I’ve been looking for the most recent official stats on homebirth and hospital birth mortality in Australia. I can’t find 2007 or 2008 figures, but there are 2006 figures available.
The Australian Institute of Health and Welfare Perinatal Statistics Unit, Published December 2008.
Most births in Australia occur in hospitals, in conventional labour-ward settings. There were 269,835 women who gave birth in hospitals (97.3%) in 2006 (Table 3.11). A further 5,460 women gave birth in birth centres (2.0%). Planned homebirths and other births, such as those occurring unexpectedly before arrival in hospital or in other settings, were the two categories accounting for the smallest proportion of women who gave birth (2,053 women, 0.7%).[…]
In 2006, 708 planned homebirths, representing 0.3% of all women who gave birth, were reported nationally. The highest proportion of homebirths occurred in the Northern Territory (Table 3.11). […]
Of babies born at home in 2006, all were liveborn. The mean birthweight of these liveborn babies was 3,687 grams (Table 3.34). The proportion of liveborn babies of low birthweight born at home was 0.8%, and the proportion of babies born at home that were preterm was 0.7%.
There were 2,091 stillbirths in Australian in 2006. 2,091 of these occurred in hospitals or birth centres. None occurred at home.
So really, mainstream media, really? This is the statistic you’re supremely uninterested in, while rumours get breathless finger-pointing and hyperventilating misogynistic diatribes from your right-wing talking heads*? Why is that, exactly?
And where were you, RANZCOG, when this was published? Anything to say?
Again: In the most recently available formal statistics, of over two thousand stillbirths in 2006, NONE occurred at home. Zip. Zero. Nada. Looking just at the planned homebirths (0.3% of births), you’d expect six stillbirths. Take away “high-risk” births, and you’d still expect at least several. Looking at all the births that occurred outside hospital or birth centre settings, you’d expect 15 deaths. Yet there were none.
These extraordinarily good statistics are definitely one of the signs that many of us are living in very privileged conditions. Access to C section is not the only or even the major determinant of maternal mortality. Most girls and women in Australia get enough food throughout our lives, have access to a variety of safe fresh foods and drinking water, have access to healthcare and contraception and abortion when needed (including when we’re pregnant too young), and live and birth in clean sanitary conditions. Most of us can expect to live our lives free from rickets, malaria, tuberculosis, HIV/AIDS, severe untreated anaemia or ectopic pregnancy or sepsis, genital mutilation, and violent rape with sharp objects. When preventative or emergency care is required in pregnancy or labour or the postpartum period, safe transfer and care is generally available.
Note the “generally” on all of this; there are caveats and issues in all of these categories, most notably with Aboriginal and Torres Strait Islander women and women living in remote areas. But in Australia, on average, our privilege on all of these points is better than most of the rest of the world. That privilege needs to be recognised, and must always be kept in mind. But the existence of that privilege should not be a roadblock to further improvements within Australia. “The women in Ethiopia would kill to have that C section you’re spurning!” is not a valid tactic to shut down birth activism in Australia – and it is most typically flung down as a trump card by those who show by their other actions that they couldn’t give a shit about women in Ethiopia or anywhere else, and that they are completely out of other arguments.
The current stories of “four deaths”** being bandied around in the media are hearsay presented to whip up a political frenzy. This is occurring at a time when supported homebirth is under severe threat, and the AMA and RANZCOG are working hard to defend their turf. Even if they are all true** (and the official stats will come out one day): unfortunately, stillbirth is a horrible, horrible fact of life. No matter where the birth occurs, some babies will never take a breath. Women who choose hospital birth know this. Women who choose home birth know this. I don’t believe that these decisions are made in naive ignorance of what “could happen”, though obviously no woman wants to think that it’s going to happen to her.
The only way anyone can rationally weigh up relative safety is to look at how many deaths occurred, and whether those deaths were likely to have been preventable. This is not something the court of public opinion can achieve. And then one will need weigh up the other dangers, the morbidity, and the hidden morbidity that doesn’t make it to the statistics. That’s a post for another day; suffice it to say, right now, that the stats being used right now by Australian barrow-pushers are not the only ones, they are flawed, and they have been grossly misinterpreted. (Please save the homebirth-study-wrangling comments for another post, as it’s not what this post is about. What follows is what it is really about.)
And here’s the other thing. Even if homebirth or freebirth were slightly less safe than hospital birth, which is pretty contentious, this is not a reason to restrict women’s rights to makes choices about their own bodies.
I’m going to say that again. YOUR assessment of “safety” is NOT a reason to restrict women’s rights to make choices about their own bodies. The State does not have the right to forcibly stop pregnant women from playing hockey, or driving, or smoking, or eating blue cheese or sushi, or skipping an antenatal appointment, or declining an ultrasound scan. None of these decisions warrant child protection referrals, or court trials, or jail terms. Nor does the State have the right to criminalise home birth.
There are fundamental tenets of feminism:
– The right to bodily autonomy without threat of State violence.
– The right to reproductive choice.
Choice runs in all directions. Do you support it?
* No, I’m not going to link.
**And this is the closest I’m going to get to mentioning this. NOTE: This is NOT a thread to discuss individual women, their choices, or their private details, no matter whether those details have been published elsewhere. If you’re tempted to do this, read the last two paragraphs again before you type. Any attempts to do this will get comments deleted, and, as fair warning: my banhammer is on a hair-trigger with this one.
If you’re looking for somewhere to donate to support reproductive justice and the health of women and infants, here are a few suggestions (you’re welcome to add your own in comments):