The Duchess of Sussex - aka Meghan Markle's - decision to birth at home has shone an international spotlight on this birthing choice. Is it safe? Why do women do it? For the homebirth curious I've reposted an article I wrote a few years ago inspired by my own very supported homebirth of our son Jax.
Latest Australian data* shows that Homebirth rates increased by 56% from 2009-10.
U.S statistics** tell a similar story with Homebirth rates there increasing by 41% from 2004-10.
Mothers who are looking for better birth outcomes, for themselves and their babies, are leading the way toward reclaiming our ancient, natural birthing wisdom and right to choose where, how and with whom we birth. Meanwhile, despite evidence to the contrary, mainstream media and governments continue to perpetuate the idea that homebirth is a risky, dangerous, selfish act.
This attitude comes from, on the one hand, a natural fear of something we can't control, and on the other hand a need to control something that can be very well managed by experienced, thoroughly equipped midwives who - unlike doctors - SPECIALISE in natural birth. It is an attitude that is contradicted by actual studies*** and facts that show: for low-risk women, who live within a reasonable distance to a hospital should they need to transfer, a homebirth is as safe as a hospital birth, with a lower risk of non-essential interventions. It feeds on an already high climate of fear around birth, and encourages harsh criticism toward those who seek to step outside that climate.
I spoke to some mothers to ask them why they chose homebirth, what their experience was like, and what they felt some of the misconceptions were around this birthing option.
Sunshine Estivo, 38, mum to Safari 4, and Honey 2, says:
“I was a career woman, running my own successful business so prior to becoming pregnant I naturally assumed I would have the best medical care that money could buy when I eventually gave birth. I even waited 3 months before getting pregnant to ensure I was covered for Obstetrics under my private health insurance. When I did fall pregnant I started reading about birthing and birth choices. The more I read about the medical approach to birthing the more uncomfortable I began to feel. Particularly in regards to the intervention and monitoring that goes on whilst in labour. The more I read about the natural birthing process and how your body is perfectly designed to give birth the more I was convinced I wanted a natural birth.
I am fortunate to be blessed with good health. I have faith in my body to do what it is made to do and believe hospitals are for people who are sick or dying. I found our society holds a lot of fear around birthing in general, which unfortunately is endorsed by the medical fraternity which leads many women to believe that they need a doctor/hospital to give birth. Many women I spoke to thought I was mad and told me that I didn’t know what I was getting myself into, especially as it was my first. The more I read about birthing experiences, both in the home and hospital births, the more I realised that I would be more comfortable giving birth at home, surrounded by people I know and with a qualified midwife. Once I met my midwife, who also provided the pre-natal and post-natal care, I knew for certain that I had made the right decision. I also realised that I was not alone and that many women have and do still homebirth today and the home birthing community is quite large.”
Sunshine feels that
“the biggest misconception is that it is dangerous. My pregnancy went fine, the baby was well engaged and my home is 5 minutes from a hospital. My midwife has over 20 years’ experience, most of it as a private/homebirth midwife. She is medically trained and equipped to deal with most emergencies if they occur. I believe the benefits of home birthing come from being in a comfortable and relaxed environment surrounded by familiar people. There are no rules when you birth at home and you are free to deal with your labour as you like. I ate dinner 4 hours before my daughter was born (I’d only just been in labour for a few hours and thought I still had a long time to go so thought it best to power up with a curry!).
I was free to move around as I pleased; I didn’t need to worry about transferring anywhere whilst in the middle of labour. I was able to have a water birth which helped with the pain relief particularly close to the end. After my baby was born, me, husband and new daughter were able to go to sleep in our own beds at home whilst our midwife was there to provide any post-natal care.”
The largest study in the world comparing perinatal mortality and morbidity in planned home and hospital births among low risk women concluded that a homebirth does not increase risk when attended by well-trained midwives. Further, Dr Hannah Dahlen, Associate Professor of Midwifery at the University of Western Sydney and midwife for more than 25 years confirms that “a homebirth attended by midwives, reduces the need for interventions in low-risk women including c-sections, inductions and epidurals.”
30% of hospital births end up as a C-section in both Australia and the US, compared to 0.7% (Aust) and 5.2% (US) of home births. The World Health Organization recommends that the rate be no higher than 10-15%.
