The Ideal Birth

Do you ever wonder if the natural birth community over-idealise the drug-free natural vaginal birth? The reason I say this is that as a home-birthing mama, I've lately begun to feel some of my own performance anxiety when I read other people's drug-free labour tales. And I'm not the only one: Betsy B. Honest has written a brilliant blog post on birth performance anxiety.

I like to do well at whatever I try; maybe it's because my parents praised me too much (or maybe not enough). It seems faintly ridiculous that anyone should feel pressure to "do well" at birth. Yet I think I speak for more than just myself when I say that we do feel this pressure to have the "right" kind of birth. I used gas and air to help me deal with the most painful part of the first stage of my labour; does that mean I am in any way inferior to someone who manages without any pain relief at all? I don't think so. But the natural birthing community does celebrate the drug-free home birth above all other ways of birthing. They don't mean to say that other ways are less good, but that is perhaps the message that they give.

A "good" birth is one on which the mother and baby are healthy, alert, unharmed and happy. This is physically best for the baby, enables the mother to recover quickly and gives them the best possible chance of establishing breastfeeding successfully. A drug-free home birth certainly achieves this, but it is not the only way. Sometimes mothers feel safer in hospitals and sometimes it is best that they are there just in case something goes wrong. Sometimes the judicious and timely use of pain medication may enable a mother to have the birth she desires. I am not ignoring the fact that the use of pain relief can trigger a "spiral of intervention", but sometimes it can help rather than hinder. Here is a lovely birth story of a lady who says that without pain relief and hypnobirthing to help her through a long and difficult back labour, she believes she would have ended up having a c-section.

Do you remember a couple of years ago when the press blamed the pressure to breastfeed on a woman's suicide? It was a typical piece of media sensationalism but the truth is that breastfeeding difficulties (not pressure to breastfeed) can contribute to the emergence of post-natal depression. A traumatic birth can equally lead to PND. I wonder if a failure of the childbirth experience to live up to the longed-for "ideal" can also contribute to depression?

All I am saying is that if we raise women's expectations of birth too high, they are more likely to be disappointed with their real-life experiences. Midwives tell us to expect the unexpected, and though I believe strongly that women should prepare and plan for a natural birth, it is also necessary to understand that sometimes things don't go to plan. Painful and dangerous childbirth is a consequence of our babies' large heads and our bipedalism, and it is only our large intelligent brains that have allowed us to develop methods to overcome the dangers inherent in human childbirth and reduce the maternal death rate. So I think it is wrong to assume that all interventions are automatically "unnatural". I am sure that humans have been looking for ways to ease our babies' paths into the world for as long as we have been on the earth.

Perhaps all I really want to say is that the drug-free home birthing experience is great if that's what you want, but that other satisfying birth experiences should be valued equally highly. Anything that is healthy for mother and baby should be celebrated.

Thoughts on Childbirth

I am sitting on front of "One Born Every Minute", a documentary series on childbirth. It's the first time I have seen it and I quite literally cannot watch the babies being born without crying. It was the same when I was pregnant; give me good births, bad births, high definition or grainy Youtube footage and I'll cry. I thought the crying might have stopped since I gave birth myself but it evidently hasn't.

I don't know how some ladies manage to watch birth video after birth video when they are pregnant. For me, they are just too loaded with emotion. Even having been there and done that once, it still scares the hell out of me. And I had a good experience! The day after I gave birth I thought "I want to do that again!", but 18 months later the fear has returned. How much did it hurt me? Did I make as much noise as the ladies on television? Did my labour hurt more or less than theirs? Would things go as well if I did it again? Would I breathe through my contractions more calmly or would I shout the house down all over again?

Television has also provided lots of birth footage via "Lambing Live", a bizarre show in which springy haired wildlife presenter Kate Humble delivers spring lambs live on air (if any sheep are cooperative enough to coincide their labours with the one hour broadcasting slot). What strikes me about this programme is how much the farmers know about natural birth. If things are progressing as normal, they leave the sheep alone to get on with her labour. When the lambs are born they place them in front of the sheep so she can lick them clean. They know how important it is for bonding that the lamb is given to its mum immediately after birth. They quietly watch on to check that suckling takes place soon after birth and they see it as essential that each lamb gets a bellyfull of colostrum before they go to sleep. If a lamb does not suckle spontaneously, they help it to latch on, and if that does not work then they milk the sheep and give the colostrum to her lamb through a feeding tube. Nursing is valued highly because it produces stronger, healthier lambs and is cheaper and less labour intensive than bottle feeding.

