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You're Having Your Baby...Where?
It's not for everyone, but home birth is the best choice for me.By Meagan Francis
When I was pregnant with my first baby, I didn't have too many pre-conceived notions about how I'd want my birth to go down. I didn't care if I had massage or aromatherapy or herbs. I didn't envision a dim room full of candles or the sound of Gregorian chanting in the background as I gave birth.
I only knew one thing--as much as I feared pain (believe me, I am no martyr), I feared needles and scissors more. When I read about the way a typical birth in America goes down--complete with an IV, a looong needle in the back to inject epidural medication, and often, a pair of sharp scissors to provide the baby with more, err, exit room--or, in the 30-odd-% of C-section births, a scalpel--I practically had to breathe into a paper bag.
A friend of mine advised me to look for a midwife. Since midwives are trained to view birth as a natural and normal event--not a medical emergency--I'd have a good chance of quickly finding a care provider whose hands-off approach to birth resembled mine.
I'd heard of midwives, but only in the context of historical novels...and the Bible. But after a visit with a midwife, who turned out to be well-trained, competent, and professional, I made the switch.
My experience at the hospital was OK, and my midwife was great, staying with me through the entire process. Even so, there were a lot of interventions that were hard to avoid, and that I felt made my birth experience less safe and satisfying than it could have been.
So I decided to have baby #2 at--gasp!--home. My midwives brought along emergency supplies: IVs, oxygen, medications. But it was understood that we probably wouldn't have to use them...and we didn't. Isaac was born relatively easily after 4 hours of labor.
Babies #3 and #4 were born at a freestanding birth center (which was essentially like having a home birth in somebody else's home). Also great experiences, but now that we no longer live within easy driving distance of a birth center, it's home again for me.
Out-of-hospital birth isn't for everyone, but I think it's interesting how many people will jump to judgment--and sometimes full-on freaking out--without first getting all the facts. Stories about babies and moms who "would have died" during a home birth are sensational, but rarely tell the whole story.
First of all, the vast majority of home birth midwives will only take on healthy women having normal pregnancies. Second, they are so well-trained in what's normal that they can quickly tell when something is deviating from that, and make plans to transfer Mom's care. If something isn't going right with my pregnancy or labor, my midwife will be the first to tell me it's time to transfer my care.
Certified and licensed midwives are well-trained--mine, for example, is a certified nurse-midwife, which means she has completed her RN plus additional years of education and clinical training.
And let's not forget that some interventions can actually cause those scary complications people like to freak out about. Research shows that planned home birth (with a trained attendant and healthy mom) is statistically as safe as or safer than the hospital. (An anti-home birth position by the American College of Obstetricians and Gynecologists is based on research many find flawed.)
Surgeons and doctors do a great job providing life-saving medical care to those moms and babies who need it. And some moms feel safer in a more clinical environment--which I totally get. I just don't happen to be one of them.
There's no such thing as a guaranteed outcome--not in life, and not in birth. Things can go wrong, no matter where you are. The nice thing is that things usually go right, no matter where you are. And this time around, assuming all goes well, my baby will be born at home--where I feel safest.
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Copyright 2009 WE: Women's Entertainment LLC. All rights reserved.
Copyright 2009 WE: Women's Entertainment LLC. All rights reserved.
Sorry, can't give you kudos for this one. You can quote all the statistics you want, but any nurse/midwife DOES NOT have near the amount of training that an OB/GYN does, should an emergency arise. Thankfully, none have for you in any of your previous births. I just hope that you live close enough to a hospital, should you need to get there in a hurry.
I disagree with jennifersee and I'm opting FOR a hospital birth in a few weeks (hand me that paper bag, would ya?). I don't think blanket statements have a place in this kind of discussion (just my opinion). Statements such as "any nurse/midwife DOES NOT have near the amount of training that an OB/GYN does." You just can't possibly know that. (Education doesn't equal "training" in my opinion.) Plenty of women have had awful hospital experiences with poorly trained, over-worked, indifferent doctors. Also, sure, no emergencies arose in Meghan's case, but after four births, this is obviously the best choice for her. I say total kudos to finding something that works so well for you and your family and, what's more, kudos that we (as women) have the choice to research and decide on a course of action we're most comfortable with.
Go for it, Meagan. I think the important factor here is your midwife. She is trained nough in normal to recognize a deviation. I've had 7 births, four in the hospital and three at home. Of the three, only one was attended by the midwife, and I regret not using her for one of the others.
Have a safe, uneventful birth. The best part of homebirth is you don't have to put the baby in a carseat right away!
An OB/GYN has four years of medical school, plus a 3-year residency (or more, if fellowship trained) under their belt. Nursing/midwife school is 2 years. So you can't say that the education/training is the same. It's not. And I think it's irresponsible for a person to argue with what the American College of Obstetricians and Gynecologists - "An anti-home birth position based on research many find flawed." Not only is that irresponsible Journalism on Ms. Francis' part, (who is this "many?" - and what do they finded "flawed?"), I find her indifference to it disturbing.
