by: Chloe Raum, EE, CPM
In 2001, I remember the incredulous looks from friends and acquaintances during the second half of my first pregnancy, when they learned of my plan to birth at home with midwives. I remember their shock when they realized that my OB had literally fired me from her practice when I honestly told her my plan and asked her to be my backup doctor. It was such a departure from what everyone else in our area considered to be an appropriate plan for birth. I understood their shock, I understood their questions, but felt at a loss to figure out how to answer them in a five-minute conversation.
Although other states in our country had home birth midwives listed in the yellow pages of the phone book, such was not the case in north Alabama. In fact, at the time I had finally accumulated enough information to determine that I was looking for a home birth midwife, I knew of no one who had made that choice. By the time I actually birthed, I knew of two women personally who birthed at home. Although the national out-of-hospital birth average is around 1%, this was not a choice being made in my neck of the woods.
The simple question of "why?" coupled with the genuine shock and concern for the safety of myself and my baby conveyed so much more. No one could fathom why a woman (especially a first-time mother) would plan to birth without pain-relieving drugs; they simply knew of no one who had ever done that, save the mother who arrived at the hospital too late to receive them. No one could comprehend that two primary midwives could possibly take care of mother and baby as well as a horde of nurses, medical technicians, anesthesiologists, and an obstetrician. No one could believe that birth could possibly be as safe in a setting without roomfuls of expensive equipment, immediate access to a cesarean section, and a NICU. No one could conceive that the risks of birthing in a hospital might possibly outweigh all the benefits that modern medicine appeared to have achieved over the past 100 years.
There were some questions that I could not answer. I had no idea what it would feel like to be in labor and give birth. I expected it to hurt. Would I be the mother who threw in the towel and asked to be transferred to the hospital for an epidural? It was a possibility; some mothers do and that's nothing to be ashamed of. Pain was a genuine concern for me; definitely something that I weighed heavily when making my decision. So what could convince me to form a birth plan that I wasn't even sure I could follow through? At great financial expense? At the risk of "changing my mind" or being one of a small number of mothers who actually had a situation arise necessitating a change of birth setting, in a hostile state where home birth transports are often treated disrespectfully by hospital staff?
It was the evidence, the cumulative information that I had read in dozens of books, footnoted to countless research journal articles, that took me a year to read. It arose from understanding enough from my college studies of statistics to be able to read the data. It swelled from a deep belief that God's word is true and that when He designed woman's body, it was good. It was the experiences of my grandmother, who birthed her first six babies at home and the last two in a hospital. It was the experiences of my mother, who had typical 1970s era spinal blocks for her first two babies and was blessed with her third baby being born within 30 minutes of arriving at the hospital, too late for interventions. Although the natural birth stories were few in number, they were all positive. It was a stark contrast to the hospital stories of almost everyone else I knew.
Since it was impossible to share a year's worth of research with a friend in a five-minute conversation, I'm sure most people never understood the reasons why I made the choices I did. Nor do they understand the reasons why I ended up making a dramatic career change from electrical engineer to home birth midwife. Nor will they ever know the heavy emotional toll I bear every time I witness birth in the hospital setting. So upon recently finding an online article that can be read in five minutes and gives many of the reasons why, I felt compelled to share it.
It's not a perfect article ... for one thing, I don't agree with one particular point. I know of no midwives personally who bring continuous fetal monitoring to a home birth when the evidence clearly show that intermittent monitoring is just as effective. For another thing, I hate the title. When 99% of the women in our culture feel safest in their choice to birth in the hospital, reading a title like "Dangers of Hospital Birth" is sure to offend. That is not my purpose! I merely want to share the reasons why I believed that my baby and I would be safer at home under midwifery care and the article does a fairly good job of that.
So here are some answers to the questions of why, courtesy of Ronnie Falcao, a licensed midwife from California.
All I can say is that it was worth it ... the benefits far outweighed the pain, the expense, and the fear. The most amazing benefits were ones I never expected, that no one told me about. I couldn't fathom the blessing of having my midwife making home visits to check on our health and my baby's weight gain during the days following birth. You can't put a price on having 24/7 access to your personal expert concerning all matters of pregnancy issues, newborn care, breastfeeding advice, and the countless "Is this normal?" questions that first-time mothers have. Nor could I put a price on the blessing of avoiding a cesarean section due to a long labor and my baby's difficult presentation.
Home birth is not the right choice for everyone, but it should be a readily accessible option for anyone who desires it.
Thank you to my dear Friend Chloe Raum, who is so good at putting the thoughts and words together...
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