Preparing for Homebirth

“I’m worried that I’m not worried.” A client said this to me the other day and I stopped in my tracks.  How is it that we have gotten so used to feeling fear that it is the pervading decision making fulcrum, the compass for every choice in life.  Hidden behind everybody selling us something, there is a message: “buy this cream and your wrinkles wont show,” “ buy this car, its safety rating means you are less likely to get dismembered.” Your health insurance, life insurance, car insurance, home insurance, all there to somehow minimize the cost should trauma occur.  Shoes for falling arches, antioxidants so that we don’t get cancer, pretty decals for our phone so that we don’t radiate our brains.

 

So why is it so odd to me when my client tells me she isn’t afraid to give birth?  And even more, that she’s worried that she’s not worried.  Did something go wrong for her, some hormone reaction not working right in her brain that she is finding herself ok with the process of what is about to happen?  We are talking about birth here people! This is a ticking bomb that might just implode on itself! Or so we are often programmed to believe.

 

The reality is, birth is not a medical condition.  It is a normal physiologic process of the body.  Kind of like, well, pooping.  Or sneezing.  And sleeping.

 

And yet, this act of delivering a baby has come to be the most feared of all human processes.  Birth is so locked and hidden behind the doors of normal day-to-day experience, that it becomes the mystery not to be unveiled until some appointed hour of reckoning wherein all life changes drastically forever.  Those who walk through the doors, when speaking of their recent journey to parenthood, appear to have swallowed the blue pill (or was it red?) drank the kool aid (because it was either that or ice chips my friend) and get a glazed look over their face, such as one might see in the eyes of a plane crash survivor.

 

Bordering on having witnessed almost 1000 births, I am here to tell you Yes, in no uncertain terms BIRTH IS CRAZY.  But not crazy in the ways that you might think.  You see there are few times in our human existence where we have the opportunity to transcend the mundane.  We spend the majority of our lives operating inside of rational thought, decision making, bill paying and weighing the pros and cons of what to buy, wear or eat.  This is all fine and well, but it has us operating inside our cortex, that lovely part of our brain that is trying to decide if its too late in the season to wear open toed shoes so we can show off our new pedicure.  

 

Most of us are so disconnected from the process of childbirth that the idea of having a doctor take control of the variables actually feels better to us.  The phrase “Natural childbirth” has become bad words to advocates of epidurals and OBs alike.  Well meaning persons say things like “why do you want to go and be a hero” or “do you think you are better than everyone else wanting to go and have your baby at home?” instead of offering support and encouragement.  But who can blame them.  Birth is a downright messy mystery and very few people really want to come into the playpen and see what’s really going on in there.  

 

Without fail, when potential clients come in for an interview, the “what if” question is top the list.  What if there is an emergency?  That is the very reason hospitals will never go out of style- just like your homeowners insurance, they are banking on the fear of the potential hazard happening.  Disregard the fact that if a true emergency actually happened, sometimes 30-60 minutes may pass before you are getting the medical attention you might need, yes even in a hospital.  The reality check here is that when you pay 20k-50k for a hospital birth, you are buying the PERCEPTION of safety a button away.  Not the reality of it.  Statistically speaking, out of hospital birth midwives do not lose more babies or mothers than hospitals.  Period.  No matter how many statements ACOG wants to come out with determining the hospital birth is safer, the evidence does not support these statements. In fact, women (low risk) are 5x less likely to have to need a cesarean in out of hospital birth.   But ACOG does feed the fear of the public who is gladly buying up all the risk adverse insurances and who so easily buy into the “what if” line of BS.  Yes, we have all heard the stories that go like this, “Thank god I was in the hospital because if I hadn’t been…” The truth is, we will never know what would have happened if you hadn’t been because you weren’t going to.  But those who do get to have an experience like nothing else in this world.  Nothing. Birth is the incomparable despite people doing their best.  It is the one human experience that will rock you, level you and show you what unutterable strength you have as a woman and as a mother.  It is the most profound high and low simultaneously.  A true to life game-changer in all the best possible of ways, and some dark ones too.  And it’s hard to sell that kind of awe.

 

So, to my client who uttered those words the other day, I had to offer her kudos.  She has done the work and prepared herself to surrender to what the experience will bring her. We midwives don’t vilify hospitals; sometimes we need them and the tools they have to help our mamas out. And there is a judicial use of things like induction, Pitocin and epidurals.  But to assume each woman needs or wants these interventions is undermining her power to say the least.  And to answer the question, “isn’t it enough to have an unmedicated birth in the hospital?” The answer is no for some.  The debate isn’t about having access to drugs, its about having the freedom to feel safe in ones own home, to not have to worry that someone else’s bureaucratic agenda is more important than the parents choices and that a newborn child will be put on a mothers chest after she delivered her and that these parents don’t want anyone at any point to get in the way of their experience.   Giving birth outside of the hospital is about owning every inch of the journey and taking responsibility for what unfolds.  It is about experiencing every last bit of this mystical messiness, the absolute zenith of human rides. It’s absolutely worth the price of admission.

~ Aleks