I didn’t have a home birth, one of my children was born in a birth centre and the other one in a mainstream hospital but I absolutely support the right for other women to choose home birth if they so desire.
Here is Andrew Laming MP (federal member of the House of Representatives and also an obstetrician) feeling as bewildered as I am to find a conservative needing to argue against the progressive side of politics for home birth rights in Australia.
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Wow. That is the sexiest speech ever given in parliament!
Unfortunately, since it was made two years ago nothing has changed as far as I know. The reprieve is almost over and there seems to be no intention of rectifying the laws. have had two awesome home births, and to think I would have to have that experience without the accumulated wisdom of generations of women carried on by my midwife is enough to make me want to wedgie a large number of politicians.
Re-claiming birth is an important feminist action – particularly looking at the history of the male takeover of birth that occurred through the 1800′s.
Pregnancy is not an illness, and women are not second-class citizens. This whole situation is totally baffling.
Yeah, in the US the situation for homebirthing and midwifery is even worse. I had my first child in a typical US hospital setting; my second as a postgraduate student in the UK–at a birth centre. What a difference to birth freely and naturally in a respectful, non-medicalised setting!
I bristle at the suggestion that giving birth without medicine or in a birth centre is somehow more “natural.” I really hope this thread isn’t going to descend into judgment the other way.
I promise this thread won’t become judgemental.. my birth centre birth was with no drugs and no intervention, my hospital birth was with several rounds of induction and an epidural. Both were hard work and both had their merits. The birth centre one was amazing and private and peaceful but the posterior pain was really scary, and I loved the epidural in the hospital one though the ‘assistance’ from the midwife totally sucked and being moved about from room to room wasn’t comforting.
Having experienced both I don’t think breadforstones is saying anything judgey in stating that a typical hospital setting is a long way from a natural experience of birth.
ok thanks, I had a hospital birth in the UK with an epidural and it was wonderful birth experience. But leading up to it there was so much pressure from the midwives in my area and the various ante-natal classes to have a “natural birth.” If I didn’t have a stronger sense of self I would have felt like I had failed in some way. And there is so much mis-information about epidurals out there too which can mean that a lot of women end up suffering horrendous levels of pain for extremely long periods of time with no relief.
That being said, I think the UK is much less interventionist than the US. My friends who gave birth in New York, for example, were almost over-medicalised in that they were being given so many tests along the way that they were made into nervous wrecks.
But I am ambivalent about the term natural = good. Yes, there might be advantages to homebirths and less medicalised procedures but they are not advantages because they are “natural.” Nature can bring with it some pretty bad stuff too.
That was an awesome speech to watch first thing in the morning!
I especially liked how often he repeated the concepts of “choice” and “taking it out on mums” and “penny-pinching at the cost of healthcare is a disgrace.”
One of my best friends had sudden-onset preeclampsia during labour. If she had had a home birth, she and her baby would probably both have died. Fortunately, she was at a birthing centre.
When a birth goes badly, it goes badly very fast – and sometimes fatally. This is why I’m against home births – because the chance of death for the baby and the mum is significantly higher. I don’t think even a mother should be able to gamble with her baby’s life.
I looooove birthing centres, where good sense and home-style surroundings come together. They deserve a LOT more funding so more mums can choose a birth style that is both safe and natural.
Louise Curtis
Ok, except things go wrong in hospitals, too. I have a bunch of friends who are anaesthetists and some of their work stories are quite.. unnerving; it is probably best not to know how frequently patients are lost or almost lost because of very understandable human errors.
And yes, birth is not without its risks. But when it comes to low risk pregnancies (which I have to admit is more where I feel comfortable with home births) the outcomes for home births are very similar to those of hospital births. High risk births, absolutely, do better in the hospital system.
Maybe if we were able to offer all women a hospital birth experience that was pro-women and pro-early attachment we could possibly imagine policy against home births but when the hospital system is still so hit and miss for so many women I think we really really need to safeguard options.
Thanks for not yelling at me, Bluemilk (not that I thought you would). It’s clear you and I have been told different statistics.
My friend’s pregnancy WAS low risk – until it wasn’t.
