“Thank goodness I had a homebirth!”

Thank goodness I had a homebirth! My baby would have died if I’d given birth in a hospital!!

Why don’t we hear women saying this? We often hear the opposite. Thank goodness their baby was born in a hospital because they needed a c-section and without that c-section their baby would have died. Their baby was too big, cord was around the neck, had fetal distress….
But we don’t hear women saying, “Thank goodness I wasn’t in a hospital – I would have gotten an epidural and my baby could have gone into distress and I could have ended up in a c-section and could have died!”  “If I’d been in a hospital they would have broken my water and caused an infection and I could have died!”

I was recently out having dinner with friends and and one of them brought her neighbor – a very nice lady with a sweet personality who I really enjoyed talking with. When it came to my profession, however, she expressed what I had heard so many times before. “The idea of a homebirth just scares me! I mean, I wanted a hospital with a level 3 NICU ‘just in case’! I just wanted to be safe.”

She wanted to be safe. That’s honestly and truly what she thought in making her decisions, and I believe that to be true. She thought she was being safe by choosing a local hospital with the highest level of care available to her and her baby – for safety reasons. She sacrificed the ‘fun’ and ‘joy’ of birth FOR HER because she wanted to increase the ‘safety’ FOR HER BABY!

Now, I didn’t have the heart to ask her if she’d been induced. I didn’t get into the risks associated with epidural anesthesia and ask her if she got an epural (because she proudly told me that she got an epidural and how much better it was after that) I didn’t ask her about all of the choices she made without a whole lot of thought and how she felt about the safety of those choices.  After all, she was in a hospital with a level 3 NICU so she was covered as far as safety goes.

It’s apparent that we took different approaches to be sure, but I always feel an exasperated sigh coming on when this conversation starts. No, we do not favor the experience over safety. Yes, we can still use that NICU if the baby needs it…however, we do everything we can to avoid needing that NICU in the first place! We avoid the things that will increase risks to mothers and babies in the first place!

Just last week I sat down to be interviewed by a couple who was expecting their second baby. She was very excited to explore the idea of a homebirth – he was very much less enthusiastic. He sat on my couch leaning back away from me into the corner, arms alternating crossed and on his lap, obviously uncomfortable with the idea of having a baby outside of a hospital. Throughout the course of the interview it became apparent why: his wife had developed an extremely high fever during labor, she was Group B Strep positive, baby had been kept in the hospital for a full week even though mom was discharged in a couple of days, and start to finish there was little that was “beautiful’ about their experience as she was induced, had an epidural, and their baby was taken away from them for the first full week of their life!!

Then came the question: What would you have done in this situation?

I told him that if, during the course of labor, she developed that same high fever then I would have needed to transfer them into the hospital and that the end of their birth story would likely not have been any different. He looked a little smug at his wife, as surely this proved his point that they were wasting their time. “BUT,” I told him, “I would have done everything I could to prevent that situation in the first place.” I then asked her, “How many internal exams did you have before labor? Did they strip your membranes?” She said she had MANY internals and they stripped her membranes several times starting at 38 weeks. I asked how many internals while in labor – same answer, “So many!” Did they break your water? Yep. I explained that I never break someone’s waters unless there is a very real reason to due to the risks of doing that – especially in someone with GBS, but even just in general.

I explained that knowing that there’s no benefit to checking a cervix before the onset of labor – and especially knowing she was GBS positive – I wouldn’t have checked her cervix at all as I don’t care what her cervix is doing, I don’t care if she has her baby at 39 weeks or 41 weeks…I am all about safety and minimizing risks and I wouldn’t want to push that GBS up inside of her towards the baby and those vulnerable membranes. I would never have stripped her membranes either because of the risks associated with that.

I watched his eyes look at her, thinking about what I’d said, and I watched as they made an impact on him. These were things he had never thought about. It never occurred to him that it was preventable! It only occurred to him to thank God they were in a place to address these problems – never that they could have caused the problems in the first place that they were trying so desperately to fix!

I explained to them choosing a homebirth doesn’t mean you can’t use the hospital services if a medical issue comes up that requires more attention (for my dinner companion: even the level 3 NICU). We use those when we need them and I want to hug and kiss those physicians in gratitude when we do! But in homebirths, we are about minimizing risks in the first place: not having an epidural that carries a GREAT amount of risk. Not inducing, not doing anything that would increase risks in the first place.

As a parent, you will care for your child through many knee scrapes and head bumps…through fevers and coughs. Each issue you will ask yourself, “is this normal? If not, can I care for it or do we need to go to a doctor?” They fall off of their bike – do you wash their knee and put a bandage on it and send them back out? Or do you need to take them in for stitches? You know what is normal and what is not, what you are comfortable treating and when you need to go to the doctor. You don’t, however, have them ride their bikes in the parking lot of the pediatricians ‘just in case’. You use them when you have a problem that you feel is too big to handle on your own.

