Why I'd Prefer to Birth at Home

Now, before you get too ready to judge, please at least hear me out. I'm not super crazy (only a little), and I don't think going back to 20,000 B.C. with no prenatal tests, no idea when I'm due due, and nothing but a friend with some herbs to help me out is the safest option to give birth!

At the same time, I do hate the idea that giving birth is seen as a "medical procedure." Yes, that is literally the phrase that was spoken to be by a hospital last week. Uhm, nope. I mean, it's not as common of a bodily process as breathing, but it's still a 100% normal bodily function. Yes, sometimes it can go wrong and you need help, but there are situations where even something as normal as chewing and swallowing can go wrong - and you end up needing the ER!

In fact just recently a woman accidentally gave birth at home. In that instance mom, dad, and baby had a great birth, with no complications and it went amazingly for them all. They didn't even have help until paramedics arrived afterward. If she can do it without help, why should I be able to with help?

C-Section and Intervention Concerns

That being said, my original reason for researching birth outside of the hospital was fear of having a c-section, and my insatiable interest in knowing as much as I can about everything. I always feel better knowing all of my options and having as much information as possible under my fingertips. Mostly though, I was pretty sure that I was hearing about too many cesarean births. I was hearing about c-sections for too many friends and family members. But why? That article goes into some of the myriad of reasons.

I was also kinda shocked to find that I was not the only one concerned about this. I am used to being labeled as somewhat high strung. I am a worrier. When I found out that I'm at the very least not the ONLY one worrying about something, I figure that it's definitely not all in my head. 

In fact, many professionals in the US are starting to realize that overuse of some medical procedures is leading to an increase in surgical deliveries. Seeing as surgery always carries risks, it's not surprising that a higher c-section rate would therefore bring a higher rate of complications. What a lot of women don't realize is that induction of labor comes with risks and as long as you don't have a medical reason for induction, it can lead down a slippery slope that results in a c-section if your baby and body weren't already prepared for delivery. 

My Ideal Birth

I know that birth does NOT always go the way you want it to. However, for the majority of women who have a low-risk pregnancy and are otherwise healthy and strong, birth can happen easily - though obviously it's still a painful process.

My ideal labor and delivery would involve being able to use a birthing tub to labor in for a long time. I've always been more relaxed in water and I've heard that the whirlpool action can soothe some contraction pain. I'd like a female licensed midwife to do "checks" on me only ever few hours, or on request. I'd like the chance to eat/drink what I want, when I want to - so I can keep my blood sugar and energy up for this extremely physical event. I've heard that a 12 hour labor and delivery is as much work as running a marathon. If that's true, I want to be able to fuel my body as I would for a marathon. I want to decide what position and location to deliver. Native/aboriginal/ancient cultures often delivered in a squatting position or on all fours so that gravity can assist. These positions can also put your uterus and birth canal into a proper alignment, and therefore facilitate baby's passage. I want to be physically free to move around as much as I want or feel the need to, and I don't want someone trying to tell me that they think I should be moving along faster or I should accept pain meds or any other medical "procedure" unless there is strict proof that there is an actual medical emergency happening.

I would love if my husband had a chance to catch the baby. I want the three of us to be able to bond for an hour, attempt breastfeeding nearly immediately, and wait for the umbilical cord to stop functioning before cutting it. We want to be able to give the baby their first sponge bath ourselves - as this way we can learn on the job, but still have professionals around to assist.

Then I want to be able to retreat to the comfort of my own bed or couch to recover in peace, at home, without vitals checks constantly. If my newborn is already going to wake me up every 2 hours, do I really want a nurse coming in every 3-4 hours to check my vitals too? I think less interruptions while I try to get the hang of things would be easier. 

My Specific Worries about Hospital Deliveries

So here's a synopsis (it's not short but honestly I could ramble on for something resembling weeks) on what my exact concerns are with starting labor in a hospital.

I do believe in the power of mind over body and positive thinking-to a point. I truly believe that if I can feel safe, secure, loved, and supported I can do a natural birth - barring any unforeseen complications. 

But that also has the dark side on the same coin. If I walk into hospital feeling nervous, apprehensive, not supported, ridiculed, and like all of the professionals think I'm wrong or crazy-then it's just going to start my panic cycle. And once that's triggered, I believe that I won't feel safe, and that feeling will stop me from believing I can deliver in the first place, because I am very nervous about the idea of being in a hospital when nothing is wrong and I'm not sick.

