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Column I had a home birth – and all mums should have the same option

Why shouldn’t women have the choice of giving birth at home? The belief that all mothers need to be in hospital is an urban myth, writes Eva-Louise Goussot.

THIS TIME LAST year I was 35 weeks pregnant. I was standing in the Rotunda Hospital clutching my urine sample in a crowded corridor waiting to see ‘the consultant’. I waited for over two and a half hours.

I waited not because I was going to have my baby there – but because I was not going to have my baby there, My pregnancy had been deemed low-risk, and I was planning a home birth. It turned out that I waited so that the consultant could give me a 15-minute lecture on safety. The consultant told me it was his duty as a Health Professional to advise me of the risks involved in having my baby at home. Home birth was OK for second time mothers or Scandinavians where there is proper infrastructure, but not for women living in Ireland (even if they were Scandinavian)!

Nobody ever thought to tell me about the dangers of giving birth in hospital. Nobody in the Rotunda mentioned the swine flu outbreak at Christmas 2010, or the fact that the ceiling collapsed outside an operating theatre in July 2011. Nobody mentioned MRSA. There was no mention of the Bump to Babe Consumer Guide to Maternal Services which had come out that very day. Nobody told me in the Rotunda that as a first time mother I had a 29.7 per cent chance of having a Caesarean section and only a 10.9 per cent chance of having what the Rotunda classifies as a normal birth.

Neither did anyone think to mention that if I was lucky enough to live within the catchment of one of only two midwifery-led units in the country I would have an 83.3 per cent chance of a vaginal birth. Or if I lived south of the Liffey and was within the catchment of the NMH Domino midwives I would have an 87 per cent chance of a normal vaginal birth.

But we need to move beyond the safety issue. Time after time the research shows that midwifery-led care, whether at home or in hospital, has better outcomes with less interventions than consultant-led care; yet we are still stuck with a medical model for childbirth.

‘Unnecessary interventions’

Krysia Lynch from the Home Birth Association says, “Midwives are the key professionals in normal birth. They view birth as a normal physiological experience. In contrast obstetrics is the profession that deals with abnormality in birth; here birth is only viewed as normal in hindsight. Part of the problem is also that we as a society have bought hook line and sinker into the great urban myth that we need to be in hospital to be safe and that we need a consultant to give birth.

“Indeed, some 15 per cent of high-risk women do need these things, but where does that leave the 85 per cent of us that are low risk? I’ll tell you where. It leaves us facing unnecessary interventions in busy maternity units stretched to their limits.”

Recently the Minister for Health James Reilly told the Irish Times that more women should be offered the option of birthing at home in Ireland. Surprisingly, this news was greeted with a torrent of negativity from lead consultant obstetricians. The very same lead obstetricians who last winter publicly announced that the maternity units they managed were understaffed and potentially unsafe.

Whilst re-structuring of the maternity system to enable more midwifery-led care and greater domiciliary options for mothers will indeed incur start up costs, in the long run all the research indicates that this will be more cost-effective and will offer mothers and babies better outcomes, greater choice and more satisfaction.

Mothers choose to birth at home for many reasons. The most commonly cited one is safety, followed closely by the continuity and quality of care provided by a midwife. Many mothers like that labour can take its own course without the interruption of a car journey to hospital. The familiar surroundings of home and the lack of hospital routines help to make birth more normal and less frightening, and also allows for mothers to stay close to other relatives, additional birth partners and older children.

‘Amazing bond’

Childbirth is something that many women have been encouraged to fear, but for me it was the most empowering experience of my life. My midwife met me first when I was 12 weeks pregnant and at every antenatal visit stayed at least two hours, learning about me and my fears and my cares. She prepared me, coached me and mentored me for the eventual marathon that was my labour and natural birth. When my daughter was born she was laid on my chest and my midwife helped me to latch her on the breast.

It was hours before she was weighed and dressed as my midwife was reluctant to interrupt our skin to skin contact. It was many more hours before she left and not before she had shared a celebratory dinner in our kitchen and tucked me, my husband and baby in bed together. One of the greatest advantages of giving birth at home is that your partner is not sent home and indeed my baby spent most of her first night asleep on her father’s chest. What an amazing start to their bond.

My home birth experience with my first child was not so much about having a baby at home but about giving me and my baby and my family the best start together. Whether you want to give birth at home or in hospital, it should always be about where you feel safest – but everyone deserves the level of care I received.

A midwife at the recent International Conference on Human Rights and Childbirth summed it up, when she said: “It is a fundamental human right for women to choose the circumstances in which they give birth, with whom and where, including a choice between hospital and home birth.”

Eva-Louise Goussot is a member of the Home Birth Associaiton. For more information on home birth see Bump2babe is the consumer guide to maternity services in Ireland. Anyone looking for support around maternity issues in general can contact Aims Ireland.

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Eva-Louise Goussot
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