“My dream is that every woman, everywhere, will know the joy of a truly safe, comfortable, and satisfying birthing.”
Marie Mongan, author of “Hypnobirthing: The Mongan Method.”
It was many years ago when I first heard of someone planning a home birth. One could say I was aghast. “Doesn’t this mom know how dangerous that could be?!” I thought I knew everything. It’s funny how opinions sometimes come back to bite you.
(To introduce this topic with a little light-hearted humor, I give you Jim Gaffigan 😉
Now that I have spent the last five years learning about birth, I myself am planning a home birth for our second child.
“Why on earth?!” my 20-year-old self would ask. Several reasons:
Before I delve into the details of our choice, I first want to thank you for taking the time to listen to my perspective. My purpose in writing this is to encourage women who might be on the fence about delivering at home, and to assuage concerns and questions our friends and family might have. I hope it is helpful. 🙂 (Disclaimer: I am not in a position to give medical advice; if you are reading this as a parent, the decisions about your care would ultimately be up to you, your families, and your caregivers.)
Let’s start with the obvious: When it comes to bringing a new life into the world, it is every reasonable person’s top priority to have a healthy mother and baby.
Now, I would submit to you that that does not necessarily mean having a hospital birth – contrary to what we Americans have been led to believe. I attempted to summarize the analyses of why this is the case, but my post got too long :). So instead, I am going to recommend several articles here that explain why home birth can be a good option FOR NORMAL, HEALTHY PREGNANCIES. Obviously, there are reasons western medicine and hospitals exist: sometimes they are needed, and for such times, we are fortunate to have those options!
- Science and Sensibility: “Dueling Statistics: Is Out-of-hospital Birth Safe? . Henci Goer is the author of “The Thinking Woman’s Guide to a Better Birth and Optimal Approach”, and an acknowledged expert on evidence-based maternity care. I particularly admire her analytical ability to sift through data to reach accurate evidence and conclusions. In this article, she compares two recent studies on the safety of homebirths, and says the studies “agree that [Out of Hospital] birth reduces cesarean surgeries, a severe adverse outcome in its own right on the maternal side with potential for severe adverse perinatal outcomes down the line. I contend that it’s time to stop asking ‘Is it or isn’t it [safe]?’ questions of OOH birth because it’s pretty clear that the answer is ‘It depends.'” Read the article to learn more!
- Evidence Based Birth: “What Is Home Birth?”. In this article, Rebecca explains the basics of home birth.
- AvivaRomm.com: “Choosing Home Birth” by Aviva Romm, M.D.. She is a physician and midwife, who birthed all four of her children at home! She says, “Birth can be seen as a healthy, natural, normal experience – unless evidence-based medical indications demonstrate otherwise, and in those cases, the least amount of intervention necessary could be judiciously provided.”
There are several scenarios that would require me to transfer care to a hospital during the PRENATAL period. For example, twins (heaven help us! :)), a breech baby, high blood pressure (preeclampsia), or placenta previa. Aside from situations which would be detected at a prenatal visit, something may still come up during the actual birth. For example, postpartum hemorrhage, or a baby lacking oxygen. Here is a list from a Tennessee midwife practice of the equipment they bring to home births. To use their words, “We do more than boil water!” On the contrary, certified midwives are prepared to tackle any number or scenarios at a homebirth without necessarily having to transfer care. Complications that would require me to transfer care to a hospital DURING the birth would include preeclampsia, retained placenta, blood transfusion, baby needing extra care, etc. (I am happy to try to answer your questions regarding specific scenarios not mentioned here). It is unlikely for a mother who has already given birth vaginally to require a hospital transfer when she is under the care of a professional midwife. Each midwife can give you her own transfer statistics.
If we approach the 38 week mark (term pregnancy), and my intuition is telling me we need to be in a hospital, even without evidence pointing towards a complex delivery, then a hospital is where we’ll be! Again, there are reasons certain technology have been introduced to the birth room, and if we believe we’ll need them I’m glad to have them!
My less obvious safety reasons for choosing a home birth include:
- Less risk of infection for both mother and baby. Even in a newborn ward, there are many people coming and going in a hospital, and despite everyone’s best efforts, it’s my opinion that baby and I would be exposed to germs there that we wouldn’t encounter at home.
- No risk of having my baby en route to the birthplace. Every year, you hear of babies being born on the side of the road as the mom and dad frantically make their way to the hospital. Granted, many times both mom and baby are ok in that scenario, but I’d much rather have the well trained eyes and hands of a professional by my side than simply rely on mine and my husbands expertise.
