Until the eighth month of my pregnancy, I hadn’t even considered a home birth. I wasn’t anti them – several friends had given birth at home and raved about the lack of a bumpy, excruciating commute to hospital, thrilled that they could get into their own beds moments after delivering. It was just that I gravitated towards the security that a medical setting promised.
But now, approaching D-Day for the second time, but with the spectre of coronavirus ramping up, I reconsidered. I already hadn’t been allowed to bring my partner in for scans, and I hadn’t seen a midwife until I was seven months pregnant (asking me at that stage if I felt mentally sound felt slightly redundant). So, the thought of picking up the virus in hospital, or my partner not being able to be there for all of the birth, or generally the heightened nervousness I now have around leaving my house, nudged me into the decision to do it at home. As soon as I made the booking, I felt a huge wave of relief. It’s been a particularly strange time to be pregnant, where I’ve often felt fearful and anxious and uncared for by an overstretched medical system. In opting for a home birth, I felt like I was making a decision for myself.
It seems I’m not the only one: my dedicated home-birth midwife says that bookings with her team have hugely increased since the pandemic, something that I’ve heard anecdotally, but that official statistics can’t yet confirm. Anna Clarkson, who goes by the Instagram handle @HackneyHypnobirthing, agrees: “I’ve definitely noticed a huge increase in women and birthing people choosing to have a home birth, particularly during the pandemic. People are understandably anxious, but also it’s the only way you can guarantee all the people from birthing partners to doulas that you want present, plus all your creature comforts.”
It is a scary decision to cut the umbilical cord between you and the hospital and all the shiny machinery and doctors that lie within. “What if…” has absolutely gone through my mind multiple times. Horror stories surrounding difficult births and near-death experiences are inescapable. But statistics are on the side of the home birth squad – provided, of course, that you’re low risk. In April a report published in The Lancet medical journal found that out of half a million women around the world who had home births, 40 per cent were less likely to need a caesarean, 50 per cent were less likely to have an instrumental birth, 55 per cent were less likely to have an episiotomy (an incision made in the perineum to avoid tearing), 40 per cent were less likely to have a third or fourth degree tear and 75 per cent were less likely to contract an infection. It followed on from a report last year that low-risk pregnant women who give birth at home had no increased chance of the baby’s perinatal or neonatal death compared to having their babies in a hospital.
Planning to have a home birth, in my specific situation, also seemed wise. As this is my second pregnancy, I am considered less at risk of birthing complications, plus, second babies often come quickly, increasing the odds of an accidental home birth or, worse, giving birth in the hospital car park – as has happened to several friends of mine.
There are other, more insidious reasons why women are choosing a home birth. Earlier this year the actor Jodie Turner-Smith wrote movingly in British Vogue about her choice to have a home birth, saying that the primary reason centred around “negative birth outcomes for Black women in America”.
It’s something Tinuke Awe feels is applicable to the UK, too, which is why she intended to have a home birth with her second child in London. Tinuke is a co-founder of the #FiveXMore campaign, which aims to raise awareness about Black women being five times more likely to die in childbirth than white women. “I launched the campaign in part because of my own negative experience in hospital when I had my first baby,” she says. “I was diagnosed with preeclampsia very late, then I was induced and felt that I wasn’t listened to when I said I was in labour. I wasn’t given pain relief, and then I ended up having my son with forceps delivery, with his heart rate plummeting. It was scary, exhausting and not something I wanted to repeat. Added to this my worries about Covid, and I thought a home birth for my daughter would be a better option.”
In the end, she gave birth to her daughter in hospital, and “had a really positive experience – in part because I was armed with better knowledge from the campaign”. But, she says that lots of other Black women are considering home births now. “The thought of being in your home gives you an element of control,” she says.
Like me, Tinuke says that she hadn’t really thought about having a home birth for her first child. “It wasn’t something I ever discussed with the midwife, and it plays into the same narrative about women not really knowing their rights and what all of their options are when they are giving birth.” This knowledge gap is something Anna Clarkson comes across a lot. “I don’t think the majority of us realise that home birth is an option for so many of us, or indeed that with prior arrangement you can have quite a few of the pain relief measures available in hospital,” she says.
There are some considerations, namely hiring or buying a pool (both options can set you back around £150 to £200). I left it quite late and many places are already sold out, but luckily I managed to rent one from Birth Pool In A Box. I’m collecting my pool this weekend and planning a practice run getting it up and in position. Then there are liners, connectors, towels… but it’s all manageable, and my midwife has told me exactly what I need. The cost for the NHS, however, is less – home births add up to about £600 less than a hospital birth per person, according to a 2012 study.
There are complications thrown up due to Covid – the Royal College of Midwives cautions that some services were and could still be affected. “Some services had to take the very difficult decision to suspend home births, because of staffing and the availability of ambulances should you need to be transferred to hospital,” says Birte Harlev-Lam, executive director for professional leadership at the Royal College of Midwives. But she recommends contacting your local Trust for more details.
Giving birth to a baby is already a deeply primal experience, and however you do it – as it’s not always a choice – is only a tiny part of the huge picture of the subsequent experience of motherhood. Everyone is different, and everyone’s health is different. But for me, planning to stay safe and warm in my cave feels like the right decision, right now.