Homebirth takes another knocking

I happened across this study on the BBC website today. Oooh it made me so mad! You can tell the methodology is flawed without even reading the study itself. Even the headline is inflammatory: Home birth to ward increases risk. Well I'm fairly sure that you don't have to be a midwife or doctor to realise that if you're transferring in to hospital from a homebirth, then it's usually because the risk has increased. Why else would you transfer a labouring woman? For shits and giggles? There was no control group of women giving birth in hospital for comparison and the study included women who had planned to have a homebirth at 12 weeks pregnant, but who had either changed their mind or had a change in circumstances which meant that they instead gave birth in hospital. Don't you think that might just skew the statistics? If circumstances meant that a homebirth wasn't the most appropriate option, that might just mean that the risk was higher for that woman anyway?

I thought this quote was one of the most interesting:

But when complications did arise for women in this group and she needed tobe transferred to hospital, her risk of losing her baby was nearly eight times higher than the national average - and 12 times higher than had she given birth at home.

This, by inference, means that if a woman does give birth at home, her risk of having a stillbirth or neonatal death (the difference not defined by this article) is far lower than the national average (a fact any midwife worth her salt could already have told you, and one that is well documented). So, given the safety of successful homebirth in comparison to the national average for losing a baby - and with 98% of births occurring in hospital this must account for the huge majority of these - why are we not positively promoting homebirth for those for whom it is an appropriate option? Which, incidentally, is the majority of women. Why don't we have an 'opt-out' system, in the way that they have had in the Netherlands for years, where women are booked for a homebirth as a matter of course and only transfer to hospital-based care if problems crop up?

Of course I can answer my own question quite easily. The majority of doctors in the UK, who have a tremendous amount of power when it comes to shifting both public opinion and funds, have little faith in homebirth. They have little faith, in fact, in women's ability to give birth without interference. They have little faith in midwives and their ability to assist women in this most natural of functions. This has meant a general lack of confidence throughout society in both homebirth and normal* birth itself, reinforced continually through the media. This has meant that women who choose a homebirth often meet with resistance from their caregivers - midwives included - who will look for any excuse to deny them their wishes. Even their peers usually say things like 'Ooh you're brave!' about their decision. Of course, it is those who choose to give birth in hospital, who choose to face the inevitable 'cascade of intervention', leading so often to the handing over of power and control to a complete stranger, with concomitant poorer outcomes, that are the brave - or some might say foolish - ones. In my humble opinion at least.

*normal, in my own parlance, meaning without pharmaceutical drugs that block their bodies' natural instincts and feedback systems and without assistance from ventouse machines, forceps or caesarean sections. I could go on to say with the woman being in control of the experience, feeling empowered and with known and supportive birthing assistants who promote the physical and mental wellbeing of the mother and baby by working with the hormones in play during labour and beyond, rather than against them. But that might be a little too radical for some.