Community Alternatives to High Technology Birth

Abstract

Presents a description of birthing practices on the Farm, a community of about 1300 people in Tennessee. Statistics on 1000 births managed by Farm midwives between October 1970 and March 1979, and statistics on high-risk pregnancies are included. The Farm midwifery services have developed what is felt to be a comfortable and safe level of technology for normal births and for detection and transportation of complicated births. The Farm now has 8 midwives, 2 physicians, 20 midwife trainee-labor coaches, nurses, 24-hour emergency medical service with 2 back-up ambulances, a neonatal intensive care unit, an infirmary, a laboratory, a pharmacy, a maternity clinic for high-risk births, and an outpatient clinic for prenatal and pediatric care. There were 15 perinatal deaths in the first 1000 births, compared to a perinatal mortality rate in Tenessee in 1977 of 22.4/1000. Amniocentesis and fetal heart monitoring were each used only once. The favorable results were achieved by amateurs, with little use of the technology that American obstetrics regards as minimal. Various kinds of support are provided for women before and after labor and delivery. The importance of "spiritual energy" in the birth process is stressed.