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Let's talk about homebirth!

Women have been giving birth at home since time began, with hospital births only being introduced in the past few hundred years. As this has become the norm, giving birth at home is widely contested, with the risks of safety and access to appropriate care under question.

As with all choices made regarding pregnancy and birth care, women should be empowered through knowledge to make an informed decision. This may include understanding the benefits, risks, alternatives, and implications, also known as the “B.R.A.I.N” technique1, 2.

For healthy women with uncomplicated pregnancies, planned birth at home results in higher rates of normal labour and birth and lower rates of most maternal complications and perinatal mortality outcomes 3. Some reasons that women choose homebirth include continuity of care with a known midwife, a familiar, comfortable setting with family support, access to waterbirth and choice of position4. Women also conveyed that homebirth was chosen to avoid instrumental and pharmacological interventions 5, hospital policies, coercion and time pressure and interrupted skin to skin, and breastfeeding post birth 4.

Australian women are eligible to plan a homebirth under the care of registered midwives if they meet certain criteria, such as an uncomplicated pregnancy, with one baby in the cephalic position, singleton pregnancy that is uncomplicated, a labour that begins between 37-42 weeks, and the home’s proximity to the hospital. In some cases, women who begin a homebirth may require transfer to a hospital as one or more risk factors arise6.

Accessibility, political, medical, and social factors limit only 0.3% of Australian birthing women for choosing homebirth4.

Hypnobirthing reduces incidences of pain, fear of childbirth, and higher birth satisfaction7. Self-hypnosis for pain relief can be used in homebirth, a space where pharmaceutical options for pain relief may be limited. The ‘Positive Birth Program’ provides women with other fantastic tools such as relaxation, visualisation, acupressure, movement, and touch allowing them to experience an empowering and positive birth, wherever that may be.

References

1. 1 Miller, S., & Bear, R. J. (2019). Midwifery Partnership. In S. Pairman, S., Tracy, C. K., Dahlen, H. G & Dixon, L. Midwifery: preparation for practice (4th ed.) Pages 299-361. Elsevier. Australia

2. Wedgewood, L. (2020). BRAIN Decision Making Tool for a Better Birth Plan. https://www.pregnancy.com.au/brain-decision-making-tool/

3. Homer, Cheah, S. L., Rossiter, C., Dahlen, H. G., Ellwood, D., Foureur, M. J., Forster, D. A., McLachlan, H. L., Oats, J. J. N., Sibbritt, D., Thornton, C., & Scarf, V. L. (2019). Maternal and perinatal outcomes by planned place of birth in Australia 2000 – 2012: a linked population data study. BMJ Open, 9(10), e029192–e029192. https://doi.org/10.1136/bmjopen-2019-029192

4. Sassine, Burns, E., Ormsby, S., & Dahlen, H. G. (2021). Why do women choose homebirth in Australia? A national survey. Women and Birth : Journal of the Australian College of Midwives, 34(4), 396–404. https://doi.org/10.1016/j.wombi.2020.06.005