The Safety of Home Birth – New Study of 530,000 Women

A recent study in the Netherlands, a country known for it’s fantastic maternal and infant outcomes, has proven that home birth is safe.  It is the largest study of it’s kind and found that low-risk women planning to give birth at home had as good outcomes as low-risk women birthing in the hospital.

Check it out!

Home births ‘as safe as hospital’

Newborn baby

There have been few comprehensive studies into home births

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study – published in the journal BJOG – but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.


It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of “low-risk” women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

“We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife,” said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

“These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth.”

Hospital transfer

Low-risk women in the study were those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose – including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.

The NHS is simply not set up to meet the potential demand for home births
Louise Silverton
Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background – the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

“However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

“There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

Mary Newburn, of the National Childbirth Trust, said: “This makes a significant contribution to the growing body of reassuring evidence that suggests offering women a choice of place of birth is entirely appropriate.”

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births “in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: “Women need to be counselled on the unexpected emergencies – such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage – which can arise during labour and can only be managed in a maternity hospital.

“Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home.”

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: “All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies.”

Trying my hand at belly casts…

I also am able to paint your blank belly cast to something meaningful to you!  I have a BFA in illustration and use it to work with you and your vision for the cast.


1.  All over color (you can add more decorations yourself if you’d like): $50

2.  All over color plus a simple design on the belly:  $100-175

3.  All over color plus a mural of your choice:  $175 and up

For #2 and #3 the fee is $40 an hour plus materials.

To give you an idea of how long things cost, the below “Tree of Life” mural took 26.5 hours to complete plus $30 in materials.  This is a very elaborate piece, the most elaborate I’ve ever done, and is on the more expensive end of the spectrum.  The second cast (blue with the vines) took me about 10 hours plus $30 of materials.  These represent the middle and high-end of the range.   Contact me and I can definitely create something within your budget!

The first cast is Brandy’s cast.  She wanted to incorporate a tree of life, sparrows, a “mother” symbol, her son’s zodiac symbol (Cancer), a labyrinth (which turned into a beautiful placenta), and a mandala.

View my process!  Click here to see a slide show of the cast going from blank to decorated.











The birds are the Jamaican doctor birds, a hummingbird with a really long tail.  This baby is half-Jamaican and mama wanted to add something from that country (also the Rasta colors and blue like the Carribbean)

Jamie with her henna belly

Jamie with her henna belly

Fear Not

I’m reading theredtentcoverThe Red Tent and cried when I read the song sung by the midwives to the women in labor.

Fear Not

“Fear not, the time is coming
Fear not, your bones are strong
Fear not, help is nearby
Fear not, Gula* is nearby
Fear not, the baby is at the door
Fear not, he will live to bring you honor
Fear not, the hands of the midwife are clever
Fear not, the earth is beneath you
Fear not, we have water and salt
Fear not, little mother
Fear not, Mother of us all”

*Gula is the Babylonian goddess of healing, breath of life

I’m Certified!

I’m certified!!  (or certifiable, depending on how you look at it 😉 )

My certification through CAPPAt came through yesterday and I’m so excited!  It’s nice to have the formality out of the way.  Basking in the glow…

You know you’re a doula when…

I’ve started a fun little game on my doula group where we come up with the funniest “You know you’re a doula when…” quotes.  I’ll try and keep adding them as they come up!

You know you’re a doula when

You misread “Pasta Primavera” as “pasta primapara.”

You carry more supplies and luggage to a birth than you do when you go on vacation.

You watch births on TV shows and can’t help but talk to the television the entire time. “See, you shoulda had a doula!” “Stop counting to ten with each push.  She knows how to push!” “WHY are they doing THAT??”

While watching “A Baby’s Story” with your ten year old son, he rolls his eyes and says “not another epidural!”

You watch a professional basketball game on TV, see all those shaved heads as caputs, and speculate as to their presentation at birth.

You spend hours each day on the computer, yet when someone mentions they are in an “LDR”, you first think of “Labor and Delivery Room”. Not a long distance relationship.

You rejoice at the following – swearing, vomiting, pooping on the bed, nausea, gas, belching – let’s see did I leave anything out? and think “Cool! We’re getting close!”

