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So homebirth is still selfish?

I know the plural of anecdote isn’t evidence – sadly most of the people commenting on the latest negative homebirth article don’t appear to have got that far in their thinking – each seems to need to say about how their neighbour’s friend’s brother’s wife had a terrible homebirth or that their second cousin’s wife’s best friend’s aunt had a great experience. None of which really helps the debate – each person’s experience of birth is unique and special.

But what really, really bugs me in the whole ‘should women be permitted homebirths’ debate is not so much the continued dictating to women about the choices they can or can’t have in relation to their own bodies, or the fact that the majority of the medical establishment views birth not as something that women are designed to do but as a potential minefield of risks and possible disasters, or even that nobody mentions that in the majority of births any issues that arise are signalled so that something can be done about them before they become a disaster.

No what really bugs me is that when people compare home birth and hospital birth they don’t focus at all on the bad things that happen in hospital.

Because one of the reasons I wanted to have a homebirth was because I didn’t want a forceps delivery, an episiotomy or a c-section and everyone else I knew who had had babies in hospital had had one of those.

And the media also seem to have an awful lot of focus on women being selfish having 2 midwives attending their homebirth.

You know what why shouldn’t women be selfish in labour?

When did we sign up that we women would selflessly not have the best care we can get hold of because the NHS is over stretched and there aren’t enough midwives to go around? I certainly didn’t and in fact one of my reasons behind having a home birth was to give me continuity of care. Yes, that was partly driven because Mr Muddling did not want to be my birth partner but also why should I not be attended in birth just because the system hasn’t got it right.

In fact one of the arguments that is regularly missed out is that in hospital your birth partner frequently has to act as stand in midwife for significant parts of the labour AND because they aren’t qualified and experienced and you haven’t got continuous care things can get missed so instead of being dealt with when issues start to arise they become more urgent, more acute.

What they also don’t focus on is that in your own home you are on your own turf and as such the dynamic between healthcare professionals and yourself changes.

You aren’t submitting to their care, you are permitting them to attend you.

So there isn’t so much of the routine things that we have to do – the vaginal examinations that aren’t actually a necessity but are part of the fill in a form culture, the breaking of waters just because it might speed things alone, or rather might kill your baby if you have one like mine with a placenta with bi-succinate lobes, and the ‘just a little injection’ after the birth rather than considering whether the woman would prefer a physiological 3rd stage rather than a dose of drugs to help deliver the placenta.

Its also apparent that a lot of people commenting on childbirth choices haven’t actually had a baby. The Guardian article contained an awful lot of focus on the mother saying she couldn’t do it and criticising the midwives for not giving her drugs, transferring her or ordering an emergency c-section.

I don’t know about many other mothers but talking to my midwife every single labouring woman she has attended has had that moment of not being able to do it as she goes through transition. I clearly remember shouting that I couldn’t do it, and that it hurt, and that I didn’t remember it hurting this much. And my cruel midwife telling me that it is called labour for a reason, that it does hurt but that most importantly all of this meant I was doing well and that my baby was getting close to arriving.  And you know what, the woman whose birth it was that the journalist attended agrees that it wasn’t  a big deal and she was going through transition and that it wasn’t cruelty or a compromise but more her midwives helping her do what she wanted.

Oh and on the debate that women should pay for choosing this luxury of a home birth actually quite a few of us do.

I hired an independent midwife with both my pregnancies something that was worth a million times its cost. Something that I now believe that every woman should have as an option and without having to be able to afford hiring someone to get your out of a health service that seems to view expectant mothers as wombs on legs not as engaged, informed participants in their labour.

So when someone can give me a satisfactory answer as to why I shouldn’t be selfish in labour and do everything I can to ensure that my experience is as good as it can be then I’ll consider a hospital birth but until then, I will look at my friends who have an almost 100% intervention rate for hospital deliveries and I’ll look at my experiences ‘bravely’ having my babies at home and I’ll know that for me, for us, homebirth was the right choice.

p.s. I had never seen this photo of me post Bigger’s birth – part way through what would have been a medical emergency in a hospital but which was actually a fairly major haemorrhage dealt with calmly and easily at home (although I would say that, I was unconscious but even Mr who was sat rocking Bigger in the rocking chair next to the Aga agrees that it wasn’t traumatic).  So there.

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19 comments to So homebirth is still selfish?

