I changed my mind about where birth belongs

I used to believe hospitals were the safest place to give birth.

Not casually. Not loosely. I believed it in a way that felt responsible and informed. Hospitals meant access to care, to expertise, to backup if something went wrong. They meant reassurance. They meant doing the sensible thing that everyone else does.

For a long time, that belief made sense to me. When we are sick, when something is wrong, we go to specialists to make us better. Hospitals are where medical problems are managed. They are places designed for diagnosis, treatment, and rescue.

What I have since arrived at is this. Birth is not medical. Most pregnant people are not sick.

That does not mean birth never needs medical care. It does not mean things do not go wrong. But it does mean that pregnancy and labour begin as physiological processes, not pathological ones. And that distinction matters far more than we tend to acknowledge.

What changed my mind was not one dramatic moment or a single bad experience. It was slower than that. Quieter. It happened as I spent more time inside different maternity systems, across different countries, watching how the same physiology was treated in very different ways depending on context, culture, and tolerance for risk.

I began to notice that safety was being defined differently in different places. Sometimes safety meant supporting physiology and intervening only when necessary. Other times it meant anticipating risk so thoroughly that birth itself became something to manage, monitor, and direct from the outset. Sometimes it was less philosophical than that. Sometimes it came down to busy hospital schedules, staffing pressures, or recommendations shaped by long weekends and holiday seasons rather than by the body labouring in front of them.

None of this made hospitals bad. But it made them not neutral.

I started to see how the structure of hospitals shapes what is possible inside them. How protocols, staffing ratios, time pressures, and liability concerns quietly influence decision making. How care can be skilled, attentive, and well intentioned, and still be misaligned with what a physiological process actually needs.

The more I learnt about birth physiology, the more obvious this became. Birth works best when the nervous system feels safe. When hormones are allowed to flow. When the body is not being constantly interrupted, assessed, or rushed. Hospitals are designed to respond quickly to pathology, which is essential and life saving when things are not normal. But that same design can struggle to support normal processes without interference.

And then I saw birth at home.

I saw what happens when time is not managed in shifts. When the environment belongs to the person giving birth. When privacy is assumed rather than negotiated. When the body is trusted first, and medicine is there when it is needed, not hovering in anticipation of failure.

This is where my thinking really shifted.

I realised that the question was not “are hospitals safe?” but “safe for what, and for whom?” Safe for emergencies, absolutely. Safe for low risk physiological birth, sometimes. Safe in ways that are predictable and consistent, yes. Safe in ways that support trust, patience, and continuity, not always.

Changing my mind about hospitals did not make me anti medicine or anti intervention. It made me more specific. More nuanced. More aware that context matters, and that a setting built to manage risk is not always the best place to support a process that depends on time, trust, privacy, and hormonal flow.

I also realised how rarely we talk about the work required to birth well in hospital settings. The preparation. The advocacy. The emotional labour of learning the language of consent. The courage it takes to say “no, I don’t consent” to an obstetrician in a white coat, knowing that doing so can change the entire tone of the room. That is not nothing. That is huge.

This is not an argument for one place over another. It is an invitation to look more closely at how beliefs about safety are formed, and whose needs they centre.

Changing my mind about hospitals did not happen because I stopped caring about safety. It happened because I started paying closer attention to what safety actually looks like in practice, rather than in theory.

And once you see that, it becomes hard to unsee.