Why home birth?
Author’s note: This is the second in a three-part series on the topic of home birth. Read the first.
For the most part, I kept our plans for a home birth a highly guarded secret. Only a small group of people knew. This included my parents – who had to know because they were the caregivers for the two older kids during the birth – and a very select few family members and friends who I knew would be supportive.
Now that the baby is here and everyone is healthy, I thought I’d share why we chose home birth. Before I do so, however, I would like to reiterate something I’ve written before in other posts related to pregnancy and parenting. This is important: My choices are not a judgment of yours. In other words, if you’ve had hospital births, I am not judging or condemning you.
That said, there are a lot of myths and confusion surrounding home birth. I am certainly not capable of dispelling all of them, but I can share my story.
Back in 2011, when I first became pregnant with Cecilia, I dabbled with the thought of home birth. I briefly mentioned it to my doula, who said she could help me find a home birth midwife if I wanted to investigate. Mike, as always, was supportive, but I lacked the confidence to pursue home birth at the time. So I stuck with the original plan – midwifery care with a hospital delivery. That was the model I chose with my first pregnancy, and it all worked out OK, so I figured the second time would be good, too.
My first two births were fairly uneventful. Both relatively quick labors with no drugs and no complications. Natural, vaginal births, just like I wanted. Healthy babies, healthy mama. I was one of the lucky ones.
So after two successful, intervention-free hospital births, why home birth? I would like to address one of the reasons I did not want another hospital birth. I tread lightly here because, again, I don’t want anyone to feel judged. Truth be told, I knew that two vaginal births did not guarantee a third, and I did not want to end up with a c-section. According to the most recent data from the Centers for Disease Control and Prevention, the c-section rate in the United States is 32 percent, or about 1 in 3 women. I find this number unacceptable. Mayo Clinic cites breathing problems and surgical injury as possible risks for the baby, while mom’s risks include infection, increased bleeding, reaction to anesthesia, blood clots and increased risks on future pregnancies. Even if mom and baby have none of the above problems, a c-section is still major abdominal surgery that leaves a scar and requires a longer healing process than a vaginal delivery. It is difficult enough to take care of a newborn, especially with other children in the house. I couldn’t imagine that additional burden.
Simply put, I wanted total control of the birth – my caregiver, my position, my environment. (Well, as much control as birth allows. Birth can always be unpredictable or “wild,” as my midwife put it.) I wanted to be the person calling the shots, which is the opposite of what I experienced during my hospital births, especially with my first baby. In that instance, I was coerced into having a cervical ripener, hooked up to an IV (in case I needed it later) and monitored with equipment that has been shown to have no positive effect on outcomes. The nurses got in my face and yelled, “BREATHE” and “PUSH!”
I must say, my second hospital birth was better because I knew I could deny many of the unnecessary hospital protocols. But I still felt stuck for 48 hours after having delivered a healthy baby. I remember that time in the hospital after my first two births as annoying and frustrating. I just wanted to be home. This was one of my primary motivations for seeking home birth – to be in my own bed and in my own clothes, to eat food my husband prepared for me, to see my other children as much as I wanted. I desired for the minutes, hours and days following the birth to be relaxed, comfortable and peaceful. I didn’t want unfamiliar people entering my room, waking up the baby or me.
There are also benefits for the baby when it comes to home birth, too. Many are related to the way labor is allowed to progress naturally, not rushing or putting unnecessary stress on the baby. But the home birth environment is also gentler for the baby than a bright, white hospital. Dim light is nice for welcoming a new life who’s accustomed to darkness, and quiet, natural sounds are more like those the baby experienced in utero. Plus, immediately placing the baby on my bare chest and leaving him there for an hour or more was helpful for breathing and bonding. And waiting until the placenta was delivered to cut the cord was another awesome perk of home birth that doesn’t always happen in the hospital setting.
It’s not uncommon to hear women joke that it would be easier to find a drug dealer than a home birth midwife. It certainly wasn’t easy for me, but I was determined. I started by asking the hospital-based midwife I saw for the first several weeks of pregnancy if she knew any home birth midwives. Fortunately for me, she knew two. I managed to track them both down and call them. I set up interviews with both and met them. I chose Melissa, who has attended nearly 900 births, which is a lot, more than some physicians have attended.
Now, I have nothing against doctors. I just really love the Midwives Model of Care because, according to the Midwives Alliance of North America (MANA), it “is uniquely nurturing” before, during and after birth. It is also “based on the fact that pregnancy and birth are normal life events” (emphasis mine).
