added clarification on home birth -- see also Clarification on our homebirth decision ... and Birth story of Peter

The medical community wants you to think that your average birth is a high risk thing that requires medical intervention. For your safety and dollar you should be going to them, asking no questions and going about your happy way. But it isn't that simple ...

I think its telling that forty percent of children in the Netherlands are STILL born at home and that infant mortality rates are better there than in the US. Well then ... maybe we should have babies at home? Not so fast. In this country, I question the home birth movement as well. I do not think its their fault. I am VERY sympathetic to their cause. The system here is setup to ensure great difficulty in operation of home birth based midwives. The required channels for its safety simply are not there in many locations. Still, I am told "its as safe as hospital birth" as if we live in a place, like the Netherlands, where the infrastructure to support that assertion DOES exist. It is very true that laws and regulations need to change and that needs to come from government at the state level. Sadly, in Louisiana, that task will be daunting.

That said, I am by no means proposing socialized medicine. I think things can be done that do not require a hands on approach from the state. In the US we have gone down the wrong path in terms of birthing for a LONG time. In the end women and children pay. I favor policies that result in an increased number of freestanding birth centers next to hospitals which specialize in emergency care. We need a sensible midwifery system that works WITH doctors and not as opposing forces vying for the same "market share". I want to clarify, lest I be misunderstood as thinking midwives are the non-sensible ones: I want an environment that is better suited for home birth. I want laws passed that will require doctors to back-up midwives (like in the UK). We also need insurance incentives that reward women for choosing the less expensive natural route over going to the hospital. If you want a lower deductible then YOU can choose to pay the higher premiums. If you elect to go to a hospital your deductible for maternity is increased by like $1500. A birth at a freestanding birth center costs nearly half that of a hospital birth. If a section is involved which at a local hospital is 50-60% of the time these days, then double it again. I also favor some sort of legal reform. I read recently that nearly every other birth in our city results in legal action. I hardly believe it but I have known doctors to quit practicing BECAUSE of the increase in litigation so I know its high. If that stat is even half true, it is absurd. Every friction we have encountered with our children was a decision being made because of possible litigation outcomes. So, you might think I am down on the doctors. Actually, I am not. I realize that the legal climate has resulted in this course. That is why I favor changes in the laws. I also think that there is an air of distrust between doctors and midwives that I think everyone should just get over. Is it true that market share and financial interests might be driving that? Likely. I don't want to concede market share to other companies in my career. I understand that motivation. Then again, moms matter. Kids matter. Birthing matters. It seems their goals are the same and in a truly altruistic world people would work together when their goals are identical.

In this country we have a system that makes sure the most possible money changes hands, pads incomes, gets people home at 5pm and results in the lowest possibility of successful legal action. Those goals are almost never consistent with the BEST practices for the health and safety of mom and baby. I realize its a complicated problem that needs reform. I don't have the answers. Still, I can clearly see that something needs to be done.