All of these practices are equally important in human births. But during the twentieth century we managed to convince ourselves that unnatural practices like keeping babies in hospital nurseries and formula feeding were beneficial. We went so far away from what is natural and instinctive that expensive academic research was required in order to persuade us that skin-to-skin contact is good, and mother's milk is far better than any artificial alternative. What a waste of time and money, when farmers could have set us straight all along!

Now be honest - do you cry at birth videos too? And are you as scared as me?

Photo from Independent.co.uk.

Dolphins Are Midwives Too

Dolphin researchers have recently claimed that dolphins should be considered the second most intelligent animals on earth, second to humans but ahead of chimpanzees. That means that dolphins have a rich and complex social life complete with culture, learning and tradition.

The underwater world is so foreign to us humans that I find it hard to imagine what a dolphin's life must be like. But we share so may of our childrearing practices with land-bound apes that I wondered if we would also have methods in common with dolphins. I'm interested in birth, breastfeeding, weaning, infant transport and any other facts about infant care that I can lay my hands on. So, to start at the beginning, I found some information about how dolphins birth their babies.

After a twelve month gestation, dolphins give birth in the water. The fluids released during labour are attractive to predators and put the mother at risk, so the birth is usually attended by several other dolphins who may well be members of the same family. These doula dolphins are putting themselves at risk by attending the birth, but the calf will also carry their genes, so the practice carries an overall evolutionary advantage.

The baby dolphin's tail is born first so that there is less danger of the calf drowning during the birth process. The removal of the newborn calf from the mother's body may actually be assisted by one female midwife dolphin; the practice has been observed in captivity, and stillborn dolphins with teeth marks in their bodies have been found washed up on beaches.



Following the birth, the umbilical cord snaps easily so the new dolphin's movement is not restricted. Calves are able to swim on their own within minutes of birth and will normally make their own way to the surface to breathe. If this does not happen, some dolphin mothers have been observed moving their calves to the surface.

Dolphins do not just make great midwives for members of their own species; they can actually assist at human births too. A Russian male midwife called Igor Charkovsky has helped pregnant women to give birth underwater in the Black Sea aided by dolphins. The animals are reputedly very gentle with human infants and they grant a sense of calm to both the human mother and her baby. Dolphin-attended waterbirths are also said to occur privately in Hawaii.

The sophistication of dolphin birthing practices has taken my breath away. Come back in a week or so if you would like to know more about how dolphins feed, carry and look after their young.

Photos: The Best Photos

Unnecessary Doulas?

There was an interesting article on doulas in The Telegraph yesterday: Doulas jeopardise care?.

The crux of the article is that doulas could interfere with medical decision making in a negative way. But, to be fair to Dr Chakladar, the author of a piece in the British Medical Journal online, the popularity of doulas in the UK may be a result of the decline in one-to-one mudwifery care. He says it very well, so I'll just quote him:

"This trend may be a sad reflection of failures in the delivery of medical and midwifery care, a sticking plaster concealing greater problems. Availability of this commercial service indicates that current social structures do not support pregnant couples adequately; healthcare professionals may not be able to support their patients as they would like to.

"Are we no longer able to make common sense decisions without asking a hired friend?

"Traditionally, emotional support came from female relatives; more recently the modern father has stepped into this role. Partners, friends, and family—those who know the mother best—should provide this support.

"Sadly, this position cannot withstand chronic understaffing, shift work, midwifery care that is less than one to one, and European working time directives, making continuity of care impossible. Nor can it withstand single parenthood and increasingly detached nuclear families."

Here's my point of view. I wouldn't want a doula because I would prefer to have people I really know supporting me, not someone I had only met a few times. I had a home birth partly so I could guarantee one-to-one attention from a midwife, and partly to minimise the interference from doctors. I am very wary of obstetricians (who I imagine, very unrealistically, to be bloodthirsty butchers wielding forceps and calling for epidurals and c-sections at any opportunity). I am also fairly confident that if there was an emergency, my parter would properly represent my views to medical staff (and there was no stage during my labour when I was so out of it that I couldn't talk to the midwife anyway). Also, I'm tight. I'm not going to pay someone when I know most people manage without a doula (though I do wish I had a close female friend who I trusted enough to be present at a birth, as women have done for millenia).

