Why I Chose A HomeBirth
Firstly, I’d like to emphasise all women have the right to choose where they give birth, there is no right or wrong choice. It is an extremely personal decision, and one that could impact how well you labour and deliver, and how positive you feel your birth experience was on reflection. I wanted to share the reasons why homebirth was something I chose with my first baby.
Four years previous, my best friend opted for a homebirth with her first baby, and I remember asking her “why!?” in disbelief. Why would anyone want to be so far from medical assistance that you just don’t know if you might need?
It was only when I was pregnant myself and learning more about birth, hypnobirthing and the biology of it all that I realised there were so many incredible benefits of a homebirth – even with a first baby. I was lucky enough to have a low-risk pregnancy so homebirth was an option for me – in fact the very first midwife I saw who ‘checked me in’ in early pregnancy asked me if I’d considered a homebirth as soon as she knew I was low risk. I quickly brushed it off as an option and just hoped I’d be able to be at the midwife led unit (based at my local hospital).
As I got into my third trimester, the global pandemic raged and homebirths had been cancelled as ambulances were under too much strain to guarantee their stand-by availability for emergency transfers. My husband and I completed an NCT course, and a hypnobirthing course learning more and more about birth and optimal environments to achieve a natural, unassisted birth. I also watched all of the Instagram Live sessions by Lucy Flow where I felt informed and empowered to achieve a birth I’d always wanted (I’d highly recommend watching as many as you can on her IGTV in your pregnancy!). And then the hospital announced homebirths were being offered again!
At 34 weeks pregnant I changed my mind about where I wanted to give birth, and I contacted the local homebirth team to set it up. Here are some of the reasons why…
THE HORMONES OF LABOUR
If you do any amount of reading or research on birth you’ll learn that there are four main hormones that are essential: oxytocin (the love hormone), beta-endorphins (the hormones of pleasure and transcendence), epinephrine and norepinephrine (the fight or flight hormones of excitement) and prolactin (the mothering hormone). You’ll need a careful and consistent balance of these hormones throughout labour and birth, and your environment can have a profound effect on them. For example if you are stressed during labour oxytocin production will be inhibited and labour could slow down.
Ideally, for a straightforward birth you will want to be as calm as possible. Oxytocin reduces stress, calms you down, and helps with the pains of labour. It’s also the most powerful ‘contraction-causing’ hormone, so it’s essential that your oxytocin levels aren’t compromised in order for labour to continue at an ideal pace and not stagnate.
Once I understood the power and importance of oxytocin in particular I knew I would be more calm and relaxed to give birth in the familiar surroundings of my home. I felt that having to leave my home and get into the car, endure the journey, get myself into the hospital, wait to be assessed etc., was not going to be conducive to staying in a bubble of consistent calm and focus.
HOME COMFORTS
Throughout labour and certainly after birth home comforts are really important. Whilst you can take as many as you like into a hospital, being at home is the biggest home comfort of all.
Getting to shower after birth in my own bathroom was great. I didn’t have to wear flip flops, the midwives helped me in and out, and I knew everything was clean, including my own towels. Getting into my own bed that first night was also pretty blissful – I mean we slept with the bedside lamp on so we could see Oscar and change nappies and feed him at all hours, but I was grateful not to be surrounded by other new mothers arriving sporadically, or crying babies setting each other off like dominoes through the night.
The global pandemic had also shown us in the months preceding that home was the safest place to be, it had become a ‘safe haven’, and a little bubble of its own, and I knew there wasn’t going to be anywhere else I’d feel quite as comfortable
CONTROL
Anyone who knows me will agree I am a certain level of control freak, so this was a real factor for me when picking a place to give birth. At home I am in complete control of my environment and this was hugely appealing. To ensure I was as happy and calm as possible I didn’t want to have to ask someone else where things were, if I could have things or what has happening.
Equally, being at home also meant my husband felt more in control as he knew where everything was, how it works what I liked and needed. We also had complete control over what space we wanted to use during labour, with the freedom to keep moving, and changing rooms as we wished with no restrictions or judgements from the midwives.
We could also practice and visualise labour and the birth much more effectively in the final few weeks, because the room I gave birth in could be set up in advance and we could both familiarise ourselves with how and when to play the right playlist and light the candles! In reality my labour was much quicker than we ever imagined and we still weren’t quite ready (read my positive birth story for more details!), but I never felt out of control.
MEDICAL ASSISTANCE
When the homebirth midwife, Debbie, came out to see us when we first enquired about the possibility, most of my questions were about the eventuality of something going wrong or needing assistance, and all her answers were incredibly reassuring.
With a homebirth, during established labour and birth you get two midwives 100% of the time, not darting in and out of your delivery suite or looking after anyone else but you.
The homebirth midwives monitor you and your baby closely during active labour to ensure that both of you are well – this is done by checking babies heartbeat every 15mins or so. If complications are developing as a result of your birth there are usually warning signs the midwives are well versed in – they will act promptly and may recommend transferring via ambulance to a different birth environment if needed. The homebirth midwife would then continue to care for you in the new birth environment and maintain as many elements of your birth preferences as were safe to do so.
Pain relief is still available – I took advantage of gas and air when they arrived as I went into the final stages of labour. You can also prearrange pethidine access via your GP, and of course a TENS machine, water, massage and other forms of pain relief are all available as you need.
Stiches post birth can be done at home too, providing they aren’t too substantial, the midwives who attend the birth are equipped and experienced in the stitching side of things too (this is where the gas and air were most helpful to me!).
five HOMEBIRTH FACTS THAT convinced ME
The homebirth team midwives care for you during your pregnancy from the point that you have chosen homebirth as your preference and aim to get to know you well before labour starts – this to me was the only way to get continuity of care having always seen a different (albeit lovely) midwife at every appointment or scan.
There was no change in environment during labour. No distractions or car journeys or anything else to interrupt my flow of oxytocin and my focus.
Medically there was less chance of me or my baby getting an infection – this was key especially in 2020 in the peak of COVID-19. Risks associated with interventions like forceps and ventouse were also lessened, in fact they likely hood of any intervention was greatly reduced by being at home.
There was no limit to my husband being with me as a birthing partner. Because we were in the middle of the global pandemic, hospitals had a number of restrictions. One of them was that new fathers were only allowed to be present from the point of ‘established labour’ i.e. 4cm dilated, and were only allowed to stay for 2 hours after birth, regardless of any complications or issues. At home, my husband was there the entire time and never left my side.
I was guaranteed access to a birthing pool – I ordered a rentable pool that was delivered and picked up and came with everything we needed which was ideal. I could have got in it as early or late as I wished during labour and stayed in it for as long as I liked too. At the hospital it would have been a first come first served basis with no guarantee I’d be able to use one at all, and the uncertainty and potential disappointment could have impacted my oxytocin again.
It is worth mentioning that whilst a first time mum will gain all the same benefits as a second or third time mum by being at home for birth, it is also a fact that statistically, homebirths for first time mothers incur a small increase in risk compared to being on a labour ward or at birth centre – but this is only marginal.
Our decisions to have a homebirth for our first baby was definitely about choice – if we opted for a homebirth in advance we had the choice to stay at home when the time came and have the midwives attend for the delivery. If we didn’t opt for a homebirth we’d have had no choice but to get to the hospital on the big day. As we’d never done it before we had no idea what to expect but it was helpful for me to know I had as many options as possible. I still had a hospital bag packed weeks in advance, and my birth plan included all eventualities, and at any time during labour I could decide to go to the hospital or birth centre, but ultimately I knew that visualising and planning for a homebirth was exactly the right decision for us.
