Home births are safer than hospital births
Dr Stuart Fischbein has spent decades delivering babies in both hospitals and homes.
In short, for low-risk women, hospital births aren't actually safer than home births.
Observational studies of increasingly better quality and in different settings suggest that planned hospital birth in many places does not reduce mortality and morbidity but increases the frequency of interventions and complications.
Euro-Peristat (part of the European Union’s Health Monitoring Programme) has raised concerns about iatrogenic effects of obstetric interventions, and the World Health Organization (WHO) has raised concern that the increasing medicalisation of childbirth tends to undermine women’s own capability to give birth and negatively impacts their childbirth experience.
Put another way, home births are not ‘more risky’ than hospital births, and they do not lead to more things going wrong.
In fact, hospitals lead to extra interventions, each with risks and complications pregnant women don’t need, making hospital births less safe in many cases.
Just to be clear, when I talk about home births, I am including the presence of a midwife.
Think about the following.
Quick comparison
What medical interventions occur with a home birth?
Pretty much none.
What medical interventions occur with a hospital birth? Well, here’s a list I copied and pasted:
Continuous fetal monitoring: Restricts a mother’s movement, which slows labour and increases the likelihood of unnecessary C-sections.
IV fluids: Can cause fluid overload in the mother and low blood sugar in the newborn, while tethering the mother to a bed.
Artificial rupture of membranes: Often fails to shorten labour but increases the risk of infection and fetal heart rate irregularities.
Pitocin: Can cause ‘hyperstimulation,’ leading to dangerously intense contractions that may cut off oxygen to the baby or risk uterine rupture.
Epidurals: Often cause low blood pressure, limit mobility, and significantly increase the odds of needing forceps, a vacuum, or a C-section.
Frequent vaginal exams: Can increase infection risk, are invasive, and are often used to justify further interventions based on arbitrary timelines.
Episiotomy: An outdated practice that can cause more pain, slower healing, and deeper, more severe tearing than natural stretching.
Forceps or vacuum extraction: Used to speed up a ‘stalled’ birth, these tools pose risks of scalp injury, bruising, and nerve damage to the baby.
C-section: Major surgery carrying risks of infection, heavy bleeding, and organ damage, while complicating recovery and future pregnancies.
And those are just the common ones. There are many more, all of which don’t happen in the comfort of the mother’s quiet, warm home.
And the thing that Dr Stu emphasises is that childbirth is not a medical condition.
‘Childbirth is not a medical condition.’
If childbirth is not a medical condition, then why do most childbirths occur in hospitals?
Money.
Think about this again.
Why lie on your back?
Why are humans the only mammals that give birth in a hospital? Elephants don’t go to a hospital to give birth. Neither do lions. Nor do dogs.
Moreover, why are humans the only mammals that lie on their backs to give birth?
It makes no sense.
But it makes cents.
Lots of cents.
Did you know?
Women lying on their backs during birth became standard in the 17th–18th centuries, largely thanks to male doctors wanting to have a look, a voyeuristic French king, and the invention of forceps — none of which had anything to do with what’s actually best for the mother (and baby).
For most of human history, women gave birth upright — squatting, kneeling, or sitting on a birthing stool. Gravity does the work. It’s faster, less painful, and opens the pelvis wider.
King Louis XIV — who fathered 22 children — liked to watch his mistresses give birth, and the lying-down position gave him a better view. Midwives went along with it to keep the king happy.
Then male doctors took over from midwives. As medicine became professionalised, men pushed midwives out. The lying-down position suited doctors— it was easier for them to examine, intervene, and use instruments to prod and poke.
The invention of forceps in the 17th–18th centuries required the woman to be flat on her back for the doctor to use them. The ‘lithotomy position’ (back flat, legs in stirrups) was originally designed for removing gallstones, not giving birth.
None of it is for the benefit of the mother and baby.
All of it is for the benefit of the system.
🎙️ Discussion
Dr Stu and I have known each other for years, so this was a great catch-up. Of course, I also recommend our conversation from 2024.
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This is such an important topic, in my opinion.