Yay! Mailbox Mondays! If you need cloth diaper advice, or have another question for me, please ask. Every Monday, I will answer a reader submitted question, and ask my readers to help too!
Questions don’t have to be cloth diaper related, just email maria at change-diapers.com with “Mailbox Mondays” in the subject, or fill out my contact form for readers, which you will always be able to find on my Contact Page.
Stephanie says:
I know this time around you are planning a home birth. The idea intrigues me, but scares me at the same time. If my husband and I decide to have another little one (our newest just turned 5 months old), what would you say to convince my husband and I it is a good idea? Well, more so my husband than me. 🙂 What type of preparations do you need to do at home to get ready for this? Do you need anything special?
Hi Stephanie! I’m excited that you’re considering home birth!
Before I answer you, I have to say that while I’m sharing this information, I absolutely do not judge anyone who births in the hospital, no matter why they choose it.
If you missed my post about my journey to homebirth, please do read it. My path to home birth was a long one, and it really wasn’t a single thing that pushed me to it. I spent literally years reading and researching. I read books, medical studies, you name it. This may sound corny, but no one can really convince you. It’s hard to explain but as your views on birth change, it changes you. It’s really a process. Or, it was for me anyway. So, you have to take that journey for yourself!!
Luckily, you have plenty of time, and I suggest you begin by reading about birth as a normal physiological process. I suppose I’m really not a good homebirth advocate (or advocate for anything else for that matter) because while I feel it is the right choice for me, I don’t push my views on anyone, and I tend to not mention it unless asked. While I really do feel that normal, uncomplicated childbirth doesn’t belong in the hospital, I respect the choice to have a hospital birth.
So first off, I’d suggest that you read a few books like Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First
I’d suggest that you and your husband both write down what intrigues you about home birth, and what scares you. If you continue to read and do research, you might find that the things that once scared you, no longer do. A lot of the things that are thrown out about why birth belongs in a hospital really aren’t true when you read the (scientific/unbiased) studies. Many of the issues and complications with birth are caused by a doctor’s inability to wait for labor to progress, their desire to interfere and “fix,” and the fact that many really have no idea what a normal birth looks like. After reading several of the books I read, you may start seeing that some of the things that you think of as being childbirth dangers are in fact iatrogenic (doctor caused) and rarely present in an unhindered birth.
If possible, join a birth circle, or home birth group. Read home birth stories and watch as many home birth videos as you can find.
Find out what the laws are in your state, what your insurance will cover, and start interviewing midwives. Some states license only Certified Nurse Midwives, some have “rules” on when they are no longer allowed to attend a home birth (after 41 weeks etc.) Educate yourself on possible complications, and the steps to take in each situation. Take charge of your body and your birth. Figure out how far you are from the hospital, and how long it would take you to get into an operating room. (I’m talking in case of a true emergency such as cord prolapse when birth is not imminent, which is actually quite rare when membranes are not artificially ruptured.) Often times, you would be able to get to the hospital with an OR waiting for you, in the same amount of time it would take to have one ready if you were already there. Find out where your nearest responding EMS is, and how long it would take them to get to you.
I don’t feel that replacing an OB with a CNM and a hospital with a bedroom is necessarily any different or better, unless your only goal is to give birth at home. Ask the midwife how long she’s been practicing, how she was trained, if she is licensed, how many births she has attended, what complications she’s encountered and how she’s handled them. How often does she do cervical checks, break water, what is her transfer rate (and the reasons for transfer.) How does she feel about breech births and how does she handle them, what steps does she take for postpartum hemorrhage (and what does she consider a hemorrhage), what steps does she take for shoulder dystocia, does she test for group b strep (and how does she treat it), does she place a time limit on placenta delivery (if so, what steps does she take?) and so on. Also important is how many clients she will take on in the same time period, if she has assistants and/or partners etc. Also ask around and find out what the midwife you’re considering is actually like, how interventive she is, how happy prior clients were with their births etc. The old “bait and switch” can happen with any medical provider!
As far as what supplies and things you need, that’s intertwined with your midwife interrogation interview. Is she certified in neonatal resusciation? Does she carry oxygen, vitamin K and pitocin with her? Does she carry any herbs with her? Typically, a midwife will give you a “birth kit” to order and hang on to (chux pads, umbilical cord clamp, sterile gloves etc.) along with a short list of other items, like an extra set of sheets, a clean towel, a large trash bag, a bowl for the placenta and such.
While I definitely recommend looking for a midwife that you are in line with and wholly trust, I also recommend taking full responsibility for your own care and researching everything for yourself. When you’ve fully educated yourself, you may find hospital birth to be a little scary.
I hope that this has helped you a little bit, and even if you do all the research and decide to go with hospital birth, you will be fully informed! 🙂
If you have had a home birth, what resources would you suggest to someone considering it?
Maria wants to live in a world where cloth diapers are the norm and moms can make parenting choices without judgement. When she’s not chasing her 18, 14 and 11-year old kids around, you might find her checking out the latest gadgets, organizing something (again) or exercising in the fresh air. 
The questions above were a good start, but it’s important to know the answers you want to hear before you ask the first question. Asking what the midwife does with a breech baby means nothing if she doesn’t first tell you the risks of delivering a breech vaginally, and at home. Doesn’t mean they shouldn’t or can’t be done, but that there are added risks that must be addressed. Also, just knowing what to do is a whooollllleeeee lot different than having done them already. ANY midwife who attempts delivering breeches, especially at home, should have buckets of experience under her belt. Not just book knowledge and a fake practice once or twice a year (typical).
