Home Birth – Risk Safety and Responsibility

It seems the media is all aflutter with the recent birthing of Dannii Minogue’s baby boy – you can read a standard example of the mainstream media coverage HERE

Honestly, it’s not such a big deal – a baby was born: congratulations to the family! It was a celebrity family: well, yeah, that’s interesting to fans, and would usually get a line in the gossip pages or something, so why all the fuss?

Dannii had a *gasp* home birth. Which is hugely confronting, because we all thought Dannii was a pretty intelligent woman who is likely to be well-informed and make sound choices about such matters. So it challenges our sensibilities – surely only crazed hippie fringe freaks have home births!

And it gets worse – Dannii, under the skilled eye of a trained midwife, transported to birth in hospital when the birthing process became complicated. Well, we can all heave a sigh of relief. See: she needed the hospital.

Except that this proves the safety of home birth with a skilled midwife – it is possible to transfer to hospital if needed, of course, the majority of cases don’t need it, and birth safely and happily at home.

When a woman plans her birth in a hospital, and complications develop leading to a transfer to a larger tertiary-care facility, or a caesarean section, no one is blazing trumpets and newspaper articles saying hospital birth is unsafe (well, I am :P )

The reality is that for the vast majority of women, home birth is a safe option, and a hospital transfer is a viable resource when back-up is needed.

Dr Ted Weaver, the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists is reported to have said

“Up to half of all first-time mothers attempting a home birth had to be transferred to hospital due to complications”

Great. He’s a doctor with a fancy title, so we can all ignore the fact that he’s just making up statistics as he goes along, and, in the words of Gloria Lemay: hallucinating his own reality.

Really? Up to half of all first-time mothers attempting home birth transfer? Based on what study? I’m willing to bet it’s based on the “study” of his own personal experience.

Dr Weaver went on to say,

“It is better if first-time mothers don't attempt a home birth or, if they do, they should be counselled about their risks and needs for transfer."

Oh the hypocrisy! When are women ever counselled as to the risks of hospital birth?

I have a real study published in the British Medical Journal showing that outcomes were the same in planned home and hospital births, but interventions were much lower at home and the mothers reported more satisfaction with their births. BMJ 1996 313 1313-8

In European countries where midwifery care is the standard, mortality rates are much lower under the care of midwives than under the care of obstetricians at all levels of predicted risk. Even when unplanned transfers to hospital are taken into account, home birth is still safer than hospital birth. Tew, M (1990) Safer Childbirth, Midwifery, 7(2):55-63

The true issue of home birth is control and responsibility. If you birth in hospital, the risks of complications, interventions, morbidity and mortality are higher than at home with a skilled midwife, but you have no responsibility. If something goes wrong, the doctor says “I’m very sorry, we did all we could”, and that’s the end of it. Taking that much smaller risk that something might go wrong means that the responsibility is taken on by the birthing mother.

If something goes wrong at home, everyone says “you should have been in hospital”. If something goes wrong in the hospital (even though this is more likely), it’s “just one of those things that happen”.

Ultimately, Dannii made a reasonable, responsible choice regarding her own birthing experience. It makes me so angry that the medical establishment is using the media to spin hype and misinformation, which is actually increasing risk for women and babies.