Friday, 15 July 2011

Hospital Birth VS Home Birth

Yesterday the Royal College of Obstetricians and Gynaecologists made a recommendation for more women to have their babies at home instead of the hospital. There’s been a lot of furore from proponents and critics alike. The RCOBG claims that home births are safer, labour is easier for the mother and leads to less complications. However, the statistics, critics claim are skewered because while proponents claim that home births are safer those that don’t go well and end up in the hospital are classified as hospital births gone wrong rather than home births gone wrong.

I was listening to Julia Hartley-Brewer on LBC yesterday and she was vehemently against home births. She had some valid points worth consideration, mainly that:

- Birthing should not be about ‘the experience’ but about getting the baby out as safely as possible while keeping mum as healthy as possible. For her it’s was a purely clinical procedure. She thinks its selfish of women to put their babies at risk giving birth at home knowing anything could go wrong at any moment and emergency medical intervention will not be immediately available. She herself had to have an emergency caesarean after baby’s heartbeat started declining. (She also admitted she was drugged to the teeth)

- A lot of fairy tales have step mothers precisely because childbirth was the single biggest killer of women since the early ages. A lot of these women died unnecessarily because something went wrong during home labour, likewise a lot of babies died when they could have been saved. She doesn’t see why women should shun the potentially life saving advances in modern medicine for an archaic method with an unfortunate track record.

- Infant mortality is lower in countries with advanced medical practices than in countries where traditional birthing practices are still in use. 

- It’s more expensive because you hog two midwives for a home birth, whereas in the hospital one midwife can attend to multiple woman simultaneously.

For her it’s a clinical procedure, like having a tooth pulled out. You go in, get medicated, get it out and all is well.

The advocates of home birth who called into the show also had some valid points:

- A woman is more comfortable in her home surroundings will be more relaxed and is more likely to have a shorter and comparatively less painless labour than being in a hospital.

- Being in a relaxed atmosphere she can manage the pain better, is less likely to need pain relief as well as episiotomies.

- Midwifery has come a very long way since the middle ages. Midwives nowadays are very capable and react accordingly should labour deteriorates and the woman needs medical intervention. They also work with the women all through their pregnancies to ensure they are making an informed choice and are aware of the options open to them.

- One medical intervention leads to subsequent medical interventions. For instance a woman that’s been given an epidural is more likely to require forceps delivery than one who was not given one.

- Finally, with hospital resources stretched thin and budget cuts everywhere women are better off giving birth at home so they can get the full attention they need at that crucial moment in their life rather than being cared for by frazzled, overworked midwives who are prone to errors.

I’ve heard and read personal experiences of women from both sides of the spectrum; all very subjective. None of my ‘mommy’ friends have anything good to say about hospital births. They had complaints like rude midwives, midwives that gave them episiotomies, midwives that didn’t give them one, feeling pressured into doing things that wasn’t in their birth plan. With most things related to the female species, what was a wonderful experience for one woman might be a horrible experience for another. However on the whole there are MORE horrible hospital experiences than there are home birth experiences. What’s weird though is that the women that talk about successful hospital births are mostly women whose labour took a turn for the worse and needed intervention and were ‘saved’.

I’ve been considering my birth plan so this discussion has come at an excellent time. A birthing center is the closest thing to a home birth. We have one that is literally across the street from us. There’s a hospital 15-20minutes away. The birthing center is 100% midwife run. There are no doctors or anaesthesiologists. Like a homebirth it’s only for low risk pregnancies. There are birthing pools, balls and all that jazz but you don’t get assigned a midwife, they work on shifts and if there’s an emergency they call the ambulance.

The hospital is where my endocrinologist works. Last year he said he was looking forward to having me give birth with them. We only met once but he made me feel comfortable. I’m hoping his attitude is a reflection of the maternity ward (wonderful logic there). It’s the closest hospital and if something were to go wrong (God forbid!) I’d definitely end up there.  On one hand I would feel comfortable walking across the street to have my baby and walk ing back home to rest after that. On the other hand I’m thinking, this is my first baby, I don’t know how my body is going to react. For now I’m classified as low risk, but anything could happen. No woman prays for it, but that’s the reality – you just never know what’s gonna happen. In any case I don’t want to regret not doing a 15 minute drive should something go wrong.

In a few months time I’ll get to visit both places, have a look around, speak to the staff and maybe get a chance to talk to some fresh mums about their experience (if I am allowed to) before I finally make up my mind. I think its important to know what options are available so one can make an informed decision. 

Meanwhile the debate continues. 


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