  • I started to think that these articles (about birth or breastfeeding) are written this way only to cause a stir!
    I think that women should make informed decisions about birth. I had both babies at the hospital. Our local hospital is really good. Both babies were born in the water in the home from home unit. Giving birth naturally is quite empowering and yes the women should be selfish.

    • Muddling Along

      Good point – they are after all trying to sell papers!

      The problem I have is that there’s informed and there’s what you are told by medical professionals – for me what I found scary (especially since I consider myself empowered and informed) was the shroud waving based on fiction that I was exposed to when I tried to even gently question the small aspect of protocol

  • Excellent post, as usual. My births were a few years ago, but I did feel from some quarters that my home births were ‘taking up valuable resources’, but the NHS Team of midwives (in 2 locations), all insisted that there was no medical reason to go into hospital, so they would support my home birth.

    No. 1 was delivered in hospital, (long story), and I think that was the initial midwife’s fault for ‘staying in attendance’ during the night when I didn’t need her.
    No.2 was delivered in my lounge, and the second midwife was only here for an hour. Not a massive extra resource. And what did we save on drugs? Hospital beds? Pediatrician time (when a GP can do the checks in local community), etc. etc.

    Thanks Mrs. The debate will continue!….. 😉

    • Muddling Along

      Interestingly one of the aspects that intrigues me is that if GPs are pushed into taking greater responsibility for budgets then will they move to promote homebirths since they are cheaper for the health service if you believe the data trends from the US

  • Great post.
    After an awful experience with number 4 who ended up in special care, which I totally blame on the hospital for the lack of support for my home birth, I used an independent midwife for number 5 so that my home birth was guaranteed (all being well) It was worth every single penny and I feel sad that only a minority of people can share that experience.

    • Muddling Along

      I agree – I feel somewhat guilty that I was ‘lucky’ enough to be able to go down the IM route. Interestingly whilst IMs tend to operate on their own the NHS requires two midwifes – perhaps a reflection upon the trend to de-skill midwives?

  • Excellent post. I had home births with both of mine with an independent midwife. Like you I made that choice because of the fear of unnecessary intervention. I think I had 1 vaginal examination with no 1 and none at all with no 2 because he arrived quicker than expected! I would, in all likelihood have chosen a midwife led birthing unit had one been available for my first. Birth should not be unecessarily medicalised. As you say there are indicators of issues which may require hospital transfers.

    • Muddling Along

      To be honest if there was a MW-led unit here (it was closed a year before Bigger was born) I would have probably gone down that route and there is a part of my drive to have a homebirth that was driven because everyone told me I shouldn’t – and a hope that actually it didn’t have to be just like the ‘but the baby was ok’ experiences of so many of my friends

  • I seem to be one of the lucky few that had a positive hospital experience. Respected my wishes for no intervention (they wouldn’t break my waters even when I asked them to!) and to be as active as possible during labour. I had two midwives present (one student who was brilliant and stayed past the end of her shift to see my labour through to the end), and had a natural 3rd stage. I realise I’m in the minority, my friends all have complaints about their hospital births and many had interventions that they believe could have been prevented. Watching programs like One Born Every Minute, it surprises me to see how quickly medical intervention is suggested or presented as if it’s the only option when it doesn’t always seem necessary.

    • Muddling Along

      And that is fab! Do you think there was any specific reason why your experience was good? Or was it just that you had great midwives (never underestimate the wonder of midwives in my book) and a hospital with an active birth culture?

  • Another fantastic post. I had a hospital birth with fantastic care and it has given me the confidence to have a home birth. What has surprised me is how positive the midwives have been. They seem to be on the mother’s side.
    I love your comments about the ‘can’t do it’ phase. It is so recognisable. I went through that and the midwives had the right mix of encouragement and telling me to get on with it. They didn’t push drugs (I didn’t have any) and resisted intervention, telling me it was down to me, which ultimately it was.
    We have just got to get away from this over medicalised view of childbirth.

    • Muddling Along

      The over-medicalised view of childbirth, the assumption that our bodies cannot cope, the assumption that we are just one moment away from a medical disaster is one that upsets me greatly

      And yes, someone who has been there, seen it, done it telling me that I need to just get over myself, give in and surrender and birth my baby is incredibly powerful – I am a great fan of woman on woman care (and yes, having started to read around historic accounts of childbirth there is something that woman ‘get’ from being attended by a ‘sage femme’)

  • I’ve had 2 c – sections 1st one a premature emergency and the 2nd by choice. I agree with choice and I think home birth should be more the norm as despite my experience I don’t believe giving birth should be as medicalised as it is. I had the option of home birth for no 1 but that choice rapidly disappeared when I found myself 50 miles away in a strange hospital having a premature baby. If I could start again and know all was going to be well I’d consider it.

