Home birthing in Australia: What’s it like for the midwives?

• Rebecca Coddington is nearing the completion of a PhD thesis looking at the experience of midwives providing publicly-funded homebirths.
• In Australia, only 0.4% of home births are planned home births. Most women aren’t aware that home birthing is an option at their hospital of choice.
• For low-risk pregnancies, planned home birthing is generally a very positive experience for women, their partners and the midwife.

Rebecca Coddington from the UTS Faculty of Health is currently researching the experiences of midwives providing publically-funded homebirths in Australia. The PhD researcher’s work forms part of a larger project being run at UTS called the Birthplace in Australia Project.  Coddington recently spoke with journalist Nick McLaren on ABC Radio Illawara to explain some of the research’s key findings.

“We know there’s a lot of interest in birthing outside of the standard labour ward environment, and there’s lots of research saying that it is safe for women to do so if they meet the low risk criteria. But in particular, no one had looked at midwives’ experiences in the publically funded home birth model,” she said.

“It’s a new way of working for midwives, so we’re really interested to address questions like: do the midwives enjoy it? Do they have the right skill set based on their standard training to transition into this new model? Are the women enjoying it? And are the midwives having good outcomes?”

Only 0.4% of all births in Australia in a home and are planned home births, a relatively low rate when compared to similar developed nations such as the Netherlands and New Zealand. Nevertheless, there is strong demand for home birthing as an option in Australia.

“Women have lobbied for this option, and that’s why some public hospitals in Australia have decided to offer it to women.  It’s really answering that call that women are making for alternative options that are safe for them and their babies and that are affordable as well,” explained Coddington.

Coddington has found that midwifery “continuity of care” makes a significant difference in the woman’s experience of home birth.

“Before I began [my research], I suspected that women were choosing home birth first and foremost, and then looking for a midwife.  In fact, what’s actually happening in the publically funded model - as far as the midwives have told me - is that women are just being cared for as normal in the public health system, and then electing home birthing when they learn it’s an option at their own hospital. So, women who otherwise wouldn’t have considered home births consider trying it out because they’ve built that relationship of trust with the midwife” she said.

Coddington acknowledged that safety concerns are often a barrier to electing a planned home birth.

“In the media here in Australia, [home birthing] is often painted as an incredibly dangerous and crazy thing to do. But in fact, what the evidence shows is that if you are low-risk, you will have - in all likelihood – a really positive experience. If there is any need to transfer, the midwife can call an ambulance and have you into hospital at some point in the labour or the birth.”

For many women and their partners, the home can be a more comfortable, less intimidating birthing environment than the traditional labour ward.

“There are all sorts of other benefits to the home environment”, said Coddington. “There’s this huge shift in power dynamics when a woman is in her own home and the midwife is the invited guest. This is what midwives are telling me in the interviews that I’ve done. They notice a difference in the way they practice, because they’re very aware that they’re in a woman’s home.”

“Husbands or partners also talk about how big that change is, especially if they’d previously had a baby in hospital. Sometimes in a hospital, the partners feel a bit useless, whereas in the home environment, they’re in charge of getting the equipment ready, offering them a cup of tea, getting her somewhere to sit… So it really changes that feeling they have about who’s in control and who’s running the show.”

Find out more about midwifery courses at UTS.

Byline: Jack Schmidt

Read the complete transcript from Rebecca's interview on ABC Radio, Illawarra.