Natural homebirth vs. Natural hospital birth

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Continuing on from the first post on natural childbirth: Natural Childbirth in Layman’s Terms, I’m going to talk now about the difference between a natural birth at home and a natural birth in hospital. Why is there a difference and what difference can it make to your birth experience?

I must remind you again that this is anecdotal, from my experience and that of women I know. However, I have researched everything I say. Sometimes I know where I read it and will reference, but sometimes I don’t.

The first thing to remember about doctors, midwives and hospitals is that they have rules, regulations and policies to adhere to.

The second thing to remember is that they are generally afraid, for good reason, of litigation.  They have to cover themselves as much as they are able.

The moment you step in to a hospital, you fall under the jurisdiction of that hospital and you need to abide by their policies. This was a massive part of why I did not want a hospital birth. If hospital policy is that you cannot eat or drink in labour, then you can not (or at least not without a fight). If their policy is to have you strapped to the bed, then you’re strapped to the bed. Most hospitals I’ve come across have a 1cm per hour dilation rule. If you’re not dilating at that rate, they will say you are not progressing (called Failure to Progress or FTP) and that you need to be induced.

For me this means that I would have been induced about 30 hours before my baby was naturally and beautifully born.

The problem with induction is that it is an intervention, and one intervention will generally lead to another.  The more interventions you have, the more painful your labour. If you are induced you are more likely to need drugs to help with the pain, having drugs means you need to be coached to push, if you’re coached you generally either tear or need an episiotomy, or if you aren’t pushing ‘right’, they’ll go in with ventouse or the forceps, and pull your baby out.

This can lead to huge medical complications for you down the line (such as incontinence) and makes your baby come out with a misshapen head (which rectifies itself eventually) and recognised ‘birth trauma’. If that doesn’t work, it’s an emergency c-section.

At the end of the day, the most important thing is that mother and baby are healthy and alive, but if you had an uncomplicated pregnancy and you are fit and healthy, wouldn’t you prefer a peaceful birth?

I must add though, that when you’re nearing the 42 week mark, or let me stop and correct myself here, if I was nearing the 42 week mark, I would consider an intervention as things can go wrong pretty quickly and pretty dramatically after that.

labouring_naturallyAt a homebirth you are given a bit more flexibility. I didn’t call the midwife till I knew for certain I was in labour and the contractions were coming pretty strong and fast (about 28 hours in). I allowed her to do an internal check, but you don’t have to allow it. I was able to eat and drink what I needed when I needed it. I was able to sit, stand, lie, float, turn and do as I needed to, as was comfortable for me and what felt right for me and my baby.

People often say that they were just too hot in the birth pool in birth centres or hospitals and had to get out and give birth in a bed. I did experience that too, and asked for a fan to be put on me. I was told it would cool the water down too fast, but I knew I needed the fan, and I got it. That made a big difference to me.

The other reason home was great was because when my baby actually made her entrance to the world, there were six people already in the room: my husband by my side, my father and sister standing behind me (by my head), my mom and the midwife standing at my feet and myself (obviously!) In a hospital setting you can have any number of people around. In our antenatal class, I remember the teacher telling us that in one scenario (I think c-section) you can have 12 people in the room with you, with only your partner being related to you!

All that said, however, there are some hospitals now days that really do try to recreate that home feeling. I know one hospital that has ‘themed’ rooms with a birth pool and a double bed and a basinet for mommy, daddy and baby to spend the night.  I know another hospital that has ‘budget hotel styled accommodation’ too. So there are those that try to recreate the home feeling with a crash cart outside the door, but generally you’d have to go privately for that kind of service.

To close this section, here are some (loosely gleaned from Made in Water) facts about home births:

Homebirths make for an easier and less painful labour, since the mother is more relaxed. (Remember that fear or anxiety increases adrenalin, which suppresses oxytocin [the hormone that helps the birth progress] and endorphins [the feel good hormone] so that their levels drop, thereby increasing the experience of pain.)

