Hello and welcome, Tricia Murray here from The Birth and Baby Academy
Did anyone catch the BBC News that in Scotland they are piloting continuity of care for low-risk birthing mums?
One of the biggest bits of controversy that many have caught on to is that they are “pushing women” into homebirths.
Let’s discuss – are we going back to the Dark Ages?
Encouraging women to give birth at home – is that not dangerous?
The fact is – that birth has never ever been so safe for mum and baby as it is now. We are still a little bit behind some of our European partners although ahead of many other developed countries round the world.
The reason many women would have died in childbirth previously was infection and haemorrhaging – both of which are easily controlled now. These are RARE reasons that women die in childbirth. The main reason women die now around childbirth is, very sadly, suicide (Confidential Enquiries into Maternal Deaths) – not a physical illness but a mental illness – and one of the contributing factors is the way women birth.
There are still sadly many reasons that many babies do die, many of these are congential issues or placenta failure – but very few of them are related birth to as per the findings of the MBRACE study.
What we know is where women feel in control of their birth and they feel safe, loved, supported – they can often reflect beautifully on their birth experience regardless of what happens. And this means that they start their parenting journey from love not recovery. It is vital that women feel as strong as possible post birth emotionally AS WELL AS physically. And this is something that a low-tech birth can help – especially one at home.
Where is the SAFEST place for women to give birth?
We’ve been made to believe for so many years that hospital is the safest place to give birth. This is in fact a MYTH. The SAFEST place for LOW-RISK women to give birth is in a midwife-led unit or at home. NOT in a labour ward (Birth Place Study).
We don’t really know what the SAFEST place for high-risk women is because there’s so little evidence around this – so we don’t know if it is a safe option or not. Increasingly more women are being classed as high risk. For so many of these women they are told that home birth or midwife led care is not accessible to them – this is in fact incorrect and is NOT evidence based because we don’t know what’s right for them.
There are always times where women DO need access to hospitals/medical support because of a specific reason – pre-term birth, babies with specific health issues, mums with serious health issues such as pre-eclampsia/HELLP syndrome, placenta issues or other. But it’s true to say many women do not need medical care.
What kind of care can you receive at home?
All midwives are highly skilled at supporting women to give birth – they have knowledge that they know what women need in labour. They know how to support physiological birth (ie vaginal birth) – this is something that many medical staff haven’t had training in.
Medical staff have been trained to deal with all emergencies and are highly skilled at doing so – but they often don’t understand how to support physiological normal birth – mainly they don’t see it.
Community midwives are highly experienced in knowing if there’s an issue and will always advise if you need to transfer to hospital.
The difference is with having a homebirth is you are very likely to know the midwife that arrives at your birth – or certainly be familiar with the team that she works with. That’s what the government is encouraging is that women get to know their midwife and have their support all the way through.
What that means is all that rapport building, trust, communication, understanding your birth wishes is all done – so you can focus entirely on giving birth.
Homebirths are often very low-key, it’s often gentle, it’s often just enough support. And women are much more relaxed in their own environment which is the key to a better birth.
What happens in an emergency?
Real emergencies in birth do happen but there’s generally an early sign that something isn’t right – so it would be rare in a homebirth that was going smoothly for suddenly there to be an emergency.
Many women who are transferred in to an obstetric unit, are transferred early on in labour because maybe the midwife has detected there’s an issue or something she’s not comfortable with. Many women are transferred in post birth if they require any stitches or medical attention. If you’re looking at the transfer rates for an indication that birth is unsafe – this will not give you an accurate picture.
In some instances, women will be taken in ambulances. In many others, women can make their own way there.
In a real emergency, paramedics will be called and you will be taken as an emergency to the obstetric unit.
There are, however, many emergency scenarios that the midwives can manage because they are so highly skilled. What again I would say, is these are rare. Many women round the whole world birth safely without medical help.
It’s in their best interests to not be taking any risks. And if homebirth and midwife-led care weren’t safe – the Scottish Government would NOT be encouraging it.
It should be noted, that it’s always your choice where and how to go give birth. If you don’t feel a homebirth is a safe option for you – then identify for what. What’s brilliant about this new initiative is that it’s promoting choice.
It’s an exciting time in Scotland for birth. I hope the pilot schemes take off. I do have some concerns about how this will be managed and I’ll write more on that next week.
If you’re interested in looking at your birth options and you want to prepare now to have a much better birth – get educated, feel in control, know how to make the right choices for you – get involved in the Academy.
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