Identifying the poisonous gases seeping into the coal mine : what women seek to avoid in choosing to give birth at home

In this chapter we review the literature on the medical interventions women are seeking to avoid by choosing to give birth at home. We also report on some of the results of the National Homebirth Survey (NHBS) undertaken in Australia. The literature review revealed that women who choose homebirth are mostly seeking to avoid: caesarean, pain relief medication, induction and augmentation of labour, foetal monitoring and vaginal examinations. Over 1400 Australian women completed the NHBS survey in 2016. While the majority of women said they would prefer to give birth at home with a registered midwife, more than half said they would give birth without a registered midwife or find an unregistered birthworker (UBW) if a midwife was unavailable. Women reported choosing to give birth at home to avoid specific medical interventions such as induction of labour, forceps and episiotomy. Women were also avoiding time pressure, the hospital environment, the risk agenda of the hospital, hospital policies and coercion. Homebirth was chosen because it gave women access to continuity of midwifery care and uninterrupted skin-to-skin contact with their baby. Women’s previous hospital experience(s) were reported as traumatic by 49% of the women surveyed and 9% reported a diagnosis of post-traumatic stress disorder (PTSD) following a traumatic hospital birth. In contrast, only 6% of women considered their homebirth experience to be traumatic and 1% reported having a diagnosis of PTSD. The majority of these were associated with how they were treated when transferred in labour.