Homebirth is pretty much synonymous with a natural,nearly drug-free birth, with most planned homebirths taking place in a water bath with close family watching. Safely at home, the mother is free to allow the body to relax (strangely enough) to birth in a familiar environment.
There is a belief that once you step into the hospital, the cascade of medical interventions and examinations would interfere with the natural process of birth. The effects could be physical, emotional and psychological, affecting the mother’s ability to concentrate on simply giving birth.
I have heard of (and experienced) natural births that have become very complicated and traumatic at hospital.
Then there’s the other side of the story, where women have had smooth deliveries where baby was born ‘through the sunroof’ at hospital, as quipped by a Nappycino forum member.
Yet another angle is the most potentially dangerous (in my opinion) choice: freebirth at home without any midwife support. To tell you the truth, it is unfair to have freebirth lumped together with homebirth and to have both treated the same way. Generally homebirth infant death rates are skewed towards freebirth events rather than the safer monitored homebirth.
With recent media coverage of homebirth from local Bunbury papers to Channel 7, the homebirth vs hospital debate has been mounting, culminating in the homebirth rally in Canberra last weekend. From what I read, a new law granting insurance only to hospital midwives would most certainly remove the choice to homebirth safely with the help of a registered and insured midwife.
Personally, I do not see homebirth as a danger if the mother has a low-risk pregnancy, is properly monitored by at least a midwife, who has professional access to the essentials for a safe and modern homebirth like oxygen. There should also be a backup plan to quickly, safely and efficiently transfer to hospital if required.
I believe that there are many cases where a caesarian section was the better choice for both mum and baby, leading to a quick recovery. However, I do agree that within the hospital setting it is harder for the mother to be in control of the birth event as hospital protocols set in place to reduce ligitation exists.
So where do I stand?
I would love to experience planned homebirths with a fully registered midwife who is insured. If this can happen in a place out of the home like a hospital but without the protocols I’m all for it too (see, there’s no cleanup afterwards, and you will be waited on hand and foot until you get back on your feet!).
Birth Experience #1
You see, for my firstborn child, it all started rather ok.
3am in the morning, contractions were happening. My husband and I decided to go off to the hospital to rest before the birth happened in the next few hours. While he rested, I rode the contractions to about 7.30am. My husband then got up and decided to go to work to see the first patient and to take the day off.
At this point the contractions were still going strong, and dilation was steady: I was halfway there.
I didn’t question the exams, though I kinda cringed everytime it was done.
At 8.30am the doctor came to see me, and decided to pop the waters. Instinctively I thought, this is a bad idea. And it was.
Once the waters were broken, a bigger than expected flow happened and the contractions grinded to a halt. It took about an hour for them to get back on track again, but they were quite sluggish. By 4-5pm nothing had advanced, so I had to be put on a pitocin drip (which I requested an epidural for to take the edge off), therefore I had to lay in bed with the epidural. The epidural didn’t work on the left side, so I felt every amplified contraction until the time came to push. The dotor then called the paediatrician to be on standby, and extra midwives, so the room was fairly crowded when BSToddla was born at 9.30pm using vacuum.
My poor doctor had:
- numbed me up with pethadine to fix the epidural that didn’t work
- to do an episiotomy to accommodate the baby’s body when born by vacuum
- a baby born quite blue, due to the cord being around the neck twice: he had to cut off the cord before her body was born.
- to fix a very big internal tear, presumably from the vacuum birth
Birth Experience #2
Number 2 was a totally different birth.
Contractions started at 2am, I rang up the midwives and they were happy for me to stay at home until I was ready to give birth.
‘Come in when they’re 1-2 min or less apart, or the waters break’ they said.
All the way up to about 8am, they were 3-4 min apart.
I kissed my husband goodbye again, thinking that we’re in for another long long day in labour.
Not 20 min after he had gone, that I got the urge to push slowly. Contractions were still 3-4 min apart and the waters hadnt yet broken.
I was caught short! Mum was home but not within earshot, so by the time she heard me it was already 9am.
There was a mad scramble to call my husband, to call the hospital to say we were coming, to get mum and BSToddla ready to leave.
I vividly remember Mum poking her head at the kitchen door after strapping BST in her carseat and reversing the car down the driveway, saying ‘Let’s go!’ I was on my hands and knees by that stage, and I could touch the membranes of the waterbag. Remembering what the midwives told me to ‘call the ambos’, I said, ‘Too late now, could you please ring the ambulance?’
I rattled out the home address and telephone number for mum to relay to the lady on the ambulance line, then BSBubba was suddenly born, at home, on the kitchen floor, absolutely perfect. No cord around the neck, and the waters broke as pe she shot out like a bullet out of a gun. My husband cleared her mouth with his finger. I had unwittingly freebirthed.
I started telling mum and my husband (who managed to get in the door within seconds of BSB’s birth) where the towels were kept. Then the ambulance arrived, the placenta was delivered, baby was fine, but I had lost quite a bit of iron so was fainting even when sitting up.
Moral of the story
Looking back now, I have a theory that the waters were helping to push the contractions along by their sheer volume. My babies are usually just under 3kg so having the extra weight in water helps a lot. Once the waters were broken, 3kg wasn’t enough for each contraction to bounce off the uterus.
There is a place for birthing in hospitals, and I believe there is a place for homebirthing responsibly too.
I wouldn’t like to have another unplanned homebirth (all the cleaning up, lack of back up birth support just in case), but I’m glad I have a regional hospital within 10 min drive from my house.
Would I like to have a choice? certainly!