Yes, home birth is risky. But let's just apply some logic and perspective to that emotive statement. Pretty much all aspects of life entail some degree of risk. Whether we're eating, driving, cycling down the road, swimming in the surf, going on a bushwalk, playing in the sun... you name it, there will be some element of risk to pretty much everything we do in life. Life is risky. But not living life is hardly the solution. We gain a lot of satisfaction and joy through the many risks we take on a daily basis. And most of us will naturally be inclined to sensibly manage risk within our lives... we chew well before swallowing, we wear a seatbelt and follow the road rules, we wear a cycle helmet, we swim between the flags, we have a daypack of essential items on a bushwalk, we wear sunscreen on sunny days. These things will reduce the amount of risk in our daily lives, but nothing will eliminate it. And if we are confronted with a physically damaging or life-threatening situation, we seek the appropriate assistance we need to get things back on track.
So how does this all relate to home birth? Within our society there exists the pervasive belief that giving birth in a hospital is less risky than giving birth at home. This seems logical enough, doesn't it? Giving birth doesn't always go to plan, and it is helpful to be where the experts and equipment reside to immediately fix the problem should one arise. But, it's not quite as simple as this. While there are some risks associated with birth that would best be managed via immediate access to tertiary medical facilities, most of the risks are either able to be managed by the midwife in the home, or 'picked up' in plenty of time to transfer to hospital if need be. But there is this fallacy in many people's minds that hospitals and their experts will be able to fix any troubling issues that arise. This is simply not true. Merely being in the hospital environment exposes birthing women and their babies to risks that they would not encounter in their own homes. A good example of this is the foreign bugs that exist within hospitals increasing the likelihood of infections in the mother and her newborn. Also, women who birth in hospital are more likely to undergo unnecessary medical interventions, none of which are free of risk.
Here's an interesting analogy: A pet-owner whose beloved cat has gone into labour is hardly likely to rush her cat into the vet clinic to give birth. Although the owner knows that there is a chance that complications could occur, she is happy to leave her cat be unless the need arises to get her to the vet. (That same woman thinks women who give birth at home are irresponsible and selfish!) In fact, if she did rush her cat into the vet clinic during normal labour, that act in itself would probably cause complications to occur. Being in an unfamiliar environment causes the labouring animal to become fearful and triggers the release of hormones which can slow labour or even stop it all together, and may cause the babies to become distressed - the next step... a caesarean. Any farmer or zoo-keeper will tell you, animals usually give birth most easily when they are given privacy to get on with doing what they instinctively know how to do. Giving birth is undeniably a very healthy, natural and instinctive process for all animals, including us humans! The soaring rates of caesarean section that women are undergoing in the Western world are not a result of more and more women needing them. We are women, our bodies are designed to give birth. Our minds influence our physical response to labour (just as it did for the scared mama cat who was needlessly brought into the vet during labour) and unfortunately, women are frequently led to believe that they won't be able to give birth without some form of intervention. This belief is bound to influence the woman's labour process.
If it was true that the risks of birthing at home outweighed the risks of birthing in hospital then it would logically follow that more mothers and babies would die or be seriously injured at planned home births than at planned hospital births. But time and again, research has demonstrated that such statistics are pretty much exactly the same for both groups of birthing women. Therefore, it follows that planned home birth is just as safe as planned hospital birth for healthy women who are cared for by a midwife. However, I'd like to dispute that statement. The 'safety' that is being referred to here relates to the physical safety of the mother and her baby. As humans, we are so much more than just physical beings... we are spiritual, emotional and psychological beings too. So, when I think of issues around safety and birth, I think it's important to consider those other elements of self that can potentially be damaged through the birth process. I hold not the smallest thread of doubt that giving birth at home is an holistically safer experience than giving birth in the hospital for the vast majority of healthy birthing women.
So yes, giving birth at home is risky. So is giving birth in hospital. So is living. How we decide to manage risks within our lives is a very subjective undertaking. Perhaps of most help is gathering as much information and research as we are able to make good informed decisions for ourselves and our babies. We need to make the choices that are right for us and in doing so, we are more likely to experience a positive and empowering birth no matter the outcome. I have had way too many conversations with women traumatised by a horrid birth experience where they have said, "If only I'd known that beforehand, I would've done things so differently." Birth is such a rare and brilliant opportunity to realise our potential. Let's not waste it on the fear-based, flawed assumptions of people who know nothing of our hopes and dreams. Our selves and our babies are much too precious.