You can see a woman vomit, urinate, defecate, spray amniotic fluid while in labor, or have a cesarean without a second thought.

You check on your kids in the middle of the night and your three year old mumbles “Did her water break?”

My daughter pumping

My daughter pumping

When your daughter’s boyfriend knows what effacement is.

Your kids tell their friends that Mommy had another baby and was up all night.

Your children think all pregnant ladies know you.

Your children know more about birth than most women who have given birth to 3 babies.

Your seven-year-old son refuses to marry anyone who won’t birth at home.

Your son is doing a great job learning to read but cant figure out why the teacher keeps talking about contractions.

Your 16 year old takes a child development class in high school and knows more that the teacher about birth, breastfeeding and parenting.

You unconsciously think “Labor Pool” is a water-filled tub for a woman to lay in while having her baby, not a group of workers.

Your child wakes you up in the middle of the night and you mumble, “How far apart are they?”

You live for the times someone says, “A doula? What’s that?”

You and your family think it’s totally normal to discuss 1st, 2nd, 3rd & 4th degree episiotomies over dinner… you explain what a placenta looked like over spaghetti… heck you even discuss placental abruptions and calcifications over a roast beef.

You’ve been in bed with more women than you care to admit in mixed company.

You’ve touched more breasts than you care to admit in mixed company.

You have more pictures and videos containing naked women in your home than the porno shop downtown.

You pack and repack your birth bag 3 times, check the on off switch on your pager/cell phone 5 times and go to bed with your clothes on… on a hunch…and you get called three hours later.

Your client snaps at you and you think: “Oh good, she’s not smiling anymore!”

When your spouse knows to ask three questions: Are you in labor? If no, Is this an emergency? Would you like her to call you back later or do you want her cell phone number?

You hubby asked was it a girl or a boy and rolls over and goes back to sleep.

The guy at the photo shop passes out while developing your film.

Although you do poorly in math, you can instantly calculate how much more weight the birth ball can hold.

Your client is nearing her due date and you become fascinated by what she sees when she wipes and how soft her bowel movements are.

Your teenagers answer the phone and start by saying “how far apart are the contractions?”

You see a metal mixing bowl in a store and think “placenta”.

Or…you see a metal mixing bowl and think “vomit”.

When while everyone else in the room is yelling and counting, “hold your breath, chin down, no noise, 1, 2, 3, pushhhhhhhhh harder harder.” You are the only one in the room whispering in the moms ear “listen to your body, you are doing such a great job, look down, push your baby out, just like that, You are sooooooooo awesome!”

You’re so exhausted you could weep, you haven’t gone pee for 9 hours even though your bladder’s bursting, you’ve just wiped poo from someone’s backside, you have flecks of blood and vomit on your shoes, but there is still no place in the world you’d rather be.

You know you’re a doula when PROM doesn’t make you think of high school. (me)

You know your a doula when your 5 year old tells another child “No your baby brother isn’t growing in your mommy’s tummy. He is in her UTERUS. Mommies don’t eat the babies!” (Desirre)

You know you’re a doula when you overhear your husband explaining to another man how to watch a woman’s behavior for dilation during labor.  (Nicole Yingling)

You know you’re a Doula When, your 5 year old Son wants to be an OB cause what mommy does is so cool, but he’s convinced that Doulas have to be girls. Even though I’ve NEVER ever told him Doulas have to be girls.  (Sara)

Site of the Week!!

I’m proud to announce that this website has earned Denver Color’s “Site of the Week” for the first week in January!  I didn’t even know it until I googled myself (which is quite entertaining!).  It’s just nice that they wrote up a fabulous little blurb about doulas.

Check it out…

SITE OF THE WEEK – FOR 2009-01-01

Birthing Body – Gentle Birth Services

To bring in the New Year, I thought I would declare a doula web site as the Site of the Week for New Year’s day 2009.

A doula is a person trained in the birthing process who works closely with a mother and her healthcare provider to help assure a happy, healthy birth. The doula works for the mother and serves as the mother’s advocate. The ideal held by the doula community is that the mother, in consultation with a primary care provider, makes all of the important decisions. Any doula worth her salt will support the choice of birth location: hospital, birthing centers or home.

