As the time draws closer to our newest addition’s debut, I’d like to address some misconceptions that seem to run rampant about home birth. (I think there are as many misconceptions about home birth as there are about Down syndrome!) I’ve heard it all – everything from “You’re crazy!” to “Home birth is dangerous!” to “You’re so brave!” to “You know nobody gets a medal for that, right?”
So let’s just clear a few things up, okay?
I think people still generally see those who choose home birth as fringe lunatics who run around barefoot in peasant skirts and catch and/or grow all their own food. It’s just not so. Most women in the U.S. who choose home birth are educated and middle class. Speaking for myself, I slack on buying organic, I enjoy a good, cold martini, I get my nails done regularly, I drive a gas-guzzling SUV (not that I’m proud), and I don’t even own a peasant skirt. Yes, yes, I’m still one of the outliers as far as birthing choices, but in most ways, I’m very much like most of the other moms you probably know. (Okay, there’s the vaccine thing, and the cloth diapers. And I probably swear more. And I have multiple tattoos. Oh, and there’s the whole God thing . . .)
So, why do I choose home birth? A Wikipedia article on home birth states,
Women with access to high-quality medical care may choose home birth because they prefer the intimacy of a home and family-centered experience or desire to avoid a medically-centered experience typical of a hospital or clinical setting.
Many women choose home birth because delivering a baby in familiar surroundings is important to them. Others choose home birth because they dislike a hospital or birthing center environment, do not like a medically-centered birthing experience, are concerned about exposing the infant to hospital-borne pathogens, or dislike the presence of strangers at the birth. Others prefer home birth because they feel it is more natural and less stressful.:8 In a study published in the Journal of Midwifery and Women’s Health, women were asked, Why did you choose a home birth? The top five reasons given were safety, avoidance of unnecessary medical interventions common in hospital births, previous negative hospital experiences, more control, and a comfortable and familiar environment.
That about sums it up for me.
I gave birth to my first four kids in a hospital setting, and every one of those experiences was pretty negative. I felt pushed around (especially in the case of my twins’ births) and assaulted, even, and it was only over time, as I started learning everything I could about birth, that I realized that most of the protocols and procedures that are routine in hospital births are medically unnecessary and designed to maximize (a) hospital profits, and (b) the medical staff’s convenience. Maternity units are the biggest revenue makers in most hospitals; birth has become an industry. Of course they don’t want moms or babies dying on them, but the safety and comfort of moms and babies is secondary. (The United States ranks No. 39 – in the world! – for maternal mortality rates as of 2008 [and the U.S. maternal mortality rate increased slightly from 1990 to 2008], the year for which the most recent data is available, and No. 34 – in the world! – for infant mortality rates as of 2011. In case you were wondering.)
Here’s what I know:
- If I walk into my state-of-the-art hospital in labor, I will be denied food and drink by mouth for the duration. Completely unnecessary, and in fact, counterproductive; the reasoning behind the NPO protocol is that they don’t want anything in the woman’s stomach on the off chance she’ll need an emergency c-section (which would require general anesthesia as opposed to a non-emergency c-section for which an epidural is used), as she could aspirate the contents of her stomach during surgery. First off, people come in for emergency surgery right off the streets all the time (think horrible car accident). During surgery, you are intubated. You therefore will not aspirate the contents of your stomach. Furthermore, to deny fuel to someone who is doing the work akin to running a marathon is counterproductive at best, and cruel at worst.
- I will also be made to accept an IV, through which they will feed me a glucose solution in place of actual food and water. I will thus be tethered to an IV pole and will have an uncomfortable needle jammed in my arm and taped down.
- I will be made to submit to at least intermittent fetal monitoring, which will require me to lie in bed for 15 minutes out of every hour. I may be allowed to walk the halls, but I will be pulling a cumbersome IV pole around with me whilst trying to keep my ass covered by the required wayward hospital gown.
- I will be looked in on by a nurse who is also looking after numerous other laboring women. I will have no continuity of care.
- I will be put on the clock as soon as they get the IV in my vein; if I fail to dilate the prescribed 1 cm per hour, I will be “encouraged” to submit to augmentation of my labor by way of Pitocin and/or artificial rupture of my membranes. If I submit to Pitocin, my labor will become unnaturally intense and painful, and I will then be “encouraged” to accept an epidural. Once I receive the epidural, that’s it – I’m stuck in bed with continuous fetal monitoring and a catheter because now I can no longer get up to pee.
