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    Bringing Out Baby ... at Home

    Home Delivery
    WebMD Feature

    May 28, 2001 -- "Having my baby at home was beautiful, inspiring, awesome!" says Jo Anne Lindberg. "I had complete freedom of movement and absolute choice in everything I wanted to do."

    Lindberg actually went to the movies during early labor, and then safely delivered a 9 1/2 pound son at home. "It was a lot of work, but no pain," she says.

    Being able to relax in a familiar, comfortable environment surrounded by those you love decreases anxiety, which in turn decreases pain and lets your body do its job, she explains.

    As president and founder of Birthlink in Chicago, a free referral service for expectant parents considering home birth, Lindberg often refers women to Penny Shelton, MD, MPH, a general practitioner with HomeFirst, a group that has safely delivered more than 15,000 babies at home.

    "Giving birth at home supports the normal physiology better," Shelton tells WebMD. "We're treating it as a normal part of life instead of a medical condition." Studies have shown that women who feel anxious or stressed release more adrenaline, a hormone that interferes with labor, she explains.

    Not for Everyone

    But home birth is not for everyone. Shelton says that women with uncontrolled diabetes, chronic high blood pressure, or a condition called toxemia (also known as preeclampsia) should deliver in the hospital. If labor begins before 37 weeks in a woman who's already given birth, or before 38 weeks in a first-time mom, it's safer to go to the hospital.

    And if the father does not fully support the mother's decision to give birth at home, Shelton also recommends against it.

    In the absence of these complications, home birth is typically safe, provided there are enough trained hands on board. Shelton prefers to work with a team that includes a midwife and nurse, but acknowledges that some well-trained certified midwives are capable of delivering without the assistance of a physician.

    "Most physicians and nurse midwives are unwilling to attend home births," Martin A. Monto, PhD, chair of social and behavioral sciences at the University of Portland in Oregon, tells WebMD. He explains that most home births are attended by "direct entry" or "lay" midwives who learn through apprenticeship rather than through conventional medical training.

    Their training may include skills not traditionally taught at medical or nursing school, such as gentle stretching of the tissues surrounding the birth canal to avoid having to surgically cut the tissue to allow the baby's head to pass through, a procedure called an episiotomy. Direct entry midwifery is illegal in some states, he says.

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