The debate between a having a home birth or a hospital birth is one that runs deep. It is a highly emotional topic for some, which is completely understandable. Despite people touting the line ‘as long as you have a healthy baby’, the way your labour and birth plays out can have a significant and lasting impact on a woman for the rest of her life.
Birth is transformative, it can be empowering, emotional, exciting, raw, euphoric, and can set a woman up for how she feels as a mother.
Who a woman has participate in this event is incredibly important. From healthcare workers to family and support, all have an impact on how a woman feels about her birth. How she is spoken to, how she is treated, whether she feels in control – there are literally so many factors that contribute to labour and birth.
And the location of where this birth happens, and the people invited to be part of this birth event, can have a significant impact on how that labour and birth plays out.
During labour, the use of synthetic oxytocin, a drug used to augment or induce labour and often given post-birth to aid uterine contraction and placental separation, and to manage postpartum haemorrhage, has also been shown in studies to increase the rate of Postnatal Depression by up to 36%.
This is before we even start to talk about the physical changes that can occur for women during labour and birth and the last effects these have on a woman’s body and self confidence.
But how does this change from home birth to hospital birth?
For me, it changed significantly. And for many women, it’s the same.
Let me preface this by saying I don’t believe one is superior to the other. I don’t believe ALL women should have home births, and I don’t believe ALL women should have hospital births.
An amazing Midwife once told me that a woman will birth best where she feels safest, and that reigns true in so many ways.
But in order to feel safe, a woman needs to be informed, educated, empowered, and supported. If that is in a hospital, and a woman feels safest there, then absolutely, that is the place she needs to be. Likewise, if that is at home, then that is the place she needs to be.
I am sharing my experiences of two very different labours and very different births for very different reasons, in hopes that you might see that there is no one right answer, that you have choices, and that the most important thing you can do is be informed, educated, empowered, and supported (we keep repeating it because it’s so important).
I swear I could write thousands of words on each of these experiences, but I promise to stick to the relevant and important parts (maybe I’ll share the rest another day).
In order to keep things concise, I’ll share the key points of each experience:
My Hospital Birth
- My son was diagnosed with a bowel obstruction at my 20 week anatomy scan. I was referred to Maternal Foetal Medicine at a larger hospital and I was told I’d have to give birth to him there.
- At 36 weeks I moved into Ronald McDonald House.
- During my ‘prenatal care’ I didn’t see the same obstetrician twice, I didn’t have a primary carer and I didn’t have access to any prenatal classes
- I was told at 37 weeks that ‘there was no need to wait until 40 weeks’ and that I would be induced at 38 weeks. There was no medical reason for this.
- At 37+5 my membranes ruptured. I called the hospital and they said to make my way over there.
- I was told my contractions weren’t strong enough and offered synthetic oxytocin to ‘speed things up’ or to go home. I was living at Ronald McDonald House – I didn’t want to go home.
- My Midwife introduced herself and said she’d just let me ‘do my thing’ and to let her know if I wanted any pain relief.
- I was offered pain relief repeatedly and had several vaginal exams.
- I wasn’t shown how to use any of the labouring tools available. My birth suite had a bath but it had things being stored in it. There was a birth ball but that wasn’t offered.
- I was told I had to have CTG monitoring and that a probe on my sons head would be ‘safer’ as they could monitor him closer.
- I was told I wasn’t allowed to eat anything and could only drink a small amount.
- I spent most of my labour on my back on the bed, albeit this is all I wanted to do. I laboured overnight (membrane ruptured at 9pm on the dot) and I was tired from not sleeping due to back pain for the previous two days.
- I used the gas for pain relief and the Midwife explained to my mum how to coach me through it. By watching the CTG, my mum would coach me to inhale as my contraction started. I essentially was knocking myself out for each contraction. This made me vomit, a lot.
- When I started to feel the urge to push, I had more exams done and was told I had to slow down and not push. That was excruciating.
- My son’s heart rate started to drop, and I was told I had 3 goes at getting him out otherwise they’d ‘get him out for me’.