“Giving birth is such a momentous occasion in a woman’s life and I believe as women it should be our right to choose the circumstances of our births, whether at home or in hospital. It saddens me to see the bad press that home birthing gets and the general lack of trust, faith and knowledge of natural birthing that exists in our society. I honestly believe that the medical fraternity is just doing what they believe is best for women however I also think as a society we have lost touch with our natural talents as women and have unnecessarily handed our power across to doctors when in fact it is our bodies which carry a baby and our bodies which birth a baby.”
Jacqui McNamara, 42, Mum to Torah 3, agrees:
“I wish people knew how natural it is to birth in your own environment with privacy and quiet. What a relief it is to not have to go anywhere when labour begins, or to time correctly the trip to hospital.How unnecessary drugs are when you haven’t messed up your own hormones. How birth makes believers out of sceptics (like me) and how empowering birth can be when you surrender to it instead of trying to manage, fight and control it.
I wish people knew how much safer it is and better for the baby when you avoid interfering with your body’s natural processes and instincts – many complications are caused by the medical “cascade of interventions”. The fact is, for most pregnancies, homebirth is a safer option and results in fewer interventions. This results in better outcomes for mother and baby and higher breastfeeding rates,
as well as a reduction in PND.”
Homebirth is often confused with Freebirth which is planned childbirth without the assistance of a professional birth attendant. Mention homebirth and people immediately picture you home alone with a panicked husband and a few hot towels! The reality is, women choosing a planned homebirth are usually attended by one or two qualified midwives, and are under their care for comprehensive pre-natal and post-natal care.
Attending midwives are fully equipped with emergency aid including oxygen and syntocinon for maternal haemorrhages. Most women choosing a planned homebirth are pre-booked into a hospital in case of transfer. Transfers occur in around 10/17% of cases (US/Australia), with the majority due to exhaustion and very rarely being emergencies.
Lisa Devenney 39, Mum to Max 5, and Tallulah 4, had to transfer after each of her births.
“We can’t know for sure how birth impacts a baby and their emotional development throughout life, so I wanted what was of greatest benefit to my babies. After much research we made the choice to birth at home. There I had the highest chance to birth naturally, without strangers, bright lights or the interventions and environment we’d experience otherwise.
After each birth I was transferred to hospital due to a retained placenta. The first time I was discharged within 4 hours. The second time the nurses and doctors were "shocked" how quickly I was up and walking around.
I think it’s a very disturbing phenomenon that the natural process of giving birth is now primarily controlled by medical processes, rather than assisted by medicine if required. I feel fortunate for this assistance, however I believe it’s so important and empowering for women to prepare for birth physically and emotionally rather than handing over responsibility to medicine. The birthing process then requires far less intervention.
A transfer doesn’t mean that the homebirth failed or was unsafe.
I am so pleased that I was able to introduce each of my babies to the world in a
quiet, respectful and loving home.”
Sarah Long 41, Mum to Belle 7 and Quinn 4, commends homebirth midwives for their high degree of professional and personal attention.
“Continuous care throughout pregnancy, birth and post partum is the gold standard of care and that's what we wanted. Being able to talk through our wishes with our midwife and know that she truly understood and respected them was invaluable after being disrespected and disregarded at hospital. Compare three nights of 5 min apart contractions and then a 10 hour induced labour at hospital with a 2.5 hour labour and birth at home. I put this huge difference down to trust in my care provider and being in a calm, familiar environment where I felt secure, private and supported.
For some women hospital may be where they feel that way, for me it is definitely at home. At home we weren't rushed, there was no one telling me what to do, we birthed in our own time and on instinct. I scooped Quinn up out of the water myself and into my arms. A truly beautiful moment. Even though I haemorrhaged a few hours afterwards I still felt safe because homebirth midwives are highly trained and experienced. They carry oxygen, can resuscitate babies, carry syntocinon for dealing with maternal haemorrhages, can suture and know when a transfer to hospital needs to be recommended.”
Ultimately, the best place to birth is the one where we feel the safest and most supported. It is every woman’s right and responsibility to make an informed choice about where that place is for her. Clearly, for a growing number of women that place is at home.
© Dana Mrkich 2015
Mum to Jaxon with a homebirth/waterbirth in Sydney, Australia attended by 2 homebirth midwives.
** Journal of Midwifery & Women’s Health, Volume 59, Issue 1, Jan/Feb 2014
***de Jonge, A., B. van der Goes, et al. (2009). "Perinatal mortality and morbidity in a nationwide cohort of 529,688 low risk planned home and hospital births." British Journal of Obstetrics & Gynaecology
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