Alternative birth practices and settings--indications of prevalence and use among California obstetricians.

Interest among women and families in "alternative" birth practices and settings has grown steadily in recent years, but little information has been available about the response of the medical profession to the desire for a more "natural," self-directed and family-centered childbirth experience. Data from a recent survey of California obstetricians, however, indicate that although home birth and delivery in freestanding alternative birth centers are discouraged or not permitted by most respondents, a large majority encourage and/or permit routinely or on request a wide variety of practices that represent departures from previous norms of clinical practice. Results of this study suggest that as long as the safety of the mother and infant are not jeopardized and unacceptable liability risks are not posed, physicians are increasingly willing to accommodate the preferences of patients and families for a more "high-touch" approach to counterbalance the increasing utilization of high technology in obstetrics.