Likewise, doulas are trained to be supportive of the OB-GYNs when a c-section is necessary. The point of a supporting role is to help people make the best decision. The data seems to show that the involvement of a doula dramatically decreases the number of c-sections without increasing the risk to mother or child. The goal of the doula is to empower the mother with information and support in making the best decision.

Quite frankly, I believe that this model being worked out in the doula community would be a good model for the health care industry at large. I have a great deal of respect for the highly trained doctors and nurses in the health care system. Unfortunately, the industrial nature of modern health care seems to have blunted its humanity. I think it would be wonderful if we all had doula-like advocates to help us interface with the health care system.

Soap box aside, the site of the week is Birthing Body by Amy Swagman who offers doula services in the Denver area. The site has a quick run down of Amy’s qualifications and services.

A quick word of warning. If you use Amy’s doula services, she is likely to paint a henna picture on your belly.

Haven’s Birth Story

image-3931619-36010647-2-websmall_0_973cdad2124a93d7966fe00319df7663_1I started having contractions every 8 minutes apart from 3pm on Saturday.  I was at the Rigpa Center in Boulder so I had my husband come and pick me up while I took a walk to see if the contractions would go away.  They continued a bit into the evening, then eased up before I went to bed.  The next day when I woke up they were 5 minutes apart for close to two hours.  I also expelled my mucous plug which was exciting and a little scary!

I debated whether to call the doctor and decided against it.  Instead Kyle and I went to Chipotle for lunch and had my car cleaned.  We were planning to go back to Boulder and go for a hike then bring Kyle’s car back, but decided against it when the contractions didn’t ease up.  So we went home and I took a nap and rested on the couch.

About 1 am we tried to lay down to sleep but ended up talking about the baby for a few hours.  It’s so hard to rest when you think you might be in labor and might have a baby soon!  I was getting annoyed that everything was starting and stopping and starting and started jumping up and down to get things going again.  Still restless I tried to wind down and take a bath for an hour.  Towards then end my contractions shot up to 5 minutes apart again for a few hours.

image-3931619-35797336-2-websmall_0_dd0f5a04af6e73346ed777299ec88556_1At 4:30 am we called the doctor and he told us to come down to the hospital.  We called our doula, Karen Voss, and told her we were on our way and she came to meet us at the hospital.  It was such a warm beautiful night for February!  Everything was so still and peaceful as we drove to the hospital.  It was hard dealing with the contractions in the car though.

We arrived at the hospital at about 5:30 am and already I was pretty exhausted.  We waited around with our doula until our doctor came and examined me around 9 am.  He told me I was 80% effaced and 2-3 cm dilated at about -1/0 station (so I was already carrying her a little low).  Then he said, “I think you’re probably in labor.”  In hindsight I think we went to the hospital way too early.  We had never been through this before and didn’t know that I was still in early labor and not very active yet.  But we thought we had come to the hospital when they had told us to (5 minutes apart, 1 minute long, for 1 hour)

That’s when we started calling friends and family to tell them baby was on her way!  My mom came over as soon as she heard and waited in the waiting room (per my request).  Meanwhile, Kyle and I were making laps around the maternity floor.  I would always stop at the nursery to keep things in perspective!

Whenever I had a contraction I would lean over a rail and groan while Kyle rubbed my back and Karen put warm compresses on my lower back.  Periodically we would go back to the room to get checked but it seemed like I was dilating slowly.  I think the move to the hospital had disrupted the flow of my labor a bit.  It took a while (like 12 hours) to get back into a good rhythm.

image-3931619-35797175-2-websmall_0_475a1dedcbeb022089418d1a3ad9391f_1When contractions got stronger I got into the jacuzzi and was able to rest for a while (what I wouldn’t have done for a nice long nap!).  Karen fed me some (illegal) trail mix and juice to help me keep up my energy.  (Sidenote:  Decades of research have found that it is better for a laboring woman to eat and drink on her own during labor as she feels comfortable, than to fast or be given a routine IV)  When I wasn’t in the tub I was sitting on the birth ball rolling around and looking out the window.  I really wanted to go outside and walk, it was such a nice day, but they wouldn’t allow it.

