Homebirth FAQ's

I wrote a post last week, explaining why I'm planning a homebirth, and what's made Boyfriend and I decide that it's the right option for us. That post did fail to address some of the most common questions (or comments) that people have when they hear that I'm hoping to give birth in my own flat though. These tend to cover the logistics and nitty gritty, the blood, sweat and tears (literally) which I didn't really go in to in my previous post. I'd been thinking about writing this post since I published the previous one, but a conversation yesterday that focussed particularly on Question 1 below, prompted me to share this now.
 
 
 
So picture the scene, I'm chatting to someone about pregnancy type stuff and happen to mention that we are hoping to be able to have a homebirth - these are the most common responses (in no particular order).
 
  1. What about the mess? This is often expressed also as "Oh, I couldn't deal with all of the mess!" - this one perplexes me, it quite often comes from people who've actually been at the birth of a baby in the past - exactly how much mess do you remember there being? There will be a bit of blood, but the baby comes from the uterus, where it's been living in a litre of amniotic fluid, you are not opening up your body entirely, other than in unfortunate circumstances, blood loss is pretty minimal. There is also the amniotic fluid itself to consider, but many people experience their "waters breaking" before they go in to labour anyway, so the risk of getting fluid all over the carpet isn't unique to homebirths, equally, it could go in the car, on the bus or in the bakery. Above and beyond that, the only mess you're looking at is the possibility of a rogue poo (pretty easy to clean up) and vomit (have a bowl handy). For the blood and fluid loss, it's easy to invest in plenty of cheap waterproof covers for any surfaces - a nice big tarp for the floor and some pound shop shower curtains to chuck over sofas etc. That should work to grab anything, and can be rolled up and disposed of (by the midwives, they fully expect to take on this responsibility - the cleaning isn't yours to do). It's worth having something (a bucket) to put the placenta in after delivery - your midwives will take this away with them unless you choose to keep it. Quite simply, the "mess" that most people imagine, doesn't exist. And personally, I'm hoping to give birth in the birthing pool anyway so hopefully anything gross is contained, many other women labour in the shower or bath which is very easy to rinse out after the event.
  2. What if something goes wrong? This is the most common question, and the most common objection to homebirth. It relies however on two assumptions: 1) that homebirth creates more medical risks than it avoids and 2) that complications can't be handled outside of a hospital environment. Both of these are misinformed. A majority of "things going wrong" that take place during labour and childbirth, take place because the woman is labouring in hospital. This isn't the hospital's fault. Labour can only progress, and birth can only take place, if a very very delicate and exact cocktail of hormones are charging around the woman's body in perfect balance. The body is capable of producing these hormones in the exact quantities needed, at precisely the right time, to create a whole chain of events that result in the baby being born. One inaccuracy in this intricate balance of hormones, and things start happening in the wrong order, or not at all. If a woman is disturbed, in any way frightened, or if she is concerned with something other than giving birth, if she meets an unfamiliar person, hears an unfamiliar sound, is expected to engage in conversation or answer a question, has to move when she does not want to move, is touched in a way that she didn't invite, or has to use the rational, everyday part of her brain for anything including answering the question "do you need something to drink?" - then those hormones are sent spiralling out of whack. That right there, is the main cause of complications during labour. The NHS guidelines, along with every other medical guidance available to families in the UK, clearly states that for low risk pregnancies, a home birth is deemed as safe, and in many cases, safer, than a hospital birth. The second most common cause of complications in pregnancy, is laying a woman on her back during labour and birth. Avoid that and you've once again halved your likelihood of experiencing any complications. If the odd special circumstances do present themselves, remember that you have two highly qualified midwives in attendance, exactly the same as you'd have available to you in a hospital. The absolute worst case scenario would be that you would need to be rushed to hospital for an emergency caesarean - which is what ambulances are for. The time taken to transfer a woman from home to an operating theatre, and from a labour ward to an operating theatre, actually don't differ that much.
  3. Oh I'd want to be where the drugs are! This one really depends on personal preference, experience and expectation and as such, it's a bit of an odd thing to say. See, I don't want to be where all the drugs are, so... that's why I'm birthing at home hopefully. If you do, that's absolutely super cool, but the fact that that is what you want from your birth experience has nothing to do with what I want from mine! HOWEVER, of the pain relief options available to women in labour, only one is available in a hospital and not at home, and that is an epidural. If you want to have access to an epidural during labour then you will need to be on a labour ward, so of course a homebirth isn't going to be for you. You can have gas & air and pethedine at home though, and your midwives will bring this in their "kit". Homebirthing women, because their hormones are better kept in check (see above) and because they are calmer and more comfortable thanks to being in a familiar environment, without lots of beeping machines and the smell of medicine in the air, report experiencing a lot less pain during labour and birth anyway, and this is backed up by figures which clearly demonstrate that home birth patients rarely use the pethedine that's available to them, and almost never transfer to hospital just so that they can get access to an epidural.
  4. If you want to die on your living room floor, go ahead, be my guest. Ok this isn't a common response - it's a one off response, and it is vulgar, disgusting and completely unjustified but it was one response I did get - just to qualify, comparatively, whilst more births take place in a hospital environment than a home environment, and high risk pregnancies rarely end in a homebirth, the chances of a woman dying as a result of giving birth at home are pretty much zero. There has been one recent-ish case in the UK, but tragically that lady would have died had she given birth in a hospital anyway. In much poorer countries, where homebirths usually occur amongst remote rural communities with little access to medical professionals, or clean, hygienic conditions and pure water, yes, birth is a dangerous business, but we're not in rural India (and actually, in India, many poorer people choose to birth at home because hospital conditions are so atrocious.)
  5. Just seems a bit risky, you never know what's going to happen. Correct! No two labours and births are the same, and it's impossible to tell exactly how things are going to pan out. That's why I've chosen to give birth where the conditions are best suited to allow my body to produce the correct hormones, in the correct amounts, at the correct time, to minimise my chances of any complications occurring. I've also opted for the only labour and birth option in the UK which secures me two fully qualified midwives for the duration of my labour, rather than a hospital birth, where midwives are stretched to their limits and often having to care for several labouring and birthing women as well as new families at once, stepping from one delivery suite to the next and having to adjust to a different set of circumstances each time. Also, as a hospital-birthing Mum I'd be congratulated for staying at home for as long as I could "manage" with no access to medical assistance what so ever, and no monitoring of mine or my baby's wellbeing - I'd even risk being sent home again if I sought to access this medical assistance "too early". As a homebirthing Mum, I would have the continuous care of a dedicated midwife from start to finish, and could labour calmly and comfortably with constant access to his/her professional opinion and guidance at any time. Afterwards I'd be in my own familiar environment, with a significantly lower risk of infection - which sounds like the "riskier" option to you?
But you live so close to the hospital! This presents an argument for and against really. One of the main reasons I've opted for a homebirth is that I live within a 10 minute drive of a very good maternity hospital. If I need it, it's there. The fact that it's nearby doesn't seem like a reason to use it, but at least I can. Many homebirthers start out discussing homebirth as a result of living very far from the nearest hospital, which is what I think confuses people. Risking giving birth in your car en-route to a far away hospital (as is the reality facing at least one of my friends at the moment) is obviously a less attractive prospect than homebirth!
 
