Cecilia is a client who did a complete course with me at the beginning of the year remotely over zoom as she lives in Norway. She got in touch to a(Translated from Cecilia’s original article here: https://www.aftenposten.no/meninger/debatt/i/RzGez5/det-foeltes-vaagalt-aa-velge-hjemmefoedsel-men-jeg-kunne-ikke-ha-hatt-en-bedre-opplevelse)
So brave you are for giving birth at home, several said. It felt quite the opposite.
I want to encourage politicians to think differently to solve the issues in maternity care.
Every summer, we read about closed maternity wards, chaos with substitutes, and reduced services at health stations. When I became pregnant with a due date in the middle of the summer holidays, I began looking for an alternative solution. It felt daring to choose home birth, but I couldn’t have had a better experience.
Uncertainty
Many seem to think that because one cannot predict the course of labor, women must endure the uncertainty surrounding the birth itself. I couldn’t disagree more.
I gave birth to my first child during the pandemic. Not knowing whether I could have my partner with me during the birth ruined so much for me. Now that the pandemic is over, birthing women still have to live with uncertainty about whether there is room for them in the hospital, and whether they can have their partner present afterward.
This time, I didn’t just want guaranteed space at the inn. I wanted to know who was working there.
I know it is possible to give birth with midwives you know beforehand (“caseload midwifery”), and that this yields good results for both mother and child. The question was whether this was possible for me, as I belong to the country’s largest maternity ward.
During my last birth, I didn’t meet a single person twice, and I don’t remember anyone’s name.
This time, I also wanted to have influence over the framework surrounding the birth. Among other things, I wanted to give birth in water because it can lead to fewer tears and good pain relief.
But would this be possible at a maternity ward where there is only one delivery room with a bathtub available for all birthing women? (I’ve never had luck in lotteries.)
It looked quite bleak until I dared to consider the thought that I could give birth at home.
Safety
By choosing a home birth, I had the opportunity in advance to get to know all the midwives who could be present.
As the due date approached, I received an emergency plan so that I always knew who was on duty. It felt very safe every time I saw this on my refrigerator. And I didn’t have to worry about whether I would have the opportunity to give birth in water, because in the corner of the living room stood the inflatable birth pool.
“So brave you are for giving birth at home,” several said when it was all over. It felt quite the opposite.
When labor started, I didn’t have to travel to the hospital with all the stress that entails. I avoided the uncertainty of arriving at an unfamiliar place with people I had never met before. Instead, the midwife came to me on her bike, just like on TV.
I was curious whether I would regret not having the option to choose an epidural. I had to have it during my first birth. That time, I received synthetic oxytocin.
Oxytocin is the hormone that drives labor, but only the oxytocin produced by the body provides pain relief. The body produces oxytocin when one feels safe. I felt safe this time, and that was all the pain relief I needed.
Values
I feel immense gratitude for having the opportunity to give birth this way, in line with two of the most fundamental values of Norwegian maternity care: continuous and differentiated care.
This time, I received continuous care as it was the same midwives who followed me throughout the pregnancy, during the birth, and in the postpartum period.
Differentiated care means, among other things, that the maternity services should be adapted to the degree of risk. Research shows that there are many advantages to organizing low-risk births like mine separately from high-risk births. It increases the likelihood of spontaneous vaginal delivery, provides a better birth experience, and is cost-effective.
The latter should interest politicians, as it is entirely unnecessary for healthy women to use specialized resources at a women’s clinic.
My birth cost the Norwegian state 3,324 kroner. That is what I get refunded in one-time benefits from Helfo.
As of today, only private actors offer home births, although the new guidelines for maternity care open up for health enterprises (hospitals) to also offer home births.
That this is opened up in the guidelines shows that this is considered a safe birth option.
Increase the one-time benefit
We paid around 30,000 kroner to give birth at home. This includes not only emergency preparedness and the birth itself but also follow-up during pregnancy and the first postpartum period.
Prices vary, but as long as one has to cover the costs out of pocket, many cannot afford to choose to give birth at home. This is despite the benefits that home births offer both for the birthing women and for society.
I want to encourage politicians to think differently to solve the problems in maternity care. The first thing they can do is to increase the one-time benefit so that it covers the actual costs of giving birth.
This would not only make home births more accessible for more women but also promote a model of care that aligns with current research and best practices. It’s essential to provide options that cater to individual needs and preferences while ensuring that all women can have safe and supported births, regardless of their financial situation.
Ultimately, we need a maternity care system that respects and accommodates the desires of women, providing them with the dignity and choice they deserve during one of the most significant events of their lives. By addressing these issues, we can create a more equitable and effective maternity care model that benefits everyone involved.
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