Look, I’m a magnet to bellies. When I see the pregnant woman on the street, I must confess, I get super excited because I know a little part of the future of our world is being carried around inside. Sometimes I get brave enough to say hello and inquire as to where the mom-to-be is giving birth, always letting her know that I am a midwife and a mom myself. I usually get a few reactions from that. The first is, with a glowing smile, she tells me that she has a midwife, and proceeds to talk about her care provider while looking like she is talking about her high school crush. Second, a wistful look falls across her face, perhaps a sense of longing, and then she inevitably tells me that they really wanted a homebirth but couldn’t afford it, or she and her partner decided if the first birth goes well, they will do a home birth next go around. And then the third most common reaction is, “You mean, without drugs? At home???”
So, I thought I would offer some clarity to you readers about why YOU might consider an out of hospital birth. As midwives, we only care for “low risk” clients. And what constitutes risk varies from provider to provider depending on the criteria that a. they feel most confident and comfortable working with and b. what their license dictates. So, for us midwives, we don’t look at age or weight as risk factors. There are some complications that run in higher numbers with age and weight factored in, however, we prefer to assess individuals based on their whole complexity rather than just a number attached to a drivers license. Some conditions that we would qualify as too high risk for out of hospital birth are: heart disease, kidney disease, uncontrolled diabetes, seizure conditions, high blood pressure, prematurity, HIV positive status, and other chronic health problems that existed before pregnancy. Twins and breech pregnancies MAY NOT disqualify you from having an out of hospital birth as long as a trained care provider has experience in taking care of these unique pregnancies AND you have been assessed with ultrasound to make sure babies are healthy and your pelvis is adequate. (Contact me for a referral.)
So, if you are a healthy woman, you have been taking care of yourself throughout your life and suddenly you become pregnant, can a high risk condition suddenly appear and thwart your plan to have an out of hospital birth? Yes, it could, but it is unlikely. The nature of midwifery care is such that women receive far above and beyond the quality of standard obstetric care that we can spot risk factors developing in enough time that we do prevention. We spend on average an hour at each prenatal exam and we are able to see factors that contribute to high risks before they develop. Beats the 7min avg in standard obstetric appointments. And so who really is the ideal candidate for an out of hospital birth and why would you want to choose this option? Let me tell you about MY ideal client: She takes responsibility for her life and trusts her body. Wants to be a part of all conversations regarding her health and is willing to do the research and educate herself about all of her options. Exercises, eats well, drinks water, doesn’t smoke, is willing to be coached and supported. Understands that birth is probably going to be one of the hardest, most beautiful and profound life experiences she and her child (and partner) will ever go through and is willing to give it her all. Wants to have a say in how and what is done to her child and her own body the moments following birth and every moment thereafter. Does this sound like you? Taking applications . . .