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Home or hospital childbirth for uncomplicated pregnancies?

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Have you been following the British television show Call the Midwife aired by PBS?  Season 4 will resume in March 2015 and you can catch up with past episodes in time.  For the record, Call the Midwife is based on Jennifer Worth’s autobiography by the same name.

The show came to mind as we read the new guidelines issues by the British National Health and Care Excellence on 03 December 2014, with the premise that “More women should be encouraged to give birth at midwife-led units rather than traditional labour wards.”  Additional excerpts:

  • Evidence now shows that midwife-led care is safer than hospital care for women having a straightforward, low risk, pregnancy.  This is because the rate of interventions, such as the use of forceps or an epidural, is lower and the outcome for the baby is no different compared with an obstetric unit.
  • Mid-wife led units can be based at hospital sites next to obstetric units or freestanding and based away from a hospital site.
  • The guidance recommends that home births are also equally as safe as a midwife-led unit and traditional labour ward for the babies of low risk pregnant women, except for first-time mothers.
  • Midwives are highly capable professionals and can provide amazing one-to-one care to pregnant women in labour, whether that’s in a woman’s own home, a midwife-led unit or a traditional labour ward.
  • All women giving birth should have timely access to an obstetric unit if they need to be transferred to hospital for medical reasons or because they request an epidural.
  • Around 45 per cent of women have a low risk of developing complications during their pregnancy.
  • Factors that can increase the risk of complications during birth include being over 35, being overweight or obese, bleeding after 24 weeks of gestation, and having a high blood pressure. Complications from a previous pregnancy can also increase the risk of complications during birth for pregnant women.

The above reminds us that childbirth is a process as old as humanity.  Women gave birth in their hut or tent or in the field for millennia; at times they ‘did it on their own,’ while other times they gave birth in the presence of other women, young or old; death from childbirth was a common outcome.

Midwifery has been around for millennia as well. We can say that midwives ‘wrote the book’ about childbirth, and along the way they have been benefiting from advances in modern medical care that further cut female mortality.  You can read more about it in a fascinating article titled The Disturbing, Shameful History of Childbirth Death.

Lastly, back to the original theme of this post: at the end of the day, it is the woman’s choice which way to deliver, and she should make her decision based on sound thinking, proper consultation with her medical team, and her ultimate sense of what is right for her.

 

 

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  • Mariola says:

    I am very pleased to read this. Our second child was born at home, in a birthing pool and it was the most wonderful experience ever! My midwives were caring, respectful and experienced. During both my pregnancies I didn’t see a doctor once. Or, actually, I did see an obstetrician just once, to approve of the home birth, and was herself terrified of birth! Wouldn’t want to end up in her room during labor. 🙂