XP: why women shouldn't fear home birth

Emerald27

Cross posted from O'14. Thought this would be a great place to discuss home birth.

Saw this posted on FB this morning and I really loved it; wanted to share. Thought it might be fun to discuss:

https://m.today.com/moms/mayim-bialik-why-women-shouldnt-fear-home-birth-1C7398354

Mayim Bialik, who you may know as Amy from The Big Bang Theory, is a very cool lady. She's a brilliant scientist IRL, and an advocate of attachment parenting, extended breastfeeding, and natural birth. I loved her book, Beyond the Sling.

I can't have a home birth because I'm high risk, and have to work with an OB, but if I had my way, I would labor and birth in the comfort of my home with my family.

What are your feelings about home birth, whether or not YOU would have one and what you think of others having them?

vvvvvfee

i am totally fine with home birthing, but it's not for me. i like the idea of being in a comfortable and familiar environment, and being able to involve your other children if you so choose. i've seen lots of videos of home birth, and they truly do seem like a lovely, intimate experience.

i know that 99% of the time, for low-risk women, everything goes fine. but, there are times when unexpected complications arise with the baby or mother. i can't imagine having to rush to the hospital mid-labor. and i would never forgive myself if something happened to the baby that could have been prevented if medical treatment were immediately available.

i had a med-free hospital birth with DS. was the environment totally comfortable and ideal? no. but the hospital is 2 minutes away from our house, and i also had a very short labor and only had to labor in the hospital for about 2 hours. so i'm fine with doing it again if we have another baby. (i would go to a birthing center, but the closest ones are a 45 minute drive and i am not up for that while in labor )

i wish that hospitals were more mom/baby friendly in the u.s. but i do think that it helps a lot to take a birthing class and/or just read up on what all of your options are. then you are in a better position to avoid any unnecessary interventions even if you're birthing in a hospital.

blush64

I would never have a home birth. No matter how small the risk of something happening I want to be in a place we can receive any sort of medical attention necessary.

I also liked my ob. I had considered a midwife but decided not to go that route. Maybe a midwife in a hospital is a good compromise for some women. You are still in a hospital if needed but you have the midwife rather than an ob.

I think birthing centers would be a good option for women who want a more home-like place. However, if a woman is a good candidate for a home birth and is comfortable with that choice that is fine, it is just not a choice I am comfortable with for me.

ncbelle

I'm a big supporter of home birth and have many home birthing friends but it's not what I've chosen for my own births.  My ideal is a birth center (which I had with Eleanor) - sadly I'm almost an hour from the only BC here in CT so I'll be having a hospital birth this time.

At this point my biggest "hang up" about home birth is the fact that it's semi "underground" - that means fewer providers to choose from and the potential for "issues" in the case of a needed hospital transfer.

While I hope that we continue to see an increase in home births, I'd like to see even more an increase in birth centers and truly mother/baby friendly hospital births attended by midwives.  I think ultimately that's the model of care that would appeal to and benefit the greatest number of women - and if we saw such a shift, it would also make the climate much more friendly towards home birth.

vvvvvfee

@ncbelle danbury birthing center? and i heard they won't check you in until you are least 5 cm dilated! i can't imagine driving all he way up there and then not being able to go in.

blu-eyedwife

So I worked as a medical malpractice attorney for a long time.  And one of the firms I worked with did a lot of birth defect cases - cases where things go wrong and the family is suing the hospital/doctors/staff.  Working in that field has made me very wary of home birth.  Because when things go bad, they go bad so quickly.  I obviously didn't have my eyes on every case that came through the door, but in every case I was part of the mother was low risk and had a completely uneventful pregnancy.  At some point during their labor/delivery an emergency c-section was called because the baby was in trouble.  For these babies, every minute counted because of the oxygen deprivation.  The less time it took to get them out, the better their chances at survival, the less defects they would have.  One case I remember clearly it took 9 minutes to get the mother from her room to the operating room and the baby out.  That child will never walk or talk.  She needed to be suctioned every hour because she couldn't swallow for herself.  She was and would always be, on a feeding tube.  If all that can happen in the time it takes to get from the delivery room to the operating room, I wouldn't want to add a car ride to that too.