For the record, I never said a nurse midwife has the same amount of training as an OB/GYN...just that I consider them to be well-trained. (the "two years" of nursing/midwifery school is two years of post-graduate education, and that's on top of a Bachelor's degree & RN, by the way.) Personally, I like that their education focuses on normal/healthy pregnancy and birth, since I'm hiring a midwife specifically for that purpose. Most births do not require a surgeon or a specialist in the abnormal--in fact, I feel that it gives midwives an edge that they are so accustomed to normal birth that they are able to quickly spot "not normal". Many OB/Gyns never get to experience, start to finish, a completely normal birth.
If you follow the links within the post you'll see exactly what many researchers find flawed about the studies used to support ACOG's position. For example, one commonly-cited study was based on incomplete information taken from birth certificates.
I'm not sure why ACOG is considered to be an infallible organization. All specialist societies have agendas, and certainly one of ACOG's is to protect the interests of its membership.
At any rate, I have strong opinions about my birth choice, but I have an equally strong belief that each woman has the right to make her own decisions regarding her own body and birth.
And yes, I do live near a hospital, and on the off chance that I need to use it, I certainly won't hesitate to do so.
Homebirth is not for everyone, but there should be that option. If people were more supportive, if doctors and hospitals embraced it, and if midwives had medical support; the FEW complications that happen at a homebirth could be taken care of without hesitation.
Jennifersee, OB/gyn's are surgeons. I wouldn't want anyone less than an OB/GYN if I had a disease or disorder in my female parts and needed surgery or other medical treatment. If anything deviates from the norm during a midwife attended normal birth, obstetricians are the best trained professionals to deal with birth related problems. BIRTH, however, isn't a disease, disorder, or problem. It's a natural process. A midwife is well equipped to safeguard and facilitate the natural process and the time and hands-on involvement she brings to the process adds a lot of security to the birth process. In a hospital with an obstetrician, that highly trained surgeon often is only involved with the last few minutes of the labor and delivery process and (at least in my experience) women spend the great part of labor alone in labor rooms with just their family/labor partner. Nurses enter the room occasionally to check monitors, adjust medications, etc -- their job duties leave little time for prolonged contact with individual laboring women. Just because you are at a hospital doesn't mean that you have a highly trained birth professional at your side watching for deviations from the norm and providing treatment every step of the way. Far from it!
In the US there is a stunningly high rate of cesarean birthss. While the World Health Organization estimates that there is no medical justification for cesarean rates of more than about 10-15%, twice that many American babies are born by cesarean. Could this be because most of us rely on surgeons to oversee normal healthy births?
Fantastic post! After extensive research my husband and I believe home is the safest place for birth in a normal healthy pregnancy. We are planning a home birth for a second child, due in May. We of course have a backup plan in place for the "what ifs" and feel very confident in our position Thank you for sharing your real life experiences!
Hey, Meagan--great post! This is Dana from Ann Arbor-hi!
We had our daughter in May of 07 at home. We had a very tough labor that in the hospital surely would have resulted in a C-Section for various reasons. Instead we worked safely through the process and have a bright, beautiful little person to show for it. And we're doing it again in August!
We have spent the past 30+ years arguing over one specific issue related to a woman's reproduction rights. In that time we've ignored all other aspects of reproduction.
My home birth was safer and far, far less expensive than a hospital birth an yet my insurance didn't have to cover it. Not at all. We feel strongly that this is the path for our family and we managed to pay our midwife ourselves and will do so again in August but it really burns me that someone else--some big corporation--gets to try to dictate to American women where they must give birth. I feel for the families who can't afford to make the choice we are making.
There is a great documentary out there called "The Business of Being Born." It's pretty well balanced and if you'd like more information on home birth, it's a great place to start.
Both the American Medical Association (www.ama-assn.org) and the American College of Obstetricians and Gynecology (www.acog.org) are against home births.
Jennifersee,
I highly recommend that you read "The American Way of Birth" by the late Jessica Mitford. There are many reasons why the AMA and ACOG are against home births - yet most industrialized nations welcome home birth as a perfectly natural and valid option for birthing, with positive outcomes. Sweden, is a perfect example.
It is good to investigate the "other side" before making sweeping statements.
Meagan it's fantastic that you are telling people about the normal, natural options of a homebirth. You made some wonderful points about safety in homebirth when overseen by a midwife through both pregnancy and birth.
I see that many people have tried to make jennifersee understand this side of birth. Unfortunetly she represents the vast majority of women in America who have been programed with lies. The reason AGOG and AMA are against homebirth has nothing to do with the health and welfare of mothers and babies. It all has to do with money. More surgeries, drugs, interventions, etc.... equals more money for them.
