By Shira Boss
Zero Cost Kids
When I told my sister we were considering home birth, she noted how many things could go wrong at a birth (“the cord could be wrapped around the neck!”), and said, “In the end, you’ll do what’s best for the baby, so you’ll be at the hospital.”
I don’t resent her viewpoint, because I used to think the same thing. I’d never heard of anyone in modern times giving birth at home until a friend of mine in England gave birth at home about 10 years ago.
“Is she crazy?” I ranted. “Why on earth would you risk having to rush to the hospital when you could just be there to begin with?”
learning the facts about home birth
What changed my mind – what has inspired many urban women to decide on home birth – was seeing Ricky Lake’s documentary on home birth, The Business of Being Born.
Following up on that, I read the very eye-opening book by famed midwife Ina May Gaskin, Birth Matters. She gives a history of birth, compelling statistics about mortality in and out of the hospital, information about how even routine medication affects both baby and mother, and stories of normal, natural births.
Birth Matters is the book Bob and I gave our parents to explain our decision to have a home birth. My dad, the ultimate feminist, was totally convinced and supportive. Bob’s mom kept a more mainstream viewpoint and asked, “What is wrong with going to the hospital?!”
Advantages of home birth
Home birth ended up feeling like such an ideal option for us, I couldn’t believe I’d heard of it only recently! Why didn’t everyone (in our situation) want a home birth?
When I say “in our situation,” here are the things we had going for us in signing up for home birth:
- We have qualified midwives in our area
- We have multiple hospitals very close by, in case we needed a transfer
- We are inherent “do it yourselfers” – a natural birth appealed to me, and I was confident about it. We were not skeptical or afraid.
Here’s why we were so enthusiastic:
The Comfort of home vs. the hospital
I love home. I think most people are very comfortable in their own homes and own bedrooms. Giving birth is such a monumental and intimate experience, I relished the idea of being in my own home, my own bed, my own bathroom….
Most of us know the hospital from high-adrenaline TV shows and movies (and of course every woman giving birth on TV or in a movie is always in a gown, on her back in bed, with someone yelling “push!”).
I and most people get nervous as they rush into the bright, busy environment of the hospital (and if you’re in New York City as we are, getting into one of the few spots in the birth center is, like everything, competitive and far from a sure thing) – that’s why labor often stalls or stops once a mom arrives at the hospital.
Laboring is uncomfortable, to say the least, and the thought of having to get dressed, pack my bag, get in a cab and travel to the hospital while having contractions was supremely unappealing.
This is personal preference. For my friend who’s basically a hypochondriac, the hospital is a soothing environment. That’s where she was most comfortable. Some women can’t wait to get to the hospital (and some want that epidural asap). So for women who feel that way – probably the hospital is the place to birth.
I’m also not speaking about high-risk pregnancies. However, midwives won’t let you birth at home if you shouldn’t be there. As part of her argument against my birthing at home, my sister told me, “You’re over 35, so you’re high risk.”
At our initial interview, the midwives were not interested in how old I was. They saw me as a pregnant woman, and monitored me throughout my pregnancy for any conditions that would warrant treatment or birth in a hospital. I ended up having healthy home births at 39 and 41.
Great prenatal care…at home!
Not all midwives make house calls for prenatal appointments, but ours did! I thought it was absolutely fantastic not to have to trek to a hospital or doctor’s office and wait in the waiting room for a brief visit with a doctor.
Our midwife came to the door, did all the medical checks while I sat or lay on the couch, and we had thorough, hour-long appointments.
Yes, midwives have medical equipment
One of the misconceptions about birthing with a midwife at home vs. with doctors at the hospital is that there is no medical equipment, or medical know-how.
Our midwife always checked my blood pressure and listened to the fetal heartbeat with a Doppler monitor, at appointments and intermittently during the birth. Several times I had blood drawn at home – one time I went to a local lab.
Although we chose not to have routine ultrasounds, twice during my first pregnancy the midwives ordered an ultrasound because it was medically necessary – I went to prenatal radiology specialists for those.
Because I had an extremely long labor with our first and was at risk for postpartum hemorrhaging, immediately after he was born I got a shot of Pitocin. When I needed stitches, they used local anesthesia and sewed me back together right there on my own bed.
Midwives have oxygen, and IV for fluids if necessary. They use gloves and sterilized instruments and are prepared to handle a host of emergency situations from stopping hemorrhaging to resuscitating an unresponsive baby.
In other words, it’s not the farm. Midwifery is way more advanced than tearing sheets and boiling water.
Avoiding nosocomial infection
I took microbiology, and anatomy and physiology, therefore I heard again and again that a huge problem in hospitals is nosocomial infection, that is, infection acquired at the hospital.
People have the general misconception that hospitals are sterile, safe environments. Oh. So not true. Don’t be fooled by the bright lights, pastel colors and scrubs (which they also wear on the subway on the way to work, and out on the street at lunch hour, I don’t know if you’ve noticed).
