"Homebirth in the Hospital"

[lil_miss_understood]

I know there's a whole forum for birth stories, but I haven't had time to check them out, so could someone tell me what they feel was different having a home birth as opposed to birthing in hospital.
My mw, on finding out that I wanted a hb but won't be able to afford one, made the statement that "we could have a hb in the hospital". Something about that doesn't quite ring "right" to me (though it was reassuring for her to say).
Thanks.

[Veritaserum]

I've had one hospital birth and four home births. I really don't see how on earth you could have a "home birth in a hospital". It's possible to have a really great hospital birth experience, but it won't be the same as staying home. Here's an article that talks about this:

http://www.birthnaturally.org/ConsumerInfo/bkbirth.htm

Your midwife does sound promising and I hope you have a wonderful birth experience.

[MegBoz]

I arrived at the hospital pushing (accidentally!) but DS had to stay 48 hours since I was GBS+ & got no ABTs.
The nurse on duty the next day took the time to read my birth plan anyway (very cool). Upon first meeting me, she said, "I just wanted to commend you. You seem very well read." Later she said, "I've been more hands-off with you than most of my patients because it seems you wanted a homebirth experience."
She rocked!

So yes, hospital birth can TRY to be more HB-like, but there just is no place like home.

[barefootpoetry]

Things that were different for me:

-I had continuous care from my own midwives from beginning till end. Not periodic checking-in while nurses and machines did most of the monitoring.

-I had free reign of positions, equipment, and any other coping techniques I wanted. No one told me "oh you can't get in the pool right now," or "oh we can't find the birth stool, someone else must be using it."

-I could eat and drink as much as I wanted. At my hospital birth I was only allowed ice chips.

-I was able to roam around totally naked and not feel self-conscious since there weren't a bunch of strangers coming in and out all the time. It was just me and my midwives.

-All fetal monitoring was done "around" me, so to speak. The midwives adjusted themselves to MY position to get heart tones, and were so unintrusive that I didn't even realize what they were doing most of the time. I didn't have to lie in a bed with belts strapped around me for required 20-minute increments.

-I yelled when I wanted to, pushed when I wanted to, basically I ran the show without anyone telling me what to do. I had the "home turf advantage." I was on my own territory and not someone else's.

-My baby was treated with gentleness and respect when he entered the world. He was distressed at birth, and was placed on my chest so I could rub him with towels to perk him up. The midwife sucked the mucus out of his nose with her own mouth instead of jamming a rubber bulb in there like I've seen so many hospital attendants do so roughly and rudely. He never left my side. I was able to nurse him right away (and he did that for about three hours!) and he slept with me instead of in an isolette.

I'm sure there are hospitals who enable you to have the gentlest hospital birth possible under their terms. But I just don't think it's possible to get close to a homebirth in a hospital. That's like going to McDonald's and expecting a T-bone steak when you order a Big Mac.

[onlyboys]

I think I might have had a hospital birth that was close to a homebirth. I went in when I wanted to, got a friend as a nurse who didn't care if I ate, drank and generally made merry. I wandered around as much as I wanted, my midwife hung out with us... I didn't have an IV, constant monitoring, or anything of the sort. I pushed my son out standing next to the bed, climbed up in bed and nursed him right away. He didn't go to the nursery at all and had no bath. We were released about 20 hours later, which wasn't too bad.

There were zero issues with respecting what I wanted. But I do know that my experience was really out of the norm for this hospital, and even for these midwives. It certainly didn't make me want a hospital birth for my fourth--I had a homebirth.

[meganmarie]

For birth #2 I switched to a different hospital and to midwives instead of OBs. I think they did achieve as close to "homebirth in hospital" as possible. Some of the elements are not dis-similar to what barefootpoetry described about her homebirth:
- The nurse (used to working with these midwives) had read my birthplan already when I arrived
- They gave me the room with the labor tub and started filling it as soon as I arrived
- The lights were kept low and the room quiet and hushed, all conversation in whispers
- No one came in or out except my midwife and one RN
- I was surrounded by loving women - besides the midwife, I had my doula and two sisters who were all fantastic and provided the best possible support. (One of my sisters is a doula and the other plans to start schooling for CNM)
- No IV or heplock
- Monitoring and vaginal checks were very unobtrusive, kept to a bare minimum and done with my permission. I barely noticed/remember
- I was allowed to be however I wanted. When I said I felt like pushing I was asked what position I wanted to push in. No one directed the pushing although my doula-sister was whispering powerful encouraging things to me (really helped me) and my midwife did tell me what was going on ie when the baby was crowning (very motivating)
- Baby went straight to my chest after birth and stayed there for more than an hour before some weighing and wiping off happened across the room with dad (I think I was getting a few stitches at the time)
- I refused the bath and baby was never taken to the nursery. She was by my side every moment of the stay "rooming in"
- I was checked out of hospital within 24 hours

My midwife was there with me the whole time; of course, that was in part because I arrived at 9 cm dilated. IMO, staying in your *actual* home for as long as humanly possible is key to success in having a "homebirth-in-hospital"!
Also, getting what I described above was due to a lot of research/work on my part to find good midwives and a very flexible hospital. I was also lucky to have a smooth labor and a good RN on duty.

