Homes and hospitals. They might not seem to have a whole lot in common, except for the fact that they both begin with the letter “H”. While I am not alone in knowing that community (out of hospital) birth is best for vast majority of the healthy population on so many levels, especially in todays times as hospitals become more restrictive of human rights, are places where fear mongering and coercion of potentially harmful practices not evidenced based are the norm; as is viewing pregnancy, birth and postpartum from a medical model of pathology that needs fixing, where basic humanity and a mother's spiritual and cultural needs are not valued, where corporations have bought out most hospitals and care is more and more mechanistic and impersonal....pregnant mamas are still birthing there for a variety of reasons.
But homebirth and hospital birth can and do co-exist, though that is sometimes hard to reconcile. We are so accustomed to categorization in our society – something has to be either/or; this or that. And often times those two choices are seemingly opposing ones. Why? Must there be conflict and judgment at every turn, especially when we are talking about teenie-weenie, precious babies and their awesome, warrior moms?
Image by Mary Elliot O'Haire
Personally, I don’t think so. I believe we should be framing birth in the context of generational wisdom, evidence-based practices, respecting a woman’s legal right to autonomy over her body and real informed consent to decline or agree to all interventions, to restoring humanity and ultimately, the sacredness of little ones coming into the world. All of these things can and should be applied to every kind of birth setting, whether it’s a home, birth center or hospital.
Some women who would like to have a homebirth don’t have legal access to care in their localities, or have financial issues; some need to birth in a hospital for medical reasons. Some choose to give birth in a hospital but desire – to the best of their abilities –a beautiful undisturbed, family centered physiological birth, a “homebirth-like” experience there (For my suggestions on how to do just that, click here, in my online Guide to Pregnancy, Birth and Postpartum ).
Image by Niki Torres
Women interpret that phrase in different ways. For some, it means being surrounded by treasured items that remind them of the comforts of home. For others, it means being cared for by midwives who support completely all natural labor, birth, postpartum when all is well. For one client of mine who I’ll call Jackie (not her real name), it meant birthing without unnecessary medical intervention.
She and her husband both came from long lines of doctors who felt very strongly that she have her baby in a hospital. Although she wanted to give birth at home, Jackie decided it wasn’t worth the familial turmoil and chose a doctor and birth place. But she didn’t take these tasks lightly. She selected a care provider with whom she felt would really honor her preferences and chart them so that they were on record. She took my comprehensive childbirth education course Guides (which taught her to be prepared, empowered AND open-minded, with a mindset shift needed for success), and made it abundantly clear to the nurses upon admittance that though she was aware pain medication was available, she did NOT want it to be offered. She would decline routine procedures like not being allowed to eat, having an IV, being confined to a bed and a continuous electronic fetal monitor, unnecessary internal exams, coached pushing, cord clamping before pulsation ceases etc…Lastly, Jackie had faith in herself and in the process of birth.
Of course, labor is completely unpredictable, and women who are very firm about their birth vision have the right to change their minds at any given time. In addition, many hospitals are in fact set up to intervene, because they are based on a model that considers labor and birth for even low-risk mothers a medical condition, not a physiological process. Of course, these potential challenges had crossed her mind. But she was determined.
As Jackie’s midwife, in hospital doula, and advocate, I certainly had faith in her. And I knew her husband was going to be a terrific and loving support partner. But I was silently concerned about those who would be attending her during labor. Would Jackie’s nurses respect her preferences? Would another care provider in her practice (in case the doctor she really liked wasn’t on call at the time) do the same?
As luck would have it, Jackie’s nurse was fabulous and agreed to her requests. Every once in awhile, she would come in and marvel at how Jackie listened to her body and just allowed labor to happen. When Jackie went into transition, this nurse came in, gently approached her and whispered in a voice that was almost inaudible, “You are doing such a fabulous job! But I have to chart that I offered you pain meds, even just once.” Jackie nodded, confirming that she heard the nurse’s comment and said “No thanks”. Then the nurse gave me the thumbs up, and quietly left us. She joked that she does not see the food and drink Jackie is ingesting.
Shortly thereafter, Jackie’s beautiful baby came into world without any medical interference in the most highly interventive hospital in the county. Jackie was over the moon at the sight of her gorgeous baby boy and proud that she had done it her way. In no small part, she was able to accomplish this because she found people to care for her who really listened and supported her choices.
In the end, it’s not that any one comfort technique, any one protocol, any one approach is right or wrong. What counts is a whole healthy baby and a whole healthy mom who’s preferences and needs are recognized throughout pregnancy, labor and birth. Whole means their mind, heart, spirit are healthy, not just basic body health, that their emotional needs were respected and honored with trauma informed or sensitive care.
There are lots of things you can do to maximize your odds for having the kind of birth you envision. You can start by building your support team with people who believe in you and your ability to birth. An aligned mom-provider philosophy is a great place to start. You may ultimately have to make some compromises, but the value of a mutually respectful relationship can be immeasurable. But here are ten supplies to ROCK your birth there.
Photo by @jennifermasonphotography
Photo by Megan Hancock Photography
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““I want to thank you for your online course. Because of it I was able to do a natural waterbirth in Nicaragua where it is not common at all. I live abroad so it was my dream to have a natural birth in my home. Little did I know there are no doulas or certified midwives in the country. Your course helped me through it! My father-in-law who is an OBGYN in Brazil caught the baby and also has never done a natural birth. He only does cesarean. What a special moment for the family! Thank you again for the knowledge I was able to achieve online!!! Our special day :)”
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@moanafilmes, @danicamata