Thanks to documentaries like The Business of Being Born and Orgasmic Birth, as well as celebrities like Alanis Morissette and Gisele Bundchen sharing their testimonies of ecstatic births at home, modern women all over the world are stepping into a positive experience of birthing their babies in out-of-hospital settings and sharing it all over the media; and more are returning to giving birth at home, where women have birthed their babies since the beginning of time. Home is still the most common setting to have a baby globally.
To begin, a little bit about homebirth
I believe many women and their families are not informed of homebirth or a midwifery model of care, and this is where much of the uncertainty and discomfort comes from when discussed among partners and family members.
Despite the latest statistics showing that a home birth with a qualified midwife is just as safe as birthing a baby at the hospital – if not safer – many are still apprehensive about the perceived risks involved.
Even so, women continue to birth at home because they feel the calling within their bodies, within their hearts, within their souls. Many women have shared with me that they desire greatly to have a home birth experience and know that it’s what they feel is best for them and for their babies. Many very educated professionals of all career types are making well researched and informed decisions to have homebirths with a midwife.
Although I am optimistic about healthcare moving in the direction of more prevalent home birth midwifery model of care, our society still expresses an opinion that babies are to be born in hospitals….
Or at the very least, in birth centers.
There is an overwhelming cultural belief in the United States that hospitals are the safest place to give birth, regardless of the extensive scientific data that planned homebirths with skilled midwives suggest otherwise. Numerous studies around the world have documented the safety of planned homebirth by trained professional midwives, with outcomes at least as good, if not better than those occurring in a hospital.
This is especially true of women who have delivered vaginally before. The total slight increase newborn mortality risk of home birth is estimated to be 10 per 10,000 babies born at home, and that 1 in 1000 babies born at home may be adversely effected by the extra transport time in reaching advanced care in the hospital; the absolute risk is small however.
Although the United States spends the most money on obstetric care, it still ranks among the lowest of industrialized countries around the world in neonatal mortality and morbidity, and ranks quite low in maternal mortality and morbidity as well.
Countries that consistently demonstrate the best maternal and newborn outcomes have a large percentage of midwife led maternity care for healthy women experiencing normal pregnancies, which constitutes the vast majority.
These countries have a higher percentage of homebirth midwifery care with supportive hospital/medical transfer arrangements when needed, while the obstetricians attend to the women with high risk complications and serious illnesses, which is how they are educated as surgeons and medical doctors.
When midwives and obstetricians work together as a team, both using their unique skills, knowledge, expertise and training, the outcomes for moms and babies are far superior. Midwives are trained in guarding the normalcy of pregnancy, birth and postpartum, not disturbing it when all is well, knowing when to compassionately observe with loving support, and when and how to use holistic remedies, or medical intervention only when necessary as a last resort; they are also educated in prevention, assessment and treatment of complications, which most times can be managed simply and naturally, but sometimes involves consultation or referral to an obstetrician.
Although unforeseen events and emergencies can occur in any birth setting (some of which can be best handled in a high-risk hospital), a low risk healthy woman entering the typical U.S. hospital expecting a normal vaginal birth is subjected to a routine barrage of procedures and interventions that dramatically increase the risk of complications and problems, with potentially longstanding physical and emotional ramifications for both mother and baby.
There are many other benefits of homebirth midwifery care, in addition to safety, which provides an alternative to the impersonal, fear-based, law-suit prevention oriented medical and hospital care that has become prevalent in our society.
These benefits include but are not limited to:
· the power of the human touch and presence
· being surrounded by supportive people of a family’s own choosing
· security in birthing in a familiar and comfortable environment of home
· feeling less inhibited in expressing unique responses to labor (such as making sounds, moving freely, adopting positions of comfort, being intimate with her partner, nursing a toddler, eating and drinking as needed and desired, expressing or practicing individual cultural, valueand faith based rituals that enhance coping) -- all of which can lead to easier labors and births
· not having to make a decision about when to go to the hospital during labor (going too early can slow progress and increase use of the cascade ofrisky interventions, while going too late can be intensely uncomfortable or even lead to a risky unplanned birth en route)
· being able to choose how and when to include children (who are making their own adjustments and are less challenged by a lengthy absence of their parents and excessive interruptions of family routines)
· enabling uninterrupted family boding and breastfeeding
· huge cost savings for insurance companies and those without insurance
· increasing the likelihood of having a deeply empowering and profoundly positive, life changing pregnancy and birth experience
Getting holistic prenatal through postpartum care and birthing in one’s own home attended by a skilled midwife, is a refuge for those who want to protect the normalcy and sanctity of pregnancy and birth.
Focusing on the normal, however, does not mean that problems go unrecognized or unattended; rather they are viewed as imbalances that need to be righted, not expected or feared.
With that said, certain hazards do exist in all settings, whether childbirth occurs in or out of the hospital; and there are risks unique to each setting.
Some of these risks will never be eradicated no matter what our state of technology or medical advancement. The practice of midwifery, nursing and medicine are not exact sciences and no assurances can be made regarding the results of examinations, diagnostic tests, treatments, procedures, or interventions.
