Childbirth is an ancient practice that dates back to the beginning of humanity.
For centuries, women have given birth in their homes, surrounded by their loved ones and attended by traditional birth helpers.
However, in modern times, the practice of giving birth at home has been replaced by medicalised birth in hospitals.
In Australia, like many other countries, hospital births have become the norm.
Only a small percentage of women choose to give birth at home.
But why is this the case?
Are hospital births truly the safest and best option for every woman and baby?
In this article, we will explore the current state of childbirth in Australia and why more women are choosing to birth in the comfort of their own homes.
We will discuss the impact of colonisation and medicalisation on birth, as well as the different options available for women who want to birth at home.
We will also address the risks and benefits of home birth and how to make an informed decision about where to give birth.
The Colonisation and Medicalisation of Birth
The colonization of Australia has had a significant impact on how we view and approach birth.
Before colonisation, Indigenous women in Australia and New Zealand were the traditional birth keepers in their communities.
However, their practices were criminalised, and the communities were forced to give birth in hospitals, which led to the suppression of traditional knowledge and practices.
Today, birth has been medicalised by the industry and is sold as being dangerous and scary.
Medicalising birth means taking something that wasn’t considered medical and making it medical.
When people have little knowledge about birth and its natural process, they turn to authority figures.
A recent study shows that in Australia, 93% of women choose to give birth in a hospital, 6% chose to give birth in a birthing centre, and less than 1% opted in for a home birth or free birth.
The women who choose to go against the authoritative message, are thought of as stupid, idiotic, and rebellious.
Women who choose to birth outside the system are being put into this category and considered rebels of society.
Despite it being the norm to have your baby in the hospital, there is no conclusive evidence that supports the argument that birthing in hospitals is the safest and best way.
If you are a healthy woman with a healthy baby, there is no reason why having a baby in the hospital is the best.
Of course, there is a time and place for hospital births.
The Authoritative Message and Home Birth
The authoritative message surrounding birth is that the hospital is the best and safest place to have your baby because it goes wrong most of the time.
And if something goes wrong, you have the experts ready and waiting to save you and your baby from certain death or disability.
When a woman chooses to give birth at home with this authoritative knowledge in society, she is met with comments like “Oh gosh, aren’t you scared” or “Wow, you are brave to make that decision”.
This is because everyone believes that birth is dangerous and they can’t possibly comprehend how you can give birth safely at home.
However, the truth is that giving birth at home can be just as safe and even safer than giving birth in a hospital, especially for women with low-risk pregnancies.
Home birth allows for more freedom in terms of choice, movement, positioning, and birthing support, leading to a more positive birth experience.
How to Have a Home Birth in Australia
Before you start packing your birth bag, it’s important to understand how the process works here.
Home birth is still emerging and not as widely accepted in Australia as it is in other countries, so you’ll need to do some research and planning.
Firstly, in 2020, there are only 15 publicly funded home birth programmes in Australia, so the options are limited.
If you want to have a publicly funded home birth, you need to be located close to a public hospital that offers a home birth programme and you have to fit their strict criteria.
This means the mother and baby cannot have any complications or risk factors.
If you don’t meet the criteria for a public home birth program, your next option is to hire a private midwife.
In Queensland, some private midwives can come with you wherever you choose to birth your baby.
But in other states such as New South Wales, there are only a few hospitals that allow private midwives to work with you if you choose to go to the hospital.
Otherwise, they can only assist you to have a home birth.
Funding can also be tricky.
In most cases, the mother and family must pay for the midwife out of their pocket, with only a small portion covered by Medicare.
For many women, private midwives are a great option, despite the cost, because there are so few public home birth programs available.
Their application for one may be denied if they are considered high-risk, and the hospital won’t take them on.
If none of these options appeals to you, there is always the option of free birthing or birthing without medical assistance.
This may seem like an extreme option, but hear me out.
If you do choose to free birth, it’s important to do your research and have a backup plan in case of emergencies.
The Risk of Home Birth
Now, let’s address the elephant in the room – the risk of home birth.
Yes, there is a risk involved in giving birth at home, just as there is a risk involved in giving birth in a hospital or birthing centre.
Unfortunately, babies and mothers die or get injured no matter where they give birth.
However, the best and safest place to give birth is different for everybody, depending on what their definition of safety is.
In hospitals, physical safety is prioritised over emotional, social, cultural, and psychological safety.
This can result in a traumatic birth experience for a lot of women.
One-third of women opting for hospital birth come out of it feeling traumatised.
In the hospital, the authoritative message is that you’re alive and your baby is alive, so why would you be traumatised?
However, physical safety is not the only aspect of safety that should be considered when giving birth.
Emotional, social, cultural, and psychological safety are just as important.
Ultimately, if you and your baby are healthy and well, you are physically safe to birth anywhere you choose.
The difference lies in the interventions that you may receive in different settings.
In a hospital, you are more likely to receive significantly more interventions to reach the same outcome as if you were having a home birth.
Physical safety in a hospital is defined by mortality and morbidity rates; The number of deaths and injuries sustained, and the number of babies and mothers who end up in ICU or special care nursery.
In their books, if you walk out of the hospital in 24 hours with your baby in tow, you’ve had a safe birth, despite possibly having an unnecessary episiotomy or vacuum and forceps delivery.
In the end, it’s up to each individual woman to decide what’s best for her and her baby when it comes to giving birth.
What is Safe for You?
What is safe for you is an individual and personal decision.
If you had a hospital birth and felt safe and supported, that’s fantastic!
If you had a hospital birth and felt like it wasn’t the safest and best option for you, that’s okay too.
