For some women, where they give birth needs little thought. As hospitals dominate as the birth setting of choice in this country, the decision is often simply between one hospital and another- and a quick tour of the respective wards tends to help the otherwise fairly simple decision.
For other women, the decision is far more agonising. This difficulty can sometimes arise because a women is spoilt for choice- where I live for example women can choose between three hospitals of differing sizes, one of which is entirely midwife run, a new birth centre attached to the biggest hospital of the three and a well-supported home birth. Sadly many women are not so lucky. Their choices are limited and anything other than a large hospital, often with wholly inadequate prenatal and postnatal care, requires either a fight or large sums of money. This postcode lottery disadvantages all women, but in particular those who can ill-afford to do anything other than what is offered to them.
In my classes I always initiate discussions about place of birth with a warning that one shouldn’t become a prisoner of one’s own birth plan. Whilst the environment we birth in has a material affect on our mental state and in turn our birth experience, the truth is that the even the best laid plans can go wrong. Whilst pondering your ideal birth place, it is essential that you remain flexible in your ideas and willing to change them if necessary. A friend of mine spent months agonising over whether to have her baby at the local midwife run unit or the larger hospital, but ended up giving birth in under an hour at the bottom of her stairs. More recently was the much publicised delivery of a woman on the A34, and another lady who successfully gave birth in a plane. Whilst these sorts of stories are highly publicised, they are obviously rare. But they serve as an important lesson; that whilst we can and should think through our birth experience and make informed and personal choices, nature’s ability to throw us a curve ball should always be respected. The truth is, we dont know where we might end up.And it is also true that many women could give birth just about anywhere.