Home or Hospital – What does
‘safe’ really mean?
Almost as soon as you announce your pregnancy, people start asking you where you’re going to have your baby.
If they’re particularly thoughtless they’ll also regale you with horror stories about their own birth experiences as well as the traumas of various friends, relations and even women they’ve never met.
The media thrive on uproar and positively trip over their own feet to publish plenty of stories of overly dramatic home and hospital births to the point that you wonder if anywhere is truly safe to give birth.
SAFE – there’s the word this article will focus on to help you find your way in making a decision on where to give birth.
So, let’s sort out what ‘safe’ means in the context of choosing where and how to give birth.
What I’m not talking about are the statistical percentages that are bandied about by the media in terms of whether it’s safer to give birth at home or in hospital; the numerical chances of mother and child dying or being damaged by birth in either environment.
It’s so much more basic and fundamental than that.
OK, here’s the science bit:
Giving birth is a primal, instinctive physiological process that’s been going on for millions of years.
The oldest and most primitive parts of the brain are engaged during the birth process.
But we’re modern human women; do we need to think about using the primal part of our brain when we give birth?
In a word – YES!
Accessing the primal part of the brain is the beginning of what makes any woman feel ‘safe’ when she gives birth.
The old instincts cannot be ignored.
A woman needs privacy, darkness, quiet and a feeling of not being unduly observed when giving birth. Only then can her body’s innate knowledge and instinct take over and get on with the job of bringing forth a new life.
And I know this doesn’t sound very different from the needs of a mother bear looking for a den in which to birth her cubs, but, at the crux of it, the human primal brain isn’t so very different from that of any other mammal.
So, the first thing to ask yourself is:
“Do my instincts tell me to birth my baby at home or in hospital?
Your reflexive answer, your gut instinct is your starting point for deciding where to give birth.
But, we’re modern hominids so it isn’t quite that simple. Let’s face it, when is anything ever simple in our complex world of noise, lights and technology?
Part of the difficulty in accessing the primal part of our brains is that the modern human’s thinking part of the brain – the neo-cortex – gets in the way.
The neo-cortex houses our higher brain functions. It’s where we process ideas and thoughts that become the source of our complex worries, fears, irrationalities and justifications. It’s the basis of our myriad beliefs, attitudes, fears, hopes and dreams.
It doesn’t have an off switch.
The best anyone can hope to do is damp down the neo-cortex and stop it running amok. Running amok usually entails any thought process that begins with ‘What if’?
For birthing women, being a mother bear in a den is a very good way of beginning to damp down the neo-cortex.
But, what do we do about all the ‘What if’ issues?
They can have a hugely negative impact on birth because they can prevent a woman from accessing her primal brain. What happens when the neo-cortex is ‘worrying’ is that adrenaline levels are running high and the ‘fear, flight or fight’ mechanism is in full swing.
Adrenaline affects birth by slowing it down or even putting a stop to it. It’s a safety mechanism from long, long ago – in those days if Tyrannosaurus Rex showed up just as you were starting to give birth, adrenaline would put a stop to things so you could waddle off to a safer cave.
(Personally, I wouldn’t rate the survival chances of Tyrannosaurus Rex when faced with a very irate, hugely pregnant woman armed with a club, but that’s another story....)
Nowadays, Tyrannosaurus Rex may manifest in the form of a car ride to hospital, loud voices, noise, bright lights, not knowing what will happen next, being disturbed, power and control being taken out of your hands.
The result is the same – birth will slow down or stop because age old defensive instincts take over when a pregnant woman doesn’t feel safe.
Knowledge is power.
A cliché, I grant you, but nevertheless true.
The fact remains that when you have information that enables you understand the why, how and where; that enables you to have a voice in what may affect you directly; that affords you the right to take responsibility for your own body; that enables you to make informed choices – these things are very powerful in alleviating fear and making one feel safe.
So, it seems that the key to feeling safe is to become informed.
And, yes, there is a scarily huge amount of information to absorb and a mountain of decisions to make about where and how to give birth.
So, find reliable people to help you, scour the internet, read books.
Ask your midwife or obstetrician; get a doula; ask women whose opinions you can trust. As soon as anyone starts with the horror stories or tells you that what you need isn’t allowed, walk away.
Now, what do you do with all this knowledge and information you’ve accumulated?
How do you translate it into choices and decisions?
The solution is surprisingly straightforward – you question it.
There is nothing wrong with questioning information you are given. You are not showing a lack of trust in the giver’s honesty or integrity in any way. You are looking at how best to utilise given information in order to make decisions that meet your personal and individual needs and make you feel ‘safe’.
It can help to have a format for questioning information. This one is probably one of the better known ones:
Having made all your choices and decisions, it can be helpful to pick out the ‘non-negotiables’.
Non-negotiables are exactly what it says on the tin.
These are the birthing choices and decisions that are so important to you that, except when there is a true medical need or emergency, you will not be swayed from them.
They are the profound choices and decisions that make you feel ‘safe’.
I can’t tell you what your non-negotiables are or ought to be. Nor can anyone else for that matter. Only you can do that.
I can tell you that most birth preferences tend to focus on where to have your baby, who should be present, comfort measures and what routine interventions are acceptable or not. But, every birthing mum has preferences that are unique to her and you are no different.
What about communicating your decisions to others?
As some one once said, opinions are like bums – we all have one.
And, unfortunately, like some bums, some opinions disgorge more c%*p than others, but such is life
To stay with the more earthy analogies, just as we all wipe our bums, sometimes we also need to wipe our beliefs of the c%*p we accumulate there too.
But, moving away from the toilet humour....
As with all decisions, no matter what you decide, there will always be people who disagree with you. This is just another reason to be informed; it’s far more difficult for others to make you feel your choices are ‘wrong’ or to put you down if you are knowledgeable.
For reasons I’ve never understood, many people speak to parents-to-be and, in particular, to pregnant women as though said pregnant women suddenly regressed into six year olds.
However, if this happens to you, all is not lost.
The art, no matter what happens, is to refuse to be treated like a child.
You are a fully grown adult with all your intellectual faculties and you are as capable of making your own choices as anyone else.
Be assertive!
Be polite whenever possible, but refuse to be spoken to in any way that undermines your status as an adult.
If someone persists in attempting to treat you like a child, calmly state you will not tolerate further harassment and leave.
You don’t even need to stand your ground in an argument. The point is that there is no argument. You are in charge and things will be as you decide. End of.
It really is as simple as that but you have to be prepared to stand your ground.
Remember the rights of informed consent – and if you don’t then read my article – ‘Am I Allowed?’
Fear of the unknown and loss of power and control in any situation can be very traumatic. For birthing women, loss of safety because of fear is known to cause trauma that can affect the mother and child relationship forever.
Above all, there are no ‘rights’ and ‘wrongs’ in deciding where and how to birth your baby.
There is only making choices that are right for you and yours.
And just in case you were wondering about the percentages:
If you live in the UK and you’re having a low risk pregnancy then birthing at home is AS safe as birthing in hospital for you and your baby.
That’s what reliable UK based research says despite what the press is throwing at us currently.
Useful links:
Kath Harbisher is a Birth & Postnatal Doula serving parents across South Wales, UK.
If you have any queries or comments about this article please contact Kath via her website.
Contact Me at The Doula Effect
Copyright © Kath Harbisher 2010. All rights reserved.
Disclaimer: None of my articles are intended to replace the advice or care of qualified health professionals
