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Monday, May 29, 2017

The Real Reasons I Homebirth




I see a lot of misconceptions out there about homebirth and the people who choose to plan a homebirth. We're not all anti-modern medicine, anti-science, or anti-vax. At least I'm not.

I've had a natural-ish hospital birth and a homebirth. We're planning for our second homebirth with this next baby.

My homebirthing is more proactive than reactive. Less about avoiding interventions and more about choosing what has proven to be more effective for me. Here are the real reasons I homebirth.


It's the best way for me to get good postpartum care

I wish this was not true but it has been for me. I was absolutely shocked with the lack of postpartum care, medical or otherwise, to be found using the traditional hospital system. You cannot drop kick moms from a tiny stay in the hospital to a six week check up and expect there to be a smooth transition. With home births I'm guaranteed in home visits by my midwife at 1 day, 3 days, and one week postpartum with a 2 week visit if needed. That's in addition to phone contact, doula visits, and other help.

It's respectful

Through so much of my hospital experience I did not feel heard - even though I had a CNM. My homebirth midwives have been very clear that we have a midwife/client relationship not a midwife/patient relationship. What that means is that I am legally and factually much more in control of my own birth and pregnancy experience. The difference is subtle but the shift in attitude is huge!

I am encouraged, and allowed, to take responsibility for my own birth

Part of agreeing to a planned homebirth is signing a form that states that I will take responsibility for my own education about birth choices, do my part to stay low risk, and prepare as well as I can for the birth and postpartum period. Planning is not an afterthought with a homebirth, and I have experienced much better support prenatally for making those plans with homebirth midwives than I was ever allowed with hospital midwives and OBs. In fact my visits with hospital based practitioners were more focused on breaking attempts at planning than support in planning.

I know who will be at my birth

Even if you have the best OB or midwife ever, you will still be at the mercy of the hospital on-call list when it comes down to who will actually be there when your child is born. I hated that I had to look up my son's birth certificate to see who actually attended his birth since I was never even introduced to the woman - before or after the birth. Giving birth is an intimate event and it is important to me that I at least know the names of the people who are there!

I am allowed to rest

I have absolutely no idea how anyone gets any rest in hospitals after having a baby. Getting woken up every 4 hours for vitals checks, no help caring for the baby, constant lights and noise, and uncomfortable beds are just not my idea of restful. Getting to sleep in my own bed, being left alone to sleep when I can, and to have a room be fully dark has done wonders for my postpartum health!

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These are my biggest reasons for continuing to choose homebirth. 
No, I don't think hospitals are evil, they are just not a good choice as a birthing place for me. 
We still see regular Family Medicine doctors for check ups and illness. We get all our shots on schedule, and believe in evidence-based medical decisions. 

Having a planned homebirth is no guarantee of having the bestest-most-amazing-birth-experience-ever! It is important to be honest and realistic about when the plan needs to change or if homebirth is not a good option. 

In the coming weeks I can do more posts about things like preparing for a homebirth and tips for picking a midwife. I do think postpartum preparation, homebirthing or not, is one of the most overlooked aspects of preparing for baby. Here are my best tips for preparing for avoiding postpartum depression. I'll have to write one about preparing for postpartum more generally!


What questions do you have about homebirth? Is it something you would consider doing or have done?

13 comments:

  1. My 2 kids and, Lord willing, our third will be born at the midwife-run birth center that is literally down the street from us. And all of these reasons you've given have been true for us there as well... With the minor hiccup of having to go back to our own home 4-6 hours after birth, but that's such an easy transition, and it's so welcome! For as home-like and comfortable as the birth center is, I'd still rather be home in my own bed.

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    1. That's awesome to have a birth center that close to you! There is something magical about your own bed for recovery.

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  2. Thanks for sharing these! It's neat that you live in places where homebirth is accepted. There are quite a few midwives who do homebirth here in Oklahoma, but within the past 4 or so months, there was lots of craziness when a legislator introduced anti-midwife, anti-homebirth bills (which thankfully were shelved for the time being). When I gave birth to Peter, we did a midwife in the hospital, because-since we were so new to the birth business-we had a little more reassurance in the hospital setting, but if God sends us more children in the future, I definitely want to pursue homebirth! We were fortunate to have an awesome birthing experience, but spending the first couple days postpartum in the hospital was lousy (aside from room service, which was wonderful).

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    1. Feeling comfortable is a very important part of birth! I've been following some of the legal dramas when they pop up in different states. I think a lot of it stems from a lack of understanding about why women might want something different from what we're currently offered in the hospital system.
      My first baby was also born in hospital with midwives, but it was very different from the "midwife model of care" that I had heard so much about. Better than when they put me under OB care for a bit, but still not what I had been led to expect. Doing the homebirths I could finally say, "Yup, this is what I was looking for!"

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    2. I'm sure that's definitely a part of it-it's probably hard for a lot of professionals to grasp why women would want to give birth in the home. Also, fear of tragedy (and lawsuits) is a push, I think-I read that one of the anti-midwife bills in Oklahoma came out of an infant death (after a transfer to the hospital). And, sadly, some of the issue does revolve around money. I'm so glad that you've gotten to have an awesome home birth experience, and I'm excited to see what else you write about regarding home birth!

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  3. We haven't had a little born on earth yet (we have one born into Heaven) but I loved your points. This post definitely made me more open to the home birth option!

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    1. Glad to hear it. I'll be praying for y'all to be blessed with a baby in arms too!

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  4. You are so brave! This is a great article, though. It makes me feel like I could do it.

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  5. Thanks for sharing this! I've had two hospital births, and they were not the best experiences. Your post has definitely given me some things to consider for next time!

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    1. It took a lot of soul searching and research into my records to understand what exactly went wrong with my hospital experience, but I'm glad I did it. It allowed me to target the areas that were lacking. Mine happened to improve outside the hospital, but other people are able to address those concerns by getting a different provider, adding a doula to the mix, or using a birth center. Each case is unique!

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  6. Oh my goodness, you're convincing me! My midwife always tells me I'm the perfect candidate for homebirth. She doesn't actually deliver any more, so she provides my care, hands me my file as the duedate approaches, and I just walk into the hospital to deliver to whoever's on call. I hate when they tell me to "lie down" and strap those annoying bands on my stomach - which is the worst thing during contractions! However, I get nervous about not having the NICU in place for emergencies... that's probably my biggest concern about homebirth. What do you think of that?

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    1. I'm not as concerned about a NICU in particular since even many hospitals will not necessarily have a NICU. The important thing for homebirth is really making sure you fit the low risk criteria. I'm very against taking big risks just to have a homebirth.

      There is also a lot of planning for the contingency of transfer. Around the middle of pregnancy the midwifes have me write two birth plans: at home preferences and "in case of transfer". The vast majority of homebirth transfers will not be emergencies but it's important to have figured out where the nearest hospital is located and have a plan for older kids. I make a transfer packet with all of my medical records and insurance information - both digital and paper copies - so the doctors can make the best decisions they can in the event of transfer. Every birth is attended by two midwives so that in the event of an emergency following the birth one midwife will stay with mom and one with baby, so that we are never having to pick who is most medically concerning.

      Overall, I'm happy with the risk level of having baby at home but not everyone is a good fit. If I were to go to 42 weeks with this baby I would transfer to hospital care. It would be sad, but it would be the right call for baby at that point.

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