We recently welcomed our fourth baby via a delightful planned home birth. It was only three weeks ago, but it feels like it’s been three long months. The newborn’s slow, sleepy routine makes the entire family, especially the mother, slow down and enjoy those still, quiet moments. It’s a great time for self-reflection and recollection of past events, and it’s a perfect opportunity to write my tribute to home birth and to my wonderful midwives.
How it started
It all started before we had children, when I accidentally stumbled upon a review of the book called “Pushed”. The book is not even about home birth in particular, it’s about modern childbirth in the hospital system and about impersonal, managed, one-size-fits-all standardized care, with all the routine interventions, that mothers receive. By the time we bought and read the book we had already been expecting our first child, so we decided to have the baby at a birthing center. After we visited a local birthing center we realized that it was not much different from the hospital, at which point my husband Kon suggested going for a home birth with a midwife. That idea had never crossed my mind before. It sounded scary, especially because nobody from our family and friends ever had a home birth. I reluctantly agreed and have never regretted it ever since. We’ve had all our children via home birth and it was the most empowering experience I’ve had in my life. Home birth is one of the best choices my husband and I have ever made, and I keep feeling proud of us for making this decision and thankful to G-d for presenting me with the opportunity to read the “Pushed” book which led to our decision in the first place.
People tell me that I am somehow a “hero” for birthing at home. This is puzzling because I’ve never understood what’s so special about it. I always reply that it’s more difficult to birth in a hospital, because it does take guts to go anywhere when you are in labor! Not to appear sentimental, but for me, home is the safest, most natural, and most comforting place I want to be at the time of pain, anxiety, vulnerability, and anticipation. And there is no better place than home to celebrate your great accomplishment and the new addition to the family. Hospital is too cold and impersonal for such an intimate experience.
So it’s the hospital birth that’s extraordinary, not the home birth. Women have done it all the time, often under conditions much less favorable than ours today. In the earlier times, home birth was not as safe as it is now. Homes didn’t have running water, many households had hygiene problems, midwives were probably not as experienced and knowledgeable, and emergency medical care was not as readily available. Nowadays most of us are lucky to birth in clean houses with professional midwives who are as amazing, skilled, and experienced as the ones I’ve had: Deborah Allen and my second midwife for the latest birth Lauren Olson Sidford.
Birth is a unique experience and it doesn’t deserve a one-size-fits all approach. In order to have the best outcome you need personal attention and individualized care, but if you think that your hospital and your doctor truly care about you and your baby and that their objective is to provide you with such care, you’re wrong.
I am not going to argue why I believe that hospital interventions are largely unnecessary and often harmful and why home birth is the safest choice for low-risk, normal pregnancies – the book above and many other similar books provide enough evidence for anyone to make that conclusion. It’s important though to understand one thing about hospitals: they don’t have your best interest in mind. Providing medical care to you is just one of their objectives, but it’s not the primary one. Their main concern is to avoid liability and to stay profitable. Also, it’s important to remember that, just like corporations, hospitals are oriented towards mass production, not custom individualized care. For them, you are just another patient, and they provide you with standardized care that it optimized to fit the average customer, but not necessarily tailored to your particular needs or preferences.
You may think that you have the best and most caring doctor in the world, but the truth is, your doctor’s schedule and convenience is a major factor in their relationship with you. Besides, even the best doctors are employees of the hospital and must first and foremost adhere to the hospital’s policies, so they will not risk their jobs to accommodate your needs in labor. They will treat you as just another patient on their conveyor belt, and should anything go out of their standard birth protocol they will not hesitate to prescribe an invasive medical procedure, not because you really need it but because they want to avoid liability or because it’s convenient for them.
Knowing this, it’s easy to follow the logical sequence of events that usually happen to so many mothers in hospitals. Out of fear of liability doctors may insist on a Cesarean in situations that can be avoided or can rather be handled with less invasive techniques by midwives at home. Out of convenience doctors may insist on induction of labor to speed it up. Remember, a hospital is a mass-production line, so no one is going to wait for you to take all the time you need, like the midwives would if you were birthing at home.
