First, a disclaimer: Every woman has the right to decide how they want to have their birth in collaboration with their birth care provider while putting the safety and health of the mother and the baby first.
I remember the exact moment I decided to search for a different route than the traditional OB/GYN delivery in a hospital. It was a phone conversation with my OB informing me that I had just failed my 1 hour glucose tolerance test at 20 weeks.
ME: “What does this mean?”
OB: “It means you need to take the 3 hour glucose tolerance test.”
ME: “Ok, should I work on cleaning up my diet? Is this a sign that I have gestational diabetes?”
OB sternly annoyed: “It means I don’t TORTURE all my patients with the 3 hour test, only the ones that fail the 1 hour test.”
BOOM, wake up call, if the bedside manner is lacking now, it’s not gonna be pretty during the birth. I was so disappointed, this was a practice of women known for delivering in one of NYC’s only birthing centers and praised by many doulas in the NYC community. Time to hunt for a different option.
I reached out to two homebirth midwives each with 27 years of experience. The first visit with each was a get to know you and see if this is a good fit interview that lasted 1.5 hours. A far cry from the 5-minute OB appointments I had experienced up until this point.
Sure, there was the “hippy” feel with the take your shoes off at the door, and the abundance of plants and tapestries. But this was immediately offset with an overwhelming feeling of comfort, trust and calm.
I’ll never forget the first conversation with the homebirth midwife I chose. I was debating getting an epidural, saying that if I couldn’t withstand the pain of labor at home, I would consider a transfer to a hospital to get one. She looked me straight in the eyes and said, “Honey, my clients don’t get epidurals. You have to commit your entire being to a homebirth otherwise it will never happen. We obviously transfer if there is an emergency or for health reasons but you can’t be on the fence about delivering at home.“ And with that, I was a convert for a having my baby at home.
Next came talking about it with my friends and family. I got two different reactions: A doubtful “Ummmm, ok?” Or an envious “I wish I had done that.” Women who entertain the idea of a homebirth typically graduate to this with the progression of each child, the first in the hospital, the second in a birthing center, and the third at home. For me, it would be my first.
As I educated and prepared myself of the benefits, I learned a homebirth offered a level of empowerment in all aspects of my care. Here’s why it was the right choice for me:
1. I really didn’t want a Cesarean. Thank the divine that I live in a place that we have access to this life-saving procedure. But I’ve seen my patients in my clinic down the road after a c-section with a wrecked core and compensatory low back pain, hip pain and poor posture. Scar tissue after this kind of abdominal surgery is often unspoken and unknown on how to heal by MD’s. I knew I wanted to avoid this unless the baby and myself were in danger. According to a 2013 survey by the NY State of Health some NYC hospitals have a C-section rate of around 40%, partially scheduled for convenience and high because of hospital protocols on time frames in how quickly birth should take place. If I had gone the traditional medical route, I would have had a C-section because my water broke and then 24 hours later my contractions started, and most hospitals consider this an increase in the risk of infection.
2. I wanted comprehensive care. I realized around Week 16 that I was overly hopeful in asking a surgeon for nutrition recommendations to combat constipation and indigestion. It simply wasn’t going to happen during my 5-minute appointment other than a prescription for medication I wasn’t interested in. My midwife appointments lasted an hour each and we covered nutrition in depth along with fears around labor, and working through my own birth story as a c-section baby.
3. I wanted privacy. My husband was extremely resistant to a homebirth, as in, nope not gonna happen. How did I convince him? We took a tour of a labor and delivery floor where every door was open to every laboring woman’s moaning, the machines beeping, and the constant intercom calling nurses and doctors in every room. It smelled of a mix of hamburgers and sterilizing agent. Privacy was nonexistent.
So much of labor is feeling comfortable in your own body to make those low groans, as being vocal is one of the best coping mechanisms for the pain. Being comfortable in my own space allowed me to drop into this primal place of labor, not worrying about if a nurse is walking in, asking unnecessary questions, and in the comfort of my own home. This allowed me to draw on my own strength when there were no drugs in sight.
Staying home also eliminates the decision about when to go to the hospital or birth center during labor---leaving too early can slow labor's progress, and too late can be intensely uncomfortable, even leading to giving birth enroute.
4. I wanted a say. I chose my support team of my husband, doula and midwife. Most OB practices are so busy you may get your OB or a partner in the practice, whoever is on call that night. This common practice never sat well with me as I didn’t want an unknown face. I didn’t want to have to fight for a strict birth plan on what to tell the birth care provider, if I wanted a delayed cord clamping, if I wanted skin to skin immediately after birth, if there is availability for a private room to recover in that I can share with my husband, etc. In a homebirth, these are a given, breastfeeding and family bonding is uninterrupted, you crawl into bed, cozy up, and enjoy that deep sleep that you and baby share after birth.
5. I believe giving birth is a natural process. Women for centuries gave birth without intervention. I took a stand for minimal medical intervention in a time where giving birth has become impersonal and emergent oriented. The process of preparing my body and mind to have a truly natural birth allowed me to trust myself on a deep and significant level. My midwife asked my husband and I to honestly project ourselves into our worst-case scenario and examine how we would feel about our original choices after the fact. What arose together was this deep feeling that birthing in one’s home with the guidance of a midwife honors childbirth to be a natural and sacred process. We recognized that problems can arise and transfer is necessary when needed. We knew if there was a chance of a great loss and this was a rare option, but not expected nor feared.
My pregnancy was anything but normal, with a subchorionic hematoma and bleeding at Week 12 and a breech baby with four attempts at an external cephalic eversion, the last attempt successful a week before I went into labor. Through all these moments of uncertainty, I knew I wanted a homebirth, it was the one thing to trust my gut feeling and it felt right.
While not for everyone, a homebirth is an amazing option to explore. 12 hours in labor walking and coping around the my own house and 1 hour pushing on my hands and knees in my own bed, and my sweet lil baby Elvis arrived.
Photography by David Dupuy.