Home Birth vs Hospital Birth
Please note: This post is not meant to sway clients one way or the other in terms of their childbirth choices. As a doula, I support women no matter what they choose. I simply wish to shine some light on some observations I’ve noted about the various options that women have for their births.
Each woman is different, and each birth is different. Most of the births I have attended have been in hospitals. I’ve worked with some incredible hospital births. Most go swimmingly, and I’ve seen women have wonderfully empowering experiences there.
On the other hand, I’ve been a firsthand witness to the effects of interventions. Most of the time, medical birth interventions, despite their legitimate risks, are overall safe and usually well managed.
However, I’ve seen the effects of invisible passive interventions as well. The clock is a perfect example of a passive intervention, and its effects are very real.
“Textbook birth” happens in one place, and one place only: the textbook. The range of “normal” in everything related to birth is vast, yet most hospitals tend to confine “normal” down to a rather narrow window. Women tend to be “allowed” to labor for “X” number of hours, they can push for another “X” number of hours, and the placenta must come within another “X” amount of time.
I see something very different in home births.
Homebirth midwives respect the birth process too much to restrict it down to a fixed series of allowable proceedings. They understand that the body can start and stop labor, that some phases can go unusually quickly and others can take longer. Midwives do not define labor by a set “allowable” time since their practice is not governed by a hospital’s rigid status. As long as the mom and baby are both doing well, labor is respected and permitted to take its course. When a stage of labor takes longer than normal, midwives carefully watch, listen, monitor medical safety, and let the birth proceed as usual.
Which begs the question: how does the hospital differ? What do they do when labor doesn’t always go according to the allowable textbook timeframe? In my experience, most normal, healthy women are given a myriad of interventions to force the process along, and many ends up in the OR with a cesarean. They often refer to the Friedman’s Curve as a guideline to call an “arrest in labor” and a need for a cesarean. I do see differences between hospital to the hospital due to policy and provider to provider due to their experiences, but for the most part, cesarean for Failure to Progress according to the textbook definition of the Friedman’s curve is really happening and many times unnecessary.
Birth interventions are known to increase the risk of cesarean so this is not surprising. However, it can be devastating to women who truly wanted to experience birth, or who were frightened of having a cesarean.
I talk to a lot of women that want to hire a doula so that they can avoid the operating room – they want to avoid having a cesarean. Doulas absolutely do reduce the incidence of cesarean for many reasons. However, my encouragement for women that truly desire to impede the risk of cesarean is to carefully consider your provider. Hospitals are wonderful places for the most part. But one cannot accurately predict exactly what their birth is going to look like beforehand. If your desire is to avoid the OR, perhaps it’s time to consider other options.
The hospital is not your only option. It can certainly be a good option, but it is not your only one. A new study on home birth safety concluded childbirth at home with midwives in the US to be a safe option for low-risk pregnancies. I encourage you to consider exploring all of the available options during your pregnancy. You can always switch your provider – up until the moment you go into labor! Read Care Providers in Pregnancy to learn more about the difference in providers. If you are considering home birth, contact me for some great referrals and care in Massachusetts!
I support you no matter what you choose – just make sure that the choice you make is for sure the right one for you.
We are celebrating my son’s 5th birthday this week! Merrick’s birth plays a large part in why I am where I am today.
Now bear with me… my mind may be a little fuzzy on all the events, and I hope I’m telling the story accurately and clearly, as this story is pieced together from past Social media posts. But of course, my birthing memory may be a bit skewed… I WAS IN LABOR LAND!
When I found out I was expecting in late August of 2010, I was utterly surprised. I had previously been diagnosed with PCOS, Polycystic Ovarian Syndrome, and had tried a gamut of medications to help my natural system take over, but was told that having biological children was nearly impossible and my insurance wouldn’t likely cover the next stages of medical intervention had I wanted to have children. I remember my mother vividly when she said, “Don’t cry. God gives us the truest desires of our hearts,” so it was common sense to call her first from the bathroom of my apartment at midnight, gripping the test in hand.
Is this real??
That’s also what I said when labor began.
5 years ago at 2 am, I looked up from my bed at my midwife and said,
" Tell me this is real."
I had been experiencing contractions since yesterday AM and was praying these were not Braxton Hicks as I had not noticed any previously in my pregnancy. She smiled and confirmed they were real labor contractions. My son’s “due date” was today. She tucked me in and said she’d be back around 10 am, but call if things changed.
