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Health & Fitness

Why My Daughter Knows a Lot About Homebirth

A personal account of my own family's informed decision to exercise our human rights and have midwife attended, planned homebirths with both of our children, and my older daughter's perspective on it.

I had a beautiful moment earlier this week.  It was the school open house and I got the chance to take a look at my six and a half year old's Writing Journal.  And there it was, the second day of writing, they'd been prompted, "What do you know a lot about?"  My daughter's drawing was, as typical for her, expressive, colorful, full of love and emotion.  It was also pretty accurate.  She had drawn a picture of her younger sister's birth.  Aside from the fact that her sister was not breech and looks a bit like she might have been in the picture, and that I was too exhausted to actually reach down and pick her up, and that our beloved Certified Professional Midwives and my mom were not in the frame of this picture, she really got it pretty darned close to spot on.  Her sister was (yes, intentionally) born in my bed, on a clean red sheet, with my spouse, both black cats and, yes, my elder daughter there in the room.  Her writing entry begins, "I know a lot about home birth."  She's right about that too, for a six year old in Connecticut, she does know a lot about homebirth.

Now, as a repeat homebirth parent, I have heard it all.  So let's get some of this straight.  First off, homebirth is really, truly, not for everyone.  For women who, for whatever reason (compromised maternal or fetal health or desire for pain medications would be the two big ones I hear),  are more comfortable in a hospital or birth center, they should birth there.  For women who are "risked out" of homebirth because of any number of health factors, medical conditions or evidence of potential complications, they should birth at a hospital.  

For those of us who are healthy, are well-read on the topic, are making an informed choice, are secure in our birth team and have the support of our immediate family, well, for many of us who are in that category, homebirth is the optimal choice.  For me, two big reasons were that I wanted to be sure I knew the people who would be around me, and that I did not want pain medications offered to me.  And, living close to the hospital, I knew if there was a complication that could not be treated at home, or that might need medical attention, we could jump in the car and go.  I had faith that the pain of labor, if I were to feel it as pain, would, at some point end with the birth of this child.  With the help of my midwives and spouse, I'd be reminded that it is "pain with a purpose," that it is not suffering.  Frankly, after two births with no narcotics, no epidural, for me personally labor sensations are nothing compared to dental work without Novocaine.  And besides in a planned hombirth, the pain factor can be overcome with something truly amazing -- love, support and encouragement of a hand-selected birth team.

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"Wow, you're really... brave (read:stupid)."  We heard this a lot the first time around.  We decided with the second one not to get into it with people.  Because here's the thing, the repeated conclusion of research that actually followed scientific study protocols has shown time and time again that for women who are low-risk, planned, midwife-attended homebirths have outcomes that are as good, or better, than low-risk births that take place at the hospital.  Plus, there are several benefits of birthing at home that go beyond what the hospital can provide.  A place where healthy people live, for example.  

I remember reading a post on one of the parenting groups I was part of when my babies were still babies, she posted, "What I brought home from the hospital...besides the baby..."  It was a staph infection.  Yuck.  No new mom needs that!  Of course, this doesn't always happen, but let's face it, there is no reason why we should have maternity units attached to hospitals in the first place when they all have their own OR suites.  The least we could do to make hospital births safer is to detach the unit from the "sick" wings!  

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Now, there are a few of you out there who may remember my name, or face, or will put the pieces together after this article.  If you got the paper on January 2, 2006, you've seen us before.  She was the first baby born in Meriden that year.  And, technically, she was not born at home.  We labored at home for around the average time unmedicated first time moms in the US labor for.  I went through Transition as many unmedicated moms do, puking, shaking, self-doubting.  I also had the loving support of my spouse and the professional care, monitoring and encouragement of my midwives.  I entered Second Stage ("pushing") and things continued in a very normal, physiological birth kind of way.  

And then with one particular contraction, there was an issue.  Being judicious and relying on their years of training and experience, my midwives had me change positions, listen to baby's heart rate with the next contraction and then we were en route to the hospital, less than a mile from the house.  So, skipping all the would-be drama, things were fine with me and fine with baby, though she entered the world in a bright room filled with loud, confused strangers in addition to our primary midwife, my spouse and, oh yeah, me.  

My own experience of the actual birth was rather anticlimatic, feeling as I did like a hard-to-open package frustrating everyone who was just trying to get at the thing inside.  This was a sharp contrast to my amazing, powerful, beautiful labor at home where I was encouraged to follow my instincts and know that the baby and I were working together.  The midwives stayed with us at the hospital until the baby was checked by the pediatrician, had nursed well and all of us were fed and as comfortable as could be.  Then they went back to our house and did the first load of wash, tidied up the room and re-made the bed for when we returned.  We now tell our older daughter, "we did all the important work of your birth at home."  She will tell you her story, she self-identifies as a "homebirthed" child.

