Wednesday, April 15, 2009

Home Births "as safe as hospital"

In 1947, my 46 year old grandmother gave birth to my mother at home, safely and without any fuss, as was the norm at that time. These days, the very thought of such an elderly mother giving birth anywhere other than in hospital under strict medical supervision and direction would make most obstetricians produce a litter of kittens.

More than 60 years later, most women in the UK give birth in hospital, many after medical intervention that simply may not have occurred had nature been allowed to take its course at home.

Now a large study has shown that it is as safe to give birth at home as it is in hospital.

Don't worry, I'm not going to go into the gory details, but let's just say that for me, arrival on the maternity ward at first made life more and not less difficult. After several hours of being very relaxed at home, walking around, sending e-mails and comforting the dog, who seemed to realise that something life changing was afoot, I found myself in hospital feeling that I was being put on a conveyor belt, and that my labour was to progress according to the obstetrician's timetable, and not my body's or my baby's. This, after the painstaking completion of a birth plan with my community midwife which outlined how I wanted things to progress as naturally as possible.

The first thing that happened to me was that I was strapped up to a monitor so that the baby's heart could be traced for 15 minutes. That simply had the effect of bringing everything to a complete halt and is still a part of procedure in many hospitals that could be dispensed with. One of the things that helps nature do its work is a relaxed mother - it's much more difficult to get efficient contractions if she is tense and horizontal. The stopping in itself was deemed a bad thing by the medics, who talked about ways in which they could move things on with barely disguised glee with scant reference to an increasingly panicked me.

I decided I was having none of this, however, and found myself somewhere to hide (generally upright) until the people who were talking about intervention with such enthusiasm had gone off shift.

Thankfully, the change of personnel brought a doctor who was unconcerned by some strange rhythms in the baby's heartbeat - said she'd heard it many times before and all was fine, and a midwife who had actually read my birth plan and basically sat with me and talked me through the bad bits in a way that was to me much more effective than any painkiller. Funnily enough, with this sort of attention, I was able to relax and get on with it. If I hadn't had either of those wonderful people, I suspect that the cascade of intervention would have been unstoppable, putting both me and my baby at unnecessary risk.

The important thing about birth is that women need to have much more of a choice than they have hitherto been given. I have friends who have given up on the idea of a home birth simply because of the negativity of the health professionals treating them. Nobody has ever said to me that a midwife has tried to talk them out of planning a highly medicalised birth.

Of course, giving women the sort of birth they want, whether at home or in hospital, means having enough midwives. It's impossible for a midwife dealing with several women in labour at once to give them all the excellent sort of one to one encouragement that I had.

For the first time, we now have evidence gathered from over half a million births, which shows that statistically women are as safe having their babies at home as in hospital. This should inform the future thinking of ministers and those who actually plan the services.

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Edis said...

Glad to have this study to hand even if it is 20 years too late for me.

My son's mother was determined to have a home birth back in 1988. We had a solemn uproar of warnings about the dangers, with me having to dig up all sorts of research findings to counter the pressure, which included a personal interview with the consultant in charge of maternity swervices in our area.. I asked him what the risk statistics were for people who planned home births, disaggregated from births which took place at home because the mother was caught in an unexpected elivery before she could get to hospital, or never actually prepared support for the birth at all.

We went ahead in the end with an independent midwife assisting and my son was born into my hands in the living room.

Three days later by coincidence the noted birth guru Sheila Kitzinger gave a lecture in the medical learning unit of our local hospital. I, my partner, our son and the midwife got smuggled in to attend and managed to mention the home birth in the discussion.

We understand that the consultant, who was present, was heard later boasting about 'his local home birth..' Make of that what you will...

Clair said...

I opted for a home birth third time round and was supported by my midwife team- there was a few hoops to jump through but as i'd had one complicated pregnancy in the past I thought it was reasonable! In the end I went so overdue I just wanted it over with and was induced (thankfully as was slightly more complicated than anticipated but I would have been able to deliver safely at home although I would have had less pain relief options). Although I was induced the midwives still tried to stick to my birht plan- monitoring was done standing up- inconvenient for midwife, great for me- but it was there idea!! I was supported.

I guess what I'm saying is that nothing will change if mums to be dont start thinking about and asking about it and that comes down to the attitude of the midwives- I (and my friend who had a straightforward home birth) was lucky to have supportive, knowledgable and enthusiastic women but i know not everyone is so lucky!!!

My mum actually delivered my brother on our sofa by herself and said it was easier than her other 2 and was ready to get back up and get on with life straight away.

Birth is so natural but I think our over medicalised lives have made many women fearful and out of control.


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