Disappointing Homebirth

I received my first request for a blog topic this week…and I’m finding it near impossible to write. Anyone that knows me would say that I’m NEVER at a loss for words (and a quick glance at my previous posts would prove their point), and yet I’ve stared at this stupid blank MSWord page for too long and need to write something on this subject.

Before I continue on let me remind everyone that I am part of the national community of midwives, doulas, childbirth educators….all kinds of birth professionals. Therefore, while what I am about to write about may remind you of someone you know – I could be writing about someone in New York or Hawaii or right here in Arizona….and just because it resembles someone you know doesn’t indicate that it is. This is why I’m writing on this…because it could be anyone.

Someone had a bad homebirth. Not a bad outcome…a bad homebirth.

Uh oh, you look confused? You’re wondering what the difference is between a bad birth and a bad outcome? Well, you see, a good outcome is so much more than a healthy mom and baby physically speaking – this is why the cesarean rate is such an atrocity! Not only do unnecessary cesareans put mom in a much greater medical/physical risk…but there is an entire emotional side that is affected by it. A good birth is one in which the mother was respected, empowered, loved and nurtured…

With the cesarean rate above 30% nationally, why am I not talking about that? Why is it that I’m choosing to talk about the ONE bad homebirth? Because it’s not one…it’s not two…and it’s not being talked about. And, in many ways, a bad homebirth is one of the worst traumas that a woman can experience.

Again, please let me explain (and you will see why I sat here for a long time before writing this).

A typical birth in this country: a woman finds out she’s pregnant, she asks her friends for the name of an OB near her. She sees the OB/practice, delivers at the hospital of their choosing, and expect certain treatments. She doesn’t expect them to be nurturing and loving, she doesn’t expect them to empower her or to be hands off. In fact, usually the only thing that really surprises her is if she has a cesarean, because that happens to other people….but even then, it’s not too surprising.

But then there’s the woman who empowers herself…she reads, researches, finds out how safe and wonderful a homebirth CAN be. She begins to dream of a world where she is safe AND nurtured….where she can explore and discover a part of herself she didn’t know she had…that wonderful animalistic she-woman that can accomplish anything – even bringing forth life into this world under her own power!!! She hears stories of homebirths and how wonderful they are…hires a homebirth midwife…and dreams of a better birth.

Not all homebirth midwives are the same. Of all of the tests I had to pass and qualifications I had to prove in order to get my license, “Nice person” was not one of them. I never had to prove my skills at “nurturing” or “empowering”.

So this mother who hires her homebirth midwife and dreams of her birth being beautiful and a family event….gets a highly interventive, intrusive birth with a bully of a midwife. She is upset, disappointed, crying. Like the woman with the unnecessary cesarean who is told, “Why are you upset, you have a healthy baby…you should be grateful!”…..THIS mom is told, “Why are you upset, you got your homebirth?”

And this woman is left feeling like maybe she did something wrong – after all, the stories she heard were always wonderful, right? She feels defeated rather than empowered…she was bullied and beaten and now feels that maybe it was her fault. She is angry at the midwife and yet is afraid to say something because she feels like she’s the only one….because nobody else is talking….because they all feel like they are the only one.

I’m not saying that I think that this family should go public with the NAME of the midwife…but they should certainly go public with their story, helping others avoid the same situation. But this family doesn’t even want to share their disappointment with the midwife!! I’m sure the midwife doesn’t know anything is wrong!! That being the case, why would the midwife change anything in the future??

We need to talk about this, so I will say it out loud. Not all homebirth midwives are nice, not all homebirths are good stories, not everyone who had a homebirth will be happy. If you have a bully of a midwife, YOU HAVE A RIGHT TO BE DISAPPOINTED!! And you should not be afraid to communicate that with your midwife. It would KILL me to hear that a client of mine was disappointed with the services I provided…yet even still, I would want to know so that I could be better for the next family and hope and pray that they feel enough trust in me to be able to tell me.

This situation breaks my heart…because I believe that we (midwives) should be held to a higher standard and that the point of having a homebirth isn’t the location in which she pushed her baby out. It’s so much more than that.

So I’m going to ask you…my wonderfully brilliant friends and readers….what should she do? What would YOU do?