It’s okay to go against what the authority says.
Trust your instincts and listen to your own body.
One thing I’ve learned is that if you don’t feel safe and supported when giving birth, complications can occur.
Giving birth becomes more difficult because you’re going against your biological instinct.
Mammals have been observed to wait to give birth until they’re in a safe, warm and familiar environment, we are no different.
You can’t birth a baby if you feel cold, unsafe, and in an unfamiliar environment.
Of course, there is a proportion of the population who need and must have medical intervention to be alive and for their babies to live.
If you have conditions that need medical management, that’s the beauty of the medical system and the technology it offers.
It allows us to survive and thrive even with complex conditions.
As I said before, there is a time and a place for hospital birth.
I’m not anti-hospital or anti-institution.
I just believe that they should be used only when needed.
Something that I heard recently that outlines this idea quite well is –
“hiring a doctor to look after you while you’re well is like hiring a paediatrician to babysit your little one. It’s over the top and unnecessary.”
Ultimately, what’s safe for you is what you feel is right and aligns with your beliefs and values.
Free Birth and Homebirth Culture
Now, let’s get into free birth and what all the fuss is about.
Free birth is birthing at home without a medical attendant.
Women might have a doula, a wise woman, their family, or a partner present.
Some women choose free birth because of deep-seated trauma from a previous birth.
Others believe any interruption in the birth space increases the risk for them and their baby, and they want to reduce that risk as much as possible.
Some women simply believe in their own authoritative knowledge of birth.
The biggest proportion of women who choose free birth are those who would have liked to have a home birth with a midwife but couldn’t access it.
However, there is a cult-like, extreme wing of free birth that becomes less about birth and more about the hierarchy of being a powerful woman.
It’s important to do your research, listen to podcasts, and hear what people have to say about their individual experiences.
But then, sit back and think about what you need and what type of birth is right for you and your baby.
Birth should be about you and your baby, not a competition or a way to prove your strength.
Birth is like a rebel
You can plan and prepare all you want, but birth has a mind of its own.
It’s like a rebellious teenager who refuses to do what you say.
You might want a water birth with calming music playing in the background, but your baby might have other plans and decide to make a grand entrance on your living room floor.
Birth is unpredictable, and that’s what makes it beautiful.
It’s a journey that takes you on a wild ride of emotions and sensations.
You have to surrender to the process and let it guide you.
When you embrace the wildness of birth, you realise that the plan is not important – the experience is.
If You Need Help, Ask for It!
There’s a birth movement that glorifies and praises those who choose to give birth alone and without help, this is the same birth movement that was spoken about before.
The extreme cult-type group that belittles and looks down upon those needing help and asking for it.
While that may work for some, it’s not for everyone.
It’s important to know what you need and to ask for help if you need it.
This is a huge transition in your life, and there’s nothing wrong with asking for support.
In fact, having a traditional birth helper, midwife, or doula present can make all the difference.
During birth, parts of a woman’s brain actually shut off, allowing the birth hormones to flow and the primitive brain to take over.
This is where having someone there to support you can be incredibly helpful.
They can help you stay grounded, provide emotional support, be your advocate and most importantly, tell you when they feel something is wrong.
It’s important to hand-pick your birth team and choose people who will care for you and respect your wishes.
If you need help, ask for it.
This is the full expression of autonomy and power.
You’re not giving away your power by asking for help.
In fact, you’re showing strength and vulnerability by acknowledging your needs and taking action to fulfill them.
It’s also important to ask the question “What if something does go wrong?”
Will you be able to and will you want to navigate that issue on your own?
Or do you want someone else to be there to help take responsibility to help you?
What about the pain?
The pain of childbirth is no secret, but what if we told you that women who have a home birth rarely discuss how painful it was?
That’s right, we said it.
The authoritative knowledge tells us that birth is painful, so we need pain relief to manage the pain.
But what you’ll find is that our perception of pain varies depending on our environment.
If you’re in a cold, sterile hospital environment with people interrupting you regularly, you’re going to experience pain differently compared to if you birth at home in a familiar environment with people that you know and love.
In a familiar environment, you are more relaxed and focused allowing birth to take its course.
Women who give birth at home often come through the other side laughing, telling jokes, and being surprised by the fact that it didn’t actually hurt that much.
Sure, it’s an immense sensation and work, energy, and mental investment, but we are moving towards a world where pain relief is being used less and less to birth a baby.
Often in hospitals, the needs of women are unable to be met due to the number of other women the midwives and doctors have to care for.
This results in women experiencing more intense pain and the use of pain relief.
- Being able to give birth in your own time in the way that you want
- Being in a safe and comfortable environment with fewer interventions and fewer traumatic experiences
- And, a thing called the foetal ejection reflex.
Now, what is this foetal ejection reflex we speak of?
If you haven’t experienced it already, you might hear women talking about it as though the baby came “flying out”.
Your baby’s head is born, and your uterus contracts, pushing the rest of your baby out.
Women normally say that when they experience this, they barely had to push.
It’s a physiological response that occurs during birth and is more likely to happen in a calm and familiar environment.
This reflex can be interrupted by interventions such as drugs or directed pushing, which can lead to further complications.
So, what’s the take-home message?
Make a conscious, responsible decision about what’s best for you and your baby and pursue that.
It might be best to have a caesarean section, it might be best to go to the hospital, or it might be best to have a home birth with a midwife at your side.
Rather than focusing on the words “free birth,” “home birth,” “hospital birth,” or “cesarean birth,” just sit back and think –
“What is best for me and my baby?”
“What is important for me and my baby?”