- At this point, I had around 10 people I didn’t know in the room, the obstetrician came, several midwives, neonatologists and neonatal surgeons where there waiting.
- I had midwives holding my legs up, one told me to stop being silly and to push my son out.
- I then heard the obstetrician say ‘this will hurt’ and I had 3 x episiotomy cuts. I later realised this was done without consent.
- My son was born at 8:11am, after 11hours and 11 minutes of labour.
- Delayed cord claiming did not happen. He was taken away straight away, and after a few minutes of me asking for my son, he was brought back to me.
- I had around 10 minutes with him before he was taken away for scans and investigations to find out what was causing the obstruction.
- I was then offered the gas for pain relief while getting stitches, got up and had a shower, and walked upstairs to the NICU to see my son.
- In the following weeks, I had limited follow up postnatal care. I had a Midwife ask me how I was when I was in my room at the hospital, but that was the most care I had.
I have to stress, a hospital birth was exactly what I needed for my son. It was medically necessary and I was confident and comfortable giving birth in this setting.
I do look back on my birth experience in a hospital fondly. I love labour. I love being in labour! I felt incredibly empowered and felt like an absolute warrior after giving birth (I’m pretty sure it was this empowered euphoria that helped me walk up a flight of stairs 20 minutes after giving birth).
I also have to say, I was incredibly uneducated when it came to birth. I was so focused on what was going to happen with my son after he was born, that I didn’t spend any time preparing myself for birth. I feel if I had prepared myself more, I would have had an even more positive experience.
My Home Birth
After the birth of my son being so medically focused, as soon as I got the all-clear at the anatomy scan with my second pregnancy, I sought the help of a Private Midwife to have a positive and healing birth.
I hadn’t considered a home birth until I was speaking with my beautiful friend Caitlin who spoke so positively about home births, and with her being a Midwife, I started to trust that this was not only a viable but also a safe option.
I knew after being so uneducated about labour and birth with my son, I wanted to be prepared with my daughter, so I sought out to educate myself as much as possible.
My home birth differed greatly from my hospital birth, these are the key points:
- From 20 weeks I was under the care of one Midwife who I met with every few weeks, was able to call or text with any questions I had and spent on average 1 – 2 hours at each meeting with me. I could have been under her care earlier but in my mind, I wanted a clear anatomy scan so I knew I didn’t have to go to Maternal Foetal Medicine again.
- At my appointments with my Midwife, we spoke about my fears, my goals, what was important to me and everything in between.
- When we got together for our meeting about the ‘Birth Plan’ we spent 5 hours going over every detail and most possible variations to the plan.
- My Midwife visited me in my home prior to the birth, gave me access to her copious amounts of resources including books and classes with both herself and other birth professionals.
- I also met with my secondary Midwife regularly, as having a second Midwife at a home birth is a requirement in Australia.
- I text my Midwife at 10pm one night when I thought I was in early labour. She texted back and forth with me for over an hour checking in and making sure I was okay (I didn’t go into labour until a few days later).
- When I went into labour, she came to my home, helped set everything up, hugged me, rubbed my shoulders, was incredibly kind and gave me space when I needed my husband to step in and be there for me.
- She gently guided me to keep moving and when my membranes ruptured and I cried, she held me and reminded me I was doing a great job.
- My Midwife gently checked my daughter’s heart rate with a foetal doppler, and only when needed.
- I did not have one single vaginal exam. When I was going through transition and was exhausted, I asked my Midwife to check to see how dilated I was. She said it wouldn’t change anything and reminded me I was doing a great job. She knew I wanted as little intervention as possible and she knew where I was at in my labour without even needing to check (my daughter was born around 10 minutes later).
- When my daughter was crowning, my Midwife helped prevent tearing, and when my daughter was born, my Midwife quickly gave my daughter to me.
- In the time immediately after birth, I stayed in the birth pool where I was warm and comfortable, I was guided through the delivery of the placenta and was helped to give my daughter her first feed.
