home birth week : q & a, part one

super sweet belly picture by the lovely andrea of hula seventy

What made you choose home birth?

There are a lot of different factors that went into my choice, many of which I shared on Monday.  My initial decision was based on my desire to create a positive, safe birth experience for me and my family, and I felt that in order to have control over my environment and body, I had to be in my own home.

I have spent countless hours reading and researching home birth, not to justify the choices I've made, but because I truly believe that women have a right to know what their options are and the benefits and risks involved in whatever birth they choose.

Did you know that the United States is ranked 33rd for infant mortality? It is safer to give birth in Cuba, Singapore, and Slovenia than it is to give birth in the United States. Doesn't that seem impossible? We have a country full of shiny clean hospitals that are staffed with trained medical professionals, AND we pay more for the care we receive than anywhere else in the world, yet somehow we are failing to keep mothers and babies safe.

When I was pregnant with Sela the cesarean rate for first time mothers was 38% at my local hospital and the national rate was 30.8%. These numbers are a result of a cycle of interventions that can be absolutely unnecessary and can make it impossible for a woman to feel in control of what is happening to her body.

I'm sure we have all heard groups of women talking about induction dates and how their doctors won't let them go past a certain date before they will induce labor. I have heard of doctors who have induced women because of upcoming holidays, family vacations, and even because it is just more convenient for the doctor if their patients give birth in the early afternoon.

Once labor is induced artificially through the use of pitocin, a synthetic form of oxytocin, your body can no longer regulate labor normally. Oxytocin is released in bursts, causing normal contractions to be irregular as labor begins, but makes it easier for women to rest between the contractions and handle the intensity of labor as it progresses. Oxytocin not only causes uterine contractions, but also sends a signal to your brain to release endorphins and adrenalin to help you cope with the intensity and pain of labor. Pitocin-induced contractions are stronger and typically closer together, causing a decrease of uterine blood flow which reduces the amount of oxygen the baby is getting. There is a decrease of uterine blood flow with natural contractions as well, but the duration and strength of the contractions are much shorter and the natural breaks between contractions protect the baby.

Because of these risks, all women who are given pitocin are also hooked up to a fetal monitor which greatly limits their movement, usually confining them to a hospital bed. When you couple painful artificial contractions with the inability to move freely to cope with the pain, it is easily understandable why many women choose to have an epidural.

Once women have been given an epidural and can no longer feel the pain of labor, their bodies stop producing oxytocin and the natural contractions slow down dramatically. This is when the doses of pitocin are increased, causing fetal distress and increasing the likelihood of a previously unnecessary c-section.

I know this isn't everyone's story and the last thing I want to do is give an inaccurate template for hospital birth. Babies are born in many different ways, and no woman has ever taken the easy way out when it comes to bringing babies into this world. I also know that pitocin and cesarean sections are important life-saving tools and I'm grateful for modern medicine and the knowledge and skill of obstetricians. I do, however, know many women who can call this story their own, and I have watched as they have processed these experiences that left them feeling confused, violated, and uninformed.

I could go on and on about why I made the choice I did, but all I can really tell you is that I know home birth with a trained, certified midwife to be a safe and beautiful experience, and was absolutely the right choice for my family.

What about circumcision?

Brian and I made the decision not to circumcise Graham, so I don't have first hand experience with this topic. However, I know you can make an appointment at the hospital and have the circumcision performed there in the days following the birth.

What are your thoughts on water birth?

I love it! I spent a lot of time in water during both of my labors, and I gave birth to Graham in my bath tub. I personally find the warm water to be very soothing and an effective tool in pain management.

How much does a home birth cost and does insurance cover any of the costs?

A home birth costs anywhere from 2-5k, depending on where you live or what your midwife offers in her practice. Many insurance companies will cover a portion of the costs, or even have a list of approved midwives they work with.

When is a good time to cut the cord?

I don't think there is any hard and fast rule on this. In hospital births, the cord is cut very quickly after birth, usually just seconds after the baby is born. I know some midwives wait until the cord has stopped pulsating, which signifies that the placenta is no longer sending blood to the baby. We waited about 2 hours after Graham's birth before we cut the cord (the placenta had been delivered intact just a few minutes after he was born) so he could benefit from the extra iron stores in the cord blood.

And that's all I've got for you today, kids! I'll post the rest of the q & a tomorrow, so make sure to check back. How is home birth week going for you guys? I'm completely overwhelmed by the kindness + positive feedback from all of you! Women are the best! Hope your Wednesday is awesome and I'll see you tomorrow! xoxoxox


BriannEm said...

So due to some minor issues, I was off of work yesterday... Anyway, I'm all caught up on birth week now. I love your photos. Hope we get to see you guys soon!

Jessica C. said...

so interesting! wow I am amazed at your strength and decision to stick with your instincts. I bet not many women even question the normal hospital birth/ induced/ epidural status quo. It's great to have this discussion and open forum. I think you share your opinions so eloquently without offending the opposite position.