They understand the physiological process of birth and are trained in emergency birth as well. Doulas are helpful for women in all settings, especially hospitals where women need an advocate as well! Homebirth midwives in the state of NY are legally allowed to provide pregnancy, birth, and postpartum care and carry medical equipment, including monitoring equipment (either Doppler or fetuscope) as well… Read more »
I wouldn’t be here today if I was born at home.
Thank you mom for choosing to have me in a hospital.
I had 3 uncomplicated births. My 4th was proceeding normally until an unforeseen emergency. My child is only alive because I was in a hospital.I then had 2 more normal births. I don’t choose the hospital for the smooth births but for the unknown emergencies. I need to do everything possible for my children. BH for hospitals and my 6 children instead of 5.
The last comment is the truth! A hospital should be set up to have a warm inviting atmosphere! Then you have the best of both!!! Having a baby is a Bracha -we say tehillim at a wedding too! These are blessings and if you are blessed to find a wonderful doctor who will “listen ” to you and respect your needs -then you are in the best situation! Tho women gave birth at home years ago etc-still for the just in case if u can b In a good place-or hospital setting that has birthing centers/rooms!! Count yourself to have… Read more »
To presume that every woman who is having a planned home birth is choosing to do so without a qualified midwife with her. In addition, if we got to peek into hospital rooms we would get to see the equal if not higher amount of emergencies that are quietly dealt with without having to call hatzalah. If we put Hatzalah into a hospital to respond to the birthing emergencies then they can talk. In addition, a traumatized, exhausted and scarred mother is no use to anyone post-partum where as a calm, supported and comfortable one can recover more quickly. Someone… Read more »
For homebirthers to persist in their dangerous and selfish attitudes in the face of incontrovertible medical evidence is almost criminal. Homebirthers: this isn’t about you. It is about your babies. No one is saying that a home birth is not more comfortable and reassuring for you. It may well be. But that does not allow you to compromise on what is best for the baby. We must stop this madness.Homebirth carries the same dangers as non-vaccination, but they share that same stubborn and ignorant embrace by its advocates. It is time that the frum community realize that medicine and science… Read more »
RE: Birthing centers…. Not all hospitals have them. What I refer to is a separate area within the hospital (not your usual labor/delivery room) with rooms/suites that are very pleasant . Think upscale motel. This is where you stay the whole time. Labor is here, delivery is here & afterwards, thei infant stays here with Mom. Depending on hospital policy, family can be present for the birth . You are not shuffled about and the enviorment is warm & welcoming. Look to see if your hospital offers such.
As a nurse myself, and a happy homebirther, I am very well aware of the risks associated with each setting and even more aware of the complications that arise because of unnecessary interventions performed in the hospital setting which escalate rates of assisted/cesarean deliveries. There are studies which compare maternal and neonatal outcomes of low-risk pregnancies who chose to deliver in the hospital and at home. The overall neonatal outcomes were comparable or in favor of home birth in this low risk population, and the interventions were greatly reduced at home. I find this Dr’s approach to birth very biased… Read more »
1. where is this assumption that women are choosing home birth for their own comfort? the vast majority of women who choose to homebirth do so for the SAFETY of their baby. There are numerous, sound studies that prove that home birth, for a regular low-risk birth, is safer than a hospital birth.
2. Look around the world. Look at the rest of the developed world and see that home births and midwife births are utilized much more than they are in America, with excellent results and lower neonatal death rates.
As a nurse for many years(not in OB) I am amazed by the ignorance some of you display.Yes,the MDs are out to get you and then force people to have c-sections.Yes the nurses are cruel and ignore you.The hospitals are very scary places-that is until you or your loved one needs one.How much schooling did you have that makes you holistic experts and pharmacology mavens?Any of you been treated for paranoia?Do whatever you want at your own risk but stop knocking doctors.They have to treat nutsos like some of you!
don’t be foolish. midwives come with plenty of emergency equipment to their patient’s home. we’re not idiots. homebirthers have done their research way more than hospital birthers.
in addition, a huge percentage of the “problems” and “emergencies” that happen are CAUSED by the dumb interventions done in the hospital. If the hospital staff would leave the women alone instead of trying to control everything, so many of the problems wouldn’t happen to begin with.
