Friday, January 25, 2013

Biblical Ethics and Medical Perceptions Pertaining to the Home Birth Practice

Note: The following article was written by two men (a father and son) who are members of Immanuel Baptist Church, where I am privileged to serve as the primary teaching elder. If you are considering home birthing, I hope you will also consider their thoughts about this important matter.

Biblical Ethics and Medical Perceptions Pertaining to the Home Birth Practice

(An Appeal to Fathers to Apply Wisdom)

By Mike Brewer and Matthew Brewer, RN, PHRN


For a variety of reasons women are choosing to give birth at home even though there may be competent labor and delivery facilities in their communities. One of the results of the Reformation was to view all aspects of life in light of the Scriptures in obedience to Christ. Great advances were made in science, commerce and industry as Christians applied a Biblical ethic to all enterprises. If the presupposition that all Scripture is sufficient for living a godly life is accepted, the trend toward home birth in the Christian community should be examined to determine if there is a sound theological basis for this health care choice. The Scriptures declare that though man is prohibited from murdering or maliciously injuring his neighbor, he also has a duty to act to avoid or minimize the risk of death and injury from probable and knowable risk. Men applying wisdom in medicine have developed equipment, procedures and treatments to repair patient injury, reduce disease infection and improve infant survivability. Several of the complications of delivery which historically have taken the lives of many mothers and infants are treatable with a high probability of survival when interventions can be promptly administered such as are available in the labor and delivery ward of a hospital. As some of these complications result in large blood loss or oxygen deprivation, successful intervention requires rapid recognition and treatment. The speed of needed intervention is on the order of minutes, which can be a challenge for a hospital and is an even more difficult, if not impossible, feat for a location outside of a medical facility. As fathers are called to be the providers and protectors of their families, it is incumbent on them to seek the Lord in His Word and to apply the wisdom of the Scriptures to their particular circumstance in faith and reverence. Given that an ethically operated hospital with proper infection control, trained staff and maintained equipment is available in the community, it would seem difficult to justify avoiding the use of such a facility in favor of intentional delivery of a newborn in a location without prompt access to life saving interventions.

(Key words: Home birth, Reformed Theology, Infant Mortality, Homeschool, Fatherhood, Pregnancy Complications, Natural Medicine )

Biblical Ethics

Many women are choosing to give birth to their children at their own home instead of at a hospital for a variety of reasons. This trend seems to be associated with displeasure with the institutional medical infrastructure and with an affection for natural medical practices. The home birth movement seems to have some following among homeschoolers who have eschewed governmental, institutional education for a home based, tutorial methodology. For those families that homeschool for religious reasons, we suggest that the theological basis for the discipleship of their children should also be applied to their medical decisions in the care of their children.  Our premise is that the Christian should seek the wisdom of God’s Scriptures first as a foundation toward exercising judgement in the various circumstances of life. If a person rejects this Christian ethic as foundational, our essay on this issue will seem as nonsense to their perspective.

Our presupposition is that all Scripture is sufficient and that the moral law of God endures. Obedience of the law generates no saving righteousness for the soul, but all souls have a duty to obey God. A soul is only made righteous by repentance of sin and faith in the saving life, death, burial, and resurrection of Jesus Christ.

In the realm of medical ethics the summary command is to love our neighbor as ourselves (Leviticus 19:18, Mark 10:31). The particular commands in the ten commandments are “Thou shalt not kill” (Exodus 20:13) and “Thou shalt not steal” (Exodus 20:15). It is inferred that if you harm another person you have stolen that person’s health, time and/or ability to work. So all men are commanded to not subject themselves or their families (a neighbor) to procedures that have the intent to kill or maliciously harm. The Scriptures record that God declared this moral law enduring and incumbent upon all men, not just the Hebrews or Christians. “And surely your blood of your lives will I require; at the hand of every beast will I require it, and at the hand of man; and at the hand of every man’s brother will I require the life of man. Whoso sheddeth man’s blood, by man shall his blood be shed: for in the image of God made he man” (Genesis 9:5,6). The Jew, the Christian, the Atheist, the Marxist, the Muslim and the pagan are all commanded to obey the moral law of God.