The worst thing is that women don’t even know there could have been an alternative approach to their care. They are convinced by the hospital doctors that all the procedures are medically justified, whether it’s true or not. If complications occur, many women are thankful to be in the hospital, not realizing that in many cases these complications were caused by the very procedures these women were led, or misled, to believe were necessary but may had been not. If they birthed at home these situations could have been avoided altogether.
Nassim Taleb, my favorite and respected philosopher who wrote about probability, uncertainty, and risk, says that medications such as antibiotics should be used only when the danger of not using them is proven to be greater than the danger coming from their side effects. In other words, when it’s a life-and-death situation any medication should be used because the risk of a side effect is small compared to the immediate and very high risk of the patient’s death. The same can be applied to medical procedures in labor and delivery: in low-risk cases they should only be used when there’s an immediate and grave danger to maternal or infant health.
This means that things like epidural are completely unnecessary, because no one has ever died of labor pain. And epidurals are known to cause complications such as slowing down labor, which can then cause labor induction or a Cesarean.
Home birth may not be for everyone. Sometimes there are unfortunate circumstances when the hospital is indeed a better and safer place to deliver a baby. What people don’t realize is that out of those women who birth in a hospital, many are capable and healthy enough to do it at home.
Unexpected disasters rarely occur at home births (and those occur at hospitals too, probably even more often). Most complications can be detected prior to the birth, at prenatal appointments, and many that occur at birth can be handled by attending professional midwives who can then transfer the mother to the hospital. So for low-risk expectant mothers, the main concern about home birth would be handling pain.
Yes, home birth means labor without epidural. Labor pain is overwhelming and extremely unpleasant – no one enjoys it, including me. The problem is that we’re so spoiled by the advances in science and the medical technology that we have become accustomed to think there’s a medical solution for everything. We don’t hesitate to use medications even for relatively insignificant problems like headache, colds, or flu, even though these problems can be alleviated with natural remedies and with some time and patience. We dread discomfort and pain so much that we are quick to go for medicated pain relief without thinking about side effects and potential consequences that the use of any medication can cause.
But sometimes you ought to do things you don’t enjoy in life, you have to go out of your comfort zone, you must go through pain and learn to overcome difficulties – not for the sake of torturing yourself, but for the sake of doing the right thing. We rely on medications too much. We don’t realize that medications are a handicap that a) doesn’t always help, b) always carries a risk of side effects, and c) disables the body’s natural mechanisms of healing and relieving pain.
Unlike pain caused by surgery or torture, labor pain is natural and women are capable of handling it without medication. Besides, it may seem like a foreign concept to some, but sometimes things that are seemingly negative have immense hidden benefits. Natural labor provides key mental and physical advantages to the mother and baby. So the choice is to either have an epidural and risk potential complications or struggle through the natural labor and reap the benefits. To me, the decision was obvious: it’s better to grit your teeth and get through the pain.
On the positive side, there are numerous pain relief methods available at home birth, such as water birth and massage. Also, it’s essential to have good midwives who provide help, encouragement, and support. Besides, I can attest that the more kids you have through home birth, the more experienced you get at managing pain.
College degree, corporate career – I’ve done all those things and I can attest that they are not nearly as empowering to a woman as the power of going through natural labor and giving birth. The pain of labor is not like any other pain. It transforms you and makes you into a stronger, more mature person. You feel like if you’ve gone through this, you can do anything.
After giving birth the pain is quickly forgotten; what remains with you is a strong sense of accomplishment and an amazing feeling of excitement about bringing a new life into the world. There’s also that satisfying feeling of being alert, active, and sharp-minded instead of feeling drugged up and sleepy after an epidural.
Home birth unites the family and brings it together. And once you see your sweet newborn right after he or she is born, you can’t help but think that all the discomforts of pregnancy and pains of labor are nothing compared to these precious moments. Though home birth is a lot of work and pain, the tremendous reward you get at the end is absolutely worth it.