Having your baby at home can be a viable option

Press, 16 July 1987, Page 16

Having your baby at home can be a viable option

CHILD-BIRTH CHOICES >

PARENTS URVIVAL GUIDE

by

MAVIS AIREY

Home birth is still only an option for people who are determined, says Maria Ware, one of Christchurch’s three domiciliary midwives. She still finds a lot of resistance from doctors and obstetricians, and many women find it difficult to get sufficient information to make a genuine choice about how they want to have their baby. "The doctors say home birth is not safe. They say they have got all the technology, the equipment, the staff at hospital, therefore it must be safer. I used to agree with them until I looked at my own hospital experience.” Maria Ware is a com-

prehensive nurse, and did her advanced diploma in midwifery in Wellington before working at various hospitals in Edinburgh, Auckland, Wellington, and the West Coast. “I could see that some of the interventions, such as forceps and Caesarian deliveries, come about through mismanagement. Sometimes it’s gross mismanagement, but sometimes it’s just because the hospital is geared to the greatest good of the greatest number, not the needs of the individual,” she believes.

“They intervene ‘just in case’.” The safety issue is assuming huge proportions — to the detriment

of normal childbirth. The technology is wonderful when we need it, but people are losing the ability to recognise the normal and understand it” So is home birth safe?

“Birth is a life process and that in itself is not safe,” she points out. “Some women still die in childbirth — most as a result of anaesthetics for Caesarian sections — and you can never guarantee the outcome for the baby,” she admits. “But I do believe for normal situations, home birth has advantages over the hospital situations. “Psychological factors play a much bigger part than I would have believed until I saw it. Women at home have faith in their own ability. Because I’m not going to give them any drugs, they know it’s up to them to do it — with amazing results.”

Woman wanting home births have to be screened — they must be completely healthy and so must their pregnancy. A general practitioner is needed legally to cover a pregnancy and birth — an issue Maria also feels strongly about. There are about a dozen sympathetic G.P.s now in Christchurch to whom they refer women.

Although she agrees that statistically there are more problems with first births, she believes the

main difficulties are with long labours, and she finds fewer occur at home.

She is sure this is because the women are up and about, having a bath or a massage, or taking a walk rather than watching the clock at a hospital.

If a home birth labour does go on a long time, the woman is transferred to hospital, where epidural injections and drugs can be very useful, she agrees. First-time women are often booked in to hospital “just in case.”

“If a woman really needs pain relief she needs to be in hospital,” she agrees. The domiciliary midwives take their own informal ante-natal classes, and visit people’s homes several times before the birth. This they find very valuable. “We are on the couple’s territory and they can see we’re there as facilitators, not to tell them what to do.”

This she compares with the hospital situation where the .pregnant woman may well feel to vulnerable and eager too do the right thing for her baby and to be as assertive as she would like.

Maria finds it is quite common for a woman to be keen on a home birth while her partner has reservations, but most come round to the idea. “I think it’s the sense of

responsibility. We’re not used to the cataclysmic life events like birth and death happening in the home.” After the birth, the midwife will stay until the woman is happy, the baby has gone to the breast, and the blood loss has diminished. Then she will visit daily for two weeks, longer if necessary. The domiciliary midwives are under contract to the Department of Health, so there is theoretically no extra cost in having a home birth, but the midwives’ salaries are much lower than what they would be earning in hospital, while their responsibilities are triple, Maria says. So the Home Birth Association with which she is associated asks for a donation of $5O to help buy equipment such as telepagers, oxygen cylinders, and baby resuscitators as well as to pay for a newsletter.

Maria is happy for people to call her and discuss any matter, whether they are considering a home birth or not

“I think women need midwives regardless of where they have their babies. G.P.s are not the people to go to for bits and pieces of advice and reassurance. I would like to see midwives with clinics in the district.”

She says she wants choice for women, and women making that choice, not just doing what they are told.