The Farm Midwifery Center

The Farm Midwifery Center demonstrates the superiority of midwifery-based maternity care.

"The Farm" - as it is referred by many - was founded by Ina May Gaskin in the 1970s.

The Farm community is located in Tennessee and is known as a place where midwifery care and home birth came to be the norm. The Farm midwives abide by 5 standards:

1. Good nutrition

2. Skillful midwifery

3. Natural childbirth

4. Home birth

5. Breastfeeding

The Farm Study 1971-1989

This study was done by studying the pregnancy outcomes of 1,707 women who received prenatal care from the Farm Midwifery Center, and who birthed with a midwife.

These outcomes were compared with outcomes from 14,033 physician attended hospital deliveries derived from the 1980 US National Natality/National Fetal Mortality Survey based on:

The results suggest that home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries.

At the time, this was the largest comparative study of home births published. We could not determine if this is still the case.

At the Farm Midwifery Center, births are conducted without analgesia - pain medication. However, great emphasis is placed on meeting the emotional needs of the mother AND of her family. Several family members and friends are commonly in attendance and are encouraged to take an active role in the birth.

In addition, the laboring mother is encouraged to stay off her back and remain physically mobile through labor and delivery.

In the absence of signs of fetal distress, women are permitted to labor beyond 24 hours, occasionally for 2 to 3 days. They are also encouraged to eat and drink during labor in the belief that this alleviates maternal exhaustion and the need for operative delivery.

Here is a question: Has anyone ever required an athlete to starve and then set a record or even just compete? We think not.

A hospital with surgical facilities is located about 20 minutes away. Women with preexisting diabetes or hypertension, Rh negative blood with positive antibody screen, weight greater than 135 kg - about 300 lbs, and hematocrit on intake lower than 28 were considered ineligible for care at the Farm Midwifery Center.

Data for both groups were obtained by retrospective review of medical records.

The Farm Midwifery Center: The Results

The Researchers Concluded

Just "appear?"

It seems to us that indeed the births were as safe - dare we say safer - than hospital births?

Furthermore, the proportion of deliveries in which operative assistance was required was much smaller in the Farm group.

There is some evidence, that elective interventions - unnecessary - which are used more frequently in hospitals, does increase the risk of various adverse outcomes in low-risk women. In addition, it is possible that the unfamiliar setting and the presence of unfamiliar personnel, the limited presence and role of family members, and the restricted freedom of movement of the laboring woman...

... May all create an atmosphere - at a hospital birth - that undermines self-confidence and encourages passivity on the part of the laboring woman, diminishing her ability to deliver spontaneously.

Recent work demonstrating the beneficial effect of supportive female attendants - doulas - during labor, highlights the importance of such factors.

In conclusion, the results of this study suggest that - for low-risk pregnancies - home birth with attendance by lay midwives is not necessarily less safe than conventional delivery.

Support by the medical and legal communities for those electing, and those attending, home birth should not be withheld on the grounds that this option is inherently unsafe.