I got back in the tub around 2 pm on my hands and knees during contractions.  Then I felt a gush and said “Um, I think my water just broke…..but it might have been a jet???”  I stood up and was still leaking so yes, it had broken.  It was a pretty high tear because the fluid would trickle out intermittently.  After that, much to my dismay, my doctor wouldn’t let me get back into the tub because of an antiquated view of infection. (Sidenote:  Some babies, if the bag is left alone, will be born in the sac or “in the caul.” Water birth, when used appropriately, has no increased risk for infection or aspiration of water by the baby)

I also had a bit of bloody show and was dilated to 4 cm.  Afterwards the contractions really started spiking and coming frequently, mostly when I was getting checked which was horrible or when I had to go to the bathroom.  It was so hard to maintain any sense of normal body functions.

I had a few visitors off and on but mostly it was Kyle and I and Karen.  Kyle was absolutely wonderful, so intuitive, relaxed, calming, nurturing, supportive, and encouraging.  Everyone was so impressed with him!  I never could have done it without him!

image-3931619-35797411-2-websmall_0_84d799ea46ebfcd93e06f09e717ab013_1Despite that, the contractions were getting incredibly strong and it was harder and harder to keep focus.  We hadn’t had any sleep for more than two days and spotty sleep before that with days of early labor.  We started talking about other options and I decided to have a little fentonyl to take the edge off and try and regain my composure.  But after it wore off my body had stopped making natural endorphines (they were replaced by the narcotic) and I was right back where I was before.

I had been stuck at 6 cms for such a long time and was completely exhausted.  Slower dilation is pretty common for first time moms, but after Haven was born we would discover what was taking so long.  I really needed to rest so I decided to get an epidural.  Afterwards I felt better and was able to relax a bit.  I had some visitors and snuggled with Kyle.  The two of us took a much-needed hour long nap.  As far as epidurals go, I didn’t have a bad one.  I could still feel the contractions but they were more round, less jagged, and I could still feel the pressure.

As the baby moved down I could feel more pain and pressure so they upped my dose of medication with the epidural and started me on pitocin to boost my contractions.  When we woke up from our nap I was almost completely dilated with a little lip of cervix.  (In hindsight that just might be what my cervix does since it was the same with Lyric’s birth)  They pushed the lip over baby’s head and called for the doctor.  I started pushing around 10 pm.

I don’t remember much about the pushing stage, just that everyone wanted to move and jostle and change the bed around.  I was so annoyed, I just wanted them to go away so I could have my baby (“Lift your butt, we’ve got to push this up, put this under you…etc”).

I got a little overzealous with the pushing and was pushing for too long.  I got really light-headed and nauseous so they gave me some oxygen and told me to push for lesser amounds of time.  With the mirror I could see the top of Haven’s dark hairy head!

At 10:44 pm, after 40 minutes of pushing, Haven was born!  As her head came out, so did her hand.  So THAT’S what took so long!  Compound presentations like that can be hard since there’s an irregular pressure to the cervix and a bigger diameter to the baby’s head.  They had to pull Haven’s arm out with her head and her elbow caused me to tear in four places.  It was pretty intense.  Haven came out, thrust her arms out, gave a short cry and then was placed on my belly (after our doctor said, “Hmm, might be a little short…” because of a short cord that just barely let her reach me).

When she opened her big, dark eyes I swear I have never seen a more breathtakingly beautiful human being in my entire life.  She calmly surveyed her surroundings and looked from me to Kyle with a gaze more intense than most newborns.  I got her to nurse and just held her, mesmerized, while our doctor stitched me up.  I couldn’t take my eyes off her!  It’s incredible to think that that tiny little baby was what I felt moving around in my belly for months!

They left us alone with her for over an hour, then took she and Kyle went to the other side of the room to have eye drops, vitamin K shots, PKU heel stick, and bath (Sidenote:  Eyedrops are primarily necessary only if you have chlamydia or gonorrhea, which I didn’t have, and you can do vitamin K orally if you wish to be less invasive.  You can also refuse a bath since it can dry a baby’s skin out).

