Sell me on a homebirth...

[stefka]

Okay all you homebirthing mamas, here's a challenge for you! I am, historically, a big believer in modern medicine. I am also terrified of needles and have never wanted to be hospitalized. With DS, I was completely confident that I could have a happy, peaceful, intervention-free birth at my local hospital, especially since I live in such a progressive part of the world.



What actually happened was an intervention-fest beyond even my vivid imagination. There were some real problems, and in retrospect a c-section might have been a smarter call than the crazy, damaging vaginal delivery that actually finally happened. For 2 years I have had myself convinced that everything that happened was necessary, and that my being almost unable to walk for several months is just one of the things that may happen during birth.

Now I'm finally admitting that I'm not so sure I received appropriate care, or that all the interventions improved the outcome at all (DS, by the way, came out floppy but was fine within 2 minutes, so only I suffered noticeable long-term problems).

I am really attracted to the idea of a homebirth, but I have a whole list of issues keeping me from seriously considering it:

1) I no longer trust my ability to deal with the pain, since I ended up really feeling I needed an epidural last time around (26 hours of back labor without the water breaking will do that to me, I've learned)

2) I'd never forgive myself if something happened to the baby that could have been prevented by more intensive medical intervention

3) My physician-heavy family will think I'm nuts and put plenty of pressure on me to change my mind. That said, DH would not be opposed (he was at least as scarred by our first birth experience as I was) EXCEPT:

4) Our insurance won't cover homebirth at all. We have Kaiser, so it's their hospital or nothing. And around here, I don't think attended homebirths are cheap. I really don't think I'm ready to think about UC!

Okay, so there's my novel. Anybody want to push me in one direction or the other?

[Snowdrift]

Originally Posted by stefka

Okay all you homebirthing mamas, here's a challenge for you! I am, historically, a big believer in modern medicine.

This could be a red flag. If you aren't confident in doing this without medical intervention, you might be so nervous that you'd have a hard time at home.

What actually happened was an intervention-fest beyond even my vivid imagination. There were some real problems, and in retrospect a c-section might have been a smarter call than the crazy, damaging vaginal delivery that actually finally happened.

I'm so sorry you had such a hard birth.

1) I no longer trust my ability to deal with the pain, since I ended up really feeling I needed an epidural last time around (26 hours of back labor without the water breaking will do that to me, I've learned)

I had a long back labor with unbroken waters as well and I did not find the pain too overwhelming, almost certainly in part due to my comfort level at home and the support measures of my midwife and her apprentice. But I also have a pairly high pain tolerance in general. I think dealing with pain in public and when you are trying to control it is very difficult. In that situation, when you reach a certain point, you cannot cope and you "lose it." At home, in privacy and comfort, ime, there isn't any point of 'losing it'. The pain just happens.

Otoh, you might want to explore hypnobirthing. I'm not a big believer in it, but lots of mamas have found it helps control thier fear of pain and even the pain itself.

2) I'd never forgive myself if something happened to the baby that could have been prevented by more intensive medical intervention

This hesitance can be very easily overcome by reading about types of obstectric emergencies, how they are handled, the time-frames required to handle them in both settings. For example, if a c-section becomes a necessity and you live within about twenty minutes of a hospital, times 'from decision to incision' can be about the same. Similarly, hopsitals, as you know, tend to create emergencies where none exist. With my labor and its particular features and the hospitals in this area, it is a virtual certainty that my peaceful homebirth with minimal long-term effects (slight tearing) would have become a c-section in a hospital.

My physician-heavy family will think I'm nuts and put plenty of pressure on me to change my mind. That said, DH would not be opposed (he was at least as scarred by our first birth experience as I was) EXCEPT:

Don't tell them. At least not right away. Make a decision. Sit on it for a while . Read lots of stories about talking to family, the good, the bad and the ugly. For example, we decided to not tell my anti-homebirth parents. They called when I was in early-ish labor and harrangued me about going to the birth center until they realized what was going on. Finally I just had DH call them back and tell them "yep, we lied. We didn't to deal with your BS. If you'd respect our choices, we'd respect you by being truthful" anbd only then could I relax and get on withy birthing. It was just a slight hiccup in my labor, but one of the possibilities. This requires research. But the fact is, your body, your comfrot, your safety and happiness, are much, much more important than your dad's or borther's or SIL's happiness with your birth choices.

4) Our insurance won't cover homebirth at all. We have Kaiser, so it's their hospital or nothing. And around here, I don't think attended homebirths are cheap. I really don't think I'm ready to think about UC!

