Homebirth

Is homebirth a safe and responsible option? Read the research HERE

2018: Planned private homebirth in Victoria 2000–2015

The 2015 Australia's Mothers & Babies report tells us that out of roughly 300,000 birth in Australia that year, 0.3% or 910 were at home.

This is even less than the "born before arrivals" which I'm sure include a few "oopsie" out-of-hospital births and involves some level of hospital aversion, as well as genunie BBA births: 0.4% or 1265 births.

The average age of homebirth mothers was 32, the average gestational age was older than than hospital born babies (39.7 weeks for homeborn babies, 38.7 weeks for hospital born babies - what does this tell you about the culture of induction?)

Babies born at home had a higher average birthweight, of 3643g, which is a key indicator of infant well-being.

Homebirth statistics from Homebirth Australia

" In 2010, there were 1,345 women who gave birth at home, representing 0.5% of all women who gave birth. The highest proportions were in Victoria, Western Australia and the Northern Territory (0.8%) (Table 3.18). It is probable that not all homebirths are reported to the perinatal data collections.

In 2010, there were 2,206 fetal deaths reported to the NPDC, resulting in a fetal death rate of 7.4 per 1,000 births. There were 2,202 fetal deaths in hospitals and other facilities. There were 4 fetal deaths at home births in 2010. Of babies born at home, 99.7% were live born (1350 babies).

The mean birthweight of these liveborn babies was 3,604 grams (Table 3.49)."

Here are some statistics from homebirth in Victoria:

(source: Victorian Perinatal Data Collection Unit, 2005)

Spontaneous onset of labour: Hospitals: 37% ; Homebirths: 88%

Medical Induction of Labour: Hospitals: 46% ; Homebirths 11%

Spontaneous Vaginal Birth: Hospitals: 46% ; Homebirths: 90%

Instrumental Vaginal Births (forceps or vacuum): Hospitals: 13% ; Homebirths: 6%

Caesarean sections: * Hospitals: 37% ; Homebirths: 4% (* I would like to see statistics for what percentage of specifically first-time mothers had c/sections.)

Intact perineum: Hospitals: 40% ; Homebirths: 80%

Sutured tears: Hospitals: 38% ; Homebirths: 16%

Episiotomy: Hospitals: 22% ; Homebirths: 4% (performed after transfer to hospital.)

No pharmaceutical pain relief: Hospitals: 26% ; Homebirths: 96% (the remaining 4% received pain relief after transfer to hospital)

Epidural: Hospitals: 26% ; Homebirths: 0%

What about the infant mortality rate? I don't know the exact stats for Victoria in 2005 - and we are still waiting for more recent statistics - but we do know this about homebirths nationwide in 2006:

280 078 total births
2,091 fetal deaths
708 planned homebirths
All planned homebirth babies were liveborn.
2,091 babies died in hospital in 2006, and none died at home.
http://www.aihw.gov.au/publications/per/amb06/amb06.pdf

More evidence of the safety of homebirth in Victoria here at Midwives Victoria

This poster used at recent rallies protesting anti-homebirth legislation has some significant statistics from the 2007 Victorian Perinatal Data Collection Unit homebirth profile - including a 90% spontaneous vaginal birth rate for homebirths compared to 60% in public hospitals; a 5% caesarean rate for homebirths compared to 28% in public hospitals; and 3% of homebirthed babies needing admission to special care units compared to 15% in hospitals.

While homebirth is an option that only 2% of Australian women choose, in other developed countries, as many as 40% of women choose homebirth. Homebirth seems to thrive in egalitarian societies where women are emancipated and regarded as competent (rather than dependent), and where midwives are empowered as autonomous professionals rather than regarded as hand-maidens to obstetricians. In some countries, homebirth is supported logistically and funded by the government. I chose to go to New Zealand (where I grew up from the age of 4) for two of our births, because there, whether you choose to give birth at home, in a birth centre or in a hospitals, you are able to personally choose your own midwife and your care is funded by the government. This one-to-one midwife-mother care is associated with high rates of safety and satisfaction.

The battle to keep homebirth alive in places like USA and Australia, where care for women is dominated by the powerful AMA, has been difficult to say the least. Currently, there is a move in USA to out-law homebirth and witch-hunt midwives. There is no doubt in my mind that the motivation behind this move has little to do with altruistic concern for the safety of women and babies, and much to do with the desire to maintain control and profit. In this respect I would say that keeping homebirth on the menu as a choice for women is very much a feminist issue. Midwives who provide homebirth services are often the target of unwarranted persecution. They need and deserve of our support and respect.

Not every woman desires an elective caesarean. Not every woman desires to give birth in a birth pool on her loungeroom floor. But surely both options, including the middle way of hospital or birth centre birth, should be available to Australian birthers?

What about safety? There are countless studies which clearly demonstrate that homebirth is as safe, if not safer than hospital birth for the vast majority of women. In USA earlier this year, two mothers in the same town died during the same week from complications from caesareans. I think that if two mothers in the same town died from complications during homebirth in the same week, imagine the out-cry!

The couples I know who have chosen homebirth are people who have done their homework, are well-informed and highly responsible. It is not a decision they take lightly or without a great deal or reading, reserach and preparation. This is a great approach regardless of your chosen place of birth.

When it comes to planning the right birth for you and your baby, the old advice, "location, location, location" is apt.


What do you need for a homebirth? This list is pretty comprehensive!
Suggestions For Your Homebirth Kit

How to find a Midwife for your planned homebirth? Look here.

The UK Homebirth Reference Site is a useful resource for your research.

And here's the USA equivalent, from the Gentle Birth Archives. You can research a huge range of topics using their 'search' engine here

Special Delivery - Antonia Kidman's article on homebirth in New Idea.

Here's an article that appeared in The Age featuring one of our local Midwives:
Women Deprived of Choice says Midwife Nicola Dutton

Here's an article about a family in Berwick who had a home waterbirth.

The times they are a-changing in USA. There were 25,000 homebirths in USA in 2006, a drop in the bucket compared to 4.3 million births in all - but the rate of homebirth has risen by 25% in recent years, and now there is a push to legitimize this as a valid choice for women. Homebirth Advocates Push for Change in Laws, 2008.

Who would have thought that under the Rudd government, we would see homebirth out-lawed and driven undergound? This is no better than the most reactionary of states in the USA. It is completely unacceptable that, after decades of refusing to fund and support homebirth as an option for Australian women, the current push is to make homebirth illegal through a loop-hole making it illegal for independent midwives to practice without indemnity insurance - which they cannot obtain.

What can be done? See this website 'Save Birth Choices' by Jane Palmer, an independent midwife in NSW. On the 'How Can You Help' page, you can find info about contacting politicians, letter writing campaigns, and the national day of action on 4 July, 2009.

Here is an intelligent commentary on the current issues at Online Opinion, Australia's e-journal of social and political debate: Risk and Homebirth - What's at Stake?



Homebirth Advocates Push for Change to Laws

What if your midwife does not make it in time? Even if you planned a hospital or birth centre birth, there is always a slight chance your 'baby in a hurry' might decide on an unusual birth setting. My second baby girl sure did. This is less likely with a first baby ... but not unknown. If you have your baby before you get to hospital, they call it a BBA - 'born before arrival'. Some mothers have unexpected unassisted births at home, either because they never even made it to the car or because they had the baby before the midwife made it to them. Some couples plan to freebirth or have an unassisted birth, after doing extensive research and preparation. Here are some basic instructions for a quick or unassisted birth, written by Jenny Blyth.

Why would a first time mother choose homebirth?

Why I chose to give birth at home by Linn Kelly

Why I had my first baby at home by Julie Bell