Why Not Just Go to the Hospital?

OK.  I have to answer this question, because it seems to be asked of me in various ways now that I am planning a home birth. 

I've been there too.  I have not always been a home birth lover.  But my dislike for home birth came from a place of not knowing much about birth in general.  Birth is portrayed as scary, painful, and dangerous in this society.  So, yeah, I guess, why wouldn't you want to be around a team of medical experts who could save your life or your baby's life?  It seems so simple.

Except that birth isn't as dangerous as it's made out to be.  It's true that half of all women used to die in childbirth, but that's over the course of their whole lives.  And back in the day women were having like 10 kids (no birth control/different cultural norms/expectations/needs).  So maybe 1in 20 births (OMG don't quote me on this stat, it's a guess), before medical advancements and the knowledge of microbes and bacteria, ended in the death of the woman.  That sucks, but let's not act like it was 1 in 2.

The other thing I had no idea about was what home birth was really like.  When I was pregnant with my first child, I knew ONE person who had ever given birth at home and talked about it openly with me, and I didn't know this person very well.  And she doesn't even live in Minnesota, so it's not like I could have used her midwife.  I'm guessing many of you know ONE person who is planning a home birth and that's it (me!), or maybe some distant relative or friend of a friend had one.  I think only about 1% of babies are born at home in the US. 

So, if this is basically your only knowledge of home births (that almost no one does it and it seems dangerous), I'm going to ask you to admit that you actually don't know much about home birthing.  It's OK, I didn't know shit about it either until after I had already given birth in a hospital and was determined to go a different route. 

So, if you don't know much about it, have never witnessed it, have never interviewed a home birth midwife, have never read a book about it, please try not to be afraid of it.  Especially when it's not even you who is currently 5 months pregnant.

I think I can safely say that 99.9% of women who choose to give birth at home are not doing it DESPITE the danger; they are doing it because they feel it is SAFER.  Mind blown, right?

It's isn't safe for everyone.  But a good midwife will tell you when you are not appropriate and will refer you to an OB when you need one.  I'm sure there are bad midwives out there, but all the midwives I interviewed made it clear that they were not about "home birth or nothing."  They are trained professionals that monitor your birth and can tell you if they think you should transfer to a hospital.  They also all stated clearly (because I asked them) that they all bring oxygen with them, drugs to stop hemorrhaging, and are trained in neonatal resuscitation.  Midwives actually can deal with some emergencies, and if they can't, they call 911.  I hear a good midwife shows up with about 4 big bags of medical equipment that they hopefully don't even need to use.  They will have a Doppler for intermittent monitoring.  They will have a blood pressure cuff.  Their biggest priority will be my and the baby's health and well being, that's why I am hiring them in the first place.  They know what normal birth looks like so well, that they will be able to spot when it is not normal and let me know.  If they couldn't do this, I'd be better off birthing alone, really. 

Having a home birth is not at all like having a baby during the middle ages.  I promise you I am in good hands with experienced midwives.  Plus I'm a second time vaginal-birth mom who is low risk, this makes it even safer for me.

But, still, why not just go to the hospital like everyone else?  Just in case??

Everyone who chooses a home birth will have a different answer to this, so I can only give mine.

Short answer:  Did that the first time and I do not care to repeat it.

Long answer:  Even for my first birth I didn't really end up needing anything the hospital provided.  I ended up on continuous fetal monitoring, but I don't really believe it was necessary.  Outside of that.... I needed one row of stitches (which a home birth midwife can do)... and... and.... that's it.  Nothing else that the hospital could have provided me did I end up needing.  It's cost my insurance probably $12k and me about $3k and what did I get?  Peace of mind?  Some people do feel at peace when surrounded by *medicine* but I really didn't.  I thought I would, and I didn't.  I chose a hospital birth for that very peace of mind you are probably wondering about, and I didn't get it.

So what did you get?!

First of all, I was planning a water birth.  And because hospitals are full of regulations they had MANY rules about who got to go in the tub and when.  I was passing those rules with flying colors.  But the one rule I was missing out on is that my hospital required me to be at 5cm dilation before entering the tub.  Which meant I agreed to several cervical checks.  I had a drug-free birth and I can say that the worst part of it was the cervical checks.  The cervix is frigging sensitive and a nurse has to jam their fingers into it to check dilation.  I screamed through every one, but I wanted in the tub.  This will not happen at a home birth, I will not have this arbitrary regulation to labor under. 

My water ended up breaking at 4cm and it was full of meconium, so I wasn't allowed in the tub at all.  I've done some research and asked some experts on meconium and I personally think they over-reacted, though it could have been much worse.  Something like 20-30% of births have meconium-stained amniotic fluid, and a small percentage of infants will inhale it, and a small percentage of those will get sick from it, and a small percentage of those will die.  It happens, but rarely.  I had maybe like a 1 in a few thousand chance of my baby dieing from this.  It also appears that these infants inhale it while in the womb, NOT during birth.  So actually limiting the tub and changing how the birth happens is not going to change the out come.  If there is meconium, it seems, what is done is done, and probably everything is fine.

So luckily my infant was totally fine, the *thick* meconium didn't bother him at all and he was placed on my chest immediately after birth and we were breastfeeding in minutes.  All in all, a pretty good hospital birth from the horror stories I have read, no drugs, no augmentation, no cutting, little interference, immediate skin-on-skin contact.  I'm not going to deny that my birth was a success, but it could have been better, it could have involved a tub of water and no cervical checks.  If you want a hospital birth I can say the HCMC midwives are pretty good.

Then enter the post partum period.  You would think I was asking my kid to be injected with polio at the crap I got for choosing to delay the Hep B vaccine (Hep B is RARELY spread to children, and I didn't want a vaccine given right at birth).  I got crap for refusing the eye antibiotic ointment, which only prevents blindness if I have chlamydia or gonorrhea, which they screened me for during pregnancy and I didn't have it.  It would have been a worthless use of antibiotics, which shouldn't be used lightly.  The nurses were constantly asking to take my baby off to the nursery when I was under the impression that this particular hospital was very big on rooming in.  And the bassinet/hospital bed sleeping arrangement was horrid, I barely slept while in the hospital, I got way more sleep when I got home.  There were other things like the nurse who told me, "you could just use formula" when I was upset over how much pain I was in.  And then there are the horror stories of nurses sneaking babies formula, I know someone who had this happen to them at HCMC about 6 months later.  I actually wrote a blog post all about the crap that happened after birth.  I could not wait to leave there.

So when all of this is taken as a whole, I just do not feel that a hospital is a safer option for me.  I am not choosing a home birth because I really want an awesome birth and I'm willing to risk my health and my baby's health to get it.  I'm actually choosing a home birth because I am trying to do what is best for my health and the health of my baby. 

If you can try to see it from this perspective, even if you are skeptical, I think it will help ease some of your trepidation about it.  I have read stories of women who had a home birth because NONE of the hospitals within several hundred miles of them would help them achieve a VBAC.  Certainly in that case you can see that they felt much safer staying home rather than give in to a second or third planned C-section.

Birth is getting a bit better, but some places are seriously lacking in options.  We are lucky in the Twin Cities, we have several hospital midwife groups, three birth centers, and numerous home birth midwives.  If you are giving birth in this area, look into all your options, I didn't the first time, so I swore I would do it differently next time.