The case law in the Scriptures expands on the moral principle to not harm another soul so as to include a burden to protect others from potential harm that has a known probable risk. Consider the laws regarding a goring ox in Exodus 21:28-29: “If an ox gore a man or a woman, that they die: then the ox shall be surely stoned and his flesh shall not be eaten; but the owner of the ox shall be quit (i.e. acquitted). But if the ox were wont to push with his horn in time past, and it hath been testified to his owner, and he hath not kept him in, but that he hath killed a man or a woman; the ox shall be stoned, and his owner also shall be put to death.” There are more nuances to this case law but the clear moral principle is revealed that if there is knowledge of a credible risk of injury to others and no prudent action is taken, there is more culpability for the harm than if the risk was unknown or unsuspected.

The case law also discloses that the prenatal infant is due the protection of the law (Exodus 21:22-25). The plain reading of Exodus 21:23, “And if any mischief follow [to a fetus born prematurely due to an injury to the mother], then thou shalt give life for life,” suggests  that the infant is due the same legal status of an adult that was murdered. The phrase “life for life” would seem to refer to capital punishment for the death of the infant. Regarding pregnancy and childbirth, it can be inferred that the same standard of care due an adult to protect him/her from credible risk would be due to an infant as well. In addition, due to God’s teaching on His special anger for evil done to the helpless and voiceless, since infants are not able to give consent or defend themselves, the caregiver should afford a level of care even more cautious than that due an adult. 

Furthermore, the authority of the parent is not absolute in adjudicating what is life-saving care of an infant or child. If we read Psalms 82 as a rebuke against civil authorities (the judges of Israel), we see that God holds the judges culpable for not defending the case of the powerless. Being that the gestating infant is an extremely defenseless person, it is reasonable to infer that the state has a duty to protect the infant from the evil harm intended by an infant’s parents. Psalms 82:4 says to “... deliver the poor and needy: rid them out of the hand of the wicked.” Also we have the noble example of the Hebrew midwives who protected the Hebrew infants from the malice of Pharaoh (Exodus 1:15-22). In verse 17 we read, “But the midwives feared God, and did not as the king of Egypt commanded them, but saved the men children alive.”  

So, in summary, it seems the Scriptures declare that there is a standard of care for infants that is at least equal to adults and that there may actually be an even higher standard of care in taking measures to avoid doing harm to infants. Those in responsibility such as fathers and civil authorities have some level of accountability for what happens in their jurisdictions. In the instance of life threatening circumstances, there is some overlap and both authorities have a duty to God to protect life even if it means to disobey the evil intent of another governing authority.

So why are professing Christians declining the use of competent medical facilities in regards to the birth of their children? Perhaps it is from a misconception of the risks and benefits of the medical facility. We are called to be diligent to understand consequences. “A prudent man foreseeth the evil, and hideth himself: but the simple pass on, and are punished. By humility and the fear of the Lord are riches, and honor, and life” (Proverbs 22:3,4). We are called to be humble and learn. We are called to be perceptive and take action. Regarding the birth of children at home, we are making the case to be wise. If a family is living where the hospital is filled with infection, incompetence and malice, it would be wise to give birth at home. Additionally, a family may live in a location where the distance to travel to a competent facility would be more hazardous than delivering the child at home. It would seem wise to not travel and provide the best care available in that remote location.

Medical Perceptions

If some of the motivation for declining medical care is due to a lack of medical information, this paper is to help highlight some of those risks. The paper will also attempt to provide a rebuttal to some of the proponents of intentionally having a child born at home. One of the benefits of competent medical care is the ability to promptly address delivery complications. Note, we are only mentioning some unforeseen complications. Many other complications such as placenta previa or structural abnormalities would be identified with standard United States prenatal care and may be accounted for in perinatal care planning.

Common Complications:

Abruptio Placentae is a sudden partial or complete separation of a normally implanted placenta before the infant is born. Vaginal bleeding may be present in marginal abruptions, but concealed abruptions do not have external bleeding; thus the clot continues to grow further separating the placenta from the uterine wall. 0.5% to 1% of pregnancies have placental abruption, and it accounts for 10-15% of perinatal (closely associated with child birth) deaths. Multigravida status (multiple pregnancies), abdominal trauma, falls or maternal age are known associated factors. Besides bleeding or known trauma, tenderness, uterine irritability (mild contractions), drops in blood pressure and poor fetal heart rate can indicate the possibility of abruptio placentae. Diagnosis is by emergent ultrasonography. If it is clearly mild, bed rest, steroids and tocolytics to prevent labor would be given. Signs of fetal compromise can develop rapidly and “intensive monitoring” of mother and baby is essential. Large bore intravenous treatments (IV’s) are recommended for administration of fluids and blood products should that become necessary. If there are signs of fetal or maternal compromise, immediate delivery via cesarean section is necessary.

