Having a baby at home

Because you're likely to be reading more posts about the midwife being prosecuted here in the near future, I want to explain my feelings and philosophies about birth in general and birth at home specifically.

I'm certainly aware that people unfamiliar with midwives and the homebirth movement may have some preconceived ideas about them. When I first told people I was planning to give birth at home, I was asked lots of questions like, "Is that even legal?", "Isn't that dangerous?", and "Why would you want to do that?"

The first one is easy. Yes, it's actually legal in all 50 states. That doesn't mean there aren't people that don't try to harass families who choose it. Plenty of doctors and "well-meaning" (read: nosy) neighbors have tried to turn people into the authorities because, well, those crazy people must be breaking the law and endangering their child!

Which brings me to the second question: Is it safe? The short answer is YES. Oh, you don't believe me? Well, that's OK. I understand. There was a time I would not have believed me either. So let me tell you why it's safe.

Statistically speaking, though it might be hard to believe, homebirths have far better outcomes and lower infant and mother mortality rates than hospitals. Part of the reason is that midwives rarely take on high risk patients, but the biggest reason is, midwives understand and respect birth in a way that the medical profession, for the most part, no longer does. Historically, birth was a rite of passage, a family and social event that was celebrated with joy. Today, it has been reduced to a medical event that doctors would have us believe could not happen safely if they were not there for it (never mind that doctors only started regularly attending births in the last 100 years). Now, I have no problem with doctors attending births, or with women who prefer to have a doctor present at their birth. I think birth should also be as positive an experience as possible for every woman, and if that means getting your epidural, then go for it! But consider this fact: among developed nations, the United States ranks something like 17 in infant mortality rates. Safe? The nations that rank near the top, mostly European, all have a couple of things in common: they utilize midwives far more often than we Americans do, and they have a much higher incidence of homebirth. They also have a far lower C-section rate than our miserable and shocking 25%.

There are lots of other issues I have with doctor-attended hospital births, like an OB's itch to DO something, let's quit fooling around and waiting, let's get in there and get that baby out! It's Friday, I'm going on vacation next week. Interested in being induced? Great, I've got something you'll love: Pitocin. It will give you contractions that will make you wish you'd never had that extra glass of wine that led to that night of hanky-panky with your husband, which led to this child being conceived, contractions that come right on top of the other without giving you a break, but that's ok. It will get the baby out faster. And if Pitocin doesn't suit you, I've got some Cytotec, which will do the same thing AND will increase your risk of uterine rupture, never mind that the FDA has not actually approved it for this use. Oh, you really need something for the pain now, don't you? Yeah, you natural birthers don't really know what you're getting yourselves into, I know. Yeah, inducing doesn't help much, I know, but anyway, let's just get you hooked up to that epidural now, shall we? There...better? Good. Now, it's almost time to push. What? You can't feel where to push? Well, right where my hand is...oh, of course, you can't feel anything because you have that epidural. Well, do the best you can....well, this just isn't working, we're going to up the Pitocin. Gee, this still isn't working. If the head was further down, I might be able to try forceps or vacuum extraction, but it's just too far up there. I'm afraid we're going to have to do a C-section....(later) Here's your baby! Unfortunately, she has a fever, which is PROBABLY related to the epidural you got, but just in case, we're going to have to take her to the NICU and keep her under observation for a couple of days....(later) I'm so sorry about that staph infection!

(DEEP BREATH)

OK, Andrea here, back again. Now...I know that among my small readership, you've mostly had hospital births that you probably feel good about. I in no way want to detract from that. The above was exaggerated SLIGHTLY to make my point that these are all things that can and often do happen in hospitals (doubt me? Watch A Baby Story or any of the other childbirth reality shows on TLC. How many of them turn out at least a bit like the above?). Homebirths attended by midwives do not have the above elements. Midwives are willing to wait for a slow baby. If they induce, it's only at the client's request, and only using fairly natural methods (though I have some opinions even about those, having endured them!). My midwives couldn't give me drugs or an epidural, that's true, but they did offer their constant presence and support, as well as practical ways to ease and get through the pain (how many women in hospitals have a nurse that stays with them for the whole birth, let alone the doctor?). Since I wouldn't get an epidural at home, I certainly would know if my baby's fever was something to worry about, and they would never have had to endure the isolation of the NICU without being certain it was for a good reason. And of course, who ever heard of anyong getting a staph infection in their own home?

Some of you may be feeling defensive at this point. Please don't. I want you to remember that I'm explaining why I chose homebirth, not trying to convince you that YOU are wrong to choose a hospital birth.

Which brings me to the third question: Why would I want to have my baby at home? I gave my reasons back when I posted Audrey's birth story. Here's that portion of it:

Even before I was pregnant, I knew I did not want a traditional hospital birth. I did not always feel this way; I grew up never knowing that there were women who had there babies at home with a midwife, and I always assumed I'd have my babies in a hospital, like my mom, and my grandma. It all started with a project for a graduate class. Our group decided to do a web page on pregnancy, with links to helpful websites. One site we included was for a birth plan, and I remember thinking, this is a neat idea, but why would people worry about some of this stuff? Who cares if I can walk around during labor? Won't I be in a lot of pain? And do I really have a choice if I get an episiotomy or not? Doesn't everyone get them? So I got curious.

A few months later, in April of 1999, Leo and I decided to start trying to get pregnant. As I always do when I'm really interested in something, I obsessed about it and got all the information I could, not only about trying to conceive, but also on pregnancy and childbirth. I worked in a public library at the time, and stumbled onto Barbara Harper's book and video, Gentle Birth Choices, which focused a great deal on waterbirth. I wondered if I might find a hospital around my area that would do a waterbirth. A birth story I read about described a woman's ordeal after a C-section she didn't want, even after trying to have a natural childbirth in a hospital, due to too many unnecessary interventions, and I realized that even if a hospital seemed to promise a chance at natural childbirth, it might not happen. The reading I had done had convinced me that homebirth was safe, and I just did not want to deal with following some hospital's "rules" (I didn't want an IV; I didn't want the baby taken from me at all; I definitely wanted a waterbirth). I decided then and there that I was going to pursue a home waterbirth with a midwife, if I could possibly find a midwife. I talked with Leo, and was relieved when he said he had no problem with my plans. He was born at home himself, so it was not a strange idea to him.

Ultimately, I believe childbirth is designed to go well, not to go wrong. That's why I did not worry about things going wrong at home. I'm no idiot; I know sometimes things DO go wrong. All the midwives I worked with are trained for many of the possibilities: they carry oxygen for babies that need it, they are trained in CPR and first aid. When I tore slightly in my first birth, my midwife stitched me up just as nice as you please. If something more serious had gone wrong, we were five minutes from the local hospital, a call away from 911.

I'm not the only person I know in real life who favors homebirth. Some of the people I know BECAUSE they are homebirthers (we belong to a group of moms who practice a certain parenting style, many of whom also chose homebirth). But I have been surprised by the friends and acquaintances I have that I didn't know chose to have their babies at home, or have since asked me about mine because they are now considering it. It's a growing movement, one that deserves to be acknowledged and accepted as an alternative. And we who are a part of the movement also deserve to have trained, capable attendants of our choice, who can acquire a license, and who are not harassed, prosecuted, or persecuted.