Louise Curtis (currently pregnant and hoping that when the time comes I can resist the temptation to use anaesthesia – that much is certainly my choice)
I accept that problems can occur with anaesthetic but the examples your friends refer to bluemilk would involve births that wouldn’t haven’t gone any better at home, no? I mean if they need the anaesthetist then there is something that requires intervention, no?
Actually don’t want to terrify any of you.. examples from my friends were across a range of situations, not generally births.. and generally involving emergency situations.
I agree with this for myself – I’d rather be in a birthing centre where medical assistance is available if needed, but I also think that women should be allowed to make *informed* decisions for themselves – if they know the risks of home births, they should be allowed to decide for themselves whether or not they want to take those risks.
I don’t think limiting people’s choices is the answer – I think it would be better to support those choices and try to work out what can be done to make home births safer rather than to cut that option out altogether.
I had 2 planned home births in the US – Washington state where homebirth midwives are licensed and relatively integrated with the rest of the medical system. My first home birth resulted in the successful unmedicated delivery of my daughter at home, and my second home birth ended in a last minute transport to the hospital that turned out to be precautionary and I had another successful unmedicated delivery about 15 minutes after I got to the hospital.
I plan to have more children and hope to never have to give birth in a hospital again (although I would if my assessment of the risks/benefits came out in favor of hospital) – my experience of the hospital was that it was very similar to jail.
For me it is a basic right for women to exercise informed consent and autonomy over their bodies. In other areas of medicine the patient themselves in consultation with their doctor evaluates the risks and benefits of their decisions – and for people to assume that they should be able to make those decisions for a woman just because she is pregnant makes me very angry.
Are you going to send the police to a woman’s house in labor to forcibly transport her to a hospital when she is saying no? Is it better for people to have unassisted childbirths because the medical system has decided not to serve them?
Exactly my thought Rebecca… whenever I think about this, I think, baffled, ‘but how can you legislate for a bodily function??? how can you enforce it’ one of my lifelong friends was born on the side of a (lonely, country) highway in 1983 because his parents didn’t make it to the hospital in time (or left it too late, not sure). (his mother broke the front passenger seat of the car.) what would you do with her? charge her? charge her husband? (ok maybe these days he might get booked for speeding).
I grew up hearing about home births as a normal option (I’m on the far north coast of NSW) and it makes me very angry that this is painted as a bad option requiring high levels of insurance. women should have all options and there should be more freakin’ birth centres as well.
That’s actually a really good point – home births might actually be safer for some people who aren’t able to get to a hospital. If they had access to a midwife at home (or on the side of a highway) that would be preferable to no one at all, surely.
I don’t think anyone is talking about the police forceably taking a woman to hospital. It is about whether funding homebirths is a good use of government funds. There is a big difference.
To be fair, it isn’t just about the funding of homebirths and the use of government money, but also about the availability of insurance coverage to midwives for homebirths. If you legislate to deny insurance coverage, then midwives who assist at home births are personally liable for any compensation in the unlikely event that things go wrong.
I feel some sense of responsibilty in all this as I have been involved in many cases of litigation where births have gone wrong. When things do go wrong during birth the injuries can be catastrophic, and where things have gone wrong because of negligence, then the compensation payouts can be very high. Although I would estimate that less than 5% of potential claims are actually successful (it is extremely difficult to prove negligence and oftentimes, things just go wrong and no one is to blame) it is fair to say that doctors, medical students and hospital administrators have a very high (and perhaps not always realistic) degree of fear about the risk of being sued. I don’t think that the threat of litigation is the only, or even the major, reason for the medicalisation of birth, but I do think that it is an easy button for the insurance industry to push in the medical community to ignite fear and promote lobbying. Amongst hospital administrators there is a desire to ‘manage’ birth so that there is no risk – an impossibility. The non-sensical part of this is that eradicating homebirths will have virtually no impact on the ‘bottom line’ – insurance premiums and payouts – and a huge impact on the lives of women who would choose a home birth. In 15 years I have never never had a case involving a home birth, though I am aware of a couple.
Having said all of this, I chose hospital births 4 times. I guess that is the point of all this – it is about choice and not having one option foisted upon us all. And like Jen I am very keen not to see ‘natural’ birth as always getting the reward points from other women. There is far too much shame around birth for far too many women.
