Why We Chose Home Birth

I received an e-mail from a reader this morning, asking about the decision process that led up to our choice to deliver DJ at home. I'm happy to write about this, but I want to stress that the decision to birth at home is very personal, and requires much thought and research. If you're considering it, I encourage you to find a licensed, experienced midwife, and talk with her. She can tell you more about the risks and benefits, as well as what to expect, and help you decide if home birth is right for you.

I wanted a home birth for so many reasons, but the main reason is that this is my last baby, and I want to be in control of my labor, and give birth in a familiar, comfortable setting, without a whole lot of unnecessary medical intervention. When I delivered Bee, everything started out normally, but when I got to the hospital, they gave me such a strong epidural that I couldn't feel anything at all in the lower half of my body. After the epidural, they strapped me to a fetal monitor, and put me on my back in a hospital bed, which, as we all know, is not the most effective labor position. Then they thought that I wasn't progressing fast enough, so they gave me pitocin. When the time finally came to push, I was so numb that I couldn't even feel the contractions, so I couldn't push effectively. When Bee arrived, she was so sluggish from the medications that she didn't breathe right away, and had to be resuscitated. I also had a retained placenta which had to be manually removed (ouch!), and I've since learned that many cases of retained placenta are a direct result of pitocin, which produces such strong contractions that the placenta is torn from the uterine wall before it's ready to be delivered, leaving fragments behind that can cause hemmorhage. The next morning, I was very sick from the anesthesia, and vomited so much that I was too weak and exhausted to even hold my baby.

In contrast, my labor with Cakes was a piece of, well...cake. In this case, the epidural didn't take, which turned out to be a blessing, because I could actually feel the contractions, and push accordingly. I had a smoother, shorter labor, a healthy, screaming baby, and within about six hours, I was up and around and felt well enough to go home.

My point is that the labor and delivery that involved the least amount of medical intervention was the most positive one for me, and I think that the ideal place to welcome a baby into the world is in the home. However, I know that in the U.S. this view is not widely accepted, because people have the perception that home birth is "unsafe," despite the fact that there is absolutely no evidence to support that theory. In fact, Lamaze International has an excellent article, which argues that hospital birth is not as safe as we are led to believe. In the U.S., where 99 percent of all births take place in a hospital setting, the neonatal death rate is higher than in 35 other countries. In 2006, The World Health Organization ranked the U.S. 41st among developed countries for maternal mortality, and 29th for infant mortality. I don't know about you, but I find that pretty alarming.

In response to the question, "Is Home Birth Safe?" the article says:

"For most women with low-risk pregnancies, birth outside the hospital is as safe as—or safer than—hospital birth. The medical attitude of expecting trouble during birth, and the hospital policies that support this attitude, prevent women from giving birth easily and safely in the typical hospital. Routine medical interventions used at hospitals interfere with the natural process of birth and present unnecessary risks that can harm you and your baby. Home is where most women feel safest and comfortable. At home, there are no routine restrictions placed on a laboring woman, which make labor and birth more difficult. At home, you can choose your own caregivers, family and friends to support you, wear your own clothes, sleep in your own bed and eat your own food. Additionally, at home, there are no hospital-borne germs to endanger the health of you and your baby."

Please understand that I'm in no way trying to disparage hospitals or hospital care. I've had two delivery experiences in hospitals - one very negative, and one very positive - and I know that there are advantages and disadvantages in every situation. I'm just pointing out that hospital birth is not necessarily the best or only option for everyone.

My husband, who fears for my safety, was reluctant to consider home birth at first, but we did two things that put his mind at ease (now he's incredibly excited!)

1) We watched the documentary The Business of Being Born
which showed several home births, and also a scenario where a woman intended to give birth at home but needed to be transferred to the hospital.

2) We found a certified nurse midwife, and interviewed her. The initial consultation was free, and after talking with her, we felt completely at ease with the process.

The laws regarding home birth and midwifery practices are different in each state. In my state, home birth is legal, but it must be attended by a certified nurse midwife (CNM), and this was the most difficult part of the process. After much searching, I finally found my midwife through word of mouth (on a blog! See how valuable the blogosphere is?) However, she is also listed at Birth Partners, which is a great place to start if you're looking for natural childbirth options.

After I found Kathy, I set up a consultation, and met with her in her home. She talked with us for over an hour, and explained all of the factors that we needed to consider, including health conditions that would make home birth impossible. In the end, we decided that home birth was an option for us, because:

1) Our pregnancy is healthy and low risk.
2) I have already given birth twice, so I know what to expect, and I'm comfortable with the idea of laboring without pain relief.
3) We live in a town with an ambulance service, only 20 minutes from 2 large hospitals with neonatal intensive care units, in the event that something goes wrong.

Once we came to this decision, we felt very comfortable with our choice. Kathy is an independent CNM, and she has provided all of our prenatal care in her home. She has full prescription privileges, and has ordered all labwork and necessary tests, just as a doctor would, but the quality of care is completely different. Even if you decide against home birth, I highly recommend seeking prenatal care from a midwife. Kathy meets with us for an hour each time, and she really listens to our questions and concerns. I am completely calm and at ease with her, and this has been my healthiest pregnancy. My blood pressure is so unbelievably low - usually 116/70 - and this is unheard for me, because I usually have "white coat hypertension." With Kathy, I don't feel stressed, because I feel like I'm just talking with a friend. In fact, because I've developed such a strong bond with her, I've decided that I will continue seeing her for my well-woman care.

We're very excited about giving birth at home, and we plan on having a water birth in a birth pool. However, we're keeping a completely open mind. I think it's so important, if you're considering home birth, to remember that ultimately, your goal is to have a healthy baby, and a healthy mom. If a problem arises, and Kathy determines that the safest course of action would be for us to transfer to a hospital, we're prepared to do that.

Here are some great web sites, which can provide more information, and assist with finding a midwife:

Midwives Alliance of North America
American College of Nurse-Widwives
Mothers Naturally
American Pregnancy

Also, we ordered our birth supplies from a wonderful Christian company in Texas, called In His Hands. I'm sure there aren't many of you who are in the market for mesh panties right now, but I thought I would mention it for future reference :)

(Note: Angie asked about the cost difference between home birth and hospital birth. Our home birth, including all prenatal care, is $3450. In my state, the cost of delivering in the hospital, not including prenatal care, ranges from $5000-$8000. If you stay the recommended 48 hours in the hospital, the cost is around $11,000. Yikes!)