[I]n Australia the cultural messaging around birth seemed to dwell on its uncertainties and dangers. The few births I had close knowledge of before having my own children seemed drawn out and vexed, typically beset by high drama, angst, and epic time scales (by Lao standards at least). This, despite maternal deaths being, statistically speaking, rare in Australia.
In Australia, at least one in three women who give birth experience birth trauma. One in ten develop signs of post-traumatic stress.
[P]eople approaching their first birth who have received cultural messaging about birth as trauma, perhaps through the rituals of worry that are so common during pregnancy, or perhaps through the Hollywood movies that dwell on birth trauma, may then be predisposed during labour to pull the trigger on the “cascade of interventions”, one leading to the next. This stream of interventions may itself be traumatising and perhaps life-threatening.
Yet the statistics suggest that birth does not have to be a horror show. In Australia, women on average have a 60% chance of undergoing an episiotomy or caesarean section, while those who plan a home birth experience these at a rate of less than 6%. Yet less than 1% of women who give birth in Australia plan a home birth. More women give birth on the side of the road each year. There are possibilities for better births.
A small but determined and wonderfully committed Australian birth activism scene is campaigning for continuity of care for women who birth in hospital, and for access to home birth for women who want it. By keeping open the possibility of birth outside hospitals, birth activists may (intentionally or not) be throwing open much wider horizons of possibility.
Comparing planned hospital and home births through their existing mortality rates is comparing apples and oranges. Yet major systematic reviews reveal no significant statistical different in infant death rates and lower rates of maternal mortality among non-hospital births.