Hospital Vs Birth Centre Vs Home

[edaj84]

I was wanting opinions from Midwives, Doulas and Mothers alike.

Over the last few years I have heard many differing opinions about this, I have heard many hospital midwives say that homebirths are dangerous, some say that homebirths are ideal. heard independent Mids say that homebirths are the way to go.

Why is there such a difference of opinion within the one profession? is it lack of knowledge (of the "other side")? lack of experience (with the "other side)? what is it?

Thanks Jade

[Just Me]

I think it must be an experience thing. The mw that delivered my DS was from the UK and she said over there it was quite common to have homebirths. She thought that was the best way to go (ironically working in a hospital to deliver babies here in Australia). She said they were the most relaxed and peaceful births she had attended. I don't think HB is for me, but I found what she said interesting.

[edaj84]

I just thought that I would add that I have personally had one hospital and one homebirth. I have madea thread regarding birth support also. https://www.bellybelly.com.au/forums...oria-area.html

[Julie Doula]

Marsden Wagner writes in "Fish Can't See Water - the need to humanise birth in Australia" that careproviders "believe the evidence of their eyes".

There are two basic models: the Obstetric Model, which says a birth is only normal in retrospect; and the Midwifery Model, which supports natural birth and assumes health and normality until there is a solid reason to believe otherwise. One is about risk management (particularly financial and legal risk) the other is about keeping birth normal.

Many midwives working in the Obstetric Hospitals are working under the Obstetric Model. They might be midwives, but that doesn't mean they're able to practice the Midwifery Model. They might believe in the Midwifery Model, and wish they could offer it - but they are working under Obstetric hierarchies and protocols. Midwives in Birth Centres can offer the Midwifery Model of care to some degree, althought they are still restricted by Obstetric policies and protocols. Independent Midwives, who attend homebirths as well as support women birthing in hospitals, are actually able to practice the Midwifery Model of care. This model will soon become extremely rare and difficult for Australian women to access if they succeed in outlawing homebirth midwifery in July next year.

So that is why some midwives might believe that homebirth is not safe. If they have been trained in the obstetric system, and are essentially in a system where they have to function as obstetric nurses, their reality and perspective is going to be more similar to that of most obstetricians, than independent midwives. Like many obstetricians, they may have never actually seen a women give birth under her own power, without technical assistance. Therefore they may have trouble believing that a mother *can* give birth or that a baby can be born well and not need suctioning, oxygen, warming lights, examination, and wrapping up.

Here's a quote from Marsden Wagner's article - so true for Australia:

A liberated woman correctly strives not to be controlled by men, an effort even more difficult if she lives in a male chauvinist society. There are many ways in which women giving birth in hospitals in 'macho' cultures are oppressed and given the message that they are not important and not free but controlled by an often belligerent staff. But if a woman accepts the medicalised, male dominated obstetric model of care with its selected information, she gives up any chance to control her own body and make true choices. Volumes have been written about how liberating and empowering it is for a woman to give birth when she controls what happens. Without fully informed choice, she will give up any control and comply with the wishes of the doctors and hospitals. Women who demand choice but get only selected doctor-friendly information unwittingly buy into the medical position and call it feminism.

[edaj84]

thankyou so so much for you comprehensive answer Julie. I have personally had one hospital birth and one homebirth, i was jsut interested to see if anyone had ideas as to why there is such a variation of opinions

[Julie Doula]

Just read Gothmum's post in the If You Didn't Tear What Position Were You In thread. It's an example of an institutionalised midwife. This midwife was threatening her with an episiotomy if she didn't hurry up. And this is a primip having a 4 hour labour!! Gothmum wisely *oops* kicked the midwife, ignored her and carried on pushing her baby out slowly and gently and succeeded in avoiding a tear.

I think many women rock up at the hospital anticipating and expecting warm, fuzzy midwife care. Sometimes, if they're lucky, they'll get it, because there's some extremely brave 'angel midwives' in the system putting their own necks on the line to help women who want to, to birth normally and dodge intervention.

But many women are not expecting such a snip-happy scenario with so many sharp objects flying around. Scalpels and scissors to cut the abdomen, or to cut the perineum, or to cut the cord, or to cut the foreskin. A lot of cutting going on. Many careproviders can't imagine how a birth can happen with no sharp objects and no cutting. But it can!

When Gloria Lemay stayed at our house (last week) she shared a lot of great stories. One of them was about a video she shows of some births she's attended, which she shows to trainee midwives to show how hands off you can be at a birth. Some of the midwives exclaim, "Oh - so you mean, REALLY hands off!" That couldn't understand how you care for a birthing woman without touching her or the baby at all. So, there are midwives and midwives.