She came back as promised and my home slowly filled with birth workers – Kim, Alexis – the other midwives – and Sarah, my doula. And even for a short time Angela, a doula I had met along my travels. I was excited, but I knew I had some time when my midwives went to lunch. I felt as if my contractions spaced and were not as strong, but my back hurt a bit more so my husband and I got in the “birth pool” which at that time was an Aquarium kiddie pool splashed with colorful fish all around it and a waterbed heating pad underneath which scorched my bottom if I sat too long.
The pool I LIKED! Leave me there for the duration of labor and I’d be one happy mama! My midwives returned and after a few more hours I began to hear little blips in my baby’s heart tones. I looked to read their faces, but they all held poker face – not one gave anything away. Joyce spent some extra time to listen the next time with the doppler. When I began presenting a low-grade fever, I went to labor in the living room, out of the warm air from the pool and onto my awesome birth ball. This is where the next heart tones were heard and my midwife laid it out; his heart tones were “fluky” and mine were beginning to mimic, along with an elevated temp.
She was talking transport, and it was previously set in my mind, if she ever considered it, I’d just go.
As the sun went down, we began preparing to transport from home to hospital. I set aside my desires for a home birth to be sure Merrick made his debut without incident. His heart had made some “wonky” blips of sound and it seemed my heart was conducting Heart Math with Merrick’s. I called my mom and told her it was just taking too long and we were transporting for a change of scenery — my little white fib to save her from worry.
We jumped, or rather slowly got in the car. I held on to the “oh sh*t” handle and I cringed while Brendon drove through the potholed streets of Worcester, following my midwife, and cracking jokes. I don’t really remember arriving – I mean, AT ALL. The next thing I really remember is my midwife-turned-doula, Joyce, saying, “I’m so sorry, I know it’s uncomfortable,” but it would be in my best interest to get on hands and knees. I remember thinking that meant Merrick was probably posterior… Boy, did I have a whole internal dialog!
Now I know I still had about 9 hrs ahead of me after arriving at the hospital, but then I assumed I’d be in labor for at least another 3 hours. I needed a break. However small it would be. I made the decision to have Nubain which gave me a 20 min “reprieve”. I remember trying to rest though the contractions in that 20-minute span. Brendon fell asleep in the cot next to me. Joyce had already been with me about 15 hrs and had seen me in the wee hrs earlier that morning… She laid her hand on me and gently rested her weary head beside me as I tried to snooze on my left side between contractions. Each time a contraction would envelop me, Joyce could feel me tense with her hand, would lift her head, and quietly remind me to relax. I remember thinking if she ONLY did THIS alone, she was worth her weight in Gold! But she did so much more! The contractions came and went and so did the 20 minutes rest! Somewhere around this time, I was told by the midwife on duty that they would break my amniotic sac. I don’t even remember consenting to it, but am pretty sure I did… I don’t know why they even suggested it. Suddenly, in my stupor, I felt the wetness and realization set in that it indeed had been broken.
Eventually, I couldn’t stay in bed any longer. I don’t remember getting naked, but I was. I don’t remember getting in the shower, but I had and was soaking wet. I sat on the toilet and remember being urged to my bed to be examined as I was feeling pressure. Low and behold, I was 10 cm dilated. It was time to push and meet my baby.
At some point in the early hours of April 23, 2011, my doula Sarah had returned and grabbed the camera – which I am so thankful for. For almost a full hour I fell asleep between contractions and pushed each time one came. I think I even SNORED! LOL!
When my baby crowned, I was reminded to touch his head, but I just couldn’t get the energy to lift my hand. Instead, I pulled it all together for one final push. “No, he’s coming out NOW!”
Finally! I met my son. “Vanessa, take your baby”. I was stunned…
My exact thought was, “Oh shit! There’s a baby!”
I looked down and lifted my son. And the realization that this little being was given to me to protect, love, and nurture changed my whole perspective on life.
I don’t remember hearing him cry. I don’t think he did much. But when I held him, I sang, “Around the world, I searched for you…” He just blinked and at that moment, my definition of love died and was reborn into something so much more magnificent!
My dear Merrick James is now in preschool and registering for Kindergarten. He breaks dances in our living room, adores listening to scores from The Lion Guard, tells me all about Professor Xavier and his X-Men, and gives me updates on his Batman video game. He’s a little obsessed with Minecraft and can do a hundred things on a tablet that I can’t. He loves digging in the yard and watering the flowers. He’s so proud to teach his swinging skills to his sister and that he can read a lot of words all on his own.
He’s everything I wished for and more!
He’s a boy through and through – dirt, dinosaurs, and DC Comics, but still a gentle and compassionate soul.
And today he is 5 years old.