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Do-It-Yourself Delivery

Lynn Griesemer gets some help with dinner from daughter Millicent, 10, and son Michael, 5, at their Centreville home.
Lynn Griesemer gets some help with dinner from daughter Millicent, 10, and son Michael, 5, at their Centreville home. "An unassisted birth hammers home what it means to be a woman," Griesemer says. (By Susan Biddle -- The Washington Post)

"There are deaths from these births that I personally know of," Norsigian said, most of which are preventable and resulted from the failure to recognize clear-cut warning signs: decelerations in the fetal heart rate, indicating respiratory distress; a breech position, in which the baby is sideways or feet first; and umbilical cord abnormalities, which can lead to brain damage or stillbirth.

"People don't report the bad stuff" about unassisted birth, said obstetrician-gynecologist Helain Landy, a high-risk pregnancy specialist who chairs the OB-GYN department at Georgetown University Medical Center. "The biggest argument against this is the unpredictability of events during labor. I've seen completely normal situations turn unexpectedly bad very quickly."

Freebirthers find such arguments unpersuasive.

"Babies die in the hospital," said Heather Jones, 27, the wife of a Navy boatswain's mate who gave birth to her third child in February at her Chesapeake, Va., home, with her husband and mother in attendance. Jones said her decision to freebirth was motivated in part by an unhappy experience delivering her first child in a hospital. [Watch Jones' birthing experience on YouTube.]

One of the most serious risks is maternal hemorrhage, which can be fatal in a matter of minutes, said Sarah Kilpatrick, chair of the committee on obstetric practice for the American College of Obstetricians and Gynecologists. The college "strongly opposes" all home births on safety grounds.

"Obviously women are adults and can make their own decisions, but do they really understand what the risks are?" asked Kilpatrick, who chairs the OB-GYN department at the University of Illinois at Chicago.

Mairi Breen Rothman is a suburban Maryland certified nurse-midwife who gave birth to two of her four children at home with "lots of midwives" in attendance. Rothman, a spokeswoman for the American College of Nurse-Midwives, said that expert guidance for women in labor is crucial -- and is best provided by a trained professional, not a self-educated layperson.

"For a healthy woman, the overwhelming likelihood is that unassisted birth will be fine," Rothman said. "But a woman having a baby is not in a position to be monitoring herself."

Five Born at Home

No one knows how many women give birth at home by choice without medical assistance, nor are there any studies of the safety of the practice. Of the 4.1 million babies born in the United States in 2004, the National Center for Health Statistics reports that more than 7,000 were born at home without a midwife or physician.

All five of Laura Shanley's children, who range in age from 20 to 28, were born at home. Shanley, 49, of Boulder, Colo., is founder of an influential 10-year-old Web site, Bornfree, and is widely regarded as the American leader of the freebirth movement, which also has proponents in Great Britain, Canada and Australia.

She credits her interest in the subject to the influence of her husband, whom she met as an 18-year-old college freshman. David Shanley, a decade older, was impressed by the writings of the late British obstetrician Grantly Dick-Read, a pioneer of the natural childbirth movement who extolled the benefits of minimal intervention by doctors.

"At the time, I never wanted kids, and I was terrified of childbirth," Shanley recalled in an interview. But a few years later, when she became pregnant, Shanley said she agreed to try an unassisted home birth at her husband's behest, much to the horror of her father, a prominent physician from whom she was later estranged for many years largely over her decision to freebirth. (They have since reconciled, Shanley said.)

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