Most mothers in labour arrive in hospitals today and are ushered into cubicles, prevented from walking around and treated like car parts on a conveyor belt. Most babies arrive in hospitals these days to be greeted by busy medical professionals who are still not sure how aware and conscious babies are. Well intentioned staff, immersed in protocols, follow procedures without ever asking permission from either parents or babies. Neither do medical professionals question whether such protocols are necessary or beneficial to the mother and or baby. And certainly, relaxing quietly in a bath of warm water in between the surges of labour, is unusual, if not unheard of, in a hospital setting.
Stacy did not want a repeat of her previous experience where she felt bullied in the hospital setting, was whisked to theatre and struggled with breastfeeding for months after her surgery. She wanted to be in a home environment where she could be in control and make decisions about what procedures she would allow in partnership with a trusted midwife. At the same time, Stacy and Wade wanted safety and an integrated collaboration between midwife and obstetrician/hospital. This was difficult to achieve, but Stacy persevered, recruiting the services of a local obstetrician, who agreed to facilitate hospital/medical back up support should transfer be medically necessary.
A large study published in 2019 by researchers at Mcmaster University compared mothers who intended to give birth at home, with mothers who chose to give birth in hospital, from 8 different countries and 500 000 planned home births. The outcomes showed that there was NO DIFFERENCE in the safety data. “The research clearly demonstrates that the risk is no different when the birth is intended to be at home or in hospital.” said Professor Emeritus Eileen Hutton, first lead researcher of the study (Hutton et al, 2019). What this means in reality is that babies born at home were at no higher risk of dying than in hospitals.
Mothers are less likely to give birth naturally in a hospital setting. This was established by the Birthplace in England national prospective cohort study in 2011, published in the British Medical Journal. What often happens in the hospital setting is called the cascade of interventions. For example, a mother goes to hospital in very early labour because she is anxious. Her labour doesn’t progress when she is placed lying down on a bed to be monitored. She is tense and afraid. Doctors suggest a ‘pitocin’ drip to speed things up. This makes contractions very painful and after several hours of this, the mother asks for pain relief. An epidural appears to solve the pain problem, but her body is frozen, and so is labour. The mother cannot walk around and is abandoned for hours like a stranded beetle. Finally the doctor suggests a caesarian (before midnight) and the mother feels relief that her ordeal will be over. Once the baby is born, the mother is in pain, struggles with breastfeeding, hates herself for not achieving her dream of a natural birth and feels disappointed and confused. Not a great state of being to be embarking on motherhood with a baby in your arms.
Physiological birth, on the other hand, can unfold slowly at home with midwife in attendance, waiting and watching and only intervening after deliberation and informed consent from the mother. The mother feels calm, and safe in her own home, is at liberty to walk around, to eat, to be comforted, to choose a waterbirth and to share her experience with a few trusted friends or family. Her body DOES know what to do. When the baby is born, it is the mother who catches the baby. They are not separated, the father is present. Baby can adapt skin to skin, to the new space and habitat, comforted by the closeness of the mothers heartbeat, welcoming words and loving gaze.
There is no ‘should’ about choices in childbirth. Mothers have options and will search for the birth place that suits them best, makes them feel safe and empowers them. Home birth is one of these options.