I was absolutely thrilled to read recently that the NHS are promoting home birth as a good safe option for predominantly ‘low risk 2nd time mums’.
After I had shared the article I clicked over to see what kinds of comments people were leaving to see what the common sentiment was. And guess what…? There were lots of very strong, very divided opinions! And most of them were coming from fear. Fears about the baby’s safety, fears about the mum’s safety, fear about the whole process of birth.
Well it turns out that ‘fear’ is the overriding first emotion when it comes to giving birth. Statistically it is estimated that over 80% of women are terrified of giving birth. This is unsurprising when you take into consideration our modern day media fuelled programming about having a baby.
Try this, I want you to imagine a woman giving birth. Where is she? How is she positioned? And what is she doing?
If you got a picture of a woman in hospital, on her back, screaming, then, like pretty much every other adult, your view of birth may have been a little tainted by modern media. And let’s face it, who wouldn’t want some serious drugs and intervention for something that awful!
So why are they recommending home birth? Are they ignorant or just downright stupid? Well…there are a few things we need to understand before we can make a more informed decision.
1 – Happy hormones for a great birth
The body is designed to give birth. It has the most amazing inbuilt pharmacy to help the process along. You have endorphins which help you to relax, they help the uterus function more efficiently and they are 200 times stronger than morphine so they are an amazing painkiller. But the kicker is that they are only released when mum feels completely safe.
Then there is oxytocin. This is the hormone that is released to ensure efficient contractions and helps mum to bond with her baby. This is often referred to as the ‘shy’ hormone as it released best by the body in an atmosphere of privacy. Just think about having sex – not usually that enjoyable for most of us if you get the feeling you're being watched!
But both these hormones have relationships with opposing hormones meaning they're mutually exclusive. You either have one of the other. So you either have endorphins or you have stress hormones. You either have oxytocin or you have adrenaline.
Adrenaline and stress hormones are the body’s way of getting you to fight or run away because your life is in danger. They are secreted in the presence of bright lights, feeling observed and being asked lots of questions (ie engaging the neocortex).
They actively cause the body to tense up, they increase feelings of pain and most significantly, they direct blood away from your uterus so it does not function very well. And yes, you guessed it. What happens in hospital…? Bright lights, lots of questions and feeling observed.
It does make you wonder that being in your own home has some merit if you want your hormones on your side during birth.
2 – But is it safe?
Often the first thing we associate with homebirth is the lack of medical care and then this is followed quickly with the assumption that it must be unsafe.
In a recent study done in the UK researchers concluded ‘The overall rate of negative outcomes (a composite of outcomes of death or serious complications) was 4.3 per 1000 births (95% confidence interval [CI] 3.3 to 5.5) and there was no difference between non-obstetric unit settings compared with obstetric units. This indicates that as a whole, home births are as safe as ones in medical settings.’*
What we don’t always appreciate is that the midwife or often midwives attending home births bring equipment for pretty much every crisis situation with them. The only 2 things they can’t bring are an epidural and an operating theatre.
They are trained to assess risk and have made informed decisions about distance from hospital should you need to be transferred.
Does this mean that our thinking that hospital is safer is just an idea and we should question it a little more deeply?
3 – Do I have a choice?
My own personal favourite! Every mum should ask herself the questions ‘where do I feel safest? And where do I feel the most relaxed?’ Because if mum feels safe and relaxed then her body is going to function best in terms of birthing her baby. She is going to give herself the best possible chance of an easier birth.
But…the answers to these questions will be different for every woman. For some they will feel safest in a hospital or birth centre environment and for others they will feel safest at home. They should then be allowed to choose which environment is best for them to give birth.
What the NHS is suggesting with these guidelines is not that women should be prescribed to but that they should have a choice and that they should be able to make that choice based on what is best for them and their babies. This thinking is way ahead of some other countries where women have little or no choice over where they give birth.
4 – Yes, I'd like some tools please!
No…I’m not talking about forceps, I’m talking about the kind of tools that are going to help you to relax when you really need it. Being able to relax is no use as a concept, it’s no use knowing the theory. It’s about being able to train your body on a daily basis through breathing and relaxation. This then sets up the best hormonal environment to naturally assist your body in giving birth.
In fact, this is the reason we have seen such a huge rise in popularity in HypnoBirthing. HypnoBirthing teaches you the tools to help you to relax and gives you the information to make the best choices for you and your baby.
So, now that you understand how your hormones work, how you can positively impact them through breathing and relaxation, you know a little more about the research and understand that you still have a choice, hopefully it will be easier for you to understand the recommendation and why it is so powerful for women.
Remember choose from knowledge and not from fear.
It’s My Birth, My Choice.
*Birthplace in England Collaborative Group. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ 2011;343:d7400