But if I felt that my wishes would not be respected - perhaps if I was a teenage mum, or if my partner was not supportive - and if having a doula would help me feel more confident about giving birth, then where's the harm? One of my friends has felt 100% more confident about the upcoming birth of her second baby since she she has hired a doula.

There's one thing to remember though. Doulas aren't midwives. They offer moral support but not clinical expertise. We must not confuse the two things.

Overdue Babies and Threatened Induction

As I mentioned in my last post, this time last year I was in my 41st week of pregnancy and hoping beyond hope that my baby would arrive before I was under pressure to be induced. As anyone who has gone over 40 weeks will know, the phone calls from family and friends start on the due date and do not stop until the baby put in an appearance.

I felt, just like any first time mother does, that my baby was never coming. I just knew I was going to be pregnant for ever. The mental leap from pregnancy to motherhood was just too big for my brain to cope with. Birth was a black hole that loomed ahead of me and sucked all thoughts of the future into its depths.

I was booked to have a home birth and idea of going into hospital to be induced absolutely petrified me. I had got myself into the right mental space to cope with birth at home and I felt certain that if I ended up in hospital I would find it vastly more difficult. So I did what I always do: jumped on the internet to reseach overdue pregnancies.

The Home Birth Reference Site is an invaluable source of evidence-based information on pregnancy and birth, whether you plan to give birth in hospital or at home. It has a brilliant page on postdates pregnancies, and here are the main points that helped me to decide what to do if I went overdue by more than 10 days or so:

* The death rate for apparently "normal" babies (with no congenital abnormalities) doubles after 42 weeks from 1 in 1000 babies to 2 in 1000.

* We are often told that beyond 42 weeks, the ageing placenta cannot deliver enough oxygen and nutrients to the baby. This sometimes happens, and sometimes does not. Research is unfortunately thin on the ground. Many people have had healthy babies after 43 and 44 week pregnancies.

* Most 42 + week pregnancies have just been dated wrong; very few accurately dated pregnancies go on for this long.

* Your body may be delaying labour for a good reason. The baby might be badly positioned for birth, for example. Sometimes we just have to trust that mother nature knows what she is doing.

* You do not have to undergo induction of labour unless you want to. Like any medical procedure, it is offered and you are free to refuse. Furthermore, the date of induction is negotiable. In the UK, induction is usually offered at 10 days or 12 days overdue, despite the fact that the "normal" length of pregnancy is anything from 38 to 42 weeks. You can delay or refuse induction if you so choose.

* The UK's National Institute of Clinical Excellence says that after 42 weeks you should be offered an ultrasound examination and twice weekly checks of the baby's heart rate.

* You can still have a home birth after 42 weeks. Your midwives might be happy to support it, or they might be reluctant. If you are really stubborn, you can insist on staying at home when you finally do go into labour. Nobody can force you to go into hospital.

* You are much more likely to have meconium in your waters when your baby is overdue. This is often enough for a mimdwife to recommend a transfer from home to hospital. But if you are overdue, it is not necessarily a cause for alarm. An experienced midwife should be able to judge the colour and thickness of the liquor and decide whether or not to recommend a transfer. This is what happened to me, and my midwife kept me at home. I am eternally grateful to her.

So here is what actually happened to me. I went to the antenatal clinic for my 41 week appointment and was offered induction. I refused it, totally flummoxing the midwife, who then called for a consultant to reason with the mad pregnant woman. The consultant was straight with me and, after discussion, accepted my wishes to avoid induction and agreed to monitor me if I should go beyond 42 weeks. A senior community midwife then came to talk to me as well and told me that they would support my desire for a home birth beyond 42 weeks. Hooray! This made me feel a whole lot better about things.

My bravery in the antenatal clinic turned out to be unecessary in the end because after two "vigorous" membrane sweeps at the aforementioned 41 week appointment, I went into labour and delivered my baby 42 hours later. The membrane sweeps felt a bit odd and uncomfortable, but I think by that stage of pregnancy I was ready to experience a bit of pain, and if it was going to help me to go into labour then I was all for it (and if you are contemplating having a membrane sweep then I would say that it is absolutely nothing to worry about). I do have a feeling that I would have gone into labour without the sweeps as I had begun to feel "twinges" prior to my appointment. I also wonder if my prolonged pre-labour was caused by the intervention. But I will never know the answers to these questions and I don't really care because I was fortunate enough to have a straightforward labour and home birth and I was blessed with a healthy baby.

I think the main thing to remember if you do go overdue is that induction is not inevitable, and is not necessarily the best thing for your baby. You always have options and if you present your views with enough conviction, medical professionals will have to listen to you.