I understand that these cases are not the norm.  In fact, one of my associates was a L&D nurse prior to becoming a lawyer, and despite seeing these things on a "regular" basis, she still had both her children at home.  But for me, it's not a risk I'm willing to take.  I don't think I'd ever be able to forgive myself on the off chance something did go wrong if there were steps I could have taken that might have given my child a better result.

TiffanyBerry

All of the medical interventions available in a freestanding birth center are brought along by the midwife* to a home birth.  Additionally, if mother is being actively monitored (and I don't mean those passive belts that hook you to a machine that somebody might look at every once in a while) by someone familiar with how this mom's labor has been going, the chances of there being a TRUE, "second matter" emergency are actually much lower than even the chances of a less time-pressured emergency.  (Midwives who are well trained and responsible are going to see how mom is progressing and how baby is moving and how baby's heartbeat is responding to labor and hear MUCH earlier in labor that baby or mom isn't doing as well as they had been and will start thinking about transfer decisions then - hours before a time-critical emergency occurs.)  And, finally, most transfers (from responsible midwives) actually occur AFTER birth, and have to do as much with mom (retained placenta) as baby.

There are plenty of people who should not have them - high risk births are just one subset; ANY woman who doesn't feel more comfortable in a home setting should choose where she IS comfortable (mentally) giving birth.

*I'm talking about a licensed, accredited, responsible midwife here.  One of the difficulties, as far as I can tell from anecdotal stories, is that there is a wider range of behavior in midwives than OB's.  Not that OB's are free from crappy, irresponsible practices themselves.  I put this caveat in here because I've read too many stories from moms who had midwives who did NOT practice responsibly and DID create a risk for their patients.  That makes my blood boil.

Mrs.AmyDylan

I had a birthing center delivery. I loved it and should I be able to get pregnant again, there is no where else I would deliver (providing I stayed within their risk guidelines).

I think that I had better care at the birthing center than when I started with an OB practice. During my birth I was actively monitored and supported. The top children's hospital in my state is across the street. 

I'm very supportive of home births, however, DH was not comfortable being that far from emergency care (about 15min). 

WanderingA

I had my LO at a birth center and while I loved my care and delivery, I am planning on having a home birth if I have another low-risk pregnancy.  I labored almost entirely at home (arrived at the BC after a 45 minute drive and was 9.5cm).  If I could have stayed home I would have been much more comfortable.  I liked the fact that the birth center was 2 minutes from a hospital in case there was an emergency, but I don't feel that those emergency situations necessitate a full hospital intervention.  I will use a trusted midwife and nurse for my birth and trust them to recognize any signs of distress and make the appropriate calls.  Accredited midwives are also equipped to deal with 99% of birth complications. 

ncbelle

vvvvvfee - yup!  After a very miserable 30 min drive last time, I'm not about to make that trek!  Very pleased to be only 2 minutes away so I can comfortably labor at home and not have to worry about a long ride in heavy labor!

TiffanyBerry - very true on home birth vs. birth center (although in my case the BC was much closer to the hospital).  Honestly though my BC preference has less to do with available resources or proximity to the hospital than it does with not wanting to deal with preparing for or cleaning up after birth at home (which I realize is somewhat foolish!).

nosoup4u

MWs clean up after home births, it's a part of their job.

TiffanyBerry

@ncbelle - I don't think it's foolish to consider cleanup. Yeah, the midwives and other people will help do that, but it's still your house!  We also picked a freestanding midwifery birth center because it was closer to a hospital (about five blocks away) than our house (about 10 minutes away by car).

I neglected to mention the other thing I LOVED about out-of-hospital midwifery care - my appointments were an hour long.  Every time.  Even when we didn't have much to do but listen to a heart beat and check fundal height.  We chatted.  Just chatted.  I wasn't sure why, during the pregnancy.  But about four weeks post partum - because yes, they saw me four or five times post partum, the first time at my own house - I realized that they were screening me for postpartum depression, by talking to me.  And they knew me well enough at that point that they really could get a feel for how things were going (as much as any outsider can, of course).  I was so sad, after DD was six weeks old, that we wouldn't be going back to the midwives.  They took such good care of us as a family.

