Catching up on the newspapers since returning to Britain yesterday, I found this article in last week’s Sunday Times
: here's the headline and first paragraph:All women to be guaranteed choice of home birth
All women will be guaranteed the chance to give birth at home with a National Health Service midwife within the next three years, Ivan Lewis, the health minister, will announce this week.
What’s all this about home births? Well, it’s partly a reaction to the kind of hospital birth that so many women have hated. Where the consultant, if you meet him at all, says “Hello, Karen, I’m Mr Jones” just to establish his status, and then talks about you as if you’re not there to a flock of medical students and invites them to examine your vagina. The kind of birth where you have to lie flat on your back. Where’s you’re left alone for hours and hours. Where, when you say the pain is unbearable, they tell you it’s not. Where they yell at you to be a good girl and push, now, or to be a good girl and not to push. Where nobody listens to a word you say, and the baby is called nothing but Baby and you are called nothing but Mum. Where – as happened when I was a child – the older brother or sister is not permitted to visit the hospital at all, for fear of infection, so that, in my case, my mother was taken away from me for a month and I have never forgiven my little brother, whose fault it patently wasn’t.
Who can blame women for not wanting to go through this? But the choice of a home birth as a “right” – well, I’m not happy with that one.
Having the baby at home, in familiar surroundings, with the whole family waiting downstairs until they cheer and open the champagne when the first cry of the new baby is heard - - ah, how lovely.
But what if something goes wrong? What if all’s going fine and then the baby goes into distress, and the ambulance is called and the mother is rushed to hospital but it’s too late and the baby is dead? Or it’s too late and the mother is dead. Or both are dead.
Can they really mean a home birth as a “right” even if you live a hundred miles from the nearest hospital and it’s your first baby? Because lots of women – especially ones with no previous experience of labour – envisage it as a warm, wonderful experience, where there’s a bit of pain, they push a bit and suddenly there’s a delightful, clean, sleeping baby wrapped in a blanket.
The bloody reality of it all comes as a bit of a shock and the women who are the most determined on no pain relief for their birth plan are frequently the ones who scream for an epidural as soon as the real pain sets in.
And who can blame them? Childbirth – especially in those lovely Olden Days when most women gave birth at home – was agony. And most of us don’t have real experience of agony these days. Childbirth frequently resulted in the death of mother, child, or both. Only a couple of generations back, in Victorian times very few marriages lasted over twenty years because the wife would die in childbirth and the husband would marry again.
The “right” to a home birth will either mean that it will only actually happen for low-risk women – third baby, no previous complications – or that everyone will have the “right”, no matter what the risk.
And some babies, and some mothers, will die, when they could have been saved.
Surely it would be far, far better to spend lots and lots of money creating small, friendly hospital maternity units, with fast access to operating theatres and all the equipment which saved my life and Emily’s life – oh yes, I have a personal axe to grind here! But one midwife throughout pregnancy would be good. And a pleasant, well-staffed, private, clean environment, with an extremely low risk of mother or child catching MRSA or other infections, would be good too. And I am trying to do my bit, in the work I do with students, to help to train medical staff to treat pregnant women with kindness and respect – of course, many already do.
But as for home births – well, pregnancy and childbirth is dangerous. I write as someone who lost one baby at six months of pregnancy, had one bad early miscarriage and had an emergency Caesarean section with Emily: and as someone who nearly died myself in all three of my pregnancies. Life’s too precious to add to the risk of losing it just for a “right” of personal choice.