Perth Birth Nerd

It is no exaggeration to say that the day I birthed my second baby was the most glorious, loving and empowering day of my life. 

My first birth was amazing too- it was the birth that made me a mother. And I, like every birthing woman, was an astounding super-human who literally portalled a new soul into this world from inside my body. Epic. 

However, my care in a private hospital was lacking, and I was coerced into an induction that wasn’t genuinely medically indicated. I had to labour in less-than-ideal conditions and fight for the type of birth that I wanted for my body and my baby. 

So, the second time around, I made a new choice: A homebirth, attended by endorsed midwives. Whilst the people I am closest to fully supported that decision, I did get some mixed reactions. 

“Gosh, you’re brave!”, exclaimed one colleague, who was also a mama of two. 

She didn’t have malicious intent. But that line, a rather common one, carries with it a particular ideology. It’s the predominant ideology around birth in our modern, Western culture: birth is dangerous, it goes wrong, and you need to be in the hospital so that medical professionals can save you. 

So, WHY? Why, then, would someone choose Homebirth? Especially a fairly risk-averse person, a person of science, like me? Especially after having a hospital birth where everything “went well”?

It wasn’t just for the fairy lights. 

In part, it was due to my first experience in a private OB care model. Another aspect was my experience of being a birth support person in a public hospital, and witnessing firsthand the effects of poor care that interfered with the birth process. 

And, perhaps the biggest influence, was the knowledge that I had gained through courses, podcasts, reading, and through talking to women and professionals- which is what I am sharing today.  

Below is a basic summary, and elevator pitch, if you will, of the reasons I chose homebirth. For fuller explanations, as well as supporting statistics and reference, keep reading.

My Why: The Reasons I Chose to Birth at Home

One: The knowledge that birth, itself, is actually so much safer (physically) than we are led to believe. 

Here in Australia, it is very rare to walk away from birth with anything other than a live mother and baby, regardless of the place that you choose to have your baby. This is especially true when mother and baby go into birth healthy- birth works most of the time. Yes, tragedies happen, but when I looked at the statistics around birth (even at home), I was comforted by the numbers. Knowing what the data said helped to alleviate the cultural conditioning, and opened me up to the idea that maybe I didn’t need an emergency team waiting in the hallway. 

Two: I knew what I wanted from my birthing experience.

My intention for my birth, my preference, was for a non-instrumental vaginal birth, followed by optimal cord management and extended skin-to-skin with my baby. I wanted all the mammalian hormone cascades and conditions that set mothers up for mothering, and set babies up for wellness and survival. And, to put it simply: this scenario, in a planned hospital birth is statistically unlikely. Sad, but true. However it is likely for a planned homebirth. Further to that, I wanted autonomy in the decision-making process before, during and after birth, and to be offered true informed consent for procedures. Unfortunately, this just is not a reality with fragmented care in a hospital or, in my own experience, even with a private OB. Having a homebirth with a midwife truly brought the power back to me. 

Three: The knowledge that hospitals- the buildings, the policies, the procedures- are not designed to promote healthy, physiological birth.

Dr Sarah Buckley famously states that the best conditions to have a baby are the same as the optimal conditions for making a baby. Almost every aspect of a maternity ward’s design and procedures seem to work against what we know about how to encourage normal, “natural” birth. Thus, being in a hospital actually increases the chance of a complication occurring, in particular for low risk women. Home, on the other hand, is the perfect spot to make a baby, and thus the hormones required to labour and birth, can flow freely without interruption. 

Four: The knowledge that many hospital policies are either not evidence-based policies, or they are shortsighted policies that do not promote long-term health. 

I spent my life under the misapprehension that everything done in a medical setting must be based on solid scientific evidence, evidence that it actually helps people more than it hurts. I have found out that, actually, many common maternity practices aren’t evidence-based, and some cause more problems than they fix. Further to that, many policies are not written with the woman or baby’s long-term health outcomes in mind, and can cause problems that affect our health for years to come. Staff are bound to follow these policies- their registration and employment depend on it- and they cannot exercise much autonomy even in the face of real data contradicting their workplace’s culture and procedures. Privately practicing midwives are held to their governing bodies’ standards of care, however they have much more autonomy to ensure that the practices they use really will improve outcomes for mums and bubs.

Five: If I chose birth at home, I would have access to continuity of care with a known midwife, the best care that there is.

Continuity of midwifery care has long been considered the gold standard in maternity care. This model is shown to reduce the chance of obstetric violence and trauma, and has been shown to improve outcomes for women and babies, both short and long term. In my homebirth, I was being attended by not one, but two, highly trained, endorsed midwives. I knew them throughout my pregnancy, and they provided many hours of clinical care during that time, so that I got an idea of their expertise and philosophy.  I felt very confident making the choice to be in their care at home. They really were outstanding, and I received such thorough clinical and pastoral care, not just antenatally and during birth, but postpartum too. 

And, the most important reason I chose homebirth:

Six: The evidence shows that planned homebirth, attended by a midwife, has much better outcomes for mothers, without increasing the risk to babies. 

I felt safer at home, because the evidence told me I would be in better condition after birth than if I was in hospital. I had heard it anecdotally, but I am a scientist at heart, and numbers don’t lie. 

Say what?! Tell me more!

I know these seem like really brazen statements, and I haven’t included much nuance. But they are my reasons, and they ring true to many midwives and consumers alike. 

So, I invite your curiosity: If you’re intrigued about any of these (rather audacious) statements, let’s dive a little deeper. 

Follow the links at the bottom of the page to find out what research and statistics I used to come to these conclusions. Everything is fully referenced- while I don’t pretend to be a trained healthcare professional, I promise it is much deeper research than a Google AI summafry. 

Home is Where the Heart Is

My birth experience at home was relaxed, private, WILD, fun, and even romantic at times. I received amazing clinical care, better than what I received in a fully resourced hospital the first time around. And I emerged from birth in excellent health- physically, mentally, emotionally and spiritually. While there might be an element of luck, it wasn’t just that: the location and the team made ALL the difference. 

I am delighted and grateful that we have hospitals, surgical teams and medication for when they are needed. However, I truly believe that home is the best place for birth for 90% of women. In the absence of genuine medical indications, a planned homebirth results in better outcomes, even in the event of hospital transfer. I might be the only person you know who has done this, but I am one of thousands who choose this path in Australia, and the reports are overwhelmingly positive from these women. So be curious, be open, you might just find that you are transformed as much as I have been by birth. 

Further discussion and the evidence to support these claims: 

1. Birth is physically safe (anywhere) in Australia.
2. A straight-forward birth is more likely in a planned homebirth than a planned hospital birth. 
3. Hospitals don’t promote physiological birth.
4. Hospital policies aren’t always evidence-based, and are frequently shortsighted.
5. Homebirth comes with the best maternity care out there: Continuity of care with a midwife.
6. Homebirth is safe for babies, and has much better outcomes for mothers. 

Reference List: The full list of articles and research used in this article and in my decision making. 

It feels appropriate to thank some people for supporting me down the path that led to the most amazing life experience:

I want to acknowledge and thank my friends Pippa and Simone, for their gentle nudges in the direction that ultimately led me to this decision. 

Thank you to Dr Melanie Jackson @TheGreatBirthRebellion for her amazing, free podcast, which gave me an awesome basis for my research. 

I am so grateful to Michelle, my sensational primary midwife, who held me through this spectacular transition. 

And finally, to my amazing husband and the perfect birth partner, Ivan: thank you for becoming a fellow birth nerd, cheering me on through this journey and trusting that I am a capable superhero. Shall we do it again? Kidding. Sort of.