Unless it is an issue of putting food on the table, don't even think about it. If you were in a car crash tomorrow, you'd have several hundred to several thousand dollars worth of unavoidable expenses. THink of a midwife like that: an unavoidable expense. It's not a luxury. It's not an indulgence. It's an approproate response to a situation, and if you decide that is the care you need then taht is the care you need.

I could have had a free birth through medicaid in an in-hospital alternaitve birth center. I feel that my $2000 homebirth was a huge savings. I would have had a c-section and PPD at the least, both of which can cause lots of future emotional, physcial, and financial consequences.

Also...look into free-standing birth center. I personally don't place much stock in them for myself, but many people find them to be a comfortable middle ground. This is asaic, only true on an emotional level, but emotions are very, very important in birth.

ETA: sorry, I thought this was in the B&B forum...not in your DDC at all. Removed irrelevent comment.

[thewaggonerfamily]

Okay, this is a FWIW, since I am not a homebirthing mama, I just wish I was. First of all, I could have written your post about my first birth, other than the unbroken water. I was in labor 2 days with back labor (that's a joke, it felt like I had a constant charliehorse from my neck to my knees all over.) with a posterior baby. They then decided that I was getting close to the time limit for having my water broken and told me I had to had pitocin. I had heard horror stories about pitocin and I told them, "If you are giving me pitocin, you are giving me drugs!" and I had an epidural. Wound up with a 3rd degree tear, a broken tailbone and messed up sacrum with my little 7#13oz baby. I was firmly commited to going intervention free. I do know if I was in our county I would have had a c-section, but I have to wonder if I had a midwife if she could have got me up and moving around and helped things to move in the right direction.

My second was 7#15oz 2 hrs labor, 2nd degree tear with CNMs in medical center hospital, third baby was 9#4oz water broken induced for postdates,2 hr labor, 1st degree tear with CNMs in hospital, fourth baby was a perfect waterbirth with CNMS in hospital 9#4oz 35 min labor (I went to the hospital not in labor, she checked me, I was at 4, walked down the hall to my room (long hall)got into the tub that was only filled about 8" and delivered the head before the birthtub was full or the midwife got there. I had 2 stitches. Baby 5 was induced by breaking water because of Strep B <that's a little sore spot, CNMs agreed w/me, but had to follow the big brother hospital protocols about antibiotics, grrrr.> 2 hrs, 9#4oz (See a pattern here? Interestingly all 5 were 20 3/4 inches long) 2 stitches, 2 hr labor. Anyhow my point is that your first labor experience does not necessarily dictate your next. I did switch from an OB (who I liked) to the CNMs and learned about Bradley (from a book) since I didn't feel that the Lamaze breathing I learned helped at all. No drugs or epidurals with any of them. Although they were intense, I think more because of being so fast than anything else, I wouldn't even begin to equate them with the pain and agony and misery I went through with my first labor. The contractions actually came and went and were manageable. I even talk about relaxing and enjoying labor!

We have very good insurance that covers 100% of a hospital birth. They will pay for the "accepted amount" for a CNM at a home birth, but will not pay the facility fees for a non hospital affilitated birth center or homebirth fees. I would probably wind up paying $1-3000 out of pocket. Since I feel like I can get an acceptable birth experience in a hospital with a CNM (and my 4th birth that was in the birthing tub and I half did myself was downright spectacular, although he was born on the 4th of July having to stay an extra day just so everything could get done since they had a skeleton crew on the holiday sucked, I like to go home ASAP), I just can't justify that with our family budget. If I had something going on that I felt was safe but ran a very high likelihood of being medicalized up to a c section (breech or twins for example) I would gladly pay the money to go with the CNM at the birth center or a homebirth. My DH is not super comfortable with a homebirth (we live a ways from a hospital in case of transport) but would go with it. Honestly I don't care what anyone else thinks (besides DH).

I am switching from my CNM practice at the the University of Michigan hospital partly because I was feeling hinky about the distance (it is a 45 min drive w/o construction and my last uninduced labor was 35 mins from start to finish) and for a couple of things, the CNMs were totally with me on(no antibiotics for strep B and allowed the birthing tub, and refusing the eye goop. The hospital threatens calling CPC if you refuse because they claim it is state law (it is for them to offer, just like vax) even though the ped from the hospital agreed that I was totally right that it is completely unnecessary.) So it just felt too much like big brother IYKWIM. I am switching to a CNM practice in Toledo that seems much more laid back and I have heard spectacular things about. I plan to go to a smaller hospital that is only 20 mins away and I have heard good things from homebirthing MDC mamas about. (We live just over the state line in MI) Although they have stopped allowing waterbirths.

