In 2013 just 2.3% of women in the UK gave birth at home. In 2014 my wife became a member of that year’s exclusive statistic. It would be fair to say that my initial reaction to the idea of homebirth was far from positive. We had spoken vaguely of her having a homebirth if we were ever to get pregnant, but I had always rebuffed the idea off hand. Even when my partner explained the difficulties she had encountered during a hospital birth with her first child, and how she had no desire to repeat the experience, I always assumed that when the time came we would be coming out of the ward with an NHS nappy on our youngest. We would have to be insane not to, right?
Part of the reason the majority of the British public (including myself) react to homebirth in this manner is the stigma attached. The idea of the incense-burning tree huggers as the only people crazy enough to request a homebirth is hard to shake, and for a small number, the stereotype may be true. However, the majority of women I have spoken to on the subject are not out to martyr themselves for a higher belief. They simply want a positive birth experience. An Australian study in 1996 spoke to women who had chosen homebirth, and they overwhelmingly stated that they didn’t want their labour to be an exercise in survival but instead a positive, enjoyable experience. After all, isn’t it meant to be one of the happiest days of your life?
Another reason for the negative press that homebirth receives is down to scaremongering in the press itself. Articles titled ‘Home birth: What the hell was I thinking?’ or ‘Call the Midwife? I’d rather have a doctor than a homebirth.’ are unfortunately par for the course, and feed in to the stereotype that homebirth is more dangerous than hospital birth. Studies have shown repeatedly that this is not the case; some studies even suggest that homebirth may be a safer alternative in low risk pregnancies. It is certainly irrefutable that births occurring in the home are far less likely to require medical intervention. Quite possibly the most egregious proponent of scaremongering I have witnessed is a site called ‘Hurt by Homebirths.’ Set up by a doctor, of all people, the site claims to be a ‘safe place’ for women to tell stories of home birth fatalities. I would argue that there is nothing safe about giving only one side of any argument. Where is the safe place on this website to offer positive homebirth stories, or ‘Hurt by Hospital’ stories?
Perhaps though, the biggest reason for our distrust of homebirth is simply the notion that when you’re pregnant, you go to hospital. It is so far ingrained in our culture that this to me was so certain a universal truth as to be up there with the classics such as: ‘we will all turn into our parents,’ or, ‘if the gin comes out someone will inevitably start crying!’ Prior to our pregnancy two things were clear to me about birth – One, it’s going to hurt, and two, it happens to your partner while you as the lazy patriarch sit in a waiting room! My wife managed to prove to me that neither of these two things has to be true. Quite honestly, if she hadn’t been so adamant and I didn’t have as much trust in her, then I would have been sat in a waiting room with the rest of them. But it hasn’t always been this way.
When we were making the decision to have a homebirth, we asked our grandparents about their birth experiences and were surprised to learn that the majority of their children (including some of our parents) had been born at home in the 1950’s and 60’s. The Office for National Statistics tells us that in 1963, 30% of women gave birth at home. From 1963 to 1975 this figure dropped at a staggering rate to 4.2% and finally fell to an all time low of 0.9% in the mid-eighties. One of the central reasons for this steep decline in homebirth rates was due to campaigns run in the 1950’s encouraging mothers to go in to hospital to give birth. Post war Britain suffered from poor housing and health conditions and it was generally accepted that the safest place for women to give birth was at home. This coincided with a reduction in stillbirths, and a precedent that continues to this day was set.
What really surprised me was just how deeply this precedent was ingrained. I expected negativity from friends and family but I knew they would ultimately bow to our decision. What surprised me was the kickback from medical professionals. Our local midwife was a perfectly caring and attentive healthcare professional throughout the pregnancy, but you couldn’t help noticing that once we had mentioned homebirth there was a look in her eyes that screamed ‘child killer’ every time she asked if homebirth was ‘still the plan?’ Several women I have spoken to who had planned to have homebirths were actively dissuaded from doing so by their midwife. This was particularly the case if it was their first pregnancy. Even for a couple such as ourselves, who were as prepared and educated on the subject as we felt we could be, it was at times an uphill struggle. One midwife during labour actually called the hospital and booked us in for an induction even though we had specifically requested no inductions unless there was a medical need.
It would seem that the art of natural childbirth has been lost amongst the midwife community. We are so used to being in the hospital, that interventions and erring on the side of caution have become the norm. The funniest moment of our labour was when one midwife asked my wife ‘what we were going to do if our daughter didn’t come out naturally.’ The look of disdain on my wife’s face was priceless. I am not suggesting that midwifes are stupid or ignorant, but simply that this particular midwife hadn’t encountered our situation before and didn’t have the correct knowledge to deal with the situation adequately. If the culture is to be changed, then we need to educate the healthcare professionals on the benefits and practice of homebirth. NICE guidelines now state that midwife-led care at home is safest for women with low risk pregnancies, and that all women should be offered this option. Unfortunately it is not enough to merely implement the guidelines, the next step must be to educate the practitioners.
Homebirth is not for everyone, and I understand that choice is the most important factor in deciding the correct option for each individual and their family during childbirth. But the culture needs to change. Our only concern upon choosing a homebirth was that if anything did go wrong the blame would be placed squarely upon us, and the support would not be there in the aftermath as a result. Most people are not living in cholera-infested squalor, and should they have known the benefits of a homebirth they may have altered their decision to have a hospital birth. I will be forever grateful to my wife for making me do my research about homebirth and for giving me the most memorable, exhilarating and tiring thirty-six hours of my life. Perhaps the best part of the experience was that once the midwives had completed their paperwork and were on their way home, we were already there.
By Ashley Birch