I sometimes have clients say to me, “I understand that hospitals have higher rates of intervention, but I’m hiring you and a great midwife, so won’t that protect me? Aren’t I getting the best of both worlds that way?”
No. No, no, no. NO!
On the one hand, yes, hiring a midwife and a good doula who will help you stay home for longer when planning a hospital birth does decrease your risk of intervention and hospital management (more info). However, it does not minimize it: your best change for optimal outcomes of health for mother and baby and low intervention risk is to birth at home.
Research shows that even with the same, yes, the same midwife, “first-time mothers who chose to give birth at home were not only more likely to give birth with no intervention but were also more likely to receive evidence-based care.” (BIRTH 39:2 June 2012).
Midwives are affected by the hospital environment. All of a sudden, your midwife, your chosen primary attendant, is having to juggle hospital policy, staff and politics along with her professional judgement and recommendations of what might be uniquely beneficial to you and your birth.
I completely understand that birthing in the hospital with their extra staff and extra equipment seems like it must be the safest way to birth, and that if you can get good midwifery and doula care in that environment, why not go for it. Unfortunately, ample research shows that belief is untrue. In multiple studies, in multiple parts of the world, it is shown that the best way to minimize the risk of interventions (from augmentation to cesareans to infections to babies ending up in the NICU), all while keeping risks to mothers and babies very low, is to plan to birth at home.