I found a CNM who has her own birth center and who does homebirths, so our insurance would pay for some, who I would LOVE to use, but I just can't justify the out of pocket.

I don't know if all this helps you or not, but your experience sounds so much like me, that I couldn't not respond.

I'm still a little sad about not having a homebirth which is what I'd really like, but I'm moslty over it and try to focus on the good things that we can do as a family with the $1-3000 we are saving. (Would be $3750-$6500 if the insurance didn't cover the CNM's fees at the birth center or homebirth, they won't cover DEMs.) I also still have a little mental fantasy about an unplanned unassisted childbirth since my births are so fast and we have to drive to the hospital. A girl can dream! (BTW DH is completely against and uncomfortable with UC)

I hope this helped.

[HeatherB]

My first birth was a hospital birth, mainly because we didn't know much better. Actually, by the time he was born we WANTED to stay home - but didn't know what to do about it. I'm terrible at doing things that are totally unfamiliar, and I know that hindered me. I didn't know *how* to find a midwife (even though I knew two friends who used them within that year) or switch care. I also had/have a chronic medical condition that we feared might affect my pregnancy and birth (it didn't, and the OB wasn't helpful with it anyway).

Looooong labor turned c/s when I didn't "progress" past a cervical lip and never got the urge to push (actually, I did - on the OR table!!). After that very rocky experience, we knew we'd never step foot in hospital again for a pregnancy.

My second was a home-birthed VBAC, and the experience was night and day. I would have most certainly been sectioned had I been in a hospital, as the labor itself was not that different - but the support and environment made every difference.

Originally Posted by stefka

1) I no longer trust my ability to deal with the pain, since I ended up really feeling I needed an epidural last time around (26 hours of back labor without the water breaking will do that to me, I've learned)

Think about how you labored with your first... Did you get up and move around? Sway your hips? Sit on a ball? Get in the shower or tub? Did you have someone coaching you through relaxation during contractions, or stroking your arm, leg, or head in a soothing way? There ARE wonderful and very effective ways to deal with the pain that don't include drugs, and these are just a few of them. Remember, too, that having had one back labor does NOT mean you'll have another. I would encourage seeking prenatal chiropractic care to help ensure that you do NOT have another posterior baby, even so far as to having an adjustment in labor (I did!).

2) I'd never forgive myself if something happened to the baby that could have been prevented by more intensive medical intervention

This is the kind of thing you talk with a midwife about when you do your first interview. What are her protocols? What does she bring to a birth? All midwives should be equipped with and trained thoroughly in resuscitation; will carry oxygen and pitocin (for postpartum bleeding); and will have a protocol for transfer in an emergency. Around here, there's a back-up doctor for the midwives, and in a non-emergency we'd transfer there (though I won't transfer if it's non-emergent, so it's rather moot - but something like a diagnosed previa or something). In a true emergency, though, we simply head to the hospital that's 10 minutes away, and/or call 911, who would be here within 5 minutes. Couple that with my midwife's extensive experience and skill, and I personally feel VERY safe birthing at home. Get the information you need to make YOU feel comfortable, and keep looking for another midwife if you don't!

3) My physician-heavy family will think I'm nuts and put plenty of pressure on me to change my mind. That said, DH would not be opposed (he was at least as scarred by our first birth experience as I was) EXCEPT:

Honestly, if your DH supports you, that's all you need! I agree with the PP that you can be selective about whom you divulge what info to. This is YOUR birth and YOUR body, and as you've experienced, you have a lot to lose if it's not done right. (Which isn't to say that homebirth is necessarily right, but it can avoid so much of what you went through in most cases.) I totally understand how hard it can be to make decisions when you feel that your family won't support you. However, I encourage you to seek the answer that is right for YOU, and then to approach - carefully - the issue of what others may think. You will be much more confident with your decision once you've researched it thoroughly enough to have made it - and then you'll have ample information to share when you're ready.

4) Our insurance won't cover homebirth at all. We have Kaiser, so it's their hospital or nothing. And around here, I don't think attended homebirths are cheap. I really don't think I'm ready to think about UC!

Talk with the midwives. Most have a much lower rate for non-insurance clients. (With mine it's like a $2k difference!) They'll take payment plans, and I hear some will even barter! A midwife needs to make her fee, BUT she will be open to working with you to make sure you get the birth you need, too.

