Homebirthing a mother of a dispute

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PLAYING in the sand with her family, Elsa Dillon looks far from the dreadlocked hippie people stereotypically assume she is. To some, the mother of six has chosen the irresponsible path of having four of her six children at home.

Like any female, Dillon has the right to home birth, but it doesn't mean it's easy ... "The doctors have had me in tears about my decision to home birth," says Dillon, who had her first two children in Newcastle Private Hospital and the rest at home, supported by her husband Richard.

"They give you the hardest time and it's shocking. But, we do it [homebirth] responsibly. We just don't go off and do it; we research it. You learn how to resuscitate the baby if something goes wrong and have the knowledge of every possible scenario that could happen."

Like many, Dillon is celebrating the news this week that midwives have been given a reprieve allowing midwives to practice legally until 2012, but says there is still a long way to go.

... Not matter which side you take, the point is the way women give birth around the globe and in our own backyards is a polarising issue.

Homebirthing advocate, Hollywood actress and former talk-show host Ricki Lake has travelled the world voicing her opinion after having her ... second [child] ... in the performer's bathtub in 2001, which is on show for the world in her 2007 documentary The Business Of Being Born.

Talking exclusively to the Daily Telegraph the 40-year-old says it's not about homebirthing versus hospital, but more about giving expectant mothers the information to make informed decisions.

"I know it's a huge issue in Australia and it is looking like homebirths could be illegal, which is shocking to me, but I am not advocating home birth," says Lake, who will also feature as part of a segment on the topic for Channel 7's Sunday Night program.

"I am advocating the choice, and home birth is not for everyone, but for me it was the right choice."

Most of the 285,200 Australian children born last year were born in hospitals and birthing centres. However, 780 were born at home, almost all with the help of qualified private midwives.

Private, qualified and trained midwives have been practicing since 2001 without insurance ...

... celebrities including models Elle Macpherson and Cindy Crawford, actress Pamela Anderson and Bill Grainger have had their children delivered at home.

Like them, Dillon says she felt more at ease delivering between her four walls.

"In a hospital it is very public and no private time for you and your baby," Dillon says. "They also push the drugs quite a bit and I wasn't prepared to do that. But it's all about being comfortable in yourself. If you're not comfortable with yourself you shouldn't do it at home. We just knew we could do it. The one line I always say is homebirthing is not an illness. People freak when you mention home birth, but it's an empowering experience for the whole family. Maybe that's what doctors are scared of."

Jenni Ridley from Killara on Sydney's North Shore agrees. Of her five children, four were homebirths including five-month-old Yindi.

For Ridley, who is of Aboriginal descent, homebirthing is also about her family connecting with their ancestry ... being born at home ... [is] about bringing back some of our culture to our family ...

Obstetrician Dr Pieter Mourik studied for 12 years and has 30 years experience in birthing after delivering more than 5500 babies. He is unequivocal in his belief that homebirthing should be banned.

On 100 occasions he has helped deliver babies after homebirths went wrong.

He says one in 1000 women request a homebirth, and of them, 50 per cent are either not suitable, or fail and are transferred to hospital anyway, which can sometimes lead to unexpected legal ramifications for doctors.

"All studies done on homebirth confirm there are three times more complications for the mother and baby," he says. "Complications and avoidable disasters from women classified as low-risk are seen almost every week in the major maternity units.

"Unfortunately the doctor who receives the woman in hospital is exposed to legal claims as medical litigation follows the patient and no midwife has medical indemnity. The argument for increased homebirth must be resisted ... The government has a responsibility to educate the public that ... the safest place to have a baby is in hospital where the woman is received and monitored by qualified midwives."

Ahem. I'm not sure that Dr Mourik has read the latest research around the safety of low risk, professionally-attended home birth. But he does have a point about the legal ramifications for doctors: since midwives do not have insurance, if the patient needs to sue, she's better off suing the doctor or hospital since most midwives do not have the private funds to support lengthy court cases and pay outs. Indemnity for private midwifery is what is needed, as a matter of urgency. Or a no-fault legal system.

I'm not sure where he got his stats from, but where he says that 50% are either not suitable, or fail and are transferred to hospital, he may have a point that judging by obstetric standards, most women who are currently accepted for home birth are unsuitable. The guidelines are very strict and forbid home birth for VBACs, anyone with a history of anything (eg bleeding after birth, previous prem baby and so on), as well as current issues like high blood pressure, baby not growing well and so on. These guidelines are supported by research from the Netherlands, Canada and the UK (except that the Canadian guidelines support home birth after 1 prior caesarean).

Melissa Maimann, Essential Birth Consulting 0400 418 448