I don't think hospitals are evil. I think they're very very very good at what they do. I think they do a great job at handling diseases and injuries. I believe hospitals are AWESOME at medical things. I still hate them, but I go because it's the right decision when I'm sick. I went to ER to get a first trimester bleed looked at. I jumped on it. I go in yearly to the doc office for physicals. I'm glad to go to prenatal appointments. When I had kidney stones, I has happy to go to the hospital and diagnose that. Unfortunately, all they could do was give me pain meds and tell me to wait it out at home.

I would strongly prefer NEVER to be admitted to a hospital, but I know that I can't do a thing about that if I have a major medical issue. So I would go. And if I were hospitalized for pneumonia or cancer or needing my appendix taken out, and if I were SUPER NERVOUS there, they would get me valium or something similar and I'd survive.

Birth is not a disease or injury though. I honestly feel like hospitals set up women to fail and need more interventions because of their policies. My concerns lie with the idea of not being able to eat, having so many tubes and wires even on a low risk woman that I almost can't get to the bathroom easily, and I can't labor or deliver in whatever position I want. I have to be in bed in a mostly reclined position. Birth has become a deeply personal experience that happens in a fishbowl environment with a whole slew of people, probably including students, watching and telling me how they think I should birth and telling me that the wires and tubes are necessary when I know they're not. A hospital gown doesn't feel natural, a bed my husband can't join me in doesn't feel natural. Having someone tell me I'm not progressing fast enough, even if baby isn't in distress, isn't natural. I don't see how I'm likely to succeed in a natural birth if being in a hospital causes anxiety. I doubt I can labor effectively and work with my body to birth if I'm clamped down  in fear, or feel like the entire situation is out of my control. It's one thing to give in when I know something is wrong, but as long as it isn't, why am I stuck to a bed in a smelly building full of sick people? I don't expect everything to go according to plan, however a hospital to me is a last resort once everything else fails. I'm sure all those women who gave birth in the car/on the side of the road where happy that everyone was healthy afterwards, but they would never have chosen to birth there from the get go.  

I honestly believe that if I plan to give birth at a hospital, I'm more likely than any other low risk mom to end up with complications just BECAUSE I'm scared of the place. I also know that I don't perform well in any circumstance whether it's an emotional or physical event (much less both like labor) when I am not allowed to listen to my body and move around for my comfort. However, the consequence of being shaken up or otherwise emotionally impaired during birth is stalling labor, causing fetal distress, and ending up with an emergency c-section. 

Birthing Centers - A Middle Ground

Now, on the other side of the story, I currently have my birth set up with an absolutely wonderful birth center. This is a location that has all of the medical equipment for an emergency resuscitation on stand by, but otherwise lets women birth as they desire. Women are certainly not confined to laboring or birthing in a bed. There are tubs and stools and birthing balls in all of the rooms. Women can eat or drink as they see fit, and midwives are present to keep their eye on you. Only low-risk women are welcome to deliver at a birth center, and they have to agree to allow for a transfer to hospital at any time during delivery if any serious complications ensue. However, while laboring, no one is told that their labor is "taking too long" or "would be easier with an epidural." In fact, the center only offer nitrous oxide for pain relief. 

Women who deliver at the birth center are able to have an hour of uninterrupted contact with their baby after delivery, as long as everything goes well. Dad or partner may catch the baby, and cut the cord. Moms are supported in attempting breastfeeding immediately, in order to help further the bond. Midwives assist the couple in their first baby bath, and then let Dad and/or other family bond with baby while mom gets to take a shower (in a private, homey shower). Assuming everything went well, the new family leaves 4-6 hours after birth.

At the same time, the birthing center has IVs, medications to reduce post-partum bleeding, antibiotics, oxygen, and other emergency supplies on hand to assist if there are any problems. 

In eight years, the center has had a 94% success rate for natural birth at the birthing center. The remainder of women were transferred to a hospital for delivery, and none of the mothers or babies were lost. In fact, the majority of the transferred women chose to transfer in order to receive pain medication - they did not have emergencies that required more medical intervention, they made the choice to move to a medical facility. To me, that's wonderful. There's nothing wrong with WANTING to birth in a medical location if that's where you feel safe.  

Problems with Natural Birthing in Illinois

So, with the birthing center option above, why do I care about hospital births at all, when I can have everything I want at the local birthing center?

Due to some crazy confluence of events, some of which we had control over and many of which we did not, my husband and I may have to relocate from Central Florida to Northern Illinois in the next 2 months.

Illinois is less progressive when it comes to childbirth. While I have a few options in Florida for midwives to perform home births for me, there aren't any that cover my area in Illinois. This is partially due to location, but mostly due to availability. While Florida has 100s of midwives licensed to oversee a home birth using all different types of insurance, Illinois only has 7. Those 7 have very specific coverage zones, and can only accept certain insurance. They do not cover my area, nor can they take my insurance. 

