Friday, September 14, 2012

Why We (Still!) Favor Home Birth

In the early stages of my pregnancy, Jon and I assumed that we would welcome our baby into the world in a hospital delivery room. We knew we wanted as natural a birth as possible and that many people have completely natural labors in hospital settings. However, as the weeks and months began to pass, we learned that some hospitals pressure expectant couples to undergo interventions. Especially after reading The Thinking Woman's Guide to a Better Birth, I found myself wishing I could avoid the policies of IV's and heart rate monitors, and the push for pitocin, episiotomies, and epidurals. I believe that each of these interventions come with risks to the mother and baby. At the same time, they also have real benefits for necessary cases, but I see them as unnecessary for a healthy, low-risk pregnancy. So, Jon and I started looking at other other birthing settings. The more we researched, the more appealing these other places became.

When I was 21 weeks pregnant, we attended a "birthing options" night at a local birthing center. As the owner of the birthing center addressed the five couples present, Jon and I kept giving each other little approving glances. We were highly impressed with management, accommodations, and natural birthing philosophy of the center. We even got to meet four different midwives who had assisted families at the birthing center in the past.

Yet, one thing were learned that night surprised us. We had previously believed that all birthing centers are the "middle ground" between a hospital and home birth. Not necessarily! Medically speaking, this particular birthing center is identical to a home birth. If we wanted to have our baby at the birthing center, we would have to pay a fee in order to use their facilities, and independently hire a midwife. The midwife could also provide the exact same service and care in our home.

So why birth at a birthing center? Some families have other kids or pets that they don't want to deal with at home. Others don't want the clutter of laundry, dishes, or papers distracting them while they focus on contractions and pushing. Apartment renters may fear the "noise factor" with neighbors living in such close proximity. Sometimes a couple lives too far away from a hospital to be able to safely transfer in case of an emergency, and a birthing center offers a shorter travel time (this birthing center has a hospital just five minutes away).

My biggest concern about birthing at home? The mess. I mean, birth is messy, right? Why would I want to deal with that right after delivering a baby?

When I brought up this concern, each midwife assured me that clean-up would not be our responsibility. Although they are not a cleaning service, they leave your home in the same condition they found it. One of the midwives stated, "When we walk out your door, we leave you with three things: a bag of garbage, a bag of laundry, and a baby." That sounded okay to me.

I remember driving home with Jon that night and talking about home birth for the first time. We don't have any other kids or pets. We have a hospital within ten minutes of us and a fire department just 100 feet away. Although we live in an apartment building, we are never bothered by the sounds of our neighbors, and everyone pretty much keeps to themselves. I wouldn't even have to worry about the mess! Above all, we knew that I was a great candidate for a home birth because both my baby and I were healthy and considered low-risk. It didn't take much discussion for us to realize that a home birth was the right choice for us.

After deciding to birth at home, we now faced the task of hiring a midwife. Luckily, the birthing center we visited had a short list of midwives on their website to get us started. We read the little introductions, and called two of them to set up interviews. I was 27 weeks pregnant when we finally sat down to meet each one in person. I'm so glad that we didn't set up interviews with any others. The choice was already difficult with just two midwives because they were both so experienced, professional, and personable!

The midwife we ended up hiring won our favor for three reasons: first, she lives closer to our home; second, my prenatal appointments could be held at the birthing center, conveniently located just five minutes from where I teach 3rd grade; and third, she is a Christian. Jon and I loved the idea of sharing a worldview with someone who would coach us through such a significant moment in our family's history. She is even willing to pray with families leading up to, and during the birth. I felt so at peace knowing that she would be asking for God's wisdom and discernment, not only leaning on her training and expertise. Even with over twenty years of experience (and only a handful of hospital transfers in her career), she knows that ultimately God is in control.

Switching to a midwife, at six months pregnant, could not have been more enjoyable for me. To start, my prenatal appointments extended from 15 minutes with our OB to about an hour with my midwife. She took the time to get to know me, understand my concerns and questions, and educate me about the changes happening in my body. I was also happy to know that she supported my wishes for a natural birth, but was also prepared to perform certain interventions, such as administering an IV, or performing an episiotomy, if they were needed. She just doesn't consider these procedures "routine" for a healthy, low-risk pregnancy.

Probably the most comforting part of having a midwife was knowing that she would definitely be present at my birth, and that she would be with me the entire labor as well. I know many people who invested time finding the right doctor, only to have a different doctor on call when it was time to deliver. In addition, doctors typically show up right before the actual delivery. The majority of labor care is provided by nurses, whom you may or may not get along with. My midwife would provide the continuance of care that we wanted.

If you've read any of Jadon's birth story, you already know that I didn't get the home birth we planned for. In fact, I added one more hospital transfer to my midwife's count, and ended up on the operating table for a c-section. This means that I had an IV, was hooked up to a fetal heart rate monitor, had a spinal tap, and underwent major abdominal surgery. Hardly the birth I had envisioned. However, because my son was breech, I consider these interventions necessary.

My midwife later told me that she has never had a baby under her care turn breech during active labor. I know that my case is unusual, but exactly what God intended for me to experience. It does not change my opinion that home births are safe. My midwife handled my surprise circumstances in a timely, organized, and comforting manner. She had already earned our trust when we hired her, but seeing her in an "emergency" situation makes us love her all the more.

We'll definitely be talking with her about a home VBAC (vaginal birth after c-section) the next time around!

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