Perth Birth Nerd

The Homebirth Series, Reason #1

Birth is much safer than we are led to believe, and this was the first piece of the puzzle, the first consideration, that helped me decide that homebirth was the right choice for me.

_{Note: For the purposes of today’s discussion, when I say “safe” I am only referring to one dimension of safety- being alive. There are other dimensions of safety, which I will discuss in the other articles.} 

We are taught to fear birth. 

Turn on the telly, and the fictional birth scenes we watch are littered with danger, screaming, emergencies and fatalities. From downright ridiculous to emotionally scarring, none that I have seen paint an accurate picture of what to expect. Further to that, media reports about maternity care imply heavily that women and babies need constant intervention to be saved from the danger that is childbirth. We are surrounded by the message, so much so that it has come to be expected that women always go to a hospital to give birth. 

However, reality rarely matches the drama. There is no denying that long ago, birth wasn’t as safe as it is today. In fact, in some parts of the world, it still isn’t. However, that is mainly due to a lack of sanitation, nutrition, education and access to testing and medicine during pregnancy and postpartum. Here in Australia, in 2025, it’s a different story altogether.

The Australian Mothers and Babies’ report notes that Australia is one of the safest places in the world to have a baby. The vast majority of Australians have access to good sanitation and nutrition. Even for those who choose to give birth at home, we have remarkable access to education, ultrasound scans, testing for genetic abnormalities, blood tests, iron supplementation, low rates of diseases (such as malaria), and, in metropolitan regions, we have fast access to free emergency healthcare. For those that experience complications, C-Section is a very safe procedure in our amazing theatres, our NICUs are well-resourced, and we have highly effective medicines for treating infections and haemorrhaging. We are so lucky.   

None-the-less, fatality is a tragic reality that affects real families, and I would never minimize a death by reducing it to a statistic. But I can discuss what the numbers are, and explain why I, personally, felt completely safe giving birth at home.

Safety for Mums

In 2022, the most recent national data we have at the moment, the maternal mortality rate sat at 4.8 deaths per 100, 000 women. This number included all deaths that occurred during pregnancy or within 42 days of birth, and included deaths that related directly or indirectly to pregnancy, such as cardiovascular issues, suicide, amniotic fluid embolisms and non-obstetric haemorrhage (they were the top 4 causes). Women who died during birth or within 24 hours of birth made up 21% of these, or 0.001% of all women who were pregnant in 2022. 

For me, these numbers were comforting. In fact, a bit of crude maths told me I was 8 times safer giving birth than driving a car for a year. 

Safety for Bubs

The most recent Australian Mothers and Babies’ report notes a rate of perinatal deaths as 1%. But that number covers a a 6 month period -“Perinatal” means any time from 20 weeks gestation to 28 days after birth. Of these, 26.2% are deaths that occur during birth or during the first 24 hours of the baby’s life- that’s 0.262% of all births. The main causes of perinatal deaths, according to the report, include congenital anomalies, spontaneous preterm labour, maternal conditions (e.g. sepsis or disease during pregnancy), and antepartum haemorrhage. 

The interpretation I had of this information is that there was a 99.7% chance of my baby surviving childbirth. Further to that, most babies’ deaths are not preventable deaths- place of birth would not matter. 

So, despite all the cultural messaging, I felt that birth actually was safe after all.

But, Mel, is it only safe because we give birth in hospitals?

No, actually! There is plenty of evidence that states that planned place of birth does not impact how safe the process is:

• The RANZCOG guidelines for home births state that “the evidence in this statement does not report either an increase or a decrease in adverse perinatal events with either place of birth for low-risk women”.
• “High-quality evidence about low-risk pregnancies indicates that place of birth had no statistically significant impact on infant mortality. The lower odds of maternal morbidity and obstetric intervention support the expansion of birth centre and home birth options for women with low-risk pregnancies.” (Scarf et al 2018)
• “For multiparous women, home birth offers the same risk of perinatal mortality and several morbidity factors (such as neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle)  with a lower risk of intervention.” (Birthplace in England Collaborative Group, 2011)
• Homer et. al. (2019) also conducted a major study, and found improved outcomes for women at home, with no significant differences in perinatal mortality for bubs. 

For a more detailed look at this evidence, read Reason #6. 

Assessing the Risk of My Own Situation

The beauty of having your own midwife throughout pregnancy, birth and postpartum, is that together you can examine your whole clinical picture, and make informed decisions about your care based on your unique circumstances.

Whilst a hospital might have slapped a “risk” label on me due to some blood conditions, we worked out how to mitigate those risks so they wouldn’t impact birth. In all other ways, I was healthy, I had no serious conditions like preeclampsia or a heart condition. I live only 10 minutes away from the local emergency hospital, should the worst happen, and my midwives, my partner and I were all open to the fact that transfers to hospital are sometimes necessary. 

And the most important reason I felt safe at home was that I was having not one, but two endorsed midwives at my birth. Freebirth (where there are no medical personnel present at birth at all) is a choice many women make, but it was not the right one for me. To be endorsed home birth midwives, they needed to undergo thousands of clinical practice hours, qualify to administer scheduled medication and comply with stringent registration requirements for ongoing training, particularly in emergency obstetric care.  I was in expert hands!

A Personal Choice

Risk is a relative thing.

These stats on birth felt safe to me, they may not to others. However, I believe that it’s important that we do look at the numbers, the actual risk, as opposed to being swayed by popular culture, which is designed to entertain and inflame. 

And my hope: Maybe, if more women looked at the stats, they would reject the narrative about birth being unsafe. Perhaps this information could lead them to a more positive, empowered and autonomous birth. No matter where, they would be free, not fearful.

See Full Reference List

Keep Reading: Reason #2: A straight-forward birth is more likely in a planned homebirth than a planned hospital birth. 

Back to Main Article: Why I Chose Homebirth