Pre-Eclampsia / Eclampsia: Pre-eclampsia is a high blood pressure condition >139 Systolic Blood Pressure (SBP) or > 89 Diastolic Blood Pressure (DBP) after 20 weeks of pregnancy accompanied by protein in the urine. Pre-eclampsia often occurs in 1st pregnancies, and is also associated with women over 35 years old, obesity, and chronic high blood pressure. Pre-eclampsia is a generalized vasospasm (blood vessel constricting) affecting 5-10% of all pregnancies. Maternal and fetal morbidity can be decreased with early detection and management while it remains mild pre-eclampsia. Severe pre-eclampsia is when the high blood pressure is to a point that it is causing significant reduction in the amount of blood flowing to the baby. Anti seizure medicines and blood pressure medications are necessary to prevent seizures and injury or death to the baby. Even at 33 and 34 weeks gestation, delivery is usual due to the severe risk. Eclampsia is when the seizures begin. This can present life threats to the mother and the baby.

Dysfunctional Labor: Multiple causes and issues, but in short, the mother’s uterus may not be able to effectively contract which can result in stresses on the baby or lack of oxygen for extended periods. Neurological damage can result.

Malpresentations: Delayed or difficult birth due to shoulder impaction above the mothers symphysis pubis bone, or other malpresentation such as breech or transverse. There is no true correlation to risk factors. Malpresentation is not predictable, unless there is known macrosomia (excessive infant birth weight). An urgent situation can develop with the umbilical cord being compressed between the baby and the pelvis. Time is essential. In the hospital, immediate preparations for surgical delivery begin while steps are taken to manipulate the baby to allow delivery before further impaction. This is often unforeseen as the baby can move at the last minute and become wedged.

Placenta Accreta: An abnormality with the placental adhesion to the mothers uterus. It can cause some bleeding and complications similar to placenta previa during the pregnancy, however it may not be diagnosed and hemorrhage may occur from the mother after the birth as the placenta does not separate, or separates incompletely allowing continuous bleeding. Such hemorrhage would require intrauterine surgery.

Prolapsed Cord: The presenting part (usually the head) of the baby does not always fit like a puzzle into the shape of the mothers pelvis. A prolapsed cord can slip down at the last minute, or with a simple movement of the baby, or with the water breaking. It may or may not be visible, but can be strongly suspected based on the changes in the decelerations of the baby’s heart rate. The pressure must immediately be taken off the cord to prevent the baby’s death. Unless birth is imminent and the cord can be protected manually by keeping the baby off of the cord, cesarean delivery is done to prevent death or brain damage to the baby. Every seconds counts with this complication.

Postpartum Hemorrhage: This can be caused by multiple factors, uterine atony (loss of uterine muscle tone), a partially retained placenta, or by blood coagulation abnormalities brought on by pregnancy such as DIC (disseminated intravascular coagulation). This is one of the leading causes of maternal death and it occurs in 4-6% of all deliveries. It is manageable but can progress rapidly apart from the hospital environment. The brain, heart and kidneys are vulnerable to hypoxia with the low blood pressure (shock) and the associated failure of the body’s compensating mechanisms. Lactic acidosis begins which dilates the blood vessels sending the mother into cardiac arrest. This is treatable but it requires constant monitoring, fundal massage, and possibly oxytocin to stop the bleeding, if it is persistent.

Endometritis / Puerperal Infection: A treatable infection after birth, a common cause of death if it goes untreated, especially in third world countries. Women with long labor and rupture of membranes that occur a longer time before delivery have an increased risk of up to 30% in those who don’t receive antibiotics ahead of time as compared to those who do receive antibiotics ahead of time. It is treated with IV antibiotics if diagnosed. If not treated, it can spread to abdominal cavity and cause major damage, sepsis and death.