21 Comments

  1. first, I don’t think that homebirth is exempt from not truning out the way everyone hopes. Nothing is. second, if a client is unhappy with any care provider, they have the right to change to another, communcate their concerns and feelings or do nothing and be unhappy. thrid, not making a choice about anything is still making a choice. not every … See Moremidwife,doula, cba ,lc, etc will be a good match for eveyone.
    I agree that people tend to lean towards homebirths as more empowering, and wonderful, but lest not forget that we each have a responsiblilty to ourselves to not be “bullied and beaten” While I know there are some midwives, as in an field, are not as gental and nurturing as others, that works just fine for some. Last but not least, there are some women who no matter what, they will be victims and find a way to blame others for thier feelings.

    Wednesday, February 24, 2010 at 11:37 am | Permalink
  2. Kolleen wrote:

    She should be willing to talk about the experience she had and let other people know her experience. Personally I would tell people her name so that they would know who NOT to go to or at least so that if they went to that person they would have had fair warning. Most women are too intimidated to say anything though…and the shame of that in a situation like this is that if it is a first baby she may think that the home birth experience was so bad that she had the next one in the hospital and misses out on the BEAUTIFUL experience of a GOOD homebirth. After a bad experience it could be hard for her to think that there are good midwives out there. My homebirth was by far the BEST birthing experience I could ever have hoped for and even more impressive and important to me is the care that I received both before and especially after my baby was born. Every appointment after Lena was born I grew more and more connected to my midwife…felt so cared for and I loved that at every appointment I was seeing the woman that was with me through my pregnancy and was there (even if it was a little late 🙂 ) at my baby’s birth. It was a much more involved and intimate process…

    Wednesday, February 24, 2010 at 11:47 am | Permalink
  3. Nicole wrote:

    I would definitely write up my birth story, and share it. I would tell the midwife about my disappointments. You’re right, she needs to know what the family is not happy with her services.

    I have a fair amount of friends who have had bad homebirths, so I know it’s not uncommon. As someone who had an unassisted birth, I know many UCers choose to have a UC after a bad homebirth.

    Wednesday, February 24, 2010 at 11:55 am | Permalink
  4. Michelle H wrote:

    This is the elephant in the room, eh? It’s like having challenges with breastfeeding… nobody wants to talk about it, because your mainstream family/friends will tell you not to bother and your alternative friends try too hard to “fix” it, and nobody just turns off their thinking, analyzing brain to just *listen* and support without chiming in or getting righteous.

    I would tell this mom, “Come to birth circle. It’s a safe place to tell your story. Let yourself cry about it. It is what it is and you don’t have to make excuses, apologize for it, change it or relive it — at least not until you’re ready. The stages of grief happen after disappointing births, regardless of whether it was at home or hospital. Just let yourself be emotional right now. Later you can figure out how to turn your story into something positive, even if it would be to help someone else avoid a similar situation. In the meantime, I love you and I care for your family and I will listen with my heart and not try to fix or change it. It’s your story–I respect that.”

    Wednesday, February 24, 2010 at 11:56 am | Permalink
  5. Rebekah C wrote:

    Oh this is a good one. Hmmm.

    No birth is guaranteed to go well, regardless of where you birth or who you choose to attend you. But you’re right, there is so much more to the experience than whether or not the birth itself was “successful”. I think feedback is essential to improving care, whether it’s at home or not. This woman needs to tell her midwife that she’s disappointed and why. If it was a another scenario, say, a hospital birth, I’d say the same thing! Midwives and doctors provide a *service*. They aren’t the bosses, we don’t work for them. If the service they provide and that has been paid for is sub-par for *any reason* than women must use their voices as consumers to demand better. This is the only thing, ultimately, that is going to bring the changes that this society needs to see in birth, whether at home or not.

