Just another thing that is naively reduced to a simple matter of sensible, right-minded people versus yoghurt knitters without actually looking at the facts.
Melanie Reid of The Times telling us that hospitals are the best places to give birth, because she says so.
“When a pregnant woman announces that she intends to have her baby at home, surrounded by friends and family, I always have an irresistible impulse to glance down and check if she's wearing sandals. She usually is. Disgraceful stereotyping it may be...”
Disgraceful. A bit like when I assume that a mainstream media journalist is going to be so self-opinionated as to damage the integrity and logic of her own written argument, Melanie.
“...but it is impossible to deny that home births are the preserve of homely, principled types who may then go on to breastfeed their child until it goes to secondary school.”
As opposed to those other, less principled women women who let their children spray paint old ladies’ houses, swear at teachers and stab each other with Stanley knives. Tut.
“When your average hard-working, aspirational woman becomes pregnant, she is no more likely to plan to give birth in her bedroom than she is to forego her maternity pay or ask her partner to video the event and post it on the net.”
Ahahaha. Well, Melanie – here’s the thing; this hard-working, aspirational woman – not to mention the other, hard-working, aspirational women she knows, is sensible enough to realise that a birth in an average NHS hospital is not a particularly desirable event either. If I received maternity pay, which, having my own business, I do not, I would gladly spend it on an alternative to Stafford General if necessary.
“That's because we're British.”
What? Do I sense an essence of Gordon Brown and his mythical "values" here? You might be British, and so might I, Melanie, but I can assure you that other than the country in which we were born and our gender, it appears that you and I have very little else in common.
“We are hardwired to go to hospital and have our babies there. It's what we do. It's in our modern DNA.”
As this sentence goes to show. Melanie, it doesn’t matter what country we live in, or what century: we are hardwired to give birth in private, in an environment where we feel completely safe and in control. Wherever that might be. It's in our DNA.
“We do so because experience tells us it's safe, it's reliable and, apart from anything else, it is a chance to have a rest and let someone else look after the mess for a change.”
Well, actually, experience tells us that for most women, birth is horrible, gruesome, painful, dreadful event, normally involving cutting, mechanical instruments and/or serious surgery. And most of those women give birth in an average NHS hospital. Although maybe, Melanie, you think it’s a break from the mess to see someone else’s blood on the walls and the instruments that are used during labour, rather than your own. Which is a novel way of looking at it.
“Accordingly, only 2.7 per cent of births in England and Wales are at home. In Scotland the numbers are so small the statisticians don't even have a definitive official category for them, and in Northern Ireland the rate of home birth struggles in at about 0.33 per cent.”
And yet if you research those women, you will find that not only were their perceptions of birth (and subsequent assessment of postnatal mental health) incredibly positive, they also had far lower incidences of episiotomies, assisted deliveries and caesarean sections, all of which carry varying degrees of risk for the health and wellbeing of the mother and the child. Because the last think you need with a mewling newborn is a great big gash across your stomach or your genitals, if at all you can avoid it.
"Plainly there is something cultural at work here."
Plainly. Despite all of us enjoying excellent 21st century sanitation, nutrition, and access to ongoing antenatal care and emergency medical treatment without having to live in a hospital or sterile bubble, we now live in a culture that is riddled with self-serving expertise presiding over every aspect of our lives. We are absolutely obsessed with risk to the point that pregnant women feel a sense of entitlement that excuses them from participating in life itself from the moment of conception. Giving birth – something that should be, in most cases, utterly straightforward given our generally excellent standard of living - has now been bestowed the status of serious, life-threatening illness and treated as such. Hmmm. Who would benefit from that, I wonder?
"The figures are cast into startling perspective by research this week from the Netherlands, where around a third of all women choose home births. Here, in the largest study of its kind undertaken, researchers have revealed that women in the “low-risk” category who gave birth at home were just as safe as those who did so in hospital."
