Moderator: At-Risk Home Birth: Whose Right Is It?

On the issue of high-risk home birth, the VCOM community members who commented on the blog were not in consensus. However, there does seem to be a strong contingent voicing support for the mother’s autonomy to make decisions about her delivery. Elective home births and non-hospital births (such as at a birthing center) are on the rise in the US. Most women who choose home birth rely on a trained birth attendant (such as a midwife) to help her deliver. There is a growing movement of women who choose not to utilize a birth attendant. In the literature, this is called “free birthing.” An opinion article was recently published in the Lancet on the ethical considerations of high-risk home birth, causing quite a stir in the home birthing community (see below).

In Virginia, there are laws governing midwives attending home births. A recent legislative attempt to prevent reimbursement to midwives attending high-risk deliveries did not make it out of committee. However, Del. Matt Lohr, R-Harrisonburg, has introduced a bill to the General Assembly that would require midwives to inform patients of the potential risks associated with delivering at home. The idea of the bill was brought to Lohr by an obstetrician and gynecologist in Harrisonburg, VA, who was concerned about the safety of high-risk home births. Lohr reports concern due to recent cases of midwives whose licenses were suspended by the Virginia Board of Medicine after they attended high-risk home births and the babies did not survive.

Thanks to everyone who joined the debate! Please keep it going in the comments section if you have more to say.

Read More
Home Birth—Proceed with Caution, The Lancet, 31 July 2010 (Vol. 376, Issue 9738, Pages 303). Full article here

Midwife legislation in Virginia
Sally Voth, “Legislation Would Impose New Rules on Midwives,” The Northern Virginia Daily, 17 February 2009. Full article here

"Free-birthing"
Madison Park, “Home Births: No drugs, no doctors, lots of controversy,” CNN, 09 August 2010. Full article here