Last time the New York Times reported on home birth it was in the “Home & Garden” section. Here’s another story, about the rise in birth video viewership on YouTube, in “Fashion & Style.” (Sigh. When will physiological birth get a page in the “Health” section??) Most of the thousands of birth videos are shot at home — as of today there are 10,900 results to the search terms “home birth” — because taping is rarely permitted in hospitals. It’s mindblowing to think that 30, 40 years ago, women didn’t have access to books or even photographs showing the normal birth process. Now you can spend a whole afternoon birth-surfing.

Here’s a favorite. Here’s encouragement for those carrying multiples. Here’s one of several women singing in labor. And check out this absolutely gorgeous birth shown in a Spanish ad for a bed! And look, a brand new video about midwives and health reform — perhaps the birth of a movement?

ADDENDUM: “The Birth of Amerlyn Grace” — a beautiful, intimate slide show shot in black and white by Austin photographer Lyndsay Stradtner.

The Big Push for Midwives campaign — 10,000 Facebook members strong — is taking their message to Congress this week with a Capitol Hill Issue briefing “on how out-of-hospital maternity care reduces costs and improves outcomes,” writes the group. “Studies show low-risk women who plan their births with out-of-hospital midwives have outcomes equal to low-risk women who deliver in the hospital, but with far fewer costly and preventable interventions.” Not to mention unnecessary and harmful interventions! Increasing women’s access to midwives and birth centers should be a no-brainer, but so far, nobody at the healm of health care reform is talking about the need for maternity care reform, which could save the country billions of dollars a year. (Read more about the potential cost savings in the L.A. Times.)

You can help out the Big Push by spreading the word about the briefing, scheduled for this Thursday, May 21, and urging your representatives to attend.

“The worldwide ‘Baby Friendly Hospital Initiative‘ is a great campaign — get the baby skin-to-skin with mom first thing after birth, leave them be for an hour to start nursing, and basically phase out the nursery. A centerpiece of the initiative is to ban formula companies from giving out free samples in maternity wards. But perhaps calling it ‘baby friendly’ was a bad idea. Perhaps it sends the message that breastfeeding is somehow not ‘mother friendly.’

That’s essentially what Hannah Rosin argues in an article in this month’s Atlantic, ‘The Case Against Breastfeeding’…”

[Read more and add your $.02 on Babble.com]

You’d think that between Erykah Badu’s home-birth twitter and Ricki Lake’s film success and the New York Times coverage that we’d moved beyond dissing home birth as fringe — “extreme.” Apparently not. The current New York magazine titles a feature about it “Extreme Birth.” The piece, by Andrew Goldman, tries to be a character study of Cara Muhlhahn, the home-birth midwife and now memoirist featured in Lake’s film The Business of Being Born. But after raising her to a teetering pedestal, crowning her “the fearless — some say too fearless — new leader of the home-birth movement,” Goldman shoots her down. It feels more like a character assassination — of both her and the movement.

This is unfortunate for many reasons. As Goldman himself admits, routine maternity ward monitoring, inducing, and anesthetizing have added up to millions of unnecessary cesarean sections (latest CDC rate: 31.8%) — a “hospital childbirth system gone insane.” Midwives who attend home birth provide a much needed, safe alternative. But Goldman can’t quite buy that (or manage to cite any research one way or another). He claims that Lake’s movie “de-radicalized home birth, conflating it with garden-variety natural childbirth and allowing Muhlhahn, largely unchallenged, to argue for its safety.”

Here’s the deal on safety: The American College of Obstetricians and Gynecologists claims that it isn’t safe; the American College of Nurse Midwives and the American Public Health Association claim that it is. The research evidence clearly demonstrates that birth outside the hospital with a trained midwife is not only as safe for the baby, but safer for the mother, provided she is considered “low risk” — a healthy woman carrying one full-term, head-down baby.

What does Goldman mean by “garden variety natural birth” and where can you get one? The “painful truth” is that it’s an uphill battle to avoid unnecessary intervention once you check yourself into a garden variety U.S. maternity ward (these “pushed births” are epidemic). In many places, like NYC, there is very little gray area between the extremes, if you will, of home and hospital. And freestanding birth centers are great if you can find one, but there’s no real clinical difference between there and at home: every piece of equipment at a birth center a midwife can bring to a home birth. If labor isn’t progressing normally or a complication develops in either location, you transfer care to the hospital.

This concept of transporting a birth from home to hospital is a toughy, especially for reporters — it looks like failure. The anonymous OBs quoted in New York magazine call transports “dumps” and “train wrecks.” In reality, transports are normal and appropriate. These are the women who actually need advanced medical intervention; most just need pain relief or antibiotics (the C-section rate for planned home birthers is under 5%). The option of transport to a fully equipped hospital is what keeps home birth safe. Supportive physicians embrace the role of providing appropriate medical intervention and emergency care, rather than demanding that every woman give birth in the hospital and be treated as if she’s an emergency.

