"The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to a woman at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby."
"If you look at scientific literature, you find over and over again that many interventions increase risk to mother and child instead of decreasing it."
The typical "cascade of interventions" in the hospital system:
Women from Western societies rarely give a second thought to where they will give birth to their baby. We're lead to believe that giving birth anywhere other than a hospital is unsafe and puts ourselves and our babies at risk. I always used to assume this too, until I did a bit of research of my own. After reading Dr. Sarah Buckley's book Gentle Birth, Gentle Mothering (1) and watching The Business of Being Born, my eyes were opened to the fact that there are actually other equally safe/potentially even safer options for birthing:
Even though we've all started to believe that hospital births are "normal" and necessary, humans have safely been giving birth without hospitals for 999,998 generations - it’s only in the last 2 generations that hospital births have become common. This means that women have given birth at home for 99.998% of human history.
Not only can a midwife-assisted home birth be just as safe as a hospital birth for women with low-risk pregnancies (shown by the numerous studies summarised below); birth complications are actually more likely to occur in a hospital environment.
As Buckley states:
Under this model women are almost certain to need the interventions that the medical model provides, and to come away grateful to be saved no matter how difficult or traumatic their experience. (1)
The scale of medical intervention in birth today is not only far beyond what is necessary, it is actually contributing to the very problems it attempts to solve. But of course, as Australians we are very fortunate that we do have access to medical procedures and technology if a birth does turn into a medical emergency.
If our own baby's birth needs medical attention, we will have no hesitations in allowing medicine to do all it can to help - the health and well-being of our baby is our highest priority after all. But unless that happens, we are looking forward to giving our baby a gentle and joyful start to life, away from the potentially dangerous effects of epidurals, pitocin, fluorescent lights, beeping machines, time limits, and doctors and nurses who are complete strangers to us. We look forward to welcoming our child into the world with the help of our lovely midwives, into a calm, comfortable, and love-filled place; our home.
A little bit of info on birthing drugs:
Drugs administered by epidural enter the baby’s bloodstream at equal and sometimes even higher levels than those present in the mother’s bloodstream. An undisturbed, drug-free birth has many benefits for mother and baby, and to me, the long-term well-being of my baby, and myself, are more important than numbing any pain I may be experiencing during labour.
One benefit that is of importance to me is that a drug-free birth greatly enhances the likelihood that the newborn will latch correctly straight away and be successful at breastfeeding, as they aren't "drugged up" themselves.
There are many potential risks to the mother associated with epidurals, including that:
And these are only a few of the possible side effects of birthing drugs - have a read of this article on epidurals and this article on pitocin for more information.
By no means do I mean to discriminate against any woman who has chosen to give birth in a hospital environment, if that is where she feels is the safest place to give birth to her baby - every woman should have the right to make their own choice.
But the unfortunate fact is that many women don't even realise they can make a choice about where they birth their baby, and that the hospital system is not always as "safe" as many of us assume it to be.
I'm so grateful that I discovered this beautiful and gentle way of birthing in time for the arrival of our first baby, and I very much look forward to the day that he or she arrives.
If you don't know your options, you don't have any.