But HOW do we know that? It is NOT better for women who want to homebirth to be forced to do so without assistance, and it is NOT better for midwives not to be able to access insurance so they can perform their job and support women. And it is not a good use of government funds to not fund a perfectly good choice used safely and effectively throughout the world. How much would this really cost? It saves money for the hospital system.
There is a big difference between women’s choices and health being supported, and not. There is a heap of research on this.
Personally, as much as I love the idea of home birthing, it seems too risky to me. Birthing centres (or maternity hospitals as they are called here in NZ) seem a good compromise, offering both safety & a more cosy environment.
My 3 yr old was born in an ordinary hospital as I had to be induced. But the midwife was great, I laboured how I liked with no restrictions on movement & no pain relief, & my son was born in 5 & 1/2 hrs, & had skin to skin & breastfed immediately.
My 10wk old daughter was breech so I had a scheduled c section. I was devastated about it, but the nurses & doctors were amazing compassionate people, which really helped me feel involved throughout the whole experience, & my daughter had skin to skin & breastfed 15 mins after birth.
I guess what I’m trying to say is that not all hospitals treat women badly (not the right word, but I hope you get my meaning). I had a really great first birth, & an ok c section. And home births do have more risk than hospital births. Like Louise Curtis above, I think birthing centres/maternity hospitals are a great option – despite never getting my wish to actually labour in one!
oh dear, I fear I am a somewhat guilty party in all this, though perhaps guilty isn’t quite the right word. Though I strongly support the right of women to have homebirths and frankly any sort of birth they damn well please, I have also been involved in a lot of litigation around births that have gone wrong (note that all of them, without exception, were hospital births). When a birth does go wrong, the resulting injuries can be catastrophic, resulting in potentially large insurance payouts (but note, this is only if negligence can be proven, an extremely difficult thing). Whilst I would estimate that less that 5% of potential claims are ever successful, it has undoubtedly led to great fears within the medical community about the risks of practicing obstetrics. This in turn has led to a desire to ‘manage’ birth to the point where there is no risk – an impossiblity. I do not think that litigation has been the only, or even the major, driver in terms of the medicalisation of birth. But I do think that the risk of litigation and the fear that it puts into doctors, medical students, and hospital administrators, is an easy button for the insurance industry to push to incite agitation and lobbying by the medical community. The non-sensical part of the equation is that homebirths account for a minute portion of those cases that end up in litigation (in 15 years I’ve never had one, though I’ve heard about a couple), so this severe curtailment of women’s rights will have no impact on the ‘bottom line’ – insurance premiums and payouts – and a massive one on the lives of women who would choose to birth at home.
Anyway in answer to Rebecca and Hendo the legislation won’t force women to go to hospital or make it an offence to birth at home, but it will remove the ability of midwives to obtain medical insurance for home births. In the absence of insurance, anyone who delivered a baby at home and botched it up (and please note that a bad outcome that was unavoidable is not the same as a bad outcome that was caused by negligence and only the latter is compensable) would be personally liable for any compensation that was awarded. You can imagine that not too many midwives would want to risk their house/livelihood, thus in practical terms, assisted home birth would be nearly impossible. Sorry for the essay (and law lecture).
oh sorry I commented from a different computer and it didn’t seem to work so I commented again an almost identical fashion. if it is possible please feel free to remove one of the comments as they are long and repetitive.
Hospital births are seen as safer because only the really big stories where something has gone wrong get into the media at lot of women are unhappy with their hospital births but there is a huge “you’ve got a healthy baby so stop whinging” stigma. There are also many women who have had good hospital experiences and have no problems going back. Likewise there are a significant minority of women having safe homebirths. Homebirths, as opposed to freebirths, involve a trained midwife and usually a hospital waiting ready should a transfer need to occur. Midwives come equipped with a lot of kit and spend a lot of time with their patients. If I had had a low risk pregnancy I would definitely have wanted to try one because I had a wonderful midwife friend who specialised in them. I get that many women feel safer in hospital, but I think the important thing is that they get a choice.
Hi guys,
Just would like to add a couple of points to the discussion
One is that I agree pressure either way is to be avoided. The experience of birth tends to be a pretty big event for most mothers, and often a very emotional and momentous one. It is so important to feel comfortable. For many women their is anxiety associated with the thought of a home birth; for others, a hospital birth.