Florida has 7 birth centers within 100 miles of my home. Illinois has 1 in the entire state. The Illinois birth center is 2 hours from my new location, without traffic. However, in traffic it is 3-4 hours depending on time of day. My due date is the week of Independence Day. I figure that will mean high traffic most of the week, and therefore don't believe that the drive will be safe. I would anticipate delivering in the car on the way. This doesn't even include the issue of trying to find time to get to weekly appointments in the last month with that long of a drive. Just not going to happen.

That leaves me with two options only. 1 - home birth with no professional present or 2 - hospital birth. I'm not willing (nor is anyone else around me willing) to attempt a home birth without a trained midwife. Unfortunately, the hospitals within a 90 minute drive to my new location are some of the most archaic I've heard of. 

Progressive hospitals recognize my concerns of birth with interventions. Many now offer birthing tubs, birthing in different positions, and have gotten away from mandatory IVs and prohibiting all food/drink. However, in Illinois progressive hospitals are not the norm. They exist only in very affluent neighborhoods of Chicago and are no closer to my new home than the birth center. So those aren't a likely option either.

Last option: the more archaic, traditional hospitals near my new home. There are three within a 90 min drive. They embody the approach I worry about. They call birth a "medical procedure" and mandate IVs. They don't allow any eating or drinking, they don't allow dad to catch the baby, or even a midwife to catch the baby. They only allow OBs to deliver. These hospitals laughed at me when I asked if I could deliver in a squatting position, or anywhere other than the tiny bed. They don't have birthing tubs, or even a bed big enough for my husband to hold me while supporting me during labor. A friend delivered at one of these hospitals last month, and she wasn't able to even hold her baby in the first hour after delivery, even though nothing was wrong with either one of them. Baby was whisked away for a bath that mom and dad couldn't even watch, and then brought to the nursery. All these hospitals mandate a 48-72 hour stay after vaginal birth (not including time spent in labor) even if nothing goes wrong at all. This is not where I want to deliver, but I think it's my only choice.

My Final Thoughts on Fear

I do feel that the overwhelming majority of all US hospitals can very safely deliver a baby c section. I think they're very good at what they do in surgical rooms. If I have to have a c section, I have almost no fears it will go wrong. I don't want one because I feel like the recovery will be worse, and I don't want the scar. I think if possible it's best for baby to physically go through the birth canal, and I think birth will be significantly less personal with a surgery. It also sucks that a c-section takes away option for my husband to catch the baby, might stop him from cutting the cord, and I'm afraid that I won't get to feel the pride of completing a difficult task (like the pride I had when finishing a half marathon). But, I am willing to forgo all of that for safety if it's medically necessary. Because if baby is in trouble from a vaginal delivery, then the benefits of vaginal birth don't outweigh risks of it.

I think I'd feel more confident in my ability to handle this if it was the pain or the delivery itself that was scary to me-lots of people know how to help with that. But I haven't met a person that has advice on dealing with laboring or delivering in a place you feel uncomfortable with. I believe all women that WANT to deliver in a hospital should have the opportunity to do so. Deliver where YOU are comfortable. 

I feel that there's a very high chance that because of my fears and aversions and the lack of support for natural birth by every medical professional I've found in that area so far, I won't manage to convince the staff to let me deliver naturally even if I don't have any medical complications. 

I can't promise that if I try to birth at a birth center that it would for sure work. If I have complications at a birth center and have to transfer to a hospital for a c section then I already know I'm going to be sedated and slated for surgery, I accept that. But I don't see how a hospital can help me even try to NOT have a birth like that. 

Really the only thing I think hospitals are downright piss poor at providing a calm, secure, non-medical feeling atmosphere to even attempt a non-medical delivery. In fact, from what I hear they push you to make it as medical as possible. Ew. I don't want to be admitted into a hospital BEFORE or WITHOUT having a medical problem. It's like being forced into rehab when you're not an addict. I'd just prefer to wait until I HAVE a medical issue before being stuck in the medical institution.

However, I probably don't have a choice, even though being pregnant isn't a disease and birth doesn't have to be a medical procedure. The more I ask doctors and hospitals to give me the birth I want (or at least let me attempt it), and the more I explain to friends and family why I want that birth, the more I am told that I need a psychologist to solve this issue. 

Is it so wrong to want to birth somewhere you feel supported and listened to? Is it so wrong to want to want to let my body do what it has evolved to do? 

Maybe so. 

Either way, I hope I can find balance in this. Somewhere between a birth at home with no help and a medical "procedure" where the doctor wants me to deliver on his schedule in a building full of sick people.