When the admonition comes out not to trust the provider, for goodness sake, what are you hiring one for? Shouldn’t you be able to trust who you’ve hired to save your life? The life of your baby? Are you going to argue with her in the middle of an emergency when she says you need to go to the hospital? This issue of trusting your provider is a crucial aspect that has created a great deal of animosity in homebirth… something that neither has to be there or has a place in the beauty of birth. Find a care provider you can trust… if you do nothing else! That doesn’t mean there isn’t dialogue throughout the pregnancy and even the birth, but TRUST is crucial for believing they have your health and life as their first priority during your time together.
I’ve written a 6-part piece about “Interviewing a Homebirth Midwife” that explains things in much more detail.
And all of us homebirth advocates are 100% right to NEVER try to convince someone, especially a reluctant spouse, to have a birth at home. Where a woman births is a very personal and individual choice and one she, ultimately, carries the responsibility for. If someone convinced her and tragedy struck, the mother would forever be crazy angry she let someone talk her into something (she later felt to be) dangerous. Explore, read ALL sides of the issues, even the anti-homebirth sides, so you can make an INFORMED decision, not just one based on the romantic side of birthing in one’s own home.
Yes, you are exactly right, that’s why I recommended she read & do her research FIRST. When I did my interrogation…err…interview. I knew what answers I was looking for. 🙂 I had already been researching for several years before I interviewed a midwife. I already knew the risks of various situations, how they should be handled and so forth. I was feeling out a midwife to make sure she was in line with me. Yes, I also asked how many of different situations she had handled.
I think you misunderstood me. I didn’t mean don’t trust your provider. I would simply never recommend that any woman take what ANY medical provider said as the God’s truth without doing their own research. The same goes for anything I am told by a family physician, chiropractor, ENT, Allergist, Pediatrician, Dentist etc. etc.
On the last point. Exactly. I have no desire to “convince” anyone of anything. I would encourage everyone to simply educate themselves so they can make the right choices.
Maria,
Our daughter, Zara, was born at home in Toronto, Canada by three amazing mid-wives. We used to live in a small one bedroom apartment and Zara was born on our bed. So if anybody is concerned about space- that should be a non-issue.
Where you took months to research home birth, my wife, Sophia, decided a day before she went into labour.
I was aghast and completely against it, but looking back we wouldn’t have it any other way.
The experience and the implicit trust that we placed on our mid-wives was what convinced me that it would be fine.
The process of birth was beautiful and one that I’ll remember till my last breath.
And seeing what a woman has to go through to give birth was awe inspiring. I found a new found respect for all the women in my life.
I’ve planned to have a homebirth for all three births. First one we ended up transferring to hospital, second was at home, and third hasn’t happened yet!
In terms of convincing one’s self or spouse – read, read, read. There are lots of studies out there, and they can be conflictingly interpretted, so sometime that’s a hard thing. But, the thing reading can do is expose what can happen, and why, in a hospital. From there, you can look at the risks in both hospital and homebirth, and decide which way you are more comfortable (free-standing birth center is also an option). For many women, homebirth is a safe option with a trained attendant. It’s not for everyone, but I think everyone should be informed enough to know the risks they are choosing when they choose their birth setting.
I would also recommend the book Pushed by Jennifer Block. There are also lots of birth blog/websites – TheUnnecesarean.com, birth without fear, and thefeministbreeder.com all have information about birthing choices.
Regardless of where you choose to birth, it is important to be self-informed, and not only rely on the information given to you by your care provider.
In terms of prep for a homebirth, most homebirth midwives will provide a list of supplies and be able to answer your questions about how to prepare your home. There are many books out there on how to prepare oneself for birth (regardless of setting). Two that I have enjoyed this time around are The Birth Partner and Birthing From Within. I’ve written some about the preparations I’m making this time around on my blog: http://www.dangerouscrayon.com/search/label/homebirth
Thanks for the advice! Pushed & Birthing from Within were two more on my read/recommended reads list. 🙂
You did a much better job of saying what I try to: “Regardless of where you choose to birth, it is important to be self-informed, and not only rely on the information given to you by your care provider.” When I try to say it, it tends to come out a jumbled mess that sounds like “don’t trust anyone!” LOL 😉
Thank you for providing a list of some questions to ask. When we have a second child, we have decided that we would really like to do a homebirth, so having an idea of some questions to ask really helps!
I asked even more questions (hence the interrogation, tee-hee!) but I didn’t keep them. I’m sure you will think of more as you figure out what’s important to you!
I am planning a home birth this week or next (my first home birth, second child). Everything you said is great, Maria.
Meeting the midwives convinced my husband. They listened to all our questions and gave us specific answers (including lots of “see this study about X”) instead of hurried, dumbed-down explanations of things.
Each midwife will have different things they want you to prepare. Mine happen to have their list on their website and this is the link in case anyone is curious: http://www.sunrisemidwifery.net/docs/HM-SM_Supplies.pdf
Also, here are videos from my midwives of what a home birth setup could look like: http://www.youtube.com/watch?v=JWo3brcg6BU
and what they bring along to the birth as far as medications and other emergency equipment (probably varies by state and by midwife!):
http://www.youtube.com/watch?v=h4g-eu8oZ-Q&feature=related
Happy researching, Stephanie. I’m sure you’ll learn a lot even if you decide home birth is not for you!
Great links Hannah!! Best wishes on your birth!! 🙂
He’s here!
http://moltoscherzando.blogspot.com/2011/11/little-guy-malachi.html