Nine Months In, Nine Months Out

This morning I realised that we had missed Cave Baby's nine month birthday on Sunday. Not that nine months is a particularly important milestone - but it did occur to me that she has now been out in the world for as long as she was inside me. Nine months in the tum, nine months out of the tum. A wonderful symmetry.

So this thought, and reading Monkey's birth story on That's Not My Monkey, inspired me to write something about Cave Baby's birth.

I had been in the early stages of labour for around 30 hours when we called a midwife to our house. Before she arrived I had been labouring in the bath, so I was stark naked, kneeling on the bedroom floor when she came in. "Oh, we're having a baby", she announced as she saw me. At that point I was only 4cm dilated and I laboured on in the bath for another couple of hours. I can remember that time quite well: with every contraction, I leaned forward to put my head on the bath taps and I kept banging my forehead. I was using gas and air and it felt pretty ineffective, though it must have been doing something because I was literally pulling my hair out before I started on it, and afterwards I wasn't.

I spent another hour or two on my knees in the bedroom and this period really is hazy. I only remember the occasions when I was interacting with other people: when the midwife called the hospital to tell them to put an ambulance on standby because my waters were stained with fresh meconium; when I peed in a bucket because I couldn't imagine getting up to go to the toilet; when the midwife asked me if I wanted to push.

There was about an hour of pushing before Cave Baby emerged. I found this stage much less painful than the first stage of labour. Whilst I had visualized each first stage contraction as a huge hot fire, the second stage contractions were like a line of gas burners lighting up in a row across my back. Each push was a gust of air whooshing through the fires and casting them aside. I felt like an athlete. Half way through the pushing stage I abandoned the gas and air because I was worried it would impair my performance (seriously. That is a glimpse into the strange mind of the labouring woman).

I felt the baby's head crowning (not painful, just a strong sensation). I felt the baby turning inside me to get her shoulders through ("The baby's moving! The baby's moving!" - probably the first thing I had said for hours). And I remember her skidding out of me, and the midwives catching her and wrapping her in a towel before passing her through my legs so I could hold her for the first time.

I wish I could remember it more clearly. Everything is so fuzzy. And I wish we had taken some photographs of those first few moments. But I am thankful that she arrived safely and that I was also well. I am grateful that I had wonderful midwives who did not transfer me to hospital, despite the meconium (though we did have an ambulance at our house for the last half hour of labour). The lovely midwives followed my birth plan exactly, letting me do whatever the heck I wanted during labour, delaying cutting the cord until it had stopped pulsating, and allowing me to deliver the placenta naturally.

An hour or so after the birth I was sat up in bed, feeding my baby and chatting to the midwife who had to stay for two hours. I remember thinking, "I gave birth a hour ago and here I am wracking my brains to come up with entertaining smalltalk at 6 in the morning."

I was so lucky to have such a great birth experience.

Why Are Human Infants Born So Prematurely?

Anyone who has held a floppy headed, red faced newborn baby in their arms must have wondered at some time why human babies are born so helpless, whilst other mammals are up on their feet within minutes of birth. So why don't humans gestate their babies for longer? Wouldn't a newborn be better equipped for survival if it had had a little bit longer inside mum?

I had long accepted the simple logistical explanation for this. Human childbirth is very difficult, painful and dangerous, for two reasons. First of all, we walk on two feet and we have evolved very narrow pelvises (or should I say pelves) to facilitate this movement. So the female pelvis is a compromise between narrowness for walking, and width for birthing children. You can see some interesting pictures of male and female pelvises by clicking here.

The second reason for the difficulty of human childbirth is the sheer size of our heads, which must accommodate our highly developed brains. In order to make childbirth work at all, we have evolved a complex method of birthing that requires the baby to rotate during delivery to fit different bits of its body through the pelvis. It is no wonder that so many things can go wrong. Neither is it surprising that we have developed a tradition of having assistants present during birth, a practice which is unseen in the rest of the animal kingdom (as far as I am aware).

So one explanation for the relative immaturity of human newborns is that gestation has to be short so that a baby's head does not grow too large to fit through its mother's pelvis. This explanation is very logical, but it does not explain why chimpanzees, gorillas and orangutans also limit their gestations to eight or nine months. They may have large heads like us, but without the limits on their pelvis size, why don't they take the opportunity to cook their babies for just a little longer? These great ape babies are born just as helpless as human babies - just like humans, they cannot even raise their own heads (although they do acquire skills like clinging on to their mothers' fur quite quickly).

