The following letter was sent to the New York Times in response to Randi Hutter Epstein's article, When Giving Birth, Opting to Go It Alone.

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I read with interest your May 7, 2002 article, "When Giving Birth, Opting to Go It Alone," by Randi Hutter Epstein. Thank you for printing this story. It's been said that affordable healthcare begins with a homebirth--what a great way to start life!

As a Johns Hopkins trained specialist in preventive medicine, who founded the first wellness center in the US (1975), I believe those brave souls who accomplish unassisted childbirth are pioneers in wellness. When medical intervention is necessary, most complications reveal themselves in plenty of time to get to a hospital.

My wife and I considered having an unassisted birth in California 1993 (my obstetrical experience was nil) but decided on a midwife, as my wife was 40 and it was her first child (retrospectively, we could easily have done it ourselves). We later moved to Virginia where it's illegal to have a midwife attend a homebirth (forcing more people to do it alone!).

I was very disturbed by this inaccurate statement in the article: "We know 20 percent of all previously normal pregnancies turn into complications and high-risk situations during the course of labor that could result in serious adverse outcome to mother and baby, including death," the president of the American College of Obstetrics and Gynecology, Dr. Thomas Purdon, said."

Twenty percent is not accurate because most of the complications seen in the hospital are created by the use of the obstetrical model of care. Many otherwise unnecessary interventions are made necessary because the stressful hospital environment interferes with normal labor. The midwifery model of care and unassisted childbirth dramatically lower the complication rate--5% is probably more accurate, and even then, death is very rare.

Again, thank you for helping wake up Americans to the fact that birth is a natural event, not a medical situation.

John W. Travis, MD, MPH,
Author, Simply Well
Executive Secretary
The Alliance for Transforming the Lives of Children

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