THE PLOWBOY INTERVIEW

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The only statistically balanced study in which home birth couples have been carefully matched with hospital couples — in terms of maternal age, number of previous pregnancies, years of education, socioeconomic status, and risk factors — was carried out by Dr. Lewis Mehl in 1977. He compared 1,046 home births with 1,046 hospital births . . . and found that there were four times more newborn infections, seventeen times more instances of neonatal respiratory difficulties, six times more cases of fetal distress, three times more caesarean sections, and three times more postpartum maternal hemorrhages in hospitals than at home. There were 30 birth injuries — mostly due to forceps deliveries — in the hospital, but none at home. The episiotomy rate was 87.4% in the hospital compared to 9.8% at home. Forceps were used on 35% of the hospital group, but only 1.6% of the home babies. And whereas 75% of the hospital mothers received analgesia or anesthesia, less than 5% of the home birth women needed drugs.

PLOWBOY: That sounds pretty convincing. How, then, was the American College of Obstetricians and Gynecologists able to publish the claim that "out-of-hospital births pose a 2-5 times greater risk to a baby's life than hospital births"?

TOMPSON: That statistic includes deaths resulting from spontaneous abortions after a few months' gestation, emergency deliveries in taxis and such, infanticides by unwed mothers, and involuntary home births of extremely impoverished women. And no home delivery advocate would suggest that such births are safe or desirable. The people who should be compared to those who have hospital deliveries are women who plan to have their babies at home. They'll tend to do lots of studying to become fully informed, eat well, exercise, not smoke or take drugs, make sensible prior arrangements, keep from dwelling on negative thoughts, and — in short — do everything they can to insure that the birth will go well.

PLOWBOY: Would you say, then, that one of the most important criteria for a successful home birth is to prepare as thoroughly as possible?

TOMPSON: Absolutely. Doing so can certainly contribute to a safe, positive experience. Of course, being prepared is just as important — and may even be more so — to a woman who's planning to go to the hospital. It'll help her know what the people there may want to do and what her options will be . . . she won't go in like a lamb to the slaughter.

PLOWBOY: What basic health factors would suggest that an expectant mother should not deliver at home?

TOMPSON: There's a lot of difference of opinion about that. Some people say a woman should be hospitalized once her labor has lasted more than 24 hours . . . but mine has gone beyond that without causing any harm. Others recommend hospitalization for anyone whose pregnancy lasts beyond nine months . . . or who is older than 35 . . . or who has had four other children. But I've known plenty of women whose perfectly normal pregnancies lasted ten months, who had children at home when they were over 40, and — like me — had fifth, sixth, and seventh children at home.

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