Raising the Issue of Inequality: Comparing Home Birth Policies and Practices in Portugal and Denmark

Planned home births are part of a quite invisible reality across different countries where hospital births are dominant. In European countries like England, Denmark, and others, home births are supported by the State, and are part of the public maternal health services. But there are countries where informal but also formal limitations can be found. Placing this option within the European context, it is clear that even where there are signs of higher levels of social and medical acceptance of planned home births, they are still a minority. Also, similar results regarding the configuration of this experience as a rejection of medical dominance, framed by particular risk perceptions, were found by social scientists in very different European settings, like Portugal, the Czech Republic, Finland and Denmark. These similarities are exceptional. When comparing the access, the practices and the organization of home birth, the differences are more evident. In this presentation, some of these local differences are addressed. In Portugal, the access, the validation of practice, and the backup support is offered differently: for women who choose to have a home birth there is worst access to health care, with more barriers and more constraints; scarce discussions and no regulation concerning practices; and no formal, adequate backup support. In Denmark, there are no evident inequalities between women who choose home births and the ones who plan a hospital birth. There are established practices and guidelines, and formal networks both in practice and research. By focusing on the home birth situation in Portugal and Denmark, in a comparative perspective, I aim to explore how the existing public system in Portugal is defining health inequalities for those who opt for a home birth.