My Turn: Alternatives to alternatives

Posted: Sunday, March 02, 2003

In a recent "My Turn" article entitled, "Experiencing Home Birth," the author eloquently summarized the powerful experience of childbirth. Unfortunately, she also perpetuated some misconceptions about hospital-based birthing experiences, especially here in Juneau.

The author portrayed hospital birthing centers such as the one at Bartlett Regional Hospital as operating from the "dominant medical emergency model." True, 30 years ago hospitals and physicians operated from this model. Nowadays, many hospitals, similar to birthing centers, have realized the benefit of a family-centered birthing model. Under this model, emphasis is placed on childbirth education and empowering parents to be involved in the birth process. Personalized birth experiences, which foster early family bonding are developed with families. Non-pharmacological birthing techniques are taught to mothers. After childbirth, new mothers are encouraged to breastfeed whenever possible and offered expert help if there are problems with breastfeeding. Bartlett, with its team of dedicated childbirth educators, nurses and lactation consultants, is at the forefront of this family-centered birthing movement.

After reading accounts of beautiful home birth experiences, one may wonder why consider a hospital-based birth? Some people feel that families have hospital-based births because they would like access to drugs and epidurals. This is not the case. Most families who choose a hospital birth do so because they feel it is a safer place to have a child. Studies in this country have supported this notion. For example, in a recent study in the State of Washington comparing 7,000 low-risk home births with a similar number of hospital births, the risk of neonatal death and poor five-minute Apgar scores (a predictor of neonatal neurologic damage) was twice as high in home births as in hospital births. Furthermore, the risk of postpartum hemorrhage for moms having their first baby was 2.5 times higher for home birth moms than for those moms who had hospital births.

My reason for offering a different perspective on hospital-based births in Juneau is three fold: First, I wanted to explain to the public some reasons why a hospital birth is a great choice. Second, I wanted to support and validate those families who choose a hospital birth. Last, for families who choose an out-of-hospital birth experience, we want to assure you that if the need arises and you have to come to the hospital, you will receive quality family-centered obstetrical care.

Lindy Jones is a family physician at Valley Medical Care who has been involved in childbirth at Bartlett for more than 10 years. Reprints from the study mentioned above are available from the author.

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