I started my venture into homebirth really just with a desire for a little more care and compassion from my medical team. The thought of having a natural childbirth, let alone a homebirth, had never even crossed my mind after I found out I was pregnant, until...
I became less and less impressed by my medical care from my OB/GYN. I suppose at the beginning I thought I wanted my doctor to just "take care of everything" for me. And you know, they are happy to oblige. In fact, I'd venture to say that many OB/GYNs appreciate you letting them be the expert and just tell you what to do. This was summed up by doctor at my final visit to her when I asked her about the childbirth classes. She said, you know, go ahead and take it if you want to. But once you're in labor and get to the hospital the nurses will just show you what to do.
I don't blame them for this attitude. Women, and society, encourage doctors to be the experts so that we don't have to go to the trouble of actually figuring this stuff out ourselves. They play perfectly into the role that we ourselves have set them up to play. "Just let the doctor handle it." After all, we've turned over our births to hospitals and medical care for the last 80 years. But think about that statement for a moment. It's only been in the last 80 years that medical care has created longevity for the human race. And granted, medical advancements deserve their kudos for sure. Because we can do C-sections and have neo-natal care, women and babies who have experienced true, dire emergencies have survived. But humans have been giving birth for over 100,000 years! Birth is not a 'medical event' like other maladies that plague us.
However, it is now treated like one. And you fall right into to the overworked insurance driven assembly line. This was my body, my child, my first pregnancy though! At least pretend like you care! But when I had to chase my doctor down the hallway to ask for my blood test results, and she responded with ‘well if there was anything wrong I would have obviously told you,’ I was over it.
But, the argument goes, `medicine makes our lives better.' And there is no denying that it does. Take cancer for instance. Up until recently, people died often and painfully from cancer and there was nothing we could do about it. Now, cancer treatment saves many lives. But therein lies the difference: up until recently, most women gave birth extremely successfully without medical intervention. Now, we still give birth successfully, but we expose our bodies and our babies to all sorts of interventions that most of us don't need. For thousands of years, cancer treatments weren't very successful, and now they are so much better. But births have always been pretty darn successful, when nature was just left to take its course, and yet now we allow medicine to intervene and end up exposing ourselves to more risk - of surgery, of infection.
But why experience all that pain when you just don't have to anymore? Because for most women who choose to birth naturally, and especially who choose home birth, its not about the pain. In fact, that plays little into the decision. The fact is, when you choose to have more personal, detailed, and intimate care through a midwife, you automatically choose childbirth without pain medication. The two go hand in hand. I’m not a martyr for pain and I didn’t explore this choice to prove to everyone how brave and strong I am. But I wanted a more intimate pregnancy and birth care experience and for that you sign up for natural childbirth.
Choosing your care with a midwife is about the ability to control the environment in which you have an extremely emotional and personal, life-changing event. For me, being laid out flat on my back for hours without feeling my legs seemed worse than labor pains. Having an IV and an epidural and a fetal monitor and a catheter attached to me for hours seemed worse than feeling everything but being able to pee, walk around and eat when I choose.
Home births for low risk women are just as safe and successful as hospitals births. There is plenty of data out there that has shown this to be true. And an argument can be made that home births are actually safer, because they don't introduce a bunch of medical interventions that could have side effects and risks associated with them.
SO, back to my OB/GYN. Didn't I WANT my doctor and the nurses to just take care of things? Well...no. My lack of knowledge was starting to instill fear in me and now I want some answers. I kinda want to know what's happening beforehand! I AM that kind of person. Some people aren't, and I can understand. But I've never been one to just turn my body over to the medical establishment. I want to know what they are doing to me. What the risks are. What my choices are. And so far, me and my OB/GYN have not discussed any of that. In fact, we haven't talked about choices at all. It's as if, because I'm seeing her, I'm already on track to go full on with IVs, Pitocin, epidurals and laying flat on my back for hours. It's as if I've already consented to them doing whatever they decide to do for intervention, including breaking my water, drugs, and C-Section. Now, maybe someday I will need these things. But at this point I haven't even been given information on how this could alternately go. I know enough women who have birthed naturally to know that there is not one way only to do this.
