Mothertongue Doulas

Many of us in the birth community, as well as expectant parents, have been wondering why home birth has not been a common choice, or even much of an option, here in Sweden. The great news is that now, at least in Stockholm, it is! Karolinska University Hospital in Huddinge has just announced that they will offer birthing at home as an option in Stockholm. This development complements the ”Min Barnmorska” initiative that is already being run by Karolinska. There are, however, some criteria that anyone wishing to birth at home will have to meet:

• The pregnancy must be low-risk.
• The birthing person must have had a previous vaginal birth.
• They must live no more than a 40 minutes drive from Karolinska Huddinge.

But, is home birth even safe?

The available evidence suggests that planned home birth is safe for women who are at low risk of complications and are cared for by appropriately qualified and licensed midwives with access to timely transfer to hospital if required.

The safety of home birth Helen McLachlan, PhD and Della Forster, PhD

Home births are attended by fully-qualified, trained midwives who come equipped to deal with many situations. They also know the importance of transferring the birthing person and/or baby to a hospital before a situation becomes an emergency.

It is interesting to note that a study of nearly 5,500 women in the US who gave birth at home, found that 12% of birthing people transferred to hospital during labour or after birth.

Around 9% of those cases were non-urgent.

People chose to transfer because they were not progressing, wanted pain-relief not available at home or were exhausted. The most common reasons for urgent transfer were fetal distress, the baby’s head not presenting in an optimal position or maternal bleeding post-birth. It was also found that first time parents were four times more likely to need to transfer than parents having a second or subsequent baby.

Why do people choose homebirth?

There are so many reasons that someone might choose home birth but some of the most common ones are:

• A previous negative experience in a hospital.
• Feeling safer and more relaxed in your own home
• Having more control over any procedures or decisions
• Decreased risk of infection
• A trust that birth is a normal, healthy process
• Not having to interrupt the labour process to travel to a new, less familiar environment

Some people also feel that, away from a hospital setting, there will be less chance of having unnecessary interventions or feeling pressured to give birth within a certain time limit. On that note, it is important to mention that whilst midwives attending home births can utilise comfort measures such as gas & air, TENS units, birth pools, counter-pressure and massage, they cannot administer an epidural or other medical pain relief.

Why might ex-pat families consider homebirth?

For ex-pats in Sweden, home birth could be a very interesting option. If neither parent is Swedish then there is probably no family close by. Many people worry about who will look after their older children when it is time to head to the hospital. Opting for a home birth means that older children could remain at home, sleeping, being present at the birth or perhaps being looked after in another room by a friend or neighbour.

It could also take away some of the worries over the language barrier.

Being somewhere where the main language is Swedish can be intimidating at any time but the possibility that you won’t understand what is being said during birth can be a real worry. I should note that the majority of midwives here in Sweden are more than happy to speak English but, being in your own home could provide more of a feeling of security and a sense of control. The midwives will be on your territory, not the other way around.

Home birth is not the right choice for everyone and it is essential to birth in an environment where you feel safe and relaxed. For some, that will be in a hospital but for those who would love nothing more than to stay at home throughout their labour and birth, that is now a very real option. I hope that, in time, home birth will become a possibility for parents all over Sweden.

Evidence Based Birth: What is home birth

Emily Wills is a doula based in Stockholm. She believes that birth can be a beautiful and empowering experience. She is also a mother of three and an enthusiastic runner.