Issue #7: Is home birth safe?
I have just found out that I am pregnant with my first and I really want a homebirth, but my partner is against it as he feels it is not as safe as the hospital. Can you please let us know if home birth is safe?
From Kara
Hello Kara,
Firstly congrats 🎉 on expecting your first bubba. Ohh exciting times ahead! And secondly even more yay 👏 for you researching on home birth!
Before we get started I’m a huge fan of home birth, (which I assume you must know as because you’re here asking) after having two of my own and supporting lots of women to birth at home as a private midwife.
Your partner is not alone in feeling the way he does. I talk to a lot of couples about home birth and the majority is the non birthing person and their concerns for safety and the most common phase I hear is “what if something goes wrong?”
The first thing I always say is, I acknowledge and understand where you are coming from and I understand your fear and concern.
If you think for a minute how pregnancy and in particular birth is portrayed to women in our society with the screaming, with the excessive pain, with the visuals of pushing a watermelon 🍉 out of your va-ja-ja. As women we see it a lot and none of it is pretty, honest or real. No wonder so many women fear childbirth.
Now take your mind to visualise what men see about childbirth. For starters they don’t see anywhere near as much or talk about it anywhere near as much as us women. Secondly, what they do see is rush, quick, hurry the fuck up and get her to hospital and then take a huge sigh of relief because you have saved her and now she’s here with the doctor to save her 🤮 They never ever see home birth, unless they have home birth dad’s in their group. There is nothing in their view point to rebut hospital birth and its always portrayed as fear, medicalised, and risky!
It’s no wonder they don’t feel safe to birth at home because women and birth need saving and if you birth at home, who is going to save them? (and of course you don’t need saving 😉) It’s them the birth partner. Hello, fuck no I’m not having that responsibility!
Plus there is that big question - “what if something goes wrong?” My next question is, “what is the something going wrong?” It’s funny no one seems to know the answer. It’s one of those loaded terms to induce fear and anxiety, and it works a treat because I hear it all the fucking time.
If you haven’t already I would be asking your partner these questions;
Why don’t you feel safe with a home birth? If they state “what if something goes wrong”, then ask what do they envision going wrong? We want to get to the nitty gritty of that. What fear is underlying there? It’s generally a story they have seen or heard. And then the next layer to that is critically review that story, because often I hear “if they weren’t in the hospital she or the baby would have died”. When we peel back the layers of these stories, we often find that the system, the medicalisation of birth and the failure to wait normally play a role in these stories.
What makes you fear home birth?
What makes you feel safe at hospital?
Are you willing to learn more about home birth and it’s benefits and safety?
If I agree to compromise to birth at hospital, what steps are you going to take to educate yourself on the maternity system and how to advocate and support me to promote a physiological birth?
Okay Okay, so is home birth safe?
Numerous research studies show that if you are having a healthy, low risk pregnancy, then the same number of babies are born healthy and well regardless of where the birth was planned to take place. When it comes to the health of babies, the perinatal and neonatal mortality risk is of no difference between home and hospital. So what is the difference?
For homebirths there is;
More chance of going into spontaneous labour
Having a vaginal birth
Not have an instrumental or c.section birth
less likely to have their waters broken
Less likely to have an episiotomy
Less likely to have a postpartum haemorrhage
Less likely to have their baby admitted to NICU or SCN
Reduced use of epidural and pharmacological pain relief methods
less likely to birth on the bed
more chance of having a physiological birth, including third stage
and more chance of longterm breastfeeding
Then we need to factor in the experience. With home births women often receive continuity of care and the majority of that care is either undertaken in the woman’s home or in community clinics.
Women who have had continuity of care are shown to have;
reported higher levels of emotional care
felt more actively involved in her care and decision-making
reduced rates of postpartum depression
felt more in control of their labour
higher satisfaction with their pregnancy and birth experience
Here is a comparison table for planned home birth and planned hospital birth outlining certain outcomes;
Photo: Courtesy from Safer Care Victoria - Homebirth Clinical Guidance May 2021
Also, when we talk about safety with home birth, we need to look at the other option and it’s safety. I won’t go into all the details (there is a great video here that goes through it all, it is a few years old but the findings still stand) but what we do know is;
1 in 3 will women will experience birth trauma (yes thats not exclusive to hospital births but with the vast majority of women birthing is hospital, the majority of this stat will come from women who birth in a hospital setting)
In Victoria in the year of 2021; (stats courtsey of Victoria’s mothers, babies and children 2021 reportVictoria’s mothers, babies and children 2021 report)
54% of women will have either a c.section or an assisted birth with either vacuum or forceps (15.1 % assisted - 39.2% c.sections)
Only 28% of women will not be induced or have their labour augmented (assisted/sped up with assistance a.k.a not physiological)
1/4 of Australian women in the year 2021 had an episiotomy performed (stats courtsey of Health of Mothers and Babies Report)
When you look at the stats coming out of hospitals within Australia, you have a pretty high chance of being cut somewhere - either your perineum or uterus.
I hope this provides some clarity for you Kara and your partner. I do highly recommend making a booking with your local midwife and having an open and honest discussion on home birth. It gives you and your partner time to ask all those questions on how home birth works, because when I have these discussions with families they are very surprised how it actually works and that I am not a crazy midwife who is anti hospital and I actually rock up to home births fully equipped, with another midwife and have with me a mini hospital in a bag. Often the partners have their eyes open to a new way.
Before I head off I highly highly recommend sitting down and watching these movies. Remember men see a really bad shit portrayal of birth and these provide them with a different more real perspective.
Or you can take them to my instagram highlights #birth story and you can watch my last birth which was a home birth. FYI I swear a lot and you may not want to have your volume full ball 😆
Plus you can read and show them these resources
What midwives do at a homebirth
How do homebirth midwives manage birth emergencies
Love Kate 💙