Are you considering or planning a Homebirth?
Homebirth allows you to birth in comfortable
and familiar surroundings
There are many different reasons why women and their families choose a homebirth. Some reasons include avoiding what they have previously experienced, or anticipating what might happen with a hospital birth, and/or to have the care of just one or two midwives who they can come to know and trust.
Common interventions that are available in hospital, such as induction and epidural, are unavailable at home, but this is exactly why many women choose homebirth. Women cope with the work and pain of labour using a variety of methods, including immersion in water, shower, massage, aromatherapy and walking.
Among the many other reasons women choose homebirth are:
- personal care from a qualified midwife and doula throughout their pregnancy, birth and post-natal period
- being able to birth in comfortable and familiar surroundings
- decreased need for interventions and drugs during labour
- women can choose who is present at their birth
- no separation from their partner and/or other children
- no separation from their baby
- less risk of infection during a homebirth, as homes generally don’t harbour unfamiliar bacteria, unlike hospitals
- women have the freedom to do what they want during labour - dance, sing, scream, walk around the backyard or submerge in a pool or bath
- babies frequently have fewer problems after birth
- increased success rates with breastfeeding
- trusting, one-on-one relationships with independent midwife or carer can be particularly important for women with special needs due to trauma following earlier hospital experiences or who have experienced sexual assault
- birth rituals can be planned according to spiritual and cultural beliefs
Is Homebirth Safe?
There is a wealth of evidence to support the safety of planned, assisted homebirth for women with low risk pregnancies. [1] In a recent, large scale study of 5000 women planning a homebirth in the US and Canada, researchers found that outcomes for mothers and babies were the same as for low-risk mothers giving birth in hospitals, but with a fraction of the interventions. [2]
Planned home birth for low risk women using certified professional midwives is associated with lower rates of medical intervention, but with similar rates of mortality for newborn babies and mothers during birth to that of low risk hospital births.
The Cochrane Collaboration, the largest and most reputable collection of evidence-based medicine reviews in the world, also recently published ground breaking evidence comparing midwifery-led care compared to other models of care (obstetric, general practitioner and shared care). The review of midwife-led care covered midwives providing care antenatally, during labour and postnatally. This was compared with models of medical-led care and shared care, and identified 11 trials involving a total of 12,276 women. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects.
Benefits for women in the midwife-led care include:
- fewer hospital admissions
- fewer epidurals or any need for pain relief
- fewer surgical cuts to the perineum
- fewer forceps and vacuum birth
There were also:
- increases in normal vaginal births
- greater feelings of control during labour and birth
- higher breastfeeding rates
- shorter hospital stays for babies
Overall there was no difference in the numbers of babies dying – though fewer appeared to die before 24 weeks under midwife care. None of the other major complications of pregnancy and birth were any different. The recommendation of the reviewers was unequivocal: All women should be offered midwife-led models of care and women should be encouraged to ask for this option.
Some people worry about what would happen should the mother or baby suddenly require medical assistance. Although there can be no guaranteed outcomes in any birth, the protective features of homebirth are linked to non-interference with the woman’s natural birthing processes. Midwives who facilitate homebirth are educated and experienced in assessing the wellness of mother and baby throughout the episode of care. Midwives in BC are required to bring extensive equipment to deal with unforeseen emergencies at home.
Midwives use the guidelines from of the College of Midwives of BC to support informed decision making by their clients when it may be necessary for the woman or baby to be seen by, or transferred to the care of, other health professionals or facilities such as obstetricians and hospitals.
The Cochrane review concluded that it was not just women with uncomplicated pregnancies that benefited from midwifery care. The key is continuity of care, recognition of complications and good collaboration with doctors if and when complications eventuate.
[1] Ackermann-Leibrich et al (1996); Bastian, Keirse, & Lancaster (1998); Campbell R, Macfarlane A (1994) Chamberlain, Wraight, & Crowley (1997); Crotty, Ramsay, Smart, & Chan (1990); Gulbransen, Hilton, & McKay (1997); Johnson & Daviss (2005); Macfarlane A, McCandlish R, Campbell R. (2000); Murphy & Fullerton (1998), Olsen O. (1997); Wiegers, Keirse, & van der Zee (1996); Woodcock, Read, Moore, Springer NP, Van Weel C (1996); Stanley, & Bower (1990) [2] Johnson KC and Daviss B, Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ 2005;330:1416 (18 June)