As far as the education a midwife undergoes, I can now personaly attest as I am undergoing training to become a certified midwife. It is a grueling process full of education and hands on training. I truely believe the only "MEDICAL" difference in what a Doctor verses a midwife knows is Surgery. Doctors routinely perform surgeries on woman and act as if they have saved thier lives, when the only reason they need a surgery was because the doctor induced for no good reason and started a downward cycle of drugs on top of drugs, combined with being confined to a bed and continuous monitoring that (by the way was never designed to be used continuously) and has a large false positive when used in this way. Cesarean rates in America now fly high above 50%. 50%, that's crazy. So if I am laboring in the hospital and there is a woman next door, one of us will end up with a c-section. While Mortality rates have continued to rise in hospitals in the US. they continue to stay consistant and low with midwife attended homebirths. Please note that these statistics for deaths at home also include the births to women who have had babies pass away and have then chosen to have the baby at home in a more personal environment. It is also important to mention that c-section rates for patients being seen by homebirth midwives has remained consistant and low in about 5% or less of clients.
Homebirth is NOT for every woman. Midwives work closely with clients looking at history, previous pregnancie's and births, and a big one is Diet. I recently learned that most problems in pregnancy can be traced back to one's diet and corrected in that way.
Meagan, thanks again for your willingness to share. I think it is so important for more woman choosing this route to shed light on it's availability and they choices they DO have. I hope this raises a huge awareness.
Jennifersee, although you have a right to your opinion, as do we all, I think you would be better served to really look at why you think homebirth is unsafe. Is it because the AMA & ACOG says it is? If so you might want to look at why they would say this...perhaps because as women in todays society are increasingly aware that their options and CHOICES in birth are being whitlled away at BY these organizations they are turning back to the begining, when birth was safe.
Statistics show that when birth moved into the hospital, babies and mothers died. Statistics now show that technology henders normal birth. Take EFM for example. The external fetal monitor was invented to alert medical personell of a problem with a baby. Research since the implementation of widespread use of EFM shows that it has done nothing to increase "saving babies" but has increased the instance of c-section. When doctors start to put more faith in their technology than in the ability of a woman to do this thing for which she was designed, things go wrong. They are trained only to see birth as an emergency waiting to happen and that it is only normal in retrospect.
Are you also aware that in the "3%" mortality rate that the ACOG /AMA puts into their research to show that homebirth is unsafe, they have INCLUDED the PLANNED homebirths of babies that are stillborn whos parents want the privcacy to bring forth a dead baby or are going to be born with a fatal defect that is not condusive to life outside the womb? Research can be skewed to make it say what you want..to fit your purpose.
Homebirth was safe thousands of years ago and is safe today. But technology does and can save lives. When we transport a homebirthing mama, we are grateful for surgeons and for physcians who are trained in the pathology of birth. Those are the times doctors are needed, when things go wrong, but when they are going right, they should be left in the hands of those trained in normal.
I hope you look a little deeper into what research is available to make a better informed choice.
K- mom to 5, 3 homeborn, and student midwife
I'm late to comment, but this is an interesting discussion. I had my daughter at a hospital and while it wasn't a horrible experience (no episiotomies, no c-section, healthy baby born), it wasn't something I would want to repeat. Yes, I was under a DOCTOR'S care. Yes, he went to MEDICAL school and did a RESIDENCY! wow. But do you know how involved he was in the actual birth? He cam in a couple times to check in on me for a few seconds each visit, then sat back and watched for the few minutes as the baby popped out, then stitched me up and was on his way. I actually really liked him, but I spent the majority of my laboring with a cranky nurse who was too busy looking for her glasses and complaining about previous patients and the "new" computer system that she was even less involved than the doctor. I spent most of the time alone.
So not only was the doctor minimally involved, but he also probably had his mind on several other more complicated births going on at the same time. So yes, he may have had more education than a midwife, but a midwife is with you through the whole thing PLUS you're the only one she is working with which means she can focus on your birth and no one else's for that period of time. If something does go wrong, she is right there noticing it. How long could I have gone before someone noticed a problem, had there been a problem, while I was being ignored at the hospital?
I know we all put medical school up on a pedestal, but they go into school and come out with biases, judgments, and pre-conceived notions. They are human beings. If a doctor tells you homebirths aren't safe, they may be attaining that answer from the same place your decorator neighbor does. Midwives have a bachelor's degree in nursing, PLUS years beyond that specifically dealing with births. It isn't a 2 week course in baby-catching techniques.
My final thoughts reflect Meagan's thoughts... Bad things happen. I know of a few people who lost their baby in AT THE HOSPITAL under an OBSTETRICIAN using all the latest tests and diagnostics. It's horrible, but these things happen and sometimes they can't be prevented regardless of where you are. The mortality rates of low risk births happening in the home and hospital are the same. Perhaps this is why. (http://awomansplacechicago.com/_wsn/page6.html summarizes medical studies looking at the safety of home births). And why in our country that has so many doctors and hospitals do we have a pretty bad infant mortality rate compared to other countries? Yet countries who use more midwives and have more home births are doing much better than us. That really speaks volumes about the state of our current system.
My next child will be born at home granted I am low risk all through my pregnancy. I feel blessed to have the doctors and hospitals there should I need them, but in the mean time I feel much safer with a midwife.