Anybody who knows me, or who has spent any time reading my blog, will know that I am a big advocate for home birth. I have experienced both the standard hospital birth (thankfully a different story to US hospital birth, but still not ideal) and the all-natural home birth, and the latter was just… wonderful. Not only was the birth amazing, but the postnatal period too. Home birth is pretty darn awesome.
I have wholeheartedly thrown myself into the online world of natural childbirth advocacy and have met some very inspiring women along the way. However, up until now I have neglected researching The Other Side –
The people who insist that homebirth is dangerous.
Don’t get me wrong; I still very much agree that home birth, for low-risk, healthy mothers and babies, is a safe and indeed preferable option. Should I get pregnant again someday, and all goes well, I will certainly be planning another home birth.
What needs to change is the terrible state of maternity care in the US that forces women to make choices that are unsafe for their babies, because they feel that they and their babies are more unsafe in the hospital.
However, after looking at all of the viewpoints through balanced eyes (rather than my usual headstrong, my-way-or-the-highway vision), I am starting to rethink the whole ‘trust birth’ mentality.
Birthie sisters, let me explain before you abandon me. In my opinion, women’s bodies are designed to give birth. When everything goes to plan, the woman’s body and the baby work together to bring baby safely into the world. However I can’t help but feel that some of the hardcore natural childbirth advocates ignore the fact that, although birth is generally safe, it can be dangerous especially when there are risk factors involved.
What bothers me is that there only appears to be two camps that are making regular noise about birth. There’s the hardcore homebirthing doctors-are-evil types, and the Dr Amy Devotees who seem to think that birth is incapable of happening safely without the guiding hand (or iron fist) of a doctor. The latter think that women choosing home birth are selfish because they care more about their own experience than the baby’s safety – this really couldn’t be further from the truth.
I’ve met women online who have taken massive risks in order to get the home birth they desire. However, the vast majority of us choose home birth because we truly feel it is the safest, and best option for our whole families – including the unborn.
Yes, there definitely are some women who get overly hung-up on the experience. I’ve met women online who have taken massive risks in order to get the home birth they desire. However, the vast majority of us choose home birth because we truly feel it is the safest, and best option for our whole families – including the unborn. Furthermore, the women who do get hung up on The Experience need our support and love, not to be chastised. They likely feel that way because they have endured horrific trauma in the hospital. Birth trauma is real and serious, no matter what many callous Dr Amy Devotees say. And sufferers of birth trauma need professional help to deal with what they have unfortunately gone through.
Furthermore, the Dr Amy Crew, even with all of their expertise (many of them are doctors with a background in obstetrics) seem to neglect the fact that the interventions they believe are nothing but useful can be responsible for many problems in the postnatal period, as well as the birth. The repercussions of birth choices do not end once the baby is out – a traumatic birth can affect bonding and breastfeeding also, which will have a knock-on effect on the child’s future health.
When I was planning our home birth, I became very preoccupied with The Experience. I told the midwife that I would stay at home should I go into labour at 36 weeks, rather than going to hospital as the midwives recommended before the 37 week point. I refused a growth scan after a fundal measurement was a little on the low side. I told my midwives that I wanted completely hands-off care. I don’t regret any of these decisions – each one was carefully researched, weighed up and agonised over. However, I don’t think at the time that I really took on board the risks of birth – instead, I was charging blindly ahead, convincing myself that birth would be totally safe as long as the infernal purveyors of modern medicine stayed out of my way. It’s very easy to convince yourself of that when you hang out in an echo chamber of others believing the same thing, where the negative outcomes are censored.
I think natural, home birth is wonderful and I’ll always, always support those who want to do it. However, the current state of maternity care in the US is preventing many women from making a safe choice for themselves and their children. Access to hospitals is a zip code lottery; some women are lucky enough to be nearby a hospital full of wonderful, respectful OB’s and L&D nurses whereas others get lumped with the exact opposite. Many women feel that they are in a position where home birth is their only option, even if that’s not really what they want.
I am very concerned about the fact that MANA (Midwives Alliance of North America) are hiding their data on homebirth death rates. Surely if the statistics showed that home birth in the US is as safe or safer than hospital birth, they would be shouting it from the rooftops?
Again, in my opinion home birth is safe for the majority of women and babies. When deciding to birth at home, you need to take on board your individual situation – do you have any risk factors? How far away from a hospital are you, should something bad happen? How experienced are your midwives? The problem with CPM’s is that some of them will happily take on high risk home births with seemingly no concern for the level of danger involved. I hate to admit it but I can’t help but worry when I read stories of women giving birth to breech twins at home with a CPM – to me, that is way too risky. That’s not to say that there isn’t a whole load of wonderful CPM’s out there – there are. But there are also plenty who are underqualified, underexperienced and take too many risks.
Ignoring the fact that sometimes things go wrong at birth, even totally natural home births, is irresponsible and ignorant. Furthermore, I am very concerned about the fact that MANA (Midwives Alliance of North America) are hiding their data on homebirth death rates. Surely if the statistics showed that home birth in the US is as safe or safer than hospital birth, they would be shouting it from the rooftops? Instead, they are withholding the data and only allowing access to those who can prove they will use it for “the advancement of midwifery”.
I cringe when I read stories of CPM’s advising mothers to refuse GBS testing, lest it come back positive and end their chance of a home birth. Why do we think that midwives are somehow immune to greed? We’re all very happy to assume that doctors only care about lining their pockets, but when a midwife advises against testing that could save a baby’s life, coincidentally preventing the mother from having a homebirth and paying the midwife for it, nobody bats an eyelid.
As I’ve said before, home birth here in the UK is a very different kettle of fish. Our NHS midwives are highly qualified. They attend births in hospitals, and are dispatched to home births also. I felt we were completely safe in the hands of my midwives because I knew that they would suggest a transfer the moment they thought things were going awry. For me, this was important because we live 30 minutes away from the hospital. I needed to know that the minute things were looking hairy, they would be honest with me and get me transferred.
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I am not saying that home birth is dangerous and irresponsible in and of itself. Home birth is wonderful, and I so hope that our circumstances allow for it with the next baby. What needs to change is the terrible state of maternity care in the US that forces women to make choices that are unsafe for their babies, because they feel that they and their babies are more unsafe in the hospital. Hospitals need to focus on allowing high-risk mothers to have gentle, dignified, natural births if that is what they desire. Ironically enough, for home birth to truly be safe, care led by experienced and professional midwives needs to become the norm.
At present, women don’t have a choice. Home birth should be chosen because it is right for the individual family involved, not as a last resort – and certainly not with a provider who is happy to take unnecessary risks in order to get paid.
I am still forming my own opinion on all of this, and I’d love to hear what you think. Please share in the comments!