NICE home birth guidelines, midwives and money.

If you’re a follower in any capacity you will know I had a home birth with number two. I’m not going to go into the experience you can read that here > homebirth what I want to talk about it how I feel about home birth, its representation in the media, midwives and the new NICE guidelines on the whole.

There are a few schools of thought on the issue and, I understand most of them. There are anti-home birth, pro-home birth, people who have utterly tragic outcomes from a home birth and the ones who didn’t even know it was a ‘thing’. I was listening to a discussion about it on BBC4 the other afternoon which I found fascinating.

When I was preparing for my homebirth with Mojo, I had nothing to go on. No information. I had to take to the internet, twitter and really research experiences. My initial midwife wasn’t keen at all, said that it wasn’t really ‘her thing’. My second midwife (who then caught Mojo and gave her the first Happy Birth Day) was fabulous, she was a source of comfort and support. The reason we CAN get through the immense pain, the breastfeeding issues and so on is largely due to support around us. As women, during labour other women can give us vital support – if your midwife says it isn’t ‘her thing’ the likelihood is it won’t end up being yours either. In the end, we all want what is proposed as best for our babies and will mostly err on the side of caution, opting to birth where we have been told it is safest – unless we have full confidence in ourselves and our birth ‘team’.

NICE is now looking specifically at 2nd + pregnancies and low risk. In summary – The National Institute for Health and Care Excellence (NICE) has revised its advice to women giving birth, in a document that has been supported by the Royal College of Obstetricians and Gynaecologists.

It says that births at midwife practices/midwife-led units or at home are safe for low-risk women who have had healthy pregnancies. 

This is a complete turn around from the precious cautions against it. 
This change currently being so well publicised I feel it will help women really understand that there has always been a choice, but more than that hopefully hundreds of future ‘low risk’ births will take place at home. Midwives are reportedly (on whole) behind these new guidelines. A Midwife is trained to notice even the smallest change in a women’s behaviour, breathing, colour, and temperature – but they are not foolproof. Even the longest-serving Midwife can miss something, you cannot see everything coming – listening every two weeks and looking at baby on a sonograph once or twice is only a ‘good indicator’ of what is to come. Maternal health is also a major factor, some pregnancies are more complicated than others and perhaps on these occasions, home birth is not the best option.

It has been long reported that home birth is more cost-effective than hospital birth, although unfair to put a price on a mother and child I think it is good to really look at the numbers.

Birthplace in England Research Programme looked into the cost per woman for hospital birth Vs home and they found The study looked at the relative costs of healthy births in different settings. It found that a planned birth in an obstetric unit was the most expensive option for mothers who already have children, with a mean cost of £1,142 per woman. Planned home birth was the cheapest at £780. Let’s face it, the NHS could probably do with saving some dosh on the thousands of babies born each month here in the UK, a figure which rises year on year. 
Home birth has been heavily debated, I find that the media like to put a darker spin on it. They present the mothers who have had horrendous birthing experiences (could have been the same in the hospital), they splash headlines with ‘Baby death could have been prevented in hospital’ – not always true and in a way they scare mothers into the wards. These things did/do happen, the fact is, birth, no matter where it happens puts mother and baby in danger. From the first contractions till the last push and beyond, both mother and baby are at the mercy of hormones, muscles, and luck. We just like to hedge our bets and do it somewhere with a notice on the door that says ‘safe’ and a group of people that are experts.

I have personally encountered my fair share of Midwives who weren’t exactly supportive of the home birth choice, during my last pregnancy I was told it was a complete no-go from 9 weeks – before there was anything technically ‘wrong’ with me. Words like stillbirth, coma and macrosomia were thrown in my face as a deterrent. I was given countless horror stories, shoulder presentation, baby having a sugar crash and heading to SCBU and the one I was fed at almost every hospital appointment was stillbirth. 

I went on to have a birth so easy and natural I was taking up space in a bed I didn’t need to be in.

I was told after that I could have done that at home – a medium/high-risk third birth. But I didn’t. I didn’t have the support from the health care professionals that I felt I needed in order to have the birth that I wanted. I didn’t have the confidence. Ultimately as parents from the moment of conception, we put our needs secondary to that of our children, but should birth really be another of those occasional? Is it not the job of the mother from the point of conception to make the choices we feel will benefit not only ourselves but the future of our children and therefore choosing the surroundings that give us the most peace within ourselves will lead to a better outcome.

The idea is to birth where the woman feels most comfortable. Personally, I have never felt quite at home in the sterile, white tiled and antiseptic smelling hospitals as much as I have in my own home.

You may even have seen this:

REMEMBER – a clinical environment is not the best place to be in early labour, and can, in fact, make labour longer and harder.

The environment a woman is in during labour and birth can have a huge impact on the progression, the more open and comfortable you are the more likely you are to enjoy a natural and relatively easy birth. If you are panicked, stressed, uncomfortable in any way your body begins to produce hormones that impede your progress.

Surely this is an indicator birthing in your normal environment is more natural anyway.

These new guidelines are really giving us all the go-ahead to have the very intense and almost otherworldly experience of birthing at home, and we have a large number of midwives behind it. However, I can’t help feeling that until we start to publicise healthy home birth, have more information provided in the pack of pamphlets given at the booking in session and see more of it on telly then we will continue to be bodies on the conveyor belt of the hospital wards.

I hope that you can see that I am pro home birth for all those who CAN, I believe that it will in the long run, not only save money but cement a stronger bond between families earlier due to no contact restrictions AND I believe that a mother who has home birthed is more relaxed post birth and her body can begin to heal quicker. I fully acknowledge that there may be emergencies in which transfers are necessary but as stated above – no matter where you birth there is always a risk.

In a world where women give birth in hollowed out trees, huts with grass roofing and in the driest environments on earth with the support of other tribes women, possibly the local birthing authority (the village elder) and drug-free,  how is it that in the UK we still run to the hospital?

I invite you to share your thoughts and experiences on this, links to your own birth experiences and information. 


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