Home Birth vs Hospital Birth (and doulas)
I thought I would write about a topic that is close to my heart – giving birth at home.
To start, I would just like to make clear that I am not fanatical about home birth to the exclusion of all other methods of birthing (and yes, I consider home birth a method and not just a place to give birth. But more on this later). I believe that what is comfortable and right for one woman is often very different for the next. And that is ok. I am just sharing my thoughts and experiences as a mom of three and experienced doula.
I brought my first baby into this world in a hospital and the experience was not all that bad. I do not feel traumatised by the experience and it does not appear to have had any detrimental effects on my now 18 year-old son. I simply birthed in hospital because I was young, it was my first pregnancy and that’s what you do, right? Go to hospital so the doctors can deliver your baby? At this time, I had no idea of my other choices but luckily for me, it turned out to be a relatively calm and happy experience (despite stirrups, ventouse and an episiotomy featuring in this story.) Being separated from my baby initially, missing his first bath and being unable to walk or sit due to the pain was the worst part. It all seemed par for the course at the time but I know so much more now about how I could have prevented all of that!
I did not actively choose to labour and birth at home the second time around, it was by default. I gave birth to all three of my children in England and at the time of my second pregnancy home birth was routine (it still is) for low risk pregnancies. I was not averse to the idea, so that is the path of care I followed. And it was ok. In fact it may even have been a bit more difficult. My labour was longer, I remember feeling more anxious than I did first time around and it was more uncomfortable. All of this despite being in the comfort of my own home with my family close by, and two midwives in attendance. This is an interesting point I think, as I believe most would assume that out of the two births, the home birth was probably better? Well, not really…. The comfort of being at home immediately afterwards was nice though…
My third home birth however was the tops. Early in my pregnancy, I was informed that due to a low-lying placenta (placenta praevia), there was a possibility that I would need to have a cesarean birth – I have never felt so disappointed in my whole life. I have no idea why the idea of a cesar was so terrible at the time just that it didn’t feel right for me. Turned out the placenta’s position was not a problem after all and I was able to look forward to preparing for my baby boy’s birth at home as previously expected. I think I valued the opportunity to have a second home birth even more than I would have before the cesarean ‘scare’.
Compared to my previous two births, my third was certainly a walk in the park. Labour was quick. I dozed in and out of early and active labour in the comfort of my warm bed. It was dark, quiet and although all of my family was near if I needed them, nobody knew I was in labour. It was private, unpressured, yet safe.
When I realised that I needed to start getting a measure of the contractions, I reckon I was already in transition (7-10 cm dilated). I didn’t realise this at the time though, just that things were starting to feel really intense. I moved quietly downstairs, savouring this magical time on my own but once I reached the kitchen, my water broke and I felt really nauseous. It was about now that I realised I needed to call the midwife!
My mother was staying with us at the time in readiness to assist around baby’s birthday – I asked her to wake my husband and tell him to get the bed ready for the birth. I think this is the perfect place to share one of my favourite quotes! (see below)
I made my phone calls to alert the hospital / midwife while trying to resist the uncontrollable urge to push. I then lay myself down on the dining room floor in a desperate attempt to keep my baby from arriving before anyone else did. Gravity was working a little too well this time! I felt a split second of complete panic then, which I remember consciously and firmly dismissing. I told myself that there was no way the midwife was going to get to me before the baby was born and it was over to me to do this. The natural expulsion reflex had kicked in good and proper and I good feel my baby’s head crowning. What followed was instinctive – I did nothing. I didn’t push. I didn’t pull. I just waited, with my hands in place, gently taking our little boy as he slipped out the way nature intended. He was quiet so I turned him over, rubbing his back and he gave us a small squawk – just enough for us to know he was okay. And then… I just held him… Here we stayed, checking each other out until the ‘rescue party’ arrived.
There was not much for them to do. They didn’t know what to say. So they checked my blood loss (remarkably little at about 20 ml), filled out their mandatory notes and made sure the placenta was intact. All perfect. Everyone was just kind of awestruck and speechless.
By this time, the two other kiddies were awake and so we migrated upstairs (I literally skipped I felt so incredible) to our bedroom where the whole family snuggled into bed as the morning sun streamed in through the window. This will remain the most amazing moment of my life. I remember the midwife standing in the doorway looking at us and saying “This is the beauty of home birth.”
Further thoughts on Hospital Birth and Home Birth:
Hospital birth can be good, yes – the security it offers some, alleviates any fear you may be holding onto (in terms of complications requiring medical attention) and this can aid the progression of labour (a woman needs to feel safe in order to surrender to the process of labour). If any complications arise, you are best placed for immediate assistance from a doctor. But there are also many drawbacks. Like being given medication you may not want, being uncomfortable and surrounded by lights, noise and strangers, or having procedures performed that you don’t understand the consequences of. In my case, I was not encouraged to change position to assist the decent of my baby’s head down the birth canal, and I still imagine how different the birth may have been and if the episiotomy and ventouse-assisted delivery of by baby boy could have been avoided. I am fairly certain if I had a doula with me making alternative suggestions in terms of my positioning, the intervention would not have been necessary.
Home births can definitely be good but again, there were times during my second labour where I needed more support than what the midwife gave. She did too many internal examinations (I never knew I could refuse these) and she should have encouraged me to try different positions other than walking (which I simply could not do) I felt watched, and I couldn’t relax. A massage would have been wonderful! Doula?
Unassisted birth is THE BEST! (for me) It has educated and empowered me as a woman and completely connected me to the natural process of childbirth. I am not recommending you choose to birth unassisted as there are very real complications that can occur for any birthing mother but there are ways you can create an environment that is conducive to a natural, comfortable birth experience where you optimise your chances of birthing calmly, at your body and baby’s pace and with as little interference/intervention as possible.
The good news is that this is possible in hospital or at home. The bad news is that there are a minefield of factors to consider and it is not guaranteed, in either setting.
However the odds do weigh heavily in favour of home birth. I mentioned home birth as being a method of birthing at the beginning of this post and the reason for this is as follows.
Being at home allows a woman to birth in a way that is different to that afforded women birthing in a hospital environment. There are environmental factors in the home setting that are very difficult (if not impossible) to achieve in a hospital setting, and these factors facilitate the basic needs of a woman in labour. Cape Town midwife, Ruth Ehrhardt writes about just this in her book. View details by clicking on the True Midwifery image.
Physical comfort options, familiar smells and sounds, food and drink on tap, activities to distract such as watching TV, listening to music, cooking, a garden to take walks in, family to help and support, being close to your other children, quiet, darkness, privacy are to name just a few.
So it seems logical that opting for a home birth does automatically put you at an advantage in terms of optimising your chances of a ‘good’ birth, as nature intended. Whichever option you choose, the best you can do is plan thoroughly and choose your professional support team carefully. This can help maximise your chances of achieving the birth you are hoping for.
Home Birth and Hospital Birth Conclusion:
Whether hospital or home birth seems the best fit for you, remember to research all your options and become informed regarding what to expect when birthing in either environment. Remember too that your best advice and honest information will come from those who have experience in achieving the type of birth you are aiming for. So talk to other moms, join support groups and consider hiring a doula – she will support you in any choice you make and will help you through your birth regardless of the path it may take.
Finally, consider birthing at Origin Maternity Hospital in Panorama. I have supported a number of births there and they really seem to offer a birthing experience which draws on the benefits of both worlds.
The rest should be left to Mother Nature.
Yours in birth,
If you found this post interesting or helpful please share it – let’s work together to get the word out on positive, empowered childbirth.