Deciding to have your baby at home
from Home Birth by Nicky Wesson
“I am beginning to feel very isolated over this matter and am almost afraid to approach anyone for fear of another browbeating over how stupid I am being. My husband respects my wishes, but is constantly accosted by people who ‘wouldn’t let my wife do it’ and tell him tales of death, gloom and gore . . . ”
Given that to choose to have a baby at home is to swim against the tide of current opinion, when should you make the decision and what reaction, other than medical, will you get? Can it be regarded as primarily your decision or will you be deterred if your partner is not in favour?
A surprising percentage of women make the choice even before becoming pregnant for the first time. At the other extreme there are those who beg an independent midwife to book them for home birth only when they are threatened with induction because their baby is overdue. You may feel happier if you get your home booking established right from the start; this certainly has the advantage of providing an opportunity to get to know the community midwives and it makes the need for provision clear to those responsible for planning it. Some people think that this increases your chances of giving birth at home. It also means that you can avoid all the hospital visits.
On the other hand you may opt for a late booking, either because you cannot really focus on the birth until it is only a few weeks away, or because you do not really appreciate what giving birth in hospital will be like until you have been on your hospital tour, or perhaps because you feel that it is not worth battling with until the birth is imminent. If for any reason you do feel that you want a last-minute change of booking, do not be deterred by a fear of upsetting people. There may not be any enthusiasm for it, but can be done right up until the baby is born. True, you may not get to know the midwife, but this is what you would expect if you were delivering in hospital anyway. People can and do book for home delivery on the community at 40 weeks and later.
You may anticipate opposition from some doctors and midwives, but what about your family and friends? Often a partner, subject to the same propaganda as women are about place of birth, will be apprehensive. He may be unable to appreciate quite why it is so important to you, or may not share your confidence in your ability to give birth unaided. He may feel that you and the baby are both his responsibility and that the question of whether home birth is putting either of you at risk is ultimately his to answer. He may believe that hospital is the safest place, may perhaps feel more empathy with technology than you do, or not know any fathers whose children have been born at home. Iain’s story on page 47 illustrates many of these feelings. In most cases reluctant partners can be persuaded to agree by being given the facts to read and by taking the opportunity to speak to other fathers who have been through it themselves. Your nearest home birth support group (details from www.homebirth.org.uk) can be invaluable for putting men in touch with each other and providing an opportunity to hear first-hand from fathers what the experience was like for them. You can point out that he will have a real part to play at the birth rather than feeling redundant, as some men do in hospital. If you already have children it can be a great boon not to have to take them into the hospital to meet the baby, where children are not always welcome and when it can be difficult to devote enough attention to you and the baby while keeping an eye on the other children. Often the father who has had reservations becomes an enthusiastic advocate once he has actually seen his baby born in his home.
Some fathers, however, will not agree, which poses a problem – should you shelve the idea, it being his baby too, or is your baby ultimately your responsibility as you are carrying it and will give birth to it, whether he is there or not? Only you can make this decision. It will certainly be harder to do it if you do not have support within your own home, but it is not impossible. It may help if you can explore his fears, talking them out to the most extreme conclusion.
If the reaction you get from the rest of your family and your friends is negative too, you may need support from other women that you know to be in favour of home birth. Home birth can arouse violent emotions and you may be taken aback by the force of the feelings other people have about it. However, you may find unexpected support from older women who had their babies at home, some of whom find it hard to understand what all the fuss is about. Others may be ambivalent, feeling that home birth was fine for them but having an impression that hospital is necessary now. Your parents or your parents-in-law may feel uneasy, concerned for the baby as well as for you.
It can be upsetting to be undermined by those opposed to your ideas. This is made worse when you feel emotional and vulnerable because you are pregnant and are only doing what you think is best. It can seem that in choosing home birth you have set yourself up as a target for everyone to advise you of your folly, regardless of the fact that otherwise your emotional welfare would be treated with care.
