Homeward-bound? A Birth Decision

I’ve been so torn lately.  The decision for a home-birth has been weighing heavily on my mind.  If I do it, what am I trying to prove?  If I don’t, will I feel like I’ve let myself down.  I’ve been weighing pros and cons.

Hospital

Meals are prepared

Someone else does the cleaning

There is help if you need it (breastfeeding)

If any complications arise, emergency services are readily available

Insurance typically covers more cost in a hospital setting and so overall, can be cheaper

 

Home

Finding a sitter would be easier

Willow will see her sibling shortly after the baby is born

Unless an emergency arises, a drive to the hospital isn’t necessary (which is beautiful news to not have to drive (even as a passenger) during transition like I did with Willow.

Fewer staff members are consistently checking on you so you get more overall rest

You aren’t required to meet time tables for labor as in the hospital (See the grievous standard by which many women are held to in the hospital:  the Friedman’s curve.  http://evidencebasedbirth.com/friedmans-curve-and-failure-to-progress-a-leading-cause-of-unplanned-c-sections/)

You are allowed to drink and eat as you feel inclined

You aren’t hooked up to a monitor, IV, etc.

You can move about more freely

You aren’t required to sign papers while laboring

You will be questioned about jeopardizing your health and your baby’s in today’s culture.  You will be called negligent.

 

Ok….so clearly when I’ve actually taken the time to write out pros and cons, it seems Home wins out.  Why didn’t I do this before? Yes, cost is a major decision point, but the benefits of home seem to outweigh a financial decision.  (At least they should and sadly, don’t in America, even in my household.)

You have to be considered an ideal candidate for home birth.  This means that if any tests reveal the incorrect placement of the placenta, diabetes, baby positioned in a breach or transverse position, 37-42 weeks gestation (anything less or more is not allowed), usually only one baby,  will disqualify you for home birth.   You have to be having a healthy pregnancy with low risk in order to be considered for home birth.  Most pregnancies are normal.  OB-GYNs are trained in emergency protocols and only know oddities.  Midwives are trained in normal birth.  This means, that if there is something abnormal, they will likely recognize the risks and potential problems.  Yes, something can always go wrong, but it is highly unlikely.  There is so much fear surrounding birth.

Our culture in America has bred fear in response to birth.  Birth is an occurrence that happens every day, but is treated as an irregular, irresponsible event (much like sex is in this culture, but that’s an issue for another musing).  Women are told that their bodies weren’t meant for this pain (which if you are strapped to a bed with IVs in your arm and a monitor continuously attached to your belly, labor pain is worse).  It seems that even in pregnancy and labor women are being told their bodies are insufficient, that they need intervention to operate optimally.  Gah, the deception is irritating.

I am a short woman.  I had a vaginal birth with Willow.  I labored for about 13 hours and pushed for 2.5 hours.  At the end, I started to get tired.  In order to assist in pushing, I was given a couple drops of Pitocin.  Now, I am frustrated with myself for getting the Pitocin, but understanding hospital protocols after a documentary I watched last night, I understand they might have needed the room.  After being administered the Pitocin, I spent the next 10-15 minutes pushing and Willow was out.  I did need it because I was getting tired and pushing is strenuous work.  However, I also understand it might have been more of hospital policy than my fatigue.  I can also see that if administered too early (i.e. at 1 week past due rather than 2), contractions are harder to keep up with and a woman can’t handle the pain.  The contractions were more intense with the medication.  Also, when you aren’t allowed to move to get comfortable then the pain does become unbearable.

Trends reveal that when Pitocin is administered a woman’s contractions are more intense and she has a harder time keeping up with them (pain management and breathing).  As such, many women will request an epidural.  Pitocin speeds up the baby’s heartbeat.  An epidural is a sedative to alleviate pain.  This slows labor (essentially counter-acting the pitocin).  Sometimes the baby’s heartbeat will slow as a result of the epidural.  This speeding and slowing is observed as an erratic heartbeat.  If a woman “fails to progress” (stays at 4-6 cm for longer than a couple of hours by hospital standards (see Friedman’s curve listed previously in this thread) she will be recommended or forced to have a C-section.

In today’s society, due in part to the fear promotion surrounding birth, having a birth at home is seen as irresponsible.  You are told that you are putting your baby at risk of death.  However, women have been giving birth outside of hospitals for hundreds of years.  The human race has progressed without frequent medical interventions.  Hospitals are advertised as being sterile, cleaner facilities than a home setting.  There is a 3% infection rate in a hospital that isn’t seen at home though.  Cord prolapse has about a 0.3% rate in a home setting.  Yes, there are risks with every situation, but home birth is not the danger it has been marketed to be.  Hospitals are a business.  They need profits to keep going.  Look at when C-sections are happening (rarely around a holiday and typically M-F between 9 am-5 pm).  With this timing, does it seem like C-sections are being used as the emergency procedure they were meant to be?  No.  Yes, there is a time and place for a C-section but it is rare!  It is major abdominal surgery and doctors have done a good job as making it seem less risky than something the female body has been doing for centuries, centuries even before the C-section came into play!

Now, this is not meant to shame a woman for the choices she makes.  It is meant to scold the doctors who are misinforming their patients.  It is important to be educated about your health and choices.  If you are educated in these issues and you still decide on medications, that is your choice.  However, it was YOUR choice, not a doctor who chose to leave you in the dark about the risks of medications and procedures or even educating you about hospital protocols.  Be informed.  The most important thing you can do is learn about these issues and become your own advocate.

Through my midwifery birth experience, I’ve become extremely passionate about women’s health.  For years I wasn’t listened to in regards to health concerns.  I had an abnormal period.  I was saddened.  Nobody listened to me.  Through the midwives, even though they might not have had a causation for my cycle, they listened to me and comforted me.  When I had my miscarriage, they called me to check on my emotional status.  My midwives sat with me for an hour as I cried about the pain I was experiencing.  I don’t know any doctor, other than a friend, who would have done this.

Now for my decision, I felt moved and motivated towards making the decision for home birth.  I was leaning towards hospital, but after the documentary last night, I feel confident that home birth is a good decision and is a great choice for me and my family.  Now, things can always change and it is important to remember to be flexible about your birth and labor.  Labor and delivery aren’t static.  They change with each pregnancy and each birth.  We just have to be informed, make choices we think are best for our current situations, and be flexible with whatever happens.

Since my parents don’t really read my blog, I feel fine admitting this publicly (or slightly less publicly than Facebook, where my mother follows me).  FYI, they are strong opponents of home birth.  (My mom had two C-sections because she was told she had big babies and wouldn’t be able to push us naturally.  Now, I was 9 lbs. 6 oz. and my sister was about the same weight, but you don’t actually know whether or not you’ll be able to push out a baby until you do so (they did exams and told her that her pelvis was too small, but your pelvis is very elastic during labor…the preparation is seen as pregnant women waddle).)  My parents don’t often question doctors but take them at their word.  I question my health care providers more often than not.

I’m glad the midwives listened and have educated me.  I’m glad that they empower me to make choices for myself rather than spoon-feeding me information.  (They tell you about risks and benefits of different decisions.)  They helped me find my voice and I hope that you will find yours.  It is time we take back female healthcare and put it in the hands of fellow sisters, women who understand our bodies, not in a male surgeon’s hands. Go forth and make YOUR choices ladies.

(Oh and good resources:  Documentaries:  The Business of Being Born and Why Not Home;  evidencebasedbirth.com)

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