Kyle stayed with her the whole time and took his shirt off so he could carry her skin-to-skin.  Then she pooped meconium all over him, super fun.  After they were finished stitching me up they gave me a few minutes to try and urinate before I could me moved to the recovery room.  When I couldn’t and they were impatient to get me into the next room so they put a catheter in which was the most excruciating thing I’ve ever experienced.  Then we were moved.

image-3931619-35797181-2-websmall_0_67b6f7f5c320ecf3ddc3a8f44fb8c256_1Even though I was beyond exhaustion, I couldn’t sleep!  I just wanted to look at her.  I couldn’t get enough!  Kyle on the other hand was completely comatose.  The next day we just spent time getting to know her.  We had some visitors and decided to name her Haven Aria Dae.  Haven becasue she was so peaceful and calm.  Aria because she was “singing” with this breathy sigh all day.  And Dae is “greatness” in Korean to honor her heritage.

At 10:30 pm we left the hospital after two days and she felt the outside air for the first time.  It was a beautiful warm night.  She fussed a little bit when we put her in the car seat.  Then we took her home.  I introduced her to her new home and it struck me, I have a brand new immediate family!

To be honest, for a while after her birth I would still feel phantom “kicks” in my belly, like she was still inside.  I loved being pregnant and feeling her move inside me and sometimes I wish I could just tuck her in, warm and safe, like a mama kangaroo.  A part of me misses us being the same flesh, sharing the same warmth and fluids and air.  She will always be a part of me in the deepest and most profound way.  When I hold her in my arms I have to resist the urge to squeeze her so hard I absorb her.  I never imagined it was possible to love someone so much!

My children are the greatest thing I have ever done in my life, and I can’t wait to see what they will do with theirs!

View Lyric’s Birth


Octuplets Born!

A California woman just gave birth to the second set of octuplets in the US nine weeks early!  The greatest thing about it?  Mom plans to breastfeed all eight babies.  It’s possible, the Harris sextuplets were breastfed exclusively for 6 months.  When they were little in the NICU mom would pump between 50-60 bottles a DAY!  Read all about it…

A US woman has given birth to eight babies, becoming just the second person recorded in the US to have delivered a set of living octuplets.

The six boys and two girls, who were nine weeks premature, were delivered by Caesarean section in the hospital near Los Angeles, California.

The babies weighed in at between 1lb 8 ounces (820g) and 3lb 4oz (1.47kg) and are all said to be doing well.

They were screaming and kicking around very vigorously, a doctor said.

The mother, whose identity has not been revealed, has asked that limited information be released about the births.

US first live-born octuplets delivered in Texas, 1998; seven survive
Octuplets born in Italy, 2000; two die shortly after delivery
Octuplets born in Mexico City, 1967, but all died within 14 hours, according to Encyclopedia Britannica
World’s first surviving set of septuplets born in Iowa, US, 1997
First all-female surviving sextuplets born in the UK, 1983, to the Walton family

She checked in to the hospital 23 weeks into her pregnancy and gave birth seven weeks later.

A spokeswoman at the Bellflower medical centre described the deliveries, which took place in the space of five minutes, as “truly amazing”.

The medical team had scheduled a Caesarean section for seven babies, but doctors were surprised when an eighth came out.

“Lo and behold, after we got to Baby G, which is what we expected, we were surprised by Baby H,” said Dr Karen Maples.

Three of the babies needed help breathing, but all were otherwise doing well, a doctor said.

The babies will be in incubators for at least six weeks and the mother is planning to breast feed them all, the hospital officials said.

“She is a very strong woman, so she probably will be able to handle all eight babies,” said Dr Mandhir Gupta.

He added that the mother was “doing very, very well” and was “really excited that she got all of these babies, and that they’re doing good so far”.

The team did not give any more details about the mother’s identity or say whether she had used fertility drugs.

‘Just enjoy it’

The US’s first live-born set of octuplets was delivered in Houston, Texas, in 1998.

The seven surviving children of the octuplets born to Nkem Chukwu are pictured with another unidentified child and their mother as they celebrate their 10th birthday in Houston, Texas, 20 December 2008

Octuplets mother Chukwu said the new parents had much to look forward to

One baby died about a week later – but the surviving children celebrated their 10th birthday in December.

Their Nigerian-born mother, Nkem Chukwu, said the new parents had much to look forward to, the Associated Press news agency reported.

“Just enjoy it. It’s a blessing, truly a blessing,” Mrs Chukwu was quoted as saying. “We’ll keep praying for them.”

Mrs Chukwu and her husband had tried for a long time to have children before turning to fertility drugs.