TiffanyBerry

I wanted to add one more thing - I have been to a home birth.  A friend asked me to come to hers (she already had a midwife and a doula).  Baby was fine, but mom bled a lot afterwards and they did a hospital transfer for her.  Was it "seconds matter or she dies" emergency?  No.  Did it feel like a real emergency?  Absolutely.  But it wasn't a chaotic crisis, despite mom and dad disagreeing on the transfer.  It sure was helpful to have my extra two set of hands there (I got to hold onto an IV bag for quite a while....), but it was also handled fairly well.  It also taught me that there are things to discuss about possible transfers and differing opinions on the matter *before* going into any out-of-hospital birth.

Chichigo

I don't think I will be a candidate for home birth if I have another baby. I had blood pressure problems throughout my third trimester with my first and I'm rapidly approaching "advanced maternal age." I was very happy with the OB practice. All three doctors are excellent, they are low-intervention, and always responded to questions respectfully. I prefer to see the DO over the MDs because, in her words, she's "more hippie than the others." I wish my state was friendlier to birthing centers and home birth.

neverblushed

My kids are 9 and 13, so I am well past the stage of making this decision.  One thing I really liked was how Bialik's article emphasized that there is supposed to be pain and strong emotions with birth -- but that's not a bad thing.  I remember when I was in labor, telling myself "not all pain is bad; you don't have to be afraid; you can do it!" 

I was always intrigued by the idea of home birth, but I didn't go that direction myself. 

I really liked my OB/GYN, who had been my doctor for many years before I ever got pregnant.  He was part of a mixed OB/midwife practice who delivered babies at a local hospital.  It just seemed logical to me to stick with this practice and have my babies in the hospital.

When I was pregnant, there was a ton of "lore" out there about how terrible hospitals are for mothers and babies.  Maybe I got lucky, or maybe I just had low expectations, but I actually felt like both my OB practice and the staff at the hospital were very supportive and accommodating.  And this wasn't a birthing center, either.  It was just your garden-variety small hospital.  The doctors who helped deliver both of my babies made it clear that I had a lot of control over things.  They seemed to see their role as advising and assisting me.

You hear horror stories about mother/infant wards running on strict schedules, about nurses sneaking babies formula, about nurses forcing pacifiers on babies, etc.  I was ready for a fight over some of these issues, but I found the nurses to be completely willing to let me call the shots.  I felt like they, too, viewed themselves as my assistants, especially the second time around.  That's not to say they weren't supportive.  I was fortunate enough the first time, to have a great nurse who was also a lactation consultant.  She was a fantastic teacher, and showed me a ton of tricks about latching, different positions, waking up a sleepy baby, etc. 

So, while I would never give the side eye to someone who wanted to have a home birth, I found the hospital to be much less of a drag than it was made out to be.

love4b

I had a homebirth with my daughter last April and wouldn't change a thing. For me, it was perfect, but for other women it might not feel like the right choice. I think a woman should be able to birth her children in whatever way feels best to her - whether that be at home in a birthing tub, at a birthing center, in a hospital with an epidural or via a scheduled c-section. As long as you're doing what feels right for you, there's no wrong choice. 

I think the relationship you have with your caregiver is also really important. I had complete and utter trust in my midwife and her ability to help me through a safe labor and delivery. If she said we had to transfer, I would've gone - no questions asked. 

I live in Brooklyn and my midwife spent twelve years as a labor and delivery nurse at one of NYC's top hospitals before starting her own practice. She also has admitting rights at a hospital in Brooklyn (i.e. If I had to transfer to the hospital, she would still be in charge of my care and working with a team of nurses, etc. with whom she already has a relationship). 

My husband was really wary of homebirth - I think he had some idea that a lady dressed in tie-dye would show up while I was in labor and light incense while waving crystals around - but that is just not the case. My midwife and her assistant brought oxygen, neonatal resuscitation equipment, pitocin, IVs and saline solution, a Doppler to monitor baby's heartbeat, sterile supplies to stitch me up, the vitamin K shot and eye ointment (had I wanted it) and a bunch of other medical stuff that I wasn't even aware of. 

Being able to labor however I wanted was amazing and I walked away from it in awe of what a woman's body, my body was able to do. I honestly have such admiration for women who give birth on their backs in a bed with a bunch of people around and bright lights - that seems so much harder than what I went through! No matter how go from being pregnant to being a mother, you are one very strong woman for making that journey.

