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Home vs Hospital- the debate rages on

Despite the fact that home birth figures in this country barely make a dent in statistics, the validity of home birth vs hospital births is still hotly debated. Very sadly the debate is cast in quite black and white terms, with advocates of each quoting scientific studies which back up the point that they are trying to make.To be honest this entirely misses the point. I am by no means averse to debate. In fact I wholly welcome it. If we are talking about where best to give birth, it means that women are thinking about it and that can only be a good thing. Active choices are the foundation of any positive birth experience and the more women become informed and armed with true knowledge about birth, the more likely they are to take their boirth choices into their own hands.I do not believe there is one best place for a woman to give birth. It is why i do not sit on either sid eof the fence in the home vs hospital argument. I am genuinely of the belief that birth is hugely influenced by a woman’s mindset, and crucially her sense of security. The key to birth is to be able to switch off, and for that we need to be in an environment which makes us feel nurtured and secure, surrounded by people we trust that can give us the emotional as well as the medical nurture that we need.What the science shows us is that for low-risk births, home is at least as safe as hospital. There are of course risks to a home birth- unforeseen and rare complications can arise, and in the odd case it might well have been better to be in hospital. But all too often the debate about hospital vs home birth emphasises the minimal risks of being at home whilst entirely ignoring the risks of being in hospital, as though the latter is devoid of risk, because it is a hospital. Yet 1 in 4 women who birth in consultant led units have complications. It is scientifically proven that once birth is intervened with you are more likely to need further intervention- the so-called cascade of intervention. Women who are attended to by obstetricians are subject to much higher rates of c-sections, forceps, induction and augmentation - all of which can sometimes be life saving but which can sometimes also be risky. There are risks to everything we do, and I think any debate on place of birth needs to take this much more into consideration. I do not believe that everyone should give birth at home, but I do believe the debate is biased, entirely ignoring the fact that births are fundamentally affected by the environment a woman births in and the intervention she has.For women who are low-risk, the choice to birth at home or in a midwife led unit is an entirely valid one. Yes, they might be taking the risk that intensive medical care is not within spitting distance. But they are also ridding themselves of the risk that their birth will be intervened with unnecessarily and increasing their chances of getting the kind of emotional care that is conducive to good birth outcomes.It is okay to speak of risks, but only when we do so honestly, showing that on both sides of the coin there are riss- and then leaving it up to the mother to work out what is most importnat to her. For some women, giving birth without the knowledge that an epidural or high tech medical care is only a corridor or floor away would be inconceivable. In that case they need to ¬†explore their hospital options, but with an awareness that they are increasing their chances of intervention. For other mothers, hospitals might well be a place they associate with the ill and the infirmed and not places they feel they could truly open up and feel secure. For them, one to one midwifery care might well be the deal breaker.There is no right or best place for every woman out there. The debate is not black and white. Different women need different things. The key is, we need to be able to choose- and for that not only do we need those in a position of power to assure us that options will always be there, but we need to look more healthily at what those options are and what they really mean for our birth.Ask yourself the question, where would I feel safe, and why? ¬†Make your place of birth a real choice.

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