For centuries all babies were born at home. Beginning in the early 1900's birth moved from the home to the hospital. Women became ignorant of the birth process since they did not witness the birth themselves because they were usually put to sleep. Today women have many choices. Birth can take place in the hospital in a delivery room or a birthing room or birth can take place in an out-of-hospital birthing center or at home.
Despite good intentions of many dedicated health professionals and very large expenditure of resources, the U.S. maternity care system has many shortcomings. Many women and babies receive poor quality maternity care, including many procedures, drugs and tests that are not needed - "overuse" - and failure to get many beneficial forms of care - "underuse". Thus, overall national performance on many quality indicators is poor when compared to the benchmarks of high performers in the United States and achievements of many other affluent and less affluent nations. In fact, important indicators such as low birthweight and preterm birth rates have been worsening for decades.
If women want more control over their child birth experience, they must take more responsibility for themselves and their babies. They can no longer wait for things to be offered to them; they must identify their need and seek out appropriate care.
The Coalition for Improving Maternity Services (CIMS) is concerned about the dramatic increase and ongoing overuse of cesarean section. Every year since 1983 no less than one in five American women has given birth via major abdominal surgery.
The largest study of home births attended by Certified Professional Midwives, as published in the British Medical Journal, has found that home birth is safe for low risk women and involves far fewer interventions than similar births in hospitals.