Giving birth anywhere except your own home is not inherently unnatural. What I view as negative about a hospital birth is the instances (which hopefully are becoming rarer) in which women have choice taken away, are not fully informed about interventions, or are pressured into doing things in a way that makes things easier for the midwives or obstetricians but that do not benefit the mother. Hospitals are much better now at promoting breastfeeding and bonding, but a lot of unnecessary and un-empowering stuff goes on.
Evaluating the safety home births is tricky. Many studies say it is as safe or safer. Laming speaks of several studies and meta-analysis that support this. Others say it is riskier. With regards to cost, a lot of studies say it is cheaper. In the US were some states have home birth as being illegal,freebirthing is becoming more common, and is much much riskier. This is happening in Australia too.
Also (i don’t want to go on too long here) but it is quite interesting to look at a breakdown of interventions and how they can in fact complicate pregnancies in a hospital setting. And also make it unecessarily uncomfortable for the mother. For example, the practice of labouring (and also doing frequent vaginal examinations and fetal monitoring which in many cases are proven to be ineffective or irrlevant) which loses the advantage of our hormonally-elasticised tailbone being able to shift its usual position and widen the birth canal.
I just think it is really important that we focus on empowering women in any situation.
Long time reader, first time commenter.
I felt compelled to comment because of how I perceive the discussion is being derailed in the name of safety. The relative risk of home birth with a licensed medical professional, either doctor or midwife — safer for some? safer for all? safer in comparison to birth in some hospitals? safer in comparison to birth in all hospitals? safer only when it’s integrated into the system? — is a red herring and has nothing to do with the real issue at hand: a woman’s right to her own body, also a woman’s capacity to access & review information pertinent to such and to make her own decisions. That I believe the state ought to support home births on a legislative level goes without saying, as mine is a leftist type of feminism that also believes in free education, low cost to no cost healthcare including access to contraceptives and abortion to those who need it, yadda yadda yadda.
Whether an individual woman perceives home birth as too risky / wonderfully low risk / potentially risky but worth it is none of my business, unless I’m talking about my own birth choices. I wish to extend this courtesy to anyone else– how other people give birth is none of my business, as long as they are supported in their choices and receive the best care they want to ask for in a given situation.
Ah, ok. Sure a woman can give birth however she likes. But when government funds are involved then it is everyone’s business. I don’t have strong views either way but if it, for example, costs ten times as much to support a home birth than a hospital birth then I think we have to strongly query why we would support home birth. Yes, I agree that women should have the right to choose but given that women’s choice can heavily impact on the allocation of resources elsewhere then we need to have a sensible conversation about how best to allocate those resources. I gave birth in a hospital where my midwife was leaving me for long periods of time to attend to other mothers. That was a good use of resources – I didn’t need her with me the whole 24 hour of my labour. Does it makes sense for a midwife to be at home with a woman who has a low-risk birth solely for that entire 24 hour period. I am not so sure…Just remember that homebirthing came about when babies were delivered by other mothers, and aunties, and grandmothers. To ask the government to fund homebirths is a completely different issue.
jen, can I politely urge you to do some more research on homebirths? They are most definitely not more expensive than a hospital birth. Any complications that may occur could easily have occured in hospital and incurred the same cost. Most of the cost of a homebirth is borne by the parents. You also have a misconception about homebirth midwives – these women have chosen to leave the hospital system because they don’t like the way it works. All homebirth midwives I know do not work in the hospital system and even when homebirths were not an option they still did not work in the system. The government is providing insurance, not funding homebirths.
Seconding Mindy, who said it all well. Cordially suggesting you may be interested to have a look into this stuff. This is off the top of my head, but Norway, Denmark, Sweden and the UK fund home birth as a normal part of their health system and have very good outcomes.
Jen, the NHS and Australian Medicare system are different creatures in many respects (some of which are outlined by Mindy).
I had my son 3 1/2 years ago on the public dime. I trusted that we would be taken care of, and get what we needed and our best interests considered. I was naive and made some bad decisions – as, it turned out, did my me4dical carers – and he and I probably cost the public thousands during my hospitalisation and his week-long stay in the NICU.