That’s what I do. I know what’s normal and what’s not…I have a ‘first aid kit’ that I bring to births to fix bumps and bruises that moms get along the way. But sometimes there’s a big fall and I say, “Oh no…this is too big to do at home, let’s head to the doctor…”
And I’d rather my child ride their bike near their home with a parent watching but wear a helmet and elbow/knee pads….than to ride their bikes in the hospital parking lot without a helmet or any protective gear whatsoever while jumping off ramps with a team of doctors waiting inside the ER doors.

Mainstream viewpoint is that homebirths are sacrificing safety for comfort and control of the birth experience. No, my mainstream friends….that’s what epidurals are. And in some instances that’s what inductions and cesareans can be (unless responding to a true and present problem).

I am a homebirth midwife – and I promise that my first and main concern is and always will be safety and minimizing risks every step of the way.

20 Comments

  1. Amy Drorbaugh wrote:

    Wow, great post! It explains the experience vs saftey issue so clearly. And since my baby was born in 33 minutes and I live 45 minutes from the hospital I often tell people, “Thank goodness I had a homebirth!”

    Wednesday, March 14, 2012 at 12:09 pm | Permalink
  2. Denise wrote:

    I had to comment on this! With my third child, I tell everyone, “thank goodness I had a homebirth!” I know in my heart, had I been in a hospital, I would have been rushed in for a c-section. During pushing, my baby decided to turn posterior (I think – her head was facing up). At this time my water had not broke yet. I begged my midwife to break my water and she refused. We needed the cushion for the baby to turn. If my water had been broken, she would have been stuck. While my pushing was longer than intended (45 minutes), she was able to turn on her own and THEN my water broke and she was born 3 minutes later. Had I been in a hospital, no doubt they would have broken my water and a stuck baby would have called for a c-section. My midwife knew exactly what to do (and what not to do) and for that I am so incredibly thankful.

    Wednesday, March 14, 2012 at 1:58 pm | Permalink
  3. Melissa wrote:

    Ooh I love that 2nd to last paragraph. Very good point.

    Wednesday, March 14, 2012 at 4:17 pm | Permalink
  4. Mirjam wrote:

    My first child was born in the hospital. I didn’t like it, people were poking me with needles, nurses walked in and out, interns wanted to ‘feel’ as well..
    Thank goodness my other two kids were born at home. Nice and quiet, just me, my husband and my midwife.
    I live in the Netherlands, here we have to fight for the right to get an epidural by the way.

    Wednesday, March 14, 2012 at 8:03 pm | Permalink
  5. Rebecca wrote:

    Excellent essay, one that I will share.

    Along these lines, how do you respond when people ask about extremely-time-sensitive emergencies, the kind of thing where 5 minutes can be the difference between life and death for mother or baby? I think this is the scenario that most people have in mind when they say the hospital is safer “just in case.”

    Friday, March 16, 2012 at 10:31 am | Permalink
  6. Kalyn wrote:

    I’m curious, could you tell me what you would’ve done or recommended for me? I wanted to do a natural birth but then found out that I was preggo with mono/di twins and baby b was breech. I had no signs of labor and at 38wks was induced (my mfm was worried about my placenta giving out.) Still after almost a day of induced “labor” I had no progression. And Dr. after Dr. (being military we didn’t have a certain Dr., it’s whoever is on call) would come in and tell me why I need a c-section and the possiblities of baby b’s death. After all that we consented to a c-section. Now could all of this been prevented? Or is it just a “perk” of having twins? If we have a singleton next is a natural home birth possible? Oh and the girls were great after birth, I was the one who needed two blood transfusions…

    Friday, March 16, 2012 at 1:47 pm | Permalink
  7. elfanie wrote:

    Kalyn:

    Rules and options vary from state to state. In my state, it is against our rules and regulations for a licensed midwife to attend a homebirth of twins.
    Or of VBACs, although they are trying to open the possibility of being able to legally attend both of these.

    I will say that your pregnancy has some definite complications – from being twins, to the fact they were mono/di and not di/di…and even with a perfectly normal singleton pregnancy, it is usually so complicated that without being someone’s care provider and having a full history I can’t say for certain what I would and wouldn’t have done in someone’s previous experience. I do have some basic protocols that we follor (or don’t follow – for example, internal exams aren’t routine)….but situations are always individualized…

    I’m sorry you had a disappointing experience – congratulations on healthy twins! =)

    Friday, March 16, 2012 at 4:23 pm | Permalink
  8. Stephanie wrote:

    Great post and fantastic comments. Clarifies beautifully what homebirthing families are thinking in their heads. Denise, thanks for sharing that experience, too, very insightful!

    Saturday, March 17, 2012 at 2:40 am | Permalink
  9. Dinah wrote:

    Thank you thank you thank you!!! What a great and well worded post. I tell people all the time how thankful I am that I birth at home. My son (1st child) was 10′ 13″ and had a head circumference of 15.5 inches. He also was in a half posterior presentation. My midwife worked with me and we did everything we could think of to bring him down. Even so, I pushed for five hours before he was finally born, happy, healthy, and completely unfazed by his hard day. I know without a doubt that, had I been in the hospital, there would have been immense pressure to do surgery. Even in the middle of those long five hours, I remember saying, “I am so glad I am not in a hospital right now!” His heartbeat never wavered and there was never a reason to panic; when he was born, he snuggled against me and went right to sleep.

