Ever since a conversation last night with my brother and sister-in-law, I've had this phrase going through my mind: "It's not where you are, it's who you're with." It seems to me that traumatic births often prompt couples to choose an alternative path for subsequent births. For those who experience that trauma in the hospital, home birth often provides the healing they seek. Because of the trauma my brother and his wife suffered following their home birth (and I do think my brother has some valid and genuine post-traumatic stress), they will likely have all of their subsequent children in hospitals. I think it's just human nature to associate those intense frightening emotions with the place where they occurred regardless of whether the place contributed to their occurrence.
We can strive to reduce complications, we can keep our bodies healthy and strong, but we can't control everything that arises as we give birth. Complications can and do arise in all birth locations. As long as a laboring woman is within the standard "thirty minutes from decision to incision," what matters most in the midst of a birth complication is who is taking care of her and how do they respond? Do they have the skills, experience, presence of mind, and knowledge of evidence-based practice to ensure her safety and well being? Being five minutes from (or even inside of) a hospital doesn't guarantee that a care provider will advise the best possible solution to a problem. Likewise, being at home with a midwife doesn't guarantee that a birth will be peaceful and empowering. Midwives can degrade and doctors can earn the title "Wonderful." It's not where you are, it's who you're with.
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