my thoughts on home births

I have thought long and hard about writing a post like this. It’s a touchy subject, especially in the natural childbirth (NCB) arena and I’m still having a hard time finding my words but I’ll try.

When I was pregnant with Logan, I had no desire to ever enter the medical field other than working in administration. When I was 28 weeks, we watched The Business of Being Born and I thought my world was turned upside down. I cannot explain how one documentary on childbirth, home birth, and how OBs are only surgeons, changed my mind in 90 minutes and made me question every decision we had made up until that point about our care. We were with an OB office and had a decent, uncomplicated experience so far. We had started going to natural Bradley Method childbirth classes and learning more about the birthing process. But as I reflect on that time almost 5 years ago, I am dumbfounded how easily influenced I was, and how I tried to manipulate my  husband into thinking that a home birth was the only way and that hospitals were just a place where they wanted to perform all these interventions so they could get more money.

Um….crazy thoughts, right??

Even still, we checked into our insurance options and switching providers and to a home birth was not something our insurance would cover. Good thing since our son had a spontaneous pneumothorax at birth. When I shared this with a local home birth midwife recently, she said it must have happened when they tried to suction him since he had meconium in the waters and she had never seen a spontaneous pneumo in her 30 years of doing home births. Not so. I have a video of Logan laying on my chest immediately after birth and you can tell he is really struggling to breathe and cry. And he didn’t actually aspirate any meconium. Had we been at home, it would have taken at least an hour to transfer to the hospital if the midwife attending was able to quickly determine that there was something wrong. By the time Logan was an hour old, he had been treated with an oxygen hood, chest xray, and diagnosed with the pneumo. It was, by far, one of the scariest nights of my life, but I am so incredibly grateful that we delivered in a hospital with a level 3 NICU.

After his birth, I found my passion. It took many months for me to accept it, but I knew pretty quickly that my career path was about to change. I toyed with the idea of what kind of midwife I wanted to be. I even considered home birth at one point but I never felt comfortable with the liabilities and risks. Even as I type this, I feel a lump in  my throat. My husband also expressed his concerns and thoughts and we have always had a deep understanding with each other that if one of us felt strongly about something, that we would respect each other’s thoughts and feelings on the subject. He’s a very easy-going guy and for him to feel strongly about my career path means the world to me.

Since then, I have busted my butt to really figure out what kind of midwife I want to be and what I believe. I know that there are good CPMs out there, just like I know there are good OBs and CNMs as well. This is not a post where I am going to knock CPMs and talk about how terrible they are and how home births should be outlawed. I’m not that close-minded or disrespectful. What I will say, though, is that I do not agree with the safety of home birth and how it is portrayed in the NCB. I think it feels like brainwashing and I can say that as I was one of those new mamas feeling the pull to make a rash decision without any education behind my choice to have a home birth (or not). I can say that I felt brainwashed into thinking that OBs were just surgeons looking for the big bucks and that they have no invested interest in their patients. In general, this is not true! I know and work with some incredible OBs, both male and female (not that that matters). I also know some OBs who I would not want to be under their knife, but isn’t that the case about any thing? You can have good lawyers and bad lawyers, good engineers and bad engineers, good OBs and bad OBs. 

There is a huge part of me that wants this to sound like I am a devil’s advocate, comfortable with either side of the debate of home birth vs hospital birth but the truth is, and what I believe, is that there IS a difference and that there are countless statistics showing how much safer hospital births are than home births. I am not going to list those here because most of us know how to use Google and other people have already gone the distance to do all that work. This blog is one of them. And here is another.