Population spread, numbers and the way the medical system is set up in this country means that pregnant women using the Medicare system to cover the entirety of their costs are funneled towards “registered birth centres”. In my area this means the maternity ward at the local hospital. It is the ONLY 100% Medicare “registered birth centre” within two hours’ drive (some of it through National Park and uninhabited spaces) of my home that is fully funded by Medicare. I live in one of the largest “cities” in Australia, though not a capital.(If we’d gone private and paid some or all the costs ourselves there were two other options, one 1/2 hour away, the other 1 hour).
Wait-times to see a midwife for my regular pregnancy checkups were similar to seeing an NHS doctor in London for something like a sprained ankle (which I’m using since a friend and coworker did just that when I lived in the UK); you could wait anywhere from 2 to 5 hours after the time of your scheduled appointment.I did not see the same midwife throughout my pregnancy. I got whoever was free in the antenatal clinic at the time.
When a scan ascertained that my baby was breech at approximately 36 weeks (at a guess; my irregular periods meant numbers were fudged. Probably too generously as it turned out) a random obstetrician on staff (again, whoever was free) told me I’d have to have a caesarean because nobody there was trained in delivering breech babies.
I requested an attempted ECV that ended up being unsuccessful. The midwives changed shifts between it and my surgery. So the woman who was meant to be looking after me and my baby came up and introduced herself (along with the surgeon, whom I’d never seen before) as they wheeled me into surgery. And then the night after he arrived my child choked on the mucus that surgery had failed to expel from his (still developing) lungs, stopped breathing, and was transferred to the NICU. Apparently with an infection of some sort, to top it off. Which he probably picked up from the hospital surrounds. And again, caring for each of us in our respective wards were “whoever was free”.
After my experiences I am utterly horrified at arguments that I should not be ‘allowed to gamnble with [my] baby’s life’ because that’s what it feels like a cascade of random strangers did, and with no reforms for the hospital system accompanying anti-homebirth insurance legislation that is effectively what they are arguing for. Alongside a system that treats pregnant women like numbers to process.
I was talking hypothetically – I said “for example.” I have no idea whether homebirths cost more or not. What I was saying is that all these posts saying “women should be able to give birth however they like” need to be open to conversations about what is also an efficient use of resources. Which we are having – thanks for filling me in on the stats!
I see I am inadvertently your enemy again Mindy! Glad I can serve some role on this blog even if it is to give posters someone to argue with and get annoyed at!
Interesting and depressing to read about the Australian system, Alphie. I guess my view are definitely overly-influenced by my own experience in the UK.
Are you really making the tax dollar argument? Really? Because, sure, I can think of a variety of ways in which we could streamline MANY services offered to the public and make them less costly — albeit home birth would still tend to come ahead as the lower cost option if we’re talking birth — but to do so would in many cases interfere with values I hold dear: choice, for example.
Sorry Jen, I was trying to be non confrontational – obviously a fail on my part (re-reading I can see where). Birth choices are a bit of a thing with me, and I’m sorry you got caught in the crossfire. I’m not generally that nasty in person!
I definitely don’t understand all of the dynamics of the Australian system – although I should probably learn more before actually moving there – as I am considering (and having up to 4 babies there). My context was that the homebirth midwives brought the exact same equipment to my home for the birth as would have been available in a freestanding birth center and in both cases I was within a 5-10 minute drive (1.5 miles/6 miles) to well equipped hospitals. In terms of cost – my entire first pregnancy prenatal care and delivery cost me a $25 copay and cost the insurance company less than $3000. Just the transfer to the hospital (resulting in a completely uncomplicated, unmedicated vaginal delivery of a healthy, normal newborn) cost me ~ $700 and the insurance company ~ $4000.
Part of my rationale for choosing home birth was that epidural/pain medication is just not available – so there is an automatic barrier to getting it – it has to be worth going to the hospital for. If I had been in the hospital (foreign/jail-like/medicalized) setting throughout my labor I have no doubt I would have gotten pain medication but because it wasn’t an option I could focus on other methods of coping in a comfortable/familiar setting.