Several times in the NY piece, Goldman thinks he’s catching Muhlhahn in flagrant malpractice, but this is because midwifery standards and obstetric standards differ so, and because Goldman is relying on a cultural bias that obstetrics is more scientific. But it’s not.

Yes, hospitals and physicians restrict women to 24 hours of labor after their waters have broken (many providers want you induced with Pitocin immediately after membrane rupture), but that’s just standard protocol, not science. The best, largest study actually showed that a woman can labor four days without risk to the baby. Goldman also sanctions Muhlhahn for underestimating a baby’s weight, and quotes an OB who claims she should have known the baby was “too big.” But again, the evidence shows that even the highest-tech ultrasounds can be off by two pounds, and that it’s impossible to predict which babies’ shoulders will get stuck. Even ACOG doesn’t recommend inducing or sectioning based on size guesstimates.

The truth is, standard maternity care is not evidence-based care (see this recent report.) And this is why more women are interested in giving birth at home. Not just so they can have candles and music and a better “experience,” but because they know that checking into a hospital means exposure to preventable risks.

Which is really the shame in all this. Because most Americans are skittish about home birth, and no woman should feel it is her only option for that garden variety, supported, physiological birth.

As for the higher-risk births (twins and breeches for instance), the ideal setting is a hospital in theory, but some midwives agree to attend them at home because they know that their clients have zero chance of a vaginal birth otherwise. They feel an obligation to support women’s choices and help them avoid unnecessary surgery. And they have the skills to do it (the current obstetric training for breech delivery is a cesarean section!). The system is shameful to an extreme.

Consumer Reports named this true/false quiz, “Matertnity Care, Beware.” Take it here. CR writes, “Despite growing evidence of harm, many obstetricians and maternity hospitals still overuse high-tech procedures that can mean poorer outcomes for baby and Mom.” Also, check out their October ‘08 report, “Back to Basics for Safer Childbirth.”

Most of us learn the word “elective” in high school, when we find ourselves with the newfound freedom to take a course like AP music theory, or advanced sculpture, or yoga. Elective implies freely chosen, life-enhancing. Laser eye surgery is elective. Tattoos are elective. But the vast majority of so-called “elective” cesarean sections are not, and it is inappropriate and disingenuous to call them so in the medical literature, as did a recent study… (Read the the entire commentary at RH Reality Check.)

Just a week after we learn that babies are suffering from C-sections performed too early — and a large proportion are — another new study finds that serious birth complications are on the rise in U.S. mothers. Nearly twice as many women needed blood transfusions in 2004-05 versus 1998-99, and there were 50% more pulmonary embolisms — life-threatening blood clots that are a direct complication of surgery. There were also more women in respiratory distress and kidney failure following childbirth in the latter group. Researchers made clear that this trend is not related to mothers skewing older in recent years, but rather the rising rate of cesarean birth, which has increased from 21% in 1996 to 31% in 2006. “It was just amazing the consistency,” study coauthor and obstetrician Susan Meikle told the Chicago Tribune, “from vaginal delivery, where the rates [of complications] were lowest, to repeat Caesareans, where we saw an increase, to primary Caesarean delivery, where the increases were the highest.” The overall risk of severe morbidity rose from 0.64% to 0.81%. With 4 million+ births per year, that’s a lot of sick mothers. This is yet more evidence that preventing unnecessary cesareans should be high up on the healthcare agenda.

You know that pregnancy guide, the one that practically has its own aisle in the big bookstores? The one that’s been on the New York Times best seller list for-ever (391 weeks)?

Well, it’s off! The Times Book Review wonders if the birth rate is falling along with the economy, but this author wonders if women aren’t skipping past the What To Expect display and buying books that give them more info and less of a talking to, books like… Ina May’s Guide to Childbirth (Ina May Gaskin), The Big Book of Birth (Erica Lyon), The Complete Book of Pregnancy and Childbirth (Sheila Kitzinger), Birthing From Within (Pam England), From the Hips (Rebecca Odes and Ceridwen Morris), Our Bodies Ourselves: Pregnancy and Birth, and maybe even Pushed?

Woah, Florida dept. of health officials really need a childbirth ed. class. Twenty — yes, 20 — state and federal law enforcement and government agents RAIDED the Miami Maternity Center on December 24, Christmas Eve, based on allegations that the center was baking their clients’ placentas together in a single batch and grinding them up into pills for distribution. The midwives deny any wrongdoing. ”They charged in here as if I were making crack cocaine,” said one midwife. Or maybe a witch’s brew…. Read more about it in the Miami Herald.

Some healthcare trivia: In the United States, what is the No. 1 reason people are admitted to the hospital? Not diabetes, not heart attack, not stroke. The answer is something that isn’t even a disease: childbirth. It costs the country far more than any other health condition. But cost hasn’t translated into quality…

[Read the op-ed, “Midwives Deliver,” in the Los Angeles Times]