Newborn Needs: There are a myriad of conditions that could be found on a fragile newborn at birth and some require urgent interventions. There are too many to list. One never knows what health problems the newborn may have. Additionally, 10% of newborns require basic neonatal resuscitation, and 1% of births require extensive resuscitation measures. As an aggregate number, 9% of all newborns require intensive care. Conditions such as bronchopulmonary dysplasia, meconium aspiration syndrome, unidentified fistulas, cardiac shunting issues, retained lung fluid, or other congenital anomalies require immediate treatment, endotracheal intubation and other urgent treatments. There are many conditions in which you do have enough time to call the paramedics and get transport to a hospital for an intervention.

Some Common Objections Answered

To answer the proponents of home birth when there is access to a competent facility, my initial thoughts are on the burden of proof. Why would a person not use a trained obstetrician and and equipped hospital to provide safe care for the mother and fragile newborn? The following is a list of some commonly disclosed motivations for having a home birth.

Reason: I would like to have control of the experience.

Rebuttal: Beware that the drive to control the birth experience has its roots in the feminist movement in the 1960s. Although all women may not have the feminist perspective, the pioneers in the movement are not ashamed of that philosophical motivation.

Reason: I do not like the loss of privacy in a hospital environment.

Rebuttal: Perhaps there is an unbiblical view of modesty in the treatment of disease and injury of the human body. Competent medical personnel are trained to respect the patient’s need for privacy as much as possible as well as give prompt care in dangerous conditions. Furthermore, many hospitals are continually working to improve the labor and delivery environment to respect the wide variety of cultural and religious preferences in our society.
Reason: Hospital deliveries are very expensive.

Rebuttal: People will spend their money on what they value. What about life? If there are no complications a delivery can cost $7000-10,000 without insurance at most Midwest hospitals. That’s is not an unreasonable expense compared to many other common expenses such as transportation. Families will spend that much or more on a good used car.
Reason: We don’t want interventions. Childbirth is a natural process.

Rebuttal: The patient’s definition of “natural” is important to clarify. Heart attacks, strokes, maternal death and infant death are natural process as well and are more common where medical interventions are not available. Is it possible the definition of “natural” is centered on avoiding the pain or discomfort of an institutional setting to be in more familiar and comfortable surroundings? Perhaps this stems from a misunderstanding of the speed of response required to manage the many potential complications needing immediate intervention.
Reason: Home birth is safe as midwives are trained professionals.

Rebuttal: They are trained professionals, but incapable of providing many of the lifesaving interventions necessary for complications. Let us be direct — if there are no complications, almost anyone can catch a baby. Even in deliveries where midwives recognize that they are in a situation outside of their capabilities and lives are at risk, the time necessary to transport the patient to appropriate care can cause further damage.
Reason: I do not want my newborn to be subjected to so many vaccinations so soon after being born.

Rebuttal: As far as I know, Hepatitis B is the only immunization recommended to be given at birth. There is no substitute for having a good relationship with your family doctor. Your doctor is a powerful advocate for your health needs and desires. Discuss it with your doctor if you are that concerned about it, or want to refuse or delay immunization until the child is older. Planning ahead and making your doctor aware of your requests is the best way to deal with these situations.
Reason: Home birth is safe as long as it is a low-risk pregnancy.

Rebuttal: While certainly high-risk pregnancies make necessary even further monitoring and interventions, most of the immediately life threatening complications for the mother or the newborn are not able to be foreseen, and can develop without warning. Without the preparedness or resources to appropriately respond to the condition, life, limb or brain function may be lost.
It is a challenge to compare the raw statistics of the deaths of infants in a home birth environment versus the deaths of infants in a hospital. Recent studies suggest the home birth mortality rate is at least 2-3 times higher than hospital infant mortality. The actual rate may be higher as some home birth fatalities are reported as hospital deaths as that was where the death was recorded. Some links to postings are at the end of the paper.


In closing, I offer an example of some Christians who have strong convictions but saw the need to change their perception on home birth. In our local region the Amish community reversed its preference for home birth after realizing their preference was resulting in loss of life and health. But, not wanting to compromise their convictions, they put their resources to work to bless their families who would need to be at the hospital for deliveries as well as be a blessing to the wider community. To accommodate their families the Amish community donated all their labor for the construction of a hospitality house adjacent to the hospital so that there would be a private place for their families using the hospital as well as other families who had loved ones hospitalized. There are no guarantees that a baby or mother will not die giving birth even with a competent facility. But the Scriptures call us to be reverent and teachable. Let us be faithful to examine all of life in the light of God’s word and redeem our time on earth.