I have to say 100 times yes to this by Ida Lappalainen “Whether an individual woman perceives home birth as too risky / wonderfully low risk / potentially risky but worth it is none of my business, unless I’m talking about my own birth choices. I wish to extend this courtesy to anyone else– how other people give birth is none of my business, as long as they are supported in their choices and receive the best care they want to ask for in a given situation.”
It should be about the individual woman making her own decision with the best information and realistic support available.
Rebecca – the short version of the Australian system is that you can go to a public hospital and you only pay for parking. All Australian citizens (and lots of other people who live here depending on visas) are entitled to this. Some public hospitals have birth centres within them, which are run by midwives, a small number of public hospitals run homebirth programs. If you have private insurance you can choose a private hospital, how much you pay out of pocket depends on your insurance. Insurance generally doesn’t include homebirth. Private midwives provide homebirth, generally their clients pay the whole amount out of pocket.
As happens anywhere, the choices people make are influenced by what’s available where they live. Choices are somewhat constrained in rural and regional areas, and distances to major hospitals are significant.
My local small town hospital is very new, built in 2008, and has all the equipment to provide care to all but the most high risk mothers and babies. Unfortunately it’s not funded to have obstetricians on call, so in reality they do only very low risk mothers, and some elective ceasareans.
Every woman’s birth experience is deeply personal and I don’t think it’s useful to judge. However I think it’s ok to say that, on the whole, vaginal drug-free childbirth for the majority of low risk pregnancies delivers better outcomes for mother and baby. By saying that I don’t think the flip side is that epidural or c-section = failure and of course there are plenty of women who have intervention and are well and happy as are their babies. There’s a place for intervention but whether there’s a place for the level of intervention that currently occurs is a matter for debate.
I’m just not sure where this idea that home birth is inherently dangerous comes from? When I was considering a home birth through our local hospital the midwife explained to me that in the event of something going wrong I would be transferred to the hospital but that there are a very small number of things that can go wrong where a c-section needs to be performed within about 7-minutes so it doesn’t actually matter whether you are in a hospital or not because a c-section is never gonna happen within 7-minutes.
In thinking about this idea of “safety” and the “risk” inherent in home birth I’m lead to think about the numbers of women with normal low risk pregnancies who fork out thousands of dollars to be under the care of an obstetrician and frankly, it breaks my little feminist heart. Sure, feminism is about “choice” but the thing that gets to me is what it reveals about what our cultural view of women’s bodies. So while we can have discussions about birth choices, this notion of choice is largely meaningless within a cultural context that discourages women from fully understanding and appreciating the amazing capabilities contained within their bodies. I have been amazed to observe the level of fear and anxiety about childbirth amongst my friends who are all well educated, strongly feminist women. But it’s not surprising really when so many of us grew up on a diet of fear and loathing about childbirth from our mothers and aunty’s and mother’s friends. I don’t think I heard a positive birth story until I was about 28! And it makes me wonder what affect this level of cultural fear has on a women’s ability to make truly informed decisions especially within the current context whereby home birth has such a stigma.
Well said Genevieve.
Often when speaking to pregnant women their attitude toward birth can tend to be ‘I don’t want to know, I have heard too many scary things, I will just do whatever the doctor tells me’.
Again TOTALLY their prerogative…but if it is a result of a culture that detaches women from their bodies through fear, objectification, social ownership of women’s bodies, and the institutional degrading of women’s faith in and control over their bodies…if that is the reason for the attitude then it is oppression.
I think this is such an important point you’re making about the birth wars – the ways in which women’s knowledge of and confidence in their own bodies has been eroded over generations. This is one of the reasons why birth is such a core feminist topic and deserves higher status in feminist discussions. It’s not all birth circles and blessingways, feminist people, this is politics, hardcore politics over women’s bodies.
In terms of the discussions about efficient use of public resources in relation to maternity care I think it’s useful to consider the wider implications and costs of the medicalisation of birth.