I dont live in New York and i must say my birthing experience in the hospital here is wonderful the nurses really care and are available 24/7. There are showers available during labor and you can request a room with a bathtub when you arrive in labor. They don’t push epidural unless you request it. So i dont knownhow you would choose the risk of a home birth over that.
A women is actually in a sakana during birth; hence, you can say tehillim for her. In case of an emergency, a doctor can do a C-Section in a hospital, but not in at home! I know of a case where a child was severely brain damaged at a home birth. I know if another child who was BH saved since the mom had a C-Section once they saw that the cord was wrapped around baby’s neck.
Some people argue that they are not sick when giving birth. I beg to differ; why else would you say tehillim for them?
It sounds so nice and rosy, until G-d forbid there is an emergency. Every second makes a difference in the outcome. And then it is too late…By the time you get to the hospital to be treated properly You are left with a handicapped baby, or none – rachmana litzlan. Why would someone in their right mind take this chance, when we have hospitals with good Doctors and state of the art medical equipment (oxygen…)????
Do home birth doulas usually come with heart monitors to see if the heat rate is going up (or staying up)?
Please don’t mix the Rebbe into your Dangerous stupidity
If you have insurance and go to a decent hospital, you should be able to implement the majority of your birth plan in a hospital. Even if they get a bit annoyed. (by the way, packing some chocolates for the nursing staff in your hospital bag might not be such a bad idea). Tell the staff what you want, eg. A private room, without traffic, to be able to move feely around, to wear your own clothes (just give permission for them to be cut in an emergency) Chassidishe niggunim music etc. You can put up pictures etc There should… Read more »
As much as u think u could have a home birth
Dr petrikovsky saved my life 4 times
Doesn’t jump to c sections
Even being @ a hospital wt the best as dr petrikovsky
So why take a risk
U could have ur baby af the hospital naturally
A person couid be in danger
For those that say that hospitals are close by – so it’s safe to have a home birth…..I had a situation after giving birth where every second for my baby counted. It was a typical pregnancy & birth – what would happen if I was home?
I have a family member who has permanent neurological sequale do to loss of oxygen at a home birth. Cleary could have been prevented in any average US hospital. I don’t think you will change these religious homebirthing zelouts but at least they were warned the risks and the more level headed ones will rethink it . Before placing themselves and the inocent baby on danger.
Unfortunately, I cannot even tell you how many times I responded on a call to find a 1-7 day old baby in need of emergency (sometimes life threatening) transport to a hospital due to complications that arose from something that was overlooked by the midwife or lack of professional hospital care after the midwife left.
are you 100% sure how healthy you are? today we are drinking toxics city water,is your water filter with top quality filters,truthfully just a filter without distiller is half a job, are you up to date with your nutrition in take,l use a holistic nutrition,she’s can tell what you need without a blood test,but still you should have them anyway,it’s not a joke today,we are very likely to have a little to much of one vit,min and a little less of another,our body do go through stress,it’s a balancing act,then again using the swiss methrod is a good choise,anyone interested… Read more »
How do they compare to home births and hospital births?
It sounds so nice and rosy, until G-d forbid there is an emergency. Every second makes a difference in the outcome. And then it is too late…By the time you get to the hospital to be treated properly You are left with a handicapped baby, or none – rachmana litzlan. Why would someone in their right mind take this chance, when we have hospitals with good Doctors and state of the art medical equipment (oxygen…)????