For various reasons your peer group may be the most doubtful. This may be because they may have never questioned the belief that hospital is safer, they may know of no one else who has done it, or simply because it seems to be an unconventional and threatening stance. They can also be envious or resentful if they have felt misgivings about hospital birth but courageously had their babies there, feeling they had no other option. Common comments will be ‘Aren’t you brave’ and ‘What if something goes wrong?’ If you feel like it you can give them the facts, although you may not want to be involved in endless debate. However, spreading awareness and clarifying the facts can make it easier for others to take the same option.
If it all becomes too much – and it can become isolating – you can claim to be going to the nearest hospital. And in the end it can be easier, if not ideal, to get a home birth by keeping your head down right until the end and then just refusing to go into hospital.
If you do find yourself feeling isolated about having a baby at home, contact anyone from one of the home birth support groups, who will understand how you feel and give you hope and encouragement. They will be happy to give you continued help throughout pregnancy and will provide a welcome opportunity to discuss any worries and anxieties you may have. This is especially valuable if you feel you are only grudgingly being allowed a home booking; in such a situation you may not feel able to discuss things freely with your doctor or midwives, although you should always mention anything that might have a bearing on your health or that of your baby. Other sources of help and support include the Association for Improvements in the Maternity Services, the Association of Radical Midwives, the Independent Midwives Association and the Midwives Information and Resource Service (see Useful Addresses).
“After having my first son in hospital, I was determined to have any subsequent babies at home. I had been unhappy with the interference and ‘clinical’ way in which I was treated during my first labour; the ‘natural’ birth I had envisaged gave way to strange faces, drips and total agony.
“When I became pregnant with my second son, I had absolutely no doubts in my mind regarding his birth place; I wanted to be at home, where I would be totally relaxed with my family. However, my GP (a young female doctor) was not prepared to offer me medical cover, and the same attitude against home births prevailed amongst all the doctors at my current practice. The consultant at the hospital had me in tears at my first visit, telling me what an ‘irresponsible’ decision I was making, and practically refusing there and then to have anything to do with me. He was totally against home births; not having had to deal with one for eight years, he saw it as a step backwards.
“From these initial reactions I began to understand why women allow themselves to be led into believing that hospital births are ‘safer’. If I had not been so stubborn and determined I may well have given into the system – I had people from all directions shaking their heads and looking aghast at the mere mention of home births; and at a time when one is feeling particularly vulnerable and emotional it is not easy to stand up to all the so-called experts.
“Finally I was given very helpful advice which was to write to the local Supervisor of Midwives, who is responsible for organising maternity cover by midwives for all pregnant women in her district. I was also told a GP was not needed.
“I was assigned a midwife, who undertook all my antenatal care; this way I was able to get to know my midwife who would be present at my labour, and consequently my confidence in her and her continuous care throughout resulted in my totally relaxed state during labour.
“Together, Phyllis (my midwife) and I fought against the petty rules and prejudices, such as the fact that I was not allowed to attend any antenatal clinic but had to be seen separately and we even had to battle for my right to use clinic facilities. But it was nice to have someone on my side, and slowly we got our way.
“The labour went beautifully. I began having mild contractions at about 3.30 am on the Tuesday morning before Christmas, and immediately phoned Phyllis (who was up wrapping presents, unable to sleep!). By the time she got here the contractions were quite strong – Mark my husband and my sister Tracey were making me cups of tea and rubbing my back whilst I crouched in the lounge.
“Phyllis examined me in the bedroom and realised I was very close. We discussed whether she should phone for assistance, but both agreed it was unnecessary. I felt very calm and in control and had the utmost faith in my midwife.
“I have a large rocking chair in the bedroom in which I had planned to give birth, but when the time came I felt more comfortable being propped upon the bed.
“Joel was born at 5.50 am after a very joyous and happy labour. Unlike my first birth, I needed no stitches and Joel was put straight to the breast. He weighed a healthy 8 lb. I remember feeling so very proud of myself and my ‘little team’, because, despite all the odds against us from the start, we had done it.
“Hopefully Phyllis and I had paved the way for other mums wishing to have a home birth. In fact Phyllis has now informed me that she is undertaking the care of four women in the district who wish to have home births.”
Karen Condon
(c) Nicky Wesson 2006
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