It is impossible for any provider to guarantee a normal healthy birth, mother or baby. However, especially in our country, when “poor” outcomes occur at home, even if the outcome would have been the same if the birth were to have occurred in the hospital, the choice of homebirth is often called into question; yet when there is a “bad” outcome in the hospital, people rarely challenge the hospital care and are much less likely to question whether or not the same outcome would have occurred or been avoided if the mom birthed at home. If problems occur at home, a home birthing family will invariably be challenged by friends, family and other professionals as to the wisdom of your choice to have a homebirth.
It’s ok to question all options, and we are seeing more of that with hospital births and women searching for an alternative.
What to do when partners or families are not supportive of a home birth
A partner or family that may not be on board
I have worked with women who gather as much information as possible and share it with their partner, in hopes of helping their partner understand where they are coming from. Sometimes these are the women, and I have also had partners of the pregnant mom feel very passionate about having a home birth although she wasn’t completely sure.
In my experience, when partners feel heard and validated, they oftentimes come around. This is through meeting with me as the months go by and having the opportunity to ask questions, get answers and receive support through the pregnancy process. But a woman who is unsure must dig deep, as she will labor best where she feels safe – and that may be the hospital; if her spouse is zealous, yet she agrees only intellectually, I am wary of her being able to relax and give birth at home.
Some extended family had homebirths themselves or are very supportive.
But some are very against the idea, especially if it’s a situation they don’t fully understand, like going to a midwife or having a homebirth; and they may be very vocal about their opinions. If family members don’t have knowledge, direct experience with home or even natural birth, it understandably may not sit well with them and they have safety concerns.
I have dealt with these situations often as well. Every situation is different. It is not a time for the pregnant mama to get into debates defending her position. I help empower her to set boundaries and maintain a fortress of positivity around her. In some more challenging situations, after discussion, we agree that the couple does not need to tell their family they are planning a homebirth at all or until after birth. They can just say they are seeing a midwife, mention the back up hospital if asked - end of conversation. In most cases, I encourage expectant couples to bring their anti-homebirth family members to prenatal visits to ask me their questions and discuss with me their concerns. They see the licenses on the wall and medical equipment - like for labs, checking blood pressure and fetal heart rate – even if tucked away in the homey office setting, and they relax a bit; but most significantly, the more time we can spend together and they receive answers and feel lovingly validated, they come around to at least stop resisting; but many times I am amazed how they transform to offer support and even excitement around the upcoming homebirth. Some do tell me they won’t relax until it’s over and everyone is healthy – but then after the birth, they become big homebirth supporters, telling everyone how wonderful the experience was.
How to listen to your intuition when planning a homebirth
This plays a large role as we discuss this topic. I have found that pregnancy is a sacred time and it’s important for women to keep their space sacred during this time.
Here are some ideas for keeping your space sacred:
· Create your vision – Take some quiet time where you can close your eyes and relax. Take slow deep breaths, releasing on the exhale, and use your mind as a clean slate. Envision on that clean slate, the vision you have for you, your baby, and your birth. What does it look like, and more importantly, what does it feel like? Take notes in a journal or draw anything that helps to hold this vision. Spend time with this vision every day and hold a feeling of gratitude that’s already been delivered.
· Share little with those who aren’t in alignment with you – A mama may have her partner, her midwife, her massage therapist and/or a few real close friends in her circle…. Be mindful about who you share your vision with, because not everyone is able to connect with high energy like this… and that’s ok…. It’s important to recognize that everyone is on their own journey, but you don’t have to lower your standards to make others feel more comfortable about your life choices. And you must avoid conversations or sometimes people who lead you to feel inner tension and fear, which does not serve you at all during this most sensitive time. Remember, it is your body, your birth, your baby, your life, not theirs.
· Get comfortable setting boundaries – You may simply need to tell those stressful family members that you love them, you appreciate their concern, but you are pregnant and sensitive, trying to keep positive, relaxed and upbeat, and you’d rather not talk about it or get into any disagreement. Many women, myself included, have spent time in life accommodating others. This is not one of those times, and pregnancy can help women shed their fears, limiting beliefs, and negative habits. Pregnancy is a time for a woman to focus on herself and her baby and for some women, this may be the first time in her life when she experiences this. I give you permission to pleasantly exit the conversation, hang up the phone or leave the room if they do not honor your request. Most will eventually learn and stop harassing you.
· Focus on surrounding yourself with positivity – this includes positive affirmations, inspirational birth stories, books, movies, radio shows, podcasts, and people. It’s important for you and your baby to keep stress low and spirits high…. Pregnancy provides an opportunity to release unconscious beliefs and emotions, so although it’s rarely a completely smooth ride, it’s one where you can always get back on board your wave of high vibes. Keep negative news media to a minimum and be mindful of toxic people that just don’t need your attention at this time.
Where and how a woman births her baby is her business…. Feel confident in listening to your body, your baby, and your intuition when it comes to this very special time. It’s not your job to convince anyone of anything, but only to show up for your own assignment… strengthen your faith muscles and know that you come from a long line of birthing women. I have helped many women over the years face the critic in their own minds and of others, and once they start listening to the voice of their inner truth, they let go and enjoy the ride.
I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote. But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby. For more info on the Bellefit girdle, check out my blog about it here. Have a Great Postpartum Recovery (with a little help from Bellefit)!
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