Having a hard time visualizing a homebirth. Thoughts?

[thencamehenry]

We are TTC #2 and I am leaning toward a HB, but I'm conflicted because this preference is based more on process of elimination than an actual desire to birth at home.

DS was natural childbirth at a hospital two years ago.  The birth was fine, not great or awful, but I had to advocate for myself to avoid interventions during labor.  OB practice has a great doctor and three great midwives and then one doctor I don't like much.  I would rotate prenatals and get whoever is on call for the birth.  The hospital is my least favorite option, and it's the cheapest but not by much because we have a high deductible health plan.

Homebirth would be with a CNM with 30 years of experience who was recommended by my OB's office.  I live 10 minutes from a community hospital and 20 minutes from a big hospital with full NICU (the one where I had my son).  My biggest hangup is that I just can't quite visualize birthing at home.  No practical reason why not, just can't see it.  Maybe it's fear of a sudden complication and transfer, dreading explaining our plans to extended family, or just not wanting to disrupt my house.  Also with my son I had a hard time laboring at home but really got into the zone once I got to the hospital.  But maybe that will be better if I know I'm home for the long haul?

There's also a Birth Center about 15 minutes away, and it's 5 minutes from the big hospital.  I like that we would be closer in the case of transfer, but I know that's pretty unlikely for a multip.  It's recommended by my pediatrician.  I would have to rotate through 4 different midwives for prenatals.  I won't know which one will be on call until the day and none of them are as experienced as the HB midwife. I love the space, the big deep jacuzzi tubs, and I can totally see myself birthing there.  It would be about $1000 more than HB.

Any thoughts?  I feel like a whiner because I know a lot of people would kill to have these three options, but I just feel like nothing is right.  If I'm choosing the option I dislike the least that makes it hard to get excited about giving birth.  Maybe I will feel differently after I am actually pregnant.  Ugh!  Any advice?  How do I choose between location (birth center) and care provider (HB midwife)?

Any feedback is appreciated!

[echospiritwarrior]

wow, so interesting. Just from my own perspective I've had three home births and never could see it any other way. For one I can't even imagine myself getting into a vehicle while laboring. I don't know, what you said about not being able to get into a groove at home but rocking it in the hospital might have some truth. Have you gone ahead and set up appointments with the HB midwife and the birth center and maybe discuss those thoughts/feeling with the midwife/s? Just a thought.... I know you have written it out a bit here, but maybe trying to itemize pros and cons of each choice on paper in more depth? Maybe also do some free form journaling on the topic to see if something you may not be logically thinking of might present itself?

Good luck on your decision, and have fun TTC #2

[labortrials]

Great options, ya whiner.  (j/k )  I think it can be hard to visualize birth, and maybe it will change once you're pregnant again.  I really can *see* myself laboring in my house, but I didn't really start to have these images pop up until after I became pregnant.

I don't think homebirth is a very good fit for someone who feels kinda "pressured" into that setting.  If you feel more comfortable at a birth center, you don't need to apologize for it!  You're a great candidate, it seems, for all of these birth venues.  That's awesome!

Good luck!!

[kythe]

Based on what you said here, it sounds like homebirth may not be the best option for you.  You are having trouble visualizing it, you labored best in the hospital with your son.  You actually haven't given any reasons why you *would* want to give birth at home.

I'm curious as to why the birth center is more expensive than home birth.  My experience was the opposite - the birth center was paid for 100% with just a single copay on the first prenatal visit.  A homebirth wouldn't have been covered at all.  I really don't like seeing money as a motivating factor in decisions like this, even though it's unavoidable since money doesn't grow on trees.  But birth experiences stick with you for life, for better or for worse, so I think it can be worth it to go where you are most comfortable as long as you can afford it.

I had both of mine in a birth center that seems very similar to what you are describing.  I loved it, and it actually offered a lot of amenities I didn't have at home at the time (lots of space, oversized bathroom and tub, tools like birth balls, etc).  My births had as few interventions as many homebirths I have read about, but I felt more comfortable there than I would have at home.

You also mention choosing between location and care provider, but these may not be as different as you think.  Your homebirth midwife is a CNM, and birth centers are run by CNM's also.  The HB midwife may have more years of experience, but they all have the same training.  Birth centers are not less safe, especially when you consider they are more likely to have a "team" mentality and work closer with a back-up physician than a HB midwife does.  The disadvantage in provider is that you get whoever is on call, not necessarily your favorite midwife in the group.  With a HB midwife, you have much greater assurances of who exactly will be at your birth.

