We need a cultural shift on homebirth

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... As a woman who chose homebirth, I wholeheartedly agree with ... statements that "too many babies are born in the traditional 'hospital' setting" and that "women deserve a medical service which focuses around their needs, is safe and effective … and one in which the woman's informed choice is respected".

... science demonstrates the positives of midwife-led care for low-risk pregnancies. A recent Cochrane review concluded that "midwife-led care confers benefits for pregnant women and their babies and is recommended" while finding numerous benefits and no adverse effects.

In stark contrast to the above the words that crop up most frequently in the comments sections of major paper's websites today are "risk", "danger" and "pain". When there is a perception that childbirth is inherently dangerous and agonisingly painful, it is logical that this proposal is being seen by many as a terrifying way of saving money at women's expense.

According to RCOG, under 10% of births happen outside hospital. For the other 90% to be confident that the offer of non hospital-based care is a positive step forwards, perhaps we need to look more closely at this concept of "informed choice".

... Without more information and support we simply can't expect people who have so recently and vigorously been persuaded out of the home and in to hospital to give birth to forget the often-erroneous arguments of safety, cleanliness and pain relief that were used in the last century to make that shift possible.

How can women who have had no education in the physiological process of birth at school be expected to know that simply with the right setting and support team they have statistically less chance of needing pain relief, a caesarean or an instrumental delivery and are more likely to feel happy with their experience? Until they know this it will be hard for them to accept the standardisation of maternity care away from hospital.

That 2011 sees UK obstetricians speaking about the importance of women's experiences and advocating a holistic approach to care is a positive thing. However, much work is needed before the RCOG maternity recommendations will be seen as broadening choice and improving safety and comfort, rather than forcing women into cheaper but less experienced and equipped care.

Perhaps the next step is to look at how we can nurture our anxious society so that it has the information at hand, the education as standard and the support as needed to make positive decisions based on knowledge rather than fear.

The above article is written in response to a report by the Royal College of Obstetricians and Gynaecologists (RCOG) which called for the UK's National Health Service to provide more midwife-led units and homebirth services for women. The report argued that healthy women at low risk of complications during birth can have a baby in a midwife-led unit without a doctor going anywhere near them.