Sunday, November 23, 2008

As promised

Why I'm planning a home birth...

1) Safety
First of all, medical research demonstrates that planned home births with skilled attendants are as safe as hospital births for low-risk women. My first two pregnancies were smooth and problem-free. This pregnancy has also been smooth and problem-free. There are no guarantees in childbirth—no matter where you are. Sometimes the worst case scenario arises. Fortunately, it is very rare (1-3% of births among midwives I've interviewed) that home birth midwives have to transfer to hospitals for true emergencies. Should an emergency arise, the hospital would be immediately notified of our situation, and we are well within the American obstetric standard of “30 minutes from decision-to-incision.” So, as long as no problems arise and I remain “low-risk,” home birth will remain a viable option for me.

In fact, I am in much better health nutritionally and fitness-wise than I was in my previous pregnancies. I plan to continue exercising throughout my pregnancy because of its amazing benefits for both myself and my baby. Women who exercise throughout their pregnancies have far fewer birth complications and need much less intervention (see here). I see exercise as a way to make myself even more “low-risk” than I already am and increase my chances of an even safer labor and delivery.

Midwife-attended home births also provide many advantages—much lower rates of complications and intervention (c-sections, etc.) and more constant and personal support and attention. Most women laboring in hospitals spend very little time actually attended by nurses or doctors. Instead, they are strapped to a machine and checked-on only occasionally by actual people. A midwife is constantly assessing both mother and baby’s condition throughout labor and watching for indications of arising problems. A skilled attendant is a much safer, more accurate, and more reliable “monitor” than a machine. Many midwives are simultaneously trained doulas or have assistants who are trained doulas. The presence of a doula has been shown to significantly reduce childbirth risks, complications, and interventions. So, being constantly attended by a supportive professional will also further increase my chances of a safe labor and delivery.

You can read more about research on the safety of home birth here, here, here, here, and here. If you’d like to read more, I’m happy to direct you to further resources and research.

2) Cost-effectiveness

Home birth is significantly less expensive than hospital birth. One study indicates: “The average uncomplicated vaginal birth costs 68% less in a home than in a hospital, and births initiated in the home offer a lower combined rate of intrapartum and neonatal mortality and a lower incidence of cesarean delivery” (“The cost-effectiveness of home birth”). Cost is a major issue for us this pregnancy because our maternity insurance only covers complications, so (barring any major crisis) we will be paying out-of-pocket for everything. It just makes economic sense to only go to the hospital if it becomes necessary rather than paying several thousands of dollars more than we likely need to.

3) The Experience
Of course a healthy and safe mother and baby is the most important goal in childbirth, but I believe the experience itself is also important. And I also believe that God intended the birth experience to be a wonderful event. I have frequently felt the impression that it breaks God’s heart to see the way some women are mistreated in childbirth. It breaks my heart, too. I’ve had two wonderful hospital births, and I probably could have had another. But I look forward to being at home and unencumbered by outdated hospital policies which have little or no evidence supporting their use—electronic fetal monitoring, lying on the bed for delivery, no food or drink, intravenous fluids, etc. I look forward to moving as I please, eating or drinking as I please, pushing as I please, and hopefully coming away from the birth without needing any stitches!

4) God’s Guidance
None of the previous reasons (even combined) would have been enough without this last one. I knew that I would not be able to take on the real, though minimal, risks of a home birth without God’s own support. Initially, when I prayed about the question back in early August, I felt a subtle impression that going with a certified nurse-midwife in the hospital was the best choice. For a time, this felt right. And I think God had some excellent reasons (I won’t go into) for suggesting I start out the pregnancy this way. Slowly, however, I began to feel uneasy about that path. So, once again, I began exploring the home birth option. I agonized over it, again. And I took it to the Lord again. This time, the answer wasn’t subtle. It was an overwhelming and profound YES. And accompanying that yes were some beautiful glimpses of why and how my taking this path will fulfill His purposes for me and those around me. I had wanted so badly to know without a shadow of a doubt that I was making the right decision, and God, in his tender, loving mercy, gave me that wonderful gift of complete assurance.

So, now, without doubt or hesitation, we are moving forward with this home birth plan. And I am thrilled about the blessings that are in store for us.

Stay tuned for details about the midwives I've chosen! They're incredible! :-)


Liz Johnson said...

I am so happy for you!!!! I'm so excited to hear all about your midwives and the entire experience. You should post about your ultrasound - how did you get them to come to you!?

Fig said...

Yay, yay, and yay. And yay.

Hilary said...

Congrats! I'm excited for you!

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