Right, okay. So women with low-risk pregnancies and their babies are no more likely to die at home than they are in hospital. Glad we got that sorted. We’ll refer back to it.
"In other words, home delivery - if we may steal the expression back from the age of internet shopping - is as lacking in danger for the large majority as giving birth in hospital is."
Because of course, Melanie, we know that now we are in the 21st century that automatically means that technology is always The Best Solution, whether we are ensuring that children are kept safe in the form of the wonderful ContactPoint, marking students’ exam papers, or driving people’s cars for them because they can’t be trusted not to speed.
"One can detect something of an undercurrent here. In the UK, the Government is making noises about home birth becoming more available. In 2002 Wales - the only place to set targets - asked maternity services to aspire to a 10 per cent home-birth rate by 2007 (they're nowhere near it). All government policy and advice literature dutifully puts midwife-supported home birth as the No1 option."
Yes, it is a bit silly to be so dogmatic, isn’t it? About as silly as claiming that all women should go to hospital to have their babies because that’s what they are "hardwired" to do -or is it just that you have automatically appointed yourself spokeswoman because you're so superior to the rest of us?
"The question, really, is whether this is a road we want to go down: and in particular to be encouraged down it by the Dutch, who one suspects are evangelising. In France and Belgium, it should be pointed out, just like America and most other sensible parts of the developed world, there is a relatively stable home-birth rate of about 0.6 per cent. In other words, women in the Netherlands are at odds with the mass female consensus everywhere else, which is that hospital is where they want to be during childbirth."
No, of course we don’t want to be going down a road that forces anybody to give birth in a specific location that is contrary to their will. That would be disgustingly authoritarian, wouldn't it? The road we want to be going down is one that ensures that women have their babies in an environment that is actually conducive to giving birth. Ask a woman if she wants to give birth in a hospital and she might well say yes (especially if she reads an article like this). Ask a woman if she expects that birth will be horrific, and she will also say yes. Unless, of course, she has some inkling of the environment required to give birth effectively, and access to it.
"So let's stay in the real world. Frankly, it doesn't matter how safe home deliveries are proven to be."
Well, seeing as that’s the argument upon which your entire article hinges, it does matter just a little bit, actually. Because if home births are as safe as a hospital births, and yet the outcomes are actually much better than those of hospitals (in terms of episiotomies, assisted deliveries and caesareans) then maybe, just maybe, hospitals could learn something from the principles of home births? Maybe, Melanie?
"It doesn't matter how much the NCT bangs on about the spiritual, emotional and practical virtues of home birth (we all know the guilt they have inflicted on women over breast feeding; ditto the avoidance of Caesareans, in much the same way)."
Damn right that no woman should be made to feel guilty for any reasoned decision she makes in relation to birthing and feeding her baby – that would be despicable. Remember that, Melanie. What is unacceptable is women who are forced into formula feeding and surgical or other interventions against their will by so-called experts who are working to agendas other than ensuring the best interests of the mother and child.
"We should resist any pressure to turn childbirth into a fashion. Home births may be fine for the tiny minority that want them - no woman should be denied the choice - but for the vast majority of us the only intelligent, progressive, logical place to give birth is within shouting distance of the benefits of 21st-century medicine."
Melanie, you just don’t get it, do you? For all of us, the only intelligent, progressive, logical place to give birth is somewhere safe, clean, private, respectful and understanding.
"This is not about encouraging the unnecessary medicalisation of a perfectly natural condition, nor is it about losing control to nasty male doctors: this is about quashing the entirely whimsical, perverse idea that we should turn our backs on modern medicine's starring role in safe childbirth."
Childbirth has already been unnecessarily medicalised – no further encouragement is needed. Everyone has already been brainwashed into seeing the hospital, and not the environment, as the be-all and end-all of labour. From the moment a perfectly healthy, labouring woman walks into a labour ward and a fetal monitor is strapped onto her stomach in lieu of a well-trained and experienced midwife who is far more able to assess the health of an unborn baby than a piece of equipment, technocrats and medical experts (whether male or female) rule OK.
