Home birth - the pros and cons
The number of home births in the UK is on the rise, and not without reason, but it's not for everyone
Posted: 12 July 2010
In the old days of course, all women would labour and give birth in their own homes but over the course of the last century, as medical science developed, it became the norm to have a hospital birth. In fact, not only did it become expected that all mothers would have hospital births, but home births were discredited as an unnecessary risk and even selfish. These days however, the pendulum is slowly swinging back to a more balanced position. The number of home births is on the rise and the obstacles to homebirths are lessening. Home birth is still, however, tainted with an 'unsafe' reputation in many quarters, and many women still find that they have to overcome opposition from their doctors if they wish to have a home birth. So what are the real advantages of a home birth, and is it a 'safe' option?
Advantages of a home birth
Disadvantages of a home birth / hospital advantages
- Familiarity - Giving birth in familiar surroundings can raise your confidence during labour, make you feel more in control (if all is proceeding well) and make you feel less inhibited: all of which can help ease labour.
- Low intervention - There's a far lower incidence of medical intervention in homebirths, whether that's prepping with shaving, having your waters broken, electronic fetal monitoring, medication or episiotomies. This is important because once medical intervention is initiated in a labour it's more likely that further intervention will be necessary, so your chances of a fully natural birth are usually higher with a home birth.
It's also worth noting that the incidence of post partum haemorrhage for mothers rises following medical interventions such as assisted delivery and induction, both of which are common in hospital deliveries (though the rates of use may vary widely from hospital to hospital). For many women the lower rate of intervention at home is consequently an important factor in their decision to have a home birth.
- Privacy - The extent of privacy afforded by a home birth very much depends on your home, but even a flimsily-walled flat can offer more privacy than a hospital delivery room, where on occasion it can feel like half the medical staff is peering up your pins.
With a home birth your birth will most likely be managed by one or two midwives with whom you have already developed a rapport and hopefully trust. It's important that you do trust your midwive for a successful and happy home birth, so particular care is needed in choosing one. Being able to control exactly who is present at the birth can increase your sense of control over the situation.
- Comfort - Birthing in your own home allows you to set the scene and arrange your surroundings in a way that will make you most comfortable and relaxed. You will also be able to use whatever alternative forms of relaxation and pain control you like to help you through labour, be that labouring in a waterpool, using aromatherapy, listening to music etc. In a hospital you may plan for these props but be more likely to end up without them: if there's someone else hogging the birthing pool just when your little one decides to think about an appearance you'll be out of luck.
- Mobility - Many hospitals do now encourage and allow for mobility during labour, but labouring women aren't always given the opportunity to move around as much as they'd like. Being able to move around can help manage the pain and help you find a more comfortable position, whether that's leaning over the basin, sitting on the loo or on all fours on the floor. It also serves as a good distraction during labouring.
If you're hooked up for electronic fetal monitoring, which is more likely in hospital, your movements may be limited. What's more, wandering around your own house and garden may be far preferable to haunting the hospital corridors in your nightgown and slippers.
- Recovery & quiet - A significant advantage of a home birth is that you can start your recovery process in the comfort of your own home straight away. After the hard work of delivery it can make all the difference to be settled into your own bed and sheets, as TB member Daddyo found: "My wife was in her
own bed within minutes - our son was born on the bedroom floor!".
The peace and quiet of home is also a big plus - the last thing that new mums need is to be kept awake by the hollerings of other women labouring through the day and night - unfortunately in some hospitals this isn't a matter of choice.
- Germ control - While hospitals do their best to maintain clean wards and control cross-infection, it is naturally far more likely that you or your baby may pick up an infection in hospital surroundings given the sheer number of people in them.
- A family affair - Who's going to take the other children? Can we find a sitter for the dog? Did I leave a load in the washer? You can forget these worries with a homebirth. While you might still want a family member or friend to be on hand to help out with the rest of the family (and as a back-up in case you do need to transfer to hospital) you don't need to uproot your family and upset them with a separation. If you do have other children it can be wonderful for them to creep in to see mum and sibling in the hours after birth.
It's a minor consideration - sorry guys - but it's also far nicer for your birth partner to spend the x many hours of labour with you at home where he can pop off and put the kettle on, rather than hanging around in a hospital falling prey to plastic cups of warm mud from the coffee dispenser.