    Wednesday, February 24, 2010 at 12:11 pm | Permalink
  6. Amy Drorbaugh wrote:

    I don’t know what I would do. I’m horrible at any kind of confrontation, but I know what I would want to do. That midwife should know how her client feels. Maybe she just doesn’t know what she’s doing wrong, maybe she would want to fix it if she knew. Maybe she’s doing the best she can with the knowledge she has. And maybe she isn’t. But if you give her the chance to change and fix the mistakes she’s made then you’ve done what you can to help other women like you. I’m so happy that my homebirth was the beautiful experience it was. Stephanie you rock! 🙂

    Wednesday, February 24, 2010 at 12:13 pm | Permalink
  7. Tatiana wrote:

    Thank you for writing this Stephanie. It’s an angle we don’t often think about or acknowledge, but it exists and is real. I love Michelle’s comments and I, too, believe that we, as a community, need to provide a safe space for women to talk about, process, and hopefully heal from their experiences without judgment.

    Wednesday, February 24, 2010 at 12:46 pm | Permalink
  8. Maren wrote:

    I agree that the midwife needs to know. I personally would write a letter because that way I could word things exactly the way I wanted. The midwife does deserve to know. Maybe it will help, maybe it wouldn’t but it would be healing to write it and let it go.

    I thought about writing a letter to my OB just to get out the frustrations and set backs that I had. I might not even send it but getting it out would help me a lot.
    I think the best advice I ever got from a midwife was to interview at LEAST 3 midwives. I had never even thought about interviewing a health care professional. Usually you take the referral from your close friend or family and you don’t question it.
    I am so lucky I don’t need to look anymore. Having a bad experience only makes the great experiences greater.
    Great topic.

    Wednesday, February 24, 2010 at 12:56 pm | Permalink
  9. That Doula ;o) wrote:

    As a doula, what do we do when we hear these stories about these midwives? A question I often ask myself. We have one in our community and I have found myself feeling obligated to tell people “you may want to ask your midwife . . .” to help them tease out the information I feel they should know before they continue on their journey with this provider. It’s such a tough issue.

    I agree, planning a homebirth doesn’t mean you’re going to receive compassionate and best evidence based care.

    Wednesday, February 24, 2010 at 1:23 pm | Permalink
  10. Erika Obert wrote:

    Ya know, as a midwife, it has been my misfortune to be on the other side of the coin. Having labored with a couple for 28 hours, then transported, then being told after she had an epidural to “go get some rest and we’ll call you when we’re complete”. I was never called and now they won’t speak to me take my phone calls or answer any e-mails. AND to add insult to injury, they still owe me money. They didn’t get the outcome they wanted, so they shunned me completely. I don’t even know how or when the baby was born.

    Bullying in any form is inappropriate. Period. And it hurts.

    Thanks Stephanie for highlighting this issue.

    Wednesday, February 24, 2010 at 1:26 pm | Permalink
  11. Sheridan wrote:

    THANK YOU, this is a problem. A lot of moms think, I have hired a midwife so I will have a low intervention birth. It isn’t that easy. homebirth midwife does not always equal low interventions.

    I think this mom needs love and support to work through her trauma. She should take time to write down her feelings and if she wants, share it with her midwife.

    Wednesday, February 24, 2010 at 9:37 pm | Permalink
  12. Rebecca wrote:

    I absolutely would, and did, let my care provider know. Before deciding on a homebirth, I had seen an OB who had horrible bedside manner. She was recommended by a co-worker/friend. After seeing her for about 4 or 5 office visits, I decided a change needed to be made. This was my first baby (as you already know). The Dr. never asked how I was feeling or if I had any questions. I always left the same way I came in…feeling that I had to search out the answers to my questions somewhere else. The final straw was when she let a student listen for the heartbeat for the very first time while she carried on a conversation with me, so I could barely even hear it. It was passed by like an insignificant event.
    That day I told her I was switching to a midwife and would not be coming back and asked for my records. I called her later that day and expressed how impersonal she was towards me and how I felt she was simply going through the motions, not truly trying to connect with me or my baby.
    Pregnancy and childbirth is so significant and so important. I am so thankful that I made the choices that I did, even if I did see 4 different practitioners throughout one pregnancy, because in the end, I had an awesome midwife and an incredible and unforgettable experience. For anyone who has not, I think that they, for their own well being, need to find closure and express what happened to others, if not the person directly so that they are not scarred by the events.

    Thursday, February 25, 2010 at 12:12 am | Permalink
  13. Pauli wrote:

    I bring this up in ICAN meetings regularly. It is not the place of birth that makes or breaks the birthing experience, but it is often the care provider and/or staff. I have had one of each: a bad hospital birth, a bad homebirth, a great homebirth, and a great hospital birth.