And we had all the benefits of homebirth care.  We had our first postpartum visit the day after we got back from the hospital, the second was about a week out, and the third is the visit women who have had OB/GYN care are familiar with, the six week visit.  And thank goodness for all of that support, because, like many women, birth had brought up a lot of stuff and I had some postpartum blues.  

With my second, it was clearer than ever that I wanted a homebirth.  The treatment we had received at the hospital was less than ideal.  I don't blame that on the staff so much as on the misinformation that most all of us have been given about homebirth.  Because we do not have a health care delivery system that supports the full range of women's maternity care options, there is a system of competition instead of one of cooperation as it exists in many nations in the world.  

Here, instead of having midwives care for the healthy, low-risk women with low-risk pregnancies as they do in 75% of the rest of the world, we expect that everyone will get maternity care from a surgeon.  To quote Marsden Wagner, former World Health Organization's former head of Women and Children's Health:

Having a highly trained obstetrical surgeon attend a normal birth is analogous to having a pediatric surgeon babysit a healthy 2-year-old.

 Guess what?  We do this, have these surgeons, the ones who do save so many lives when there is a serious issue, we have them attend the normal births, the ones where they don't need to be there, and we have a surgical birth rate of around 36%.  The World Health Organization states that the rate of acceptable (read:necessary) cesaran section births should be between 10-15%.  

We have so much about birth all sorts of backwards.  Instead of trusting that the human race is still here in good part because birth actually works, our medical system views it as suspect.  Anything could go completely sideways at any moment so let's monitor everything, keep mom still and in bed and in a gown like a sick person and... we have a dangerously high rates of many, many medical interventions.  Skip forward to my second homebirth.

I knew it would be hard, it was intense as all get out.  I worked at unknotting a rope friends had knotted for me as a "labor project" for about four hours.  I sat on my exercise ball, I brought loads of laundry up and down stairs, vacuumed the floor (she was a couple days before we anticipated her arrival and I really wanted the room sparkling for baby's arrival).  I swayed my hips, shouted here and there, moaned a ton, had a little snack if I recall, I know I was in the kitchen at some point, talked to my little two year old child who was well prepared for this, called the midwife and hunkered down in my room finally to have this baby.  I was solid through to the point where we had problems the first time around.  Then I got to experience, first hand, the very thing I found so fascinating when I was working on my own Childbirth Education training -- "Psychological Dystocia."  To put in 1960's vernacular, I got hung up in my head.  

Suspecting this was the issue one of my midwives, who was taking photos for me, put down the camera, told me to look at her, and asked me if I was scared.  She talked to me as a human being who cared.  And we talked it out before the next contraction and then there we were again, having this baby.  Two midwives, my spouse, my toddler, my mom (there to watch my elder daughter if she decided she didn't want to stay) and yes, both my black cats (and the gray one was some where, he came out later), all there when my second child was placed onto my thigh and when she nursed for the first time a few minutes later, both of us tired.  It was a good birth.  And it was what I had chosen for myself and my family, based on lots of reading from multiple perspectives for several years prior to being pregnant, based on my own health status and that of the baby, based on my own need for a safe, intimate setting to give birth in (as 1:3 women are, I am a survivor of sexual violence), so that I would be in the right head-space as I began to parent this brand new baby, as I continued to parent my two year old.  This was the choice that was right for me and my family.  

Homebirth is not right for everybody.  Some women need the hospital, others just prefer it.  There are many women who seek out one of the two birth centers in the state (only one of which is "free-standing") that stand as the "middle ground" for those who are looking to be closer to a hospital, but cared for by midwives in a home-like setting.   But for those of us who find homebirth to be the best fit, there is no hospital that could even come close.  The beauty of bringing a new life into the world right here, in this home with both of my children has left a lasting impression of the strength and caring of our family.  My bedroom is something of a sacred space in my mind, it was here that the work of the Divine emerged through me.  Though I don't expect the rest of my family sees it in such poetic terms, clearly it has a place of some importance with my kids as well.

Should you have questions about homebirth as a maternity care option, I know a six year old that may indeed be able to answer a good many of your questions.  In her words, "Me and my sister were both home bi[r]thed.  I liked being homebi[r]thed."  I liked that too.

If you're looking for more information, you can also watch The Business of Being Born, Pregnant in America, Orgasmic Birth, and More Business of Being Born on Netflix.  There is also a great documentary called, "Freedom for Birth," that was just viewed at Yale Nursing School this past week, and a Birth Consumer's Nonprofit, United Families for Midwifery Care, that has a facebook page here: http://www.facebook.com/groups/90072133235/ if you're looking to find out more about Midwifery Options in CT.  Birth Network National   http://www.birthnetwork.org/ and Childbirth Connection http://childbirthconnection.org/ also have some great general information.  And, as always, you can reach out to me as well.  I'm always happy to hear from readers, and I love talking about homebirth!

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