Home Birth - A Complete Guide
Where once home birth was the norm, today there are just 2.3% of women who opt to give birth at home (Part of Characteristics of Birth 2, England and Wales, 2012 Release 2012). For the majority such an idea very often seems a far riskier an option than choosing to give birth within a hospital. With this in mind, and as a mother to be myself, I wanted to comprehensively explore the option of choosing a home birth and specifically ask, whether for a first time mother such as myself, if a home birth is particularly risk prone.
Home birth: A biased opinion
Whilst this article presents plenty of cold, hard statistics I must outline now that it is a topic upon which I’m slightly biased. For me, having an option of home birth, notably for my first child, is a more than welcome relief, particularly as the mere thought of attending any frantically busy medical centre can raise my heart rate so much so that at my last Doctor’s visit the blood pressure results were rendered useless.
Who is a suitable candidate for a home birth?
Most women will be a suitable candidate for a home birth, even those who will be giving birth for the first time.
Who isn’t suitable for home birth?
There are some women who are specifically not suitable for a home birth, this includes women who:
Have a medical condition such as high blood pressure or diabetes (either gestational diabetes or otherwise).
Have had a C-Section previously or who have undergone any other form of uterine surgery.
Have suffered from pregnancy complications in this pregnancy or sometimes previous ones (such complications may include premature labour, preeclampsia, twins or a baby who is found to be in the breech position at 37 weeks).
How do home births work?
When you go into labour you’ll call your community midwife, who will then attend your address to see how your labour is progressing and to confirm what stage you may be at. He or she will time your contractions and talk to you and your birthing partner to find out how you may be feeling. He or she will then carry out a standard medical examination and confirm how far dilated your cervix may be.
At this stage you midwife will either stay with you, or may leave to come back later, this will depend upon the results of the examination as well as how far along you are. When you reach the final stages of labour your midwife will contact a second midwife to attend so that when your baby is actually born both midwives are in attendance.
With a home birth you still have many of the same options that are presented to you if you were to give birth in hospital or within a birthing centre. Specifically this includes things such as pain relief options (the choice of pethidine and demerol, for instance) and you can even opt to have a water birth within your own home.
That said those who choose this route must appreciate that if any issues or potential warning signs do arise (such as a change within the baby’s heartbeat, signs that mother or baby are in distress or a drop within blood pressure) then there will most likely be a transfer to hospital if deemed necessary.
An Epidural: One thing you will need to go without
Epidurals are one thing that won’t be available as an option to you if you choose a home birth. Due to the nature of such pain relief, and the fact that both mother and baby must be closely monitored after it, epidurals are only provided within a hospital setting.
Is a home birth safe?
As of 2014 there seemed an official push for home births and alternative birthing options. Today there continues an uprising of shiny new so-called ‘birthing centres’ which present a halfway house between home and hospital, this, in addition to a promotion of home births, are aiming to reduce the immense pressures that hospitals face today. This would, for the cynic, perhaps raise the concern that home births are merely a way of reducing the burden upon hospitals, to the detriment upon mother and baby.
Home births: “Better for mothers and often as safe for babies”
All governmental health policy is only put into place following a full analysis, usually by the National Institute for Health and Care Excellence (known as NICE for short). It is this body that specifically stated that home births were “better for mothers and often as safe for babies”. The operative word that I personally take from this sentence however is ‘often’, particularly as most mothers would likely agree that any added risks to either the mother's or baby’s health through labour are both unwarranted and unjustifiable for the sake of convenience on behalf of a hospital. So the question is whether there really are any additional risks to opting for a home birth.
The solid stats behind home birth
Research has found that around 45% of women are at an extremely low risk of labour complications and as such, may be better giving birth outside of a hospital setting.
Beyond this however the largest study into home births found the following:
For those who are having a second baby onwards, home births are as safe as giving birth within a hospital setting, and moreover actually offer additional benefits for the well being and general health of the mother.
For those who are giving birth for the first time, home births are subject to a slightly increased risk of an adverse outcome’ (which can include everything from a birth injury through to the death of mother or child). For women who give birth in hospital there were 5.3 in every 1000 borth that had an adverse outcome, this then compared to an incidence rate of 9.3 out of every 1000 births with an adverse outcome for home births. These figures then equate to a 1% increased risk for those opting for a home birth.
Do you remain unconvinced that home birthing should be an option for mothers to be?
Home birth or hospital?
The positives of a home birth
One factor that I did find surprising is that far from home births presenting potential problems it can instead actually offer up some advantages over and above hospital births, specifically these include the following:
A lowered risk of the women undergoing a C-Section (which arguably lends favour to the point of unnecessary medical interventions becoming more commonplace).
A lowered risk of interventions such as a forcep or venous delivery.
A lowered risk of Hemorrhaging.
I hope that this article serves to inform other mothers to be in their birthing choices and I’d love to hear about your thoughts on the issue of home birth in the comments section.
I myself can’t wait to give birth in a setting that I call home and in addition to my planning for this I’ve also been researching the possibilities of a water birth, and thinking about my pain relief options, both of which are topics that I’ve also recently written about in other hubs.