Tuesday, October 12, 2010

The Choice for Homebirth

A while back I posted a homebirth Q&A. I only got a few questions on that post, but they were all great ones. Before I go on to answer the specific questions, I will tell you a bit about why we chose to have a homebirth.

Let me first say that I definitely do not believe that homebirth is for everyone. Both partners need to feel comfortable with the idea or otherwise, it will never work. I don't want to give anyone the impression that I think that hospitals are bad for birthing babies or that everyone should give birth at home (or have a natural childbirth, for that matter). That is not the case - each person, and each birth is unique and you must make these decision based on your own circumstances and convictions. I would love to say that all my babies will be born naturally, in our home, but I don't know if that will be the case or not. My pregnancy and labor with Evalyn was very straight forward, with no complications, which allowed us the option this time around. We'll see what happens next time.

With all that being said, let me explain the three main beliefs that I had/have that influenced my decision to plan a homebirth.

1. I believe that my body was designed by God to give birth to children and that, in most circumstances, childbirth can be achieved with minimal intervention. Further, I believe that birth should not be viewed as a medical emergency but rather, a right of passage for both baby and mother.

2. I had confidence in the fact that my midwives were well trained and qualified and would be able to provide valuable guidance throughout my pregnancy, labor, and delivery. I also believed that in the event that something occurred and my body was not able to perform the task at hand, that the midwives would help us make the necessary decisions, always keeping my baby's best interest as the focus.

3. The final belief ties into the first two - I had confidence that God would be in control. One of my labor verses was "Be strong and courageous! Do not tremble or be dismayed, for the Lord your God is with you, wherever you go". If was the "wherever you go" part that I focused on - I knew that God would be in control and protect us regardless of whether we delivered at home or in hospital. During my pregnancy I spent a great deal of time praying that God would give me the physical and emotional strength that I needed to achieve a natural birth. I also prayed that He would grant all of us involved - me, the Dude, the midwives - with sound judgement and discernment so that we would make the right decisions.

With those beliefs in mind, we decided to plan for a homebirth and go with the flow. I wasn't in it to be a hero and I knew that it might not work out and if we changed our minds and decided to (or needed to) go to the hospital, that would be fine, as well. We felt it was wiser to plan for a homebirth and have the possibility of transferring to the hospital than plan for a hospital birth and decide we wanted to stay at home, without things set up and ready.

With all that in mind, I got three questions about homebirth from other bloggers ....

Katie asked if it took a lot of convincing for the Dude to be comfortable with the idea of a homebirth and midwives.

It actually took no convincing at all. I always knew, long before we conceived, that I would want to have midwives and he had no problem with that as we share many of the same convictions. We had also often talked about the possibility of homebirth, although, we both kind of had the assumption that you just don't do homebirths with your first baby. When we first found out we were pregnant, I brought up the subject and the Dude said no, he didn't want to have a homebirth this time. However, after our first two meetings with our midwives, gaining valuable information, he changed his mind. Then, for a few months, he wanted a homebirth and I was saying no, but eventually, we both got on the homebirth page and started to get very excited about the possibility of welcoming our child into the world in our own home. Throughout the entire pregnancy, our plan was to labor at home as long as possible and if that meant that the baby popped out at home, then great ... if not, that would be okay, too.

Laura asked what brought us to the decision to have a homebirth.

I think this question was mostly answered in everything I've written so far.

Joanna asked about safety. Particularly, she asked if I was very far from a hospital, what the midwives protocol would be for transferring to a hospital, and if the midwives do Vitamin K shots at home.

We live about 10-15 minutes away from the closest hospital, if you are driving "normally". Of course, if necessary, the Dude (or an ambulance) could have gotten me there much faster. The main premise is that planned homebirths in low risk pregnancies, assisted by qualified midwives in an area close to a hospital are just as safe as hospital births for a number of reasons. One of those is the 20 minute rule. Even if you are in the hospital and get to the point where you need an emergency C-section, it will likely be at least 20 minutes until you are actually in surgery. This is because OR's need to be prepped, nurses and doctors need to be called in, the patient needs to be prepped etc. If it came down to me needing an unexpected, emergency c-section, I would have still be able to be in surgery within 20 minutes because the midwives would call the hospital and the ambulance and all that "prep" work would be done while I was en route to the hospital.

Further, it is relatively uncommon to need a C-section very quickly without any warning signs earlier in the labor. Much of the time, things have happened earlier on that would indicate the possibility of needing a c-section (baby showing signs of distress, failure to progress resulting in pitocin drip etc), and I would have been already been transferred to hospital.

The midwives monitored the baby's heart rate every 20-30 minutes early in labor and then every 10-15 as things progressed. They also checked my blood pressure and temperature a number of times throughout the day. I wasn't constantly hooked up to machines, but I never felt as though things weren't being monitored.

If I had decided (or needed) to transfer to hospital, the protocol would have depended on the situation. If it were for pain relief, or because things just weren't progressing, then we would have all gotten in our cars and driven there. If it were an emergency, an ambulance would have been called. I was registered with the local hospital so my paperwork was already done in the event of a transfer.

And finally, the midwives did the Vitamin K shot and the eye ointment here at home after she was born.

If anyone has any other questions about homebirth (whether it be our experience or homebirth in general) send them my way!