If you've got any questions about preparing for a homebirth, please get in touch, if I can help, I will, if I can signpost you to someone else who can help, I'll do that. These are the questions I find myself answering about my birth choices, but I'm sure you've had some different concerns to face from well meaning (or less so) friends, whatever sort of birth you've planned!
 
As always, when I write about my decision to have a baby at home, please remember that my son was born on a busy labour ward, and I had a positive birth experience. I am by no means "against" hospital, surgical or otherwise medicalised births as long as they're approached by a couple who're entirely confident and happy with their decisions. I never seek to convince anyone that a homebirth is the right option for them, just because I believe it's the right option for me, nor do I suggest that anyone has made the wrong decision by deciding to labour and birth differently.

4 comments:

  1. I love the idea of a homebirth and have always wanted one but I have a blood condition that won't allow me too. It's such a shame I will never get to experience one x

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  2. I'd love a home birth!! I was always high risk for one reason or another though *sigh* Maybe one day!!

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  3. After having 2 quick drug free births at hospital, if we have a 3rd I am definitely going to be looking into a home birth, will definitely be stalking your blog to see how you get on. #mummymonday
    www.mums-space.co.uk

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  4. Great post, I might go back and edit my homebirth post to link to this one of yours. Some well written points there. I loved my home birth, and if I had a third I would most definitely have another home birth! It was an amazing experience. :) x

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