Stop Saying That: Home Birth as an Easy Fix Edition

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Yesterday, I implored people to stop saying “Why would you put your baby’s life at risk just for the experience of a home birth?”

Among other things, I think that statements like these mischaracterize the risks of home birth, ignore their potential benefits, and, most of all, undermine the radical uniqueness of the reasons that each woman appeals to when she chooses her birth setting.

Yet just as much as I dislike statements such as these, I also bristle a bit when, after a woman expresses second thoughts about her care provider, or misgivings about her hospital’s labor and delivery policies, or dismay about her previous birth experience, or whatever, someone replies:

“Just have a home birth!”

STOP SAYING THAT

“Just have a home birth.”  As if it’s “just that easy.”

As if it’s like putting a bandaid on whatever complex issues a woman might be having regarding her pregnancy and birth choices.

Now look: there is a part of me that understands the sentiment behind statements like these.  Especially when it comes to women who have had truly wonderful home birth experiences.  I mean, after my home birth with Eric, I was so high on oxytocin that I was ready to start jumping (perhaps delicately) around the room, shouting Oprah’s-favorite-things-style, “and YOU should push a baby out of your vagina in a tub in your living room, and YOU should push a baby out of your vagina in a tub in your living room, and YOU…”

You get the point.

But this bliss shouldn’t translate into anyone casting home birth as an easy fix for problems or negative feelings or misgivings that a woman might have about her upcoming birth.

One of the most obvious reasons for this is that home birth is not an appropriate choice for every woman.  Some women and families cannot afford home births (and few insurance companies cover home births in the United States).  Some women might feel uncomfortable with the home birth care providers in their particular community.  Some women face health circumstances that do place them squarely in the “hospital birth is actually safer for my baby and me” camp.

And some women just don’t want a home birth.  And you just need to respect their feelings.  Period.

In addition, the “just have a home birth” comment can make it seem as if home birth is the only way that a woman can achieve a respected or empowered or low-intervention birth.  And though achieving these sorts of births can be an uphill battle–trust me, I know–planning a home birth is not a singular path to “the birth that a woman wants.”  In fact, planning a home birth isn’t even a guarantee that a woman will have a respected, empowered, or low-intervention birth either!

What’s more, planning a hospital birth is not in itself a surefire ticket to a disempowering, high-intervention birth either.  With the right care provider in the right setting–a combination that it can take some work to piece together–hospital births can be fabulous.  I’m even living proof: I had a marvelous OB-attended hospital birth when my second son was born!

So the next time that you see a woman at a crossroads in her decisions about her upcoming birth, please try not to tell her to “just have a home birth” to fix everything that might be frustrating or scary or daunting about her situation.  It might not be a good fix for her, and it might leave her feeling even more frustrated by her situation if home birth is something that is not an option for her, for whatever reason.

So try saying the following instead:

1 Do you have any questions about your options as far as your care provider goes?

 

2 Do you have any questions about the local birth settings that are available to you?

 

3 Do you have any questions about any [legal, evidence-based, personal story, community, etc.] resources that I can point to you?

I’m happy to listen to what your specific needs are and then brainstorm with you a solution that might best fit your particular needs, preferences, values, and circumstances.

Because when it comes to birth, one size (and one place) does not fit all.

Minutes after A's birth, snuggling skin-to-skin with him as Tim looks on.

Hospital birth: it was the right choice for me for this birth.



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8 Comments

  1. Lekki Frazier-Wood
    Lekki Frazier-Wood01-04-2013

    I LOVED this. I wanted a home birth, but my husband did not (wanted hospital), so we compromised on a birthing center birth. While we were investigating birth centers, I found I was asking so many questions, it reflected my lack of trust: trust in that setting, and trust in my body. We went for a hospital because it was the best of choices for me, at the time. But it wasn't a fix-all. I still had my doubts, as I am sure people with home births do. I really appreciate you writing about the complexity of the decision.

  2. Juliette
    Juliette01-04-2013

    Loved this.

    I had a relatively low-intervention hospital birth with my first and was happy with the experience, but wanted a different experience with my second, with fewer interventions (no IV, no standard monitoring, delayed clamping, etc etc).

    In Ontario, midwife care is publicly funded for low-risk births, so as long as you can get in with the midwifes (they’re popular!) it removes a lot of the barriers. However, even though we had awesome midwifes, I still didn’t want a home birth. Not for risk reasons – I’m sold on home births being the safe as or possibly safer than hospital births, other things being equal. But I’m a very private person, and for reasons I can’t really explain, I just didn’t want people in my private places (my bathroom and bedroom) while in labour. So, we chose a community hospital with a midwife-friendly policy and a brand-new birthing suite. We essentially treated the hospital as a hotel – there were no professionals in the room other than the midwife and her apprentice during labour and birth, machines and IV poles were hidden… yes they were around, and I know that the nurses were hovering in the common area “just in case”, but it was the choice that worked for me. We left the hospital within 4 hours of the birth (could have left earlier, but it was the middle of the night!) and the midwives visited me at home (in the living room :P ) later that day.

    I’m fully in support of, and understand, friends who faced the same choice and made a different decision. :)

  3. Rebekah Bissell
    Rebekah Bissell01-06-2013

    Love this follow-up to the home-birth edition. Hospital birth is a valid option and home birth is not a fix-it answer for everyone.

  4. San Diego Midwife
    San Diego Midwife01-08-2013

    Thank you for creating this blog. Midwifery practices are growing at a very past pace in the US. Here in San Diego Alone over 33% of all hospital births end in C-Sections. So sad, yet such an eye opener for families in their childbearing years. Of course, homebirths are not for everyone, but I do encourage mother’s-to-be to look further into the pros and cons of the home birth vs hospital delivery. You’ll be surprised what you find.
    San Diego Midwife´s last blog post ..Comment on Frequently Asked Questions – FAQ’s by Light

  5. Carey Couzelis
    Carey Couzelis01-17-2013

    Well said indeed!

  6. Quiet You Mothers
    Quiet You Mothers01-19-2013

    Love this. I was just saying to my husband that birth is a very complicated issue and both hospital and home birth have their merits. If I could have a safe, natural VBAC experience I would do it in a heartbeat. My body just isn't made that way, though. And I'm so thankful to live in a time and a place where I can bring living children into the world and you know, stay alive to take care of them, too. There is no "one size fits all" birth experience.

  7. Elizabeth M.
    Elizabeth M.04-23-2013

    I know this post is a few months old, but I just wanted to thank you for this post. I’m due this summer with my second child, and planning a VBAC. I’ve lost track of the number of times I’ve had people on message boards tell me to just plan a homebirth. And this is in spite of me mentioning I live in Alabama where it is illegal for midwives to attend homebirths, that I’m not comfortable using a provider who is breaking the law, that my husband doesn’t want to pay out of pocket for a homebirth when our out of pocket costs for a hospital birth are (he’s active duty Air Force) $0.00, and that I don’t want to drive four hours to TN. If my husband was to miraculously get orders to somewhere more birth friendly, I’d probably plan a birth center or homebirth, but as things stand I’m making do with my current limitations by switching to the slightly more natural birth friendly hospital with a higher VBAC rate and hiring a highly recommended doula. Suggesting things that are virtually impossible is less help than offering no advice at all.

    • BirthingBeautifulIdeas
      BirthingBeautifulIdeas04-24-2013

      Your last point is spot on–these sorts of suggestions are anything but helpful to people! It it truly sounds like you are making plans that fit your circumstances and your wishes for your birth as best as they possibly can. Wishing you a healthy and beautiful birth!!

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