Sunday, October 5, 2014

Head above the Parapet

Where I work in RuralTown a vast majority of births are in the hospital. We don't have any home birth midwives as far as I know, and we don't have a birth centre. Our private obstetrician also delivers at the hospital, so women who want a home birth don't have much choice out here. 

From canvassing the opinions of my colleagues I don't think home birth is a big thing in Australia. I don't have much in the way of stats, but something like 1% of births are home births, and this is confined to large cities, indigenous communities and accidents in remote areas where there isn't time to get to hospital. 

So, in ante-natal clinic, a pregnant woman asked me where I'd like my wife to have babies when it comes to her.

Now, I'm not quoting studies or being a vagina-controlling doctor, I just answered her question honestly.

I would like my wife to give birth in quiet, clean, safe environment surrounded by people who care about her, and give her the choice to do whatever she wants.

I would also like to be within a 
cord prolapse distance from a fully staffed obstetric operating theatre, with full obstetric, midwifery, anaesthetic and haematology support. Preferably with a neonatal ICU available, ready to deal with any catastrophe that could arise.

I don't think that the two places I have mentioned have to be mutually exclusive.

I have seen enough women and young babies who are alive because of prompt intervention to make that decision for me. And they weren't all "high risk" women either. All any of us want are healthy mothers and babies and I think with births in hospital the trade off between losing some privacy, choice or seeing the likes of me is outweighed by being in an environment that can deal with an emergency. Some things in obstetrics are too fast to allow a transfer. Fortunately, it doesn't happen often, but when it does it's fairly harrowing stuff.

I also think that there is a reason it is so difficult to get indemnity insurance to be a home birth midwife and there is a reason RANZCOG do not advocate it. For balance, have a look at this 
site to see why doctors are all self-serving control freaks who rely on scaring women into having Caesareans. Now, putting my obstetrician hat on, I would love nothing more than every woman birthing their babies at home in complete safety and ease. But they don't. Which is why I get called at 3am.

So that is why I wouldn't want my wife to have a home birth. She happens to agree with me, and if she didn't I would support any decision she made. 

I'm not cleaning the sheets after a 
PPH though.

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