After I voiced my concerns on my blog, I heard from my cousin Shannon. She has birthed naturally and gave me some great resources. So I started reading. I started informing myself. I will tell you that I'm not going to get up on a soapbox and now declare that birthing naturally is the 'BEST' way, the way you should do it, the way every woman should do it. The birthing process is very personal and each woman must decide what is important to them. If you feel safer bringing a newborn into this world at a hospital (and I totally get this) then that is what will make your birth experience go that much smoother and go for it, sister. What I will preach, as loud as anyone can hear, is that each woman has the right to be informed and to know facts and all of the choices before going through one of the biggest moments, one of the most important rites of passage of her life.
So let me tell you what I didn't know. What my doctor didn't tell me.
- The C-Section rate is at an all-time high, around 33% in the USA. At the higher-income hospital that I was going to attend, its at about 45% (Higher income = better insurance. Get it?) In 1965, the rate was 4.5%. The rate was 50% lower in the 1990's. This is nearly twice as high as France's rate. The World Health Organization recommends a rate between 5-15%.
- More babies in the USA are born Monday through Friday between 9 and 5 than on weekends or evening hours.
- Despite spending the most in the world on health care, the U.S. has the second worst newborn mortality rate of the industrialized world.
- The U.S. also has nearly the highest maternal mortality rate of the industrialized world.
There are a lot of factors that contribute to each of these statistics, and I'm not going to start throwing around conspiracy theories. What it does tell me is that the maternity industry is in serious need of some accountability and oversight.
What I've also discovered:
1. In European nations nearly 80% of births are carried out wiht the assistance of a midwife. (Less c-section, lower mortality rates...hmmm.)
2. In the U.S. it's less than 5%.
3. Midwives use less intervention overall, and nearly every study has shown that less intervention on average equals healthier babies and mothers.
4. Midwives do not have increased complication rates or death rates (despite general public opinion that this is a 'less safe' way to deliver) compared to hospitals in reference to low-risk women. They have lower rates.
So here's what else. The cycle of intervention seems to go like this: you get to the hospital and take up a bed. Often you arrive too soon, in very early labor, especially first time mothers, because you just don’t know how this works. The hospitals have money to make (C-sections are the most performed major surgery and a huge money maker for hospitals - and they have beds to turnover), your doctor has a family to go home to at night, so let's get this show on the road!
You are set up on an IV and given some Pitocin to start things moving, because early labor moves just too slowly for the modern medical establishment. You're also hooked to an Electronic Fetal Monitor that prohibits normal movements. You start laying around on your back, which is the worst position to be in for your baby and for you while you are in labor. (But its great for your medical team, makes monitoring you nice and easy.) Pitocin causes stronger than normal contractions, which hurt you and make your baby uncomfortable. Epidural!! Yes, that takes care of the increased pain (that your body is now not equipped to handle naturally) but it slows down contractions. You can't walk around (which promotes labor progress and pain relief) So...more Pitocin! Now your uterus is contracting like crazy and your baby is starting to get a little peeved and quite possibly has decreased oxygen intake. Unless he gets out fast, his heartrate starts to falter, and as soon as that happens the doctors start talking C-section. They have a lot less liability taking the process out of your hands at this point and doing surgery that they've done a million times before. Plus, it's quicker and more profitable.
Don't get me wrong here. My mother had an emergency C-section, my friends have had them. I am not suggesting that in some cases these aren't totally necessary. But with a C-section rate that is twice as high as the WHO recommended rate, something is amiss. C-sections are major abdominal surgery. In my homebirth group in smalltown rural PA, one woman’s baby was sliced during a C-section, and one woman had an infection from a botched epidural before a C-section that kept her in the hospital for 6 months. (Why do you think they chose homebirth for their next babies?!) Those aren’t awesome odds. And from what I've researched so far, it starts with the beginning intervention. This is not something that my doctor talked to me about.