Long story short, I am not a fan of home births. I respect you if you’ve had one and if you are planning on having one, I hope you’re doing everything you can to learn about risks and complications for both mom and baby. Post partum hemorrhage, nuchal cord (around the neck), shoulder dystocia, meconium aspiration…just a few to name as complications that can happen even to a low risk healthy mom. Some of these become even greater risks if mom has other identifying factors, but they can still happen. I had a mom come in recently who had been laboring most of the day. She came in to be checked, was a 3, contractions kind of all over the place so she was sent home. She came in later that night when I was on and was a 6, but complaining of terrible pain in her stomach and baby heart tones were pretty low, despite position changes and even after contractions ended. Baby was not recovering and something was wrong.  We rushed her to the OR and it turns out her placenta was abrupting. Had we waited much longer both of them could have been in a world of trouble and had she been at home…I don’t even want to think about how badly that could have turned out.

I am constantly learning. The more I learn, the more I realize that home birth really is not a safe choice. It wasn’t for me, and for so many others it has ended in absolute tragedy. I have worked in the hospital for over 3 years and in that time, no babies or mothers have died due to something we were able to treat them for. Yes there have been hemorrhaging and codes and even an amniotic embolus in which both mom and baby survived!!

In closing, I would like to officially join the #notburiedtwice movement. I’m not going to go into detail about it here as I’d like to encourage you, dear readers, to find out for yourself. I am a firm believer in self-education and this is an opportunity for you to do just that.

Thank you for reading and allowing me the space to express these tough feelings. All I ask is that if you choose to comment, be respectful.

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23 thoughts on “my thoughts on home births

  1. Thank you so much for sharing our campaign! And thank you for what you have written and sharing your thoughts on these issues. It needs all the attention it can get!

  2. Dear Midwife 101,
    Thank you for your honest thoughts on this subject. It is often difficult for midwives to be publicly honest, but it seems that more and more enter the conversation with perspectives like yours once the topic is brought up.

    As a mom whose baby died in out of hospital birth, in a very preventable circumstance, I greatly appreciate your perspective and voice. I wish I had read this, or met you in person before we made the choices we did. You very accurately described the “brainwash” we subscribed to. Looking back we feel so misled, so fooled, so used for an agenda that proved to be false. The risks in out of hospital birth were glossed over in careful ways, even in a high risk situation like a breech birth, which was our case.

    It means a lot to me personally to see midwives themselves identifying the issues in misleading agendas, yet still advocating for midwifery in safe ways. I would also never propose that midwifery end or home birth as an option for that matter, but I do think it could be a whole lot safer. I wish midwifery as a profession could rally around that concept and work to put in place safety measures that would protect mothers and babies instead of working so hard to protect themselves in the OOH sector.

    Not Buried Twice is an important campaign because it seems that many of the mothers in that video are women I know through shared heart ache. Magnus is my son, and I appreciate your voice in not letting him be buried twice. He deserved better, and every mother out there deserves to understand the risks before she chooses OOH birth. Too often they are hidden and the “experience” of natural birth in the convenience of home or freestanding center are glorified. Before our son died, I didn’t know babies still died during childbirth. As it turns out, they do far more often outside hospitals. It seems so obvious now, but boy I sure fell for the illusion. Your perspective matters a great deal as someone aspiring to be a safe midwife. Thank you.

    Sincerely,
    Sara Snyder
    Safer Midwifery for MI

    1. Wow I am so sorry for your loss. It’s not fair that you and others share such a tragedy that would have been most likely saved in a hospital setting. Love and hug my dear!!

  3. Thank you so much for sharing. It is rare to hear anyone talk about the possible downside of home birth without the person being disrespectful, or even angry. You seem concerned for new mothers, and I think you are absolutely right about the brainwashing that goes on. Women often times think if they want a natural birth experience, they must do it at home, and I absolutely disagree. I would love for you to check out a post I wrote on the topic last year. I had just seen The Business of Being Born and felt I needed to address the issue of home birth/hospital birth: http://atlantamomofthree.net/2013/07/31/natural-childbirth-not-just-for-homebirthers/

    Thanks again!

    1. Awesome thank you! I will check out your post! I have loved reading your blog recently. Any chance you’d be willing to allow me to guest post this piece? I’d be happy to do the same for you! 🙂 More need to hear and read this, just as the previous comment from Sara who wished she’d read it before her tragic loss.