It’s very telling how some commenters are utterly contemptuous of a woman’s need for comfort and reassurance during labor. Women DO NOT need to put up with rude and obnoxious treatment during labor or postpartum. There is absolutely no excuse for such treatment in any hospital and it is these conditions which drive people away from hospitals towards home birth. We won’t talk about women who put their babies at risk by medicating themselves during labor. Do you ever wonder why the epidural rates in the hospital are so high? Because take away from a woman every possibility of using… Read more »
can you please give a source for your comment?
Why don’t you ask hatzolah for the number of botched up deliveries that happened in crown heights these past 12 months during home births!
Actually he’s a high risk OB so he doesn’t need to pander. If you are high risk, you’re not going to do a home birth anyways.
I had 2 unnecessary c sections, and my wonderful OB, Dr A Weinreb told to me to my face during my 6 week check up. Because of his obsession with putting women under the knife, so he can eat melave malka with his family is making women more and more less trusting of docs and hospitals. I’m not advocating for home births, but I do say take OB’s have the highest amount of Malpractice insurance for a reason: when they interfere with what Hashem created to be the most normal, natural thing in the world, they make problems happen. Do… Read more »
Risk your own life but not your child. Give birth near the best ICU and then go home. How many close calls or maternal or infants deaths will it take. I would make home births illegal. Women used to give birth in the field also.
I’m fine emotionally in the hospital. I don’t need to be home to feel safe. Medical wording, a beeping machine, a different smell, a not comfortable pillow are all not a reason to panic. Hashem does his miracles in the hospital too. I’ve accepted long ago that I can”t control life and it’s ok. And I as a bonus, i don’t make a mess in my house and there’s someone on staff to disinfect the bathroom. P.s. I would imagine that one complicated home birth transfer (which just got more complicated due to the wait to get to the hospital)… Read more »
How do they compare to home births and hospital births?
And that is the bottom line of these misguided homebirth fanatics. They are willing to risk their life as well as the life of their infant baby for the emotional part of having a baby in the comforts of their own home. People make such a big deal about their “birth plan.” Labor and delivery never goes as planned. Better be prepared for anything in a proper facility than suffer horrible repercussions at home.
Hospitals have their own heavy set of risks and dangers. But it is easier for doctors to have all the women convene in one germ-ridden place than to go hopping from house to house at the patients’ convenience.
Thanks for taking the time to put this together. So many people just don’t know the risks of home birth…and so many things have to go right during a birth for the mom and baby to be safe. Why take that risk?! So that for one or maybe 2days of your life you are a little more than comfortable? Being in labor is not comfortable anywhere!
Individuals are entitled to their beliefs too, based on their own lifes’ experiences. Doctors are not the beginning and end of all opinions. Shut up and let us live our lives. We don’t want nor need to be ruled by MDs.
Sorry doc, you keep mentioning “scientific evidence” but yet to demonstrate how how births are more dangerous.
I’m so surprised that studies funded by gynecologists support their own beliefs. I must say I was totally shocked!
Can you stop the propaganda please!
Said that only because a child isn’t born in a jewish home did they start putting shir hamaloes. A normal ideal situation is a child born into it’s Jewishhome with sefarim and tehilim being said. Most drs don’t deliver children in hospitals, the midwife does. Medical mistakes kill over 400,000 people a year. Drs have an invested intrest in preventing home births since crown heights has one of the largest homebirth populations. There are enough hospitals near by if something did go wrong. A birthing center is always a second option that was made so you can still stand and… Read more »
How many of those 5,000 births were natural? I ask because as a woman who chooses home birth wife education and without any complications during pregnancy, I avoid Ob/Gyn’s like this guy. Say what you will, the people who choose to have home births and the women who choose to have hospital births probably won’t change. He’s just preaching to his own peanut gallery, no offense intended.
As a nurse, I totally agree. A home does not have the equipment for dealing with an unforeseen/unexpected (yes, they do happen) emergency. Even if you have had previous home births, it doesn’t mean the next one will be uneventful. I’d suggest utilizing your midwife in a patient friendly hospital birthing center. If necessary, medical help is steps away. One infant lost is too many!