At 20 weeks pregnant we made the decision to have birth at the hospital for our second baby. In order to help other mothers make informed decisions and provide a little personal insight I wanted to write this post to help out other mothers who may be struggling with the *where? of giving birth. We were not forced to have a hospital birth- we hadn’t ‘risked out’ of having a home birth, but we had suffered emotionally after our first baby’s birth from the postpartum hemorrhage, and we had a scary close call with antibodies revealed in the second pregnancy blood work. Can you have a safe home birth/hospital birth/birth center birth? This is a question you have to determine for your specific case. I have noticed in this natural community you can find a million reasons to HAVE a home birth but the natural community doesn’t really give any reasons why to choose another path.
*Please note I will include all our personal reasons including religious/spiritual reasons. This is not to start a religious/spiritual debate and if you disagree- please ignore these parts, but I will continue to express my full, raw and honest opinions as I always have on this blog. Also I am not anti homebirth, midwives, hospital etc. etc. I am expressing my opinions.
Here I have listed my concerns and questions in general, my concerns with home birth, with hospital birth, and why I chose a birth center the first time.
The pregnancies are close together, by about four months in between. When we found out we were expecting our second baby- our first baby was four months old. We didn’t plan it that way- however we decided not to prevent a second pregnancy in between children with our ages as parents and not knowing how long a second child might take to conceive.
Being scared about the placenta being mismanaged again, and having to go through manual removals again. One thing that still haunted me was feeling like a Thanksgiving turkey as the midwife violently moved her hand inside my uterus, blood gushing. It felt like a horror movie. I wanted to make sure I chose a care provider who could properly prevent this manual removal process from happening again.
A second postpartum hemorrhage. It’s no joke, and it’s one of the leading causes of maternal death. Oh yeah- and it’s traumatizing. It leaves you very weak and for me, it made my body go through a long recovery, I had trouble producing enough breastmilk which I believe part of the factors was that my body was just plain weak.
Hospital birth concerns.
An unnecessary C-section. Who wouldn’t be scared of a serious surgery which could result in complications? (I have made some peace with this fear which you can read about here.)
The baby being separated from us (for non emergencies) and receiving interventions which I hadn’t agreed with. I think a lot of women who choose a birth center or home birth may have this same fear, and it’s taken me a long time to do research about this.
Too many interventions and/or being treated poorly. Birth is a vulnerable time. You don’t want to be looked at like a barn animal with your legs spread wide open by multiple people, you want to keep some dignity intact and be treated with respect and compassion. The truth is though- these rude people can happen anywhere (aside from at a home birth where you have selected a specific midwife who will be on call no matter what.) and I actually got the short end of the stick with a midwife who didn’t treat me with any sympathy during or after my hemorrhage.
Home birth concerns.
Hospital/Emergency transfer distance. I am about 15 minutes from the nearest hospital. The home birth midwife I was using was confident that it was close enough, but I still felt a little uneasy with the idea having had an emergency transfer once before.
Tools and equipment that are not available at home. Most people don’t want to think about this. I had a long list of questions on what the midwife could do in case of emergencies such as placenta abruption, hemorrhage, breech birth, shoulder dystocia. Most midwives carry Pitocin (ask yours if she does), which made me feel a little better. She also carried oxygen tanks and resuscitation equipment for both mother and infant, and both her and the birth attendant knew neonatal resuscitation. However, she doesn’t carry blood in case of a needed blood transfusion, she could not perform a C-section (obviously), and didn’t have the type of equipment for a newborn if the newborn were to need extra help as the NICU would have.
Non emergency transfer such as pain I cannot/will not handle. I liked to think that the second birth would be easier- but there was no guarantees about that. I couldn’t imagine it being more painful than last time, but I had to really think long and hard about this one. I went through a few weeks of researching different pain relief options for which my first choice was Nitrous oxide- which isn’t very popular in the U.S. The closest hospital and birth center that provided this option was 2 hours from me and I couldn’t justify this travel distance. I had to really come to terms with the fact that I maybe wanted more options than last time- when the jacuzzi and moving around just didn’t cut it for me. Of course- I thought maybe being at home would make it more relaxing and take some of the pain away, but that wasn’t a guarantee either and a car ride at the point of pain you cannot handle would be very, very difficult to endure… maybe not even making it in time for any pain relief to take effect.
