Bug = 1 year 9 months 7 days
Bub = due in 48 days
I mentioned in passing in a recent post that I’d decided to have a home birth this time around, so I thought I’d better give some more background on that decision.
Last Time Around

I don’t think I considered for a second having a home birth with Bug. I faintly remember the midwife asking where I planned to give birth, and I probably said “Here [the hospital], I guess!”. Home birth wasn’t mentioned as an option in our antenatal classes, except in the context of what to do if the birth happened before we had a chance to get to hospital.
So Why This Time?
When I mention that I’m having a home birth, many people (who know about Bug’s birth) assume that the speed of Bug’s birth is the driving reason for my decision. However, this is not the case.
La Leche League
My heavy involvement in La Leche League (LLL) is probably the first influence in the decision. LLL doesn’t specifically advocate home birth, but one of its core philosophies is:
“Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.”
“Active birth” is a birth philosophy commonly mentioned in LLL materials.
However in early 2007 I was still not convinced that home birth would be the way to go for me – I described myself as 60:40 for hospital versus home birth. It’s in my nature to have great trust in and respect for authority and professionals, and my experience of a hospital birth had been very positive (although obviously I had no comparison).
Diane Wiessinger
The second and strongest influence in my decision came in April this year when I went to the LLLNZ 2007 National Conference in Christchurch. The keynote speaker at this conference was Diane Wiessinger, an American lactation consultant with a background in evolutionary biology.
Her keynote speech was focused on the natural behaviours of (non-human) mammals in relation to birth. The points that stuck out for me were:
- Farmers, vets, and other professionals who are experts in dealing with animals know that the best way to let a horse, sheep, dog, etc. give birth is to leave them alone wherever they are safe and comfortable and let them get on with it.
- No matter how “home-like” an environment attempts to be, whether it’s a cold, clinical hospital or a romantically lit, super-comfortable birthing centre, it is not your home, and your body knows that. Diane uses the example of being being on a wonderful, fun holiday in a blissfully comfortable and relaxing environment, but in spite of this still finding that you spend the entire holiday constipated because your body – while happy – isn’t at home.
- When people first compare home and hospital births, it’s easy to think of them as equivalent, but with more “safety measures” there for a hospital birth “just in case”. But the two are not equivalent: even in the most modern hospitals that are supportive of “natural” birth, the very fact that they provide easy accessibility to interventions, pain relief drugs, anaesthetists, etc. has a powerful psychological effect on everyone involved in the process. (While making use of these measures is obviously useful or necessary in some cases, they can all have short- and long-term effects on the mother, the baby, and their relationship.)
- There are risks associated with home births, but official parties giving advice find it too easy to use that as an excuse to recommend against them in spite of the benefits that such births also offer. Compare this to driving cars, which is a much riskier activity, but we all acknowledge the “need” to drive, so we do all we reasonably can to research, legislate and educate to minimise the risks. (This is exactly the same point that had already occurred to me about bed-sharing: why not advise the public of its benefits and how to do it safely, rather than tar all bed-sharing with the same brush and recommend against it?!?! We don’t tell parents not to drive children anywhere – we tell them not to drive drunk or tired, and to use approved child restraints at all times. Yet after medical causes, transport is the biggest cause of death for 1- to 19-year-olds in New Zealand.)
The overall effect of the presentation was to impress upon me the fact that birth is a natural process that has been going on for thousands of years, and in most cases (where there aren’t complications such as multiple babies or a baby in a breech position) with a positive outcome – and doctors and hospitals haven’t had to be involved in the process at all.
Diane’s speech tipped the balance, and after it I knew that I would prefer a home birth for my next time around.
Home Birth Association
Since my decision to have a home birth, I’ve joined the Dunedin Home Birth Association, so while this organisation didn’t influence my initial decision, it now plays an important role in supporting that decision by providing education and contacts. It’s encouraging to meet people who have had positive, problem-free births in their own homes with their whole families – including their older children – around them. It’s a side of birth that you don’t get exposed to in mainstream childbirth education, even though 5-10% of births probably take place at home (more info on the NZHIS website).
Choices in Dunedin
For some people who aren’t comfortable in hospitals or with the medicalisation of childbirth, there is the option of choosing a primary maternity facility as the venue for your birth. These facilities are often called “birthing centres”, and it’s my understanding that they offer the focused care that hospital staff would offer, but without all the trappings – positive and negative – of a hospital (such as doctors and operating theatres) and – in general – with a stronger focus on low intervention, family involvement, and home-like facilities and decor.
Unfortunately in Dunedin, mothers don’t have this option. Their choice is between home or hospital. I guess it’s the downside of being lucky enough to have a big, teaching hospital in the city.
(I’m not an expert on these facilities and the distinctions between primary, secondary and tertiary medical facilities in New Zealand. The best reference I could find after a quick Google was on the NZ College of Midwives website, and that’s still pretty brief! Anyone other references on the subject – in the context of healthcare in general, not just birth – would be interesting.)
What If…?

What if I didn’t live just 10 minutes from a large, tertiary public hospital?
What if my birth experience last time hadn’t been as smooth as it was?
What if I was giving birth for the first time but with my current level of knowledge?
Would my decision be the same?
I really don’t know. I’m glad I’m not in any of those positions.
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