[emmaegbert]

for me, realizing that the HB midwives will deal with and clean up all the mess of the birth and aftermath was a big deal in helping me "visualize" doing it at home. and it was true- by the time one of them helped me with showering and peeing, and helped me dry off and dress, the bedroom looked spotless.

FWIW I am not a clean freak at all (haha kind of the opposite), but that just seemed like too much to deal with immediately PP.

The biggest plus side I anticipated, and which was borne out, is that the family was able to be together. The focus was on OUR FAMILY not the birth as some kind of event to take care of and get past. It didn't require a separation for my older son, and he felt involved and part of the whole experience. He was able to be as involved as he did or did not want to be, since he was in his own house. And it was so freaking amazing to just snuggle up in bed and go to sleep in a quiet, peaceful house, together, rather than in a hospital (or have to take baby out in the car!)

Extended family had WAYYYY less to say about it than we thought, pretty much nothing. They know us both though, that is, they know better than to give us a hard time ;)

But maybe its not important to decide now? Wait until you are pregnant and see how you feel then. You can even start your care with OBs (if you want to go ahead and have an early appointment for dating U/S and bloodwork and such) and transfer care if you want to later.

[GoBecGo]

Do you know why you didn't get into "the zone" until you got to hospital with your DS?  If so that might give you your answer...  Like if you were worried about having to move then you'll be great at home, but if you didn't want to "let go" until you were in a "safer" (in your mind, which is not to say it wasn't IN FACT safer, i just mean where YOU felt was the "right" place to be for labouring) then the birth centre might be the better option.

I've only had homebirths, i cannot imagine anything else!  LOL.  I mean i can't imagine getting in a car in labour, or having a needle stuck in my hand/arm, or having a band on my wrist, or having uniformed people around me, or being in a place that wasn't MY space, or not being able to go into my (clean because *I* cleaned it) bathroom and take a (just how i like it because it's my bath and i've had plenty of practice) bath.  And it's funny how you say you don't want to "disrupt" your home with a birth, and i didn't want to disrupt my birth with a hospital! :)

I think you have more thinking to do, and i think that as you go you WILL find clarity in plenty of time.  So think on, but don't stress, and talk here anytime. :)

[KatyLinda]

I am right there with you.  I had a highly interventionist induction with my oldest, and it was awful.  The docs didn't care about what I wanted, the nurses were rude.  It was absolutely awful.  I refused to ever be treated that way again.  So for #2 I chose a birth center.  I wanted to be somewhere I could be comfortable, with midwives who would respect me and my family.  Then I showed up to the birth center, in labor to learn that my daughter had gone from head down to feet down in the previous 4 days since my last visit.  So, I was ushered off to the hospital for a c-section.  In all honesty, the hospital, nurses, OBs, and midwives all did everything they could to stick as closely to my birth plan as possible and to make it as easy on me as possible.  (The hospital peds are another story, but I won't get into that)

Now I am stuck. As a VBAC mom a birth center is no longer an option, and I just can't imagine having a baby in a hospital after what I went through at a hospital with the first.  I can't imagine ever being able to have anything close to the birth I want there.  

I also can't imagine having a baby at home.  My house is small and usually cluttered with toys and housework I haven't gotten to yet.  Totally not a calm & relaxing place to deliver.  So, I really  have no advice, but I can totally understand where you are coming from.  We're a few months from TTC again and I'm utterly confused as to what we should be doing about a birthing location.  

[blessedb2u]

Hi there!

It is understandable that it is hard to envision, especially if you have never witnessed one before.  It probably seems rather...foreign?  Do you have any local friends or family in your community that you can talk with?  Are you affiliated with anyone or could your midwife recommend anyone that you could talk with that is your age who has had a recent homebirth?  It may be difficult to speak with her since she has seen SO many...it is second nature to her.

I have been around both hospital and home births.  I have to say this...envision an environment where you aren't surrounded by noises and interruptions.  Visualize a place where people aren't admitted with sickness.  Visualize a place that you are comfortable and safe and have complete control and security.  Visualize that there aren't constant machines beeping, people entering your room without permission to "take your temperature"  "take tests"  "do blood work" and tell you what to do at atrocious hours of the night.  I am sure you get the gist of what I am saying here...