In the event something went wrong- would I blame myself? This was the toughest question for me. This was the question that haunted me throughout the entire journey of choosing where to give birth, because as many empowering stories as I read… I knew that if I became a small statistic again and something went wrong I would be the one living with the guilt. Could I handle that possibility? I knew deep down that I couldn’t.
Birth center option.
Proximity to hospital. “Just in case,” the birth center we chose for our first birth was across the street from the hospital. Not even 5 minutes away. This helped us feel comfortable choosing the birth center we chose, it seemed like the best of both worlds. We ended up having to use the hospital for my hemorrhage. If I’d have been more than that distance, I don’t know how much more blood I would have lost.
Home like atmosphere. Dim rooms, jacuzzi tubs. When people asked about how I felt about where I was going to have the baby before she was born I used to joke that it would be like staying at a nice boutique hotel for the night. This seemed nice before labor, but DURING labor… I didn’t really care all that much about how anything looked, I was in another world of time-space continuum. And I’d put way too much reliance on the idea that the jacuzzi tub would get me through it- ironically I craved a shower part of the time, a squat bar, and something to position my feet on to push. However before labor, I concluded that it looked nicer and felt nicer than a hospital room- maybe I put too much emphasis on that though.
Competent and compassionate care providers. They had a lot of great things to say and treated me nicely at my prenatal visits. Nothing to complain about for the prenatal visits although I did have to test my own urine each time which I found odd and even a tad lazy. (Not all women may be able to figure out how to read this right.) During labor I was mostly left alone, which was alright. It was when I became an emergency situation that everything went downhill quickly and she was mostly covering her own a**. I thought I would feel more cared for than I did, but she had little empathy and showed little concern when leaving me with hospital staff (who were very empathetic.) This will not be the case with every birth center and/or hospital. It’s a toss up, unfortunately. The birth center had 5 star reviews from thousands of moms- so I was the odd ball out that they wanted to forget about and blame for how things happened. I was forgotten about and all the “positive” births were documented, shared and announced happily while mine was hidden from websites, the birth photo wall in the birth center, and social media.
If you are close to hospital, feel good about midwives and are comfortable with a back up plan if need be… the birth center option CAN be the best of both worlds for you. My experience does not negate that for everyone.
Why I chose not to have a home birth.
I had many, many weeks of calling around, researching, praying, frustration, concerns and worries. Here is how everything transpired.
First- I called birth centers. Although another birth center birth could have been an option for me- it just didn’t hold the same appeal or fantasy it once did. Two birth centers that I took an interest in were about two hours away (who had nitrous oxide options for pain relief) but after explaining I had a mismanaged placenta and hemorrhage, one didn’t feel comfortable taking me and the other would- but it was still a four hour round trip, which made me feel that I may be missing more prenatal appointments than I should- and made the drive during labor seem more annoying than with my first baby (which was one hour away.)
Next- I interviewed an OB/GYN. Who ended up being the epitome of what I wasn’t looking for. Rude, condescending and uncaring. She made me ask questions in a paper outfit and I felt as though me and my questions were beneath her. She belittled me pretty much the whole time and then disregarded that I didn’t want an internal exam… because my whole reason of having an appointment with her was to interview her. But of course- you usually cannot just interview them… you have to fill out all the paperwork and go through the whole appointment jazz. This incident then made us both angry and we found ourselves looking into home birth midwives. Let’s just nickname her Dr.Condescend.
Next- I interviewed a home birth midwife. Who was awesome. She was respectful and diligent, smart and trustworthy. She had plans of eventually opening up a birth center about thirty minutes away from our area (there aren’t any within an hour.) She had trained with not just certified midwives but gotten some experience working with certified nurse midwives. I really liked her and felt confident in her capabilities. I still had some doubts though that I couldn’t quite shake, especially doing research online. She had all the right answers to all my questions, and I ended up signing the paperwork and we agreed on a home birth. Let’s call her CPM Sugar.
We agreed to have a home birth on the condition that nothing out of the ordinary came up. My husband and I believe in signs. It sounds funny… but hear me out. We were very conflicted with what to do. On one hand we heard stories of bad hospital births, and on the other we had experienced a bad experience with a birth center midwife. What to do?! Dr. Condescend had cleared me as being low risk and said a there was only a small chance of a postpartum hemorrhage to happen again. CPM Sugar had also cleared me as being low risk with only a small chance of a hemorrhage happening again. So, for a few weeks I settled into the idea of a home birth and read birth stories about home birth. I would run into the bad home birth story and feel a little worried. I prepared mentally for a home birth.