- No sharing! 🙂 Robinson was born on a wild night at the hospital. I think there were at least two other women pushing at the same time as me, and there simply were not enough midwives to go around (I’m not placing blame here – the midwives were great! It just happens sometimes when you birth in a place with more than one pregnant mama.). So despite their best efforts, I had no one coaching me through pushing, to help me know when to pause and let the baby’s head stretch the perineum. I think if someone had been watching the perineum I might not have torn as badly. With a home birth, you don’t have to share your midwife! Another example of why I love the idea of having my care provider all to myself is because I can call her directly anytime! I had a scary evening midway through Robinsons pregnancy which sent Paul and me to the ER where I waited tearfully for hours to make sure my baby was ok. With a home birth, you can call your midwife at any time and she knows your history, your current condition, and she can probably advise you a lot sooner than a hospital staff would be able to.
- Care for the entire family – We have a photo of Paul holding Robinson immediately after we were settled in our postpartum room and our nurse was about to take her leave. I was asleep on the bed after having fainted getting up to use the restroom. Paul’s expression would be perfectly described as “deer in the headlights”. “You’re going to leave me with this child?!” “Is my wife going to faint again?” With a home birth midwife, you are 1) already tucked into your own bed, so no risk in traversing anywhere, 2) consistently monitored until you can prove you are stable and able to take care of your bodily functions without fainting (seriously, this is something they wait around for ;)). As with prenatal care, you have access to your midwife 24/7 to call if anything seems amiss, and when you do call, she will know your history, having walked this road with you for nine months instead of having met you five minutes ago. I take great comfort in the background knowledge she carries, which I view as contributing to my and the baby’s safety.
We know that birth is directly affected by a mother’s sense of security and comfort. Like other mammals, we can subconsciously stall birth if we feel unsafe. For me, one of the places I will feel safest is at home (for others, this might be at a hospital). Also when you’re at home, you have the freedom to snuggle with your partner and so forth, which might be more difficult to achieve in a hospital setting. Also, there are still very few hospitals that allow water births, though it is commonly practiced in other countries, some of which have far better maternity results than we do. So birth at a freestanding center or at home is one way to achieve that.
I’ve already mentioned blissfully crawling right into my own bed with my baby and sleeping soundly. No one will be sneaking in every hour to monitor me. I have the comfort of knowing my midwife is just a phone call away if Paul or I needs her, and she will be checking on us regularly.
Plus, we won’t have to worry about wrangling an hours-old baby into a cold, hard car seat! This may seem like an insignificant thing, but both Paul and I remember how strange it felt to drive Robinson home in his car seat after he had been lying on my chest for days, and prior to that, had been living inside me for nine months. So I look forward to hopefully just staying in bed all altogether for at least five days or so. Many homebirth midwives will come to your home for the first couple newborn checkups because they believe moms should be resting during this time. Indeed, we are one of the few cultures who expects our moms to be “up and at ’em” within a week or so of delivering a human.
This isn’t necessarily a comfort point, but… I want Robinson to have the opportunity to be present for parts of this special family event, to be one of the first people to welcome his sibling into the world – how cool! Even if a hospital wanted to accommodate a two-year-old in the delivery room, I don’t think there would be a good way for him to see around all the supplies, equipment, and people who appear at the pushing stage.
The more births I attend, the more I believe that a mother’s trust in her care provider is essential. If something comes up in a birth, and the mother and her partner have a serious decision to make, it is going to be infinitely harder to make that decision if they are at all distrustful of their provider’s opinion. What a terribly uncomfortable position to be in – for everyone!
So as I strongly encourage my clients (more now than I used to) to choose a care provider they really believe in and trust, so I have taken my own advice 🙂 I have chosen a (certified! registered!) home birth midwife in particular because she views birth as a natural, normal process, and herself as the lifeguard, diligently watching over myself and my baby in case anything goes wrong. Many hospital midwives and birth center midwives (and some doctors too) also hold this perspective on birth.
Here is a thoughtful article written by a doula on questions to ask YOURSELF and your potential care provider when choosing your birth attendant. She says, “During labor is not the time to question if [your caregivers] have your best interests at heart. After the birth is not the time to wonder if the recommendations they made could have changed the outcome. Pregnancy is the time to really evaluate these issues.”
Also, I believe that trust in my body will come more easily at home. Even as a doula, I doubted my body with Robinsons birth, and I want to give my body more credit this time. If the pain meds aren’t around, it’s likely I won’t need them! (Like not having a giant thing of Oreos in my kitchen while I’m trying to cut down on sugar ;)). In my opinion, I think there are times when a mom needs to rest and pain medication can be helpful. But I think our society tells us all too often that we can’t handle the pain of childbirth and we should opt for an epidural the minute we walk in the door. In actuality, I have yet to meet a mother who regrets having given birth naturally, as there is much to be gained from experiencing the challenge of natural birth. Many have said something along the lines of, “If I could do this, I can do ANYthing!”
This concludes my personal reasons for planning a home birth. Feel free to ask me any questions you might have. As always, disrespectful comments or questions (no matter what stance on the matter) will be deleted ASAP.
If you had or are planning a home birth, what are your reasons for choosing that option? What did you enjoy about it?