To be slightly graphic, someone wrote how she could not orgasm in front of a room full of people, with bright lights and the sounds of other people screaming.  Giving birth involves much the same process, so how could she be expected to give birth in front of a room full of people, in bright lights and listening to other women screaming?

There is less chance of intervention in a home birth as a woman is allowed to let her body do its thing. Rushing a woman to birth her child is about as effective as, well, rushing her to have an orgasm!

A 1987 National Childbirth Trust (NCT) survey found that nearly 22 percent of women in hospital contracted a postnatal infection, compared with less than 5 percent at home. So a homebirth reduces the chance of infections. And that was before MRSA and Swine Flu!

As I said previously, without drugs there is a greater chance of successful breastfeeding. In most homebirths, if any drugs are available, it would generally only be gas and air (although some GPs might prescribe Pethadine)

Finally, a staggering 99% of women who have experienced both home and hospital birth will say that they would choose to have a home birth in the future, which says it all really.

* Please note that this article has been checked by a registered midwife for accuracy.

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20 thoughts on “Natural homebirth vs. Natural hospital birth

  1. Cady

    This is a great post. It helps me put into words my feelings about why I want a natural birth at home (versus the hospital) this go-round.

    I am wondering, though, could you share any information you have on the post-42 weeks scenario? I was induced at 42 weeks 1 day with my son. I don’t want another induction, but I’m wondering if I will feel comfortable giving myself till 42.5 or 43 or even 44 weeks…. My midwife leaves that call up to me, and says there is a shocking lack of information on the subject and I haven’t begun to dig for any yet.

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  2. I had 3/5 children at home. Would highly recommend it. The last pregnancy I was lucky enough to be able to use an independent midwife after being disappointed that there was not enough midwives on duty to have number four at home.
    I am a private person and liked being able to labour virtually on my own…not be examined, not be monitored and certainly not give birth on a bed. Great post.

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  3. What an interesting post! I’ve got three children and had three very different experiences. My first was a highly medicalised and traumatic birth, my son was in the wrong position and got stuck. Because my first birth was difficult I was told I had to be in hospital for my second, well that labour was very quick and he was nearly born in the car. After that experience I had a homebirth with my daughter, she was born in the living room. It was lovely to have a perfect birth with her and I felt so in control unlike the other experiences. However this was probably because she was my third and I couldn’t have had my first at home. It’s important who you have with you in labour and birth and I’ve learnt it’s very important to have confidence in yourself too.
    .-= Emily O´s last blog ..Hoping and praying our cat has nine lives =-.

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  4. I just wanted to comment about the risks surrounding going past 42 weeks. The data that the NHS uses is over 50 years old, based on post WW2 data of malnourished women still on rations! Today the risks are very different. For example, the risks of stillbirth between 42 and 43 weeks are almost identical to that of the previous week and lower than 38-39 weeks. I did see the figures somewhere a while back but haven’t been able to find them again, sorry.

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    Luschka Reply:

    @Holly, Hi Holly, yeah – I’ve read that research myself. I also read in, I THINK, the same study that there’s a link between lack of spontaneous labour and SIDS – a chemical or something that’s low in the baby. I had a friend who lost her baby (stillbirth) at 42+6 though, and that’s why I would do something if I felt the baby wasn’t moving much anymore. I guess this is really a personal decision, up to every woman. Thanks for stopping by and for sharing your thoughts! I appreciate it!

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    annabel Reply:

    do you have a link to that research by any chance? would love to read it!

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    Luschka Reply:

    Hi Annabel, do you mean the NCT one?

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  5. I love love love reading different opinions on this topic – even though I would never choose a home birth I think it is fascinating. I will say however, that it is important that women visit hospitals, doctors, talk to others who have had experiences in those hospitals.

