After watching the DVD and seeing how comfortable the woman were at home it got me thinking as to why I had never considered a home birth for my own son's birth over a year ago. I guess like many first time mothers I worried about the "what ifs" but to be honest I didn't really know too much about having a home birth and the only stories I had heard about were the ones that were unplanned home births. With only approx 3% of UK woman having a planned home birth it is no wonder I personally didn't know someone who had.
Obviously that has completely changed now that I am a hypnobirthing practitioner and not only do I know many women who have given birth at home, I also know many who have attended the births or who are home birth advocated. So with my new found knowledge I wanted to share some things I previously didn't know below.
1- Having a planned home birth is just as safe as birthing in hospital (in "low risk" pregnancies)
Some people worry that having a baby at home is risky and its best to be in hospital where you have emergency services on hand in case something goes wrong, but studies show this is not true. Being pregnant and giving birth doesn't mean you are sick or in life threatening danger. In normal "low risk" circumstances a woman could give birth just as her body was designed to do so, without any medical interventions. Research has shown that woman who are relaxed and comfortable have shorter and 'easier labours' and it goes without saying that for many woman, being at home rather than in hospital will make them feel more relaxed and comfortable.
So what are the chances of things going wrong? What happens if I need to transfer to hospital?
Probably the most comprehensive study of home birth ever undertaken in the UK was by The National Birthday Trust, they found that 40% of first time mothers that birthed at home had to transfer to hospital. Some of these transfers occurred before labour actually started, whilst others occurred during labour. The single largest reason for transfer was slow or no progress, accounting for 37.2% of transfers. Premature rupture of membranes (waters releasing) accounted for 24.8% of transfers, and most of these occurred before labour had even started.
If the mother does need to go into hospital the midwife present will arrange for an ambulance or as in half the cases in the study above she can go by car (as you probably would in a planned hospital birth). The study also showed that planning a home birth halved the chances of mothers having assisted or caesarean births. The overall rate of these events was very low. So if you add in the reduced risks of infection, ventouse, forceps, tearing and caesarean section, you may even conclude that for some woman having a home birth is safer than having a hospital birth and what deems as an "emergency" rarely happens.
2 - In the 1950s home births were actively discouraged
The reason home births have been unfashionable for years, is mainly because in the 1950s it was actively discouraged by the health service which ran campaigns to persuade mothers to go into hospital to give birth. In post-war Britain, just as the NHS was being created, our housing conditions and general health were quite poor. For many poorer women at that time, it probably was safer to be in hospital. However, those campaigns convinced many people that home birth itself was unsafe and that hospital was always safer. This has been perpetuated by the media so that many, particularly older, people still believe that hospital is safer than home. This is not supported by the evidence, see point 1.
3- A home birth will be attended by one or two experienced midwives
Whether the couple have hired an independent midwife* or have chosen NHS midwives to attend their home birth, only experienced midwives will be sent out. Almost all midwives love attending home births but it is unfortunate that at this current time, we have a shortage of midwives and very often a mother that has planned a home birth will be told to go into hospital as they are short staffed. This will also mean that many student midwives graduate without ever attending a home birth, something they are very keen to experience and may rarely ever do so.
Now It isn't against the law for a woman to refuse to go into hospital but many go in as they don't know that they have any other option. The hospital have an obligation to find a midwife to attend the birth. Even if this means they send out the head midwife on duty (as only midwives with home birth experience can attend). AIMS** advises any woman who is told during her pregnancy that "if we have a shortage of midwives at the time of your labour you will have to come into hospital" to write a short letter back stating that they have no intention of coming into hospital and they expect a midwife to attend when called. So far, each one has had a midwife attend at home (a sample letter for women in this situation is available on the AIMS website at the address below). If enough women exercise their right to choose their place of birth then things may start to change, the home birth rate may go up and more midwives may be employed.
* Independent Midwives are fully qualified midwives who have chosen to work outside the NHS in a self employed capacity. Traditionally one midwife would look after a woman throughout her pregnancy, giving them a chance to get to know one another, attend the birth and care for them both after the birth. www.independentmidwives.org.uk
** AIMS, Association for Improvements in the Maternity Services www.amins.org.uk
4- You can still have pain relief during a home birth
It's important to remember that women who are in control, relaxed and in their own environment and having one to one care from a midwife are much less likely to experience severe pain and less likely to ask for pain relief. However, the midwife attending the birth will carry entonox (gas and air) and may carry pethidine. A recent study by the National Birthday Trust showed that
- 53% of women who planned a home birth used entonox compared to 72% for planned hospital birth.
- 8% of women planning a home birth used pethidine compared to 30% for planned hospital birth.
5- Birth at home = Birth where you like, birthing pool, bedroom, hallway, kitchen....
From talking to many midwives and fellow Hypnobirthing practitioners it is my understanding that many women will give birth where they feel the safest. For some this will be in a the birthing pool after their partner lovingly fills it up with warm water and for others it will be in a part of the house they feel safest and most secure. This usually means some small, dark, cozy area of the house, like the hallway or toilet. As was the case with a friend of mine who birthed her first child at home on the upstairs landing. She said the birthing pool was all set up downstairs in the front room, she had music playing softly and candles lit around the room to give it the "relaxed" feel she had been dreaming of. She needn't have bothered because she just didn't want to move from the tiny landing and she wasn't going to move for anyone, candles and all! She stayed up there with her husband by her side and her lovely very understanding midwife, positioned on the top step of the stairs for a good few hours until she gave birth to her beautiful son. So as much as you plan for a birth you can never be sure how you will feel at the time, and where nature may take you.