For a lot of Australians, when we hear the term “home birth”, we think of hippie types insisting on no medical intervention.
“The first question is, ‘Is that safe?’” says Hilary Rorison from the Australian College of Midwives. “The second question is, ‘Oh, can you do that?’”
Rorison says in some other countries, like the UK, home birth is “not such a big deal”.
“Home birth is part of their system. It’s more normalised.”
Mums and non-mums answer questions about childbirth with very telling results.
In Australia, only 0.3 per cent of women have a planned home birth. That’s around a tenth of the number that give birth at home in the UK.
There are a small number of publicly funded home birth programs operating from Australian hospitals, and women can also choose to give birth at home with private midwives.
So what’s like to have a midwife-led home birth in Australia?
Rorison, who is based in Adelaide, has spent four years as a home birth midwife.
“There’s something really special about women labouring at home that is quite difficult to bring into a hospital environment,” she tells Mamamia.
Rorison says women who choose to give birth at home with a midwife tend to be “highly educated and very informed”.
For a woman to have a publicly funded home birth, she needs to go through what Rorison calls a “safety check”. That takes into account their medical history, mental health and their social situation.
Women can be ruled out if they’ve had previous medical complications, such as a caesarean birth for their first child, or if they’re above a certain age or a certain BMI. However, privately funded midwives might be willing to take on some of these women.
“It’s certainly not accessible to everyone and it’s certainly not safe for everyone,” Rorison says.
Women need to live close to a hospital – generally, within 30 minutes. Women can also be ruled out of a publicly funded home birth if their home isn’t considered suitable – for example, if there’s too much clutter to allow access or if there’s illicit drug use going on.
“You spend the whole pregnancy asking all sorts of questions, really getting to know the woman and what’s going on with her – in a supportive, good way.”
As the time of birth approaches, the midwife will turn up to the house when the woman is in established labour, usually about three contractions in 10 minutes. The woman and the midwife will have already talked about where in the house she will give birth.
“Women will want to be somewhere that feels really private, that maybe they’re able to make a little darker,” Rorison says.
“Oftentimes women will want to go to the bathroom, somewhere really poky and small. Oftentimes women having a home birth will rent a pool so they can labour and/or birth in water. The shower’s a really nice place as well.”
She says when women are at home, they can go wherever they want without having to ask permission.
“It’s nice being able to go to the fridge and grab some ice cubes. I’ve had women go for walks, because they just wanted a break.”
There’s no limit on the number of people that can be present at the birth, either.
“I had one client and she had her other four children around the pool watching, right at the very end when the baby was being born. But some kids don’t cope well.”
Things don’t always go according to plan with a home birth. In fact, studies have shown that anywhere from 10 to 30 per cent of women planning to have a home birth end up transferring to hospital.
Rorison says it happens more often with women having their first baby, and usually, it’s for non-urgent reasons.
“Eighty per cent of the time, it’s ‘All right, you’ve been in labour for a while. We’re getting to that time where we’re wondering what’s going on. You’re getting a little bit tired. You might want some pain relief.’”
When there is an emergency, midwives have the equipment to deal with it.
“We bring drugs to manage a post-partum haemorrhage, we bring oxygen and suction, we bring resuscitation equipment for the baby,” Rorison says.
“It’s not as if, when an emergency happens, we ring an ambulance and we’re sitting and waiting. We’re actively managing that.”
Midwives generally stay around for about four hours after the birth, or until everything is stable.
“When I’m leaving, I’ve tucked them into bed, she’s had some toast and a cup of tea, we’ve had a chat. It’s a really beautiful experience.”
Rorison says a lot of people don’t understand how strict the guidelines are for midwife-led home births and how much equipment they bring to keep it safe.
“We’re not like hippies in the background wishing everything goes well. We’re certainly modernised.”
She says they’re always “extremely grateful” to have the hospital there.
“It’s certainly not ‘home birth or nothing’.”
Have you had a home birth? What was your experience like? Tell us about it in the comments section below.
For more on this topic:
These very real photos of a home birth are incredible.
"We’re confident": Bookies have closed bets on where Meghan Markle will give birth.
"So lovely and rewarding." Hilary Duff just shared the emotional video of her home birth.
Marissa Heckel gave birth unassisted in her bathroom. Her photo has sparked debate.
"Australian women deserve the right to choose a home birth."
Alexis had a home birth... then hosted her daughter's 3rd birthday party a few hours later.
After successfully delivering twins, midwife Martina was suspended. Now mums are fuming.
Top Comments
In our family - I birthed at home, with a privately practicing midwife in attendance, and had a smooth, uncomplicated birth of less than 4 hours which followed a smooth and uncomplicated pregnancy and a healthy baby boy. My sister in comparison, had fragmented care through the public hospital system, had an outwardly uncomplicated pregnancy, was ignored during labour even after she said she felt something was wrong and was sent home because she wasn't 'far enough along', ignored again by staff when she was re-admitted saying she didn't feel right (it was a slow night and the staff on duty were busy catching up on admin jobs) and it took my brother-in-law yelling in the corridor for someone to come... and discover the baby was in distress... and my nephew was born with an APGAR of 3 and will spend the rest of his life with CP.
Let's quit politicising place of birth and start looking really carefully at modes and models of care for women and their babies (and for the long term health and wellness of the family) and assess the safety and danger there.
It is easy to target homebirth to demonise and ignore the fact women and babies are damaged and traumatised in the hospital system. The fact that suicide is the number one mortality risk for post-partum woman in Australia tells us that there is something horribly wrong with the way birthing women are treated when they are at their most vulnerable.
J.C. - Brisbane
My concern is this - no matter how educated, well-informed the mother-to-be is & how well-set up the home-environment is and how prepared and capable the midwife is, there's always a crucial "unknown factor " in any home-birth.
The baby.
There will always be an element of risk with a home-birth that is unpredictable.
That 30 min or 5 minute delay in getting expert hospital intervention could risk the baby's life.
Both of my children would have fared very badly in a home-birth situation so even though my personal experience isn't enough to say no to a home-birth my point is -
both of those births were doing really well - until they didn't.
In 2019 there's no way I'd ever risk the baby's safety so that I could have a "special, comfy, relaxing experience".
It is not just the baby who is at risk, but potentially the mother as well. Women still (not very often) do in or just after giving birth.
This is why I can’t understand the comments around it being perfectly fine for straight forward births - yes, this is true, but you can’t predict what kind of birth it will be so how is this even relevant? I personally don’t understand how anyone can take such a risk when they don’t need to. There are options to join a midwife program or find a supportive OB if you want an intervention free birth, but still have the safety net of a hospital.
Well they can kind of tell how things are going- any early signs of trouble you go to hospital - no different then waiting for the obstetrician to arrive when called in.
It’s a judgment call people make and the risks are very very small so it’s best to let people make their choice without judgement.
If you 42 and birthing at home without a midwife then I think your mad and I will judge as the stakes are so much higher.
You can't predict everything, though. For instance, the best midwife in the world can't give an 100% guarantee that a catastrophic postpartum haemorrhage won't occur - and there's no way of predicting them all ahead of time. Sure, drugs can be initiated while you wait for the ambulance, but in those circumstances, literally every second counts, and there's only so much a midwife can do. I know I'd sooner be in the same building as an ICU, surgeons and operating theatre than have to wait for an ambulance to get me there. When we're called to a delivery suite MET (medical emergency team) call in the hospital, we literally run there - it's time-critical.