Tuesday, January 6, 2009

(My Personal) Thoughts on Homebirth

A friend of mine who recently gave birth had planned on doing a homebirth. My reaction to this was as follows:

1. That's going to hurt
2. That's going to be messy
3. That's going to be fun for your neighbors

But other than that it seemed like a reasonable choice to me. I have at least one other friend who is a home birth advocate so I was familiar with all the reasons why someone would want to do it at home. Such as:

- Hospitals are for sick people and childbirth is not an illness
- 30%-40% of American births (depending on the state) result in medical intervention of some sort, much of which is probably not necessary. (The intervention rates in other developed countries are much lower)
- Concerns that the hospital and staff would not respect the parent's wishes regarding a natural childbirth experience

However, my friend did end up going to the hospital and had an emergency C-section as the baby was breech. It also turned out the cord was wrapped in an knot around his neck and also around his foot.

The thought of my friend attempting to deliver this baby at home and what could have happened to both her and the baby were very frightening to me. (Although my other home birth friend said that as soon as they figured out the baby was breech, they would have gone to the hospital and probably everything would have happened as it did anyway) Then I started thinking about all my friends who have given birth and how many of them had complications that required intervention. One of my friends had a severe hemorrhage after her second child and almost died. Another friend had to have an emergency C-section because the baby was too big for her to push out. My sister had a C-section due to concerns over the baby's health.

As the new Dad said to me, they had tried to have this child "off the grid" and I think that was the scary part to me. That no one knew they were there trying to do this. What if an emergency situation arose and the ambulance didn't get there in time? Illinois is a state particularly inhospitable to the idea of home birth and it is very difficult to make this choice in a safe and legal way here.

In the Netherlands, four out of every ten births happen at home. If you do have the baby in the hospital, you are attended by a midwife and an OB is only called in in case of emergency. After the baby is born, the midwife comes to your house several times to check on you and the baby. Many breech babies are delivered vaginally.

Some states have Birth Centers as an option. These are freestanding facilities where a child can be born under care in a non-hospital setting but there is prepared convenient transport available to a medical facility should it be necessary.

I think that after this experience, while I could still continue to support a friend who made the choice to do a homebirth, but it would be slightly less enthusiastic- at least in Illinois.

Ps: In case you were wondering about my own personal choices, I say the more intervention the better for me! i wish it was the 50's and they just knocked you out and brought you the baby when it was over.

10 comments:

Lakeview Coffee Joe said...

I think I'm along the same line of thinking as you stef: if they let you be completely unconscious, why put yourself through the pain?

It's like:
-still cooking with fire on a daily basis
-foregoing even having a television
-not using a credit card
-using a outhouse.

Why would you pointlessly make life harder on yourself? It's hard enough already. I guess I shouldn't get too upset though, if they aren't in the hospital, it's more resources for me when I have my vertigo attack!!

Anonymous said...

I had a friend who did a home birth for her second birth, because the only (!) birthing center in all of DC closed after she had used it for her first. She said it was the best thing ever, but she also had a midwife who was very careful to only accept births she thought would be safe. It seems like a very personal decision, so I think childless me won't weigh in more than that :)

alexis said...

I have to agree with Joe, sometimes I am almost offended by the disdain with which we toss off the conveniences and technology SO MANY of our ancestors in the past would have gladly taken. For starters it ain't easy to have a stable, democratic, not-too-corrupted-to-hamper-function state. And one that has modern medical facilities. People around the world, including the Netherlands, go to the states because it has the latest, best treatments.

I respect other people's decisions, but when it comes to something like birth which in the very recent past was a serious question of life or death for women, I can't help but think of all the untold numbers of women in history who died giving birth because they didn't have the option.

And the other side of the NL story? It is discouraged to have a baby in a hospital, and only this year allowed women to get pain relieving aid. I have had friends who have had kids here and they were not all glowing fans of the "keep your ass at home" Protestant ethos.

Anonymous said...

As we discussed on the phone, my brother's experience in being both a homeopathic and halopathic caregiver has sensitized me the fact that being overly attached to anyone approach is cutting yourself out of significant possibilities.

Also, I think along with AinA and Lakeview that many people forget just how dangerous childbirth has traditionally been and it has only been in the very recent history (last 70 to 100 years) that the mortality rate for mothers and children has improved substantially.

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Anonymous said...

I did have drugs on board with Ella (dilatted) due to the anesthesiologist running 2.5 hours behind my request for an epidural; but, I don't recommend it. You can still feel pain, you are just too drugged up to communicate it. However, once I had the epidural, I slept through the final stages of labor, which was kind of nice.

That all being said, I have to say that I really don't understand some of the modern trends in birthing and parenting. Really, in the end, all that matters is that the baby arrives safely, it doesn't matter how. So, why take any chances? Although I know this scenario isn't likely, I would not even take the slightest chance that I'm being rushed to the hospital because the baby's life or my life is in danger (and ditto, Steph, I know so many people, including myself, who have had "little" things, which if not detected and addressed promptly could have been life threatening). Another trend I don't understand: not vaccinating. Again, why take any chances, especially when you consider that just this fall, Evanston had a whooping cough outbreak. I think a lot of these trends are being driven by the fact that our generation really has no idea of how awful the alternatives are. Quarantines are probably an awful thing to witness, as is the death of newborn or pregnant friend/loved one. Lisa

Pulisha said...

Stef - just wanted to chime in that J wasn't born by C-section, but she was an emergency induction due to health concerns (luckily everything turned out fine in the end). However, I did almost have a c-section w/C because they thought she was too big for me to push out on my own (thank god I started pushing anyway and she came out on her own b/c I am deathly afraid of gong under the knife!).

As to your larger point, I think it is important to recognize that childbirth is a very personal experience, and where and how a woman chooses to give birth is something I for one am very greatful that we are able to choose for ourselves. I can sympathize with someone who would like to have a private birth experience, as my experiences have ranged from awful (army doctors!) to awesome. But, also needed major medical intervention in two of the three births of my children, so there is definately something to be said for hospitals. I think so long as your prenatal care is under the watchful eye of a qualified OBGYN and/or midwife we are pretty safe to have a home birth here in the US. Thank god for American health care (even if you do have to pay for it with your first born ;) Also, best to the H's and congrats on a healthy child!

Pulisha said...

Stef - just wanted to chime in that J wasn't born by C-section, but she was an emergency induction due to health concerns (luckily everything turned out fine in the end). However, I did almost have a c-section w/C because they thought she was too big for me to push out on my own (thank god I started pushing anyway and she came out on her own b/c I am deathly afraid of gong under the knife!).

As to your larger point, I think it is important to recognize that childbirth is a very personal experience, and where and how a woman chooses to give birth is something I for one am very greatful that we are able to choose for ourselves. I can sympathize with someone who would like to have a private birth experience, as my experiences have ranged from awful (army doctors!) to awesome. But, also needed major medical intervention in two of the three births of my children, so there is definately something to be said for hospitals. I think so long as your prenatal care is under the watchful eye of a qualified OBGYN and/or midwife we are pretty safe to have a home birth here in the US. Thank god for American health care (even if you do have to pay for it with your first born ;) Also, best to the H's and congrats on a healthy child!

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