    Saturday, March 17, 2012 at 1:43 pm | Permalink
  10. Emily wrote:

    I too am curious to your response to Rebecca’s question. In my hospital birth (c-section) 5 minutes did make a difference.

    Saturday, March 17, 2012 at 7:44 pm | Permalink
  11. elfanie wrote:

    Time sensitive things rarely happen….and, in fact, most of the major things that would be “immediate emergency” things you are at a greater risk for BEFORE you are full term.

    Emily…what occurred in your birth in which 5 minutes made the difference?

    Saturday, March 17, 2012 at 9:42 pm | Permalink
  12. Tara wrote:

    Absolutely brilliantly insightful article, thank you! My second child was born at home two years ago and my third child is due any day now, also hoping to birth at home. I so loved your paragraph about wanting to control the experience and the epidural… Will definitely remember that one.

    Sunday, March 18, 2012 at 5:48 pm | Permalink
  13. Annette Harkness wrote:

    Your words are so true.

    Sunday, March 18, 2012 at 6:27 pm | Permalink
  14. Lucy wrote:

    LOVE this post. Have had 3 home births myself, write about home birth myself professionally, this the the best writing on home birth I have ever come across. I wish I had had it when I was preparing for my first to give to all the nay Sayers. Our second was born at home, on the bath mat, blue, un breathing with the cord around her neck, no hospital would have been able to do any more than our incredible midwife to keep us calm and bring her back. When she pinked up the midwife kissed her and held her with such love as I got over the shock of it all. Thank you for your wise words and precious vocation.

    Monday, March 19, 2012 at 4:34 am | Permalink
  15. Rach wrote:

    Thank you so much for this post. We had a hospital birth due to premature labor, and were able to avoid many of the interventions because we were fortunate enough to have a nurse who was a CNM. She instructed my husband not to let anyone do internal exams on me, nor to let them induce. I’m so thankful for her advice.

    I think a lot of people– whether they have had a hospital birth or not– don’t realize just how much coercion is involved. The doctors tell you that you need to do X, that it simply must be done, and the mother isn’t in a position to know she can refuse. How would she know, if that’s her supposed ally and advocate, telling her that any other choice would be deliberately causing harm to her baby?

    I’m willing to bet that the vast majority of “literal emergencies” where a mere five minutes make the difference between life and death are situations where– as the article stated– other decisions led up to it.

    It saddens me that mothers are so eager to look back and be glad that they surrendered their power. Not that we should regret our births or that I wish sadness on anyone, but I dislike this natural assumption that the doctors basicly forcing you into a decision makes it de facto the right one.

    Tuesday, March 20, 2012 at 3:54 pm | Permalink
  16. Olofe wrote:

    This is why I can´t even think about having my babies in the USA. I always fly back to Iceland to have my babies in the natural birthing ward with my midwives in Iceland. My baby never leaves my sight and they haven´t even been weighed until a few hours after birth because they want me and my babies to bond first and then they are weighed and measured in my room.

    Tuesday, March 20, 2012 at 7:02 pm | Permalink
  17. Carol wrote:

    Wow, what a great post, and a lovely comments, I got quite emotional reading them all. I had my first child in a hospital, mainly because I was unsure how my body would cope with child birth and again, – I wanted to make sure we were all safe. I had such a wonderful, natural birth and the hospital staff were very respectful of my birth plan however I am looking forward to having a home birth with my second.

    Sunday, March 25, 2012 at 4:07 pm | Permalink
  18. Ellen wrote:

    Great post. In the Australian documentary “the Face of Birth”, Hannah Dahlen describes it beautifully (loosy quoted) that at a home birth all is so calm that you can see a ripple in the water and act upon it, preventing it becoming a tsunami. At hospital there might not be that continuity of care and therefore they are sometimes “fighting” the tsunami. Then those 5 minutes count. At home they could have seen that tsunami coming and possible prevent or act upon it.

    Sunday, April 15, 2012 at 6:47 pm | Permalink
  19. Dawn S. wrote:

    Thank goodness I had a home birth!! The hospital was the last place I wanted to have Greg (although I would have gone if we needed to). I probably wouldn’t have been able to do it “natural” in the hospital since they don’t usually let you push in a birth pool, and the entire birth team watched me try, and fail, at having 1 “pushing” contraction on my bed. I think the comment was “Dawn, you look so uncomfortable on the bed.” The pool was my saving grace and I’m glad I had it. Thank you to everyone for making Greg’s entrance into this world so wonderful and easy!

    Monday, April 23, 2012 at 5:43 pm | Permalink
  20. tori wrote:

    I’ve ÇctuÇlly said, to a number of people thÇt I’m certÇIn I would’ve either hÇd Ç deÇd baby or Çn unnecessÇry C-Sect. if I’d had two of my last 3 in hospitÇl. They look at me like I’m nut

    sorry for the missing A at times… my keyboÇrd is fickle and puts it in or not at it’s own discretion. YES, it IS Çnnoying! *sigh*

    Thursday, May 3, 2012 at 2:20 pm | Permalink

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