I found a possible answer in the book "Why Love Matters" by Sue Gerhardt. She suggests that a human baby receives extra time outside the womb so that its brain can develop appropriately for the social environment that it will live in. Since human beings live in a such a variety of different ways across the world, perhaps it is necessary to expose the human baby to its own society at a very early stage. She also suggests that the increased activity that a brain experiences outside of the womb may be necessary to help it to grow quickly enough. She explains this much more elegantly than I can:

"Towards the end of its first year, the preparatory stage of infancy comes to an end. In some ways, the human baby now reaches the level of development that other animals achieve inside the womb. But by doing it outside the womb, human brain building is more open to social influence. This extended human dependency outside the womb enables an intense social bond between caregiver and child to develop. This generates the biochemicals that facilitate a high level of neural connections and brain growth which will never be as rapid again."

The advantage of this explanation is that it is also applicable to primates like chimpazees and gorillas - they also have complex societies, and different cultures within different groups, and they may also require the extra time outside the womb to socialise their babies and to grow their large brains.

So perhaps our relatively short gestation is not just a compromise between small pelvises and big heads. Perhaps our babies really do need to meet us at that helpless early stage so that we can begin our lfetime's work of teaching them how to be human.

By the way, "Why Love Matters" is absolutely fascinating, especially if you have an interest in psychology or biology, and it is giving me so many eureka moments as I read it. And I still have half of the book to go!

Home Birth Back In The Day

When I was preparing for Cave Baby's birth, an old lady told me about how things used to be before the National Health Service began providing free health care for all in the UK (in 1948). She said it was very expensive to stay in hospital so people like her would give birth at home, attended by a midwife. But this was still expensive - I forget how much it cost but she said that it was about a week's wages. She said that weeks before your due date you purchased a box of supplies that would be needed by the midwife during the birth, and that this box was so expensive and precious that you dared not touch it. In fact she said you never knew what was in it because nobody ever opened them. I can just imagine the symbolic significance of these boxes in the houses of expectant mothers.

I am not trying to make any point with this vignette, I just really enjoyed it at the time, and remembered it today. It must have been really tough to go without health care because you couldn't afford it. It must have been scary to give birth without the back up of a nearby hospital, knowing that the loss of a baby would be a possibility. On the other hand it must have been nice when giving birth at home was normal, and all your friends and family could rally round to help, and birth would just be a normal part of life for everyone around.

Incidentally, the old ladies who had actually experienced home birth all that time ago were some of the most supportive people of my own plans to give birth at home.

Home Birth As Safe As Hospital Birth Shock

It is great to see a study in the news today showing that in he Netherlands, between 2000 and 2006, home births were as safe for low-risk women as hospital births (the study compares outcomes for babies; outcomes for mothers are not mentioned). For example, here is how the Times reported it. The study is not perfectly applicable to the UK because the structures of our maternity services are different. But it is still a nice story! And while pondering this news, I was struck by how lucky we are in the UK that our National Health Service does support home birth, even if it struggles to find enough midwives to provide it. We can give birth at home if we want to, and the law will change this year to stipulate that we have a right to a home birth. We have a maternity service run primarily by midwives, with obstetricians acting more as a safety net when problems occur during pregnancy and birth. Community midwives work from clinics and even visit us at home, meaning that we barely have to go near a hospital or a doctor if we do not want to. And, in my experience, midwives have a lot of respect for women's wishes regarding how they wish to labour, what pain relief they require, whether they wish to deliver the placenta naturally and even whether they want to keep it to eat (which I did not).

These are just my little thankful thoughts for the day.

Have Yourself a Good Birth

So, my intended birth post. I was fortunate enough to have a satsfying birth experience with Cave Baby. If a woman has a straightforward birth we tend to think she was lucky. But if a woman who ate unhealthily, took no exercise, knew nothing about childbirth and never did pelvic floor exercises had a bad experience of birth, would anyone be that surprised? Preparing well for birth has to have some bearing on the outcome, even it is only 5% compared to 95% good genes and good luck.

Some women are obviously blessed with bodies that are great at birthing babies, and some babies are great at getting themselves in the perfect position for birth. But no matter what cards you are dealt, you must be able to slightly increase your chances of having a straightforward birth. Consider the philosophy of the British Cycling team who won so many gold medals at the 2008 Olympics: they do everything possible, within the rules, to improve their performance. They do nutrition right, they do training right, they take food supplements, they do rest right. They hope that if a competitor neglects to take just one of the measures that British Cycling take, then they will have a tiny advantage over that competitor. What I am trying to say is that by taking lots of small preparatory measures you may be able to make a small difference to your experience on the big day - but that small difference could mean a normal vaginal birth instead of a ventouse delivery, for example.

