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Monday, March 16, 2015

One of the dangers of home birth--being judged by everyone you meet: Contributor Post

As the Big Day approaches, I’m finding that a lot of the things I used to think about childbirth and child-rearing have gone right out the window. For instance: never in a million years would I have imagined I’d be on board with cloth diapering. Not only did it seem like something for the granola and kefir set, I had this image in my head of a baby that looked like a heroin addict from all the safety pin pricks left by a dad with shaky hands. And then we got our first delivery of adorable cloth diapers with little buttons on them and I thought well, that won’t be so bad then.

Same thing with breastfeeding in public. There was a time when I thought it was kind of weird and mildly offensive for a woman to flop out a boob in public. Now I’m actually looking forward to our first “nurse-in.”

But when the subject of home delivery came up, I freaked out a little. OK. I freaked out a lot. My mom delivered my younger sister at home, and the stories that I grew up with (told mainly by my dad) about her being breech with the umbilical cord wrapped around her neck, and completely blue by the time they finally got her out, went a long way in shaping my opinions about home birth. I should mention that my sister is totally fine, and Mom has since gone on record that it wasn’t as bad as all that, but the thought of having a baby at home still terrified me.

The girl had a certainty about wanting to it at home this time around, though, and when she told me why, I couldn’t really argue. Her first delivery had been a nightmare experience of abuse by medical professionals in a hospital setting, and she didn’t want a repeat of that experience if it could be avoided. So when we started planning to make babies, we met with a midwife who came highly recommended and I got to begin the process of getting over my initial fear and getting comfortable with the idea of home delivery.

Then came the fateful ultrasound, and suddenly things got a little more complicated. Twins are a special case. The medical establishment would prefer that you not deliver multiples at home at all, ever, case closed; the State of California, though, says go for it, so long as one of your midwives is an OB. We were fortunate enough to have selected a midwifery practice with one of the only OB midwives in the state, so we were good to go. We opted to take a dual-care approach: continue to see the doctors in the big buildings with the fancy machinery and the schedules of tests, and also receive in-home care from our midwife doctor.

Now that I’ve had the opportunity to experience the American medical establishment’s approach to treating pregnancy as a disease firsthand, my terror has started to shift; I’m becoming increasingly worried that we might actually end up delivering in a hospital. It’s not that I think the doctors or nurses are incompetent (although a couple of the ultrasound techs have been); it’s that they seem to value competence to the exclusion of compassion.

Don’t get me wrong: If I had to choose between competence and compassion in a life-threatening emergency, of course I’d rather have a competent doctor. But pregnancy isn’t a life-threatening emergency, is it? So why treat it like it is?

Let me be clear: I’m not anti-science. I’m not anti-medicine. I don’t believe choosing home delivery makes us better parents or that folks who go the hospital route are doing something wrong. I understand that the amount of pregnant women seen by your average HMO-based OB practice is overwhelming, and that things like compassion and caring are often sacrificed at the altar of efficiency and standardization.

As a result, though, we seem to be approaching pregnancy from the position of what can go wrong; it doesn’t seem to leave any room for the beautiful, miraculous thing that’s unfolding along the way. The medical viewpoint, as summed up by Martha Reilly, chief of Women's and Children's Services at McKenzie-Willamette Medical Center near Eugene, Ore. is that, “Reproduction is very dysfunctional.” That quote, by the way came from an article in The Daily Beast title Home Birth: Increasingly Popular, But Dangerous (, one of several articles turned up by a quick Google search for “dangers of homebirth,” which all seem to boil down to the conclusion that hospital births are inherently safer because of the proximity of staff and equipment in the event of an emergency.

I can’t argue with that logic, but considering the fact that fully ⅓ of hospital deliveries in America end up in a C-section, I can’t vouch for the safety of a hospital in the event of a *non*-emergency delivery.

So what can you do? Like any decision in life, you do your research, weigh the options, take the risks into account, make the choice that seems right to you. In our case, the choice that seems right is to aim for a home delivery, have a solid backup plan if things get hinky, and let go of any attachment to certainty.

Oh, and be prepared for every armchair expert you meet to offer an opinion (and their judgement) on the subject, cuz that’s gonna happen no matter what you decide. Fuck ‘em.

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