More than a thousand New Zealand women each year shun the hospital system and instead give birth in their own lounges, bedrooms and bathrooms. Is homebirth a fringe lunatic choice?
Melanie Patterson describes the scene at her place at first-light last Boxing Day as cosy - she and husband Darren, three-year-old Jake, a friend and the midwife were sitting around eating pancakes with bananas and syrup and chatting about the travel photos on the living-room walls.
Every now and then Melanie had a contraction ...
When things became more intense, the friend took Jake to the park, and 45 minutes later his little brother was born into his father's hands as Patterson leant into the sofa and pushed with all her might.
"Darren just reached out and Juliet [the midwife] told him what to do and he caught Lee," Patterson says. "That was pretty special. Then we all snuggled up. Jake arrived home and he had a baby brother."
She says the experience was much less harrowing than her first birth, which included a panicked trip to the hospital after a fast labour and the fear the baby would be born in the car.
"[This time] it was peaceful. It was cosy. I was curled up on the sofa quite a bit, with people around me, getting done whatever I wanted. We had relaxing music and then, later, silence. I was quite open in saying where I wanted the hot towels placed. All my needs were met so I felt really comfortable."
The Patterson's choice is not a mainstream one. Health Ministry figures put the percentage of New Zealand women having homebirths at 2.5 per cent ...
"As midwives we want to support women to have a positive birth experience wherever they give birth."
... when women give birth at home or in a primary birthing unit they are less likely to have intervention in the normal physiology of labour and are therefore more likely to have a normal birth.
... midwives believe home ... is ... the best place for well women to give birth.
Those with complex pregnancies or medical conditions should go to a secondary or tertiary hospital ...
... two Canadian ... papers ... and a Dutch study ... of low-risk women ... show no increased risk to mother or baby from planned homebirth and fewer interventions such as forceps and caesarean, even taking into account the women who have to transfer to hospital.