Four years ago when I was 42 I gave birth to my first child. At home. On a farm 1.5 hours from the nearest hospital, which is reached by crossing the river and traversing 20kms of dirt roads before reaching the bitumen highway.
I had engaged the services of a home birth midwife I felt safe with when I reached the 4 month milestone. She was a strong lady and I knew I could trust her completely. I believed, and still do, that home is a safe and viable birth place for many mothers and that birth rights are human rights – ie the parents get to choose.
The vitriol I encountered when I announced my decision was quite incredible. I am amazed to this day that I have forgiven some of the emails I received from my family. I educated myself, I read books and so did my husband. We both felt completely comfortable with our decision. While I might be accused of being a lentil muncher, neither of us are hippies and hubby is a red blooded Aussie tradie, farmer and crack shot (who loves lentils as much as steak). I read hundreds of birth stories, watched DVD's and worked through many of my fears or blocks which might prevent me from relaxing into a primitive birthing process.
I don't like hospitals. Never have. They stress me out. Maybe it is because I am a control freak, maybe because I am a rebel and I don't like people telling me what to do, or maybe it is because we are somehow rendered powerless and abandon responsibility for our own lives in the hallowed hospital halls. My very low blood pressure rose significantly on the two occasions I visited ante natal. On the second visit I was examined by an obstetrician who barked that I was too small even as I walked in the room and immediately started lecturing me. When he finally examined me he admitted that I was the perfect size for my dates but 'most of the mums here are so fat they can't see their pubis before they become pregnant, let alone after'. Then he harangued me about my iron levels and refusal to take prescription iron tablets because they would constipate me. 'I've never heard of it' he spat, when I mentioned the over the counter alternative supplement I was taking with success.
Needless to say I didn't bother telling him I was planning a home birth, nor did I go back to satisfy his need to berate and belittle mums to be.
The debate rages fast and furious wherever there are women and babies. Home birthers are dismissed as hippy hooligans who care only about themselves and disregard the safety of their baby. While Home Birthers protest the increasing interventionist approach to birth.
The UK has a strong culture of natural birthing in homes, birth centres and hospitals and The National Childbirth Trust is a respected charity promoting healthy birthing based on evidence based research. The UK's National Health Service actively encourages and instructs midwives to 'focus on normal birth and reduce the caesarean rate' and prenatal and postnatal care is midwifery led, with obstetricians only called in at the discretion of the attending midwives.
The recent 'Birthplace' scientific study which was published in the British Medical Journal concludes that birth is as safe at home as in hospital.
The Netherlands has the highest home birth rate in the western world at around 30 per cent. It also has the highest infant mortality rate in Western Europe which Home birth detractors cite as argument enough, but a closer look at the facts indicates that the vast majority of those deaths occur after hospital births so we can argue that the stats are being skewed to suit.
A detailed study by the Department of Obstetrics and Gynaecology at Erasmus Medical centre in Rotterdam in November 2011 concluded 'Home birth, under routine conditions, is generally not associated with increased intrapartum and early neonatal death, yet in subgroups, additional risk cannot be excluded.'
Home Birth rates are extremely low in the USA and Australia, where Home Birth is becoming almost impossible as Midwives are unable to source insurance for labour itself, only ante and post natal care. Recent Federal Government reforms stipulate that home birthing midwives must work in collaboration with a Doctor and therefore under their medical insurance cover. However, few medicos will collaborate with midwives and few midwives want to be constrained by the medical model of birth.
Birth is not a disease, it is a very natural function of the female body. Healthy women can birth their babies. Perhaps the problem is that women are too fat or not fit and strong enough for the rigours of birth. That's one of the things that a continuity of care midwifery model teaches mums to be – that they must be emotionally and physically fit for labour. It's not called labour for nothing – it is seriously hard work!
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