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Index To Home Birth

  • Miracle Of Birth
  • Home Birth Is Safest For Low Risk Factor Pregnancies.
  • The Dutch Experience
  • The Role Of The Doula
  • Summary

Birth_1

 

Introduction To Home Birth

Let us set one myth to rest right away. A hospital is NOT the safest place for most women to give birth, in fact many studies have shown that mother and infant mortality rates are much lower in those countries that pursue a policy of encouraging home birth. While some very high risk pregnancies most certainly do not to happen inside the hospital all low risk and nearly all medium risk births can take place in the safety and comfort of a woman’s own home, and as long as she is supported by a professional midwife service mortality rates will be lower than those for the same birth taking place inside hospitals.

In the Netherlands nationally 45% and rising of births happen in the home, with most of the remainder taking place in local birth clinics and a minority in hospitals. In the USA and Canada only 0.9 per cent of women gave birth at home in 1991 (some of them unplanned), compared with 1.7 per cent in Britain. The argument against home birth focuses on the fact that it may subject mother and/or baby to avoidable risks and that even in seemingly healthy, normal pregnancies things can go wrong at the last minute. However birth cannot be made risk free, it is a risky time for both mother and child, but it should always be kept in mind that it is still a Natural process. Experience shows that most emergency birthing situations can be handled by a well trained midwife / birth attendant at home or that transfer to hospital can be arranged in time to avoid risks to mother or baby. In Holland Midwives carry some emergency equipment and will arrange for speedy transfer to hospital if needed. Of course Holland is a highly urbanised country and hospital care is rarely more than just a few minutes away.

Birth Is Not A Medical Condition

Birth_3The miracle of birth creates babies, changes women into mothers, and turns individuals into families. Being born and, in turn, giving birth are the most transformative and miraculous events human beings experience. Yet in our society the medical profession and the ‘ eliminate all risk ‘ brigade have turned the experience of birth into a technological and medical event experienced by most families. In the USA Currently, 50% of babies born in the United States and the rest of the English speaking world are surgically delivered from their mothers' bodies. Another 30% are born to mothers who are numb from the waist down and tangled in a web of tubes and wires. Worst of all is that the rate of Cesarean section in the UK, Canada, and United States, has more than quadrupled in the past 30 years, with no corresponding improvement in neonatal outcomes – c-sections simply do not help to improve mortality rates, in fact they make them worse. Every expectant family desires the safest possible passage through birth for both mother and child. When it comes to birth, most western families equate "safe" with the sterile, closely monitored, technological environment of the hospital. These families may be shocked to learn that giving birth in a "sterile" medical environment designed to monitor and control the birth process does not improve the quality or safety of birth. Despite all of this birthing technology and intervention, the US, Canada & the UK maintains one of the highest rates of maternal and neonatal mortality among all developed nations, Holland has one of the lowest.

Home Birth Is Safest For Low Risk Factor Pregnancies.

Birth_5In fact, study after study conducted on the issue has shown that for healthy women with low- to moderate-risk pregnancies, giving birth in a hospital is actually less safe than giving birth at home with a trained midwife. So perhaps this is a major factor in the mortality rates. A particularly large Dutch study so comprehensively endorsed home birth for low risk and even many medium risk mothers that the the declined in home birth has been arrested and is now march towards 50%.

A great many studies throughout the westernized world support these findings. No study has ever proven hospital birth to be safer than planned, midwife-attended homebirth.

Most women innately choose to move around during labor, finding the most comfortable positions in which to give birth. At a home birth, midwives encourage such position changes and a woman's freedom of movement is limited only by the size of her house and yard. Licensed midwives also offer their clients the choices of laboring and birthing in water, delivering their babies with their own hands, or having the father/partner catch. After birthing at home, mother and infant may bond without interruption. A comprehensive newborn examination is done right on the family bed next to the mother. Home birth also allows for greater sibling involvement in the birth process, in our extended family siblings, cousins even, are brought along to watch the birth, this may well help to explain the strong bond within our family.