      1. Absolutely! I was already planning to reblog it. Would you prefer it to be a guest post? If I reblog, my readers will have to come to your blog to read it after they read the intro on my blog. If I do it as a guest post, they will read it in its entirety on my blog (but I’d like to you, of course). Let me know, I would be happy to do either!

  4. Reblogged this on Atlanta Mom of Three and commented:
    Not all midwives (or midwives in training) support home birth. Read this honest post about one woman’s view on birth, from her feelings about “The Business of Being Born” to her concern for NCBers.

  5. I was going to write a bit of a missive here about my own journey away from being a home birth CNM. Instead I will just thank you for having put your thoughts into words. More midwives are beginning to speak out against OOH birth. I am becoming more hopeful that it will become easier for women to find information about the dangers so they can fully educate themselves rather than repeating the platitudes of the NCB community.

  6. Very brave and honest post. I experienced that “brainwashing” in a different setting. Our first was a complete breech, so I had a C-section after an attempted version failed. Afterward, when breastfeeding was very painful, I sought out a La Leche gathering for help. The did assist with better latching on techniques…but they were horrid about the fact that I’d had a C-section. They got all nasty when my husband carried the baby into the room in a carrier (I couldn’t, obviously, being just 10 days post-op), because men were NOT allowed in the meeting. Duh. Several women came right out and said that a Caesarian was just a conspiracy by the doctor to make more money and that C-sections are totally unnecessary. It was extremely unwelcoming and unhelpful. Thankfully, I was confident enough in myself and my doctor to ignore their comments, but now I wish I’d told them off.
    -Amy at http://www.momgoeson.wordpress.com

    1. Oh Amy I’m so sorry you experienced that! The irony in this is that the NBC talks about how women have birth trauma and need to find healing and yet here they are berating you for the way you have birth! Nothing like throwing more salt.

  7. Thanks for this post.

    More of this needs to come out of the mainstream midwifery community. So long as the renegades are not called out from within their own community, it is easy to say that they are persecuted by “The Man”.

    I implore rational, science-based midwives and nurses to stand with their other clinical colleagues for safe, evidence-based care. One can be caring and empathetic but also practice safely and scientifically.

  8. Sarah, love, I completely agree! Had my son been born anywhere else other than a hospital, he would not be alive today. I could not be more appreciative to the amazing hospital staff and what they did for him. All opinions are needed for a truthful discussion on this topic.

    1. Thanks Katie!! Why do you suppose we do everything we possibly can to protect our children but not when it comes to the kind if birth someone wants? A mother will put her needs and desires first for the kind of birth she wants rather than do what’s safest. Baffling.

  9. I saw The Business of Being Born when I was pregnant with my first, as well. I was already working with a group of midwives at a local Birth Center affiliated with a large medical group in my area. I talked about wanting a home birth and know a woman who had two, but insurance wouldn’t pay for it and I always had some doubts in the back of my mind.

    With both my children I planned to birth at the birth center, but ended up at the hospital for different reasons each time. The first time I was TERRIFIED, but the experience was fantastic. The second time was even better and I am so glad I was at the hospital. As we plan to have a third child, I am going to stick with the midwives, but plan to be at the hospital.

    Great piece of writing. Thank you.

  10. Such a great post especially coming from a midwife! I would never ever consider a home birth because I am well aware of the risks involved in birthing and as you mentioned, even if you are considered low risk, so much can happen at the time of birthing that I would never ever put my baby at risk

    I think its horrible the way people are getting pushed more and more into “natural home birthing” experiences. I think its a very personal choice and women should not be left feeling guilty for choosing to have their babies in hospital! An environment where both mum and baby will be looked after! I think its crazy but its fantastic that more people like yourself will speak up about the realities and you see the reality every day in your line of job so thank you

    1. You’re welcome! Thank you for your response! I’m a midwife to be, but am so glad I have a clear path as the kind of midwife I’m becoming.

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