Then we got a scare with my blood work. High antibodies which needed to be determined as to why and my husband needed to have his blood tested to make sure our baby wasn’t the cause of high antibodies. Pretty much meaning that my body was attacking the baby. We spent a week not knowing and waiting on the results. We were so thankful when we got good news at the maternal fetal medicine that the baby was not anemic, and my husband and baby didn’t have an incompatible blood type- it was from my blood transfusion. We were deemed low risk again. We couldn’t shake this from our minds though.
We believed we were getting signs not to have a home birth. Every time I went to websites that had home birth stories I tried to focus on the positive ones- but… I would stumble into the negative ones too, and I couldn’t ignore them by saying “That will never happen to me! 1 in 80,000 chance!” Well only about 9% of all people have the blood type that my body rejected- and of that only 2% form antibodies. I was part of a 2%. Freak things happen is what I’m getting at here, and you cannot always rely on the reasoning that well… 99% of the time I won’t be in the statistic I don’t want to be in. As we waited that week for the blood results- we both silently and collectively were more drawn to having a hospital birth. We didn’t know what the blood results would be that week- and it helped us put into perspective what was most important to us, the baby being healthy and doing anything we could do to help the baby. When we got the blood results- we had 90% decided that this was a sign to go to the hospital, and looking back… we realized that God may have tried to given us other signs as well… like…
The emergency that happened after the birth of our first baby. That emergency could not- and would not be able to be handled by the midwives and birth center. Even if I had a more competent midwife than she was- they just simply didn’t have the tools to help. Blood, and pain relief for the suffering I would endure during manual procedures. Somehow we had gotten away from the fear of the first birth and put so much blame on the midwife that we forgot- maybe it was also a sign that a future birth would be better handled in a hospital.
Our insurance wouldn’t cover home birth at all. I had sent an appeal to our insurance to cover the home birth midwife as in network- and they called to decline- the day before the appointment with maternal fetal medicine for our blood work results and anatomy ultrasound. Of course I don’t put a value on the birth of our baby- it’s sacred and special. 6,000$ instead of about 2,500$ in hospital. Eek. We would be spending a large chunk of our savings… which was a big negative but it didn’t TOTALLY deter us from the home birth idea. I think God knew that that wasn’t quite enough to get us to choose a hospital… which brings me to sign three.
The blood-work scare. After signing up with the home birth midwife- not even a week later my blood work came back with scary high antibodies. Was this our second sign from God that we were choosing something that we shouldn’t go through with? We took it as yes. It was a scare enough to lead us to choose a hospital instead, and then we felt a little bit silly that we had to have another sign after the trauma from the first birth… Those natural home birth stories sure are persuasive though… We agreed that if anything abnormal came up, we wouldn’t go through with home birth and sure enough after agreeing that God sent us something abnormal- even though we were lucky we still ended up being cleared low risk. The day after we got cleared from maternal fetal medicine- I called CPM Sugar and let her know all was cleared with MFM, but the insurance had declined us- and we felt that for this baby it was a better fit for us to go to the hospital although I was sad because I really appreciated the level of care she provided me. Just as sweet as her name- she let me know of a doctor 45 minutes away who was “natural minded,” and a hospital that had, “taken steps in the right direction regarding birth,” and was very nice and helpful. I asked a few more questions about other hospitals and she had recommendations- I said “I just don’t see some of them as very peaceful when I see the photos,” I was reminded by CPM Sugar, “You’re giving up a lot of the atmosphere of a home birth or birth center to be in the hospital- that’s just part of the reality what it is.” So true.
I had to remind myself not to be misled with the nice atmospheres, jacuzzi tubs, dim lights and sweet words. When we went on our first hospital tour ever (the hospital CPM Sugar had recommended) (kind of exciting to go on one for the first time- I might add) I went into the hospital open minded and looked at the pros and cons trying to really look at the birth suites of the hospital without natural birth rose colored glasses. The protocols were mom and baby friendly- kangaroo care and immediate skin to skin after birth, being able to go wherever the newborn goes, encouragement of in room babies and breastfeeding, delaying the first bath. So, although the birth bed looked uncomfortable, the room was a little small and sterile and they only had showers- I tried to focus on the care instead of the setting- and I liked the standard procedures. It fit my top wants/needs. I realized that instead of mostly focusing on the care provided the first time I chose- I was greatly influenced by the nice rooms at the birth center… and I think the birth center uses that to their advantage- and tries to make the hospital the big bad guy for their own gain.
