Home Birth - Should you choose a homebirth
and is homebirth safe?

Many women and couples like the idea of giving birth in the home environment.

It is a place where you are more in control and if you feel that there is no medical need to give birth in a hospital then a home birth may well suit you and if you are a resident of the UK, you are entitled to have the presence of an NHS Midwife at your home birth. Certainly if you plan to have a waterbirth (link to page), then in order to guarantee access to a birthing pool, you may want to have a homebirth, as not all hospitals in the UK have enough for pools for every woman who would like one.

Obstetric Healthcare providers often claim that a hospital birth a safer than a homebirth, but there is absolutely no evidence for this with a normal risk pregnancy with no anticipated problems. Of course if your baby is breech, you are expecting twins, have pre-eclampsia or any history of medical problems around birth, then you will want to follow the medical advice that you are given for the safety of yourself and your baby. However, in a hospital environment you can still use the Second Nature Birth Programme as it will help you remain more relaxed and in control in any birth environment. The most important factors are that you should feel confident, safe, respected and supported in whichever birth environment you choose.

There follows a sample piece form Sarah Wickham. She describes some of the salient issues around the choices of place of birth. While we at Sussex Natural Childbirth agree in principle with her comments, we also feel that she does generalise about the hospital birth environment and so the article has to be taken in context.

Homebirth: What Are the Issues

This article is copyright to Sarah Wickham at www.withwoman.co.uk

It is well understood that sensations of pain in labour are regulated by hormones released by the woman’s body. During labour, oxytocin—the hormone that causes contractions and helps the baby be born—works in harmony with endorphins—the body’s own pain relieving hormone.

During a homebirth, the woman’s body will release these hormones according to her needs and she will usually cope well with the sensations of labour.
When a woman attempts to give birth in another environment such as a hospital, however, this process may not work as well. Even if a woman feels rationally that hospitals are “safer” places in which to give birth, her subconscious mind knows that this is not the case, and she feels insecure. This causes her body to secrete the hormone adrenaline, which causes the levels of both oxytocin and endorphins to drop. She experiences far more pain than she would in her own home. Women experience lower levels of intervention at home.

There are two main reasons that women experience lower levels of intervention at home. The first concerns the hormones described above. Adrenaline inhibits the release of oxytocin, and labour may well slow down. Although this slowing of labour is a natural safety mechanism designed to let the woman know she needs to find another environment, it is interpreted by many medical professionals as “failure (of her body) to progress.” Rather than suggest that the woman talk about her fears or find a different environment, they will turn instead to drugs to speed up the labour. This drug can cause distress in the baby, among other effects, and often itself leads to a “cascade of intervention” which may result in an instrumental delivery or a caesarean.

The second reason is that hospitals are systems that need to run efficiently. They need to have procedures in place for workers to follow so that chaos does not ensue. Unfortunately this often means that hospitals have policies where a certain number of interventions are carried out on all women who choose to give birth there. Often there is no evidence to support these interventions, and many of them are known to be harmful when used routinely. Every intervention is useful to a small number of women when used appropriately, but when applied to all women they often cause far more harm than good.

Sara Wickham, excerpted from “Homebirth: What Are the Issues?”.