This article from The Wall Street Journal provides some great historical information that connects meaningfully with my previous post (Home)Birth is Safe.

The author, Nathaniel Johnson notes that,

In 1923, Mary Breckinridge started the Frontier Nursing Service in rural Appalachia….Within a decade, the astonishing impact of that care was apparent. The women the Frontier Nursing Service cared for, who were desperately poor and usually gave birth at home, were 10 times less likely to die in childbirth than the average American at the time. The nation as a whole wouldn’t catch up until the 1950s, after the widespread acceptance of antiseptic and the discovery of antibiotics.

Given that antiseptic practices and the use of antibiotics are available and in use in midwife-attended home births today, it makes sense that, as Sheila Kitzinger has argued, it is not a high level of medicalization that makes birth safer – it is overall health: access to good pre-conception, prenatal and postpartum healthcare, good quality nutrition, access to clean water and access to skilled birth attendants. This has been borne out the world over, regardless of whether women are typically birthing at home or in hospitals. Access to medical interventions for the few women who actually need them is important, which is why midwives are thoroughly trained to detect possible complications before they become problematic and why they only support home births for women who are not at risk. Obstetricians are trained to deal with problems when they arise, but midwives are far more likely to be able to prevent them in the first place. Continue reading →