It is such a lovely experience.  The smells are better.  You are warm, your baby is cozy and not being prodded and taken away from you and YOU call the "shots".  IMO it made it more like 'life" and not like a "condition"--like people *should* be in hospitals when they have a "condition", right?  When they are ill and sick and dying, no?   

Anyway, best of luck to you.  I am more than positive that you will make the choice that is best for you.  :)

L

[elus0814]

It was difficult to picture for me too after several hospital births. I went through how it would go at home in my head many, many times. It didn't go exactly as I had imagined it but was still great. Walked through the house and assumed positions I like laboring in different rooms. I sat down right where I put the birth pool and thought about being in it in labor. I ended up having the baby standing up while walking back to the birth pool from the bathroom because it was so fast which I could never have imagined but it was fine.

I'm wondering if your block is more about laboring and after the baby is born than the actual birth? For me the birth itself wasn't all that different than a natural hospital birth but the labor and immediate postpartum times were but in a good way.

I also wrote out pages and pages of how everything would happen. It didn't go exactly that way but it helped me sort out what I wanted and how things would look like and feel like when the day came. I also gave copies of these pages of thoughts to my midwife to give her an idea of what I wanted.

[mmaramba]

My house is small and usually cluttered with toys and housework I haven't gotten to yet.  Totally not a calm & relaxing place to deliver.

Just an observation and a curiosity, really, but I find statements like that fascinating.  My own BFF said she liked the idea of homebirth, but didn't want one because she'd be giving birth just a few months after moving into a new home, and it wouldn't "feel like home" yet. 

I guess it's just a foreign sentiment to me...  To me, homebirth is not about being in "a home," per se, (or scented candles or anything like that, of course).   More about not needing to be anywhere else (and all of the interventions that often accompany being "anywhere else"-- though moreso in a hospital than a FSBC).  

But I feel like if my home were so stressful that it would inhibit my labor*, it would be so stressful I could barely live in it at all-- before or after pregnancy, so that would almost be the bigger problem, YKWIM?  Because a laboring environment makes a difference, of course!  But as long as we're not talking extremes like living in a halfway house or next to a weapons testing range, or with 20 stressful people...  I would think that, generally, a sinkful of two-day-old dishes and toys on the sofa are going to be balanced by the fact that it's your own home, you control who enters and exits, you don't have to ride in a car during labor, blah blah blah.

I never know in these cases whether the person who expresses such a sentiment actually has other reservations about homebirth generally, or if I just don't "get" it. 

[azhita]

I would suggest discussing your concerns with your available options!  #1 and #2 were hospital births for me.  #3 ended up being a midwife-assisted homebirth.  We live an hour away from the nearest delivering hospital.  With #2 we almost didn't make it in time.  It consisted of my dh driving 150 km/h to get there.  We didn't have that option with #3 as he was due in the middle of winter.  I was afraid of delivering in a snow bank halfway to the hospital.  I figured the midwife might not get there in time, but at least I'd be warm and comfortable!

I first went to an OB practice for an initial appointment, and discussed my quick labour concerns with him.  His solution was just to induce me early.  After being induced with #1 and having an awful labour, that was NOT an option for me.  I too am NOT a fan of interventions.

I was EXTREMELY lucky as just in that time frame a midwife moved into the area.  We didn't have that option with the other two.  I discussed concerns with her.  I immediately felt at ease with her.  I was finally being treated as a person and not a number.  My main concerns were complications - as I'm sure everyone's are.  She reassured me though that with regular care, they would be aware of any difficulties - minor or major - that would contra-indicate a homebirth.  Also she had me pre-register with the hospital, just in case I needed to be transferred.  They also have a second - a back up they bring with them, in case there are complications - one to deal with mom, and one to deal with baby.  They bring all necessary resucitation equipment.  It really put me at ease.

I was a bit worried about the process, but really, if I could do it all over again, I would have had all three at home.  My house is a disaster most of the time, but pregancy nesting took care of that!  It was so relaxing to just hang out during labour, not being bothered by nurses.  I stayed in my comfy jammies all day, played with my boys, made some freezer meals.  My mom came down to help with the boys - again so they could be as involved as they wanted.  Birth was VERY quick and easy.  Boys came in right after to meet their brother.  I was helped into MY shower.  When I came out, they had my bed all cleaned up for me with fresh sheets!

