THE PLOWBOY INTERVIEW

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TOMPSON: No, of course not. Certainly some women, maybe 3% to 5%, will run into a situation — such as placenta preview, in which the placenta starts to come out before the child — that might require a caesarean section or some other form of medical assistance. Unfortunately, in our society we tend to take medical tools designed for dealing with emergencies and apply them more and more often to normal situations.

The same was true of bottle feeding when I first worked with La Leche League. You may not realize that infant formula was originally developed for use in the case of a mother's death, or some other calamity, when there was nobody around who could wetnurse the baby. But pretty soon more and more people were bottle feeding. It became the fashionable thing!

Still, there is a definite place for hospital births, and not necessarily just for emergencies or high-risk cases. After all, some people just wouldn't be comfortable birthing at home.

PLOWBOY: That's certainly true. When you mentioned that labor stops for some mothers when they reach the hospital, I remembered a woman I know about who intended to deliver at home . . . but found that she couldn't relax and have full contractions until she went to the hospital.

TOMPSON: Oh, I'd never favor forcing anybody to have a baby at home. And without doubt, there are hospital workers who really try to be responsive to people's needs. The fact is, though, that the survival of the home birth option is important even for people who want to deliver in hospitals. Not only does it offer one model for what an optimal birth experience could be, but it also provides a form of competition that influences hospitals to do a better job of meeting people's needs. This has been clearly shown in Alberta, Canada. Since home birth was effectively outlawed in that province, hospitals there have been steadily eliminating such "frills" as allowing the babies to room in with their mothers and letting children visit their newborn siblings.

PLOWBOY: We've talked a lot about the risks of hospital births. Now, let's turn this discussion around and look at the hazards of home deliveries. You've said that most women who feel comfortable with out-of-hospital births are safer having their babies at home. Do any scientific studies substantiate that claim?

TOMPSON: Well, the most thorough collection of data on relative safety has been compiled by David Stewart — ABCC board member and executive director of the International Association of Parents and Professionals for Safe Alternatives in Childbirth — in his book The Five Standards for Safe Childbearing. According to Dr. Stewart, the medical establishment itself has carried out only one honest study of the issue. That study, which tabulated data on all the births in New York City from 1930 to 1932, concluded that "the relative safety of the home should be recognized" . . . and actually recommended midwife training and home birthing programs.

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