Home Birth

Many women do not even think about a home birth as an option but some recent research by the National Childbirth Trust has shown that at least one in five pregnant women would like more information given in a supportive way [1].

Home births account for about 1-2% of all babies born in the UK with some wide geographical variations ranging from under 1% to over 20%.

We fully support women who plan to birth at home. In fact we always promote this to clients because for women with a healthy normal pregnancy, home is as safe if not safer than hospital.

We feel we should be honest with women about the risks of going into hospital, which include a one in four chance of a having a caesarean, about a one in three chance of some kind of instrumental birth and far more chance of the baby getting a hospital infection.

We are constantly amazed how empowered women feel after they have birthed their babies at home, with their family and comforts around them, and the wonderful intimate hours together after the midwife has left.

Some frequent questions prospective parents ask about home birth.

"Is Home Birth Safe?"

With regard to the safety issue there is no evidence to support the notion that home birth is less safe than hospital. In fact the risks associated with a hospital birth such as risk of infection, less one-to-one care, more medicalisation, are overlooked and can be equal or greater than the benefit of immediate access to medical attention.

Planned home birth is safe and associated with good outcomes for women and babies [2] and there is lots of evidence to demonstrate this. The National Birthday Trust Fund conducted a comprehensive UK study in 1994-5 for almost 6000 women who booked a home birth and matched them to similar women planning to deliver in hospital.

The results of the research showed the home birth group (which included women that transferred into hospital) had half the chances of a caesarean section or instrumental birth. This is very significant given the alarming increase in the caesarean section rate, and has been demonstrated in further research that planning a home birth increase spontaneous vaginal birth. [3] The home birth group were less likely to use drugs for pain relief, and more likely to use non- drug methods such as water, aromatherapy and homeopathy, had fewer episiotomies and post-partum haemorrhages. Babies in the home birth group were less likely to be in poor condition after birth (with low APGAR score) and had fewer birth injuries [4].

"What Do I Need For A Home Birth?"

Not much in fact. The most important thing is a plastic sheet to protect floors, sofas and beds, and some soft covering like old sheets or towels. And then lots of nice little touches like music and candles for atmosphere, comfort foods and drinks, ice cubes, hot water bottle for example to help with labour. We always discuss this in more detail nearer the birth – we find that women feel settled and relaxed knowing that all is in order.

"Is It Messy?"

We find that birth isn’t messy actually, but perhaps that’s because as midwives we have seen so many births! Provided there is adequate protective covering, everything can be folded up and put into a dustbin sack and you’d never have known a baby had been born. So many of our clients comment afterwards that they are so pleased that the carpets are clean!

References
[1] Singh D and Newburn M (2000) Access to maternity information and support: the needs and experiences of pregnant women and new mothers. London:NCT
[2] Campbell R and MacFarlane A (1994) Where to be born? The debate and the evidence. Second Edition National Perinatal Epidemiology Unit :Oxford
[3] Hodnett ED. (2001a) Caregiver support for women during childbirth (Cochrane Review) The Cochrane Library. Issue 3. Update Software: Oxford.
[4] Hodnett ED (2001b) Home-like versus conventional institutional settings for birth (Cochrane Review) The Cochrane Library. Issue 3. Update Software: Oxford.
[5] National Birthday Trust Fund (1997) Home births, the report of the 1994 Confidential Enquiry Parthenon Publishing Group: London