How safe is home birth?

How safe is home birth? There seem to be two opposing camps on this – doctors who tell us it’s a foolish risk that shouldn’t even be considered and midwives who tell us it’s no less safe than in hospital.  Does the answer lie somewhere in the middle?  

Birth does carry risks. For people without access to medical care or before modern obstetric practices – dying or mental or physical impairment can and did happen.  Even today, these things still happen occasionally. However, for a mom giving birth in a hospital this risk is allegedly very low. I personally know two people who died giving birth in hospital – one in a rural hospital with poor medical treatment where complications during the birth weren’t recognised, and one who had pre-eclampsia and even an emergency c-section in a modern private hospital didn’t save her (but this was already a high risk situation).  Both of these were in this decade.  

When comparing fatalities from home births and hospital births, one does have to compare apples with apples, and any comparative numbers should only look at low risk hospital births rather than total hospital births (which include high risk births) compared to home births.  

Giving birth in a hospital means that there is a midwife on hand who checks on mom every half an hour or so or if called. The doctor is called if there is a problem or when mom is ready to push. The doctor isn’t necessarily at the hospital, so if an unexpected emergency arises, he or she may need to make their way to the hospital.  

In this country, our midwives are well trained so it is the same level of care from a midwife whether in a hospital or at home. There are some countries where this is not so, and a home birth midwife may have no training in recognising a medical emergency. If a complication arises, a midwife advises travelling to hospital. An ambulance could be called, or mom could be driven to hospital – possibly through peak hour traffic or a distance. A back up doctor is alerted and meets them at the hospital.  

If it’s meant to be...

We wear seat belts because they prevent some deaths and injuries, we wear helmets when riding bicycles and motorbikes – we take precautions that will hopefully reduce the severity of injury or chances of death if an accident does happen. Should it be any different with birth?

One argument I’ve heard made is that there is risk in everything we do and that sometimes it’s just our time to die and that as with all other areas of life, some women and babies are just meant to die in childbirth. Is this a reasonable argument? “No, sorry Jane, it’s your time to die now, we won’t give you that oxygen”. We don’t do this in other areas of life. If someone has an infected dog bite we don’t tell them they’ll just have to wait to get septicaemia and die, they get given antibiotics and the wound gets cleaned and antiseptics applied.  

As to whether to give birth at home with a midwife, in hospital with a private midwife or in hospital with a gynaecologist (or strictly speaking an obstetrician), it’s all about weighing up the risks. Different mothers have different risk tolerance.

Would you consider a home birth of you were having a low risk pregnancy?

Disclaimer: The views of columnists published on Parent24 are their own and therefore do not necessarily represent the views of Parent24.

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