phew…busy times. Yesterday I began a daily newspaper for childbirth professional called: The Doula Daily and then today, on our second day of running in comes the huge news as NICE announces new guidelines that recommend 45% of women are going to be advised to give birth outside of hospital (no, sigh, not in the car park) but in birth centres, midwifery led units and yes, one of the all time favourite places to birth…H.O.M.E.
Yes people NICE has announced finally that home is ‘safe‘ you can do it and in fact you will now be supported do it there. This is great news for the thousands of home birth supporters around the country, the pockets of communities that come together, creating home birth support groups and sharing stories about how giving birth at home is not as crazy as some people make out.
This is new actually new news though. In June last year research in the British Medical Journal (a large Dutch study) said planned home births are less risky than planned hospital births, particularly for second-time mothers (1). Then in 2009 the largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife (2). Looking further back ‘Changing Childbirth’ (1994) was a woman centred report recommending one to one known midwife care (3). So sadly this isn’t new news, not for the media point of view and certainly not for the childbirth professionals who support woman outside of the NHS and have first had experience of having to ‘be allowed’ to have a home birth.
The question is why haven’t these changes happened. Why do birthing families in many places feel they have to fight for their right to give birth at home? And the answer is not simple, actually I don’t think we have all the pieces of the puzzle to answer that question fully. However the answer does include the fact that the NHS midwives are overworked, under supported and bogged down in paperwork. Also the quiet selling off of NHS services to private companies (all school healthcare in my area is now run by Virgin). I also feel that the natural birth process is little understood. Ask a hospital midwife just how many births they have attended which have been 100% natural and free from any kind of medical intervention (drugs for induction or speeding up contractions or pain relief, instrumental delivery) , the answers are shocking. Also the fear that surrounds giving birth, the pain involved, the lack of coping strategies, the fear of fear is crippling.
The way to really change is to work from the grass roots up. When birthing families know their options and are free to choose the place where they feel most safe to give birth, be that home, hospital or birthing unit then we have a fully empowered and focused group who are in their choice. That is what makes all the difference to how a labour progresses. A woman needs to know that she is safe, that she is looked after and supported in her choices. Then her neocortex brain can relax allowing the instinctual birthing primal brain to take over and move through the birth process.
1. Home birth complication risk ‘small’ http://www.bbc.co.uk/news/health-22888411
2. Home birth as safe as hospital 15 April 2009 http://news.bbc.co.uk/1/hi/health/7998417.stm
3. House of Lords debate on maternity services 1994 http://www.publications.parliament.uk/pa/cm200203/cmselect/cmhealth/796/79603.htm