UHF: There's no place like home.

If you missed "The Clause" I put up earlier today, please start there.

We are planning on having this baby at home.

There, I've said it. No doctor, no hospital, just us and our (Certified Professional) midwife here in our nice cozy home welcoming our little one into the world.

Now comes the why part. I wanted to start off now talking about the main reason we are choosing a homebirth but honestly, there isn't just one main reason. So I'll just go over the mental journey we took to get here.

It started off with the idea that it was possibility. This was definitely one of those things I had never even considered before several bloggers mentioned theirs. Until then, I didn't know anyone who had ever had there baby anyplace other than a hospital so I probably wouldn't have even considered it if it wasn't for them.

And then, still way before I even got pregnant, I heard that in there were those who didn't want it to be a option. Well, that made me mad. But also curious as to why one would be so opposed to it, not just for themselves, but for others. So I did some more research and found out some interesting things:

Home birth is safe:
Despite what you may have heard, in terms of infant and maternal mortality rates, home birth is just as safe, if not safer, for mom and baby as a hospital birth is. In fact, in the last study I linked to, newborns in the home-birth group were less likely to require resuscitation at birth, oxygen therapy beyond 24 hours or meconium aspiration. There is a ton of information out there but the two pamphlets and two study summaries above will give you a good start if you are interested.

Many medical and public health organizations consider homebirth a good option for low risk mothers:
While the America College of Obstetricians and Gynecologists opposes homebirth, the American Public Health Association, the World Health Organization, Britain's Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, and The Society of Obstetricians and Gynecologists of Canada all support midwifery and an individuals choice of birth locations. (Links go to policy statements or recommended birth guidelines)

Inquisitive Reader: Okay, so it's one option, but why are you two choosing it?

Our research taught us that there were two main ways of looking at birth and that as a family, our thinking about birth was very much aligned with the midwifery model of care and not very much aligned with the typical medical model of care.

Basically, I don't think birth is a problem, an illness, or anything that needs to be fixed or solved. Birth is the way life is supposed to begin. A woman's body, including mine, has been specifically designed to go through this process. It doesn't mean it always goes perfectly, but it also doesn't mean that the whole thing is one big medical mistake that needs to be managed. I hate the saying "Giving birth is like trying to fit a orange/watermelon/grapefruit/fruit of choice out your nostril." Well, that is just stupid. Nostrils are not made to have large pieces of fruit go through them, birth organs are (well, not fruit, babies, but you understood that right?)

With that knowledge base already in place, when the time came for us to make a decision, the right one (for us) was obvious.

Inquisitive Reader: "Why can't you just have that mindset while having your baby in a hospital like a normal person just in case something goes wrong with this whole natural, normal process?"

That was what we probably would have tried to do if I didn't know about home births. But along with my midwifery mindset came certain ideas of things we want:

• chance to labor in multiple places and positions
• option to eat and drink during labor
  
• the baby placed immediately on my chest
• the opportunity to breastfeed within the first hour
• allow the cord to stop pulsing before it is cut
• nothing going inside the babies mouth unless it is attached to a human being. (Fingers and boobs = okay; water, glucose, pacifier = not okay)
  

and do not want:

• Induction
  
• membranes artificially ruptured
  
• drugs of any kind
• an IV
• electronic fetal monitoring
• to labor on my back
• episiotomy
  
• any forceps or vacuum assistance
• c-section unless absolutely necessary
• any shots to be given to the baby right away

Now some women are fine with all those things and that is their choice. I hope that they make well-informed decisions but either way, it's up to them to figure out what is best for them just as Craig and I have looked at each of those things and determined what we want and why we want it that way - we think it is the safest option for me and the baby.

And yes, it is technically possible to have a completely natural childbirth in a hospital, but it isn't easy. And to be honest, I know quite a few women that wanted it but not a lot that have actually managed to get it. You have to be willing to fight for want you want and have a bit of luck on your side.

Midwifes are experts on birth, they are trained for this and they see so much "normal" that they can recognize abnormal and take the appropriate action. And unlike doctors who you will likely only see for a short period during the labor and the nurses who come in every so often and check the fetal monitoring system, the midwife is with the laboring women the whole time. She knows her and her body and is there for her.