Some thoughts on the risks associated with home birth and midwife-assisted birth:

Update 7 February 2013

After receiving some feedback from the blog's readers, Mike and Matthew Brewer have offered the following clarifications:
1) Theological Basis - We wanted to point to the Scriptures first to lay out the moral principles involved. The particular application will be different for different circumstances. We acknowledge that home birth may be wise where you have poor hospitals or a hostile medical community. Our brothers in some communist and third world countries may need to avoid the government health system.
2) Data - As we mentioned, the amount of research data is not large. The data we found, even cited by midwifery associations, disclosed an increased infant mortality rate with identifiable home births when compared with hospital births. We avoided using anecdotal knowledge for the paper.
3) Risks - We disclosed what are medical risks of an urgent nature that are difficult to manage even in a hospital. Our desire was to help non-medically trained fathers be aware of the medical conditions that their doctor is trying to manage in the treatment of their wives and children.
3) Relationships - We recommended a good relationship with your doctor to seek accommodation for your concerns and convictions. This is so helpful in the event there is a death of an infant regardless of where the birth occurs. The civil authorities have a duty to investigate the deaths of children. Your doctor can advocate on your behalf that you have acted with integrity in the care of your wife and child should death occur. Although we did not quote John Frame, we found his book "Medical Ethics" very helpful. He exhorts Christians to seek the assistance of their elders/pastors in navigating difficult medical situations. We think this is a theological sound recommendation. There is a perception in the homeschool community that we have a hard time listening to the counsel of others.
Thank you to all for taking to time to read a lengthy document for a blog. Keep seeking the things above in your service to God and others.
Thank you for you kind attention to our blog.  


  1. Keith,

    The article is interesting. Has a clear bias against home birth, therefore fails to give balance. As we continue to move toward a socialistic police state, where doctors become informants for the rulers upon the citizens, many of us would not necessarily find the comfort that the hospitals are "safe" as your post implies. We have 7 children, four home births, three hospital. Two easy homebirths, two difficult, with one shoulder dystocia, one just long. Outstanding midwife, well qualified thousands of births. Actually went to her with our planned 5th and she advised the hospital for number 5 due to size of number 4. She was willing, but preferred us to use hosptial. We did and all went well, very easy, etc. However, my wife and number 6 almost died at the hands of a foolhardy/intrusive nurse in the hospital. Bad experience, but wonderful doctor who reacted in seconds, did emergency C-Section and saved our little boy from the nurses error. NICU for weeks, cost a fortune and yet now he is fine, 13 years later. Hospital nurse should have been fired and sued. We let it go. Number 7 - our last, born in hospital, all well, but had some really unkind nurses with the baby, alot of interference since she was a Down's. My point is this - your post implies how dangerous and almost unbiblical homebirth is, but neglects to say the fact that hospitals have HUGE risks as well. Balance, prayer, wisdom and sensitivity to the needs as they progress is most important. The official medical system has botched many a surgery, many a life and often never goes reported or resolved. Becareful of too much trust in such a system. All in all our hospital experiences were generally ok, but so were our homebirths. Both have risks. Be careful about trying to force the OT to say that it is morally unlawful to have homebirths when hospitals are present. This is no where supported in the NT in any specific sense and a stretch in the OT. Your members are adding to the Word to press a viewpoint.

    All I am saying is that homebirth is a good option for many in healthy birth situations, as well as hospitals. And it is a growing, real threat that as Obamacare takes over that hospitals become "tools" of the state to force conformance to the police state edicts. Beware, for these institutions and the medical staff that serve in them are not always as "innocent" of agenda as they want to appear.

    1. I appreciate your thoughts and would agree that either a home birth or a hospital birth can be a good option for Christian families. But, then, the authors of this article would also agree with that point of view, as they make clear, for example, when they say:

      "We are called to be humble and learn. We are called to be perceptive and take action. Regarding the birth of children at home, we are making the case to be wise. If a family is living where the hospital is filled with infection, incompetence and malice, it would be wise to give birth at home. Additionally, a family may live in a location where the distance to travel to a competent facility would be more hazardous than delivering the child at home. It would seem wise to not travel and provide the best care available in that remote location."