- D. Korte
Recent research on home birthing:
Marjorie Tew published an article in the British Journal of Obstetrics and Gynaecology, analysing "official statistics, national surveys, and specific studies". Tew found that "perinatal mortality is much higher when obstetric intranatal interventions are used, as in consultant hospitals, than when they are little used, as in unattached general practitioner maternity units and at home." Tew also concludes that the decline in perinatal mortality over the previous 50 years owes more to the general improvement in mothers' health than it does to the increased use of hospital-based interventions. (2)
The Northern Region Perinatal Mortality Survery (UK) published the results of its study, looking at 558,691 births from 1981 to 1994. The researchers found that perintal mortality for planned home births was less than half the average for all births, and even those few deaths among the home birth group were "mostly unavoidable". (3)
Similar perinatal mortality rates for home births and hospital births were found by a Swiss team looking at a total of 874 women in Zurich. The researchers note that "the home birth group needed significantly less medication and fewer interventions", and those babies born at home had slightly higher Apgar scores than their hospital-born counterparts. (4)
A study of 1,836 women with low-risk pregnancies in the Netherlands found that place of birth did not influence perinatal outcome, except in multiparous women, where the perinatal outcome was significantly better for those giving birth at home. (5)
A researcher from the University of Copenhagen published a meta-analysis of six studies comparing home birth and hospital birth. Among the 24,092 women participating in these studies, "perinatal mortality was not significantly different in the two groups [women delivering at home versus women delivering in hospital]", and no maternal deaths occurred in either group. Babies in the home birth group were less likely to have low Apgar scores, and the mothers were more likely to deliver without medical interventions (induction, episiotomy, Caesarean section, etc.). (6)
The National Birthday Trust (UK) published the results of its confidential survey of 4.500 home births in the UK, concluding that "a woman who is appropriately selected and screened for a home birth is putting herself and her baby at no greater risk than a mother of similar low-risk profile who is hospital booked and delivered". (7)
Gavin Young, a general practicioner, and Edmund Hey, part of the Regional Perinatal Mortality Survey Coordinating Group (UK) noted that "there has been no intrapartum death and only one neonatal death in the past 15 years among the estimated 3,400 mothers...who were booked for home birth when labour started." (8)
British Medical Journal published the largest ever study of planned home births attended by a certified professional midwife (CPM). Looking at the results from all 5,418 women expecting to deliver at home with a CPM in the US and Canada in the year 2000, the researchers found that "planned home birth for low-risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low-risk hospital births in the United States." (9)
A Dutch study examined 529,688 births of which 60.7% were planned home births. It was found that "planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system". (10)
1. Buckley, Sarah J. Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices. Celestial Arts, 2009.
2. Tew M. Do obstetric intranatal interventions make birth safer? British Journal of Obstetric Gynaecology 1986; 93: 659-674.
3. Northern Regional Perinatal Mortality Survey Coordinating Group. Collaborative survey of perinatal loss in planned and unplanned home births. British Medical Journal 1996; 313: 1306-1309.
4. Ackermann-Liebrich U, Voegeli T, Gunter-Witt K, Kunzi I, Zullig M, Schindler C, Maurer M, and Zurich Study Team. Home versus hospital delivers: follow up study of matched pairs for procedures and outcome. British Medical Journal 1996; 313: 1313-1318.
5. Wiegers TA, Keirse MJNC,van der Zee J, and Berghs GAH. Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands. British Medical Journal 1996; 313: 1309-1313.
6. Olsen O. Meta.analysis of the safety of home births. Birth 1997; 24(1): 4-13.
7. Chamberlain G, Wraight A, and Crowley P. Home Births: The Report of the 1994 Confidential Enquiry by the National Birthday Trust Fund. New York and London: Parthenon, 1997.
8. Young G, Hey E. Home birth in Britain can be safe. British Medical Journal 2000; 320: 798.
9. Johnson KC, Daviss B. Outcomes of planned home births with certified professional midwives: large prospective study in North America. British Medical Journal 2005; 330: 1416.
10. de Jonge A, van der Goes BY, Ravelli AC, Amelink-Verburg MP, Mol BW, Nijhuis JG, Bennebroek Gravenhorst J, Buitendijk SE. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. British Journal of Obstetrics and Gynaecology 2009; 116(9): 1177-1184.
- Chris Kresser: Natural Childbirth
- 161 Reasons To Birth At Home
- The Sydney Morning Herald
- Home Birth: "Brave" Has Nothing To Do With It (I love this article!)
Formerly known as Paleo Pregnancy & Parenting,
Mikaela's personal blog explores topics relating to ancestral-based nutrition, pregnancy, undisturbed birth, and natural parenting.