Jen @ Canadian Rhapsody said...

I was so that dumb person who laboured as long as possible at home and then when i was told we needed to move to the hospital i didnt want to go but we hadnt made any preparations for it. I definitely believe that moving to the hospital is what caused my labour to stall and thats part of the reason i definitely want it at home next time. I just dont want anyone other than the midwives and Craig there next time and i think his mom may not respect that wish at home (she didnt at hospital).

Joanna said...

Awesome! Thanks so much for answering all the questions! And I agree that our God is in control and am so glad that you were blessed with the peace of mind and went with that trust! It's difficult for me to "turn off" my nurse brain at times having seen so many things and I will definitely have to be in constant prayer with our future kiddos so I don't drive myself crazy with diagnosing things! :) I also love that the midwives can do all of these things at home b/c I feel that modern medicine is often so focused on protocol rather than making it customized to the family and patient and you definitely got to have a great experience with sweet Eva in your arms! We aren't that close to a hospital, but I would still like to consider this way, as I love the timing and intimacy as a family! Blessings and thanks for your openness about everything, it really does help your readers out to see your opacity and obvious faith in our Lord!

Jaclyn_Rose said...

Okay, I really want to know about the house prep and clean up process - not that I paid that much attention during my own delivery, but I'm assuming there was a lot of mess! haha - I think you mentioned that you put plastic down on the bed, what other kinds of things, and did the carpets take a beating?ge

Lucy Marie said...

Great question Jaclyn! I should have thought to put that info in the post, too.

Here is the answer for anyone interested:

Apparently there was quite a mess but I didn't notice it. In fact,about an hour after she was born while I was breastfeeding I said "that was a lot less messy than I expected" and my best friend said "no .. it wasn't". the midwives were like little fairies, they cleaned stuff up before I even noticed it. When I went into labor, I put an extra protective cover over our mattress (we already have one so I left it on there and added an extra) then we made our bed with an old pair of sheets. Then we put two vinyl table cloths overtop and made the bed again with another pair of old sheets. We put all our pillows into plastic bags and covered them with old pillowcases. My birth kit had a bunch of those big blue and white "soaker pads" that they have at the hospital that the midwives put under me everytime they checked me and when they broke my water (although she was so low by that time, that very little fluid came out until she was born). There were also two big boxes in the room and the midwives put a bag in each one ... one for garbage and one for laundry. When all was said and done, the bag of laundry was dumped right into the washing machine and my mom washed it with peroxide and salt (and everything came out looking entirely clean).

I had a bunch of old, clean towels and wash cloths that were used for both me and baby.

And then, after she was born, when they helped me up to go pee, they took the top layer of sheets off the bed, tossed out the table cloths, took the plastic bags off the pillows and I was left with a clean, comfy bed.

There was nothing on the carpet, at all.

The only mess that got made anywhere other than on the bed, was a tiny spot of blood that dripped as I was getting out of bed later that night and got on the protective cover on our box spring. But we washed it, and it came out clean.

Robin said...

I was wondering about the cost. Did insurance cover any of it? Also, what sort of aftercare did you midwife provide. In the hospital they will help you learn to nurse, give basic instructions on baby care...be there the answer questions.

Lucy Marie said...

Robin -

1. I live in Ontario and our healthcare system is very different than in the US. There was no cost to me for having a midwife (other than paying $20 for the birth kit), just as there would have been no cost for me to have my baby in the hospital. Both are covered under OHIP (Ontario Health Insurance).

2. The aftercare that I was provided from my midwives is the very best part!! It is absoultely fantastic. They stayed here for about 4 hours after she was born to ensure that everything was okay and to help me breastfeed. Then, they came back to visit us on day 1, day 3, called to check in on day 5 (and would have come to visit if I needed them) and came back again on day 7.

I then went to the clinic at 2 weeks postpartum, and will go again at 4 weeks and 6 weeks.

They have been awesome with helping me with breastfeeding especially!

I also still have access to them 24 hours a day through pager service if I need anything.

Jen @ Canadian Rhapsody said...

I read on an online home birth supplies list that you need old pans and such for the various instruments and I guess to put the placenta in and such. Did you need that?

What came in your birth kit?

Laura said...

Very nice. It all makes sense. I like that you talked about what you'd do in case of an emergency basically with going to the hospital and everything. I didn't think about it like that, but that makes sense. Luckily you weren't too far away and everything went perfect anyway! It was smart of you to preregister anyway, but really focus on the home birth and the hospital only for emergencies since that was your plan. Glad you didn't give up on your dream of the perfect birth!

I also have to say that I appreciate the fact that you have strong views about your own birth, but aren't opposed to other people having hospital births and stuff. Sometimes people can be so particular about what they think is right and they rub it in your face that what you plan to do is wrong. I'm glad you're understanding! I completely agree with the idea that home births aren't for everyone just like hospital births aren't for everyone. Its all about your beliefs and the confidence you have in whoever is taking care of you and the baby. :)

Holly said...

Once you've made the decision and done it once, and decided that it's the only way to go if you have any say about it, the next time around is a cakewalk as far as preparation and concern.

Katie said...

Thanks again for answering my question. A home birth is something I would like to consider when my hubby and I have kids so I appreciate you being so open about your experience :)