Is home birth REALLY that risky?
Another day, another Meghan Markle story. This time, it’s about her choice of birth place, which is rumoured to be *clutches pearls* in the comfort of her own home. GASP!
The media is on its high horse. How dare she even consider breaking royal protocol by choosing to birth where she feels most comfortable, they scream. How inconsiderate of her to put her own preferences first, without giving the slightest thought to how it might make the population at large feel!
(For the record, Princess Diana was the first to opt for a hospital birth following a long long line of successful royal home birthers).
In reality, no one actually knows where the Duchess of Sussex will be giving birth. That’s because she’s chosen to keep this private and personal decision, PRIVATE.
But that hasn’t stopped the sensationalist press jumping on the “lets criticise another woman and her choices to make ourselves feel better about our own experiences” band wagon. And with it, they dismiss the intellect of future birthing women and their ability to decide for themselves, assuming they’ll be swept up in some kind of home birthing mania thanks to Meghan’s “whacky” decisions.
Here's a newsflash for you: women have brains and are fully capable of making informed choices, based on evidence and their own intuition, given half the chance.
But I digress.
The thing is, a home birth is a totally viable option, particularly for low risk pregnancies. And that’s not just me saying it, The Birth Place study, which was carried out in 2011 agrees. It states that:
The overall rate of negative outcomes (a composite of outcomes of death or serious complications) was 4.3 per 1000 births and there was no difference between non-obstetric unit settings compared with obstetric units. This indicates that as a whole, home births are as safe as ones in medical settings.
In a more recent study (2018), researchers found that the "planned place of birth appears to have little significant impact on adverse perinatal outcomes. Moreover, women who planned to give birth in a birth centre or at home had significantly lower odds for intervention and severe morbidity in labour and birth."
I’ll be honest here and say, I’m a hospital birther. Experiencing early labour at home, for me, was not a very nice experience. That's partly because I was living in what can only be described as a backpackers refuge in Bondi beach. The walls were paper thin and my next door neighbours were permanently raving in their living room with, what sounded like, the entire population of Sydney's Eastern beaches. It did not feel calm, it did not feel comfortable. And as soon as I was wheeled into the labour ward, surrounded by pain relief and doctors, and monitors and disinfectant, I finally felt I was able to relax.
Despite the statistically proven increased risk of induction, instrumental delivery, Caesarian, and all the other interventions that are more likely to come with a hospital birth, I knew it was the right decision for me. And it really was. Because I felt safe. And women have to feel safe to birth their babies.
For other women, the thought of entering hospital at one of the most vulnerable times in their lives and essentially handing themselves over to a team of doctors and midwives whom they have never met before, with imposing machinery all around them and the sounds of labouring women filling the corridor is something they’d much rather avoid. And, having weighed up the pros and cons and risks and benefits with their own preferences, have decided, for themselves, with their own brains, logic and intuition, home is the right place for them.
Once you chose a home birth, it's not like you're shunned from the obstetric ward, either. Home birth mums know that if things don’t go to plan, or they change their mind at the last minute, they can always, easily transfer to hospital.
The transfer rate from home to hospital for a first time mum is 45% and the most common reason (35%) is because labour is progressing slowly and mum is exhausted. Other reasons include meconium in the water (12%) baby’s heart rate (10%) request for epidural (9%) stitching of tears (9%) retained placenta (6%) concerns for baby after birth (2%).
In other words, transfer is rarely a life or death emergency.
For second time mums, the transfer rate is just 12%.
Birth is not just about extracting a healthy baby - that's vitally important, of course, but should not be the pinnacle of our expectations. With over 28,000 women a year in the UK affected by maternal post-traumatic stress disorder, the mum's experience HAS to be carefully considered too. And birth place is a massive part of that.
Home birth is a legitimate, evidence based choice, which has its pros and cons - as with all decisions in birth. And while it may not be the right choice for me, it absolutely will be for many many other women. And as a doula, that's all I really care about - what feels right for each individual person. Because, after all, birth is not about anyone other than the mum and her baby. Anything else is just noise. End of story.
So please, press. I implore you, let Meghan, along with her birth team, make the choices that are right for her and stop shaming her for doing so. Because at the end of the day, her birth is going to affect no one else but her. The only early Motherhood that's going to be impacted by her birthing decisions, is the one she will experience. All she needs from anyone else is support.
PS I just HAVE to share: I supported my first home birth only last month and it was absolutely incredible. The mum got to birth on her terms and the midwives got to drink tea while she did it, completely unconcerned by what was happening. As community midwives, they tend to only support home births, so they know that when it's progressing normally, which for them is most of the time, it's completely and utterly, well, NORMAL.
How lovely is that?