Before the midwife left, she gave me some instructions, told me she'd be out the next day to check on us, told me to enjoy the baby's resting and recovery sleep he would have tonight (SO nice after being forced to wake up and MAKE the baby eat every two hours).  I had a wonderful, delicious dinner prepared by my mom and husband, emailed baby pictures to everyone, and slept like a baby without the constant hum of a hospital, and interruptions by nurses.

Does that help you visualize?  I get weepy just thinking about it.  I almost felt bad that we were done after #3.  I would almost have another one just to have a homebirth again.

Dallas

azhita.blogspot.com

[KatyLinda]

Thanks Dallas!  

I think part of my problem is that I see us as having already outgrown this home.  The thought of getting into my shower here is not relaxing, and the thought of a 3rd child in our house stresses me out.  When we were looking at houses a few months ago there were multiple homes I could envision giving birth in.  I think part of my issues right now are the condition of my house, DH and I both own our own businesses which keep us very busy, plus he has a full time job so we have benefits.  We are both very active in our church and I'm an LLL leader.  We also have 2 kids who need us.  We spend so much time on everything else, that the house tends to fall into last place.  When I'm sitting here looking around I get stressed about it, and that's where my fear stems from.  I can't imagine being in labor and freaking out about the fact that my carpets haven't been vacuumed in days and there are dishes in the sink and piles of papers/mail on the couch.  

I want to cry at the thought of having a baby in a hospital, and the thought of driving 2 hours to another state to have a baby in a birth center is not thrilling either.  Two hours in a car in labor does NOT sound like a good idea, and I'd rather be at home and comfy.  Maybe I just need to hire a housekeeper to come every week during the last few weeks of my next pregnancy.  I always have envisioned myself laboring in a big tiled tub.  I just need to go find a home that will accommodate that sometime in the next 12 - 15 months.  

[azhita]

Oh I TOTALLY hear you on the house being dead last.  Mine was last to begin with, then #3 came along, and it's so far past last, I don't even know where it is anymore!  lol.  I have since hired a housekeeper once a week, whether we can afford it or not, because I CANNOT keep up with 3 boys, and a husband...lol.  Do you have family close by?  My mom came down for the birth and helped me with cleaning and stuff for the first week.  HUGE help!

Mine did not go completely as planned either.  I had borrowed a pool from my good friend and neighbour, had intended on labouring in that, but it was stolen along with our truck a couple months before the birth.  Truck was eventually returned, but the pool was long gone.  Thought about going in my teeny tiny bathtub, but I didn't really need it.  Early labour was long, but not painful enough to want to go in.  Hard labour lasted all of 2 contractions, then it was go time.

HTH!

Dallas

[thencamehenry]

Thanks for all the replies.  They really are helping me think through this.
 

I don't feel pressured to pick any one option, other than general societal pressure to follow the herd on over to L&D and do the "normal" thing.  I want to figure out whether the birth center or the homebirth would be a better choice for me personally, since they both have plusses and minuses.  I am nervous about family reaction to a homebirth but my husband will totally back me up and our parents are okay, just the type to worry.  The birth center would sound better to them because it's more official and they don't get that the safety is equivalent.  But whatever, my IL's already think I'm weird because I did NCB, breastfed my son for 19 months, his car sat is still rear-facing, etc.

I do know three women who have used the birth center.  One had her first there and then her second at home, one says if she has another baby it will be at home, and the third would go back to the birth center again.  Honestly, if we have baby #2 at the birth center I could easily see switching to a homebirth if we had a third baby.  What does that say?  Sometimes the birth center feels like the best of both worlds, but it could also be the best of neither.

The more I think about it, the more it comes down to location vs. personnel.  The fact that I had a hard time laboring at home before was mostly due to anxiety about knowing when to transfer to the hospital, and the fact that the OB on call was the one I didn't like.  The physical space at the hospital didn't bother me at all, but dealing with nurses I'd never met before, an OB I didn't like, and policies I disagreed with was hard.  So even though I love the space at the birth center I think that is negated by the fact that I could get a midwife that's not my first choice.

Anyway, thanks again.  It looks like I am not the only one working through these thoughts.