So here are some ideas that I used last time around, and will use again if I have another baby:

• Eat a healthy balanced diet throughout pregnancy. This is pretty obvious advice but there is a trend for women who eat really fatty diets to have overly large babies so it is definitely worth being careful about what you eat (I am not talking about dieting).


• Take moderate exercise throughout pregnancy, without pushing yourself too hard. A certain amount of endurance is definitely advantageous during labour so gentle exercise like walking and swimming has to be a good idea during pregnancy. If in doubt, refer to the "what would a cavewoman do?" test. I doubt cavewomen spent 9 months sitting around their cave - food gathering and housework (or should that be cavework) would certainly still need to be done.


• Plan a birth that you feel happy about. If you want a home birth, press for one. If you want a hospital birth, visit the hospital to check it out. Research your options for pain relief. Find out about positions for labour and birth. Write a birth plan and make sure your birth partner understands it. It may not (actually, probably will not) turn out as you had planned but you need to feel confident about the upcoming birth and to pass on those good vibes to your baby.


• In the third trimester, be aware of the position of your baby. Read about belly mapping and use the knowledge to keep a mental note of where you think baby is lying in your tummy. There are things you can do to help your baby to get into, and stay in, the ideal position (this is called Optimal Foetal Positioning). Sit up, crawl on your hands and knees or swim front crawl to get baby to face your back. There are even things you can do to help a breech baby to turn upside-down (doing surface dives in the swimming pool is my personal favourite suggestion). There is loads of information on the Spinning Babies website.


• Drink raspberry leaf tea. Nobody really knows if it genuinely does tone up your uterus, but it can't do you any harm when taken in the third trimester. It is nice with a bit of sugar in it, or chilled with sugar and lemon as an iced tea. Start with one cup a day and build up to three or four.


• Surround yourself with supportive people who help you to feel confident that you can do it. Read some nice birth stories. If anybody close to you has a bad attitude towards natural birth then make that topic off-limits for a while.


• Some people swear by perineal massage. This is not somethiing I fancy but you never know, it might help to reduce tearing when the baby is born.


• Practice some kind of relaxation for use during birth - but don't get obsessed with it. Some people go the whole hog and learn self-hypnosis whilst others manage perfectly well with a bit of self-taught deep breathing. Personally I think it's mainly instinctive and you will manage best by feeling calm and confident inside, not by the use of any particular technique. But that is just my perspective.

Once again, I know that birth is unpredictable. But when I was expecting Cave Baby, I couldn't help wanting to do whatever was in my power to help myself to have my version of a "good birth", and this list was the result of my reading. If you are preparing for childbirth I hope there might be something in here that helps you. And if you have any ideas that have worked for you please tell me!

A Good Birth

I was writing a future post about birth when I realised I had written the phrase "good birth" several times, as if it actually meant something. So what is a "good birth"? For some it may be a healthy baby and no more. For others it may be an elective Cesaerean. Some demand to experience "ecstatic birth". For the pregnant me, a "good birth" would have been one in which I would have a healthy baby, could be present and aware for the whole process, and would feel relaxed and happy. My post-birth view is still pretty much the same though the healthy baby bit has assumed a much greater importance in my mind - somehow, the pregnant me could not quite comprehend the fact that I would actually be having a baby.

A few weeks ago I spoke to a woman who was about to have her first baby and had planned a home birth with an independent midwife. She had experienced nothing but negativity from her friends and family, one of whom even asserted that she was being selfish to wish for such a birth. Is it selfish to wish for a good birth experience for yourself as well as your baby? Was I selfish to have a home birth?

I have no categorical answer but I instinctively feel that a woman's postpartum mental health is extremely important for her baby's well being, and a happy birth can surely have a great impact on this. Traumatic birth can certainly contribute to postnatal depression. And there is of course a weight of evidence to indicate that home birth does not pose any additional risk to a baby's or mother's health. So no, I do not think it is selfish to wish for your version of "good birth" and whether that takes place at home or in a hospital should be up to the mother and her family. If only society would value "good birth" like mothers do.

If you doubt the safety of home birth, there is a wonderful website here that should put your mind at rest.