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 (http://www.thedailybeast.com/articles/2012/06/25/home-birth-increasingly-popular-but-dangerous.html), 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.

In Praise of C-Sections

Cesarean sections get a lot of attitude. They get a lot of snark. They're looked down upon. Many women feel like they've failed their babies and themselves should they give in to the the doctor's suggestion of a section. Many more feel guilty their entire lives because they (shudder) opted for one.

Any quick google search will show you that "more women are dying in childbirth, and it's due to increased Cesarean sections."

And I'm not trying to sweep that under the rug. C-sections are a major surgery, and like any major surgery, they are dangerous. They're not a walk in the park.

But let's take that from the other side. C-sections are a major surgery. They're hard. So when I see headlines like "Too Posh to Push," I have to wonder what on Earth everyone is on about.

Women who have to undergo sections require serious recovery time. If someone is choosing to have one, there's probably a reason.

There's this feeling that, as women, we should be able to do what we're biologically intended to do. We think that C-sections are "cheating," in a way. Women have been having babies for millions of years, we say. Long before C-section was an option. And they were just fine. Why are we such babies ourselves, these days?

We conveniently forget that those women were not just fine. In third world countries, dozen of women die in childbirth every day . In the 1800s in Sweden, one in 14 women died in childbirth. Although our mortality rate is up slightly now (due to the surgery), it's not a blip on the map compared to those figures. Women are having healthy babies and living themselves, in large part because C-section is available.

Obstructed birth is no joke. Breech babies are no joke. Fetal distress is no joke. A cord around a neck is not a joke. These are serious conditions that Cesarean sections help to alleviate.

The fact of the matter is, our biology has yet to catch up to our lifestyle. We're having bigger babies. We're having multiples. We're having children later in life. We're getting smarter (one would hope), we have bigger brains.

Overlapping skull and all, some women's birth canal simply cannot handle a 10-pound baby with a 34-cm circumference head. C-sections help them have their children. Why make them feel bad about that?


I have two beautiful healthy girls because C-section was available to me.

At 34 weeks, Baby A (Dulce) broke my water. She was low, head to the cervix, ready to greet the world (or just tired of sharing such a small space with her sister). Baby B was happily hanging out right up near my rib cage, feet down, no plans to move. She was going to go ahead and hang out in the womb a while longer, if it was okay with everyone. But it wasn't. I had to have the kids. Dulce decided.

When my doctor told me Lilly was breech and she would prefer to do a section, I nodded and signed. I'm not saying everyone should do that. There are many women who are more secure and attached to their birth plan than I was. But I didn't know the risks, I didn't know the likely outcomes. I knew my doctor thought the girls would fare better with a section. I nodded and signed.

And she could have flipped. Maybe she would have flipped. But I wasn't willing to risk it.

So, while my C-section was technically an emergency surgery, it actually wasn't. They had time to prepare. They had time to assess. They could do the surgery calmly, with no one in any stress.

When you have bypass surgery before you have a heart attack, you're much more likely to survive it.

And maybe we should look at that. Why would more women be dying in childbirth from 2007 on? Shouldn't the technology be getting better? I would think these numbers reflect an increased number of emergency C-sections having to be performed after every avenue for natural birth has been exhausted. With limited time, limited resources, and a baby or mother already well on their way to injury or death, of course the surgery is more risky.

I'm not saying everyone should go out and have sections. I'm not saying this surgery is better than natural childbirth by any means. I'm simply saying that if a woman chooses to have a Cesarean, perhaps there's a good reason for it. After all, surgery is hard. But having healthy children, and being able to care for them as a healthy mother is important, at least to me. And if the surgery does what it's meant to do, that is its purpose.

So maybe we can lay off other mothers for how they have their children.

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