Homebirth and other naughty words

Bronwyn's picture

Although I am not a birth professional, except in so much as I focus a certain percentage of my practice on prenatal health, I feel compelled by recent events in my personal life to write a short entry on the hotly contested phenomenon of home birth.  No topic I ever discuss inflames stronger sentiments in two deeply polarized camps.  After all, what could excite your passions more than the safety of your newborn? It’s no small topic so, naturally, choosing the manner of birth for your own family requires a great deal of consideration and research.  Unfortunately, looking online may lead unsuspecting couples into a labyrinth of blogs and chat rooms with endless blistering dialogues by angry opponents and proponents maligning one another from their corners. It’s distressing, polarizing and, above all, unhelpful.

Without claiming to end the age-old debate, I will suggest that some resolution could be found in a simple definition of terms.   Appealing to the BC College of Midwives Handbook on Planned Home Birth, I have found this simple definition.

 

Home birth involves careful screening of clients by their midwives for suitability and

Coordination between midwives and other healthcare providers.  Home birth is not simply

an interaction between a midwife and client, but is provided within a broader support

system that includes hospitals, physicians and emergency services.

 

The key point is the co-ordination of several services working in concert to ensure the best possible outcome for baby and mother.  “Home birth” describes the decision to birth at home, under the care of appropriate healthcare providers (in BC that would be 2 midwives or one midwife and a college approved second attendant) with a back-up plan, emergency services, and appropriate transportation. In BC, the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.  After all, even when you plan your homebirth, you still need to be registered at a hospital.

 

Many opponents interpret home birth as an inherently antagonistic approach where women “rebel” against the patriarchal medical system and strike out on their own to do it “their way”.  Thus birth is mangled into a political statement where it becomes a form of protest.  In this view, home birth pays primary consideration to the woman and her birth experience while the baby and his survival are secondary.  As we can see from the above definition, this is categorically false.  Home birth exists very much inside of the current medical standard of care.  B.C. College-registered midwives are some of the best trained birth professionals in the world who attend births in both home and hospital settings.  They carry emergency equipment such as oxygen, resuscitation equipment and anti-hemorrhage drugs; they have hospital and prescribing privileges.  These are not fringe para-medical professionals; they are one very important link in a chain of services to ensure safe care.

 

So hopefully this definition helps to clarify the grave misunderstanding of homebirth as an irresponsible choice of woman who risk their baby’s lives to satisfy their own need to define themselves.  In addition, I’d like to leave you with a link to a massive study done recently here in BC.  It’s well done and notes no significant difference between planned home birth (as defined by the College of midwives) in terms of perinatal mortality and morbidity.  I worked with the primary researcher Dr. Patricia Janssen Ph.D. several years ago on an acupuncture study at BC Woman’s hospital and know her to be a tireless advocate for healthy birth.  As it happens, Lee Saxell, who also worked on this study, was the second attending midwife at my daughter’s birth.  Here’s a link to the full text article.

http://www.cmaj.ca/cgi/rapidpdf/cmaj.081869v1