During my thirty years in pediatrics I have watched many levels of
obstetrical competence in diverse settings:  Home births, birth center
births, deliveries in hospital labor rooms, corridors and operating rooms.

I have seen excellent certified nurse midwives, sensitive skilled
obstetricians and direct entry midwives of great skill and experience.  I
have also seen practitioners in each of those categories with insufficient
skill and experience to handle difficult situations.  I have watched
practitioners in each of those three groups make ³good² births bad.

My observation and my reading of the literature has led me to believe that a
home birth with a well-selected healthy family supervised by a skilled
midwife (CNM or direct entry) is the safest birth.  This must include
contingency plans for expedient transfer to a tertiary care hospital if
problems arise in the antepartum, intrapartum or post-partum periods.
Obstetricians who attend home births are rare.

Breastfeeding success is higher outside of hospitals than inside hospitals
and I believe that infants and their mothers receive more sensitive and
intelligent care in a home birth setting. I believe that virtually 100% of
my moms who delivered at home succeeded at breastfeeding.

I therefore encourage any family interested to explore the option of home
birth.

Jay Gordon, MD, FAAP, IBCLC, FABM

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