Most people inherently think that giving birth in a hospital is the safest option for childbirth. But did you know that United States hospitals are THE most dangerous place to give birth in the developed world? Every year more than 50,000 women are severely injured and about 700 women die in American hospitals due to childbirth complications. Many are either preventable or nosocomial (complications caused by the hospital environment). That equals 26.4 maternal deaths per 100,000 births reported in 2015. In 1990, about 17 maternal deaths were recorded for every 100,000 pregnancy. This indicated the numbers are rising every year and not improving. This information comes out out of the Global Burden of Disease 2015 Maternal Mortality study published in The Lancet medical journal, which looked at maternal mortality rates from 1990 – 2015.
What is even more surprising is that these numbers are increasing in the United States when other developed countries are decreasing their rates. And this is not even touching upon infant mortality rates. In 2017 the CDC reported 3,855,500 births 23,161 of those births resulted in a neonatal death which translates into 587.0 neonatal deaths per 100,000 births! The majority of these deaths are congenital abnormalities, preterm birth, and listed under unknown causes.
These numbers are astronomical. These numbers don’t speak to the countless of more minor injuries mothers and babies face in a hospital setting. Our national average for cesarean section is 32% when the World Health Organization’s research suggests the data for cesarean section rate world wide should rest somewhere around 10-15%. Infection rates run particularly high in hospital settings. According to the CDC an estimated 1 in 25 hospitalized patients in the United States will acquire a healthcare acquired infection (HAI).
Furthermore, what is even more shocking about these statistics is that if you are a woman of color you have a two to four times higher risk than a white women for maternal and infant mortality!
This is Not Just a Public Health Emergency – It Is A Human Rights Crisis.
Why is this happening? One of the reasons is that birth has become over medicalized in the United States. We have been misinformed about what are safe practices for labor and birth. While good quality prenatal care is key to a healthy birth, relaying solely on the medical model of care to guide you through the process of labor and birth may not always work in favor of a woman’s best interest. Obstetrical care often entails a process of intervention even with a woman’s most trusted caregivers.
Research shows that widespread adoption of midwife-directed care could alleviate, many if not, all these problems. News from the University of British Columbia research 2014-2015 ranking of US integration of midwifery care: Midwife-friendly laws and regulations tend to coincide with lower rates of premature births, cesarean deliveries and newborn deaths, according to a U.S.-wide “report card” that ranks each of the 50 states on the quality of their maternity care.
In many other developed countries, such as the U.K., France, Canada, and Australia, midwifery is at least as common as care by obstetricians. Thus, for women with low-risk pregnancies who wish to deliver vaginally, it often makes sense to employ a midwife rather than a more costly surgeon. Yet only about 8 percent of U.S. births are attended by midwives. Why has midwifery not been more successful? The problem stems from America’s fraught relationship with midwifery and home birth. Once a staple of American society, by the 20th century both midwives and home birth were portrayed by organized medicine and the media as outdated and potentially dangerous. America’s aversion to midwifery began in the late 1800s, when the advent of germ theory and anesthesia reduced much of the danger and discomfort associated with childbirth. Why would anyone endure the pain of childbirth at home with a midwife when they could have a painless experience in the sterile environment of a hospital under the care of a trained obstetrician? The benefits of these technologies brought doctors to the forefront of maternity care and pushed midwives aside. Obstetricians helped to bar midwives from practicing in hospitals, which were now considered the safest birth settings. By the early 1960s midwifery was virtually obsolete. This assumption that midwives are a relic of the past rather than part of an integrated health-care system of the future has had a profound effect on 21st-century attitudes toward birth, as well as on the health of millions of women and new babies each year.
If you are a healthy woman having a healthy pregnancy and are low risk for things like high blood pressure or obesity, my wish for you is to consider an out-of-hospital birth. Having been a birth attendant for the past 10 years both in and out of hospital my best advise to you is to avoid the hospital unless you have a medical reason for going there to give birth. The midwifery model-of-care is much more compassionate and often along the lines of care a woman most desires during their pregnancy anyways. The standard prenatal testing offered is the same as what an obstetrician can offer. A midwife who specializes in out-of-hospital birth will screen you and your baby throughout pregnancy and constantly access if you are a good candidate for a home or birthing center birth. This is not to say that there is not a time and a place to seek out a hospital birth or the medical model of care as defined in the U.S. *High risk pregnancies and certain conditions are not good candidates for out-of-hospital birth; and, thus the need for medical management of your birth becomes more necessary.
