More Than Four Walls: The Meaning of Home in Home Birth Experiences

Abstract

The "home versus hospital" as places of birth debate has had a long and at times vicious history. From academic literature to media coverage, the two have often been pitted against each other not only as opposing physical spaces, but also as opposing ideologies of birth. The hospital has been heavily critiqued as a site of childbirth since the 1960s, with particular focus on childbirth and medicalisation. The focus of much of the hospital and home birthing research exists on a continuum of medicalisation, safety, risk, agency, and maternal and neonatal health and wellbeing. While the hospital birthing space has been interrogated, a critique of home birthing space has remained largely absent from the social sciences. The research presented in this article unpacks the complex relationship between home birthing women and the spaces in which they birth. Using qualitative data collected with 59 home birthing women in Australia in 2010, between childbearing and the home should not be considered as merely an alternative to hospital births, but rather as an experience that completely renegotiates the home space. Home, for the participants in this study, is a dynamic, changing, and even spiritual element in the childbirth experience, and not simply the building in which it occurs.

Place and space in relation to childbirth: a critical interpretive synthesis

“…Women´s planned place of birth is influenced by several complex factors, such as cultural and normative expectations and earlier experiences (Coxon, Sandall, & Fulop, 2015). Our study demonstrates that a safe place was a major consideration, regardless of which location birth took place (Burns, 2015;Lee et al, 2016;Parratt & Fahy, 2004). This finding is in line with the recently published review of Downe et al (Downe et al, 2018) that highlighted that women have a strong desire for safe care during childbirth.…”

Exploring social and health care representations about home birth: An Integrative Literature Review

“…The Home versus Hospital subdimension debate has a long history: not only are physical locations compared but also opposite birth ideologies can be found. Health institutions have been strongly criticized for their childbirth and medicalization approaches: it is necessary to understand that home birth is not a mere alternative to hospital delivery but rather an experience that procures a different meaning to childbirth and the place in which it unfolds (Burns, 2015). The hospital scenario is associated with more laborious, prolonged deliveries, subject to increasing medical intervention whereas home childbirth is reported by women to be more natural and human that allows them to have a central and active role (Delgado, Sampalo, & Barros, 2007).…”

“…Research included in the Dimension of Comparative Socio‐Medical Childbirth Studies emphasizes the importance of giving birth within health care institutions, where mothers receive greater comfort and security (Burns, 2015). However, according to women's narratives, a greater number of medical interventions take place in centers than at home (Bernhard et al, 2014; Boucher et al, 2009; Delgado et al, 2007).…”

From hospital to home: Australian midwives’ experiences of transitioning into publicly-funded homebirth programs

“…39,40 The home as a setting for birth can be interpreted as being both geographically and ideologically distant from the hospital. 41,42 Indeed, Cheyney refers to women choosing homebirth in the United States as a 'systems challenging praxis'; 42, p. 254 a political act of rejecting the dominant obstetric model of childbirth. In this sense, it is understandable that there may be a level of discomfort felt by midwives who are employees of the hospital when they begin supporting women to homebirth.…”