All that said, I do think a homebirth for low-risk situations is preferable. And certainly doing 12 hours of labor at home and then putting yourself in a car during transition (ouch!!) just so you can be in a hospital room for 90 minutes to get checked and push the baby out is kind of silly. You are basically putting yourself through a VERY uncomfortable car ride...and in exchange you get insurance to cover your birth and/or peace of mind for a paranoid DH. But, I guess my story just says it CAN turn out okay - if that's your only option.

[fruitfulmomma]

I think it depends entirely on the hospital and the staff there.

I have planned homebirths with all five of my pregnancies. I would not purposely plan a hospital birth unless it were for medical reasons. However, things don't always go according to plan and so far I have had two home births and two hospital births.

Personally, I think my hospital births were very good. The only thing I really remember being irritated over in the hospital (2nd time) was having a lock thingy in my arm in case they needed to do an iv. I agreed to that over automatically having the iv put in. It was a pain because I could not get on my hands and knees without it jabbing me.

The first time I was only there an hour before she was born so there was not much done except some pain relief and and a VE.

Second time I had AROM and the monitored me periodically, but they let me actively labor most of the time and use the tub until I was ready to push. I had a pediatric team on hand when I birthed because there was a possibility of birth defects and she did end up needing to be taken to NICU for room air and tests, but otherwise my husband caught her and cut her cord and handed her to me before she was taken. I had good nurses, including one Bradley trained one, and they all respected my wishes about birthing. My midwife was with me, and even though legally she can not practice in the hospital, the doctor and other staff were really good about letting her support me through the labor and birth. DH stayed with the baby the whole time she was in NICU and they took me in to bf her, wasn't ever given formula. When she was let out we took her to our room and she stayed with me in the bed the rest of the time.

All that said, I don't think you can have the same experience as at home, but that doesn't mean it has to be bad and in fact can be very positive.

[AugustLia23]

Well a homebirth was nice for me in that I gave birth and that night slept in my own bed, without having to go anywhere. I didn't have to drive anywhere in labor(which seemed to really S-U-C-K for my partner when I was driving her around). I ate my own food, I peed in my own toilet. I walked around naked without any concerns of who would see me. My children were able to be as close or as far as I wanted them, and they too were able to sleep in their own beds two rooms away from me. After my baby was born, there was no bring home a baby from heaven knows where, the baby was always a part of the family.

NOBODY came into the room who I didn't know or invite to be there.

Just being in my own space was irreplaceable. I consider myself a homebody, and even the most comfy cushy LDR cannot compare to the space that I have designed to suit me and my family.

Also there were no protocols that I "couldn't" refuse. No all night vitals checks.

The two just cannot compare, not even close.

[mamabadger]

Contemplate conceiving a baby in a typical L&D setting, compared to doing it at home in your own bedroom. That is how different a home birth is from a hospital birth.

[lil_miss_understood]

Originally Posted by Veritaserum

Your midwife does sound promising and I hope you have a wonderful birth experience.

She really is a good mw. My birth with ds2 was great with her there.
That article you linked is kind of what I was feeling but couldn't really express. I had kind of wanted to labour in a squat or some "alternative" position but found myself in the delivery bed last birth, which was mildly disappointing (but not enough to mar my experience, iykwim).
Thank you everyone for your responses. You have given me a lot to mull over and discuss with my mw.

[UrbanCrunchyMama]

I happen to be processing my birth trauma from almost three years ago right now. Here's what happened and how I feel about our hospital birth. Next time, we're home birthin'.

[mamazee]

I had a very natural and good hospital birth, but even given that I can't say there's any such thing as a "home birth in the hospital." First of all, you aren't in familiar surroundings, but even beyond that, if your provider really does try to do things the way they would be done in a home birth (and mine did) you still have the nurses, who have lists to check off. Those lists are nothing like what you'd see in a home birth, and you have to constantly fight them off. And once the baby is born, it's all off - they are more concerned about their liability and getting all the heel pokes and what-not done to the baby then they are your comfort.

