Why I don't want another hospital birth

I've told you all about Marko's hospital birth. And I've mentioned that I didn't much like it. So I bet no one will be too surprised when I tell you I don't want to do it like that again. Luckily, there's another option: home birth.

What a lot of people will tell you about home birth goes like this: "The hospital is the safe place, so if you don't care about your health and the health of your baby, go ahead and stay home just so you can get some 'positive vibes.' While you're at it, why don't you have a shaman catch your baby in a mud hut?"

The fact is that in many cases, home can be safer than the hospital.

Think about it this way: our bodies were designed/evolved to give birth. You are descended from a long line of women who were capable of giving birth. Every one of your ancestors, up to the past hundred years or so, survived birth without medical intervention.

Of course some mothers and babies did die before modern medicine. So why not use modern medicine to improve the situation so not only most, but all mothers and babies survive?

Because our bodies have not had time to catch up to all these changes, that's why. Birth is a very delicate physiological process which, under normal circumstances, unfolds perfectly with no interference. Routinely interfering in birth might cause more problems than it solves.

In fact, this seems to be the case. Fifty years ago, it was pretty standard to knock out all the mothers with chloroform and pull their babies out with forceps. Most survived. But some children had broken skulls, some had mental disabilities from being born blue (from the chloroform), and nearly all the mothers had some injury or other from those forceps. We know more now, so things are better. But even so, the perinatal mortality rate (death of babies shortly before, during, and after birth) in the US is fairly poor, and it has shown no improvement in the past 25 years. There are still many things hospitals do that are not backed by any evidence and which are actually harmful!

For instance:

*Episiotomy. Some doctors routinely cut the perineum of every laboring woman. Others do it for various indications, such as "the baby isn't coming out fast enough" or "you'll surely tear otherwise." But there are few or no real reasons to give one, and the side effects are pretty severe -- such as pain and sexual problems for a year or longer! Why make women suffer something like this if it's not necessary?

*The lithotomy position -- delivering the baby while lying flat on one's back, with feet in stirrups. This is pretty much the worst position you could give birth in (except maybe hanging by your ankles from the ceiling -- and I hear that's been tried). There is only one person it benefits -- the doctor. It's much more convenient for the birth attendant. It can cause a lot of problems for the actual labor, though -- such as restricted blood flow to the baby and stuck shoulders. But at least the doctor got to sit on his swiveling stool, right?

*Immediate clamping of the umbilical cord. There's no particular reason why doctors do this, except force of habit. Throughout history, doctors have decried "premature cutting of the navel-string" as "very injurious," but somehow it became a fad. This way you can easily zip the baby off to the nursery in a hurry. However, that leaves almost a third of the baby's blood still sitting in the placenta! Study after study has showed delayed clamping to be better, but hospitals are slow to catch on. Instead, we are told that anemia in babies is a result of breastfeeding.

*And, of course, a c-section rate at 32% and still rising. It's not just because women prefer them (for the most part, they don't). But doctors prefer them. They get a good deal more money, and none of this pesky waiting around! Not to mention, since it's the "most cautious" choice, you're unlikely to get sued for doing one. They happen all the time for all kinds of silly reasons, but it's telling that the rate surges at about five o'clock when the doctors like to go home.

I could go on and on: continuous fetal monitoring, routine use of pitocin, artificial rupture of membranes, and many, many more. The standard policies in hospitals are based mainly on convenience, avoiding lawsuits, and what was considered safe twenty years ago. Doctors don't have much time to read all the latest studies, and why should they? Their patients are all healthy, so even if you mess up quite a bit, things are still likely to be more or less okay. And if they're not, just tell the mom that she and her baby would have both died without your help!

Okay, so not all doctors are like that. Imagine your ideal doctor. He (or, better yet, she) is up-to-date on the newest studies. She carefully reads your ten-page birth plan and agrees with every point. She won't interfere with the natural process unless there's a need. Great!

But even then, there is a slight problem. Birth is hormonally driven and responds to psychological triggers. If the mother is afraid, it will halt or even reverse. Why? Well, think about it -- if there's a danger around, it's a bad idea to have a baby right now. Even when it's too late to give up on labor and come back tomorrow, it can stall, leaving the baby stuck.

Imagine this scenario. You're at a party. You suddenly realize you have to go to the bathroom. So you unobtrusively make your way over to the hostess and quietly ask where the bathroom is. She directs you to a table in the middle of the room. After stripping off your clothes and putting you in a skimpy hospital gown, she has you lie down on the table and gets two of the guests to hold your legs in the air. All the guests, who are strangers to you, gather around. All of them are yelling "PUSH! PUSH!"

Could you go to the bathroom under these circumstances? I couldn't! And people who tell you, "Just suck it up, it's no fun, but you have to deal with it because it's what's best for your baby," don't really understand. There may be a psychological basis, but you can't make yourself relax, stop releasing adrenaline, and believe that you are in your own home surrounded only by those you trust. There are many methods of meditation and hypnosis that are supposed to help you do that, but it's hit or miss when you're already in an unsupportive environment.

It seems much safer to me to give birth at home, where the natural birth process will be interfered with as little as possible. Rather than being told "relax, relax, it won't work unless you relax!" I will actually be able to relax easily, in my own environment. And I will have the freedom to do things my way -- move around, choose comfortable and safe positions, and avoid interference. As an added bonus, most midwives are experts in normal birth and do study up on the latest scientific knowledge. They know what normal birth looks like -- and what a problem looks like. And since they stay with you throughout the birth (unlike doctors, who might check on you every couple of hours), they will recognize a problem immediately and can take appropriate action.

All I have to do now is figure out how to pay the midwife!