Sunday, February 6, 2011

Home Birth or Hospital Birth?

Are you going to have your baby at home or hospital?  How many times have you heard that hospital births are safer than home births?  I have heard this said many times during my midwifery journey when discussing birth place choices with women.

Would it surprise you to learn that, for low risk women (eg., women who have no medical concerns regarding themselves or their unborn babe)  home births are as safe if not safer than hospital births (Johnson & Daviss, 2005).  It is safer because at home there is less medical intervention, less pain relief and less instrumental births).  The woman at home is more relaxed and in more control to make decisions (Kontoyannis & Katsetos, 2008), she also feels safer in her own surroundings.  It is known that if animals in the wild are disturbed or feel unsafe or stressed, they will stop their labours until they have found somewhere quiet and dark.  The hospital environment is a strange and unfamiliar one and it can a scary place if you have never been in hospital before, and  If women are very anxious and stressed their labour can slow down, possibly leading to a cascade of interventions.  I am not saying that all women who have their baby in hospital are going to have medical intervention because not all will, however, the risks are greater.

We could debate the patriarchal intervention that came about when data from a British study had been misinterpreted and, the study claimed that home is a dangerous place to birth (Tew, 1995), but we will save that story for another time. Midwives in New Zealand and worldwide are trained to detect any deviations from the normal, that means, if she feels that a problem is arising during your pregnancy/labour or birth, she will, with your consent, discuss the concern with the obstetrician or paediatrician.  This may mean transferring you to hospital but it should be a three way discussion between you, your midwife and the obstetrician. 

The main point is that you have a choice to birth at home or hospital so please discuss your options with your midwife. For women and midwives who would like further reading, I have put the references in full below, also, for those interested in having a home birth a link to the home birth association and the New Zealand College of Midwives are included.

Johnson K.C., & Daviss, A. (2005) Outcomes of planned home births with certified professional midwives:large prospective study in North America.  British Medical Journal, 330, 1416.
Kontoyannis, M., & Katsetos, C. (2008).  What influences women in Athens to chose home births?  British Journal of Midwifery,16(1),44-49.
Tew., M. (1995). Safer childbirth?  A critical history of maternity care (2nd ed).  London:Chapman and Hall.

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