    • Muddling Along

      E I’m not a medical profession hater, my sister in law has had all her babies by c-section and you know what, without doctors there are an awful lot of bad things that would happen but not every situation will end like that

  • I think the whole thing is very interesting. Before I found out that A&S were twins I was contemplating a home birth, having had a good experience with great midwives in a hospital based birth centre first time. Was not to happen though, and now, as we cross our fingers for a VBAC for no 4 it’ll be hospital again.

    I thought the article was interesting, but, as you say, quite anti-home-birth in its tone, although I thought it encouraging that the consultant she quoted at the beginning as the author of the report was relatively pro the idea for uncomplicated second births (ie the situation I would have been in) – made me feel right which is always nice!

    That said, what gets me about all these articles is that they seem to ignore the fact that what matters most is healthy baby, healthy mother. Whether your baby comes out at home, in hospital or in a layby between the two is immaterial as long as you are both ok. If you are likely to be more ok at home, why shouldn’t you labour there?

    That aside, a GP friend of mine was recently ranting because he never gets to see pregnant women any more. As he pointed out, if he never sees the normal ones, how’s he supposed to know what normal looks like when someone is referred to him… He also objected to being asked to prescribe morphine by the midwives for women he’d never seen and never met. We do have to remember that doctors have trained to help people. They’re not (or at least mostly not!) in it for a power trip or because they like sticking needles in you. I didn’t want a c-s, but I had to take the advice (though not without questioning it) of people who knew the statistics better on what was best for me and my babies. We all came through it safely and for that alone, I would do it again in a heartbeat. Surely with home birth it must be the same. We, and our babies, are all different, and what I did think was interesting was the comment that some women (and I obviously am making a generalisation here) are more worried about the process of birth than the result. I know I was. I didn’t want a c-s because I didn’t want to be seen to “fail”. How can the delivery of a healthy baby (or even two) be seen as failure, however they come out? I think women should have the choice and I think where appropriate what could be more wonderful than delivering at home, surrounded by loved things in a safe space. But where it is not advised (which was, of course not the case with the woman in the article), isn’t that just foolhardy, and yes, maybe even selfish?

    Sorry, too long as usual…

  • Di Mayze

    Hi Thanks for your article. I think Home births do get a bad press, when my husband & I agreed on one the first thing my father said was “What happens if there is an emergency & you need to be in hospital?” I knew I couldn’t rely on his support & a guilt of using up scarce nhs resource promoted us to hire an independent midwife. Turns out my husband was the best midwife there ever was and as our baby landed in his arms after a labour without any intervention (that there would have been in a hospital with the baby bring 11 days overdue & me having pushed for over an hour and not getting anywhere). Let parents to be decide where is best to have their baby!

  • Juliet

    Cracking post. They just get better and better! Every mother should be able to make an informed decision on the way they birth their baby and then manipulate father to agree with said decision! Joking aside, I know so many people who had amazing home births … I also know many people who had difficult labours in hospital which wasn’t as they had dreamed. My 2 planned c-sections were perfect, I know no other way … I am proud of me for listening to my obstertrican and making an informed decision with his advice. I don’t see myself as failing because I didn’t have any labour pains. It’s not about the birth, it’s the journey after you have to worry about!

  • I’m still rather sad that Meredith refused to budge without help so I didn’t get my home birth. I don’t think it’s at all selfish to want the “best” option for labour for yourself and your infant, whatever you deem that to be. And I don’t think two mws is selfish.

  • I’m preparing to have my first child and it’s been homebirth on the cards from the start. I’d like to avoid the hospital if I can because I associate a lot of risks *with* the hospital. Articles like the one from the Guardian led me to think I’d have to fight for a homebirth if I wanted one and so I prepared to put up with a lot of negativity from the outset. To my surprise, every health professional I’ve deal with has not only been supportive of our decision but has actually been really warm and positively encouraging. My GP has had two homebirths herself. Apparently, homebirths also usually work out to be cheaper for the NHS than hospital births so I don’t really see how ‘cost’ could come into the argument for selfishness.

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