Safety was probably the most common concern from the people with whom we discussed the home birth. It usually came in form of, “What if something goes wrong?” I mean, Melissa is not just some lady I met on the street. She is a trained professional. Something going wrong does not necessarily warrant a transfer to the hospital; Melissa is capable of handling all kinds of situations. However, if Melissa had determined that a complication was out of her league, we would’ve gone to the hospital.
On the other side of the safety coin, multiple studies have shown that, for low-risk pregnancies, which include most healthy women, home birth is just as safe as hospital birth. Christiane Northrup, M.D., author of “Women’s Bodies, Women’s Wisdom,” penned the foreword to “The Essential Homebirth Guide,” which, by the way, is an absolute gem of a book that I just happened to stumble upon at the library. I would highly recommend it to anyone even remotely considering home birth or anyone who has a family member planning to birth at home. “Today we have statistics that have proved, beyond any shadow of a doubt, that home birth for low-risk women is as safe as birth in the hospital. And in many cases, even safer!” writes Dr. Northrup, who refers to herself as “a midwife disguised as an M.D.”
I believe this whole safety issue stems from our culture’s deep fear of childbirth. In the United States, we will obsess over a mama giraffe about to give birth and drop everything to watch it live online, but we have much fear surrounding human birth. Most women, even pregnant women, have never seen a vaginal birth. And if they have, it’s probably been on a TV show or in a movie. So there’s a good chance that 1) the birth was sensationalized to show a woman screaming hysterically in pain, while medical staff comically attempt to control the situation and 2) the vagina, labia, anus and nipples were censored. What does this say about us? We think birth is a super private, even dirty, act. While it is true that birth is special and sacred, it is still a normal physiological event. If women never see how amazing the female body is, how the perineum can stretch and not tear, then they will continue to be fearful of vaginal birth. And so will everyone around them – their husbands, their parents, their children.
Fear was one thing that I completely renounced. There would be no fear in my being, and I would not allow anyone to speak fear or negativity regarding my prenatal care and birth plan. This is why I kept the home birth plan a secret. With most people, I didn’t know who would be supportive and who would not. I felt I couldn’t take the chance of telling someone who was negative or fearful because their emotions could affect me.
I will say – it was very difficult to not reveal my home birth plan. Before my third pregnancy, I was an advocate of home birth. But as I researched and read, I became a full-fledged champion of home birth. Part of me wanted to shout it from the rooftops. But the other part of me – the cautious, reserved part – won.
In the end, my home birth was an amazing experience. (You can read the birth story on the blog.) All of my hopes for the home birth were fulfilled, and there were no complications. On this side of my home birth, the most common remark I’ve heard is something along the lines of, “You are brave.” I believe most people are referring to birthing without pain medication. But, to me, this was pretty much a non-issue. I did it in the hospital twice. Plus, and more importantly, I would like to flip this whole bravery notion on its head. I am nothing special. My body is made the same as most other women’s bodies. Almost all women are capable of giving birth without drugs or other help, like forceps or a vacuum or a scalpel. Notice I said almost. I realize there are situations when natural birth is not possible, when assistance or c-sections save lives. And thank God for those rare instances. If you’ve had a c-section, you are not a failure.
Also, if you simply wanted a hospital birth because you liked the choice of having an epidural or some other pain relief, that’s OK. Again, no judgment from me. However, if you were ever made to believe you couldn’t do it without drugs, I am here to encourage you that you can. If I can, so can you.
All that said, I humbly ask for your consideration. Perhaps we have some things backwards. Unfortunately, birth has become so institutionalized that hospitals, inductions, epidurals and c-sections are now common and women, like me, who choose home birth are labeled as crazy or, as my uncle told me, medieval.
To end, I would like to share an excerpt from the foreword* to Ina May Gaskin’s book “Birth Matters.” In it, singer Ani DiFranco perfectly and eloquently summarizes so many of my own feelings about childbirth. She writes:
One of the downfalls to our excessively comfortable society is the idea that pain is a bad thing to be avoided at all costs. We have built great pharmaceutical empires on masking, subduing and eradicating pain, even emotional pain, from our lives. We are taught to view pain as an enemy, not a teacher. But pain is the right hand of growth and transformation. Pain is in the history of all human wisdom. The pains associated with menstruation and childbirth (even the emotional pain) are the price of having agency with the bloody, pulsating, volcanic divinity of creation, and they lie at the core of feminine wisdom. The literal expression of:
my body is your body
your blood is my blood
holds great insight in the way of things. A self-possessed woman in childbirth can be a powerful teacher for all (including herself) on the temporality, humility and connectedness of life. What if the medical establishment that purports to be saving women from the specter of pain and danger is instead ejecting them from the seat of their power?
Women are wise and powerful, not crazy and weak.
* Notice that I quoted forewords from two different books in this blog. Book forewords can be gold mines of wisdom. Give them a try.