    Yes, she should share her feelings with the care provider. It helps someone move through the grieving process about their birth. The midwife I worked with didn’t seem to care but I tried to get my feelings across. I don’t know that it changes how the care provider acts or not… but it is cathartic. I also see people have UC’s because of bad homebirths as well.

    The hard part for me is that other people want different things in their birth. What is abusive to one person is what another person seeks out. So when someone comes to me and tells me they are working with a certain midwife I say great and that I will find them a wonderful doula to work with. Sometimes they ask me why I wont do it, and sometimes they don’t.

    Thanks for bringing this topic up!

    Thursday, February 25, 2010 at 8:25 pm | Permalink
  14. veronika wrote:

    Hi Sthephaine. Congrats on your blog.
    I don’t know what the Mother should do. Maybe in her own time write her birth story and publish it in the local paper, blog about it, send it via email to all the lists she is part of. I think it could help her process it and heal as well as educate other women walking in her shoes.
    I had a doula client five years ago. I never made it to the birth of her first one – it was a very fast home birth and the registered midwives just made it as the Mom was pushing. It was great. Her second pregnancy, two years later, she did not hire a doula. she did not talk much about her PG or birth as she did the first time around – she was too busy with her toddler, plus was not surrounded by birth junkies. Her second homebirth was a nightmare. She emailed me she was in the birth process and when I got the message I phoned her to see if she changed her mind and wanted me or anybody to be with her beside her DH and the kid. She declined. Five hours later I got a strange feeling and just had to call her. Her husband answered and was going to put her on the phone but when I heard her she sounded as she was in serious active phase and not coping very well. She told him to $%^& off (understandably). The next day she phoned me in tears. Fifteen min after the phone call I made to her her midwives came. She was tired and everyone thought she seemed quite far along. She was 1 cm. She lost it. She did not manage to get past seven/ or eight but because the mws knew how much she wanted to stay home they gave her two options – a)hospital with an epidural so she could rest and re-group; or b) stretch the cervix manually to full. They told her it was going to hurt like hell. She chose b). She felt raped, however. She did not expect it to hurt so much and for so long. The baby was born very shortly after that. She is still traumatized by that manual stretch that she is booked for a hospital birth for her now third pregnancy. And she still does not want a doula.
    I am working on bringing her to Glo’s study group so she feels in a supported nurturing environment and can soak up some birth-sense into herself.
    Cheers.
    V.

    Friday, February 26, 2010 at 2:04 am | Permalink
  15. Susan Peterson wrote:

    “They gave her two choices…”

    What if she chose neither?
    Suppose she chose, say, to ask them to leave for a while, to take a shower, to have a cup of tea, to hug her husband…. It really wasn’t their say, it was hers. If someone is going to boss you around, what’s the point of being at home?

    If she got to seven or eight, doesn’t that mean she was almost there? What was the big hurry? If she stalled there, what was the reason for it? Nervous midwives making her feel so nervous she didn’t feel safe to give birth to her baby while they were around?

    I also wonder about all this cervix checking. Do you know that babies actually get born if no one ever knows how much the cervix is dilate! I didn’t have one cervix check for babies four through 8!

    But I did have a midwife with baby #5 who kept me in bed so she could do perineal massage, which is what she was taught, back in the 70’s. I didn’t like it, hated being in bed, and really didn’t have a terrific birth, even though I was home.I had much more pain than was necessary due to lying down.I wondered afterwards why I didn’t tell her I didn’t want to lie down, I wanted to walk! I suppose that is why I didn’t even bother to look for a midwife for the next three; my husband and I did it on our own, and I had a doctor who was available on the phone and who came afterwards and examined me and the baby. Even that wasn’t ideal; one time my husband came home after working 13 hours in a restaurant and found me in labor. He went to sleep, and I only just barely woke him up in time to catch the baby.
    I much preferred this to being bossed around, and infinitely preferred it to being in a hospital, but it was lonely. I had some negative thoughts as I paced the hall between my bedroom and the bathroom. But, baby came out just fine,Daddy caught, and I was in my own bed nursing my baby.
    I guess I think life isn’t perfect and things don’t always work out the way we would like them to, but for me, going to a hospital puts the odds WAY up there for them not turning out the way you hope.
    Second to that would be ignoring uncomfortable feelings you have about a midwife or doula, before the birth, because they are sure to cause trouble during the birth. Even someone who wants to be there, who you aren’t comfortable with even if you think you should be, can be a problem. With the midwife you should be able to talk through anything which makes you uncomfortable. She should be able to accept that. Remember to say “I feel” rather than “You-”
    Easy advice to give, but much more difficult to do, for sure. How we all hate confrontation. But birth doesn’t let issues be ignored; they emerge before the baby does, a lot of the time.