- Access to the trappings of the hospital - The weight of research indicates that homebirth is safe for most mothers with good health care (the exceptions being those with a medical background or pregnancy history that rules them unsuitable for home birth), in addition, when needed, most medical intervention is due to slow labour, in which case you would have plenty of time to transfer to hospital. But however good your midwives are, you're still distanced from "a big building full of trained doctors and lots of drugs", as one ThinkBaby member puts it, and if there are complications, or you really want an epidural once labour is underway, then you may face the mid-labour upheaval of a hospital transfer. If you aren't yourself comfortable with the idea of being at a distance from hospital then there's little point in considering a homebirth.
Your birthing partner too, may have some reservations about this, and it's important that you reach an agreement you're both comfortable with. The distance of your home from hospital and condition of roads and traffic may influence your final decision.
- Ensuring rest - If you have a home birth and you're aware of your family's needs continuing around you then you may be tempted to get up and about before you've had your recovery time. It's important if you do have a home birth that you have family, friends or a home help to take care of the household and make sure there's no pressure on you to get back into the fray prematurely.
- Privacy? -
If you have your own house then you're unlikely to disturb your neighbours when giving birth but if you live in a noisy conversion you might want to think twice about whether you'll be able to feel uninhibited in those conditions.
- Intervention rates vary - If the rate of intervention is one of your key reasons for considering a home birth, but you're reluctant to labour away from the full amenities of the hospital, then you might want to check out the rate of intervention when choosing a hospital. The approach to using induction, episiotomies and even caesarian sections can vary from hospital to hospital and doctor to doctor, so make sure you know where yours stand.
If you're interested in exploring the possibility of a home birth then speak to your doctor or midwife. If there's any reason why the circumstances of your pregnancy or your medical history rule you unsuitable for home birth then your doctor will be able to advise you.
Some doctors and midwives are reluctant to allow home births, particularly with first pregnancies. If your carers attempt to put you off the idea without giving a reason particular to your own circumstances then don't be afraid to politely press the issue.
Discuss this story
Well done on the home birth decision! You will love it.
I had a home birth for my second baby and i will do the same for this one al being well. (Due early Jan 08)
I had to change consultants as my first one wouldnt even consider me having a home birth as i have kidney problems but my second one said as long as i was fit and healthy and promised to go into hospital if need be then she could see no reason why not! Of course i promised but i had nointentions of it unless the baby or I were in danger!
It was a lovely experience and one i would recommend to anyone who has had a problem free pregnancy.
I had a gym ball and bounced on it for hours, had my son at home until I was ready to give birth, (When my friend took him for a few hours), then he came back and was the first to see his baby brother!
I was relaxed, my midwife was fantastic, my husband felt involved and could do everything he wanted, pop kettle on, make sarnies, etc. He felt so left out first time round and kept getting shoved out of the way!
I had a cheap shower curtain to give birth on and hopped straight into a clean, familiar bed with my new baby. My husband cut the cord, dressed our son, and it was all about us.
No noise from other babies, hospital staff or anything and within 40 mins of the birth it was just us and our new arival.
We all snuggled up in a warm cosy bed and spent the night looking at our little miracle! And the next day our friends and family could come at our convenience to visit. Lovely!
I had no pain relief as i was so relaxed at home but everything was there on standby should i have needed it. I got a little scared at about 6pm (he was born at 9) but i think that was more the fact that I had had such a time of it before and was scared it would be the same...it was nothing like it!
My baby was well over due but he was perfect. Breastfed straight away. (My first was so traumatised by his hospital birth it took him 36 hours to feed!)
Well done Laura
Best of luck for July. Keep us posted as to how you get on xx
Posted: 08/05/2007 at 19:53
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hiya philippa- thanx for replying to my thread, your labour sounded just what i want, when i was having my second baby i was sure i wanted an epidural as i did with my 1st, however when it got round to them sticking it in the woman was getting very annoyed as i has contractions every few seconds as he was already coming out,so in the end i felt everything as well as a needle in my back. this gave me the decision that if i know what it feels like and am still willing to have more children then gas and air will do me. one thing i did want to ask tho is u said your baby was overdue, i just wondered how overdue because i was told if i do go overdue then i wont be able to have a home birth, i was induced last time at 42 weeks. i do have big babies too 9lb at least. when i reach 36 weeks i will be doing eveything in my power to bring on labour just incase-long walks, curries, pineapple, old wives tales i dont care im doing them as well as more fun ones that include my husband lol.also u said about just having a shower curtain to deliver on, was this enough because i have just decorated my living room and have this image of my new laminate floor being ruined lol. only 8 weeks to go now and counting xxx
Posted: 09/05/2007 at 09:42
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