So it is possible to have a very good hospital birth. I was pleased with mine and my next will be a hospital birth too. But the reasons people have home births can't be handled the same way in a hospital, so I would suggest someone who wants a home birth just have a home birth.

I think hospitals are trying to compete with home births by making changes to the front ends of labor/delivery, but I don't think what happens after delivery will ever change much.

[mamabadger]

Originally Posted by UrbanCrunchyMama

I happen to be processing my birth trauma from almost three years ago right now. Here's what happened and how I feel about our hospital birth. Next time, we're home birthin'.

UCM, I read your account. I was also confused by the offer of an "Ina May Gaskin episiotomy." Her name doesn't immediately spring to mind when I hear of a woman forced to lie down with her feet in the air to push and being given an unwanted episiotomy.

[hollycat]

i really think the things that you value in a homebirth, its tough to get at a hospital. and i think the things people really value about hospital births, it would be tough to get at home, too. they are just a different kind of experience. in my mind, not one is better, or worse, its just a preference.

one difference is there must be a really wide variety of the types of hospital births you get out there because the accounts i read on this board of horrific hospital births bear absolutely no resemblence to the hospital births of my sisters or girlfriends, or myself. in fact, these accounts are as far away from our hospital births as homebirths are from hospital births. many of them do sound like my mom's horror stories, tho.

so i think it REALLY depends on where you are. if youre looking at a hospital birth you may be limited by your geography, but do your homework and look for the wonderful, respectful hospitals and providers that are out there.

[LilacMama]

In my hospital, you could strive for something "home-like" but obviously it wouldn't be YOUR OWN home. Very different! But you could:

Bring your own music, bring your own aromatherapy, blankets, lotions, pillows, clothes to wear, and comforting pictures or "focal points." You could create a very personalized space within the hospital room.

You can move around in whatever position you like, you can get in the tub or the shower. Monitoring is always intermittent in natural births unless there are complications.

We keep it low key and quiet and respectful. So, in a way, it's "home-birth like" because we keep the excess technology out of it. But, of course we could never recreate each patient's own home and the particularly intimate atmosphere there.

But I think your midwife sounds good!

I thought of a negative aspect: Almost no soundproofing in the walls of the hospital! If someone decided to watch TV really loudly or if another woman is um, yelling next door then you hear it.

[gemasita]

so could someone tell me what they feel was different having a home birth as opposed to birthing in hospital

To me, the difference is the philosophy, not the location, so I think it's impossible to have a "homebirth" in the hopsital. They touch on this topic in the movie Orgasmic Birth. They suggest that the change in location alone impacts the birthing woman, even before you consider the change in philosophy. So a hospital birth is not a "normal" birth in so many ways. I would tend to agree with that.

That's not to say that you can't have a positive experience in the hospital though.

[pantufla]

Why don't you ask her what she meant by that?

[Turquesa]

Mothering had a great article on one woman who made it happen. Depending on your hospital, however, it could be a tremendous challenge. Get a hold of the admissions paperwork now, refuse to sign the "consent to treat" form as it is (because it gives them unfettered license to do anything to you, often without your informed consent), compose a well-researched birth plan, and hire a good doula.

Home birth is not always an option for mamas. But if you're savvy enough, you can uphold your best interests and rights in a hospital.

[lil_miss_understood]

Originally Posted by Turquesa

Get a hold of the admissions paperwork now, refuse to sign the "consent to treat" form as it is (because it gives them unfettered license to do anything to you, often without your informed consent), compose a well-researched birth plan, and hire a good doula.

I actually intend to talk to her about it some more, pantufla.

Regarding the above quote, I already refuse to sign the "consent to treat" form as it is even for doctor's appointments both for myself and my children. I took ds2 in for vaxes with the intention of delaying some and he got them all anyway. : Because I had already signed the form saying I agreed to everything they felt was necessary or whatever, I had no recourse. Excuse my language, but so much bullhocky. They won't get my Jane Hancock on that little paper ever again.
DH was the greatest advocate last birth.

ETA: Thanks for the article.

[bella99]

I gave birth at a birth center, here's my experience:

-I was on the monitor for the first 15 minutes after being admitted, then just periodically checked with the doppler. I never had an IV.

-I was encouraged to eat and drink throughout my labor.

-I had one nurse assigned to me. She and my doctor were the only people besides my family that were in the room.

-I labored in bed, in the shower, in the tub, and walking the halls

-I pushed lying down at different angles, on the toilet, squatting, and on all fours, all with my doc's encouragement.

-The newborn exam was done in our room. She was given her bath about 90 minutes after her birth.

-The baby left my room only once, for her hearing test and my husband was with her the whole time. Otherwise, she was with me. She slept in bed with me each night.