The familiar comfort of home makes it the safest birthplace for healthy, low-risk women. In the safety of their own homes, women are less likely to experience complications of labor, such as hypertension and muconium staining, which may be brought on by stress. The freedom to move about as desired decreases both length of labor and the need for pain medications, therefore lowering the risk of maternal exhaustion, fetal distress, and caesarean section. Whereas a woman's home usually contains only microbes to which she and her baby are immune due to daily exposure, where as hospitals are full of disease-causing microbes, many of which are resistant to most antibiotics.

The Dutch Experience

Birth_6We have conducted trials and studies all over Holland, but here I will take the Northern region's perinatal mortality survey as an example as it is very representative. The Northern Region of Holland reports 134 perinatal losses in 3466 births outside the hospital, about four times the number of losses in hospital births. At first sight this seems to endorse the view that hospital is the safest place to deliver. But 97% (131) of these perinatal deaths at home were recorded in women who were actually booked for a hospital delivery or had no prearranged plan for delivery. The perinatal outcome in planned home births was better than for all women giving birth in the region - a result in line with Swiss and other Dutch findings also reported. This supports the safety of home birth provided it is offered to women at low risk of obstetric complications. Most perinatal deaths occur in women with health or obstetric problems that existed before or developed during pregnancy, and these women can be identified and referred before the onset of labor.


To put this into plain figures, of 3333 planned home births in Holland's northern region there were 3 deaths, this is a mortality rate of one tenth of just 1 %. This is one quarter of the mortality rate found in hospital births

Read More: the Dutch Way Of Birth              Read More: The Rights Of Birth

The Role Of The Doula

Birth_8We are pleased to say that in Continental Europe the Doula was never completely squeezed out of existence, but even so many people do not know what a Doula is. The word, "doula," comes from the Greek word for the most important female slave or servant in an ancient Greek household, the woman who probably helped the lady of the house through her childbearing. The word has come to refer to a woman experienced in childbirth who provides continuous physical, emotional, and informational support to the mother before, during and just after childbirth.

Doula's perform many tasks, which vary between countries and cultures, here are some of them:

  • Explanations of medical procedures
  • Emotional support
  • Advice during pregnancy
  • Exercise and physical suggestions to make pregnancy more comfortable
  • Help with preparation of a birth plan
  • Massage and other non-pharmacological pain relief measures
  • Positioning suggestions during labor and birth
  • Helps support the partner so that they can love and encourage the laboring woman
    avoid unnecessary interventions
  • Help with breastfeeding preparation and beginnings,

In Summary

Birth is a family event and, with very few exceptions, happens most naturally and safely in the mother's home. Families who birth at home with the help of midwives generally report far greater satisfaction with the birth experience than those who have given birth in hospitals. Women who birth at home and the midwives who attend them understand that birth is as safe as life ever gets, and that attempting to control birth actually causes more complications than it prevents. Midwives maintain the safety and sanctity of the natural birth process, mainly through the practice of non-intervention. When excellent prenatal care has been given, addressing all aspects of a woman's life and relationships, a mother is well-equipped to birth her baby with minimal assistance. Midwives specialize in normal birth, they are quick to recognize any deviation from normal and to use the appropriate measures to help correct the situation. Midwives and families who birth at home are not anti-hospital, but feel that the hospital should only be accessed when truly needed, or when clinical indicators are pointing to problems. Midwives trust in women's ability to give birth normally and they help instill and reinforce this same trust in the families they serve. Far from being a medical event which must be suffered in order to receive a baby, a midwife-attended home birth is a joyful celebration of life and the family

Birth_7Photo left: Me standing alongside me. Our children wanted to keep tracking of their little sister as she grew inside me and so on their height wall we let the children draw around me every few weeks.

Related Page: Birth the Dutch way.

Related Page: The Birthing Rights Of Women.

Related Page: Breastfeeding

 

 

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