“Home Birth Experience 1: Decision and Expectation” is a midwifery clinic teacher’s summary of her interviews with eight women who planned ahome birth in the recent decade.  Author Alison Andrews proposes that the birth experience leaves a very strong imprint on the woman’s mind, while the medicalization of birth has reduced the birth experience to terms relating to a consumer decision, i.e. “satisfaction” or “attitudes on intervention.”  It is the desire to experience birth as an organic experience leaving its memory on the mother’s whole self that is a strong basis for choosing home birth over medicalized birth.

Women will share their birth experience with great detail and acuity in the days immediately following the birth, be it a positive or a negative experience.  The quality of that experience is beginning to be recognized as having a lifetime impact in other areas of the mother’s life, including her marital relationship with whoever was her partner at the birth.  As birth moved into hospitals through historical industrial developments technology served to also separate mothers mentally and emotionally from the xperience, fewer and fewer natural birth experiences existed tobalance the case for home birth as a safe and healthy experience.

Birth “narratives” in fact, are an essential and typical skill for the midwife to have.  The medical profession would relay a birth only in terms of patient notes, regardless of whether the birth was organic birth or some interventions were introduced.  This is a detriment to improving maternal health care because a mother’s birth story is a valuable data source recording live testimony to maternal health care protocols enacted upon them.  Based upon this theorem, Ms. Andrews interviewed eight women from her home region of South Wales with backgrounds ranging from affluent to indigent, from rural to desolate.  Of these women, seven had previously birthed in a hospital and therefore provided that experience in relation to their choice to birth at home.

The results concluded n two themes, each with secondary threads for further discussion.  The two main topics that women related the strongest emotion to was the decision to have a home birth and the expectations they held for their home birth experience.  the reasons behind their decision to birth at home ranged from pragmatic – fewer worries about child care for the siblings of the new baby – to addressing the need for intimacy via familiarity of surroundings.  These mothers also considered the risks of home birth, and in some cases the risk carried less weight in their decision-making process.  One woman sought only to ensure her midwife had basic emergency care items, while another retorted that things go wrong in hospitals too.  All women undertook some form of birth education and preparation but the preparation was more about the physical location itself than about their own body’s preparation for the birth.  This is interesting to note in direct contrast to the often reported indicator for hospital birth being about women desiring to be near pain relief or help if their body cannot manage the labor.  In other words, labor is in the eye of the beholder and that’s another post in itself!  To continue, the women’s expectations themselves were not of as great a note as the importance of recognizing that women held expectations for their births both in terms of the birth itself and the care they would receive.

This last consideration, it was observed, led to both discussion about holding dialogue with their friends and families regarding their decision.  It also led to strife with hospital care providers, who viewed the decision to birth at home as a personal indictment of both their profession and their personal reputation, rather than an honest examination into the quality of care – which is the basis for many of these mothers’ decision to birth at home.  It is this sole perspective from proponents for hospital birth that casts light on the goal of the medical profession: to lobby strongly to keep births in hospitals, although there is little evidence that home birth is not safe for lowl-risk, otherwise healthy women.  If this trend continues, concludes Ms. Andrews,

… childbirth … (will no longer be) part of life in the community for most women and will remain so as long as birth remains centralized in the hospital setting.

She quotes the Welsh Assembly government paper, “Delivering the Future in Wales,”  which concludes the option of a home birth with a skilled midwife must be a protected option.  Further, Britain itself is pleding to strive fora goal of a ten percent (10%) home birth rate based on utilizing home birth as a safe option in maternal health care birth choices.  this humble goal is indicative of the  deft persuasion and patience that will be required to advance the view of home birth is a complementary option to medical obstetrics.

Are you listening ACOG?  Complementary.  Working together.  Is it really your goal to improve mother and infant birth outcomes in the spirit of care and concern for humanity?

For more on the home birth decision making thought processes at large look into the Nursing and Midwifery Council report of May 5, 2005.

Works Cited:  Andrews, Alison, “Home Birth Experience 1: Decision and Expecation”; August 2004, Brtish Journal of Midwifery, Volume 12, No 8

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