Ok, so I realize that I already wrote about our decision to have a home birth (see post here) but I didn’t really get into the facts regarding home birth. I wrote about how it’s important for women to realize that they have choices and encouraged them to research birth options. What I didn’t think about was the fact that each mama has a support system who needs to be educated about home birth too if they’re going to be supportive. Caleb and I have struggled with this a lot since our decision to do a home birth. When we first told our family that we were planning on doing a home birth, naturally they were concerned because it isn’t the norm in our society. Luckily, most of the people in our support system were wiling to educate themselves about home birth or at least ask us questions about it. Unfortunately, many didn’t. That leads to us being surrounded by the anxiety of other people and feeling the need to reassure them that we will be ok. I know I can’t reach everyone about the facts regarding home birth but I thought that this could at least be a starting place. So if someone you know is considering or having a home birth please check out the facts below before freaking out! (I also strongly encourage you to see the documentary, “The Business of Being Born.”)
Concern #1: We don’t know what we’re doing.
Some people don’t understand the difference between a free birth and an assisted home birth.
- Free Birth: Unassisted, super crunchy way to give birth. It’s mama, her partner and whoever else she’d like but no medical professionals are seen as necessary.
- Home Birth: Generally, when someone says they are having a “home birth” they are referring to a birth at home that will be assisted by a licensed midwife.
Our midwife has been through medical training and also brings two birth assistants who have nursing degrees to each birth.
A “licensed midwife” is an individual who has been issued a license to practice midwifery by the Medical Board of California. The practice of midwifery authorizes the licensee, under the supervision of a licensed physician and surgeon, in active practice, to attend cases of normal childbirth, in a home, birthing clinic, or hospital environment. For the purposes of California licensure, these allied health care professionals commonly are referred to as licensed midwives. – Medical Board of California
Concern #2: What if something happens??
This question is obviously difficult to address because what the heck does “something” mean anyway? Most people are just scared of birth in general. Our culture sees birth as a dangerous endeavor. Look at the way movies portray birth. Women are screaming, fathers panicking… Most women will tell you that their birth was nothing like what you see in the movies. Home birthers will confirm that it surely does not need to be that way. So when people ask me “what if SOMETHING happens?” I will usually respond with a follow-up question to try to understand which “something” they could be referring to.
Notice how the above quote about midwives says “cases of NORMAL childbirth.” Midwives monitor their patients
vigorously throughout the entire pregnancy to ensure that the baby and Mama stay healthy and low-risk. They do not take on high-risk patients but refer them to an OB who is trained to work with such patients. This is why many midwifery’s, such as the one we are using, can boast that they have never “lost a mama or a baby.” Truthfully, they give the hard cases to the hospitals because that is where they belong. Midwives respect the appropriate usage of hospitals and OB’s. Before South Coast Midwifery would even take us on as clients, we had to go through a screening process to make sure that we were good candidates for home birth. They wanted to make sure we had no pre-existing health conditions and that we were close enough to a hospital should we need to transfer. We were also required to go birth classes so that we could learn about how to stay low risk. So the likelihood of “something” happening in home birth is very low to begin with because the mama’s and babies are both healthy to begin with. In addition to that, during the birth, the baby will be monitored for fetal distress and I will be monitored as well. If anything seems even close to the danger zone, they will transfer me to a hospital.
A home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low risk women, provided the maternity care system facilitiates this choice through the availability of well-trained midwives and through a good transportation and referral system.- British Journal of Obstetrics and Gynaecology, 2009
Many people have either heard stories or have their own stories regarding complications during child birth. When I hear these stories I’m saddened that most of them happened because of the result of hospital interventions. I really don’t want to bash hospitals or the medical staff that assist births because I personally know some awesome people in that field. However, there are many OB’s that push unnecessary interventions that often cause more harm than good. First off, they usually want to rush the process. This results in sort of a snowball-to-cesarean effect. A drug like Pitocin is administered, making the contractions that much harder to tolerate. So of course, the mama begs for an epidural. The epidural makes pushing and the contractions less effective so labor slows more. Then, everyone starts panicking and next thing you know, the mama needs a c-section. C-sections are inherently more dangerous than vaginal births (see info on that here). Now, my “snowball” scenario is very simplified and of course, does not always happen, but it is very common. USA Today reports that 44% of women who were induced resulted in having a cesarean section.
So the idea that birth is “dangerous” is largely due to a misunderstanding as to why people are having complications during child birth. Usually it’s either because there was a high-risk factor to begin with or because a medical intervention was administered that went awry (Bailit et al. 2009).
