“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.