“The horrible bright lights! The forced episiotomies and C-sections! The cascades of interventions! They are taking away our birth experience! Come here instead- to a place where we will watch Orange is The New Black (that actually happened, yes.) and monitor you with a doppler, wherever you labor every hour or two. Then when you don’t have the perfect natural labor that we know your body can do and you have some sort of emergency- we will toss you next door to the hospital and then go home and sleep, because it’s 4AM. TRUST your body.”
I did trust my body. I did eat healthy. I did everything I could do. I didn’t enjoy the pain part. I didn’t feel that if I would have had pain relief anything would have been taken away from my experience. And I will be so bold as to say- I will make peace and love (yes, LOVE) however my birth goes because that is my baby’s and I’s first day we met. With my husband I didn’t choose where we met- or how we met- or under what circumstance we met- but I sure as hell cherish that day and will never forget it. Just like my baby’s birth day.
Thinking about where to have birth?
I am a believer in looking at all options and sides of the spectrum. I am a researcher, and I don’t look at websites or books that only believe my way- I look at professional opinions coming from every angle in order to determine my own conclusions. I don’t just watch or read ONE news network. I read multiple studies and sources. This is important when determining your own choices, because I feel so many people stick with what they want or desire- and only look at the pros of their desire. For example- when I looked into home birth I looked at a lot of positive home birth stories and tried to stay away from the negative ones. I broke my own rule here!
I was putting on my natural birth rose colored glasses again without realizing it. Without realizing it The Business of Being Born and Ina May’s book was persuading me forcefully into a decision- while I ignored other viewpoints. And this can happen to anyone. I encourage you to try to look at both sides to your decisions. I am not anti home birth, hospital birth or birth center. Everyone has to make their own choices based on the research they do and what they are exposed to. Or- like me- maybe they look for ‘signs,’ when they have no idea exactly what to do! Don’t get trapped watching only Fox news. Don’t get trapped watching only CNN. Don’t get trapped reading only Natural News. I know that’s a funny way of describing it- but people stop questioning and making their own informed choices when they start blindly following other’s views and opinions. The internet is powerful- use it to your advantage. Do you ever meet those people that use ONE bible verse to skew whatever their doing as being right or wrong? Yeah… that can happen in this instance too. Using one statistic to make your point isn’t wise sometimes- look at all statistics.
Most of all try to distance yourself from the emotional and opinionated aspect of stories and articles. Realize that when a woman describes her birth as “Empowering, beautiful, or healing,” that birth could happen in any setting, because this is how she FELT. You may or may not be guaranteed these feelings in any one of these settings, whichever one you may choose. Try not to let the feelings of someone else be a deciding factor because you don’t know if you will share the same feelings- nothing is certain.
If you liked this post- and want to read farther into which websites I looked at, researched and studied to make more informed decisions, here are some links which include a few different birth stories from different perspectives and in different places, and a few different studies from different sources.
I encourage you- if you read any of these to read them all, because they each contain pros, cons, and view points from every angle. Don’t just read the ones that suit your wants or desires. *WARNING* Some of these stories include traumatic experiences and loss of infant or mother. Some of the opinions and/or views may seem harsh.
“Making Peace with The Epidural” – Birth Without Fear Blog
“The Empowering Home Birth of our Second Child” – Birth Without Fear Blog
“An Empowering and Healing Cesarean Section” – Birth Without Fear Blog
“A Home Water Birth based on Faith and Evidence Based Care” – Birth Without Fear Blog
“Why Homebirth?” – Midwifery Today
“Shridam’s Story” – Hurt By Homebirth *warning infant death*
“The Business Of Being Misled: Critique of The Business of Being Born” – American Home Birth Blog
“How Babies Brains get Injured During Childbirth” – The Skeptical OB
“Birth Isn’t Medical, Until It Is” – American Home Birth Blog *warning infant death*
“MANA Study: Total Mortality Rates” – American Home Birth Blog
“Home vs. Hospital: The Equiptment” – American Home Birth Blog