Concern #3: But what if there’s an emergency?
Again, this is a fairly ambiguous question. Emergencies that I’ve heard the most concern about is regarding the baby not being able to breathe. This is a problem that is easily solved by basic equipment that the midwife and her team carry with them at all times. They carry the same equipment that would be available in a neo-natal ambulance. Another concern is the mama losing too much blood. This was one of Caleb’s fears and to be fair, in 1997 it was the number one reason for maternal deaths internationally according the the World Health Organization. Luckily, we are not in a third world country and it is very uncommon for mama’s to die from this here. Our midwife reassured Caleb that they have drugs that they can administer by injection to help stop the bleeding. Most other emergencies, like I said above, are related to pre-existing medical conditions. The other main cause of death during child birth is eclampsia, which can be detected by monitoring a woman’s blood pressure, weight gain, and other prenatal factors. These are things that can be screened before child birth occurs.
Concern #4: I’m Trying to be Super Woman.
I can’t speak for all home birthers, but personally I can say that I am not trying to prove anything by doing a home birth. Caleb and I both received degrees in psychology which has resulted in us believing very strongly in the importance of bonding. We chose a home birth because we want a calm, comfortable environment in which to bond with each other and our baby while laboring and after the birth. For us, that environment is at home. Other people would be more comfortable in a hospital setting. We also would like to avoid medications as much as possible because research is still inconclusive as to how much it effects the maternal bond after birth. It seems that babies are indeed effected by epidural anesthesia immediately following birth. Being at home will lessen the chance that I will receive an epidural or any other interventions that we do not prefer during our birth. I also believe that a water birth is less traumatic for the baby and also assists in pain management for a natural birth. Most hospitals don’t offer this option.
Hospitals Aren’t Bad
I personally know some women who have had very positive birth experiences in a hospital. Some of them attempted to have a natural birth (meaning NO interventions) and were successful, some of them attempted to have a natural birth and were not. The similarity between the two groups was that they were all educated about birth and the interventions available to them. They made choices willingly and based on their education, not because they felt pressured to. They all walked away feeling empowered and proud of their birth experience. I’ve heard that many hospitals are moving towards a more “baby-friendly” approach. In other words, they are honoring the wishes of the parents and they are making bonding a priority after child birth.
There is a chance that even after all of our preparation, I could end up being transferred to a hospital. For South Coast Midwifery, the number one reason for transfer is exhaustion. If for any reason I’m not dilating enough after many, many hours of labor I could hit a wall and need a break. I may need to transfer, get some meds so I can rest, and then try again. It happens. It’s not my first choice obviously, but the hospital is there for a purpose and I will use it if necessary. Ultimately, Caleb and I have discussed our priorities. Our number one priority is my safety. If our midwife says we need to transfer, we’ll do it. Fortunately, she has a very good relationship with the hospital nearest to us and we feel confident that we will be in good hands should we need to transfer.
In a Nutshell
I hope that this post is a useful resource for both home birthers and their support systems. I think it’s safe to say that, in the end, everyone wants a healthy mama and a healthy baby. This can be achieved by both a home birth and a hospital birth. There are inherent risks associated with both, just like anything in life. It is not negligent to have a home birth. It’s ok to have hospital interventions too. Neither are wrong by default. My hope is that home birth will become more accepted as a very safe and fulfilling way to give birth. My other hope is that more women become educated about the realities of hospital interventions so that they can advocate for themselves if needed. The Bradley Method is an excellent course for both parents to learn about ways to stay low-risk and how to advocate for themselves in a hospital setting should they need interventions. Truly, birth can be a very beautiful and meaningful experience in any setting. We don’t need to be so scared of it.
Please leave any thoughts you may have about this post, I would love to hear any comments you may have! Also, stay tuned for an upcoming Birth Series featuring real birth stories from home and hospital birthers alike. =)
**Almost a year later and this post is still one of the most popular on this blog. I’m SO glad that people are curious about home birth! Also, I’d like to note that I wrote this just four days before I got to experience my own home birth for the first time! I think I wrote this post to be educational for others but also as a reminder of reassurance for myself. If you’re in need of some reassurance because you or someone you love is having a home birth, check-out The Business of Being Born. I also included some more articles on the subject below.**
- Midwifery Benefits? Improved Outcomes For Moms Who See Midwives, Review Finds (huffingtonpost.com)
- The ten best things about having a home birth (42weeks.ie)
- Is Home Birth safe? (birthnatural.wordpress.com)