Home births are not just more 'natural' but also could save NHS Highland ‘a fortune’
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Home births for women who are expected to have low risk labour experience is not just better for the mother and child but could also save the NHS “a fortune.”
That is the view of Sheila Macdonald, who spent 29 years as a midwife followed by another 12 years working in hypnobirthing helping women deliver children.
The Courier asked Mrs Macdonald her views after the suspension of the home birthing service in Inverness due to staff shortages.
She believes that the primary benefits of home births – often combined with hypnobirthing techniques – are that it is a more natural and positive experience for the mother and child.
Hypnobirthing is when women in labour use practised methods that include using deep breathing, relaxation, visualisation, and affirmation or hypnosis scripts in a bid to replace a negative, painful labour and delivery with a positive and confident one.
But she also noted that instead of seeing women transferred to hospital by ambulance and tended by a full medical team giving birth at home could reduce the burden on the NHS.
Underlining that point, Mrs Macdonald said clearly for complex births should be in hospital but for those with a low risk of complications a home birth is a serious consideration – and this is supported by the evidence.
Mrs Macdonald said: “It would save them a fortune in terms of bed spaces, staff, everything. But it absolutely depends on whether it will be a complex birth or not. Women are rated when they come in for a booking.
“Depending on their past obstetric history, their medical history, their social history so we would see then if we expected them to low risk, medium risk or if they are high risk and if they are high risk then they are not just seen by the community nurse but also the consultant.”
Mrs Macdonald believes that the benefits of home births is that it places the mother in control and avoids what she called a "cascade" of medical interventions.
“Pregnancy is an altered state of health – it is not an illness. And for the vast majority of women they should be able to birth without medical intervention," she said.
“When you think of it is one of the vulnerable times in a mother’s life and she is then forced into a clinical environment which is not conducive to the natural progression of labour.
“The home feels safe to a woman so she will naturally labour in that environment. But in Raigmore the rooms are like cell blocks, honestly: there is a room and a chair and medical equipment, we don’t even have an en suite toilet.
“The clinical environment is not conducive, labour should be instinctive not prescriptive – women shouldn’t be told what to do and they should be allowed to express themselves.
“But in that hospital setting the vulnerability leads to a loss of empowerment and that loss of control is handed over to the professionals and what happens then is a woman’s self-belief and trust in her own body starts to dissipate and it interrupts the normal physiological process.
“She is not then meeting the time requirements that the staff want her to and beds need to be released for other women that then leads to cascade of unnecessary interventions – as in we start to do things to speed up the labour.”
She added: “So for women who are low risk, it is not safer to be in an obstetric unit when the evidence shows that is not the case. It is fundamentally more natural to give birth at home.”