- I will be limited on the number of people important to me whom I’d like to be present for the birth.
- Once I am deemed “ready,” the doctor will swoop in to save the day. By this time, I have been swabbed from belly to mid-thigh with Betadine, and sterile sheets have been draped over me, exposing only the baby’s direct exit route. I will have an extremely bright light shined on my nether regions, and I will be made to give birth in a supine position (the least optimal position for opening the pelvic inlet, but the most convenient position from whence the good doctor to deliver the baby), with directed pushing (“PUSH TO THE COUNT OF TEN! NOW! PUSH! NOW STOP. PUSH AGAIN, TO TEN NOW!”).
- Once the baby is born, s/he will be placed on my chest for a few moments, and Dad will be allowed to cut the cord if he so desires. The baby will then shortly be whisked away to the other side of the room for suctioning, weighing and measuring, bathing, administration of Vit. K shot and antibiotic eye ointment (you know, just in case I have VD and don’t know it, or am holding out on everyone). I probably won’t see or hold her/him again for a good 20 – 30 minutes.
- Meanwhile, it is imperative that I expel the placenta pronto. To assist, the doctor will use cord traction to help things along – that is, he will yank on the cord. Time is of the essence; he’s got other moms to doctor and/or a golf game to get to! If I have not received Pitocin in my IV to help my labor along, I will now receive a shot of Pitocin in my thigh as a matter of routine to control bleeding, whether I am bleeding or not. The nurse will also grab my tender uterus through my now squishy abdomen and knead it like bread dough to make it clamp down. I will want to strangle her.
- Within an hour or two, I will be moved, along with my new baby in a clear plastic box on wheels, to a postpartum room. My husband may be allowed to stay the night in a narrow vinyl pull-out chair. There will be visiting hours that must be observed, and my other children won’t meet their new sibling until visiting hours.
- Throughout the day and night I will be monitored by different nurses at regular intervals who will check my blood pressure, temperature, etc. I will have to listen to all the hospital noises and people coming and going at all hours. I will be admonished if I bring my baby into my bed and actually fall asleep with him or her there. I will leave the hospital with formula samples, you know, just in case.
And all this if I don’t end up with a c-section! Just walking into the hospital in labor puts me at a 1 in 3 chance of having a c-section. Yes, that’s right, 1 in 3!
Here, in a nutshell, by contrast, is what I can look forward to when having a baby at home:
While in labor, I can wear what I want, do what I want, and eat and drink what I want. My midwife will come over when we ask her to, and from then on, she will be there for the duration, occasionally checking my blood pressure, listening to the baby’s heartbeat, and doing as few vaginal checks as necessary (I’m actually aiming for none this time around, I hate them so. I figure I’ll know when it’s time to push since I’ve done this a few times already). She will bring with her oxygen and necessary emergency medications. She’ll stay out of my way if I want her to, she’ll make bawdy jokes if the situation calls for them, and she’ll offer tender encouragement. She will mostly observe and allow me to do what I need to do to cope with labor and deliver my baby into the world. She does not deliver babies, her mothers do; sometimes she catches babies as they ease into the world, sometimes the moms themselves catch their babies, and sometimes Dad catches the baby. There will be no time limits placed on me. I can go for a walk around the neighborhood if I want to, or I can relax in the birth tub. I can labor in whatever position works for me, and when it’s time to push my baby out, I can do so in whatever position works for me. I can have as many or as few people present as I wish. After the baby is born, I can hold her for as long as I wish – there is no hurry to bathe her or do anything else under normal circumstances. The placenta will come when it comes. When everything is said and done, I will crawl into my own bed with my new baby and my husband, and my midwife will stay to make sure we’re all settled and fed. She will empty the birth pool and clean up whatever needs to be cleaned up (birth is not as messy as you might imagine – most of the mess is towels, plastic sheets on the floor, etc.) My other kids can come in and meet their new sibling right away. After she leaves, she will come back numerous times over the next week or two to check on us.
And that’s pretty much it.
Listen, if you’ve had a positive birth experience in a hospital (and I know many have), then bully for you. But just like home birth isn’t for everyone, neither are hospital births. And before you make any snap judgments about home birth, do some research. It cracks me up how many people say that home birth is reckless and crazy who really know next to nothing about home birth, and who have no facts to back up their assumptions.
I don’t do this because I’m crazy or brave. Deciding to give birth at home after four hospital births was a very thoughtful, research-intensive process. In the end, I have chosen this because it’s what’s best for me and my family.