Doctors are trained to find problems and solve them. And they are very good at finding problems. In fact, they find so many problems that the national c-section rate is now around 30%. But maybe those problems weren't there until they started messing around. Because those things I listed that we don't want, they can cause problems and they really aren't individual requests like it may seem but are tied together.

Induction means you get an IV and drugs, which pretty much guarantee you need electronic fetal monitoring. Even if you can take the extra long and hard contractions that come with Pitocin and don't get an epidural (and that is a big if), you will still probably need to be on your back and that means you will probably need at least an episiotomy or "help" getting the baby out. But you probably won't be able to take them, so you'll get an epidural which might slow things down to much so that now you need more Pitocin. And you may be numb but the baby is still feeling all those super strong contractions so due to fetal distress a c-section becomes necessary to "save the baby's life." Suddenly, all your hopes for a natural birth are out the window. There are lots of ways to get sucked into the non-natural birth cycle and very few ways to get out of it again. It's a vicious version of If You Give a Mouse a Cookie.

From our very first doctor's appointment, I felt like I was already fighting the system with the testing that we didn't want done. And I don't want to fight during my labor. I don't want Craig to have to fight for me during out labor. I want to work on getting this baby out and I want Craig to be able to help me without either of us stressed or distracted.

When we met our new midwife, she had just gotten home from an 18-hr birth and had barely had time to shower before we got there. I could tell she was exhausted and at first, I was a little worried and wondered if we should reschedule. But unlike the 10 minutes quick visits I was used to with my doctors, she sat with us for about an hour talking with me and examining me to see how things were going. I feel very confident in both her ability to guide me through this process and my ability to deliver my baby and am sure those feelings will only increase as we spend more time with her.

One common misconception, perpetuated by the ACOG, about women who want home births is that they are willing to trade safety for comfort. Not only is that not statistically true, I hope I showed above that is is not the attitude we, and I believe most other home birthers, have. We are doing this because we value safety.

But beyond that issue, that misconception fails to recognize the link between the two. And there is a link between the two, but you don't have to take my word on that:

Routine, though unfamiliar, procedures, the presence of strangers and being left alone during labor and/or delivery cause stress, and stress can interfere with the course of birth by prolonging it and setting off what has been described as a "cascade of intervention." -World Health Organization's Care in Normal Birth, pg 11.

A cascade of interventions - that is exactly what Craig and I feel want to avoid because it is unhealthy, for both my body and the baby.

I'm not saying home birth is for everyone. Decisions are about weighing the risks and benefits. For some high risk pregnancies, it just isn't worth it. For others, they wouldn't be comfortable laboring at home and believe the risks and benefits are again on the side of the hospital. Even with us, if something arises later on in this pregnancy or during labor that warrants going to the hospital, we won't hesitate to do so. If we get to the point where our midwife says go, we know that the benefits will far outweigh the risks. Our midwife will become our doula, supporting us and helping us make the right decisions at the hospital but allowing us the medical support that we will need in that case. I hope we don't ever have to deal with that, but if we do, I know we can trust our midwife to help us make that call.

Inquisitive Reader: But what about the pain!

Ah, yes, why go through the pain of childbirth if you don't have to? I have heard those that choose natural childbirth described as supermoms who obviously have more pain tolerance than normal women to martyrs who are only doing it for selfish egotistical reasons. I honestly don't think either is true of me. I'm doing what I'm doing because I think it is best but also because I think it will benefit me the most in the end.

While I have heard stories of women that through natural childbirth methods have been able to labor pain-free and would not mind at all if that happens for me, for most women pain seems to be part of childbirth no matter what route you choose. Without drugs, you feel the contractions but have a better chance of a normal delivery without episiotomies, non-superficial tearing and c-sections. With drugs, you might not be in as much pain during labor (if they work), but your recovery time is often longer. I would rather suffer for 12-48 hrs before the baby comes then get to enjoy my first few weeks with the baby with as little pain as possible than try to juggle the care and feeding of a newborn while balancing a bag of peas on my crotch for the first month. But that is just my opinion.

To summarize, I think home birthing is a great option. I don't think it is for everyone but I do wish that more women would look into it for themselves and make an informed decision. They might like what they find.