Childbirth was the subject of another ‘celebrity’ article over the weekend. Dr Alice Roberts is a scientist and, as she is about to give birth to her second baby, has written about making the decision to have her baby in hospital, based on the science, on the facts.

It is a great article and she makes some valid points about making informed decisions and the importance of encouraging women to feel empowered about birth and being able to make choices. BUT there are a few issues I take issue with…

•  “human childbirth has always been difficult and dangerous” – this fear of childbirth seems to be at the heart of this article because why would you want to birth at home if you feared the process and needed the reassurance of having a managed labour:  “I was very happy with the way that the birth of my first baby was handled in a maternity unit.”I don’t challenge anyone who births in hospital but neither do I challenge anyone who books a homebirth but the tone of this article is to make homebirthers feel like they have made a selfish, ill-thought out decision. However, in my experience anyone who books a homebirth has researched it to death and everything has been read, discussed and analysed again and again.

•  “Another problem is the politics of birth. It can be quite hard for mums-to-be to access impartial evidence and advice when it seems there are plenty of people wanting to influence your decision in one way or the other.”I refer you to my previous comment because, yes there are midwives, antenatal teachers and other maternity professionals who are passionate about homebirth and will promote it and suggest it but, in my experience, women are not going to book a homebirth if it is not what they want, if it doesn’t feel safe or right for them. It is hugely patronising to suggest that women who book a homebirth are somehow stupid – they don’t do it on the say-so of one person.

• “Evangelical advocates of home birth often talk about the importance of women’s choice and empowerment, as well as instilling distrust in obstetricians.”

  I am passionate about women having options for the birth of their baby and about women making decisions based on the right place for them to give birth. In my work as an antenatal teacher I want to empower women and their partners to believe in their ability to birth their baby and to be involved in decisions if the need arises. Personally I do not distrust obstetricians but they simply are not needed in a normal, straightforward birth. Their skills and experience need to be used if labour does become more complicated and medical intervention is needed – until that point, the midwife is all the team you need.

• “I’m not scared of hospitals, and I also know that, however calming the home environment might be, I’ll feel even calmer in hospital.”
  
  And this is why women need to make the right decision for them about the birth of their baby, where they feel safe and calm, and to be supported in this decision. This could be on an obstetric unit, in a birthing centre or at home.

• “The Birthplace study found that about four in 10 first-time mums who planned a home birth or birth in a midwife-led unit had to be transferred to hospital during labour, whereas about one in 10 women having second or subsequent births were transferred.”

  I have had two homebirths, which were well researched decisions. I trusted my midwife and her homebirth experience and knowledge, as well as my ability to birth my babies. I knew there was a chance that I might want/need to transfer but it was a risk I was prepared to take and I would happily have transferred into hospital if I needed to. For me, I knew I would feel calmer at home with my husband, midwife, gas & air and pool – and I was.

  I have also had a hospital birth, which I needed because I was classified as high-risk and it was the safest place to give birth to my baby, as we knew he would need care as soon as he was born. I still had a straightforward, active birth but the atmosphere was different and there were more doctors who wanted to be involved – however I had a fiesty midwife who knew I was doing ok, who was checking my baby and who told the doctors that she would get them if my labour moved away from being straightforward. She observed and supported me and let me get on with it but I knew she was there if I needed her.

•  “But surely the most important thing to consider when making this choice has to be the safety of both mother and baby.”I agree that a healthy mum and baby is important but a healthy mum is not just about physical health, it is about emotional health as well. Women want to feel safe, supported and reassured in labour, they want to feel empowered and listened to, which is why choosing home or a birthing centre is the best option for some expectant parents and it is wrong to suggest that anyone who books a homebirth is making a selfish, ill-informed decision and putting their baby at risk. There is risk with everything we do and birthing in hospital does not make it completely risk free.

To me birth can be magical and beautiful, as well as powerful, painful and intense. All three of my birth experiences have caused me to dig deep to enable me to keep going, to stay calm and allow my body to birth my babies. I have been supported by excellent midwives, as well as my excellent, calm husband.

I am not someone who believes that birth is automatically difficult and dangerous, I just don’t think nature would have designed us that way. Given the right environment, support and reassurance women can and will birth their baby. And, if pregnancy or labour does become complicated, then the medical interventions and the skills of the doctors and midwives save lives and I am thankful for them. However, as a medicalised culture we very much view birth as something that needs to be managed and handled by midwives and doctors, our confidence and belief in our bodies and our ability to birth our babies has been knocked sideways. When labour is uncomplicated, we need observation and support to feel safe and reassured, to enable us to let our bodies get on with it and birth our babies. Interventions need to be left alone until they are needed, not seen as being a necessary part of everyone’s labour experience.

Thankfully most of us will be classified as low risk, with uncomplicated pregnancies, so we have more options about where we birth our babies. This article has raised an important issue for me – it talks about gathering information and making an informed choice about home or hospital but I also think it is just as important to gather information and make an informed choice about which hospital to give birth in. They are not all the same – find out about the facilities, check out their statistics, ask friends and colleagues who have given birth locally, talk to your midwife, talk to your antenatal teacher and go on a tour of your local maternity units.

That way you can get the support you need to help you work towards a positive birth experience, which includes your emotional health as well as your physical wellbeing.

There is nothing wrong with Alice Robert’s approach to childbirth in that it works for her, but it won’t work for everyone because birth isn’t simply about facts, figures and science it is also about instinct, hormones and emotions and that is what makes it such a unique experience for us all.

Posted by Janine Rudin in antenatal classes Tags: alice roberts, antenatal classes, homebirth, hospital birth, informed choice