WA maternity hospitals should allow water births as part of a more flexible approach to cater for women disgruntled with mainstream services, a report into the safety of WA home births has found.
An independent review by Sydney obstetrician Michael Nicholl and professor of midwifery Caroline Homer has found that home births in general are not riskier than hospital births, but calls for tighter scrutiny to make childbirth safer, particularly for high risk babies.
The report was commissioned by the WA Health Department after a series of apparent deaths among home births. It found that while 18 babies with planned home births died in the review period of 2000-2007, none was reported in 2006 and 2007.
... It calls for an urgent review of the State’s home birth policy developed in 2001 and warns that home births are more likely to become unsafe if they are marginalised and out of the mainstream services.
The review found some women were opting for home births because they had limited choices in traditional maternity units, including access to water births, which were often discouraged by hospitals, and women wanting to have a normal delivery after a previous caesarean.
“It seems apparent that the maternity systems are, for some women, too medicalised and restrictive, and do not meet their needs,” the report found.
Professor Homer said when home births were well supported they were a safe option for some but not all women. “Our report does not support that home births in general are unsafe but we need to have the right mechanisms in place,” she said. “We need continued education and more checks and balances.
“What many women really want is continuity of care and services close to their home. They don’t necessarily want a home birth but they want all the things that they perceive home birth women get.” ...
It'll be great if waterbirths can be given the go-ahead in WA, as currently there are no hospitals in WA that support water births. But ... having a waterbirth policy does not mean that women will be able to birth in the water. Restrictive policies around fetal monitoring often mean that women are not "allowed" to labour and birth in water. When you remove women who are: over 42 weeks under 37 weeks VBAC prolonged ruptured membranes being augmented or induced with syntocinon having twins baby ? too small gestational diabetes hypertension any bleeding in pregnancy long labour meconium in the waters having an epidural had pethidine or morphine
and anything else you can think of, you will see that very few women are actually able to labour and birth in the water. Some hospitals in Sydney offer waterbirths, but only if you don't fall into one of the above categories, and only if a midwife is on duty who is comfortable with waterbirth. If water birth is important to you, the best way to facilitate this is to book a private midwife for a home birth.