      I would also agree that we should not force our own views into Scripture where they are not clearly present. But, then, I don't see where the authors of the article have done so. Had I thought they had done so,I would not having published their article on this blog. As I read their article, however, I see them as trying to apply moral principles derived from Old Testament case law. These principles teach that we must wisely take care not to needlessly place our children in danger, a point which the authors have shown may be true of either home births or hospital births, depending upon the particular circumstances in each case.

      Thus, I do not think the authors have been as unbalanced as you seem to think, although they may appear that way to some because of their primary focus on defending hospital births as a good -- and often the best -- choice for Christian families. But this focus was due to the nature of the article, which presupposes a bias in their audience in behalf of home births and against hospital births. It is this narrow audience to which their arguments are primarily directed because they have found so many to be strongly biased this way in the circles in which they have been involved. In fact, some from the opposite point of view have been quite hostile at times and have treated those of us with any other point of view as somehow less Scriptural or less spiritual in our actions due to their own preferences on the matter. Viewed from this standpoint, I frankly found the article to be quite restrained. At any rate, I thought it was both careful and fair, and I do not think it misappropriated Scripture.

  2. Wow - I am really disappointed in this article. I would expect a lot better than this from my fellow RB brothers. Speaking as someone who has never done a home birth mind you. I can't even begin to describe how thoroughly disgusted I am with this article.

    From where I sit, this looks like a thinly veiled attempt to force your preferences on a group of people with a little sloppy research propped up as a strawman with a veneer of eisegesis as an attempt to bind people's consciences to your own view. This is absolutely unconscionable for a blog that purports to represent confessional reformed baptists. I would suggest you carefully consider Ch 21 of our confession and re-evaluate the wisdom of this post in light of it.

    There are some valid points regarding our need to be wise, and to realize that in general, God has given science and modern medicine to be a blessing and it is to be received with thanksgiving and used freely according to Christian wisdom in the light of Scripture.

    However, just because it's there doesn't mean we *have* to use it, and it doesn't even mean it's necessarily the best way. "Modern medicine" has been wrong about a lot of things throughout history, only later realizing the harm they were doing. It is not to be treated as a god, to be trusted absolutely.

    Your post here paints with a really broad brush, and doesn't even come close to accurately representing the people I've met and come to know personally who have chosen for all sorts of reasons to have their children at home.

    I don't mind disagreement, or voicing a differing opinion. I highly value that because it requires me to carefully consider and reflect on why I hold the ones I do. But I do expect a certain standard in that disagreement - especially from a blog like this one. This isn't the first time I've felt like you've missed the mark - but it's definitely the worst.

    1. Unknown,

      I just want to point out first that I typically do not publish comments from those who identify themselves only as "Anonymous" or "Unknown." This is because I strongly believe that people ought to be responsible for what they say and how they say it. In fact, this is why I have disabled anonymous commenting on this blog, and it is why this blog tends to have so many fewer comments in comparison to many other blogs. It is also why, after I respond to this comment, I will post no others from you labeled "Unknown." I suppose you could just make up a fictitious name, but I leave that as a matter between you and the Lord and simply hope that you have a higher moral standard than that. With that bit of blog housekeeping aside, I would simply point out that you have made a number of unsubstantiated and unsupported allegations in your comment. For example:

      1) You have accused the authors of making "a thinly veiled attempt to force [their] preferences on a group of people" and of "an attempt to bind people's consciences to [their] own view," yet you ignored their caveat to the contrary:

      "Regarding the birth of children at home, we are making the case to be wise. If a family is living where the hospital is filled with infection, incompetence and malice, it would be wise to give birth at home. Additionally, a family may live in a location where the distance to travel to a competent facility would be more hazardous than delivering the child at home. It would seem wise to not travel and provide the best care available in that remote location."

      2) You have accused them of "sloppy research propped up as a strawman with a veneer of eisegesis," yet you have provided absolutely no evidence of this. And you have made no attempt at all to demonstrate that they have read into the text. Nor have you offered any explanation as to how their reading of Scripture runs afoul of chapter 21 of the London Baptist Confession of Faith of 1689 (to which I presume you are making reference).

      I suppose I could respond further to your comments, but I think my basic point has been made. I only stress in closing that, 1) no further "unknown" comments will be allowed, and 2) accusations without arguments to back them up will be exposed for what they are.

  3. Interesting. I am by no means an expert on these kind of things. I would like to see the numbers of infant and mother mortality between the two forms of giving birth. Without teens giving birth by themselves in their bedroom being included as "home birth".

