We are very lucky in Australia to have a health system that enables us to make choices, educated and informed choices about where, how and with whom we will give birth to our children. We have access to medical facilities that allow us to give birth in hospital and birthing centres under the guidance of experienced physicians and specialists. Our available options include natural birth and home birth. And while we’re not as well set up as countries like the UK or the Netherlands, with their flying nurse squads and neighbourhood health centres, we still have dedicated medicos who will help no matter what happens. And lets’ face it – anything can happen during a birth.
Some surprising stats about natural birth and home birth
It may surprise you to learn that, even as recently as 2013, only 2.3% of births occurred outside hospital, and of those, only 0.3% took place at home1. The overwhelming majority of births in Australia take place in hospitals in conventional labour wards, and for many women, that’s the right choice.
But the majority of women who choose a hospital birth – 67% – give birth naturally, vaginally, and 82% of those do so without any form of intervention. The other 18% of births involve the use of either vacuum extraction – 11% – or forceps – 7%2.
In a homebirth setting, the figure for natural vaginal births increases to 90%. However, in 2013, 17% of women intending to give birth at home were transferred to hospital because of complications either during labour or within one week of delivery3.
Of all mums giving birth in hospital, 44% were first time mothers, compared with 35% of mothers choosing a birthing centre, and only 25% of all births at home. Home birthing mums are usually older, with an average age of 32 in 2013. They may also be more motivated to prolong breastfeeding, with 69% of home-birthed infants fully breast fed at six weeks of age, compared to only 58% of hospital- or birthing centre-born babies4.
When it comes to neonatal deaths, we might think that any figure is too high in these days of modern medical miracles. But sometimes the unexpected and unthinkable does happen, no matter where the birth takes place.
Though we often hear of these cases via sensationalised media stories, the statistics for home births versus hospital or birthing centres are surprising. Of all 1350 babies born at home in 2013, four died, or 0.3%. The figure for hospital and birthing centres that year was 1%5, but possibly accounted for by the fact that home birth decisions are generally made by women with low-risk pregnancies with no expected complications. This fact probably also explains why a higher percentage of hospital-born babies have lower birth weights than those born at home.
Home Birth in Australia
Australia falls short of its western counterparts when it comes to percentages of home births within the general population. In 2010, 0.9% of Australian women chose a home birth, compared with 2.9% in England and Wales, 11% in New Zealand and 20% in The Netherlands6. In The Netherlands, however, home birth is endorsed and actively encouraged, with the offer of free or government-funded services by university-trained midwives throughout a network of small, localised clinics.
The birth of a child has got to be one of the most life-changing days of our entire lives. If it’s your first child, it’s also represents the birth of a family. So it’s important to make the right decisions and properly prepare yourself for all eventualities. The decision on where to give birth is one of your first choices – and yes, you do have one, but no, not everyone is going to agree with your decision.
My Natural Home Birth
When I was pregnant with my first child and considering my birthing options, my first antenatal visit was to the family GP. It was the early 80s and, being the hippy I am, I had returned home from a year-long trip backpacking around Asia 6 months pregnant. After hearing my story, our friendly family doctor informed me that my baby was too small for my dates, probably the result of inadequate nutrition.
He also told me that if I was planning a home birth, he was not interested in providing me with any further antenatal care. I left his surgery both worried and angry – worried about my baby, and angry at his arrogant and condescending attitude to birth.
Looking back, I should probably thank him, because he forced me to go looking for the right people to help me with the delivery at home. And I found them – a wonderful, caring doctor who shared my sentiments about the importance of the experience for both mother and baby, and a fully-trained, spiritual midwife who emanated peace and tranquillity. Both of them attended my delivery, which was long but free of intervention, and my son was born a healthy four plus kilograms.
Your Body – Your Baby – Your Choice
The moral of the story?
It’s your body, your baby and your choice. You want the best possible outcome. Just make sure you carry out all the preparations and arm yourself with as much information about the process as you can. And choose your team with equal care.