There really is NO comparison between a hospital and a home birth. I'd suggest you read some of the home birth stories here on MDC to get a feel for how home births may go. There are also hospital birth stories, and you can read some of those, too, to compare. Judge your own personal reactions to those stories and see what you are really most comfortable with. What appeals to you? What draws you in? What do you yearn for?

Take the time you need to make the decision that's right for YOU! And post here when you do.

[~minnow~]

I can't highly enough recommend Ina May's Guide to Childbirth! I also love love love Michel Odent's Birth and Breastfeeding!

I don't have any birth experiences to share, but my own mind was changed by reading about other mother's birth experiences (esp those who had both hospital and home birth experiences), and also reading the above books.

Once I also started to realize HOW MANY mothers who had hospitalized births reported complications and not being happy with their experiences... these birth stories I read (here, on the web, on mainstream sites) supported the ideas in the books that unless you have a high risk pregnancy of certain types a home birth is SAFER and MORE GENTLE.

I would just say, read a lot of birth stories. Read the terrific threads about homebirth and dealing with fear. See if the stories support the inclinations you're having. And try to make a decision out of your values, beliefs, and self-confidence, rather than out of your fears. We all have fears. Sometimes they hold us back from experiences that we really want. If we can be friendly with our fears, acknowledging them but not letting them run the show, then we can make decisions we feel good about.

Good luck!

P.S. My friend was in labor for over 50 hours with her first -- a hospital birth, required the vaccuum, lots of back labor! Her second was a home waterbirth and she told me that it was NEVER as painful. She was comfortable and hanging out in a pool on her own sun porch. Her cat was there and helped her through early labor. All the lack of tension made the experience completely different from her first.

I have to pay for my homebirth as well. Silly insurance

[flowers]

I would really stress that if you decided to have a homebirth it would be ideal (if not necessary) for YOU to feel 100% confident about it. We can weigh in with our experiences and opinions but birth is so personal and unique...it is really up to each woman to take responsibility for her own birth and create a situation where she will birth best.

Originally Posted by stefka

1) I no longer trust my ability to deal with the pain, since I ended up really feeling I needed an epidural last time around (26 hours of back labor without the water breaking will do that to me, I've learned)

You will have to prepare for this mentally with an "I can" attitude. Lots of women perceive childbirth pain differently and it is possible for you to have an entirely different experience. After, my homebirth (36 + hours/ most of it back labor....ouch!) I said that had a new understanding and compassion for why mom's choose drugs for pain relief. The difference is at home when I got to that point where I thought I couldn't go on I got a hug from my midwife and a serious pep talk....usually right when you think you can;t do it anymore...that is when the baby comes. Point being if I had been in the hospital drugs would have been very tempting. At home they are not a reality....you just do it.


[/Quote]2) I'd never forgive myself if something happened to the baby that could have been prevented by more intensive medical intervention[/QUOTE]

Do your own research. You need to be confident in why you choose a homebirth. Most moms I know choose it because they feel they are safer there with their baby than in a hospital. My mw said she has never transferred in an emergency situation. It has always been a first time mom who is too tired. If you have great prenatal care you should know already if you are high or low risk. MW are trained to handle anything that might happen at a normal birth. They wouldn't take you on as a client if you were showing signs of being high risk. How far are you from a hospital. We called our local EMT's told them our due date and gave them our address so they would be prepared. They said they could be anywhere in our town within 5 minutes. Also, mw's come in different packages. You should look into a CNM who is a more medical and you can still do many of the tests if that is what you want. Better care in the privacy of your own home. After you go to your first prenatal with a mw you will be shocked at the difference.

[/QUOTE]3) My physician-heavy family will think I'm nuts and put plenty of pressure on me to change my mind. That said, DH would not be opposed (he was at least as scarred by our first birth experience as I was) EXCEPT:

4) Our insurance won't cover homebirth at all. We have Kaiser, so it's their hospital or nothing. And around here, I don't think attended homebirths are cheap. I really don't think I'm ready to think about UC![/QUOTE]