I had wanted a home birth through our local hospital but due to myriad reasons I wasn’t able to be a part of the hospital home birth program. However I was able to birth in the birth centre. According to my birth centre midwife I had a very “textbook” labour. Things progressed really well with the help of bajillion litres of water and he was born into the bath. But because I was Strep B positive I had to stay in the hospital for 24 hours. As per hospital policy I had anti-biotics during labour and my son was in his sac for almost the entire labour, my waters only broke about 5-minutes before I pushed him out. So the chances of him picking up the bacteria were really slim to none. Despite this, he was taken away from me in the middle of the night. A midwife had detected some rapid breathing and took him to the special care nursery for observation. I had no idea what was going on until I found him hooked up to drips and oxygen and machines in the special nursery and there he remained for 48 hours. He was x-rayed and pumped with anti-biotics and given formula and we were effectively separated during a really crucial bonding and attachment time. Now if his life had really been in danger I would be grateful for this intervention, however all he had was a self-correcting glitch that posed no threat to his life but the hospital followed policy with little concern for our individual circumstance. I have no doubt that everyone felt they were doing the right thing but the ramifications of the hospital intervention were pretty severe. Because of breastfeeding problems that I largely attribute to the special care nursery we had to return to hospital when Oscar was 2 weeks old, he was dehydrated and skinny and dare I saw it, malnourished. We spent another week in the hospital under the care of paediatricians and doctors and nurses and midwives. Then I spent 4 months trying to breastfeed him during which time I developed post-traumatic stress from my initial hospital experience and post-natal depression which led to 6 months of Medicare subsidised psychological counselling.
Everything has worked out and Oscar is now a really happy, robust, adventurous, beautiful 18 month old. But really, one has to think that a home birth would have been a much better use of public resources?
For my first pregnancy I had an unmedicated birth in a small, under-funded public hospital with minimal doctor attendance and fairly basic resources. I stayed two nights. And that cost the government $5,000, approximately.
If I’d gone with a private hospital, had a C-section and stayed a week, that would have cost my private health insurer around $10,000.
For my second, I’m having a homebirth with a private midwife. Neither the government nor my private health insurer is picking up any of the cost. Not a cent. And for every antenatal visit, post-natal visit and attendance at the birth itself, she’s charging me $3,000.
It’s pretty clear to anyone who’s done any research at all on this that home birth is cheaper. I mean, obviously it is – it means no need to maintain a huge standing structure with equipment and beds and ancillary staff, which more than cancels out the cost of a dedicated attendant rather than sharing a midwife with several others. This is also the case in the UK. And yet I see Jen’s argument over and over – it’s the government’s business what a woman wants to do with her body because it’s public funds. Fine, but if you’re going to argue that, you have to acknowledge the really, really clearly documented fact that home birth is CHEAPER.
I don’t really understand what you are saying here – isn’t one option cheaper because the birth isn’t complicated. If your birth is complicated then you are going to need all that expensive equipment and attendance. So I don’t think we need to be knocking hospitals – for some (me included) it is the right place to be.
I am wary of your confidence in saying “For my second, I’m having a homebirth with a private midwife. Neither the government nor my private health insurer is picking up any of the cost.”
You just don’t know though, do you, how each birth is going to go? God forbid, you may end up in hospital and I worry about this position of pitting home births against hospital births.
Another thing I thought of is that feminists, too, benefit from taking a critical look at the culture of the bad/good mother. Say I, personally, choose to have a homebirth with a hypothetical future baby. My medical history (including a previous cesarean and certain pregnancy complications that will likely be low key when managed but very much present in any future pregnancies) would imply that a hospital birth would likely be the better option in terms of outcome for the baby. Yet I don’t want one, because I value my own sanity and comfort — both of which I would find hard to come by in a hospital environment — above the slightly increased risk of uterine rupture or other complications that might better be dealt with in the confines of the hospital.
This is why I think the conversation about risks, important though it is, is ultimately a pointless one. I’m familiar with what the research says, as is anyone who has bothered to take a more in depth look at these topics, now what? I know my mental health better than anyone involved, and for me staying sane means being able to give birth in the privacy of my own home, or more importantly outside a hospital. To me, homebirth is pro-woman and pro-feminist, despite the fact it might very well be physically riskier to a potential future baby. Conversations with members of the natural birth at all costs brigade aside, I notice a culpable level of discomfort in the air when I acknowledge these things (“homebirth would likely be somewhat riskier to my baby, I want to have one”) to other women, even to ones identifying as feminists.
Have your say here:
http://www.surveymonkey.com/s/BBFRH39