Hospitals, try as they do to sanitize, are filthy and therefore dangerous places. I’m more than happy to go to the hospital for treatment when it’s necessary. But giving birth does not under normal circumstances call for medical treatment in a hospital.
Yes, the labor and delivery floor of the hospital is not one of the more infected places, but unfortunately, people, equipment, and air all circulate from floor to floor. Bacteria are incredibly hardy, invasive and adaptable. They even live in the sterile solution that surgical instruments soak in. This is a whole other topic, but in short, I didn’t want to be exposed to such a foreign environment if it wasn’t necessary.
Bacteria at home
Yup, homes are full of bacteria too. But it’s OUR bacteria, the kind we’re adapted to. It’s beneficial that the baby is exposed to our home environment from birth – and not the environment at the hospital or birth center.
Control over interventions
Midwives listen to and value your opinions. They follow guidelines, but believe in shared decision making. They aren’t up against hospital protocols, insurance company policies, and bureaucratic pressures to follow certain procedures.
Among those common procedures we didn’t want were continuous fetal monitoring, routine IV fluids, a cocktail of antibiotics when not warranted (because my water had broken several days before I gave birth, had I been in a hospital, both the baby and I would have been given a lot of antibiotics as a precaution. The midwives instead monitored us closely for signs of infection, and there never were any), and the big one, a c-section that was not a true emergency. (The c-section rate nationwide in the U.S. is 1 in 3 births.)
If the labor I had had been in the hospital, there’s no doubt I would have been pressured to agree to a c-section. And we all know it’s hard to go against professional medical “advice” when doctors tell you the baby is in danger (even if he’s really not).
Natural Pain relief
Let’s not lie, labor is uncomfortable. I’ve seen those videos of women breathing deeply and calmly, with no more help than their husbands rubbing their shoulders, and then, Oh my gosh there’s the baby!
Of course I wanted a birth like that. I listened to Hypnobirth meditations. I was a believer. I thought – after decades of the most painful periods possible – that I would be able to manage pain calmly.
That’s not how it went. My first labor took two days – I was up for 60 hours straight, most of that throwing up. It was basically torture.
The second birth was soooo much easier, shorter, better. But I still screamed so much my throat still hurt the next day. (Bob told me later he actually started crying in the next room because it “sounded like an ax murder.”)
Not trying to scare any pregnant ladies out there (moms do love their war stories!), just saying that even when birth is uncomfortable, it’s still doable! And nothing makes you more proud than handling it.
However. Don’t offer a drink to an alcoholic. If I had been offered a way out in the middle of my hellish first birth – whether that was pain relief or even surgery – I might have taken it.
I would never have asked for it and it never crossed my mind to want to be in the hospital or ask to go there. But if I had already been there, and the options had been dangled in front of me or even encouraged, I might have given in.
And I would have missed the magical experience of natural birth (not to mention risked the aforementioned infections and risks of other interventions).
Paying for home birth
I need to say a word too about costs. We are fortunate to live in a state that requires insurance companies to cover home births.
The first time, our insurance company covered every dollar without complaint. The second time, with a different insurer (and an Obamacare policy – don’t get me started!), it took a lot of letter-writing to get them to pay what they were obligated to pay, but eventually they did.
Our only financial risk was if we had been transferred to the hospital and given birth there, the insurance company would have paid the hospital bill but not the bill for the midwives, and we would have still owed the midwives a minimum fee of several thousand dollars.
The best part about having home births was staying together as a family. The baby was never whisked away for cleaning up or testing or swaddling.
Once the midwife and birth assistant and doula cleaned everything up, they made something for us to eat, made sure we were comfortable, then left us alone, in the comfort and privacy of our own home. (They were always a phone call away, and came by regularly after the birth.)
When our second boy was born, our first son was right outside the (open) door. We all slept together in the bed (no, this is not dangerous, a topic for another time). Although our older son was barely speaking yet, the second he opened his eyes the next morning, the first thing he asked was, “Where’s [the baby]?” They bonded literally from birth.
There was never a hospital stay to split us up. (In NYC there’s competition for a private room at the hospital – needed if you want your husband to stay with you, if it’s your first baby – and that’s assuming you can pay the $750 a night surcharge that insurance won’t cover.) And we didn’t have to share our experience with staff and strangers.
If you are considering home birth
There’s so much more to say on the advantages of home birth. This article covers only our personal situation and thought process.
If you are interested in home birth, I urge you to read Birth Matters and other research and see what options are available in your area, including how to pay for it. (For instance, we paid for a birth doula but there are ways to get a birth doula for free!)
You might check out Choices in Childbirth. I also got a lot of interesting information at local La Leche League meetings (which I attended for 6 months while I was pregnant, when I could still absorb information!), and from reading Dr. Sears’s The Birth Book.
You could do this!