    I gave birth to my daughter in a hospital and it was an absolutely wonderful experience. It was not bright lights with screaming and tons of people. Toward the end an extra nurse came in who would focus on Prayse, the rest were focused on me. There was one more individual to help my Dr. make sure as she was trying to stop the bleeding (I had a 9lb 2 oz lovey – and I’m quite small) that everything was going well.

    For me personally – I ONLY wanted my husband in the room for family. I even hated that there were people in recovery when I got there. So I do think a lot is personal preference. I only have one experience however – and can never argue with another women’s experience. Thus the fascination :)

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    Luschka Reply:

    @Tiffany, Thanks Tiffany! May I ask why you would never choose a homebirth? I agree though – we can never argue with another woman’s experience, and there are no do-over’s so there’s no point in trying, really! Initially I had only wanted my husband and one midwife in when it came to the actual delivery – all through my pregnancy i had told them they would have to leave. And as it was, they were all asleep, but in the last moments, I was so calm, so collected and so excited, I wanted them all there to witness what birth can look like (especially my sister, so she knew it didn’t have to be like on tv!)

    You’re right though – it’s a totally fascinating area of life, literally!

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  6. Thanks for posting this!
    I think that a lot of women do not know what a truly natural birth is because they birthed in the hospital. I encourage birth classes that are not affiliated with the hospital at all! I find they are most educational.

    Stoppin’ by from SITS!

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    Luschka Reply:

    @Danielle, Absolutely! Our antenatal class was by an independent midwife, and she had nothing to gain either way. It was really good! I agree – any intervention is really no longer natural, but at least we can aim for degrees of naturality. Glad you enjoyed the post. I hope you like the rest of the series!

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  7. I think you really need to check into the hospital policies if you’re wanting to have any say it how the birth goes. I was terribly misinformed by the Lamaze class that took place in the hospital that I gave birth in. I thought I would be permitted to walk around for instance, instead I had to fake needing to go to the bathroom to be permitted out of bed. If I’d have known then what I know now, I would have gone somewhere different!

    You’re posts are really great on this topic – provides a lot of great info for an expectant mom trying to decide what type of facility to use.

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    Luschka Reply:

    @Joey, Thanks Joey! That’s exactly what I’m hoping to achieve with these posts… succint information for moms to be (or be again). I’m glad you’re enjoying it!

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  8. I think it depends quite a bit on the individual hospital’s policies, too. There are numerous hospitals local to me – I’ve spoken with women who gave birth in one or more of them – and the experiences had by birthing women in each were vastly different. I planned to give birth in a birth center but went into premature labor so was shuttled off to the hospital. I was terrified! I had yet to take a birth class and had never even been in the hospital. But my midwife was there with me, the OB on call popped her head in once to ask if I wanted drugs and left when I said no, there was a nurse in the room (but she stayed in a corner not saying much), and thankfully it was not a teaching hospital, so no one else came in until the end, when nurses from the NICU set up the warming tray and readied the oxygen and such (which thankfully wasn’t needed). Like I said, I’d planned on a birth center birth, possibly a home birth if certain policies had been adopted at the birth center, but I can’t say I found my hospital birth unpleasant. No one pushed interventions on me or tried to pressure me into anything.

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    Luschka Reply:

    @Christa, Thanks for sharing your experience. You are absolutely correct. It depends not just on the hospital, but on the specific Ob, Midwife etc on duty. I’ve heard good and bad things about the same hospitals local to me, and it’s generally down to the staff, or how busy the hospital is on that day (i.e. how stressed those staff are!). It doesn’t even seem to make a difference if it’s private or not, but yes, teaching hospitals will normally have more people in attendance (which was a big no no for me).

    But you won’t know till you get there what you’re going to get, which is why I prefered a home birth as you have slightly more ‘say’, less opportunity for pressure, and more moral support from your birth partner and whoever else you choose to have around.

    I’m glad you had a good birth. That’s such a gift to treasure. Thanks for stopping by!

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