Meghan Markle Had Every Right to Want a Home Birth
Before she welcomed her new son, the Duchess of Sussex's home birth plan was mocked by experts. Here's why the attitude behind that criticism needs to change.
As details of the new royal baby’s birth pour in and hit news outlets around the world, there’s been buzz about everything from the unconventional baby name Meghan Markle and Prince Harry chose (Archie!) to the Duchess’ original birth plan. In terms of the latter, various reports noted that she had been hoping to have a home birth, with a a team of all-female midwives, at their home at Frogmore Cottage on the Windsor Estate. Others said she might have a midwife and a doula.
In the U.K., home birth is offered as an option by the National Health Service, is recognized by leading obstetric and midwifery bodies as being safe and suitable for many women, and the National Institute for Health and Care Excellence (NICE) says home birth home birth is safer than hospital birth for some women with uncomplicated pregnancies. Yet, stateside, the Duchess’ rumored game plan was allegedly criticized by leading obstetricians at the annual meeting of the American College of Obstetricians and Gynecologists (ACOG) held in Nashville, Tennessee on Saturday, May 4.
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The Daily Mail reports that Dr. Timothy Draycott, envoy of the Royal College of Gynecology and a professor at the University of Bristol who received an award from the Queen in 2014, told an audience made up mainly of U.S. doctors: “Meghan Markle has decided she’s going to have a doula and a willow tree… let’s see how that goes. She’s 37, first birth… I don’t know.”
Not only is it inappropriate for a doctor who has never seen the Duchess as his obstetrics patient to make a flip, critical, ageist comment about her birth plan, but the more so American school of thought that home births are risky and ill-advised, especially for women over 35, does not reflect research. Sure, the National Institute of Child Health and Human Development may say define any pregnancy for a mom who is 35+ as “high-risk,” and both the National Institute of Child Health and Human Development and ACOG recommend against home births.
A 2011 study out of Oxford looked at over 64,000 low-risk births (defined as births in which there were no complications during the pregnancy or leading up to the delivery) and found that, for women having their second or subsequent child especially, hospital birth was not any safer for their babies than home birth. Another study of higher risk women showed similar outcomes for babies at home as in hospital, and a higher rate of admission to neonatal units for hospital-born babies.
And in the U.K., NICE’s childbirth guidelines from 2014 say that home births are appropriate, even beneficial, for almost half of low-risk births. If a woman's age is her only high-risk factor, the UK's Royal College of Midwives says then a home birth would still be appropriate, if it's what the woman chooses. At the same time, fewer than 9.2 per 100,000 women die in childbirth in the U.K. and Western Europe, according to The Daily Mail. In the U.S.: 26.5 per 100,000 die in childbirth. Evidence shows that Europe's low and dropping rate of deaths is in great part due to midwives, and a low rate of C-sections, forceps, vacuum, inductions and other interventions.
Unfortunately, women in the U.S. aren’t urged to make their own choices as much as they are in the U.K. But attitudes like Dr. Draycott’s haven’t discouraged American moms who know it’s right for them. One such mom is Sasha Brown-Worsham who was 35 when she welcomed her youngest via home birth, not long after moving from Massachusetts to New Jersey.
“My husband is a scientist and a director in the pharma industry,” Brown-Worsham tells Parents.com. “If anyone would be against home birth, it would be him. But my home birth was my third birth after two very easy and healthy, drug-free, midwife-attended births in the hospital. He’s all about statistics, and when he saw the stats on C-sections in our new state, he was as concerned as I was. Once he did the research, he was understood that my comfort and feelings of autonomy mattered most.”
Ultimately, Brown-Worsham’s home birth experience was “easy, quick, and so much better” because her older two children could be involved, she says. “Being at home right away is an experience I’m grateful to have had,” she notes. “Worth every single skeptical eyebrow-raise from the hoi poloi. Women know their own bodies.”
The benefits Brown-Worsham points out are just a few reasons a woman might choose to have a home birth. Perhaps she endured a traumatic birth experience at a hospital previously, or she wants to minimize the chance that she’ll be subjected to unnecessary interventions that could result in physical or emotional scars. She might find that working with a midwife and possibly also a doula would allow her to feel more relaxed, emotionally centered, and physically prepared and supported.
That said, Meghan Markle had absolutely every right to plan a home birth, regardless of her age. Perhaps she ended up at a London hospital. The fact of the matter is that, due to the unforeseen yet common twists and turns that births often take, some women who plan home births will. But the U.K. recommendations and women like Brown-Worsham prove, welcoming your little one at home, with the help of a licensed midwife, is a viable option for expectant moms of all ages.