Crystal318

I just wanted to share my experience. Ill try to make it short and sweet. I had a 100% completedly normal, no red flags, completely healthy pregnancy. I went in the be induced at 40 weeks and 4 days (which If I coulld take back I probably would). Labor lasted 2.5 days but there were still NO sign whatsoever that anything was wrong. It wasnt until I started pushing that my sons heart rate kept dropping and dropping. They rushed me to the OR and did Emergency C section. My baby was born and he was not crying, he was not breathing, I asked if he was okay and no one said a word.  They worked on him for SEVEN minutes, suctioning him, pumping air into his lungs,trying to get him to take a breathe. They were finally able to get him to take a breathe (althought one of the doctors ahd already shut the heat lamp off and the otehr took thier stethascope off...they thought they couldnt save him. One doctor just kept on and on). Thank God!!!. He ended up having Group B Strep...even thought I was NEGATIVE and did not have ny signs (fever during labor, etc). What happend was he was in the birth canal so long he contacted the GBS (they colonize in more than one spot so if you are swabbed and not swabbed on every single cell on your cervix you are still at risk of haveing GBS. Not likely but possible. The cord wrapped around his neck and every time I pushed it got tighter and tighter. He went into distress and ended up releasing his stool inside of me and then inhaling it (Meconium aspiration sysndrome). He tried so hard to breathe that his lung collapsed. The GBS caused a blood infection (sepsis) and he was treated for menigitis as well. He didnt have suck/swallon reflex, he was swollen from head to toe and had to be placed on a cooling blanket for 72 hours in order to decrease likilhood of brain damage. We were told he may not make it and if he did he cold be a vegtable, deaf, blind, learning disorders, Cerebral Palsy, not walk, talk, etc.   He was in the NICU for 17 days. I wasnt able to hold him until he was 5 days old and he had wires from head to toe.

My point is that if we were not in a hospital where there was immediate medical intervention I dont think my son would be a completely normal, healthy, happy three year old boy today. I dont even know if he would be here today..

Sorry for my story being so long....and that is the condensed version. Just wanted to share my story. Hopefully it can save a life. Thanks

stripes82

An amazing story and you are indeed so lucky to have your beautiful boy.

I would say no also.  I had my first baby at a midwife unit.  They were very proactive about telling me all the risks of birth and the limitations of their care and also that they did not have any drugs there that they could give me other than gas and pethidine in early stages.  Also because we live semi rural the closest hospital is an hour away.  I did not need pethidine in early stages and we discovered that the gas made me vomit  

Through my rose coloured glasses I just assumed everything was going to be fine and that birth is natural and my body will just do the work.  Well I was wrong and she got stuck, twice.  The first time the midwife was able to assist in pushing my cervix aside so her head could push through (so painful) the second time she got stuck was because she just could not fit or I was unable to push her through.  I had to have an episiotomy and they then had to pull her out.  

My point is I got lucky in that not once did her vitals diminish, she stayed calm and happy through a very long and dramatic labour, for me anyway baby girl was obviously quite happy and did not see what all the fuss was about.  Between contractions in the 1 hour ambulance trip to the hospital I just could not get out of my head how lucky I was that something more serious had not gone wrong.

If I had a do over there is no way I would have my baby anywhere other than at a hospital where I have access to everything for all eventualities no matter how small the chance. 

MommyCricket

That is so sad. Thanks for sharing those harsh realities. I have a relative who was deprived of o2 (in the 1940s) and it's devastating to the brain.

spainy17

I'm another one who would have lost both my baby and my own life of I had given birth at home. I had an easy pregnancy, no issues, went into labor naturally and labored at home before going to the hospital. A number of hours later my baby was such because my cervix wasn't opening properly. Thirty six hours of labor I was doing poorly. My temp was 102, heart rate was 140. Baby was stuck and the cesarean section that brought my daughter into the world saved both of us. The doctor told me once he opened me up that my uterus had worked so hard to get her out that it was just thin and floppy in there. He said we both would have died. I could care less if my birth was peaceful, comforting, calming. When it came down to it, all that mattered was that my daughter came out pink and perfect and that I am alive to enjoy her. Do I wish that it could have been all of those things? Sure. But given the choice I would choose outcome over venue any day.

Baby2323

Mayim Bialik is the reason I know what Attachment Parenting is. And I would do natural home birth but I'm also high risk and don't really have a house to do it in. But I will give birth naturally in a hospital.