Well, I think most homebirthers experience this and you will find abundant support here on how to deal with the nonsupporters. I just attended a homebirth (as a doula) where they never told dh's parents until afterwards. Personally, I never told anyone unless I felt like it or it was appropriate. Again, if you are confident in your decision you won't much care about the non-support b/c you will know you are making the right choice for you. Plus, you could always be prepared with a myriad of official articles and info to handout to everyone and then say you will discuss if after they have educated themselves on the subject We also found that people were more likely to say things to dh rather than me (the oh so fragile preggo woman: ). Dh would get a little upset and I would say, "okay so how many books on birth has Harry at work read??? How long have I been researching this??? Okay, so why would we listen to Harry?" The other thing I realized was that people were saying things because they wanted what was best for me, not necessarily b.c they were educated on the subject. So I started looking at the comments as love notes on how much they care. A response like "Thank you so much for your concern. It means a lot to know how much you care. You know I would never do anything to endanger the life of my baby or myself. I need you to trust me." might be appropriate.

$$$$$$Well, we didn't have a lot of money, but I really agree with the previous poster. This isn't a luxary. This is a very important life event. A mw I work with accepts sliding scale and she says she can't believe how many people tell her they can only afford to pay her minimum but when she visits their house they have a huge flat screen tv or some other luxury. Think about what is important to you. A few grand, made in payments does not seem a lot to me ESPECIALLY when I know it is going to a hardworking mw who is working very hard for a good cause and will probably go to paying her bills and feeding her children. Where is your money going in a hospital?
Unless, you are truly struggling financially (like can't afford Christmas presents or food on the table) I don't think hiring a mw is out of the question.



Another option. Pick your OBwisely, or get a CNM in a hospital or birth center. Hire a kick*%@@ doula and make one heck of a birth plan. Make yourself a force to be reckoned with and take control of your birth. Create a birth team that works for you and your interests and let yourself do what you do best....birth!

Good luck mama, with whatever you choose!

[stefka]

Thanks everyone, for all your encouragement and information. I have A LOT to think about in the next few weeks/ months.

One of the things that got me really thinking about this was a conversation with an OBGYN friend who chose a homebirth. I think I need to have coffee (or, um, steamed milk...) with her and really get her perspective as a medical practitioner who didn't see the need/ advantage of a hospital birth.

Katie, you are my new birth hero. Of course, I'm now completely counting on a 2 hour labor.

[flowers]

You know my doula instructor told us about a birth she attended where the HEAD OBGYN of a huge Conneticut hospital choose a homebirth. ( I am sure she received a ton of slack from the hosp!)

[Wugmama]

I had my first in a midwife unit that has been named in the top 10 places to give birth 3 times in the last 10 years, and never saw a doc. Unfortunately I too had many interventions. I was ultimately pretty happy with my birth experience with the "med-wives" though.

When pg with my second we went with a homebirth midwife. I was so happy throughout the prenatal care. When someone I knew got pg, I would tell them they should look into it. I would never want to tell someone the *should* have one - it is a personal choice yada yada. Well, I could not believe the difference when it came time for the birth. It was like night and day. I truly believe (just like the statistics say) it was so much safer and healthier for my second baby, and for me. Now I tell people they absolutely should have a homebirth - it is best for all involved. I acutally ended up transporting to the hospital for a flukey reason, but my midwife was with me the whole time, the hospital was very respectful of all of us, and I just needed pitocin - had 4 ctx and baby was born. We left the hospital fairly quickly, and had all our post-natal care from the midwife. BTW, one of the nurses on staff at the hospital proudly told me her baby was born at home.

Now for this pg, we are with the same midwife, and I have absolultey no worries whatsoever.


I think it is "normal" for you to be worried because in our culture we are brainwashed to view birth as dangerouse and a medical procedure instead of a natural fact of life. Once you learn more about birth and homebirth, you will probably lose your reservations. i wouldn't take your initial skeptisism as a sign you shouldn't do it, or can't do it. Your are taking steps to investigate it. I believe there are very, very few people for whom a homebirth would not be appropriate.

Best wishes,
Tracy

[k9sarchik]

I have Kaiser insurance also and I am switching to a homebirth midwife. What really changed my mind was Ina May Gaskin's book Guide to Childbirth.
I am going to pay for her services out of pocket. But I think that it's worth it.

The last line in her book is what is ringing in my head "My body is not a lemon!"

[lactivist]

I can't tell you what to do one way or another but I will share my experience. It will be short. The reason that I have never given birth in a hospital is because I worked in a NICU and attended high risk deliveries. I saw more atrocities than I could ever imagine. I worked there while pregnant with my first and everyone thought I was NUTS to have a birth outside the hospital but there was NO WAY I would have ever stepped foot in the hospital unless absolutely necessary. I worked at a very well renowned hospital that was supposed to be great for births. I have never seen such disempowerment in my life. It is just not something I could choose for a normal healthy pregnancy.
Wendi