Thursday, April 16, 2009

More from the UK

Another article has come out of the UK in support of the recent article in the British Journal of Obstetrics and Gynecology. We need to make sure this information doesn't just "come and go."

Annalisa Barbieri: I gave birth at home – and here's why

A hospital is not a natural environment for a natural event.

This week a study – the largest of its kind – was published in BJOG: an International Journal of Obstetrics and Gynaecology. It showed that giving birth at home was "as safe" as giving birth in a hospital.

Periodically, we get studies like these. They come, they make a bit of a splash and then they go again. What they're saying however is so fundamental that we can't ignore it. Because a woman's experience of labour can shape her entire life, even the relationship she then forms with her child.

I'd go further than these studies and say that giving birth at home, these days, is safer than being in a hospital. A woman in labour needs to be confident and relaxed. Fear is the enemy of labour progressing because it causes the woman's body to release adrenalin which inhibits oxytocin – the hormone needed to make the uterus contract.

A pregnant woman needs to build a relationship with her midwife so that she feels confident and the midwife can anticipate problems before they actually occur. Despite popular scare-mongering, a woman or her baby don't just die without warning in labour. There are signs that something is amiss, and these signs can be missed in a busy hospital.

All of this is difficult to achieve in a hospital where you're in a strange place, with people you may have only just met coming and going ("how are you getting on?") and with the almost constant threat of induction (which ironically is when they administer artificial oxytocin – having inhibited the natural stuff – to speed things along) if your labour doesn't conform to their timetables.

In The Father's Home Birth Handbook (a quite brilliant book, as dads are often more fearful than women of homebirths), it asks which would you prefer? Having sex at home, all low lights and candles; or in a hospital with bright lights, and where everyone is monitoring your every move. A hospital is not a natural environment for a natural event.

Eight weeks ago I gave birth to my second child. She was born at home. I had no drugs. Easy for you, you may be thinking: you were obviously low risk, brave and had a high pain threshold. I was none of those things. I was 42, my previous labour had ended in an emergency C-section and I'd spent five years grappling The Fear. But, crucially, since I'd last given birth, I'd been a lay representative in a major maternity hospital (so I had also seen the wonderful things hospitals could do) and spent four and a half years as co-founder of a parenting board. I learned that the majority of problems with childbirth weren't solved by hospitals, but introduced by them.

When I hear a woman say, "If it wasn't for the hospital little Johnny would be dead" and trace the story back, nine times out of 10 you see little Johnny would never have got into distress if his mother hadn't been in a hospital in the first place.

Home births aren't for everyone. But then, neither are hospital births, which also carry risks. We're in a unique position now in that we have more medical knowledge than ever before and most of us are near a hospital in case we need to transfer. Yet women are still told of all the risks of a home birth, and none of the benefits. The latter far outweigh the former.

Annalisa Barbieri is co-founder of www.iwantmymum. com

1 comment:

Amy Romano said...

Nice post and I totally agree. I've decided in my risks/benefits discussion with clients, I'm going to start talking about one of the serious risks of home birth - the risk that the woman will become a tireless advocate of maternity care choice; become a childbirth educator, doula, and/or midwife; start a blog; etc.! :) A good birth changes everything, and I've seen so many women so transformed by their birth experiences that they want to tell the world about the alternative to the dysfunctional and disempowering package of care that our maternity care system has to offer.

Glad to have found your blog! I'll be blogging over at starting next week on all things birth-research-related. (Am guest blogging on Lamaze's Giving Birth with Confidence Blog already)