Birth is women's work, and I'm male. If you'd like a female view of Home Birth, I can recommend the website Giving Birth Naturally. Catherine, the author, has given birth at home and can speak with authority. But if you want more information about back pain and birth, you might like to read on.
For many decades hospital birth has been the norm for western mothers. In hospitals, women are usually required to lie on their backs to give birth.
On this page I consider why this should be avoided. The reasons are partly anatomical, partly complex and personal.
Although hospitals are better-equipped for dealing with medical emergencies, there is growing evidence that home births have much less need of medical intervention than hospital births, and that they are just as safe as hospital births.
There's a thought-provoking TED talk by veteran midwife Ina-May Gaskin here.
Women don't choose to give birth lying down. Leave a woman to her own devices during labour, and she'll use all sorts of positions, standing, on all fours, lying on her side, sitting. Most of the time she will choose a vertical position, which makes good sense, as it allows the baby's weight to assist the birth process. None of the positions have anything pressing against her lower back and pelvis. This also makes good sense.
Your tailbone is usually in the baby's path through your pelvis, and needs to move out of the way in the direction of your back. If you're lying down, your tailbone is jammed against the bed, and it will be more difficult for it to move back and out of the way of the baby. The results may be more pain than necessary, more difficulty giving birth, and even the need for medical intervention such as Ventouse (suction), forceps or Caesarian Section.
Birth is painful for most women, and a time of vulnerability. Some writers (e.g. Ilana Machover's E-book of Birth Stories) suggest that:
make about as unnatural a situation for giving birth as it is possible to conceive of. Given a choice, a woman will find a cosy nook, with low lighting and privacy. It is hard to disagree, but why should this matter?
Because if a woman is in any way fearful or insecure, it can affect her labour. Female mammals have the capacity to partially reverse their labour under threat. It makes sense: they can get away from danger and find a safer place to continue their labour. If the above unnatural situation is considered in any way threatening to the mammalian brain of a labouring woman, it may send her labour into reverse, or delay birth. From an Alexander Technique teacher's point of view, the "threat" will lead to a stiffening of your neck, and a shortening and narrowing of your back and limbs. All of these are poor preparation for giving birth to a child.
Home Birth means means giving birth at home, or a home-like space, rather than in a hospital. The idea is that as a woman, you know what you need instinctively for your own birth, and in your own house, you're firmly in control. With a home birth, for example, you can arrange your own favourite room for the birth, with candles, familiar smells, your own music and a steaming hot bath, and get in and out of the bath at will. You can be with people who love you, know you well, and will not try to take control. Or you can choose to give birth alone, with a friend (and a midwife, if you choose) sitting next door until you ask for help. Some birthing centres in the UK and elsewhere will support your wish for a home birth, and will provide you with midwifery support. Our local town, Kendal, has such a system for those wishing to give birth at home.
If you choose to use an independent midwife, the same midwife can be with you all the way through your pregnancy and labour, and you will have developed a trusting relationship with her. In hospitals, midwives are typically looking after several women simultaneously, often disappearing just when you most need them. You may never see the same midwife twice all the way through your pregnancy and labour.
Supporters of Home Birth say that women, given power, a pleasant birthing room, privacy and loving support, have fewer complications than women giving birth in hospital. Fewer complications includes less back pain and injury, and fewer problems with bonding and breast-feeding afterwards. Supporters of hospital birth point out that expert help is available immediately for a mother or child if either has serious complications. This is true, but other research suggests that the hospital setting is not necessarily safer overall. As with everything to do with pregnancy and birth, how you do it should be a matter of choice, and you will probably hear and have to decide between conflicting views on what is right. Health professionals, midwives, friends and family are there to inform you, not to dictate your decisions. There are strong feelings on both sides of the Natural Birth/Hospital Birth debate, and voices on both sides sound like there is no alternative to their way of thinking. If you're interested in finding out more about Natural Childbirth and Home Birth, there is a is plenty of information on the Internet. I enjoyed Giving Birth Naturally, which is friendly, passionate, well-informed. And the author has actually done it!
My wife Liz chose Debbie Rhodes as her independent midwife, and our little boy, Sam, our first child, was born at home.