    Another thing, has anyone ever looked into the connection between contraception and many of these complications? Maybe we should be discussing birth control via medication and whether or not it's biblical.

    As far as your links go. I could find all kinds of links about infant deaths/ injures caused by medical malpractice.It all depends on which risks you would rather take and who you want to believe.

    I also know that many hospitals practice abortion. Do I want to support the willful murder of children in hopes of avoiding accidental death? I see some possible ethical problems with this, going by your standard.

    This, I believe, really is a matter of christian liberty. I wholeheartedly agree we must be wise in these decisions. As for me and my wife,(who by the way has been studying the pros. and cons. of home birth for over 10 years) we think home birth is the best choice for us.

    I would also add that there are many modes of home birth that most certainly are not biblical.

  4. I am in agreement with each of your points, brother. Thanks for the input.

  5. For those who have been following the post and these comments, notice that I have added an update from Mike and Matthew Brewer to the end of the original post.

  6. Pilgrim,

    Christian liberty? Yes. I simply add that our liberty is an opportunity to apply wisdom considering potential consequences of both.

    By favoring a birth location with access to life-saving resources, my arguments are dismissed a few as being "biased" even without knowledge that I formerly was of a different opinion. My personal position changed from becoming educated on specific life-threats in my professional training and work, and from multiple experiences in which preventable deaths were directly attributable to home birth.

    Here's a few clarifications:
    -It's not as much about home or hospital, but about access to skilled providers and the equipment necessary to save lives within the necessary time.

    -You would be much better off hiring an equipped Obstetrician and Neonatologist for your home birth--than if you had a hospital birth where a midwife did not have that backup or resources. Likewise, midwives do serve in hospitals where they can work with access to such resources.

    -Some complications truly can be managed with limited equipment by midwives at home. But the most deadly complications--though infrequent--do not give you enough time to get to help before death or hypoxic brain damage occurs

    -Christians should seek out good relationships with medical providers--particularly Christians, and be open about preferences and wishes. Providers love patients who want to be active and involved in planning but won't ignore them if they feel the need to apply their wisdom to a situation.

    -Abortion-providing hospitals and doctors should be avoided. In my town, neither of the two hospitals allow elective abortions, those are done at a private clinic and at Planned Parenthood. Many OB doctors are even pro-life activists. Use them.

    -"Babies die at hospitals and at homebirths". What is not often considered is that most babies who die in hospitals die despite being given every chance possible. Teams of prepared specialists will do everything they can to save a baby--and do save many. Home birth baby fatalities are usually deemed preventable deaths as the fatal problem could have been treated had there been access to the life-saving interventions in most cases.

    -There are several meta-analyses that point to higher neonatal death rates in midwife-assisted home births compared to equivalent-risk hospital births. As a health professional, I am not simply "ignorant" or "biased" and have spent a some time critically examining both sides.

    -Malpractice is real. Midwives as well as doctors have malpractice liability. A doctor's care is subject to great scrutiny by peers and nursing staff, and the level of accountability is greater than that of independent midwives being constantly under the eye of other professionals.

    I simply hope some will examine the call to protect the life of the vulnerable, and separate life-risks from other risks in their decision making. Maybe I might spare someone some the grief of a preventable loss.

    Though procreation was created perfect and blessed, it remains affected by the curse of sin and death pronounced by God himself. Medicine, with it's Christian ethical basis, is a way in which believers can minister to others by using knowledge, skill and wisdom to save some that would otherwise be lost. Until recent generations was singularly a Christian (and catholic) initiative, and the benefits of the medical field should not be dismissed without careful consideration.

    Thanks for responding!

    God Bless,

    Matt Brewer

    1. Well said, Matt. As I have reread and pondered your article, I personally have become even more convinced that hospital births are usually the best and safest approach. Of course, I already agreed with your concerns, which is why I posted the article to the blog. Such concerns were also factors in my and my wife's decision not to home birth our three children. Although I do not think there is only one right option here, since such a decision depends heavily upon situational factors, as you and Mike have made clear in your article, it seems clear to me that hospital births are typically going to be the better option. Thanks for being willing to share you views here. It is important that we be informed and thoughtful in making such important choices, and it is important to promote loving dialog on the matter. I hope this article will help to do so.

  7. Here's an article to consider...

  8. Thanks for the input. We welcome comments and informative links representing both sides of the issue.