Birth Safety:
Side By Side Statistics 

Comparing Community Birth, Hospital Midwives and Hospital Births with OBs
Families deserve better maternity care than what's standard in the U.S. today.

P. Kayti Buehler, Founder of See Midwives and Licensed Midwife in San Diego

Is Community Midwifery Care Safer than Conventional OBGYN or Hospital Midwife Care? 

Midwifery care in the home or birth center setting is actually as safe or safer than conventional hospital or hospital midwifery care for low risk pregnant people by every measure we have.  Given this stark truth, why are Americans still going to Hospitals for their care about 97% of the time? 

Fewer medical interventions + individual care = better outcomes

Fewer medical interventions during pregnancy and birth means taking fewer medical risks, each carrying their own potential for unpredictable side-effects. For example, adding Pitocin to speed a labor increases the risks to baby and mother including C-section by 50%.  Constant fetal monitoring, which has been proven non-evidence based, but is absolutely required by most hospitals, leads to higher C-section rates without better outcomes in babies. A common hospital practice such as artificially breaking the bag of waters creates higher rates of infection which puts babies into NICUs and puts moms at risk as well.  All of these add up to higher infant and mother mortality rates. The U.S. has some of the highest rates in the world.  And our healthcare system can not figure out WHY this is!!  Outside the U.S., around the world, midwifery care, which normalizes and supports the natural birth process, is the norm, and those countries which use midwives and have high levels of home and birth center midwife integration get much better outcomes for moms and babies. 

Conversely, Home and Birth Center Midwives are equipped with medical expertise and equipment to ensure safe care during pregnancy, birth, and postpartum care, but they use these things a minority of the time, not over-medicalizing the process, leading to fewer interventions and their negative effects. The midwifery care model sees birth as a natural process and sees the birthing person as the protagonist of the birth story.  Midwives are there to support the birthgiver and their partner(s) and their baby through pregnancy and the birthing process, seeing that the process is often natural and intuitive, wanting a little gentle guidance but often not needing medical intervention. 

Individual Care
In their position statement of Midwifery care and birth outcomes, the March of Dimes states: “Midwifery care takes place in partnership with women, recognizing the right to self-determination; and is respectful, personalized, continuous and non-authoritarian.”

Imagine the following: 

Your water breaks on its own, before labor begins, as it does about 10% of the time. You call your provider (whom you don't know) and they say: "Come right in!"  You go in.  Instantly your hormonal pathways are interrupted. Bright lights, poking, strangers, cold walls:  Labor does not begin. Instead after a few hours your providers say they want to start Pitocin because you "need to be in labor." Your body is not primed.  Your hormones are in the "stranger danger" zone.  The Pitocin has to work against all of that, and against the natural rhythms of your body.  After 24 hours on Pitocin, they recommend a C-section because your body just won't have the baby.  (This is a VERY common story)

With your community midwife it will more likely go like this: 

Your water breaks on its own, before labor begins, as it does about 10% of the time.
You call your provider (whom you really like and are comfortable with) and they say: "It's 2am.  Go back to bed.  Your labor will likely begin on its own within 24 hours." 

You go in to your midwife's office in the morning for some standard blood, temperature and baby heart beat checks.  They give you reassurance that you and your baby are doing great. You go home and relax, with your partner, excited, knowing your baby is coming. 

Your body goes into labor around sunset that evening.  You have a good strong labor pattern and the next day at sunset your baby is born safely, beautifully, into your and your partners arms- both of you feeling confident, and powerful and so proud of yourselves.  

THIS is the world of home and birth center birth.  This is the world where because your midwife is able to focus on YOU, your unique labor, and your labor unfolding the way it can when nature is allowed to unfold as it knows to do.

Equity vs Trauma

By empowering mothers, midwifery care is also equitable.  In a conventional setting, People of Color are particularly vulnerable to disempowerment and the resulting negative outcomes of intervention or disregard for the expertise of the birthing mother and body.  According to Birthplace Lab, one in six women experience mistreatment during childbirth.  By choosing a model that honors the birthing person as the protagonist of their birth, mistreatment is less likely to occur.  Empowered pregnancy and birthing experiences can be the start of empowered parenting.

 

Which care is right for you? Considering the differences in care and outcome, meeting with multiple care providers before committing, talking to families like yours, and researching the statistics are great ways to find out.

Whether you choose Community Midwifery or conventional or midwifery based hospital care, remember- you are in control of your pregnancy and birth. Healthcare providers are your support team.  

For Community Mother's Stories, see our Stories Section (Coming soon). 

Safety: Home Birth Complications: 8 Things to Reassure You

Videos: For more information about what we bring to a birth that makes it so safe, see our video: What We Bring to A Birth. 

Partners: For more on why community midwifery is so good for your partner, check out our Partners page.

Check out See Midwives Care Provider Directory here! 

Sources and notes for Comparison Table Above:

“Often these studies do not report the same outcomes or use the same definitions or terminology, making it difficult to develop assessments or to draw useful conclusions across the existing body of literature (Khan, 2019). In addition, the overall small number of U.S. women giving birth in home and birth center settings (under 2%) compared with hospital settings (about 98%) complicates many studies of outcomes by setting (MacDorman and Declercq, 2019)." From: Birth Settings in America: Outcomes, Quality, Access, and Choice. National Academies Press (US); 2020 Feb 6. Link HERE to MANY more statistics to show how VARIABLE statistics on this are.

1) https://mana.org/healthcare-policy/about-mana-homebirth-study
2) https://health.ucsd.edu/specialties/obgyn/maternity/Pages/quality.aspx
3) Google c-section rate + your city name to see the rates near you. For San Diego, https://oshpd.ca.gov/visualizations/hospital-c-section-maternal-care-quality-indicators/ is a great resource
4) Midwife‐to‐newborn ratio and neonatal outcome in healthy term infants, January 2020, Acta Paediatrica, 109(9), DOI: 10.1111/apa.15180 
5) Variation in Use by NICU Types in the United States, Official Journal of the American Academy of Pediatrics, Pediatrics November 2018, 142 (5) e20180457; DOI: https://doi.org/10.1542/peds.2018-0457, Erika M. Edwards and Jeffrey D. Horbar
6) http://c-hit.org/2018/10/30/midwives-could-be-key-to-reversing-maternal-mortality-trends/ (using this article as a means of demonstrating. In fact, this article is not a fantastic source but I could find none better. 
7) United Health Foundation, 2018, https://www.americashealthrankings.org/search?q=maternal+mortality - actually it was 17.4 per 100,000 in 2020
8) https://health.ucsd.edu/specialties/obgyn/maternity/Pages/quality.aspx

What We Bring To A Birth

Here's why having your baby with a local midwife is the safest way to have them.