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Is giving birth at home really a safe option?

Only a few decades ago, giving birth at home was very much the norm. However, with the advancements in medicine and maternity care that we've seen within recent times, giving birth at home has become the exception (and sometimes even considered to be a radical choice), with only around 2% of people choosing to do so.

Now, the goal here is not to convince you to have a home birth. Instead, the goal is to challenge the idea that giving birth at home is somehow less safe for you and baby and to demonstrate that, despite our advancements in maternity care, giving birth at home is still a perfectly viable choice.

Firstly, research shows that there are no differences in neonatal (mortality, resuscitation) or perinatal (mortality, postpartum hemorrhage, risk of severe tearing) outcomes when comparing home births to births in other settings.*

In addition to being in a perfectly safe environment, when it comes to giving birth at home, some of the other benefits include:

a reduced likelihood of having your labour artificially augmented or sped up

a lower chance of requiring an episiotomy or instrumental delivery

a lower chance of having an unplanned caesarean

a greatly reduced risk (up to 75%!) of contracting an infection

But what if the idea of homebirth still feels unsafe?

For many people, the above findings can feel very counter-intuitive. They go against the view of birth as an inherently medical event and challenge deeply held beliefs and societal expectations about birth, which might feel uncomfortable.

When I speak to couples about the possibility of having a homebirth sometimes their instinct is that it wouldn't be right for them 'just incase something goes wrong'. Now, when I work with expectant parents in 1:1 birth coaching sessions, my goal is never to convince people to do anything other than what feels right for them. Having said that, I do think that understanding decisions based on worries, as well as the source of those worries, is important.

If you can relate to the 'just incase' feelings around not wanting a homebirth but you're a little curious about where they have come from (and maybe there's even a part of you that's open to giving birth at home), I invite you to explore a little further with the following questions. You can write down your answers or discuss them with your midwife or birth partner.

What birth-related possibility makes you feel nervous and why?

Where does that worry come from?

Is it a previous experience?

Is it based on a birth story you were told by someone else?

Are you making an assumption or is your worry evidence-based?

Do you know the absolute probability of something like that happening?

What if I'd like to have a homebirth but my partner isn't on board?

If you follow me on social media, you will know that this is the exact scenario that I have been navigating with my own birth partner recently.

I am currently pregnant with our third baby and my preference is to give birth at home, but my husband was initially skeptical. Here's why it was important for us to actively work through that skepticism ahead of labour (and how we did it):

In labour, my husband is my voice - he is the person I trust above anyone else to advocate for me because, based on my previous experiences, I’m not able to do that myself when the intensity of labour really sets in. In order for him to do that effectively, confidently and in a way that serves me (and our baby) best, I believe that we must be on the same page when it comes to my birth preferences.

That will require trust. Trust in the plan and an even deeper trust in birth. Without that trust, he will be a lot more likely to panic and a lot less likely to be the advocate, calming presence and practical support that I need him to be. And I know exactly what impact that could have on my birth (something I also teach in my online birth prep course).

In other words, to achieve the birth that I want, our differences in feelings and preferences will require more work than simply overruling him as the person giving birth. So here’s how we worked to get onto the same page:

We created a space where we BOTH feel heard and validated - sharing our feelings, beliefs, preferences and where they have come from without judgement or defensiveness. I'll admit that it was hard for me not to come in hot with everything I know about homebirth (see evidence above) to begin with. Ultimately though, the idea of it felt hugely unsafe to him, which was so very valid when you consider everything we've ever watched and been told about birth, so I started with the recognition of that.

We worked to expand our feelings of safety around the idea of homebirth - because of the work I already do as a birth coach, this has been more for him than for me. For him, this has looked like listening to homebirth-related podcast episodes and considering research around the safety of homebirth, as well as the homebirth stats for our local NHS trust.

We keep talking - about where we are in our feelings around it all, all of the “what ifs” that come up for us and the logistics of actually having a homebirth.

All of this isn’t just my reality at the moment but a scenario that I support couples with all of the time. It takes work and often, deep reflection and conversation, but I do genuinely believe that it makes birth better.

*Dr Sara Wickham provides an excellent overview the available literature on home birth on her page - I'd really recommend checking it out!

I do appreciate that giving birth at home is not a viable or preferred option for everyone. If it is an option you'd like to explore but you're coming up against specific worries or anxieties that are holding you back, get in touch with me. I'd love to support you in working through those worries and making home birth feel like a more comfortable option for you. 

If you'd like to follow my journey as I prepare for my own homebirth, come find me on Instagram where I share my personal experiences as well as my top tips.

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