Coercion is commonplace and intervention is not confined to medical necessity - it is rampantly widespread for the convenience and efficiency of hospitals and professionals, as well as (self-defeating) minimisation of statistically insiginificant risk. Not just prevention of actual harm.
"British women are, on the whole, conventional, sensible, unflamboyant types."
Unless of course you listen to your colleagues in The Times’ Style magazine, in which case British women are unconventional, quirky and eclectic.
"We wish to give birth safely and quietly in hospital with as little fuss as possible."
No, we wish to give birth safely and effectively. That is all.
"How utterly spoilt some women are, how complacent, that they think they can manage without wonderful things like blood transfusions, anaesthetic, surgery, antiseptic techniques and obstetric technology, which, in a century, a blink of an eye for womankind, reduced maternal and infant mortality almost to zero."
How utterly illogical and stupid some women are, to use wholly contradictory arguments in the very same article for the sake of superficially compelling rhetoric. Really, I don’t know why we don’t all live in hospitals, because sooner or later a few of us are going to have a heart attack or a stroke. We’re so spoilt and complacent.
Melanie, the rates of maternal and infant mortality are reduced whether one gives birth in hospital or outside of hospital, because we all enjoy fantastically high standards of cleanliness, nutrition and standard, risk managing medical care as a matter of course. Giving birth at home is no more dangerous than giving birth in hospital – as you yourself have just stated, and as the research (and other research) has shown.
In which case, not having such speedy access to emergency treatment as a woman who is already in hospital is clearly countered by the fact that the woman who gives birth in an environment more conducive to giving birth is far less likely to need such emergency treatment in the first place. Unhelpful hospital protocols and procedures often cause the nasty complications they then are required to treat.
"If nothing else, we owe it to those millions of women, who over thousands of years died or lost their babies from infection and puerperal fever, from breech births and haemorrhage, to take advantage of every last damn thing a hospital can offer."
Ah, the unwarranted guilt, from one woman to another - thanks for that!
Melanie – you know those things you just listed? Well they are, in the main, things that constitute a high risk birth – you know, not a low-risk birth. The kind of birth that would never be considered for a home birth anyway. The kind of birth that any sane person would happily go to hospital for. For goodness’ sake, you absolute moron.
Really, this argument has nothing to do with hospitals and homes and everything to do with ensuring an appropriate environment for giving birth – this is really what improves outcomes for new families. No person is spoilt and complacent for choosing any alternative to being treated without a modicum of care and respect; being berated and subjugated for being scared and in pain; being unnecessarily physically restrained; having their labour time-limited; having no privacy or control; being starved because of protocol; unnecessarily cut, sliced, butchered and stitched; having instruments forced into her vagina for no reason other than hospital protocol, being exposed to utter filth, other people’s germs and bacteria, as well as their bodily fluids. This is abusive, it leads to long, painful (or stopped) labours which then require further medical intervention, and it is the experience of many women who give birth in hospitals. Unless you’re lucky, or you can afford to pay twice - for the NHS and private healthcare.
I could go to my local hospital, a place where many people enter but far fewer leave than ought; or I could stay in my nice, clean home, eating, drinking and moving around at will with just my partner and a midwife; one who has safely delivered thousands of babies in all manner of settings and knows what a healthy, normal labour looks and sounds like. I have complete control and I will not be treated like an animal. I can watch TV, listen to music and surf the internet. The hospital is down the road in case of emergency, and our shiny new car is big and fast. I might want pain relief, but (because of NHS protocol) I shall do without. Not because I think it will make for a spiritual experience, but because I know what happened last time in hospital, even with it.
The safest place for me to have my baby is the place where I feel safest; until there is a sea change in NHS maternity care (or possibly privatisation), that’s not my local hospital.
By the way, Melanie, they’re not sandals, they’re Jimmy Choos.