    Susan Peterson

    Tuesday, May 25, 2010 at 11:33 pm | Permalink
  16. Lyssa wrote:

    I have nothing to add except this article found me at the exact right time. I am struggling with a disappointing home birth, and it felt great to know I am not alone. Up untl recently, I felt totally alone. I think this topic needs to be discussed even more in the birth community.

    Monday, November 15, 2010 at 2:12 pm | Permalink
  17. laceyrio wrote:

    Hello..I just ran across this blog post and just wanted to say “BE CAREFUL” and unless you’ve talked to this midwife I would not encourage these people to blog or talk about it publicly in a negative way. I would encourage them to talk to the midwife.I know of a wonderful midwife who took on a client who would wanted an unassisted homebirth but decided on a “hands off midwife”. Everything went fine with the 3rd birth but with her 4th birth this wonderful and skilled “hands off midwife” wanted to take her into the hospital due to tachycardia. Well, guess what, her friend/doula who had had 7 unassisted homebirths kept interfering with the midwive’s decisions and it took over 2 hours to convince the family to go in. Finally, on the way to the car the woman was having urges to push and the baby came out dead.
    If you read this woman’s blog it is a totally different story.
    So, please, I urge you from one midwife to another,
    1)stay humble-it can happen to you too
    2)support every midwife till you know BOTH sides of the story- a maybe even then. None of us are perfect
    3)Remember, there are many high needs clients that even a midwife cannot satisfy 🙂

    Sunday, April 17, 2011 at 6:37 pm | Permalink
  18. elfanie wrote:

    Heh…it HAS happened to me!! I had a client that, frankly, had a beautiful and low intervention homebirth of her first baby (from my point of view). I stripped her membranes because she asked me to at 41 weeks despite my misgivings – and now she’s upset that I did that. I told her she was doing a good job pushing and that she had the power and whenever she decided she could push her baby out – and now she feels that she had a “very coached second stage”. She has mental issues that stem back a long long ways in her life…and even though I did my best and gave her my heart and tried to respect every decision every step of the way….she is incredibly disappointed and dissatisfied with her birth and is currently talking against me in the community.
    Please read this blog post that I made about “Monday Morning Care Provider”…. http://www.nurturingheartsbirthservices.com/blog/?p=65
    so I’ve seen both sides. And right now with the client who is talking publicly, I get people that question me about her birth and my response is, “Her birth memory is real to her…I’m sorry that she was disappointed in her birth experience.”
    Is it possible that the midwife I spoke about in this piece was a loving caring nurturing midwife with a client who couldn’t be pleased no matter what? YOU BET! I’ve seen those clients, both in my practice as well as others’ practices!! But it’s just as possible that the midwife was a bully and mistreated her client. BOTH ARE POSSIBLE….and I just want to make sure that both possibilities are presented. This blog post was not meant to point fingers…but to encourage people to interview, choose carefully, and maintain an open communication with their client. I choose not to support every midwife…I choose to try to support every woman. I’m not going to cut someone slack just because she’s attained the title of “midwife” (just like I don’t think i should be cut slack because of this title)…but neither do I think that we should ever take someone at face value.

    To my dissatisfied client…*I* was the bully! And that is her memory, and it is valid and real to her. Can it happen to me? Absolutely…and it has. Does it mean that there aren’t cruel and self centered midwives? No….they exist…and it needs to be acknowledged.

    Sunday, April 17, 2011 at 7:37 pm | Permalink
  19. Tiffany wrote:

    Summary…can’t please everyone all of the time.