[GoBecGo]

Another image of a home birth...  It was 7.57am (she was 1 minute old).  The MW is pointing to the knot in her cord.  I was amazed by her.  It was one of the sunniest days of the year and the light was streaming in.  You can see her cot set up in the background full of stuff because we cosleep!  LOL.  I'm kneeling on a shower curtain thrown over a feather duvet (for knee padding).  There wasn't a lot of room, but it was our own bedroom.  I had a brief shower at about 8.40am and then got into the bed which the photographer, DP, was sitting on when he took this pic. :)

[StillWaters]

So interesting.  For me one of the major reasons I wanted a homebirth was that I felt that the walk from my house to the hospital took me out of my zone, and I never got it back.

[mamahen2coop]

I'm so in your boat.  I dont really have the option of a birth center.  although there is one about an hours drive from here, the thought of driving an hour just does not sound cool-at.all...  I have a tough time canceling out the images I see everyday at work enough to visualize a homebirth.  I've never seen a hb in person but watch any video I can (which, btw, somewhere I stumbled on a site that was just hb videos and now I cant find it.  Anyone know of it??).  I've been reading books like a mad woman and feel like it's only making me more conflicted.  I was kind of hoping I'd either not be able to find a midwife or that DH would refuse it so I wouldn't have to be the one making the decision but alas I've found some midwives to choose from and DH is no on board after talking with one of them. 

I cant picture in my head where in the house I would want to deliver, except that I would love to deliver outside since it'll be the middle of summer here.  But then I think what if it's night, what if its too cold, what if, what if.  Then I try to picture inside... not on my bed, maybe in the kitchen area in a tub, maybe in the sitting room if I moved some furniture.  I have a nice big jetted tub in the bathroom but the bathroom doesn't seem very friendly.  Really I want to somehow make the out-of-service hot tub into a giant pool and deliver out there but that has it's own mechanics. 

I can picture delivering in the hospital but I see it for 24+ hrs a week so it's easily accessible to my prego mush brain.  I love my OB, my coworkers are great.  they'd be supportive of how ever I wanted to deliver but aren't good at adapting to truly intermittent monitoring or delivering in various positions and water birth is not an option.  But it's the hospital and they do all their hustle and bustle and I dont really want that either.  Even though I have a hard time visualizing homebirth, I think the principles are more in line with what I want for this, possibly our last, birth.  However, I too worry about what the family will say, but not as much because I dont have a hard time standing up to them, but I worry more about what my OB and my coworkers will say.  I KNOW it's my choice and none of their business but it's still a fly in my soup.  I wish I had Pam England at my disposal for a few therapy sessions on the subject!!!
 

I also can't imagine having a baby at home.  My house is small and usually cluttered with toys and housework I haven't gotten to yet.  Totally not a calm & relaxing place to deliver. 

:)  Me too.  Im seriously contemplating having my uber organized grandma come help me declutter before baby gets here.  I just cant ever seem to catch up!  Maybe because I spend time on the computer finding birthing videos and reading threads like this because the conflict in my head is always at the forefront and wont rest! 

Originally Posted by thencamehenry 

Thanks for all the replies.  They really are helping me think through this.
 

I don't feel pressured to pick any one option, other than general societal pressure to follow the herd on over to L&D and do the "normal" thing.  I want to figure out whether the birth center or the homebirth would be a better choice for me personally, since they both have plusses and minuses.  I am nervous about family reaction to a homebirth but my husband will totally back me up and our parents are okay, just the type to worry.  The birth center would sound better to them because it's more official and they don't get that the safety is equivalent.  But whatever, my IL's already think I'm weird because I did NCB, breastfed my son for 19 months, his car sat is still rear-facing, etc.

I do know three women who have used the birth center.  One had her first there and then her second at home, one says if she has another baby it will be at home, and the third would go back to the birth center again.  Honestly, if we have baby #2 at the birth center I could easily see switching to a homebirth if we had a third baby.  What does that say?  Sometimes the birth center feels like the best of both worlds, but it could also be the best of neither.

The more I think about it, the more it comes down to location vs. personnel.  The fact that I had a hard time laboring at home before was mostly due to anxiety about knowing when to transfer to the hospital, and the fact that the OB on call was the one I didn't like.  The physical space at the hospital didn't bother me at all, but dealing with nurses I'd never met before, an OB I didn't like, and policies I disagreed with was hard.  So even though I love the space at the birth center I think that is negated by the fact that I could get a midwife that's not my first choice.

Anyway, thanks again.  It looks like I am not the only one working through these thoughts.

haha!  Me too!