So apart from rare complications, what’s the big deal? You get your baby out, you go on your merry way, why does it matter how exactly it happens? To some people it doesn't. The end result - a healthy baby - is all that matters and the rest is just a means to get there. And that is any woman's right and choice to feel that way. For me, no matter how you slice it this is the first bonding experience I'll have with my child. A child's birth is something you always remember, and it is a rite of passage. And I want to know, at the least, how this process has gotten so far askew from the way women used to do it. For thousands of years. As far as that end result - the healthy baby - we don't yet know all of the complications that these drugs can have on our bodies and our children's bodies.
Medicine continues to evolve, and doctors continue to try new and improved ways to get this inherently natural process done. As late as the 90's a drug called Cytotec was used to induce labor in women who had previously had C-Sections. This drug caused ruptured uteruses and an epidemic of stillbirths. It is now used in abortion procedures instead. That was in the 90s!!
Also, some very interesting research is coming to light (see Michel Odent, MD) on mothers' naturally produced "love hormones" like oxytocin. Oxytocin is secreted during labor to induce contractions and it also performs a host of other functions. The synthetic version, Pitocin, does not have the same characteristics and reduces the amount the mother produces naturally. Research is suggesting that medical intervention is also intervening in the transfer of these hormones during critical moments between a mother and her newborn, potentially affecting immediate bonding and also potentially affecting the foundational groundwork for the infant's capacity for loving relationships later in her lifetime. This is crazy stuff!!
Who knows where all of this research will lead. My point in all of this is that when we mess with the natural order of things in the name of progress, convenience or comfort, we don't always know where we'll end up. The hormones in our food are now being linked to premature menstruation in girls. High fructose corn syrup is linked to an obesity epidemic and diabetes. The chemicals in our cleaners, plastics, and food is linked to alarming rates of cancer. Things we were told were safe we are questioning now. We're talking major shifts in our health despite all of our "progress." We have a right to be informed before we make choices.
I started off on this journey not remembering a damn thing from my sex-ed classes and not knowing at all how this pregnancy thing worked. I thought I'd just go into labor at the hospital and be done with it. But my lack of knowledge instilled fear in me, and I needed to know more. And I feel so much better for searching for answers. I'm not a martyr for pain, I'm not a hippy living on a commune. I'm not looking for a medal for choosing to go natural - and as was pointed out to me by my girlfriend no one issues these medals anyway. But I did want to know what was going to happen to me and my baby. And that's what all women have the right to know too.
Fortunately for me my labor progressed fairly quickly and uneventfully. It was extraordinarily painful, more than one can ever anticipate. And believe me, if I had been offered pain medication while in the throes of this experience that was so excruciating I was passing about between contractions, I would have said Hell Yes!! But as soon as it was over, I lay on my own bed, with my husband beside me and my baby on me and breathed a big sigh of relief. The pain was done. It was just joy. I looked out my own window. My midwives waited on us for hours afterwards, brought us food and drinks and cold washcloths. They did some laundry. And they came back every day for the next 3 days.
And as I wrote before, after a few days I realized that I was not successfully breastfeeding. My body just wouldn’t produce enough milk, and so I had to turn to formula. I really wanted to breastfeed, and as you might imagine it is heavily promoted in the natural childbirthing community. But my body just wouldn’t cooperate. No matter how hard you try, some things just do not go as planned. My birth could have been the same way, and my next one could go totally awry. You just never know. But you do your best to make informed choices, and then you let the rest up to God. And you let go.
I urge everyone to watch The Business of Being Born which is eye-opening if nothing else. It is probably the most unbiased documentary on modern childbirth and illustrates all choices.
Also look at The Thinking Woman's Guide to a Better Birth for an in-depth and fully supported discussion on the interventions used during a hospital birth.
Read Pushed: The Painful Truth About Childbirth and Modern Maternity Care