- After about 20 minutes, my Midwife helped me shower while my husband held our daughter to his chest, and she checked for tearing (no tears!).
- She helped me get dressed, helped me to the toilet and then set me up on my lounge cuddling my baby girl.
- After around 2 hours, my second Midwife helped us ‘cut the cord’ by performing a cord burning ceremony, a gentle way to separate baby from the placenta.
- My Midwife cleaned up (I even have photos with her in the background cleaning the floor with towels), my mum made me food, and I was surrounded by people who love me and cared for me.
- There was no rush to do anything. There was no rush to weigh my baby, there was no rush to be anywhere to do anything. Everything was slow, and blissful.
- After around 4 hours my Midwife left, and returned the next day with a massive bunch of flowers and fresh vegetables from her garden. She visited and stayed for a few hours checking in on my daughter and myself, chatting about everything and making sure we were okay.
I had the most amazing postnatal care too, but that’s another story for another post.
My home birth was the most amazing experience, I would relive that day over and over. I loved being in labour, I loved the whole experience, and I felt so incredibly powerful and empowered from that birth.
What I Want You To Know
My two birth experiences where vastly different, not only because one was in a hospital and one was a home birth, but because both of my labours had different needs.
You can have an incredibly empowered birth in a hospital, you can have a private midwife in a hospital. It’s not black and white. It’s not one or the other.
These are some of the things I want you to know from my experiences that you can apply to your own, whether you have a hospital birth or a home birth:
You Have Options
For every decision that needs to be made, you have options. Rarely is there ever a time when your options are limited and where a decision needs to be immediate, even during labour.
The best way to ensure you receive all the information you need to give informed consent is to use the BRAIN acronym in discussions and asking questions of health care providers.
B – What are the benefits (of the procedure)?
R – What are all the risks involved?
A – What are the alternatives?
I – What does your intuition tell you?
N – What if we do nothing? OR Not right now, we’d like some time to discuss it.
This will help you gather all the information you need to make an informed and empowered decision and help you to be in control of your birth.
Educate, Educate, Educate
I cannot stress this point enough. I thought ‘winging it’ was the way to go with labour. I figured I’d just know what to do.
But having the information and knowledge of ways to help prepare myself for labour, help myself through labour, and to understand why certain parts of labour required certain things from me, made the world of difference.
Learn about the stages of labour, the hormones of labour, what positions help and hinder, and what you can do to naturally reduce pain and cope will totally change how you approach and experience your labour and birth.
A Birth Plan Isn’t A Wish List – It’s Plan A through to Plan Z
As I mentioned, the meeting to prepare our birth plan was 5 hours long. It wasn’t a simple straightforward plan A and that was it.
We had everything mapped out, my wishes, what I was hard against, what I would prefer not to have, and what I absolutely wanted. We covered many, many ‘what would happen if’s’ and even timed how long it would take to get from my house to hospital (3 minutes by the way).
Your birth plan isn’t just what music you want playing or oils you want diffusing. It is a comprehensive guide that helps you look at as many possible situations as you can and determine what you’d like to do in each situation.
When you start considering your birth plan, as yourself ‘and what if…’ to make sure you’re covering as many bases as you can.
Get The Best Support, Before, During and After Birth
The support I had before, during, and after birth was far more impactful than the location of where I gave birth.
Get the best possible support you can, depending on your financial situation, the available resources in your area, and what you have available.
Whether it’s a Private Midwife, continuity of care model at your hospital, a doula, a birth coach, or any other possible support option. Just make sure you have support.
The people you surround yourself with before, during and after your birth can make the biggest difference to your experience.
Again, I don’t believe whether you have a hospital birth or a home birth that one is superior to the other. I don’t believe ALL women should have home births, and I don’t believe ALL women should have hospital births.
Hopefully by sharing my experiences, what I learned and what I would love for you to know, you’ve been able to gain some insight into things to consider when choosing your place of birth and help you have a beautiful and positive birth experience.