    Sunday, April 17, 2011 at 8:48 pm | Permalink
  20. kelli wrote:

    The bottom line is that even the most “perfect” midwife/OB/provider isn’t perfect for everyone, my hands off midwife might scare the heck outta the mama expecting moniters, pain meds, and the machine that goes ping…just like those things would traumatize me. So, every woman needs to know she HAS to be highly selective and willing to ask tough questions, and willing to change providers for the benefit of HER birth wishes.

    And I’m so sorry about the mama that is upset about her birth, sorry for you and her both. It is real for her. I’ve seen this recently in the woman’s whose birth I attended 3years ago, only in reverse. She was bullied and tormented, she was begging and pleading for her healthy baby for an hour. The baby care nurse taunted her saying “The baby’s safety is a higher priority than your neediness, you shouldn’t tell me how to do my job.” as she inked the baby’s feet for footprints and measured head circumference slowly while the girl and mother wailed for eachother. This mother spoke to me about these events as I saw them for a year or so, then we drifted in and out of contacted and just recently, near the baby’s 3rd birthday my friend recounted her birth and how “Rude, demanding, and unreasonable” she had been when her baby’s health was “in jeopardy”, her memory was entirely different. I couldn’t bring myself to correct her. Its not my birth to remember. I was and still am shocked. And yet, I’m not. Birth is so intense and personal and even more so, its vulnerable.

    Its just important that we can talk honestly about our experiences, however we percieve them. (Though I don’t think that requires gossip)Just like we need to hear the birth story of a woman who needed a c-section and was respected and empowered and her baby was treated kindly, or the woman who felt her epidural allowed her to be more connected to her birth process, and the woman who had a peaceful homebirth against the odds, so too do we need to hear from the woman disappointed in how her choice of pain relief failed or made her feel disconnected, or the woman who was bullied through her homebirth, or who was abused during her c-section, we need to be reminded of all these possibilities so we can take charge and choose the best place and provider to birth with for the birth that we each want remembering that when the unexpected happens, we should still be cared for respectfully, and should ensure the providers we hire will do so.

    Bah, I wish I lived in a dream world with rainbow unicorns and everybody having a happy and perfect birth just the way they wanted.

    Tuesday, April 19, 2011 at 12:58 am | Permalink
  21. newmom wrote:

    Thanks for this post! My son was born 3 months ago and I’m still trying to sift through a very disappointing experience with my midwife. It would be easier in some ways if she had been a bully but she wasn’t. It’s a small birthing community in my town so I’m reluctant to talk about it. I’m not ready to talk to the midwife yet (maybe one of these days) but I’m feeling I really need to talk to someone to help sort through everything. It wasn’t the birth so much for me (although it ended up as c-section) but the postpartum care I received that was really disappointing and traumatic. The midwife I worked with had 3 births in 4 days (one was mine and one was a set of twins!) and whether it was poor scheduling on her part or dumb luck I felt like she was so busy and distracted that I didn’t get very focused attention – missing appointments, forgetting my son’s chart, forgetting to do a test, misdiagnosing a case of thrush so that I spent 2 months worrying about something that wasn’t there, etc. We had a hard time getting started breastfeeding and she wasn’t very helpful at all, didn’t even offer to call a lactation consultant, she kept saying it was my supply which wasn’t the case (I had tons of milk in the fridge/freezer). She got me so worried about my son because his weight gain was low by a few ounces but didn’t do much to solve the problem. I finally found some really good mainstream health professionals who helped me stop worrying and fix the problem that was really there.

    The few forums I’ve found online that talk about this are not helpful. It seems alot of people in the natural birth community are ready to blame the mother if she is disappointed in her midwife/homebirth. In my experience I’ve found the natural birth community can be just as judgmental as the most stereotypical mainstream doctor! I do have a beautiful, healthy son and I’m very grateful for that but it was not an “empowering” experience. I take comfort in that fact that I never HAVE to go through the birth experience again. I have no idea what I’d do next time, if there is a next time. If you’re disappointed in a hospital birth you can hire a midwife next time but if you’re disappointed in your midwife where do you go? Especially if you just don’t have alot of options in your town. I understand now why people consider and choose unassisted births or even scheduled c-sections (both of which I think are generally a bad idea).

    Thanks again for the post. It’s good to know I’m not the only one!

    Friday, December 30, 2011 at 9:52 am | Permalink

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